To All Mothers Who Have A Teen Or Adult Child Struggling With Drug Addiction

Every single Mom I have ever met who has a child struggling with the disease of addiction,  will be able to relate to this powerful testimonial by Former WWE Westler, Marc Mero.  It is a powerful, honest and love filled testament to a mother’s love.   My grandson’s Mom came across it and sent it to me.  I know it will touch your heart as profoundly as it did mine.

This is a powerful story of unconditional love.

My son Nathan once said to me, “Mom you can’t understand me, just love me”.  The love I had for my son when he was deep in his addiction or taking a brief break over 23 years of hardcore heroin, cocaine, crack cocaine and meth addiction, was always the same.  It was unconditional.  Of course he was more “likeable”  when he was not using, but my love for him never waivered.  It was constant.  It was real.  It was deep.  It was an unbreakable bond.

Extended family all to often completely walk away.  Siblings, who are so profoundly affected often say, “enough”.  Sibling truly are the “unseen” victims of a brother or sisters addiction.  And tragically, fathers all to often give up.  From my experience, it is the Moms who keep trying.  It is the Moms who never give up.  It is the Moms who maintain that unbreakable bond.  It is the Moms who keep encouraging and believing and loving, even when their child’s behavior is most unlovable.

This testimonial  could be for any one of the Mom’s who never gave up.  Who continue to love.  Whose love is unconditional always.

When our child is deep in their addiction, they have no idea of the co-lateral damage caused by their addiction.  They truly believe they are the only one who is being affected.  That is one of the false realities they live with.  But as we who love them know, our devastation is raw.  It is not until the drug use ends that the person who struggled with the addiction gains clarity.

Please watch this story and warning:  You will need a tissue.  This will touch your heart profoundly


As Moms, as parents, as families we must continue to stand up, speak out and advocate to end the stigma and shame around addiction, so those living in the shadows of addiction will reach out for help.  We have lost far to many to this horrific disease.  Thousands of lives lost every year.  Families completely devastated.  Societal  resources and first responders stretched to the max.

Take care of yourself and remember you are not alone, I truly care.

Is Harm Reduction The Same As Enabling?

There are many who believe that harm reduction is really just enabling.  To many they are adamant.  To others they see harm reduction as a absolute requirement in treating the disease of addiction.

After 27 years of experience, having a son who battled severe addiction to heroin, crack and meth, volunteering more than 12,000 hours in the Whalley area of Surrey with those struggling with addiction, homelessness and violence as well as working many years in a shelter in Whalley,  I have cared for, loved and lost far, far, far to many people who battled the disease of addiction.  And so, I have my own opinion on that.

I give approximately 60 presentations each year on addiction, homelessness and gang violence. All part of raising awareness.  Society looks at statistics and while these numbers are vitally important to know, what we must never forget, is statistics are far more than just a number.  They are lives.  Lives of sons and daughters, mothers and fathers, sisters and brothers, friends,  lost because they battled an unforgiving disease.  The statistics represent lives of people who were deeply loved.  Who are mourned for everyday. Whose families are left devastated because that candle of hope has blown out.

And we can not forget those who are suffering every single day.  Those battling the disease of addiction are truly suffering.  The ‘party’ ended for them a long time ago.  They are not using for the “high” or the “low” – they are now using to just get through the hour, the day, the night. To stop the incredible pain. The nausea. The vomiting. The involuntary leg movements. The cold. The cramps. They feel isolated. Broken. Shame. They are lonely.

Are they responsible for where they are at?  Did they ultimately cause where their lives are at?  Yes, they made a choice.  Unfortunately many choices we make in life are made in the teen years and early twenties.  During a period when people take the most risks.

What no one ever thought was that choice would awaken a beast that would hold them hostage. That would devastate their lives.  That would devastate the lives of every person who loves them.

Addiction is a chronic and often terminal disease.  When addiction raises its ugly head it takes control and for far too many people suffering with the disease of addiction, they are not able to break free.  This is where harm reduction is paramount.

Harm reduction can take many forms – from needle exchanges to prevent the spread of disease, to overdose prevention sites and consumption sites that save lives every single day, to prescription of Methadose, Methadone and Suboxone which is an absolutely crucial component to so many in staying away from what was their drug of choice.  To  providing prescription morphine or heroin to those who have tried absolutely everything else but have not been able to stay the course.

We need to keep people alive if we are going to save lives.  If harm reduction methods save lives and the evidence is there, then we are not enabling.  We are saving lives.  Each day a person battling the disease of addiction lives,  is another day with the opportunity that they may reach out and ask for the help that will ultimately save their lives.

Every day that a person makes contact with someone in harm reduction, is an opportunity to build a relationship.  Build trust. Build a opportunity for that person struggling to reach out for help.

When we provide options, we provide possibilities.

To deny people life saving options, to deny people possible treatments is just plain wrong.  Everyone deserves the opportunity to be their best self.  Whatever that best self is.  And one person’s best self may well be a far cry from another person’s best self.  But we are all different.  Our needs are different.  Our circumstances are different.  Our up-bringing may have been different.  Trauma experienced. We have different needs.  No one size fits all in anything in life but especially in the treatment of a horrific disease.

What works for one person may not work for another.  But the most important thing is to never give up on that person struggling.  Remember they are sick.  You just never know when they may decide to reach out for help.  And it is in talking about addiction openly.  About ending the stigma around addiction as somehow being a moral failing.

Addiction is not a moral failing.  It is a horrific disease that sadly has far to many people in it’s grip.  Harm reduction is not enabling people.  Harm reduction is keeping people alive.  If we can keep people alive we are giving them the opportunity to access help.  To access services that may lead them in the direction of gaining control over their addiction.  Over their life.  For some this may mean embracing several components of harm reduction.  For others it may be embracing one.

When I hear someone has been kicked out of or removed from a treatment program because they used, I cannot understand that.  They are only confirming that they desperately need help.  So lets put more action in place for them.  Don’t kick them out.

If someone struggling with diabetes eats a piece of chocolate cake every day.  If someone with high blood pressure does not watch their diet and exercise.  If someone is in a car accident because they were speeding, do we deny any of those people the help they desperately need?  Of course not.  We have them work with a dietitian or a trainer.  We get that car accident victim transferred to the nearest ER for full on treatment.  We don’t say, “sorry, you brought this all on yourself.  You didn’t listen. Get out, you are on your own”.

We have to give people struggling with the disease of addiction to drugs and alcohol that same consideration.  We can’t just pick and choose what disease deserves treatment.  These are precious lives.  And we are loosing them every single day because too many people view those suffering with the disease of addiction somehow less worthy.  They are not. This is a disease.  History will judge how we treat our most vulnerable.  We must embrace harm reduction in all its forms until someone working in science lab in a hospital or university discovers what is needed to eliminate  or treat the disease of addiction in a way we don’t yet know of.  Until that time, harm reduction is not enabling.  Harm reduction is compassionate care for those are struggling and have not been able to climb out of that dark hole of addiction.

Until next time, take care.


My Friend “Paulie From Whalley” Would Have Celebrated His Birthday Today

Many years ago while out on some rounds in Whalley, the area of Surrey, B.C. with  a tremendous poverty rate, where there are huge numbers of people living in homelessness, batting hardcore drug addiction, chronic alcoholism, many with mental illness, all people struggling to just get through the day, I met Paul and Bill.  They were sitting in some tall grass, beside two old bicycles drinking some beer.

That meeting would lead to a lifelong friendship.  Bill always smiles and laughs.  He is the nicest, most gentle of men.  He suffered a brain injury many years ago.  “Paulie” as he was known to everyone close to him, had the bluest eyes and the kindest heart.   Both men struggled with severe and chronic alcoholism.  Both were the utmost gentlemen at all times.

They offered me a beer and were especially relieved when I told them I didn’t drink!!  And there began our friendship.

Paulie and Bill truly were “brothers of other Mothers”, as the saying goes,  and they always referred to me as their “Westcoast Mom”.  What an honour to be given that title.

Neither men had family in the west.  Their families were back east, two thousand miles away.  But they were each other’s brother.  And they had a close circle of friends who looked out for each other.  Most of their circle of friends, like themselves, struggled with chronic alcoholism and homelessness.  They all knew who would seizure first after sleeping.  The body’s reaction to not having alcohol.  And they made sure to look after each other.

I remember one time while at the Mission, Paulie ran in the door yelling for me, “Danny’s having a seizure, it’s a bad one”.  I called 911 while running to the tree they were all sitting under.  I knelt next to Danny, trying to keep him safe while he seizured and waited for the ambulance to arrive.

When I stood up one of my knees were wet.  I said, “I sure hope I just knelt in some spilled beer and not pee”.  At which Paulie said, “sorry Mom, but nobody spilled beer”!!! Oh great.  Just great, of course I just knealt in pee!!  So I went inside the Mission and scrubbed my pant leg and my leg and got back to work.  Welcome to our world.  And at that time, there was no place I would rather have been.

Paulie and Bill rode their old bicycles probably 30 to 40 km a day.  They followed the recycling trucks pickup days and stuck to that schedule.  They made their money collecting cans and bottles.  They didn’t ask for any handouts.  They made their own money. And that money paid for their alcohol for the day.  After years of doing this, they had homeowners and businesses that would regularly set aside the bottles in a bag just ready for  Paulie and Bill to pick up. Every day you could see them riding their bikes balancing several full bags of empty cans and bottles on their way to the bottle depot. They were wonderful recyclers.

Like many of their friends, they preferred to be outside in the spring and summer months.  But when the cold wet weather of fall and winter arrived they would often stay with us inside the shelter.

Paulie started coughing a lot in the winter of 2014/2015.  One day I found him slumped against a tree.  I asked him to come inside.  He said no he was just getting some rest.  I took him out a pillow and blanket and told him I was worried he had pneumonia.  He’d get it check he said.  Of course he didn’t and over the next couple of weeks he was clearly getting sicker.  One of the nurses at the sobering centre noticed it as well and told him to get it check or she wouldn’t let him stay (sometimes you have to use a loving threat to take care of someone when they won’t take care of themselves)!!  It worked.

Paulie did go to the doctor, was diagnosed with pneumonia and given antibiotics.  Only he didn’t improve.  He just got sicker.  Paulie was given x-rays and an ultrasound.  He had lung cancer and it appeared terminal.  He agreed to chemo-therapy but after the first round he decided it wasn’t for him.  He was so sick and his hair was starting to fall and he just decided no.  Paulie always wore his hair in a long ponytail. Since he was a kid. His ponytail and his bright blue eyes were what attracted the girls he would say!!

I made it my mission, that my friend Paulie was not going to die on the street.  And I wanted him to reconnect with his family.  It had been over twenty years he said since he had seen or talked to them.  I encouraged him to make that call.  I told him, as a Mom, I knew his Mom would be overjoyed to hear his voice. It did not matter how much time had passed.

He called his sister first.  We explained the situation to her and she agreed to go to their Mom’s the next day with their other sister and be there when he called back.   Paulie’s family, aside from being devastated to hear of his terminal cancer were overjoyed to hear from the brother and son who vanished from their lives two decades earlier.  They always worried they would one day get a call that he had died.  After all that time they never expected to hear his voice.   And a few months later his sisters came out to visit with him for a week and took him on some wonderful local adventures.  And they provided him with a cellphone so they could all stay in touch every day.  Paulie’s Mom was not well and was unable to travel but she was able to speak to her son every day with that phone.  Paulie and his family were now reunited and everyone of them took advantage of the time they had with each other.  This was a very loving family whose lives had often been hijacked because of his addiction to alcohol.  Paulie left, not because he didn’t love his family.  He left because he did.  Addiction for most carries a tremendous amount of shame.  And because of that sense of shame people struggling  with addictions often make the decision to stay away from those they truly love.

But Paulie and his family were now reunited and they spoke every day on that cellphone.

Every week I drove Paulie to his doctor’s appointments for checkups and got his prescriptions filled for morphine and for fentanyl patches.  I gave him just one day supply at a time so he would not be a target for anyone wanting his painkillers.  I also did not want to take the chance of him trading his morphine and fentanyl for alcohol.

When we finished our appointment each week with the doctor we made it a habit of going to the Dairy Queen.  Peanut Butter Parfait was a treat he remembered eating with his father as a child and it was like a walk down memory lane.

But now I had to get Paulie off the street – he was getting sicker and weaker and becoming more vulnerable to violence in his weakened condition.  For a couple of months he slept on the couch in the shelter.  But he needed to be in hospice.  I met with a wonderful lady named Michelle  Wright, a very kind and dedicated Social Worker who pulled out all the stops and did everything she could to help and together we made progress in getting Paulie into hospice.  The only problem was his drinking.  Paulie drank two litres of cheap sherry every day.  Hospice would agree to take him but he would have to get down to one litre  a day.  Over the next two months Paulie steadily decreased his intake.  Finally he was down to one litre a day and Michelle was able to arrange that bed in hospice for my dear friend Paulie.

Hospice agreed that Paulie could have one bottle of sherry a day. That they would dispense it to him throughout the day if I provided them with the bottle daily.  Paulie’s family agreed to pay for the sherry and cigarettes.  We had a solid arrangement and Paulie was accepted into hospice.  It was a warm, caring compassionate environment.

His first night there he was lying in his bed with this big fluffy comforter and pillows propping up his head, with his bottle of sherry beside him, a pack of cigarettes that he could be wheeled outside to smoke, a TV on the wall, and the control in his hand.  He was dying and yet he felt like a king.  He said, “June, if everyone on the strip knew how good this was, they would all want to get cancer”!!  That was Paulie – he could make the best out of any situation.

October 31st – Halloween was Paulie’s birthday.  Two years ago today he had his last birthday. He lived Just a few weeks longer.  Paulie’s addiction was so severe, that even in his last days, alcohol remained his focus.  That is what addiction is.  As so extremely sick as my dear friend was, his body, his mind, demanded alcohol.  It was a disease so severe he was never able to escape it. The last two days he used a sipper cup.  He really could no longer drink but it could slowly seep into his body.

That is addiction.  That is not a choice.  That is not a moral failing.  It is not a human flaw. Or a weakness of character. That is a disease. Addiction is one of the most unforgiving of diseases.   And until you watch addiction up close, it is hard to sometimes understand just how profound it is.

Paulie always called me his “West Coast Mom”.  He said I was the best friend he ever had. He asked me if I would promise to be there  holding his hand when he died so he would not be afraid.  I was privileged to be there with Paulie when he took his last breath.  He was not afraid.  He went peacefully.




Addiction Affects Everyone And Everyone Handles It Differently – Even Strangers In Traffic

For those of us who have or have had a loved one who struggles with addiction, we all know one thing, addiction affects everyone  touched by it and everyone handles it differently.

Within the family unit, dynamics drastically change and how could they not.  Life as we knew it changed and to survive a loved ones addiction we have to recognize our lives have been tragically altered.

But what about strangers?

The other day I was driving through Langley, B.C.   I was stopped at an intersection when a young woman, clearly in distress, was trying to maneuver her shopping cart,  piled high with bags,  off the curb.  The cart tipped to the side and  bags of bottles and cans fell out of the cart spilling onto the road.  Her anxiety level escalated and how could it not?

She scrambled into traffic in attempt to pick up the cans that rolled away.

I put on my flashers and threw my car in park.  One other driver did the same.  We quickly retrieved  the cans and bottles she had clearly spent all night collecting and returned them to her cart.

Two  men in a raised Ram truck honked their horn and yelled obscenities.  A few drivers used hand gestures while continuing on their way.  But the majority of the drivers sat patiently in their vehicles.  Most people find no satisfaction in judging a person battling the disease of addiction.  The tide is turning.

Even just a couple of years ago, those struggling with addiction were judged as morally weak.  Morally corrupt.  Someone people avoided at all costs.

It has taken a very long time, but thankfully society for the most part is beginning to recognize that addiction is not a moral failing.  Addiction is a horrific disease that affects the brain and every single thought and action of the person affected.  Those struggling with addiction are not having fun.  They are simply trying to survive.  The party for them ended a long time ago when addiction raised its ugly head.

What has caused the dramatic change in the way society looks at addiction?  Sadly it has been the dramatic rise in overdose deaths due to the entry of fentanyl in the drugs being sold.

When the rate of deaths of teen, young professionals, parents with young children began to rise, and it wasn’t only the “homeless junkie on the street corner” overdosing and dying,  society started to look at drug addiction differently.  To those of us who have a loved one addicted, our loved ones were never the “homeless junkie on the street corner”, they were our very loved sons and daughters, brothers and sisters, mothers and fathers.  They were more than their addiction.  They were our beating heart and they were struggling every single day.

Tragically the number of deaths continue to rise.  Addiction can no longer be swept under the carpet as a dirty little secret within a family.  For too long many families suffered in silence afraid of the repercussions and stigma around addiction.

I was never one of those people.  I recognized very early on in my son’s struggle with addiction that he was battling a disease.  I called it a disease long before addiction and disease were used in the same sentence.  I recognized it was way bigger than any other disease I could imagine because it did not seem to present as a disease but rather a moral failing. But I knew my son was not morally weak.  I knew his heart.  I knew he was sick.

So today, thankfully much of society is looking at addiction differently.  But we still have a very long way to go.  Everyday our death rate is rising dramatically and families are left devastated, wondering what they should have done, what they could have done differently.  Thinking that somehow they had failed their loved one.

Addiction affects every single family member differently.

And clearly addiction affects society differently.   The “good old boys” in the Ram truck, honking their horn and yelling obscenities.  The people raising their fingers and driving over the pop cans and those who sat patiently in their cars aware that addiction had a once beautiful girl in its grip.  That the disheveled girl in front of them was someone’s daughter.  Was once a girl with hopes and dreams until addiction took hold and held her hostage. And so they waited while we picked up the bottles and cans and returned them to her cart.

Addiction affects everyone differently.  But be assured, the subject of addiction does affect everyone in one way or another.

We need all levels of government on board to address the drug crisis.  We need a dramatic change in how addiction is looked at and treated.  We need to embrace harm reduction full on.  We know harm reduction is the only way at this time.  Hopefully one day researchers and doctors who are working tirelessly, will find the cause and cure for those battling  addiction but that time has not yet come.   Lets all push for harm reduction.  Our loved ones deserve nothing less.  We deserve nothing less.  Society as a whole deserves nothing less.  Addiction is a disease.  Let us give those suffering with this unforgiving disease the kindness, compassion and respect they deserve.

Until next time my friend, take care of yourself.

Much love,



Life And Loss On Methadone Mile – Boston Globe

I found the following article in the Boston Globe – it is a powerful description of what addiction is truly about.  The lives it takes hostage and the unbelievable pain and suffering of those addicted. And of those who love them.

You will read about men and women,  who would do anything to be free,  but the all consuming life of addiction keeps them chained.

This article follows one area of horrific pain.  But truth be told,   this story could be about many communities – Vancouver’s Downtown East Side, Surrey’s Whalley Strip, Edmonton, Calgary, Winnipeg, Toronto, Halifax , Los Angeles, Miami, – this health crisis has taken lives hostage across all boundary lines.

For twenty-three years my son was one of those hostages.  He tried dozens of times to walk away.  Detox, treatment, harm reduction.  A family who loved him deeply and would have done anything, given anything, to help him.  Each and every time he said he had enough, he meant it.  Everytime he said he wanted help, he meant it.  I never doubted that for a moment.  That is what he wanted.  His addiction had other plans.

This article by Nestor Ramos and Evan Allen is a real depiction of addiction, loss, lives devastated and surviving one day at a time.  It is worth reading.

LIFE AND LOSS ON METHADONE MILE a section of Massachusetts Avenue known as Methadone Mile.

Last night’s needles line the sidewalks at dawn along the blighted blocks where Massachusetts Avenue and Southampton Street meet. People emerge from shelters and halfway houses and trudge toward the methadone clinics that lend this place its ugly nickname.

An open-air drug market is in full swing on the corner outside a convenience store, where offers of drugs trill like music. “Clonidines-Clonidines-Clonidines-Clonidines!” “Does anybody need Xani Bars?” Phenergans, Pins, Johnnies? A man grimaces one chilly morning, unsteady on his feet. He opens his mouth to reveal a knotted bag of heroin, double-wrapped and ready to be swallowed should police wade into the crowd. “This is all I have left,” he says.

Some come to this sad section of the city to get high, slumped on street corners and shooting up between parked cars. Some come to get clean, ducking into low-slung clinics where they swallow the fuchsia medicine, sweet and bitter at once, that frees them from heroin’s grasp. The people here call it Methadone Mile, and it is the congested heart of Massachusetts’ raging opioid crisis.

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Those working toward recovery at the many clinics and services here try to steel themselves against the streets outside. On the mornings when she must brave the chaos, Alyssa Bowman swallows her 80 milligrams of methadone and walks to work quickly, eyes on the ground and earphones stuffed in her ears.

Like many of the others who populate this place, Bowman, 35, is passing through on her way to somewhere else: A life with her children, a return to her career as a dental assistant.

Clean at 23 thanks to daily methadone treatments, she relapsed about a year ago with a seven-month binge of alcohol and benzodiazepines, a type of tranquilizer, that destroyed her life and her liver. By March, she was living in a nearby halfway house where the other women called her “mom,” and brought her their broken necklaces and eyeglasses to fix. She collects heads-up pennies for luck and gives them to women having rough days on the road to recovery. Now, she lives in her own apartment; she walks through Methadone Mile some days on her way to her job doing merchandising and marketing for a retail service company.

The sing-song offers of pills and dope make her stomach turn.

“That road,” she said, “leads to nothing.”

But these streets were paved with suffering long before today’s drug epidemic earned much notice. And in the wake of the closing of the Long Island Shelter, the chronically homeless mingle with a new generation caught in addiction’s grip, parading this most confounding of problems out before an audience at a busy Boston intersection.

Even as a rising death toll stokes compassion and newfound resolve, gaping holes remain in the systems set up to combat the crisis — nowhere more visible than here. As more and more people stumble along the sidewalks of Methadone Mile each morning, those holes seem harder than ever to patch.

Lexi sits in the median as she takes a break from panhandling along a stretch of Massachusetts Avenue nicknamed Methadone Mile. Lexi, who had been an opioid user, has been homeless for nearly nine years. (Keith Bedford/Globe Staff)   Lexi reaches out from the blankets to take her coffee at the place she sleeps under a highway near a stretch of Massachusetts Avenue. (Keith Bedford/Globe Staff) Lexi has been homeless for nearly nine years. A former heroin user, she spends her days panhandling along Methadone Mile. At night she sleeps on sidewalks and under bridges in the neighborhood.
Recovery and relapse jockey for space in the same few blocks. A constellation of services for those suffering from homelessness, mental illness, and drug and alcohol addiction line the streets near Boston Medical Center, compressed into one of the only corners of the city where such facilities can exist without uproar from nervous neighbors.

The Woods-Mullen and Southampton Street shelters, for women and men respectively, house hundreds every night, a few blocks apart. The headquarters of Boston Health Care for the Homeless, a 30-year-old program dedicated to the city’s most vulnerable patients, occupies part of the building next to Woods-Mullen. The same building is home to several Boston Public Health programs — among them one that distributes clean needles and another, PAATHS, that helps coordinate services for people making their way through a thicket of acute, residential and outpatient care for drug addiction. In the middle of it all is Boston Medical Center.

In the battle against substance abuse, these are the front lines. For some, access to so many services in such close quarters is a boon. People who live in one of the shelters can make it to therapy groups, see their primary care doctors at BMC, and visit a recovery center without commuting all over the city. And service providers here, many say, show their patients a respect they rarely find elsewhere.

Jennifer Tracey, head of the city’s Office of Recovery Services, says there is “probably nowhere else in New England if not the country where you find . . . . the level of services that you’re finding here.”

But the challenges of the area are obvious. Despite a heavy police presence, low-level dealers work the streets, harassing and baiting those clinging to sobriety, and selling to those who have lost their grip.

By dawn, people are already beating a path toward the methadone clinics. Dozens make their way down Southampton to the clinic on Topeka Street, a shabby one-block roadway flanked by industrial businesses and a fenced, inactive construction site that signs warn is an environmental hazard. People sleep there anyway, bedding down behind a concrete structure that’s either half-built or half-demolished.

Couples walk by holding hands. Women push strollers. Yesterday’s panhandling signs sit discarded along the chain-link fence. A billboard rises over the run-down gas station on the corner, where Michael McCarthy and Rachelle Bond, charged in the killing last summer of Bond’s daughter Bella, used to sit in the dirt. The billboard faces the other way; the side overlooking Topeka Street is blank.

Some drive to the two methadone clinics here and duck inside for a few minutes to take their dose before driving away. Others walk in and out quickly, dressed in the uniforms they’ll wear at the jobs they’re bound for. But many — those with nowhere else to be — linger outside, crouching on the dusty roadside.

Methadone, an opioid that wards off withdrawal symptoms while blocking the chemical craving associated with heroin, is one of the most effective treatments against opioid addiction, along with Suboxone, a similar drug that can be taken at home. That’s why this area’s derisive nickname infuriates many who have spent years working in the treatment programs here: It stigmatizes the people whose pain and suffering is very public and mocks their efforts to get clean. They wish it were known instead as Recovery Road.

But methadone itself can be extremely addictive, and some take it indefinitely for years, trading one addiction for another that allows them to go to work and lead less fractured lives. Others, still active drug users, take it to ward off withdrawal symptoms for the days or hours until they cobble together enough money to buy heroin from one of the dealers on Massachusetts Avenue.

Even the combination of pills the dealers sell in their looping cadence — a specially tailored mix of seemingly random medications called “the cocktail” — is designed to intensify heroin’s potency or amplify the pain-relieving effects of methadone into a powerful high.

Users swallow a benzodiazepine like Klonopin or Xanax, the blood pressure medication Clonidine, and the seizure medication Neurontin or Gabapentin. An antinausea drug, Phenergan, completes the blend.

Then they drift away. The people piling the pills on top of their methadone doses are easy to spot: Some, overcome, stoop so low that their hair and hands scrape the sidewalk.

One woman, a regular on the sidewalks and under the bridges here who studied toward a master’s degree in health education before her life fell apart, likened the layering of pills atop an opioid to Maslow’s hierarchy of needs, the theory in psychology that basic physical needs must first be met before a person can seek safety, love, or esteem.

In the cocktail — and for many on the Mile — opioids come first.

Shaun kisses his wife, Donna, as they sit in the parking lot of a mall near Mass. Ave. Both have been homeless opioid abusers for several years. (Keith Bedford/Globe Staff) Shaun and his wife, Donna, have been homeless opioid abusers for several years. They kiss in the parking lot of a mall near Methadone Mile.
Shaun stands shivering in front of the Cumberland Farms store on Mass. Ave. and does the math: A week, maybe more, before he can get on Suboxone after being kicked out of his methadone clinic. Two hours before he’ll be dopesick. Less than $20 needed to buy a quarter-gram of heroin.

His stomach is cramping. He is nauseated, and he is anxious: Soon, the diarrhea and vomiting will start, and pain so complete he’ll be able to feel it in his hair.

The tall and skinny 45-year-old from Lynn has been clean for several months, he says, and so has his wife, Donna. Among his prison tattoos, he has her name inked across his chest and her initials on his wrist. They always promised each other: We’ll quit this together. For years, they said, they have lived in shelters, rooming houses, and on the streets; using, detoxing, relapsing, getting arrested — always together.

Shaun and his wife, Donna, look for warm-weather clothing in their storage unit in Boston. (Keith Bedford/Globe Staff)    Shaun counts the change he made panhandling while waiting to board a van that takes homeless men to a shelter. (Keith Bedford/Globe Staff) Shaun and Donna look for warm-weather clothing in their storage unit. A few days later, Shaun counts the change he made panhandling while waiting to board a van that takes homeless men to a shelter.
Now, in early May, Donna is living in a halfway house, looking for a job. He is staying in a homeless shelter, and wakes up at night reaching for her. He walks her down Southampton Street every morning so she can get her methadone without succumbing to the temptation of the dealers she passes on the way.

He’s too old to go through withdrawal, he says. He doesn’t have it in him anymore. He decides: He’ll use heroin, just for a week. Then, Suboxone.

Shaun, who goes by the nickname “BonZ” (pronounced Bone-zee), panhandles $17, and vanishes into the stir of people in front of Cumberland Farms, looking for his dealer. He emerges moments later, smiling.

“It’s as easy as that,” he says.

Like many others here, Shaun’s addiction predates the current opioid crisis. For him, heroin serves as a refuge from a lifetime of traumas — some self-inflicted. Even with the wealth of treatment options he is surrounded by every day, a remedy has been elusive, the damage that deep. Court papers document a tumultuous childhood, hospitalizations for mental health issues, and repeated arrests. He started drinking at 8, the documents show, and by 13 he was smoking angel dust, snorting cocaine, and using LSD; he started using Oxycontin in the late ’90s, he said, before switching to heroin. He served time for a failed robbery at a McDonald’s. His brother died of an overdose in 2012.

“I love heroin. I live it. The first time I ever did it I fell in love with it,” he says. “But you hate it. You want to kill it. But you can’t. It always wins. It’s the biggest lie.”

Shaun holds a needle in his teeth before shooting up heroin. (Keith Bedford/Globe Staff) Shaun holds a needle in his teeth before shooting up heroin.
He lopes over to a low orange box of a building at the edge of Mass. Ave., The Universal Church, and squats down on blacktop wet with rain. He opens a water bottle, takes out a clean syringe, and squeezes a few drops of water into the upturned bottle cap on his knee. Then he unwraps the folded Keno ticket that holds his heroin.

It is too windy to cook, so he stirs it up in the bottle cap and draws the amber liquid up into the syringe through a makeshift filter, a cotton pad he found discarded on the ground. He rolls up his sleeve, revealing dark blue veins he calls “ropes,” and plunges the needle in, waiting for the eddy of blood called the “red flag” that means it is safe to inject.

The red swirl beckons, and he presses the plunger.

His shoulders relax, no longer sharp points under his jacket. He is not thinking about the hours and days that will follow this one perfect moment of relief: That his plan to use just once every day will fail by the afternoon; that he will begin missing his morning walks with Donna to panhandle for more dope; that he will spend two days trying to raise enough money to take her to see “Captain America: Civil War,” only to spend it on heroin instead; that he will fail to get into a Suboxone clinic, try detox, then return to the streets and to heroin, then detox again. In this moment, there is only the pain leaving his body.

Boston Police officers and a security guard chase an alleged drug dealer after he ran while being questioned in front of the Cumberland Farms store on Mass. Ave. (Keith Bedford/Globe Staff)   Officers handcuff the alleged drug dealer as the security officer stands by.  (Keith Bedford/Globe Staff) On Methadone Mile, Boston police officers chase an alleged drug dealer after he ran while being questioned.
In many ways, the center of this teeming neighborhood — the hub of the Mile — is not a shelter or a clinic. It’s a convenience store.

The Cumberland Farms on the corner of Massachusetts Avenue and Albany Street was the company’s first foray into an “urban location” in Boston since 1981, and a month-long fund-raiser for Boston Medical Center accompanied the store’s opening in November 2013 — a nod to their new neighbors.

“With our brand new look and store concept, we felt the timing was right for us to provide this vibrant neighborhood with a convenient, affordable option for freshly prepared food and our everyday convenience items,” Cumberland Farms president Ari Haseotes said in a news release at the time.

The firm couldn’t have known what was coming. Less than a year after the store opened, in October 2014, the condemnation of the bridge to Long Island shuttered the shelter there and tossed the city’s already overburdened support systems into chaos. It also resettled hundreds of Boston’s homeless here.

Almost overnight, the number of homeless, drug- and alcohol-dependent people crowding around Cumby’s appeared to double. Shoving matches block the doorway. People mill around inside indefinitely, buying nothing. The bathrooms stay locked, to keep people from shooting up heroin inside. One night, a pair of men’s dress shoes sat abandoned in front of the register; a woman with a black eye and a metal bar slid through the belt loops of her jeans added packet after packet of sugar to a yogurt she brought from outside.

Many of the people out front are simply having a cup of coffee with their friends outside the local shop — they’re living in the shelters and spend their days outside, said Tracey, whom Mayor Martin J. Walsh appointed in 2015 to head the city office charged with addressing substance abuse. But others are nodding off on their feet, conked out by the cocktail.

“It’s scary for people to see people that sick and unaware,” Tracey said.

Service providers in the area meet with one another and with police and neighborhood and business groups regularly, addressing problems as they arise — harassment outside methadone clinics, or parked cars being used as cover for injection drug use. But the daily responsibility for reining in the chaos often falls to the Boston Police Department.

“Gotta go, gotta go,” say the police officers who show up every hour or so to sweep away the restive crowd, pointing down the sidewalk. But no one here has anywhere to go. Everything they own, they carry in backpacks and plastic bags. They grumble and swear, walk grudgingly 20 or 30 feet, stop. A skinny man spreads his arms wide, gesturing to the public sidewalk. “They always say that this is theirs, but what’s ours out here?”

Cumberland Farms, in a prepared statement, said it appreciates the efforts by police, but the company worries that the concentration of troubles is overmatching city efforts, forcing reconsideration of the store location. “We at Cumberland Farms have tremendous compassion for the homeless and people affected by drug and alcohol addiction . . . It’s a difficult situation for everyone. Cumberland Farms is unwaveringly committed to keeping our customers and employees safe.”

Police are trying. Officers can often be seen searching backpacks or questioning loiterers, and they arrested more than 200 people within a quarter-mile of the Melnea Cass Boulevard and Mass. Ave. intersection in a nine-month period ending in June alone, according to department statistics. But the most common charges are low-level possession or distribution of drugs, and people are often back on the corner within days or hours. Many need help, police and health officials say, more than they need jail time.

Officers patrol on bikes, in cruisers, and on walking beats, and some hand out postcards filled with information about how to get clean. Just last week, Boston Police launched a pilot program designed to refer people who are summonsed to court on drug charges in South Boston and the South End into treatment at PAATHS while they wait for their court hearings, which can often take weeks.

“The problem is, you’ve got so many public health resources to help the people that need help, but then you’ve got the people who want to take advantage of people down on their luck,” said Lieutenant Detective Brian J. Larkin, commander of the Boston Police Drug Control Unit. “The shelters open up in the morning, and they flood the streets.”

When the cops leave, the Cumberland crowd inches back. Jae Cleva reclaims his spot in front of the store selling synthetic marijuana joints and dreaming of becoming a rap star: “I own this galaxy,” he spits out in one of his favorite verses, “I burn you like a calorie.” He darts away to deal with his customers.

Robert, who at 39 has been using heroin since he was 17, wobbles on the corner. “I have no one except for my sister,” he says. “She begs me to come home. For some reason, I don’t.”

He’s high on heroin and Xanax. Cars whip past. He feels like he’s flying.

Sherry, a homeless woman, leans against a street post in front of the Cumberland Farms store on Massachusetts Avenue and Albany Street. The location is a place where homeless people and those struggling with addictions gather near the Boston Health Care for the Homeless facility. (Keith Bedford/Globe Staff)    Shirley pushes her shopping cart across a parking lot. Shirley, who is homeless, says she uses a variety of drugs. (Keith Bedford/Globe Staff)   Ramon Perez picks up discarded drug paraphernalia near a section referred to as Methadone Mile in Boston. Perez, whose wife works with homeless people, decided on his own to help clean up the neighborhood. (Keith Bedford/Globe Staff)    Robert Morgan hands out clothes, food, and toiletries to members of the homeless community on Massachusetts Avenue. Morgan and his wife, Chrissy Joubert, live nearby and hand out donations twice a week as concerned citizens. (Keith Bedford/Globe Staff) Sherry, a homeless woman, leans against a street post in front of the Cumberland Farms store on Massachusetts Avenue and Albany Street. Nearby, Shirley pushes her shopping cart across a parking lot. Ramon Perez, whose wife works with homeless people in the area, picks up discarded drug paraphernalia and Robert Morgan, who lives nearby, hands out clothes, food, and toiletries to members of the homeless community.
These streets were paved with suffering and struggle decades before the bridge to Long Island came down.

Boston City Hospital, which merged with Boston University’s hospital in 1996 to become Boston Medical Center, has served the city’s “worthy poor” at this site since 1864, according to a city-published history of the hospital.

About a century later, the boulevard that now bisects the neighborhood was slated to become an interstate — an inner beltway through the city. But the project was canceled in 1971, and instead of Interstate 695 racing past these blighted blocks, a new surface road was named for Roxbury civil rights leader Melnea Cass.

In the refashioned cityscape, cars and trucks cluster as they enter or exit Interstate 93, cut across Roxbury toward Fenway Park on game night, or head home to the South Shore after a downtown workday. The traffic islands on Mass. Ave. and Melnea Cass quickly became an ideal spot for panhandling, with beggars accosting drivers waiting two or three light cycles to turn through the busy intersection. Some hold signs, but many simply walk down the dotted lines separating lanes, peering into window after window, cup in hand.

By the time Mayor Thomas M. Menino said in 2007 that some homeless people “had become problems on the street,” the intersection of Massachusetts Avenue and Melnea Cass Boulevard was the most obvious example. Panhandlers crowded the streets right outside the Woods-Mullen Shelter even then — an intersection a Globe columnist called “the crossroads of all cadgers” in 2008.

“This is a neighborhood that has for a very long time been a place where poor people in Boston receive services,” said Dr. Jessie Gaeta, medical director of Health Care for the Homeless, which has been on the corner of Massachusetts and Albany for 30 years.

Some of the homeless people they try to help have been here nearly as long. Craig, a 61-year-old husk of a man missing most of his teeth, said he has been out panhandling on Methadone Mile for nearly 20 years. He spends his nights shuffling through traffic, leaning on his cane with his cup outstretched, alongside the men in reflective vests selling $10 roses on the median.

Gradually, more services set up shop in one of the few parts of the city where it was possible to open new recovery centers and methadone clinics. As Boston’s real estate market exploded, the notion of opening more facilities elsewhere started to feel like a fantasy.

“There are pros and cons to having things clustered this way,” said Gaeta. “If we were doing urban planning today, would we do it this way? I have no idea.”

The area, which spans corners of four neighborhoods — Roxbury, Dorchester, the South End and South Boston — has always accepted the burden graciously, Gaeta said. But the influx of people displaced by the Long Island closure, which came as the opioid crisis was reaching new heights, pushed the concentration to a new and concerning level, and brought addiction — and all the eyesores that accompany it — into plain view.

At the same time, the crisis outside of the city has grown, a wave that many leading the fight against substance abuse saw coming a decade ago but were powerless to stop.

People from the suburbs show up in larger numbers now, said Devin Larkin, director of the Recovery Services Bureau at the Boston Public Health Commission, who is not related to Lieutenant Detective Brian Larkin. Once they’re downtown, they “pick up a case” — slang for an arrest — or become regulars at one of the methadone clinics here. They sleep in shelters, or under the highway overpass. Their families won’t let them come home, or they stay away out of shame.

This new generation of those from outside the city, for whom homelessness is relatively new, add to the already overburdened shelter and recovery systems. They stumble side-by-side with those who have spent decades on the street.

Andrew sits with his girlfriend Briana after getting high on marijuana at Ames Nowell State Park in Abington. The two have struggled with alcohol and drug addiction for several years and are trying to stay sober. They spent several months living in a tent and buying heroin on the streets near Methadone Mile. (Keith Bedford/Globe Staff)   Andrew hugs his mother, Barbara, in the kitchen of her home in Abington. Andrew has spent time off and on living on the streets. (Keith Bedford/Globe Staff) Andrew and his girlfriend, Briana, have struggled with alcohol and drug addiction for several years and are trying to stay sober. They spent several months living in a tent and buying heroin on the streets near Methadone Mile. Now he’s living with his mother in Abington.
Huddled on a fire escape above Massachusetts Avenue on a soggy Saturday morning, Andrew, 31, reaches the same conclusion he’s come to again and again during a 15-year battle with addiction: “I’m ready for this to be over.”

He’d spent Friday night high, bouncing on the balls of his feet as if an electric current was coursing through him. A small crowd writhed nearby: A wild-eyed man with a scraggly beard grabbed a woman by both shoulders and shook her; another, barely conscious, stood hunched on the sidewalk, staring vacantly into the middle distance.

“It looks like a scene out of ‘The Walking Dead,’ ” Andrew says. Late at night it can seem just as dangerous.

When a handful of men threatened him with a knife late that rainy Friday night, he fled and hid on a fire escape, still and silent and too scared to sleep.

He’s been done with heroin a hundred times before, promising himself and his family that he was finally committed to getting clean. And again and again he’s relapsed — bolting from his mother’s house in Abington, drawn inexorably to drugs and sometimes to the Mile, where they are cheap and plentiful.

Each time he promises he’s done, he says his mother asks a question he can’t answer: “What’s different this time?”

Like many of the other men and women who parachute in from the suburbs, Andrew can leave the Mile whenever he pleases. He looks young for his age. He’s long-armed and thick-shouldered like a welterweight fighter. A warm bed awaits back in Abington; a well-connected uncle will help him get into recovery beds that are always scarce.

But the cycle keeps repeating: He’s been through detox 15 or 16 times, he thinks; six or seven ‘Section 35’ commitments, named for the statute that allows his mother to force him into rehab without his consent; a long record of arrests for minor crimes, nearly all of which he beat.

Andrew cools his head off in the sink, feeling feverish as he tries to reduce his heroin usage. (Keith Bedford/Globe Staff) Andrew cools his head off in the sink after feeling hot as he tries to reduce his heroin usage in his home in Abington.
He’s been to Florida for treatment. He’s stayed in one of the sober homes his family operates — that lasted only a few days. He’s even detoxed right here on the Mile, at CAB Boston, where he remembers looking out over the chaotic scene.

“You can literally see your drug dealer,” he says. “He’s waving to you.”

Now, the men he calls the walking dead look frighteningly like his future.

“My next step is washing my hands,” says Barbara, his mother.

Andrew isn’t a bad guy, says his uncle, who operates several sober homes and recently retired from a job with the Boston Public Health Commission — “he’s not a criminal element.” But this has gone on for more than a decade now, and the family is waiting for a call from police to tell them he’s dead.

But the call Barbara gets that morning is from Andrew. From the fire escape, he begs her to rescue him.

At home in Abington, where Barbara makes chili and a shiba inu dog trots around the yard, the madness of the Mile feels very far away. Andrew heads to one doctor’s appointment after another, hoping to try a relatively new medication called Vivitrol that’s said to mute the effects of opioids so thoroughly that shooting up is pointless. In a few days, driving back from a job interview, he passes exit 18 on Interstate 93 — the highway entrance to the Mile — and doesn’t turn off, grateful for once to be carrying an empty wallet.

Within days, the cycle starts again: Barbara finds Andrew passed out on the couch, overdosed on a bag of pills his friend said were Xanax. A dose of Narcan at the hospital revives him, but within hours he’s lying shoeless under a highway overpass in Quincy.

He’s ready for this to be over. Again. But what’s different this time?

He finds a bed at a detox facility on the Cape, but they can’t take him for a few days — long enough to go into withdrawal. So Barbara drives him to his dealer in the city to get heroin to hold him over. Taking her money, he shoots up while she waits in the car — a new low, he says.

As she drives him to the Cape, to a detox facility far from the Mile, Andrew says he’s grateful that she hasn’t given up on him, and hopeful for a happy ending. He’ll get clean and look for a bed in a nice sober home on the South Shore, far from the fire escape and the grim glimpse of where his life is leading him.

“I don’t want to be one of these 40-, 50-year-old guys still going to detox,” he says. So he keeps fighting for sobriety, hoping each time that something will be different.

Homeless men board a van bound for a shelter near Methadone Mile. (Keith Bedford/Globe Staff) Men wait to board a van that will take them to a homeless shelter.
There are dozens of programs for combating addiction, but a typical path to recovery is supposed to look like this: Determined to get clean, a drug user walks into an emergency room. Users are admitted to whichever Boston-area detox program has an available bed, and — prescribed methadone or Suboxone — they spend up to two weeks under medical supervision.

Once the heroin is out of their system, they move for a month into a transitional program somewhere, where the work of treating addiction begins in group or individual therapy sessions.

Finally, they move into a halfway house, from which they can go back to work or hunt for a new job. They can visit drop-in centers and attend group meetings, which are typically a requirement for methadone therapy. Slowly, sober days pile up; lost lives are reclaimed.

But the system is fractured and inadequate, said Gaeta.

Detox — the first step — is generally available on the Mile and elsewhere, though that varies some by time of year and even time of day. But after that, the obstacles to recovery mount.

“Getting into detox is a four lane highway. Coming out of detox is a one-lane country road,” said Vic DiGravio, president of the Massachusetts-based Association for Behavioral Healthcare.

Critical post-detox programs such as transitional support and clinical stabilization services are in short supply around Boston, and the 40 beds at Boston Public Health’s only facility — Transitions, in Mattapan — are typically full. Beds are so scarce that agencies here put patients onto trains or in taxis with instructions not to stop until they reach facilities in Tewksbury or Worcester.

While some agree to go, many are not comfortable leaving their lives behind. Discharged from detox and back on the street, people who have spent a week or more getting clean make their way back to the Mile to wait. Relapse is almost inevitable.

That problem was compounded when the Long Island closure eliminated more than half of the city’s post-detox addiction recovery beds.

Even those who navigate the gantlet that far can find themselves back on the street, because beds in halfway houses are also hard to find, said Andrew’s uncle Charlie, whose sober homes are typically full. After several drug overdoses, he got clean in 1989 and became an addiction counselor.

“The whole system is short on beds,” Charlie said. “There’s no place where you can just knock on the door and get in.”

But many on the Mile aren’t ready to knock on those doors anyway — they are still deep in the throes of addiction.

That, says Drug Control Unit commander Brian Larkin, is the most difficult part of policing the area.

“You can arrest people all day long, but you dump them in jail for 30 days, and what happens then?” he said. “People who are addicted have to want the help. There are plenty of people offering it.”

Solutions for those who aren’t looking for help have always been harder to come by. Boston Public Health’s AHOPE needle exchange program and Healthcare for the Homeless’s SPOT (Supportive Place for Observation and Treatment) target those who aren’t yet in recovery, seeking to reduce the health risks and steer people toward treatment. And the city plans to hire a street worker focused on substance abuse — something once supported by the state but cut during recession-era budgets, Devin Larkin said.

State funding for substance abuse treatment has climbed in recent years after stagnating from 2007 through 2014, according to statistics provided by the Association for Behavioral Healthcare, which represents mental health and addiction treatment organizations. But even a dramatic ramp-up in spending in recent years could not keep pace with demand, said DiGravio.

More frustrating for many who have long worked in drug treatment was how long help was in coming, and how slow sympathy for addiction was to arrive.

“It’s tough to argue that there’s more attention on this epidemic because it’s reaching into suburbs,” DiGravio said. “I think there’s resentment . . . It took this spreading to Wellesley and Needham and Milton for people to sit up and take notice.”

Shaun (right) watches as his friend Chris shoots heroin behind a building in Boston. After a night in a homeless shelter, both were feeling the symptoms of withdrawal from heroin. (Keith Bedford/Globe Staff)   Boston, MA – 05/05/2016 – A homeless man holds his prosthetic leg in his wheelchair in front of the Cumberland Farms store on Mass. Ave. (Keith Bedford/Globe Staff)  People sleep wrapped in blankets on Malnea Cass Boulevard. (Keith Bedford/Globe Staff)   Chris gives Diane a hug after getting high on a synthetic marijuana cigarette in front of a gas station on Mass. Ave. Keith Bedford/Globe Staff) Suffering and struggle take many forms. Shaun and his friend Chris felt the symptoms of heroin withdrawal after spending the night in a shelter. Shaun watched the next morning as Chris shot up. A homeless man holds his prosthetic leg close in his wheelchair, afraid it will be stolen while he rests. Others sleep on the streets. Chris gives Diane a hug after getting high on a synthetic marijuana cigarette.
Sleep will not come for Terrance tonight. The 21-year-old homeless man is restless, lonely, and afraid of his dreams, so he paces Mass. Ave., waiting for something to happen. Around him, headlights illuminate the nighttime panhandlers, and a sinewy man with his hair in his eyes tries to hawk a television set he pushes in a shopping cart. Terrance, who goes by “Delicious,” is less than 24 hours removed from a stint in the hospital, where he was admitted after threatening to kill himself.

“All I could ask for was to be loved,” he says. “And I could never get it.”

He grew up in foster care, residential homes, and psychiatric hospitals, he says, and has been living on Methadone Mile for two or three years. In a year or two, he says, he imagines he will be dead.

He’s not afraid. He’s waiting.

Kenny, who has been homeless off and on over the years, walks while wrapped in a blanket on Mass. Ave. (Keith Bedford/Globe Staff) Kenny, who has been homeless off and on over the years, walks Methadone Mile wrapped in a blanket.
Behind him, Mass. Ave. stretches into Back Bay, the grit and construction giving way to brownstones and gardens. But his world is small. He has no one, owns nothing but what is in his pockets: a photographer’s business card, a lighter, and two pictures he drew while hospitalized. One depicts the apocalypse, and the other, the beaked beast that stalks his dreams, poisonous sulfur pouring from its mouth.

“This is not a life I would wish on anyone,” he says, his voice slow and clear. “This is just a death sentence waiting to be carried out.”

But people understand him here. And besides: Where else would he go?

The cacophonous dirge of the morning drug market is just hours away, but the streets are never fully quiet. People huddle in tight groups, passing K2 joints back and forth. A drunk man in a loose business suit slurs his way through a story about his dead parents. A woman pulls off her hat to show an open head wound.

Sleeping here is dangerous: Thieves snatch bags and rifle through pockets. Some people bed down together on patches of grass, parking their shopping carts like circled wagons.

Others hover just above slumber. White sheets draped across their shoulders, they shuffle under the streetlights like ghosts.

This story was reported and photographed from April to July 2016. Produced by Jennifer Peter, William Greene, Mark Morrow, Laura Amico and Michael Workman. Maps by David M. Butler.


“What??  Legalize heroin?? Are you fucking kidding me”??  That’s what a woman yelled at me the other day.

She went on to say how much she hated her brother.  How much he had devastated the family.  How legalizing heroin would feed into the beast and make it easy for everyone to use heroin.

“Prescription heroin?  Hell give everyone a prescription for heroin. Fuck you lady.  The only thing he is a good candidate for is a  wooden box and a hole six feet deep.”

It was heartbreaking to listen to her.  Clearly she has been deeply hurt.  That deep hurt has been turned to toxic anger. Sadly, she is not alone in her thinking.

In spite of all the research.  In spite of all the medical professionals speaking out.  In spite of reports from all first responders.  In spite of all the collected data, the overdoses, the deaths.  In spite of the undeniable proof that addiction is a brain disease, far too many people still have the “locked them up and throw away the key” mentality.

And that is a tragedy.

The evidence is there.  Harm reduction is paramount is tackling this horrific medical issue. And what will reduce harm for one person suffering with addiction may well be different than what will reduce harm for another person suffering.

There is no “one size fits all” solution.  Everyone suffering is unique and has to be treated as such.  And we can do this.

This entire generation has been taught by parents, taught by educators, taught by law-enforcement “Do not use drugs”.

No one can say they have not had that message drilled into them from the time they could talk.

If someone says, “don’t touch the stove, you’ll get burned”, we don’t touch the stove.  If someone says, “don’t jump off the bridge, you’ll break your legs”, we don’t jump off the bridge.

There are just some things that just make sense.  We don’t have to touch the stove or jump off a bridge to know we will get hurt.

“Don’t use drugs, and you won’t ever have a drug problem”.  Seems like common sense.  Why risk it?

Think for a moment – how many times have you heard, “Don’t drink and drive”.  “Don’t smoke, it can cause lung cancer”.   “Slow down when the road is slippery”.  “Don’t text when driving”.  “Don’t share too much online”.   “Don’t get into a car with a stranger or with anyone who has been drinking”.

And that is all good advice.

Yet every single day people don’t follow that advice.  Cars filled with young guys race down the highway.  People drive home after a couple glasses of wine. A girl shares too much online.  A parent texts they’ll be a bit late getting home, traffic is moving slowly.

The thing is, we all know what we should and should not do.  It doesn’t take rocket science to figure that out.  But we take risks.  And most of the time there isn’t  huge repercussions.  UNTIL THERE IS.

I believe people first try a potentially addictive substance, believing that they will not become a statistic, for one of two reasons.  Curiosity or pain.

Curiosity because they wonder what the big deal is all about.  A lot of people they know seem to be having fun.  They want to see for themselves.

Secondly, people often try something, anything that will take away pain.  It may well be physical pain. From an injury.  A car accident.   A fall.   Often it is emotional pain.  A feeling of deep rejection.  Physical, emotional or sexual abuse in childhood.  Abandonment.

There  is always a reason.

For some, they can try an potentially addictive substance and walk away after.  For another, they are caught in a trap they cannot seem to get free of.

And it is that person who is caught, that has the disease of addiction that becomes a prisoner to their addiction.   When addiction raises it’s ugly head,  our addicted loved one is no longer having fun.  They are simply surviving in a world of pain and suffering.  Merely surviving one day at a time.

And sadly, far too many don’t.  We have a horrific health crisis going on and we have to start treating it with the same intensity we would treat another horrific health crisis.

A large increase in the number of detox and treatment beds is imperative.  A place of safety  is paramount.  Methodose and Suboxon have to made  easily available to everyone asking.  And no one should have to go “pharmacy shopping” to find a pharmacy that dispenses Methodose.  Or to try and find a doctor that will prescribe it.  If you are a licensed pharmacy,  if you are a licensed physician, this crucial, life saving drug should be available.  No stigma attached.

For those people who have tried  treatment, counselling, methodose, everything possible available to them and still they cannot stop the devastation of their disease, they should be prescribed medical heroin.   This is not a complicated concept.  It works for those who have not been able to grasp that lifeline.

The amount given is the amount necessary to keep the person suffering stable.  STABLIZATION IS THE KEY.  The amount given is not keeping the person sick.  It is allowing them to stabilize and function.  It allows them to know what they are getting will not kill them.  It is clean and safe and given in a clinical setting.

These are not short term fixes.

I often hear from readers, Moms predominately, who are concerned because they don’t want their loved one on Methadose or Suboxon.   The truth is, that medication is keeping their loved one well.   It is keeping them stable and able to function.  It may take time to get to the right dosage but that is no different than with any other disease.  And they may need to remain on it for the rest of their lives.

Not to sound simplistic, because there is absolutely nothing simple about the disease of addiction,  but think for a moment, if you take medication for high blood pressure, do you quit taking it because your blood pressure has come down?  If you are a diabetic and your glucose levels come down, do you quit taking your insulin?  If you are suffering from clinical depression, do you stop taking your anti-depressant because you begin to feel better?

No.  You realize that the medication along with perhaps diet and exercise is able to stabilize your condition.

Methadose, Suboxon, prescription Heroin – they are those vital medications that can keep your addicted loved one stabilized, along with counseling and compassionate care that will allow them to live the life they deserve.  That everyone deserves.  These treatments can bring about changes so dramatic that families come back together.  That overdoses stop happening on our streets and in our homes.

This crisis is not going away.  Several Europeon countries have adopted the harm reduction approach that includes prescription heroin given in a clinical setting and the death rate from overdose due to toxic illegal drugs has dropped in some countries to near nil.

The Crosstown Clinic in Vancouver is proving that very thing with the limited group using their facility.  Lives are being saved.  People are feeling healthier and hopeful.

We have to stop the insanity of the “blame game”.  The disease of addiction is literally stealing the lives of wonderful, kind and loving people every day.  This madness must end.  We must embrace harm reduction, in whatever forms work.  It is going to take every social agency to come on board, healthcare, treatment options and facilities, the criminal justice system, housing, benefits that allow healthy diets.

Every time someone finds the help they need, all of society benefits.  This truly is a disease “that takes a village”.   Let’s be part of the solution, because if we are not part of the solution, we stay part of the problem.

Until next time – take care of yourself and know you are not alone.  I truly care.

Much love,





The Disparity Between Physical Diseases and Brain Related Diseases – An Open Letter To Everyone – Because Everyone Knows Someone

No two diseases are the same.  Because of that,  we treat diseases in different ways.  But for anyone who has disease, affecting their physical well-being, one thing is clear – we believe they should get the best possible care available, as soon as possible and for as long as needed.

I believe this.

I also believe that anyone suffering any condition that affects their thinking, their emotional well-being, their behaviors, their decisions, their stability, their capabilities, deserves exactly the same.

So why the disparity.  Everyone of us knows someone that is not treated in the manner their deserve.

We all know people who think those battling addiction “should be locked away in prison”.   That “they are selfish, weak, losers”.   That “they are a drain on society”.

We all know people who think someone battling depression should “just get over it. What have they got to be depressed about”.

Those battling anxiety and panic attacks and at times are unable to even leave their home, are “looking for attention”.

Those battling schizophrenia are “crazy”.

Young people struggling are often dismissed “hormones” “the teen years”.

Diseases or condition affecting the brain are dismissed as something the suffer has control over.  Something the suffer is perpetuating. Something the suffer has brought on themselves.

And nothing could be farther from the truth.  Addiction, mental illness, brain related conditions literally incapacitate the suffer.  These conditions and diseases literally rob the suffer of any pleasure.  Any peace. Any laughter.  Any positive feelings.

These conditions leave the suffer in a deep, dark hole that makes them feel completely alone as they further isolate themselves out of fear, shame, embarrassment.  Because of the stigma society has placed on diseases and conditions affecting the thinking, the behaviors, the ability to process, those suffering often suffer in silence and with beliefs that only compounds their shame and isolation.

This has to stop.  People are dying every single day.  Lives are destroyed.  Families are devastated.  Society is affected.  This must end.

Never before in modern times have we seen this degree of health crisis going on, on our streets, in our homes, in every community in the country.  Countries around the world.  Even the AIDS crisis did not take the number of lives addiction has taken.

Addiction takes the person addicted hostage.  Their behaviors take their loved ones hostage.  Very sick people are dying at an alarming rate every single day from overdose and the opioid crisis.  Those who survive an overdose with the administration of Naloxon or Narcan, as it is often referred to, are often left permanently brain impaired because of the lack of oxygen to the brain.

What many don’t  realize is that hospital wards and long term care facilities have an ever expanding number of those with permanent brain damage – no longer able to care for themselves because an overdose left them permanently disabled.

When addiction has taken hold of someone, the party has ended.  The suffer is no longer “choosing”  to use, rather is “dependent” on using.  That might seem difficult to comprehend but it is factual.  The addict’s brain has been altered.  The person addicted has a brain disease.  The science has proven what those of us who have a loved one suffering have long believed.  The long line of professionals, doctors, scientists, addictions specialist, they all concur.  ADDICTION IS A DISEASE.

We need to have a system in place to treat those addicted in the same timely manner and with whatever is deemed necessary to stop the deaths, as we do for those suffering physical diseases.  Whether that be making Methadose or Saboxon prescriptions more easily availble.  Doctors meeting patients where they are at.  Safe injection sites.  Medically prescribed heroin.  We need to stop this deadly disease trajectory.  If keeping people alive and able to function means prescribing opioids in a controlled environment under strict guidelines, then lets do it.

We will never stop substance mis-use or abuse.  But we can steam the tide.  We can reduce the colossal damage.  The  number of lost and broken people.  The number of devastated families and the financial burden on society.

We need to have detox and treatment immediately available when an addict reaches out.  That window of opportunity is very small – we cannot afford to let that loved one fall through the cracks.  That three week wait list.  That just does not work.

For those people battling any one of the large number of mental illnesses that we are acutely aware of, they cannot wait.  They need immediate help when they reach out.

People with altered brain functioning because of any one of the diseases affecting the brain can not wait.  They are suffering horrifically just trying to get through the day.  Doctors, therapists,  support workers, counsellors, medication, continuous, long term supports.  These are not negotiable.  These are necessities.  People are dying self-medicating.  The numbers of people struggling with addiction and mental illness together is massive.  We need to help those who are at a place where they are feeling helpless.  Where they are feeling hopeless.  Where they are feeling desperate. Where they can no longer help themselves.

Would we as a society leave anyone battling a physical disease in  the same manner in which we leave those battling a mental illness or a brain disease like addiction.  I think not.

We have to do better.  Our loved ones can no longer wait.  Way too many have died.  Stand up.  Speak out.  Let your voices be heard.  They are counting on us.

Until next time my Friend, take care of yourself and reach out when you need to.  I truly care.

Much love,




Drug Addiction: The Light of Her Love

As we go through life we may meet someone who touches our life and it is changed forever.

We hear something that resonates with us.  It touches us to our core.  It may be something we hear someone say.  It may be something we read. Very often it is a song we listen to.  A song that speaks to us.  A song that feels it was written especially for us because it says in a song what we feel in our heart.

This week I received a letter from a gentleman in New York, USA.  We have never met.  Yet, we have touched each others lives by chance.  I have never believed in coincidences.  I believe life unfolds as it is supposed to.  People enter our lives when it is meant to happen.  And our lives are better for it.

With his permission I want to share with you a song he has written.  It is a powerful song that will touch the heart of every single person who has a loved one struggling with addiction.  It will especially touch the heart of every Mom with a child struggling with the disease of addiction. And  I am going to share his note with you.  Bill has truly captured the agonizing experience of loving a child who struggles with drug addiction.

Log onto the site indicated in his note.  He has so generously provided this for free. Close your eyes so you have no distractions and allow his words and music to enter your heart.  Every word, reflected the feelings I have carried in my heart.  And as a Mom who a child you so deeply loved, struggling with addiction, I know these are the feelings you too, carry in your heart.

I hope after listening to his words you will write him a review that others may find his words and know their feelings, their fears and their pain is validated and understood.  And I would love to hear from you as well.

Please find Bill’s note below and the link to his song:    The Light of Her Love
Dear Ms. Ariano-Jakes,

About a year ago my cousin emailed me and asked if I could write her a song about the experience of having a child who struggled with drug addiction.  Her son is in his thirties and had been addicted since he was 14, although he has been in recovery for three years now.

My initial thought about writing the song was that I couldn’t write a song about this since I had no firsthand experience with it.  As I continued to think about it I realized that I did know what it was like to love a child and I did know what it was like to fear for a child (I’m a 59 year old grandfather.) so perhaps I could write the song.  I began to look around the internet and came upon your book.  I ordered and carefully read your book.

Although my cousin shared a few things with me about her experience, almost everything I now know about what it is like to be the parent of a child who struggles with addiction comes from your book.  I hope I haven’t gotten it horribly wrong and I apologize if it’s presumptuous to think something so poignant, personal and painful as this can be expressed in a four minute song, but here it is. I hope it somehow will have some value to someone.

I’ve attached the song to this email.  The song is streaming and downloadable for free at this music platform.

Warm Regards,

Bill Mott



And until next time my Friend – know you are not alone. Reach out. I truly care.

Much love to you all,


Stand Up, Speak Out – Together We Can

Hello my Friends – I wouldn’t normally send a second message off to you in the same week but yesterday one of our Addiction: A Mother’s Story Moms, Penny Douglass from Kamloops, British Columbia Canada kindly shared a letter with me that she sent to our Provincial Minister of Health Terry Lake.

Penny’s letter voices the very concerns everyone of us have.  Society is very slowly beginning to realize what we parents have known for a very long time.  Addiction is a disease.  A disease that alters the brain of our addicted loved ones. We have watched it unfold  for years begging for help. Tragically it has taken the incredible number of  overdose deaths this past year due to fentnyl and carfentnyl  into the mix, to shake up the stigma surrounding addiction.

The momentum of awareness and what is needed must continue.  We are just at the starting line.  Our addicted loved ones deserve every bit of care, compassion and help from highly qualified professions.  There is not a “one size fits all” solution.  Like any other health crisis, those suffering with the disease of addiction need us to pull out all the stops. They need intense help to overcome their addiction but they also need  just as much  help to deal with the trauma that addiction has brought into their lives, trauma perhaps carried from childhood. PTSD that results in high levels of anxiety, panic attacks, sleeplessness, night terrors, the list goes on and on.

As Penny indicates in her letter, our addicted loved ones desperately need and deserve to be treated with the same level of professionalism and expertise as anyone struggling with any other deadly disease.

Please find Penny’s letter below – she is generously allowing me to share it with all of you. Both Penny and I encourage you to write your government health officials, government leaders, representatives wherever you live – it will take us Mothers, we as  family members  to keep the pressure on.  STAND UP – SPEAK OUT – TOGETHER WE CAN. Our addicted loved ones are not  able to advocate for themselves while deep in their addiction so we must. Let your voices be heard.

Be kind to yourselves – take care and please keep in touch.  I truly care.

Much love,


Again, thank you Penny for allowing your words, wisdom, and your experience to be shared.

On Feb 1, 2017, at 9:17 PM, PENNY DOUGLASS  wrote:

I would like to make some comments on the Coroners recommendations following the inquest, into a clients death, in an addiction treatment centre in BC. I would strongly urge our Ministry of Health to implement standardized regulations for the operation of Addiction and Substance Abuse treatment centers in our province. This needs to include a requirement for professionally trained staff to be actively involved in patient treatment. Folks with ‘lived experience’ have valuable knowledge & skills but this needs to be partnered with education and recovery longevity. It is my belief and the belief of other parents that a licensing system needs to be in place.
The regulation of these centers needs to include a standardized measurement of outcomes. I find it very difficult to find out what these centers base their success percentages on. What is a success-someone who completes treatment but may return to using 3 days after they have ‘graduated’? What is counted as a failure? Is a death in treatment a failure? Or did they just not complete treatment? Remember these centers are businesses. Success numbers draw clients.
The opioid crisis has highlighted the increasing need for easily accessible Detox and treatment centers. Most,treatment centers’ recovery philosophy is narrow in focus and they demand total abstinence; therefore, designing recovery plans which exclude clients who require medicinal therapies for their individual recovery. This means many treatment facilities do not admit clients on Suboxone or Methadone ( both recognized therapies in opioid addiction treatment) as this requires more staff, work and expense.

When families and/or addicts are choosing a treatment centre they need to do their homework. Ask questions, look at staff qualifications, look at policies on replacement drugs, read rules and regulations. If you identify red flags, deal with them prior to paying or having your addicted love one enter the facility. Most addicts enter a facility at a critical point in their disease and their admission is totally voluntary and they are free to leave at anytime. In theory they are choosing to be there-unlike jail. By the very nature of addiction these are folks who have spent much of their time substance/drug seeking. It is their desire to stop, partnered with the skilled help of treatment professionals. At this critical crossroads, the addicted persons need speedy and efficient access to regulated, standardized treatment in facilities that are inspected, licensed and monitored.
I have had experience with some very good, professional treatment centers and some that are substandard. We have a standard for patient care in other areas of health care system and our family members and others suffering from addictions and substance abuse deserve the  same standardized quality of care.
In concern, Penny Douglass
Kamloops, BC.

Immediate Places of Help For Your Addicted Loved One

Hello Friends – As we come to the end of January we continue to hear of the increasing number of families being affected by the number of overdoses happening in our homes, in our communities, on our streets.  It is a crisis situation we as parents, family members have been pleading for help with, for many years now.

As more research confirms addiction as being an altered brain disease, our political leaders are beginning to speak out about addiction as being a health crisis of epic proportions.  We have a health crisis on our hands and it is not going away.  Our loved ones are suffering unimaginable pain and as you watch your loved one struggling the pain and heartbreak you are living with is unimaginable except to another parent struggling with the same.

I am attaching a letter I received outlining a comprehensive listing of resources to improve access to opioid agonist therapy for individuals with opioid use disorder across Vancouver, Canada.

For those of you living in other areas or countries, I encourage you to approach your Health Authority or your  political health representative to find out what is available in your area.

While your loved one may not be at a place where they are ready to accept help, I encourage you to look into whatever resources are available so that when your loved one does reach out for help, you will have this information at your finger tips.


For those of you who follow Twitter, I hope you will go to my Twitter feed   @AddictionAMS  I post valuable information throughout the day that I believe you will  find helpful and informative for those who have loved ones struggling with addiction, mental illness, homelessness.

Please take the time to take care of yourself.  In the midst of all the kayos of addiction, those of you who have a loved one struggling, often suffer in silence with extreme anxiety, fear, devastation and sleeplessness.  Remember you count.

Please remember you are not alone. Please keep in touch. I truly care.

Much love,