The Casserole Effect

By Jackie Daniels
Recovery Established 12.15.2000

Note from Phil Valentine: I recently met Jackie Daniels in Indiana. She is a passionate recovery advocate with a winning name! During my keynote, I spoke about The Casserole Measure. It obviously had an impact on Jackie. She wrote a Facebook post and I was impressed. I contacted her to see if we could repurpose it for the Coaching Recovery 923 blog. Here it is.

I recently learned about something called “the casserole effect.” Thank you, Phil Valentine. It stuck with me.

I find out I have a cancer diagnosis, and I’m going to fight it. My family and friends gather around me in love and support, and they don’t shame me or use “tough love” for the illness. Nobody even speaks about “enabling.” They research the specific type of cancer I have, investigate trials and holistic treatments. They promise to take time off work to drive me and sit by my side during chemotherapy. I have great insurance and I’ve met my deductible, but I still expect to be billed exorbitant amounts, and a friend or colleague starts a GoFundMe campaign. No questions about the bills, because it’s life or death.

My school, community, and place of employment make great accommodations so I don’t fall behind. Someone drops off a casserole, calls to see how my loved ones are coping, and celebrates or mourns with my family accordingly. I ring a bell, surrounded by medical staff, if I enter remission. I have a validated, understood medical condition. I didn’t “cause” it. People are sympathetic and compassionate. They bring CASSEROLES to me and my family. I’m never arrested for being sick, and I never have to be alone if I don’t want to be. I participate in walks and am surrounded by other survivors of the same type of cancer, and we’re celebrated for surviving. (Disclaimer: broad generalizations, I know. But….)

OR

I am diagnosed with substance use disorder. In elementary school, I’m taught…

“Drugs are bad, mmm ‘kay?”

I figure out that people who do drugs are bad people who do bad things. I’m told to stay away from bad people. As I enter middle school, I start smoking pot and cigarettes because my friends do, and I know they’re not bad people who do bad things. I even drink beer with my dad. When I’m 18 or so, I get in a car accident/fall at work/sustain a brain injury and am prescribed Norco, Percocet, or Opana for pain or some Xanax for the anxiety and depression that make my family uncomfortable. I don’t sleep/eat/talk/move a lot and become irritable at times. The meds ease the pain and tension, but they don’t remove the memory of the trauma from the injury/the summer fun I missed out on during my recovery/the relationship I lost.

I start to feel worthless and discouraged. My hopes and dreams are replaced by nightmares. I can’t tell anyone because I think I’m crazy and crazy is “bad,” and they wouldn’t understand. My friends change, I’m less honest with my family because I’m ashamed. I visit doctors for chronic pain because legal prescriptions are acceptable. I develop a tolerance to the medications, and nobody explains hyperalgesia to me. I’m prescribed stronger painkillers, and might even get a methadone pump if I’m lucky. The doctor eventually takes me off pain meds, cold turkey, because he’s concerned I’m becoming dependent.

No recommendations for how to cope without them. I begin to seek the drugs elsewhere. The physical pain subsides because heroin works faster. I become aware of an even darker pain – the psychic emptiness I can’t explain. I don’t know where it came from, but I can explain that I was raped or victimized, and maybe I use because it medicates the loneliness and worthlessness I feel. Ultimately, I use involuntarily. I’m a robotic slave avoidant of withdrawal pain. I can feel it in my bones. I just know “more” makes it go away. I become more isolated. I don’t have insurance, and can’t afford a cell phone on my social security income. I can’t apply for state insurance without a phone, and there’s no public transportation in my rural part of the county to visit a healthcare navigator. The only people that visit regularly are the friends that accept my use unconditionally. They stop coming around as they die from the same disease, or go to prison for 3 to 10 years because they can’t stop using on probation or parole, because they’re avoiding withdrawals.

I’m arrested for possession of a syringe. I’m evicted from my home while I’m in jail. I don’t have drugs on me at the time of my arrest, and it’s a clean, unused syringe I started getting from the community harm reduction outfit after I find out I have Hep C, and HIV. I’m so sick when they release me from jail that I use. I get an abscess that leads to an infection that requires open-heart surgery. I move into a nursing home to recover, and then I’m sent home to take care of myself.

My family doesn’t speak to me. I have no one to talk to. I consider suicide. I return to the only comfort I’ve ever known.

Nobody ever brings me a casserole. Nobody asks my family how I’m doing, or offers them a casserole.

See the distinction?

WE DO RECOVER

It’s National Recovery Month. 23+ million people live in addiction recovery in the United States. People recover when we TALK about addiction, and speak out about the hope recovery offers. Don’t ignore, abandon, or shame. Love people struggling like you would someone diagnosed with cancer. After all, they’re both recognized as medical DISEASES, backed by years of scientific study. Why the double standard? Compassion, folks. It goes a long way.

So do casseroles.