Drug abuse places deadly toll on families

The concept of taking his own life never really registered with Tim Howe until Julie died.

She was one of his two daughters.

Twenty-eight, blue-eyed and blond-haired, she had graduated from Penn State and married a Marine. Outgoing and unafraid, she had tried spelunking and ridden dirt bikes.

An accidental heroin overdose took her life in 2009.

Her father, after early retirement from work as a patent attorney, sank into depression. He thought of suicide.

Therapy helped. Tim Howe realized Julie's death had not been his fault.

"Now, it's just normal grief," said Howe, who is 58 and lives in Upper Saucon Township, Lehigh County. "I miss her."

Howe's experience underscores the relevance of a question that is seldom asked about two topics heavily laden with societal stigma: Are there connections between the nation's soaring number of drug overdose deaths and the steadily increasing number of suicides?

While the effects of a drug overdose death on family members are profound, there is no data to show that they are more likely to commit suicide.

But Dr. Richard McKeon, chief of the Suicide Prevention Branch of the Center for Mental Health Services in the U.S. Substance Abuse and Mental Health Services Administration, said in a telephone interview that there is a significant link between substance use itself and suicide.

The link remains misunderstood. A University of Washington study on addiction-related suicide was awarded more than $500,000 this year by two federal agencies.

A two-death tragedy in Berks County early this year yielded another glimpse of the interplay between drug abuse and suicide.

'Always had a weakness'

Valarie Breneman was 30 years old and had two daughters when she died Jan. 17.

Coroner's office records listed the cause of death as an accidental overdose involving heroin and cocaine.

Her husband, Brett Breneman of Laureldale, knew she was living with another man and that both were abusing heroin.

In what Breneman acknowledged was an unusual dynamic, he remained on speaking terms with both of them.

"I know how my wife was. She tried to be strong, but she always had a weakness," Brett Breneman said. "I felt bad for her. I tried everything in the book to help her."

Valarie Breneman served three months in Berks County Prison in late 2015. She was released on Christmas Eve, her husband said, and went directly to a drug abuse treatment facility in Pottstown.

She left the facility Jan. 13. Four days later, she died in her boyfriend's pickup truck, parked at a truck stop in Bethel Township.

Her boyfriend was distraught, Brett Breneman said.

"He was so madly in love with her," Brett Breneman said. "He totally did not want to be alone. He called me all the time, crying. He was living in his truck at the Bethel truck stop."

The boyfriend, a 43-year-old man whose last known address was in Muhlenberg Township, was found dead in his truck Feb. 11 in a parking lot in Reading. He had killed himself using a combination of heroin and asphyxiation, officials said.

His name is being withheld by the Reading Eagle because a family member did not respond to requests for an interview.

According to the Berks County coroner's office, of the 227 drug deaths since Jan. 1, 2014, 12 have been suicides.

Coroner Dennis J. Hess said he sees a correlation between substance abuse and suicide.

A drug user, he said, starts out seeking a high. The path might then lead to hard-core drug use, arrests, multiple rehab stays and destruction of relationships with family members.

When rehab and their parents cannot help, Hess said, "What else is left to them?"

Many factors involved

Survey results published by the Substance Abuse and Mental Health Services Administration in September showed 4 percent of U.S. adults had suicidal thoughts in the preceding year.

Among adults who had used marijuana in the preceding year, though, the percentage who had suicidal thoughts was 9.8. Among those who used heroin, the segment that had suicidal thoughts was 17.5 percent.

But suicide is a very complex phenomenon where individual cases usually cannot be traced to one cause, according to Fred Redekop, a professor in the Counselor Education Department at Kutztown University.

Hence, prevention is not simple.

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Suicide numbers

A federal survey during 2015 yielded the following:

• 9.8 million, or 4 percent, of adults considered killing themselves in the prior 12 months.
• 2.7 million of those people made plans.
• 1.4 million lived through an attempt.
• More than 42,000 people took their own lives in 2014, the latest year for which data are available.

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"You so wish there would be one unique risk factor, like, 'If they exhibit this, then we know,' " he said. "There is no substitute for a real thorough awareness of the risk factors."

Those risk factors include a history of mental illness, a history of alcohol or substance abuse, previous suicide attempts, family history of suicide and the experience of maltreatment as a child.

Dr. Carolyn Ross, a Colorado-based addiction medicine specialist who has written about addiction as a risk factor for suicide, said many people who abuse drugs have mood or anxiety disorders.

"They are self-medicating, unknowingly, with substances," she said. "And these are people who haven't been diagnosed."

In addition, Ross said, many substance abusers have a history of trauma and deal with the memories via drug use.

A general goal of treatment, she said, is to keep people free of drugs long enough to start dealing with the problems prompting the drug abuse.

George J. Vogel Jr., executive director of the Council on Chemical Abuse, said the mix of drug use and what he called psychological behavior causes outcomes that cannot be attributed to one or the other.

He said, "It is a combination of the two that may have led the person to contemplate serious thoughts of suicide."

'They just weep'

In 2014, there were 47,055 drug overdose deaths in the U.S., an increase of 179 percent from the 16,849 deaths recorded in 1999. At the same time, there were 42,773 suicide deaths in 2014, an increase of 46 percent from 29,199 deaths in 1999.

Tim Howe's battle with depression allowed him and his wife, Nancy, to see common ground in the discussions of the two trends.

Three years ago, Nancy Howe formed a Lehigh County chapter of a national organization called Grief Recovery After a Substance Passing, or GRASP. The meetings have shown her that the shattering experience she and Tim endured is not unusual given the circumstances.

"You can just see the people who come in the group," she said. "If the loss was not too long ago, they just weep. They can't even speak."

She believes unexpected drug overdose deaths must contribute to the risk of suicide among close family members.

Nancy Howe's own grief, she said, has never caused her to think about suicide. It's more of a longing for something that cannot be.

"There are times, with me, that I miss her so deeply that I just wish I could be with her," she said.

Contact Ford Turner: 610-371-5037 or fturner@readingeagle.com.