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April 9, 2018

My dearest Zoe,


It was eleven years ago today when you came home tired from a weekend of partying with your friends. 


You said you were going to make yourself some tea and go to bed.


And you did, you went off to your bedroom carrying a cup of tea. 


I never thought to hug you one more time that night or tell you I love you with all my heart. 


I wish I had, because I would never have another chance. 


On that night, April 9th, 2007, drugs stopped your heart, and you lost your life at 22 years. 


You overdosed at home, in your bedroom, in the middle of the night.


And that’s how it happens.  And it happens all the time. 


Opioid overdoses happen approximately 115 times each and every day in the United States.


It’s heartbreaking, Zoe, that 11 years later, we’ve identified an opioid epidemic, we know more about this terrible problem and yet people are still dying. Tragically more people are dying today than back in 2007.


With all the smart and dedicated people in this field, finding good treatment is still challenging.  All too often, treatment is ineffective, harsh and not based on science.   The costs can be prohibitive, and insurance coverage is woefully inadequate.


Stigma persists and that keeps many from even seeking treatment.  There continues to be this tragically incorrect notion – held by too many -- that substance use disorders are simply a function of poor character or a failure of will.


Since you died in 2007, I’ve learned much about drug misuse, addiction, drug overdose, prevention, treatment, mental illness, markers, the medicines that treat addiction -- and the life-saving drug naloxone.  John (my husband and Zoe’s step-dad, John Sicher) has been on this learning journey with me.


I’ve come to understand that, at this point in time, two things can make a difference.


One is to focus far more than we do now on the underlying mental illnesses that afflict many who suffer from substance use disorders and drive their misuse.


The other is to expand dramatically the availability of the drug naloxone.  This medicine prevents opioid overdose victims from dying, so they have a chance to get treatment.  Where there’s life, there’s hope.


One day, we’ll have a more broadly-held understanding of what effective treatment is. 


One day, we’ll better understand prevention, with, for example, pediatricians screening early for mental health issues, so interventions can prevent youngsters from self-medicating emotional pain with drugs and alcohol.


That “one day” can’t come soon enough.


But today, we have naloxone, a drug that reverses a fatal opioid drug overdose. 

It is not treatment for substance use disorders.

It does not encourage risky behaviors.

It is a life-saving medicine for someone who has overdosed.


Zoe, we now have it at home, and I often carry it in my purse. 

Schools, restaurants and bars should keep it on hand.  

Naloxone should be in every first aid kit, right along with the bandages and antiseptic.


Zoe, every year I write a letter to you, but this year was particularly challenging.


When you lost your life, I thought if we had the courage to tell your story, we would help break down stigma. 

But stigma stubbornly persists, our country isn’t making enough progress yet on prevention and treatment is too often insufficient or inadequate.  So, more people are dying not less.  Eleven years later, seeing the epidemic worsen, I have begun to wonder how and when things are going to change.


Which bring me back to naloxone.


Until the prevention and treatment of substance use disorders broadly improve and until there is the public and policy will to make that happen, we need to be sure naloxone is widely accessible. 


Naloxone won’t just save a few lives.  It could save the lives of the 42,000 loved ones we lose each year from overdose deaths in the U.S.


How I wish I had had naloxone on April 9th, 2007.


Forever Love,


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