Angela Maccarter remembers playing a game called Don’t Wake Daddy. There was a board game by that name, and for most kids, that’s all it was: a board game. But for Angela and her sister Melody, it was real life.
Angela remembers crushing baby aspirin into her father’s mashed potatoes to try and poison him. She remembers hiding in the closet to call 911 when her father beat her mother.
Angela and Melody used to hold each other in bed at night, promising each other that the next morning at school, they would tell the principal on their daddy.
They never did.
When Angela was 6 years old, she saved her father: He’d taught her CPR, and she used it on him when he stopped breathing after ingesting too much of his own opioid and alcohol mixture.
“Even when I was 4 or 5 years old, I knew what he was doing was wrong, and what my mother was doing by staying with him was wrong,” Maccarter said.
So, when Maccarter, at 21, looked in the mirror and saw her father in herself, she was horrified.
“I was a full-blown IV drug user before my 21st birthday,” she said. “I despised my father for the pain he caused me.”
“’How did this happen?’” she asked herself.
The broken childhoods of opioid addicts
It happens a lot. Children who grow up in abusive households where this is already drug use often end up abusing drugs themselves.
A recent study from the University of Vermont specifically shows that emotional abuse during childhood leads to opioid addiction in adulthood. Researcher Matthew Price, an assistant professor of psychology at Vermont, started his research with the following observation: “Why is it that folks who misuse opioids also seem to have a lot of rough trauma history and a lot of mental health issues going on? How do these folks come into this situation?”
“In early life, they had some adversity as kids, and then they started misusing substances,” Price said.
Price said that emotional abuse is even riskier for addictive behaviors later in life than physical abuse.
“If you are abused in a way that has a physical component, someone else is very clearly the perpetrator,” Price said. “Emotional abuse is a little more insidious.”
That’s because emotionally abused children often hear that they are something negative, he added. “The person has to deal with the fact that they have been called these things; they are swirling around in their head.”
Often, these children haven’t learned proper coping mechanisms, and so whenever there is a negative trigger to their feelings of negativity, they are wired to having a “flight or fight reaction,” he added. And that’s when they begin to self-medicate with drugs, and opioids in particular.
Maccarter’s father abused everyone in the family; her sister, who had learning disabilities growing up, bore the brunt of comments like, “You’re stupid.”
“She still believes that she’s stupid,” Maccarter said. “Neither of us have learned coping skills.”
Instead, Maccarter learned drugs.
“By the time I was a pre-teen, drugs would numb the emotional pain. That was an easy, simple fix,” she said.
Stomach problems, which were brought on by anxiety, morphed into Crohn’s disease, which kept Maccarter in and out of the hospital—where she could get opioids from an early age.
“I learned how to manipulate the system pretty young,” she said.
By the time Maccarter was 18, she was going through 200-250 hydrocodone pills per week.
“It didn’t take me long to graduate to heroin,” she said.
Treating emotional abuse and addiction in tandem
Maccarter was 19 when she first went into rehab. It would take another ten years—in and out of rehab six or seven times—to come clean. She has been clean since Dec. 13, 2013.
What worked for Maccarter is an approach that Price suggests in his study: treating mental illness and addiction in tandem, rather than separately.
“Historically, the treatment model was you treat one, then the other. First substances, then depression,” Price said. “It’s hard to do better on either if you don’t do both at the same time.”
But the literature is showing that tackling both at once produces better outcomes, he added.
Anecdotally, that’s been true for Maccarter.
“They call me a dual diagnosis,” she said, referring to her anxiety, depression and PTSD, as well as her addiction.
She was treated at Coastal Horizons Center in Wilmington, in a “wrap-around program” with medication-assisted treatment to get people over the hump of addiction cravings.
“Then they set you up with a therapist to purge these emotional experiences,” she said.
Nearly 80 percent are sober four months later, she said.
Maccarter, now 31, went back to school for a certificate in early childhood education.
“I know that there are a lot of children out there right now that are in these patterns, and it’s not a happy way of life,” she said. “It’s a very helpless feeling. Children don’t have that voice to say: ‘Hey, I don’t like what’s happening in my life.’ It can scar very deeply.
“Now that I’m an adult, it’s been switched around to where I can take control, and I will, if I see a child that’s in need, in danger. Or one that has experienced what I have.”