'Strung Out' Tackles Pain, Stigma And Shame Of Drug Use

Drug addiction continues to be wildly misunderstood and deeply stigmatized in the United States.

We've witnessed this in its many and varied degrees. Take the headline of this recent New York Times profile by Brooks Barnes as one casually awful example: "Ben Affleck Tried to Drink Away the Pain. Now He's Trying Honesty." The implication here is that drinking and honesty are opposite tactics, making drinking away one's pain an automatically dishonest act. I don't really care about Ben Affleck the celebrity — what bothers me about this kind of framing is how it perpetuates the narrative that using substances is inherently amoral, reinforcing the shame that already surrounds those living with, or trying to recover from, substance use disorders.

In her new memoir, Strung Out: One Last Hit and Other Lies That Nearly Killed Me, essayist and advice columnist Erin Khar writes candidly and at length about this particular difficulty:

"Shame is a gatekeeper. Shame takes old shame and turns it into a new shame. The heroin helped push the guilt to the side. The grief I couldn't acknowledge stayed buried underneath, pulsating but muzzled, like a drugged dog. The high coated me with enough apathy to make it through the night."

This shame, clearly compounded by the stigma surrounding her drug use, didn't originate there for Khar, but rather in early childhood trauma. The first time she escaped the pain of being inside her own skin, when she found a bottle of expired Darvocet pills (a pain reliever in the opiate category) and took one, she was only 8 years old. When she was first offered heroin and tried it, she was 13.

Strung Out begins here, with Khar's introduction to heroin, and moves chronologically forward as she tries to but doesn't get the support, love, and acceptance she needs from her distant father, who mostly throws money at the problem of his daughter's unhappiness, and her mother, who was dealing with her own relationship turmoil and grief. One of the strengths of the book is Khar's frank discussion of her relapses, the profound difficulty of those experiences and their utter mundanity.

In 1997, she completed her first inpatient rehab program; about ten months later, shortly after moving in with a man she deeply loved, she went to see a friend at a boutique, and demanded the friend share her heroin. Soon enough, she was using daily again and suffering withdrawal symptoms all too often. "Every time I started using heroin again," Khar writes, "it didn't feel like a consequential decision. I realize this is not a satisfactory answer for most people. The critical thing to understand about addiction is that my decision to get high, to get low, to exit, had been made long before the drug entered my body." In other words, drugs were a coping mechanism for her buried trauma and unaddressed mental illness.

It's notable that Khar makes no secret of the particular advantages she grew up with — her white-passing privilege, her parents' affluence — and doesn't claim at any point in the book that there is one correct pathway towards recovery. She knows that she had access to facilities and healthcare and a safety net that other people didn't. Kathie Kane-Willis and Stephanie Schmitz Bechteler wrote for The Chicago Reporter in 2018 that the prevailing perception in the U.S. "is that African Americans are more likely to use drugs. And not just any drugs, but especially 'hard drugs' like cocaine and heroin." That perception is false — the rate of substance use disorders among white people as of 2018 was higher than that among African Americans (and Latinx/Hispanic people, Native Hawaiian and Pacific Islanders, and Asian Americans).

Khar touches upon these inequalities at various points in the book. In her case, it wasn't only access to care that led to her recovery, but a pregnancy. Staunchly feminist and pro-choice, she was nevertheless haunted by an abortion she'd had some time before, and when she learned she was pregnant again, she decided she wanted to carry it to term. Reaching out and asking for help this time wasn't only for herself — a self she still loathed, a self that would still take her some years to reconcile with — but for the potential of this new human being as well.

This book, in a way, is a prolonged answer to that human being, Khar's son Atticus, who asked her one day when he was 12 whether she'd ever used drugs. It is an answer that Khar hopes to share with others too: "When we write the truth, when we write about our experiences, we reflect back what it means to be a human being. And that reflection creates connection."

And connection, we can all hope, can reduce stigma, and shame, and pain.

Ilana Masad is an Israeli-American fiction writer, critic, and founder/host of the podcast The Other Stories. Her debut novel, All My Mother's Lovers, is forthcoming from Dutton in May 2020.

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