By Sara Schapmann Opioid abuse claims thousands of lives every year, but some people do manage to escape its crushing grip. Emily M.\u2019s story is one of hope in the seemingly hopeless world of heroin addiction. With an excruciating amount of hard work, the help of specialized heroin abuse treatment, and a loving family that didn\u2019t enable, Emily beat the odds. \u201cI needed to run away from myself.\u201d Emily started using drugs and alcohol at age 14. \u201cI smoked weed all day, every day. I skipped class to smoke,\u201d she said. \u201cI did well in school, so no one really bothered me about it.\u201d She also experimented with other drugs like mushrooms and LSD. During college, Emily started drinking more and hanging out with people who did cocaine. Eventually, she transferred to a school in Canada. \u201cI needed to run away from myself,\u201d she said. But Emily would come home during school breaks and party the entire time. \u201cA lot of alcohol and cocaine. Whatever was around. I used some opiates with a couple of friends who did pills,\u201d she said. Despite her substance use, she managed to graduate. After college, Emily moved in with a boyfriend who was using heroin. It wasn\u2019t long before she joined him. \u201cIt started with pills,\u201d she said. \u201cAbout two years later I was using IV heroin.\u201d She was stealing purses from bars to fund her opioid addiction \u2013 until she got caught. \u201cI would lie and say I wanted to quit.\u201d Facing a theft charge, Emily walked out of the courthouse to find her parents waiting for her. She hadn\u2019t spoken to them in several months. They found out about her whereabouts when she missed her first court date and the police showed up at their home with a warrant for her arrest. Her parents persuaded her into their car under the guise of taking her to lunch. Instead, they drove to her father\u2019s house where an interventionist was waiting. After eight exhausting hours with the interventionist \u2013 and with no job, a theft conviction, and the prospect of facing painful heroin withdrawal with no money to buy more drugs \u2013 Emily agreed to enter heroin abuse treatment. But her heart wasn\u2019t in it. She thought, \u201cOh, this is great. I will get a medical detox and will have a low tolerance when I get out, so I can get high easier.\u201d Emily went through the motions in heroin abuse treatment. \u201cI would lie and say I wanted to quit, but I was still talking to my boyfriend [who was also my] drug dealer on the phone,\u201d she said. \u201cIt gave me hope.\u201d Though it didn\u2019t end with sobriety, treatment wasn\u2019t a complete loss. Emily had a therapist who helped her work through underlying issues. "It felt great to be clean for the first time in years." The family therapy aspect of treatment did wonders for her relationship with her loved ones and the ways they communicated. It was also the first time Emily opened up about situations that once brought her shame. For instance, she\u2019d never told anyone about the rape that happened when she was 15. \u201cIt was cathartic getting that stuff out,\u201d she said. \u201cThere were things I shared with people, and seeing their response of, \u2018that\u2019s not okay\u2019 was impactful.\u201d Trauma-focused therapies like EMDR helped her start getting to the root of why she\u2019d felt the need to numb and self-medicate with substances. \u201cIt gave me hope,\u201d she says about that time in treatment. Emily got a taste of what life in recovery could be like, but she wasn\u2019t ready. She thought she would quit one day. Not yet. \u201cPart of me was honest, but inside somewhere, I knew something to be different.\u201d \u201cIt was the \u2018searching-streets-for-cigarette-butts\u2019 level of addiction.\u201d Emily found a job and somewhere to live, but everything fell apart faster this time. \u201cI planned to continue using, but didn't want to get physically addicted, which is impossible.\u201d She relapsed within one week of leaving drug rehab. At her lowest point, Emily lived with an abusive boyfriend for several months. She used drugs and was barely allowed to go outside. They lived in a tiny room and shared a bathroom with the 12 other rooms on their floor in a dorm-like apartment complex. She slept on the floor. Emily would do whatever amount of drugs her boyfriend allowed and cried all day, every day. She hadn\u2019t showered in a month. \u201cIt was the \u2018searching-streets-for-cigarette-butts\u2019 level of addiction,\u201d she said. \u201cI was just absolutely miserable and knew I couldn\u2019t live like that anymore.\u201d \u201cI was completely open to anything anyone could do to help.\u201d One day when her boyfriend was out getting drugs, Emily called her mom sobbing; she needed to leave. Her parents set up everything with The Ranch treatment center, picked her up when her boyfriend was gone, and flew her to treatment. This time, it was different. \u201cI felt like I couldn\u2019t do anything anymore. I was torn open,\u201d Emily said. She had no reservations about being vulnerable, and no energy to keep her self-protective armor intact. \u201cI was completely open to anything anyone could do to help.\u201d When Emily arrived at The Ranch, she started medical detox. The process was more challenging this time because she\u2019d injured her back at some point after passing out from using. Without opioids to numb the pain, physicians helped ease her discomfort with topicals and anti-inflammatory medicines. She was on Subutex to manage cravings and withdrawal symptoms. \u201cI felt like garbage for a month to six weeks,\u201d she said. \u201cI learned everything over again \u2013 like eating three meals a day.\u201d With her emotional defenses down and intrinsic motivation up to get better this time, Emily was able to open herself up to what was being offered. \u201cI had the most amazing therapist I\u2019ve ever had in my life while I was there,\u201d Emily said. \u201cShe was just not hesitating to call you on your shit, which most addicts need \u2013 and she radiated unconditional acceptance at the same time.\u201d Emily drew strength from the group sessions and her peers in treatment. \u201cThere was just so much support from each other, [it was] a great group of women,\u201d she said. \u201cThey loved you until you could love yourself.\u201d She also credits the trauma therapies as well as the spiritual connection she discovered through some of the Native American healing traditions like the sweat lodge. \u201cI think I could have been ready, but if The Ranch didn\u2019t happen, it wouldn\u2019t have ended up the same way \u2013 if I didn\u2019t have that support and couldn\u2019t be in that bubble where I was safe and literally had to figure out how to live again,\u201d she said. At The Ranch, Emily lived in a cottage with other clients where they were responsible for everyday activities like cooking and doing laundry. \u201cI had done it before and I knew how to do it, but I didn\u2019t know how to live,\u201d she said. \u201cI would eat a bag of candy weekly. I had lost 70 pounds. I learned everything over again \u2013 like eating three meals a day.\u201d In heroin abuse treatment, Emily addressed the situational events that fueled her substance abuse and learned to manage her depression, which had also led to her addiction. \u201cI had severe depression episodes since I was a kid that I now manage with medication,\u201d she said. Her anxiety was high and she had a lot of trauma: \u201cThe 15-year-old incident wasn\u2019t the only time I\u2019d been raped.\u201d Emily also explored trauma in childhood. \u201cI grew up in a very loving household, but medical stuff that occurred made me horribly anxious as a child,\u201d she said. \u201cI learned how something [traumatic] can really invade your brain. My brain started functioning differently because I was so terrified.\u201d Armed with a new understanding of her issues and a toolbox of healthy coping skills, Emily left treatment to try her hand again at recovery. \u201cEverything was super bright.\u201d So what helped Emily stay sober those difficult first several months after treatment? Emily said, \u201c[I was] just so happy, honestly, waking up to a whole different world where everything was super bright.\u201d That, and a lot of hard work. When Emily left heroin abuse treatment this time, she moved into a halfway house. Some of the women from treatment also lived there, so she had a built-in support system. She called several staff members at The Ranch on a regular basis. \u201cEveryone was so supportive and offered continued support after I left.\u201d\u00a0 She transitioned into an intensive outpatient program, got a job and went to 12-step meetings every day. With no car, she walked home every night, arriving around 10 pm and leaving around 4 in the morning for work. \u201cIt was intense, but I needed to have a lot of things to focus on so I didn\u2019t think of other things as possibilities,\u201d she said. After five months, she moved into an apartment with friends from the halfway house. They signed a contract. If one of them relapsed, they were out. One of them did. She moved. Emily continued to attend 12-step meetings and experimented with alternatives to the 12 Steps like Dharma meetings. She meditated. All of her closest friends were in recovery. She found a really good sponsor that kept on her about working the steps and had her check in with him every morning and night. \u201cI found a different way to live.\u201d Eventually, sobriety felt like the new normal. Emily worked and enrolled in classes at Vanderbilt University. She graduated with a Master of Science in Nursing. Today she\u2019s a psychiatric nurse practitioner and works at a community wellness center. She\u2019s marrying the love of her life this spring. \u201cHe\u2019s in recovery too, and he\u2019s amazing,\u201d she said. About maintaining her recovery from a drug that has a 90% relapse rate, Emily says, \u201cI found a different way to live. It feels like I\u2019m my true self now.\u201d She doesn\u2019t have those feelings of wanting to run away from herself anymore. She hasn\u2019t had cravings in years.\u00a0 She\u2019s been sober since March 2012. Emily says desiring something different has been a large part of her success. \u201cIt had to be more than just not wanting to be an addict,\u201d she said. \u201cIt wasn\u2019t about fighting against addiction. It was about choosing a different path.\u201d \u201cDon\u2019t enable.\u201d Emily\u2019s advice to the loved ones of individuals caught in heroin\u2019s vicious cycle is \u201cContinue to not enable.\u201d Family members of addicted loved ones hear the phrase \u201cdetach with love\u201d a lot. That\u2019s exactly what her parents did, and it worked. Emily doesn\u2019t think she would have gotten sober had her parents continued to provide her an apartment, car, food and money and rescued her from her mistakes. There was a lot of anger back then, but today she says she can\u2019t imagine what it was like for them, not knowing how she was doing or even if she was alive. She gives them credit for holding those loving boundaries. Emily knew her parents loved her unconditionally and would be there when she needed them. And they were the first people she called when she was ready. \u201cKnowing you\u2019re there for them when they\u2019re ready, and you have hope for them makes all the difference,\u201d she said.