I wasn't expecting it. That day, I was out with one of my grandkids when I received a call from an unknown number. At one point in time, I would have stopped everything to take that call. But I didn't pick it up this time. Instead, I continued to enjoy my time with my grandchild.
That missed call turned out to be the police calling to notify me that Tommy was found dead in his bed at his recovery home.
Our Tommy died and there was nothing I could do to change it, no matter how much I wished I could. He died after using heroin that was laced with fentanyl. He passed away when he was 27 years old, on August 31, 2018.
Sadly and ironically, it was International Overdose Awareness Day.
Tommy is not my biological son. Tommy came to live with us when he was 9, a few years after his dad, who was my husband's cousin, died from an opioid overdose. We raised him as if he were our own child. I was his legal guardian.
We didn't talk about why Tommy's dad died as a family, which I later learned was a mistake. At the time, I didn't understand addiction like I do now. Back then people didn't talk about this stuff. I didn't know that the brain is hijacked by a substance that makes it really hard to stop using or that there is a genetic component to addiction. I didn't understand a lot about addiction until I watched it play out with Tommy right in front of my eyes.
Before Tommy's journey, I thought addiction was a choice—I can tell you it's definitely not.
Like many, Tommy's addiction to opioids started with pain medication. When Tommy was younger, he was very active. He was adventurous and fearless. He rode motorcycles, ATVs, and dirt bikes. He also played football. He loved to use our camcorder to make daredevil videos.
Being the daring prankster he was, he also came with many injuries which resulted in many prescriptions for pain medication. It was a different time then. People were often prescribed opioids as a result of minor injuries or dental work.
The last prescription I remember Tommy getting was when he was 18 years old and he had a bad motorcycle accident. He ended up in the burn unit for about a week. Tommy was able to mask his addiction for a while because he was very functional. Even at the height of his addiction, he was a hard worker and went to work almost every day.
When Tommy's prescriptions ran out he started to buy pills off of the street. Eventually, the pills on the street became less available and more expensive. By the time Tommy was 20 he made the switch to heroin. It was absolutely terrifying to witness.
I did not know where to go for help. In the years following, I spent my time learning as much as I could about addiction to try and help Tommy the best that I could. It was during those years that I found the Partnership to End Addiction and the resources and support they offer.
As I became stronger, I started to advocate for other families that were caring for loved ones living with a substance use disorder in the hopes that no one would ever have to feel as alone and afraid as I did.
During this time, Tommy was also trying his hardest to enjoy a life in recovery. He had some setbacks and his substance use led him to some legal issues. At one point Tommy was in jail for a probation violation and a few months before he died, he was released to the street. He called me and I picked him up, and he moved back home with us.
Tommy said that he didn't want to use heroin anymore, but I knew that being newly released he was about 48 times more likely to die from an overdose. I had Narcan—an overdose reversal drug—at home and was prepared for the worst.
While Tommy was living back home with me, we had a lot of fun together. We ate at restaurants often and he helped me create some of my presentations at work. He also did some advocating with me. I ended every call with him, "be safe, I love you," just in case it was our last.
In June 2018, Tommy decided to move to a recovery home in Pittsburgh, about five hours away from home. He thought he would have a better chance of maintaining recovery in a different area. We were far away and the recovery home looked like a great place, but I only checked it out online.
I never even asked if they had Narcan. I assumed they would—being a recovery home and all. I didn't know anything about the location either. It turned out to be in a bad area of Pittsburgh known for the amount of drugs.
While he was living there, Tommy often called to tell me how beautiful the city was. He loved to walk along the river and would describe in detail the skyline. He loved the Steelers and was thrilled to be so close to their stadium.
A week before Tommy died, I visited him. We talked about some concerns I had about the area. In the past, Tommy had to be revived from overdoses with Narcan. He joked with me that he never really thought he would die. I told him how serious this was and how worried I was. I offered to help him look at a different place to live, but he said he was doing great in that recovery home and made friends.
He wanted to stay.
The night before his fatal overdose, Tommy attended a support group meeting and told me about a new job he'd just landed. He was so excited. Tommy had no intention of dying. He very much wanted to live. He loved life. He loved his kids. He loved his nieces and nephews and his siblings. He was an amazing father and awesome uncle. He really wanted to be here to see the kids grow up.
The next day, Tommy had his final setback. In the end, he died alone in a private room on a private floor in his bed at a recovery home that had no Narcan. None of which should have ever happened.
As a grandmother, I am terrified of what is out there on the streets now. Through the years I have met a lot of families that are impacted by addiction and a lot of families that have lost loved ones.
It seems as if lately the kids that are dying are younger and younger. Some are just experimenting with substances for the first time and trying things that happen to be laced with fentanyl.
We also now have xylazine to worry about; a veterinary tranquilizer known as "tranq" that is infiltrating the drug supply and can be deadly. It seems like every day I learn of a new emerging threat.
I have watched the effects of the opioid epidemic on the last three generations of my family and I feel that more could be done to end this public health crisis. It saddens me that we are not doing everything possible to save lives.
I am watching now as we continue to fail the next generation, including all of the children that are left behind, affected by a parent's active use, incarceration, or overdose death.
As a whole, we're doing a poor job communicating to the caregivers of these kids, who are growing up not only with the trauma of what's happened in their lives, but also the genetic component of addiction.
It's tragic that after all these years, the addiction crisis remains unaddressed. Do we have to wait until yet another generation gets wiped out before we take this seriously?
Kathleen Strain is a mental health and substance use disorder advocate and educator at both the state and federal levels. She is involved with many grassroots organizations that have a focus on substance use disorder. Kathleen currently works as the volunteer coordinator at Partnership to End Addiction.
All views expressed in this article are the author's own.
As told to Newsweek associate editor, Carine Harb.
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