Cost

by Roxana Robinson, 2008

One of the most powerful books I’ve ever read. Excellent but harrowing. So painful and scary. If anyone is thinking about taking heroin, read this first. Through the character of 22 year-old Jack, you learn what it is like to be an addict. The dark, awful, soul-consuming world of a heroin addict – the cravings, the utter squalor of a life taken over by this drug, the horrible withdrawal symptoms that make it impossible to quit, how easily one becomes addicted. The story is about what a family goes through when one of its members is addicted to heroin. All of the characters are well drawn out and so real. Jack and Steven are brothers and Steven finds out Jack is addicted to heroin, tells his mother, Julia, who tells her ex-husband Wendell, and they put in motion the steps a family takes to try to end the addiction. From page one, you are living the nightmare with this precious family. The horrible things an addicted son can do and put you through: Just finding him in his dark, derelict, smelly apartment; discovering the lies he has told you time and again in order to get money; the withdrawal symptoms he goes through when he hasn’t had the drug for just a few hours; the harrowing, extreme steps he takes to try and get the drug (a boat ride and they run out of gas, have no oars, no light, no life-jackets, it’s dark and stormy and Jack is puking his guts and in agony and all he can think about is getting some heroin somehow, someway; Jack ripping out the IV in the hospital, stealing someone’s boots, walking out of the hospital in pain and agony, stealing a car, breaking into a drug store, going to jail; going through an intervention with his family and a drug counselor). Nothing works, Jack is kicked out of rehab for using, runs away from halfway houses, Julia and Wendell try to find Jack in his old Brooklyn neighborhood. The scene is so dark and hopeless – Jack sees them in their car in front of his dealer’s apartment. He needs heroin so bad and he is hiding from them, it’s cold and all he has on is a windbreaker because he sold his warm coat. He hates them and waits and waits for them to leave. Here is the scene:

Rounding the corner behind them, Jack stopped at the sound of his name. He saw the small dark car parked at the curb, someone leaning out the open door. He heard his name called again. He recognized the voice.

He drew back into the shadows of the building and turned sideways, hunching his shoulders and ducking his chin beneath the collar of his jacket. He watched Julia leaning against the door, motionless. She called his name again.

The words came at him like weapons. Jack glanced around. A bearded black man with a knitted cap was walking by. He paid no attention. No one noticed the call, no one realized it was his name, that he was Jack. Still, it was like weapons, knives thrown at him. His mother waited, holding on to the door. Jack waited, shifting from foot to foot in the cold. He sniffed largely: doper’s drip. Was that his father in the driver’s seat? It was. His parents were parked outside his dealer’s.

Rage rose up in him: they had no business here. This was his territory, they should get out. The universe was dark enough, filled with his shadows. He could hear footsteps on the sidewalk, He hated that, the pock-pock on the sidewalk, like the horror of an approaching clock. The sound filled up the cavity of his chest. His heart was ready to tear itself from his body, he felt it pounding dangerously in there. No one could come near him, he couldn’t risk anyone approaching him. Panic flapped its huge leathery wings about his head and he shut his eyes. The world tipped slowly on its axis, slanting horribly away from under his feet. He could feel its shift: in a moment he’d fall off the curing side of the planet, dropping into black gravityless space. He felt himself losing his balance and opened his eyes. Slowly the planet righted itself. He looked around, in the shadows, but there was no evidence: no slanted buildings, no toppled trash cans. But it was real, he’d felt it in his body, the vertigo, the fear. There was nothing that was safe, nothing. You were on your own. He heard the pock-pock of the footsteps again, approaching him.

Maybe he should walk over to their car and offer to clean their windshield for twenty bucks. Maybe he should just ask his parents for money. But they’d stopped giving him money.

There was something about going up to Maine: it was the fucking trial. That’s why they were here. His mother wanted to take him u to Main for his trial. He’d shoot his foot off first. He’d shoot her foot off. He stood in the shadows and watched them, his chin behind the collar of his jacket. It was getting cold.

They had no right to be here, in Brooklyn. On his own block, one of his blocks, his territory. He was cold. He’d sold his parka, and all he had was this windbreaker he’d found in a bin. He was cold, and he needed dope, and he could feel the world swirling around him. He felt the air fill up with menace. It was in his throat, he felt the choke of it in his throat.

Two young black men, in black parkas and knit caps, walked toward him on the sidewalk. As they neared, one of them glanced at him. His eyes were bulging, the whites liquid and brilliant.

His heart thundered in his chest. Everything now was perilous. The air was full of glittering blades. What he could not see, what was just beyond the corner of his eye, was deadly. How long were they going to sit there in their car, waiting for him to walk by? He should go over and tell them to get out of here. He hated having them here.

“I think he’s everywhere,” Julia said. She pulled the door closed. “I keep seeing him. I think he’s that guy over there on the corner, the one with his back to us, in the windbreaker. He looks like a bum. Jack probably looks like a bum now.” She turned to Wendell. “How long do we go on with this? I don’t mean looking for him, I mean the whole thing. How long do we just–pursue it?”

Wendell didn’t turn. “What choice do we have?”

“Sometimes I wish it were over, just over, any way. I can’t stand this,” Julia said. She leaned back against the seat. “I just wish he’d end it.”

…They sat without speaking. A black woman walked quickly past, wearing a long coat and pushing a stroller. The man on the corner waited, his chin tucked under the collar of his windbreaker, freezing, angry.

The call came at eight in the morning.

It was not an alarming moment of the day, it was not as frightening and heart-thudding as two o’clock it eh morning would have been, but still, it was too early for most calls, though what did any of that matter?

Julia went over it afterward, moment by moment, how she had felt when she raised the telephone–faint uneasiness–what she had been looking at–the grimy molding around the kitchen doorway–what she had felt when she heard a strange man’s voice say her name–“Is this Julia Lambert?”–terror.

Everything went on high alert, then, heart pounding, chest thudding, as though, by sending out adrenaline, as though by knowing at once what was happening, by giving herself an extra split second of awareness she would somehow be in more control of this, but she was not in control of this, there was no control to be had over this.

“Mrs. Lambert, my name is Terry Shaughnessy, and I’m calling from the Public Examiner’s Office. I’m sorry to say that I have some very bad news.”

That was how it happened. That was how the rest of your life turned black and empty, like the sky around a tornado. You hear those words, you knew what they meant, and you were powerless to prevent them. You could say, Don’t say anything more, you could say, You have the wrong person, but none of that would help, because what he was telling you was true. It was true and it had happened, no matter whether he told you or not, and it had happened to your son.

She heard him say other things. Where the body had been found, the address. It meant nothing to her. There was identification on the body (the body, the body, she waned to tell him it was not a body, it was her son), but they needed someone to come and make a positive identification.

Julia was standing in the kitchen. She leaned against the sink, bending over from the waist. “What happened?” she asked. “Tell me what happened.” She straightened and put her hand over her eyes, as though that would let her hear better.

“Cause of death has not yet been determined, but it appears to have been an overdose of opiates.”

“Yes,” she said. “Tell me where he was.”

He had been found in an abandoned building; drug paraphernalia had been connected to the body. The needle still in him.

A shooting gallery. She thought of his body lying on a filthy mattress, or on a gritty cold floor, in the darkness. He would be in some posture of protest at what was happening, the limbs raised and stiffened, the eyes closed, the features caught up in that last moment, bliss: at least he’d had that. An overdose was said to be the greatest high of your life, though who would know.

pages 402-406, near the end of the book

Here are some quotes about the nature of heroin addiction by Julia’s neurosurgeon father named Edward:

Edward nodded. “Intervention,” he said. “I don’t know how well these things work.” She might as well know the truth. “Counseling, meetings. All that talk.”

“We don’t know what will work, Daddy,” Julia said. “We don’t have a lot of choice.”

Edward sipped his coffee. Heroin addiction was chemical, not psychological. Opiates destroyed the dopamine receptors. The structure of the brain was altered. Trying to cure it by talking was like trying to set a broken leg with meditation.

from page 234

More about heroin from Julia’s sister, Harriet:

It was bad, then, thought Harriet. It was very bad.

Before she left she’d done some research; the numbers were frightening. Most people died from this. Heroin was an opioid, an opium derivative, like codeine and morphine. It had an insidious chemical grip that coiled around the brain like a python.

Heroin was diacetylmorphine, a synthesized form of morphine with extra chemical boosters that delivered it quickly to the brain. Opioid addiction destroyed the natural patterns of behavior, including those of survival. The craving subsumed everything else. In one study, rats were offered morphine or food. They chose morphine, over and over, until they died of starvation. It was a scientific anomaly, a brain stimulation pattern without biological value…

from page 241

After Jack disappears from the hospital and the family doesn’t know where he is yet:

Julia turned to them. “How could he do this?” She was nearly crying. “He still had that thing in his arm. He stole his roommate’s boots. How could he act like this? What is the matter with him?”

“He’s and addict,” Wendell said. “Remember what Carpenter said: he’s not the person we know.”

“I don’t want to hear what Carpenter said,” Julia said. She took the cutlery basket from the dishwasher and began rattling silverware into the drawer.

“Opiates alter the chemistry,” Edward informed everyone. “They change the personality. They produce a physical change in the makeup of the brain.”

Here’s the words of Ralph Carpenter, the counselor the family hired to help Jack get clean:

“So,” Carpenter said, leaning forward. “Let me tell you what Jack’s going through. What it’s like to be an addict.

“Someone who tries heroin is usually already a drug user, so the idea isn’t really foreign to him. He’s been using all sorts of things -pot, hash, probably some hard stuff – but heroin’s a giant step up from everything else, into the big time. Heroin gives you status. Heroin is the king of cool.” He paused. “And heroin gives an unbelievable high, a pleasure you can hardly imagine. It’s rapture. There is nothing, nothing, so great as the first heroin high. Nothing.” Carpenter sounded severe, as though he were daring them to disagree.

Is he boasting? wondered Harriet.

“So. At first it seems pretty harmless. It only costs ten or fifteen dollars a bag. But your body will always compensate for a foreign substance, bring things back to normal, and so, as the user’s body starts to adjust to it, he needs more and more heroin to get high. And once he’s addicted–which can take several weeks or several months–his habit starts to interfere with everything in his life.

“Getting heroin and using it take up a huge amount of time. And it’s expensive: he needs more and more money, and is less and less able to hold a job. So he turns criminal. This isn’t such a big deal, though, because he’s used illegal drugs for a long time. In a way, he’s been living outside the law for years. He’s used to breaking it. So now he starts breaking promises, lying o get money, maybe stealing it. It feels normal, though, because everyone around him is doing this, too–lying and stealing, selling, buying, and using an illegal drug. His whole community functions outside the law.

“When he starts committing crimes, sometimes his first victims are family members, because they’re the easiest targets. He slips a twenty out of Mom’s wallet, he picks up Dad’s digital camera from the set of the car. It’s a terrible irony, if you will: the people who most trust him, who most want to help him, are the ones he first betrays.”

He was wrong about Jack. What about the person Jackie was, besides the heroin addict? Jackie had such intelligence and vitality, such talent and potential. Carpenter made him sound like some hopeless loser, without brains or resources: he was wrong, wrong, wrong.

“On some level he’s ashamed o this, which is another reason to take heroin–as a protection from shame and depression. Heroin becomes a shield. By this time it’s no longer such a big source of pleasure. His body’s adjusted to it, and it’s increasingly hard to get high.

“Once he’s addicted, he has no choice. He has to take heroin constantly, all the time, or he’ll go into withdrawal. This is called jonesing. It’s a craving, and it’s excruciating. He’ll feel as though all his joints are on fire. And it will do strange things to his mind: he may want to vomit at the sight of red, something like that. It’s weird stuff.

“So now he’s using for both physical and psychological reasons. If he tries to quit, he gets an unbearable craving and he’s horribly sick. So usually he ends up by using again, and because he’s failed to quit, and is ashamed of that, he uses more.

“For someone young – Jack’s age – it’s especially hard. He doesn’t have a long successful period in his life to look back at for reassurance If he had trouble in school, for example, he may be secretly afraid that he’s never done anything right and he never will be able to. That he’s a failure as a person. And that’s frightening. So he has another reason to take heroin.”

“Now he’s trapped,” Carpenter said. “He can’t get out of this by himself. It’s not just a question of using willpower. Heroin is big-time, it’s one of the most powerful addictions we know. Jack needs help. This is where all of you come in.” Carpenter looked around the table, holding them each in his gaze. “You, each one of you, are at the enter of this. I can offer you direction, maybe clarity, but it’s you who will make this work. You can save Jack’s life. It’s your love that can make this happen.”

“Well, it’s not my field,” Edward said snobbishly. “I’m not an expert. But I’d suggest you get a neurologist, someone who specializes in opiate addiction. It alters the chemistry of the brain. Destroys the dopamine receptors.”

“That’s one theory,” Carpenter said courteously. “Another is that is creates new ones.”

That’s one theory. Harriet felt a thrill, a shock: here was a direct challenge to Edward.

Edward leaned forward. “May I ask what your training is?”

“Daddy,” Julia said, “stop it.

“I’ve given my credentials to Wendell and Julia,” Carpenter said politely, reminding Edward that he was not in charge, “but I’d be happy to give them to you. MSW from the School of Social Work at the University of Pennsylvania, with certification in intervention and treatment of addiction disorders.”

Edward said nothing, betrayed. His own institution.

“Addiction causes changes in the brain,” Carpenter went on, “You’er right about that.”

Edward snorted. He didn’t need Carpenter to tell him he was right about the human brain.

“They now think it creates a kind of supermemory that never fades,” Carpenter said.

“What are you talking about?” Edward asked.

“It’s a new theory from MIT. Certain drugs release surges of dopamine, which create memory. Normally, these memories relate to survival–we get dopamine surges about food, sex, and shelter. But addictive drugs create something they call ‘extreme memory.’ It reinforces drug-taking, reminding the addict how great it is. They think it may never fade, which is shy addicts can be clan for years and then have terrible relapses.”

“I’ve never heard of anything like that,” Edward said dismissively.

“It’s new,” Carpenter said. “They’re doing tests with D-cycloserine, trying to destroy old memories so that new patterns can replace them.”

“D-cycloserine is used for tuberculosis,” Edward informed him.

“At higher doses,” Carpenter said. “These studies were done with rats–maybe you know about them, Harriet?”

Here’s from earlier in the book when the brothers, Steven and Jack, are in the boat in the dark, drifting out to sea:

“I’m coming down,” Jack said, without moving. “Jonesing.”

There was a pause. The boat rose sideways, rocked down.

“What’s it feel like?” Steven asked.

“Like fucking hell. My skin is on fire, I want to scratch my whole skin off. My head feels like someone set off a bomb in it, and I want to throw up. I wanted to throw up all evening.”

Jack put his head lower, between his knees. He began to vomit, his body convulsing with each heave. Each contortion seems terminal, as though it were dragging the last of something out from the interior. He made guttural sounds. The smell was vile.

And as Jack is riding in the back seat of the car with his parents in the front seat and it’s only been a few hours since he took a shot of heroin:

..It was an hour. They’d already started, it was now less than an hour. It was less than an hour.

He scratched his neck, hard, though not hard enough. He should have kept his duffel here with im instead of putting it in the trunk. Have a discreet snort. No, that was crazy, snorting in the backseat while his parents were in the front. He had to remember not to do anything crazy. It was hard to know what was actually crazy. He was beginning to jones, he felt the craving welling up…

…The guitar evaporated and he scratched himself hard. Not hard enough. He could feel the elastic surface of the skin giving way. He could feel his blunt nails breaching the fragile defenses of the skin. He dug harder, deeper. Not hard enough. The itch blazed, the bloom of it tantalizing. He ached to satisfy it.

“Do you think, Jacko?”

His mother was asking him something.

“What?” He leaned forward, tucking his chin down and resting his forehead against the seat, as though to hear better. He didn’t want her to see his eyes, which were certainly pinned, the pupils shrunk to tiny dots, irrefutable evidence of his condition. Though his mother was driving and couldn’t see his eyes. This might be junkie paranoia. Still. He kept his head down. She might look in the mirror, his father might turn.

The parts of the book that she writes from Jack’s perspective, as he is going through withdrawal, doing crazy things to find the drug, are harrowing. Heroin is awful – it’s a death sentence.

The only cure it seems is death. Awful, awful drug. May God protect my precious grandchildren from it. May good scientists find a cure for this addiction.