Little Black Bracelet

 Nicole Assante

HST 401 – A

Professor Horgan

28 February 2024

Little Black Bracelet

              I wear a black rubber bracelet on my left wrist every day. It used to have a phrase on it, “Fall down seven times, stand up eight”. But the effects of wearing it every day has washed away the white lettering. Each morning, I put the bracelet on because it is the closest thing I have to my sister.

              My sister overdosed on fentanyl laced heroin on April 22^nd, 2022, at the age of 35 in our childhood home. But do not let age long stigmas of addiction and addicts plague your mind. My sister was a mother of 2, a daughter, a sister to 3, and a friend to many. While her battle with addiction lasted a long 17 years, the phrase that used to shine brightly on her bracelet is a reminder of not only the struggles, but the precious moments we had together.

              Addiction affects nearly 48.7 million people each year. That means that nearly 1 in 3 adults aged 12 or older has a substance use disorder. Alongside this, 46% of Americans have a family member or close friend who has dealt with a substance use disorder.

              According to the CDC, prescription drug abuse is America’s fastest-growing drug problem and has been classified as an epidemic. Rates of overdose deaths involving prescription drugs, such as synthetic opioids, have increased 22% just from 2020 to 2021. Overdoses in 2021 have reached a rate 22 times that in 2013. This is mainly due to the rise of fentanyl.

              Fentanyl is a synthetic opioid, meaning that it was synthesized in a lab. It has been approved to treat severe pain. However, fentanyl is 50 to 100 times more powerful than morphine. Lab produced fentanyl is a growing concern for its ability to be misused, like OxyContin and Vicodin. But the real worry lies in illegally made fentanyl that is sold in the illegal drug market. In 2023, the Drug Enforcement Administration seized more than 77 million fentanyl pills and nearly 12,000 pounds of fentanyl powder. Fentanyl has a heroin-like effect and is often mixed with heroin and/or cocaine. Most of the time though, heroin and cocaine are laced with fentanyl. In my sister’s case, the heroin she took was laced with a deadly amount of fentanyl.

              If I asked you to describe to me the stereotypical drug user, you might tell me someone who came from a troubled home, who was disadvantaged, who lived in the inner city, who lived in poverty, who dropped out of school. While stereotypes have a smidge of truth to them, it is unfair to paint all people with substance use disorders the same. My sister did not come from a troubled home, she lived in an upper middle-class family, graduated from high school, lived in rural suburban area, and was surrounded by love. She had two children, an aspiring chef, an animal lover, a makeup enthusiast, and a fashionista.

              It is these types of stereotypes that make recovery so difficult for an individual. In a study conducted by the Government Medical College and Hospital of Chandigarh (India), researchers found that one of the most common reasons for not seeking help was “I feel ashamed at having become an alcoholic/drug addict” and “I am sick and tired of being know as an addict”.  I could tell you the countless times my sister apologized to my family and me or the number of times she blamed herself for her actions. But addiction is a disease that affects the brain, and once settled, it runs rampant.

              According to the American Society of Addiction Medicine, “addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry”. Addiction affects neurotransmission, which is the transfer of information between neurons. Alongside this, it affects the interactions between cortical and hippocampal circuits, which are the regions of the brain that support memory formation and retrieval. This is where addiction stems from. When one becomes “addicted” their brain connects external triggers to a behavioral response. This is like when we pass a restaurant and the smell makes us hungry. So, when an external trigger presents itself, there is a behavioral response, such as cravings or using. Alongside this, repeated drug use weakens the ability to exercise self-control and tolerate stress. With this perfect storm, it is incredibly difficult for people with a substance use disorder to control their drug use, despite their yearning to.

              Recovery is not a linear path. According to a study done by Okasha Institute of Psychiatry (Cairo, Egypt), 45% of patients will relapse following rehab. Relapse happens for many reasons, such as cravings, personality disorders (my sister was diagnosed with bipolar personality disorder), socio-demographics, and much more. This does not mean that recovery is impossible. According to the Substance Abuse and Mental Health Services Administration, in 2021, out of 29.0 million adults who said they ever had a substance abuse problem, 72.2% of them considered to be in recovery or recovered. This is an important statistic to combat the cultural stigma around people with substance use disorders. My sister’s journey followed a boom bust cycle, to describe it the best. I remember sitting by the phone, waiting for her call from rehab but also remember visiting her in jail when she was arrested for possession. But there is no doubt that the bracelet she wore was a motivator for trying to recover.

              The United States spent $43 million on drug control in 2023. This money goes to treatment, prevention, law enforcement, and education. However, I’ve found that the most change comes from homegrown organizations. Since my sister’s death, I have raised over $15,000 to the Center for Prevention and Counselling, which is a resource for those struggling with substance abuse in Sussex County, New Jersey.

              Since her death, I have corrected the way I look at those struggling with substance abuse. They are someone’s child, parent, friend, not just another face lost to a disease. My sister left behind 2 children, 2 brothers, a sister, her parents, and countless friends and family. She is not another life lost to an epidemic, but a chance to raise awareness about a problem that affects people worldwide. The bracelet I wear every day is a reminder of her struggles, and how I can continue to remember her and make a change.

 

Works Cited

Arun, Priti, et al. “Journal September.” Indian Journal of Psychiatry, 2004.

“Fentanyl.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 8 Aug. 2023, www.cdc.gov/opioids/basics/fentanyl.html.

Gramlich, John. “Nearly Half of Americans Have a Family Member or Close Friend Who’s Been Addicted to Drugs.” Pew Research Center, Pew Research Center, 26 Oct. 2017, www.pewresearch.org/short-reads/2017/10/26/nearly-half-of-americans-have-a-family-member-or-close-friend-whos-been-addicted-to-drugs/.

“HHS, Samhsa Release 2022 National Survey on Drug Use and Health Data.” SAMHSA, 13 Nov. 2023, www.samhsa.gov/newsroom/press-announcements/20231113/hhs-samhsa-release-2022-nsduh-data#:~:text=In%202022%2C%2048.7%20million%20people,an%20AUD%20and%20a%20DUD.

Mikulic, Matej. “Total Federal Drug Control Spending U.S. 2012-2024.” Statista, 21 Mar. 2023, www.statista.com/statistics/618857/total-federal-drug-control-spending-in-us/.

Nagy, Nahla El Sayed, et al. “Assessment of Addiction Management Program and Predictors of Relapse among Inpatients of the Psychiatric Institute at Ain Shams University Hospital.” Middle East Current Psychiatry, Ain Shams University, Springer Berlin Heidelberg, 2022, www.ncbi.nlm.nih.gov/pmc/articles/PMC9579533/.

“Reported Drug Use among Adolescents Continued to Hold below Pre-Pandemic Levels in 2023.” National Institutes of Health, U.S. Department of Health and Human Services, 5 Jan. 2024, nida.nih.gov/news-events/news-releases/2023/12/reported-drug-use-among-adolescents-continued-to-hold-below-pre-pandemic-levels-in-2023.

“Samhsa Releases New Data on Recovery from Substance Use and Mental Health Problems among Adults in the United States.” SAMHSA, 20 Sept. 2023, www.samhsa.gov/newsroom/press-announcements/20230920/new-data-recovery-from-substance-use-mental-health-problems-among-adults-in-united-states.

Staff, Written by Casa Palmera. “Drug Addiction, Stereotypes: Casa Palmera Recovery Center.” Casa Palmera, 19 Apr. 2019, casapalmera.com/blog/drug-addiction-stereotypes/.

“Substance Abuse and Addiction Statistics [2023].” NCDAS, 1 Jan. 2023, drugabusestatistics.org/.

“Year in Review: The DEA Rocky Mountain Field Division Sees Record Year in Fentanyl Seizures.” DEA, www.dea.gov/press-releases/2024/01/31/year-review-dea-rocky-mountain-field-division-sees-record-year-fentanyl#:~:text=United%20States%20Drug%20Enforcement%20Administration&text=DENVER%20%E2%80%93%20Fentanyl%20is%20now%20the,12%2C000%20pounds%20of%20fentanyl%20powder. Accessed 27 Feb. 2024.