Congresswoman Madeleine Dean thought she understood addiction – but it wasn’t until her son Harry Cunnane was struggling that she came to truly realize what it means when a loved one has a substance use disorder. Now Harry has been in recovery for more than eight years, and mother and son have written a joint memoir, Under Our Roof: A Son's Battle for Recovery, a Mother's Battle for Her Son.

Heart of the Matter podcast host Elizabeth Vargas speaks with Madeleine Dean and Harry about what they gained from writing their book, what it means when people refer to addiction as a family disease, and the importance of amplifying the possibility of recovery – not just the horror of active addiction.

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Episode transcript

Elizabeth Vargas

Hello, everybody. Welcome to “Heart of the Matter.” I am your host, Elizabeth Vargas, and it feels like… I don’t know. If you’ve been reading newspapers or watching television news, it feels like politics has invaded every single corner and aspect of our daily lives, so perhaps it’s no surprise that there’s also a bit of a political divide when it comes to the topic of addiction. And our guest on today’s podcast, actually, is a member of Congress. She is Congresswoman Madeleine Dean, representing Pennsylvania’s 4th District. Many of you may remember her as one of the impeachment managers for President Donald Trump’s second impeachment trial in the House of Representatives, but we’re not talking about that today. We’re not talking, actually, even about politics today. What we’re talking about today is the fact that Madeleine Dean and her son Harry Cunnane have written an extraordinary book about Harry’s battle with drug and alcohol addiction.

Madeleine Dean is… I actually saw in, when I read her book, a lot of myself as a mother. She was on it. She was strict. She was forceful with her kids, tracked them closely. Wasn’t a helicopter mom, because I think that has a bad connotation, but she was a careful mother paying close attention, and yet still, her son Harry developed a debilitating and devastating addiction to drugs and alcohol. In fact, Madeleine tells me at one point, she thought she understood addiction and didn’t find out until her son really struggled with this that she truly “had no idea about this disease.”

Since this podcast is part of our Partnership to End Addiction sort of series, we like to do stories and have guests on our show who are experienced in family recovery, and they are certainly experienced in it. The book is written in dueling chapters. Madeleine will write one chapter about what it was like from her perspective, and then Harry writes about what it was like from his perspective and how he finally hit bottom, how he finally got sober, and what parents can do and should do to help their kids who are struggling. It’s an incredible book, and I really, really am thrilled to welcome Congresswoman Madeleine Dean and her son Harry Cunnane to “Heart of the Matter.”

Madeleine Dean and Harry Cunnane, thank you so much for being with us and joining us on “Heart of the Matter.” It’s great to have you, and congratulations on this extraordinary book.

Harry Cunnane

It’s great to be here. Thank you.

Elizabeth Vargas

It’s really amazing. You have written this in basically two parts. Madeleine, you wrote your part, and Harry, you wrote your part, and I was surprised, because they’re mixed in throughout the book, that neither of you read what the other was writing until you were finished. What did you learn about each other’s stories?

Madeleine Dean

Harry, you want to go first?

Harry Cunnane

Sure. I mean, to sum it up, I learned so much. Going through the recovery process, I knew and had a sense of how much harm and damage I had caused in my active addiction, but to really go back and read the things that my mom wrote that she was feeling was really impactful. I think to understand… Also, there was a lot of time where I thought I had people fooled longer than I did, because in the beginning, I knew I had everyone fooled, but for a little while there, the turmoil that my mom was in, my dad, my entire family, when I thought I was still kind of getting away with it. It was painful to read about the pain that I put them in, and worry, and fear.

Elizabeth Vargas

It’s a true family disease. I think we tend to forget that. Madeleine, I was struck by… especially when Harry was writing about some of the things that he experienced in active addiction, it’s terrifying. I’m the mother of two teenage boys, and I read this is a mom, and it scared me.

Madeleine Dean

Well, it scared me to read it, because I thought I understood what we had been through. And just by way of process, Elizabeth… First, thank you for having us, but by way of process on the book, what we did was we created an outline, Harry and I. Sort of chronological, what we thought the chapters might include with our own time frame, but we purposely didn’t want to read each other’s work so we didn’t blur our own memories. I guess we got about halfway through, Harry, when we first read each other’s first half of the book.

To your point, it was originally what I think was chapter five, and I would call Harry, and I’d say, “I actually am having a hard time getting through your chapter five,” because it was so painful. While I knew he was in distress, I knew he was in difficulty, I had no idea how addiction had hollowed out his gorgeous personality to the depths and the extent that it took him to such dangerous places and dangerous habits. So I kept saying, “I really can’t get through chapter five.” It’s no longer chapter five. It’s earlier on in the book, but it was painful to read.

Elizabeth Vargas

Tell me why the two of you decided to write this and to be this honest about what was such an extraordinarily painful time in your family’s history.

Madeleine Dean

Well, it really wasn’t our idea. This was the summer of 2018. I was running for Congress for the first time, and it was our eldest son, his brother Pat, had written a book in the past, and his agent came to him and said, “Are you ready for your second book?” And he said, “No, I don’t think I have a second book now, but my brother and mother might have an interesting story to tell.” And so, that was literally the idea. Pat suggested it to us. His agent came to meet with us, sat on our patio, and we talked about it, and I think, Harry, we both immediately said, “Yeah, this sounds like a great idea.” And we both immediately envisioned separate tales, even envisioning that mine would be one font and his would be another to signal our different voices and our different experience. So, we immediately embraced the idea. What do you think, Harry?

Harry Cunnane

I think once we agreed to do it, there were a couple things that really… the agent, right away, one of our questions was, “Can we help somebody with this?” And that’s something that we held onto. We wanted to share a story to try to help others, to share a story of hope. For me, being in recovery, something that I thought was important was to really dedicate a large portion of the book to recovery. So much of what you hear in the media and in other outlets is the horror stories, and if recovery is a part of that story, it oftentimes looks like a footnote. And I wanted to show what the recovery process looks like, because it’s a little bit messy and difficult, but there’s so much hope and so much possibility that’s there. I think to help others and to really break down that stigma, we’ve got to share the possibility that’s out there through recovery.

Elizabeth Vargas

You talk about that stigma, both of you, and that’s a really key… I mean, every single one of my guests on this podcast, most of whom are in recovery themselves and have gone on to extraordinary things in their lives, that’s the reason I want them to tell their stories, because we know that a third of all Americans think that if you suffer from addiction, it’s a moral failing. They don’t understand that it’s a sickness, it’s a disease. And if we just write off people who struggle with substance use disorder, we’re writing off an extraordinarily amazing group of people, and that’s part of the reason why I like having people in recovery to talk about that.

But because of that stigma, I was struck my something Michael Botticelli said recently. He was President Obama’s “drug czar,” and he’s been in recovery, and he was in recovery for 20 years when he said… Senate staffers, as he was getting ready to come before the Senate for his confirmation hearings, one Senate staffer said, “You’re never going to get confirmed, because you’re an alcoholic.” And it’s striking. I mean, he went on to get unanimous confirmation, but there were people in the Senate staff who believed he couldn’t get confirmed because he had once, 20 years before, been an alcoholic. Madeleine, does that surprise you?

Madeleine Dean

Oh, gosh. Yes, but maybe it shouldn’t. So many people are in the dark, and even if you’re in that high chamber, you could still be in the dark, but particularly a staffer. It’s a stunning recognition that stigma and shame connects to mental illness, to the disease of addiction, and that was really another one of the reasons we wanted to write the book. We thought, “If we can tell people that this happened under our ordinary roof, it can happen under anybody’s roof, and it is not something to be ashamed of. It’s something to lift up, shine a bright light on, and get people help.”

Elizabeth Vargas

You actually said in the book, though, Madelei ne, at one point, you were afraid that somebody running against you would use that against you in a campaign. Like, “She can’t manage her own house. How’s she going to manage our district?” Have you seen any blowback like that?

Madeleine Dean

No.

Elizabeth Vargas

Good.

Madeleine Dean

Yeah. I’m pleasantly surprised. I’ve not had any blowback like that, or if I have, they’ve kept it from me, because I haven’t read or seen it. No, my opponents wound up using other really bogus things to complain about me about. And I always thought… When we decided to do this, I said to Harry, “Are you comfortable with being this public?” And I said, “I am, at this stage in my career and this stage in my life,” and he was at that point six years, I guess… almost six years in recovery when we started this project. I do think if it had been much earlier in his recovery, I would’ve been very hesitant for him. I wanted him confident in where he was.

Elizabeth Vargas

I want to read, Harry, something… it’s actually from two different portions of the book, and one of these is from the very beginning, and one of them is much further in, and I’m struck by the connection between these two portions and, as someone in recovery myself, how much I related to this part. You wrote, “As far back as I can remember, I saw myself as an outsider. I vividly recall crying at night as a kid, never really understanding why. It left me with a sense that I shouldn’t or couldn’t let anyone know how I really felt, a subtle, growing fear that if people got close enough to see who I really was, the little kid who cried himself to sleep, they might not like me anymore.”

And then you go forward, much further on in the book, and you say, “During active addiction, I had built walls around myself, protecting me from exposure, pain, and abandonment, yet these same walls were now working against me.” I really, A, related to that. I did the same thing. I felt the same way. I had panic as a kid. I felt I had to hide it from everybody. But talk a little bit about… Because I think that’s the crux of why people turn to substances. They don’t feel okay. And what you don’t realize is that the very life skills that we use to survive, keeping people at arm’s length so you can’t see how vulnerable I am or how anxious I am or how miserable I am, backfire when it comes to reaching out for help when you’re struggling with substance use.

Harry Cunnane

Absolutely. I mean, I’ve heard more recently, the opposite of addiction is connection. Right?

Elizabeth Vargas

That’s our campaign.

Harry Cunnane

And I think that that’s so important, because everything about my active addiction, although it was masked in the beginning, with a sense of using with friends, and as it started out in this trying to feel a part of when I did it. But really breaking it down and looking at the substance use as a symptom of what’s going on, and it worked in the beginning, and it numbed those feelings, and it made me feel connected. It made me feel a part of a group of friends when I was so fearful.

But at the same time, you continue that because it’s working at first, and all of a sudden, you find yourself in this spot where that shame and that stigma kicks in where I didn’t feel like I just had a disease. I felt like I was a bad person, because the actions that I took in order to continue using went against everything that I believed in. I didn’t want to be this lying, manipulative person. I wanted to be the type of father that I saw in my dad for my own daughter, and I found myself incapable. That’s when those walls come up, because then it’s those fears as a child when there’s really nothing backing it. You build up these years of negative actions that just fuel that need to… If anybody knows what’s going on, they’re going to want nothing to do with me.

And what was such a shame was in reading my mom’s part of the book and through processing it was I truly felt that even my parents, who loved me unconditionally, if they knew, they would be so devastated, they wouldn’t want anything to do with me, because that’s how bad I felt. And that’s, I think, the stigma and the shame that gets internalized that just is killing people, because I would’ve rather died at times than ask for help. Because to ask for help was to expose that massive secret and the years of secrets.

Elizabeth Vargas

And something that you learned as a child, that, “I have to keep this part of me hidden.” In other words, we start hiding our fear and our anxiety. We later learn to hide our addiction.

Harry Cunnane

Exactly.

Elizabeth Vargas

But it’s all connected. You started using alcohol in high school. Did you try drugs? I can’t remember the progression off the top of my head.

Harry Cunnane

Yeah. So, for me, alcohol came first, and very quickly, I started smoking marijuana. That was sort of my next step, and that became an almost daily thing right away, and then it just continued to snowball from there. But I remember the lead-up to when I was using, and I had been through the D.A.R.E. program, and I had this information that I swore I was never going to do drugs. Alcohol seemed acceptable. Even my parents, who I admired, drank alcohol occasionally, but once I tried alcohol, that hard no I had on drugs became a whole lot easier to say yes to, because I had felt the effect. And if alcohol could do this, what does marijuana do? What does cocaine do? And that’s where it snowballed. It was one small step at a time to something that I just couldn’t see coming.

Elizabeth Vargas

Madeleine, you write in the book, “Families fall into patterns, and I had fallen into a pattern of my own: the warrior mother who tries to pull the truth out of her son while standing in defense of him in public.” You write very honestly about the fact that you saw all sorts of warning signs. You tried really hard. You asked a lot of questions. You badgered him. You were tough. Why couldn’t you penetrate that wall he had around him? Why do you think… What is it you wished you’d done differently, looking back?

Madeleine Dean

I tried to rack my brain to figure out what I could’ve done differently. It was certainly an imperfect path. We were battling for years. I attempted drug tests. He took drug tests, and it was a strange dynamic in the house where I was fighting him, he was fighting, manipulating, lying to us. And yet, as you said, in public, I defended him, and I believed in defending him. I believed he had a right to a mother’s love and defense for his best good. But what I wish is that maybe we would’ve brought professionals in sooner, maybe even just to build our relationship to a healthier spot, and maybe that would’ve revealed more of what was going on.

I thought from early on that Harry was… Imagine, in the very beginning, I thought, “Well, it’s youthful experimentation.” But pretty quickly, he was doing poorly in school, total change of friends, total change of affect and look, and so I wish I had… We did confront you. We did say, “We think you’re using drugs,” and… He was a very good storyteller, and he’d tell another tale, I always say, that would make his Irish grandmother proud, because he could tell a story or two. I guess I wish I had been smarter about understanding what addiction really looked like, what it looks like for whether you’re a white suburban kid or you’re an inner-city person or a rural American person. I wish I had understood what addiction really looked like the way I now understand it.

Elizabeth Vargas

Yeah, that’s something you both talk about in the book, about white privilege when it comes to addiction, and we know this in this country. We criminalize crack cocaine much more so than powdered cocaine. It’s the same drug in different forms, and yet people go to prison… mostly inner-city Blacks go to prison, and Hispanic people go to prison, for using the same drugs. Harry, you’re very honest in the book about the fact that you… police officers many a time said, “Here’s your pot. Go home. I’ll arrest you if I see you again, but just get in your car and drive home.”

Harry Cunnane

Absolutely. I mean, for me… for anybody who’s on the fence about white privilege, just look at my story and what happened to me. And I think a big part of that was we lived right on the fringe. Right? We lived in this nicer, middle-class neighborhood just outside of North Philadelphia, so I would go and I would use in North Philadelphia, and the way that I was treated… I like to put it, it was unfairly fair. I was always given a break. I was always given a second chance.

In hindsight, what’s so sad is how many people… I did some volunteer work in one of the local jails, and just the number of people who are incarcerated for the things that I did every day, and not just the short term, but the long term impact that that has. When we criminalize the disease of addiction and look at it, you put that permanent mark on somebody’s record, and let’s say they get to recovery. How much is that holding them back to be able to do the things that they’re capable of, that they could and should do but maybe can’t because they have a record?

Elizabeth Vargas

Right.

Harry Cunnane

We’ve got to find solutions to that so that it is just and it is fair and it’s not this inequitable system that punishes some and lets others go.

Elizabeth Vargas

You eventually found your way to Percocet in your drug use, and in the book, you write of finding out you were going to be a dad. And this was one… I actually had to put the book down for a few seconds when I was reading this part, because it was very powerful. You had decided to, on your own, which is unbelievable, get clean from Percocet so that you could be clean and sober for the birth of your daughter, and you were. And that night, you go to the parking lot in the hospital, and you get high again. Can you… I mean, I think… help our listeners understand? I mean, if there isn’t a more graphic example of the power of this disease, I don’t know what is.

Harry Cunnane

I think it shows the power of the disease and the way that it can get you to do something that all rationale would tell you otherwise, but I think it also shows the ignorance that I had to what the disease was and I think that so many others have. I had this idea of it’s sort of just this physical dependence. Right? And once I had weaned myself off it, gotten clean before my daughter was born, I was no longer feeling withdrawal symptoms. I thought I had it beat, and I remember thinking that night, “It’s just this one time to celebrate.” And at the moment, while I was getting ready to snort the pill, and I’m breaking it down, I’m telling my friend and dealer, “Hey, this is how I did it. This is how I beat this thing.”

Elizabeth Vargas

“This is how I got clean.”

Harry Cunnane

Just, “If you ever want to do what I did, let me know,” as I’m about to snort a line, and that just shows how insidious it can be in my mind, because I was both very aware of what I was doing but also completely blindsided by what that decision was going to do and how that would alter the rest of my story. And that next year of my life was hinged on that one moment.

Elizabeth Vargas

Right. Because you were off and running and doing that calculus of, “If I just do a little bit, I’ll feel well enough to be able to read my daughter a book at night and function as a normal human being.” Madeleine, you write in the book how many times over all those years when Harry was using that you would take him to the hospital, and he would… the doctors would come up with other… “It’s an allergy, a weird allergic reaction to something.” I mean, it’s unbelievable the journey and the deception on Harry’s part.

Madeleine Dean

Oh, the deception is so haunting, and it’s just awful. Harry had gotten into a pattern of getting very sick, vomiting. I’d hear him in the morning, waking up, vomiting. Or he’d go up in the middle of the day, and he’d be vomiting. And so, I convinced him to go to the doctor, to try to figure it out. He had, as a child, had an intestinal problem, a digestive problem, where he threw up every day for almost a year, and I took him at that time down to CHOP, and they diagnosed what it was, and he wound up… sort of an ulcer-like condition, and he wound up taking Tagamet medication, which cured it. So, in my mind, I thought, “Here he is vomiting again. Maybe it’s a connection to that original childhood disease that he had.”

Elizabeth Vargas

You didn’t think it might be drugs?

Madeleine Dean

I didn’t understand the not eating thing, and I didn’t understand that portion. Again, if I had educated myself a little better, but I made in my mind this connection that maybe this was a return of that ulcerative condition, and Harry went along with me. We made one doctor’s appointment, and I remember they said, and I said it to him affirmatively, I said, “Harry, they have warned us, if you have anything in your system, it could really be a problem for how they’re going to try to treat and diagnose you.” And I remember we canceled one appointment. Harry gave some other excuse, but I now believe it was because he knew he had something in his system. And so, we went, and I continued down that path as I still was battling with him, fighting him, drug testing him. I was a mother trying any avenue to a solution.

Elizabeth Vargas

Do you think you were also a mother, maybe way down deep inside, looking for any other problem to solve other than addiction? In other words, I can only imagine there was a desperate hope that “Maybe it really is just an intestinal thing. Maybe it really is a bizarre allergic reaction to something that he was exposed to causing this illness, and not drugs.”

Madeleine Dean

Oh, I’m sure. Somewhere in the pit of my stomach, or in my heart, I wanted it not to be what I believed it to be, but I had a sense of the desperate shape we were in. I had an expression in those days where I said, “I feel like our house is on fire, and I’m the only one who knows it.” It just felt like there was a fire in the walls of the house, and that fire, I thought, was likely connected to his drug use.

Elizabeth Vargas

Why do you think you were the only one who knows it? I mean, we talk about this family disease. It impacts different members of the family differently. Often, husbands and wives have different opinions on what we should do about our child. Were you and your husband on the same page? Because it sounds like, reading from the book, you were the real enforcer in the house. You were the one standing outside the bathroom door with a drug test.

Madeleine Dean

Yep, I was the one leaving the door open so I’d make sure it was Harry who was filling the cup. My husband and I were of one mind in terms of our love and passion around Harry. We were of one mind in terms of our worry over the change in this young boy who bounded into high school with the greatest enthusiasm, set of friends, heart, and who went out of high school, practically had to be dragged out to just get over the finish line. All of his beautiful talents were draining away from him. But my husband’s approach was different. Elizabeth, I have to tell you, he actually wrote a chapter for the book entitled I was There Too, and we don’t want people to…

Elizabeth Vargas

That’s perfect.

Madeleine Dean

This is a whole family story. I’ll share that with you. I’ll have to email it to you.

Elizabeth Vargas

I’d love to read it.

Madeleine Dean

We offered it to the editor, who said, “No thank you.” But his attitude, I think, was different, informed by his own childhood. Mine was informed a little bit by my own upbringing, and his informed by his. He smoked pot as a young kid. He smoked cigarettes. He quit both of those on his own, and so I think he was informed by his own experience. But I was definitely the bad cop, and poor PJ was trying to keep peace in a house that was not peaceful.

Elizabeth Vargas

It all finally erupts and comes to… I mean, all the walls are broken down when Harry, you’re caught stealing money from your parents with their ATM card, and there it is in black and white in the bank statements, Madeleine, that you went and got from the bank. I think I had a pit in my stomach reading about your meeting with the bank manager when he shows you the withdrawals and you realize, “Of course, that’s where the money’s going.” And Harry, it’s something… you’re confronted with evidence that you can no longer spin a tale to fix.

Elizabeth Vargas

And you agree, at that point, to go get help, to go to rehab, and you write in the book… You had just taken a little bit of Percocet, I think. “It was a turning point in my life, though I had no idea how significant. I felt a brief moment of calm, and not just from the drugs dissolving in my bloodstream. There was peace in my mind and a slowing of my racing thoughts. The truth had come out without killing me. I wasn’t disowned or even yelled at. I had been obsessed with covering my tracks. It had kept me from seeing that all my parents wanted to do was to help me.” Can you talk about that moment, that realization? It’s like you finally stopped running, and you realized no one’s chasing you.

Harry Cunnane

That’s exactly what it was like. It was years of running and just being so exhausted. And to go back just a little bit from that moment, you talked about I had no story to spin when I was confronted that time. My mom mentioned something a few days before that I was confronted, so I knew it was coming. I knew I was… and I had three or four days to think about it, and I spent those days trying to come up with something, anything, that would be believable and buy me more time to get out of this. And I realized, by the time that I was confronted, I was just too exhausted. I was broken, and I had nothing left. And it’s important in that moment, I didn’t know a single person in recovery. I couldn’t identify what that looked like. I didn’t know anyone, especially anyone my age, who was in recovery.

Elizabeth Vargas

How old were you at that point?

Harry Cunnane

I was 22, and all I knew were friends who had been to treatment, came back, and came right back to me and the group and were doing the same thing. So, I had no exposure to what was possible or what treatment looked like and what recovery might look like. But I just knew in that moment that if nothing else, I was willing to try something, because I had been so crushed emotionally. This feeling was part of it, but really, that last year, it was just a couple days after my daughter’s first birthday. From the moment in the parking lot at the hospital to that day, just the self-loathing that went along with using against my will, with this new baby that I’m trying to be a father to, had devastated me, and I was just broken and willing to just see what else was going to happen, because I knew my way was not working.

Elizabeth Vargas

You agreed to go to treatment. I had to laugh at some of the… You’re like, “Four weeks? That’s forever!” And you end up staying for four months, because you, after spending a month at Caron, went to a halfway house, basically. Sober living. I’m curious. It’s funny that society… and Madeleine, I want to talk to you as a Congressperson in a moment about insurance companies and why they do this, because you’re one of my rare guests on this podcast who has the capacity to actually effect change.

But insurance companies routinely deny coverage and say, “Two weeks should be enough,” or, “How about outpatient?” Or, “We’re not going to pay for Caron, because it’s way too expensive, but we’ll pay for this cheaper version over there,” that is cheaper for a reason, sometimes. Tell me about… I’d like you both to weigh in, Harry, you first, and then you, Madeleine, on this expectation that anybody goes away for 28 days and they come back cured. I suppose there are people out there who can go for 28 days and come home and never drink or pick up a drug again. There are some people who go to an AA meeting and find sobriety and recovery there. But recovery isn’t like… it doesn’t happen like that.

Harry Cunnane

Absolutely not. I mean, when I went, that was all I ever heard of, was the 28 or 30-day… that’s what rehab was. You went to rehab, and you came back. It showed, also, my limited understanding of the disease of addiction, because I looked at it when we were driving up there as, “Yeah, that’s enough time to detox me and get it so that my body is no longer physically dependent.” But it isn’t enough time, or wouldn’t have been enough time, for me to make the other changes that I needed to make as a person in terms of my behavior and my belief system so that it could be sustainable. I had never heard of this longer-term treatment before I got there, and I was in for a week or two, and I started hearing rumbles of aftercare and continuing care. I was terrified. Right?

Elizabeth Vargas

Yeah.

Harry Cunnane

You said it, and it’s funny in hindsight, but I still… I wound up… Because I couldn’t decide on aftercare, I stayed at Caron for 32 days, and those still feel like, and probably because of lack of sleep, the longest 32 days of my life. But once I was able to get past that and have more time, that’s when I started to realize as a 22-year-old kid that had just been to treatment for the first time, that had just learned about what recovery could look like and ways to achieve it, that it wasn’t this miserable death sentence of just this life without all of the things that I thought I wanted.

Because I started to see people my age that I could identify with that were accomplishing things. Little things, but they were accomplishing things that I didn’t think were possible and they didn’t think were possible just a few weeks before, and I saw that they were having fun, and I saw that it was something that maybe, just maybe, this is worth fighting for, because it looks a whole lot better than where I’m coming from. But in 28 days, just to get the clarity and the physical ailments to go away? I mean, I still wasn’t sleeping well after 28 days. The importance of treating this as a disease, and a chronic disease, not an episodic treatment where you just pop in, you pop out, and everything’s okay, because that’s not how it works. And there’s so many things that need to change that can’t even start until you pull the substances out.

Elizabeth Vargas

Right. I mean, I’ve had several friends who’ve battled breast cancer. Even in its mildest form, they’re all for five years out on a medication. I don’t know of any other disease where we… and Madeleine, I’d love to talk to you about this, because it also dovetails with public policy, but I don’t know any other disease where we say, “Get it fixed in 28 days, and I don’t want to hear any more about it, and if, God forbid, you need to go in for another fix, you’re fired,” or “We’ve had enough,” or “I’m not paying anymore,” or… You know what I mean?

Madeleine Dean

Absolutely. And I have to admit, Harry, I knew when you went in for the 28 days, that was not going to be enough. I don’t think I ever mentioned that to you. I remember about two weeks in on a phone call you saying, “Wait a second, I’m hearing something about something after Caron?” And that’s when I sort of broke it to you that yes, I’d done my homework, and this disease is not fixed in 28 days. Obviously, it’s a chronic disease that we don’t yet have a cure for. But I was deceiving you there, Harry. I knew when you went in, and when you were so mad that, “How could I possibly be gone longer from my daughter?” for example, from the responsibilities of being a dad, and I tried to convince you that the only chance of being a good dad was if you really took care of yourself first and worked at a longer term recovery.

And so, you’re absolutely right, Elizabeth, and that’s something I got interested in as a state representative. Before I came to Congress, I was a state representative for six and a half years in the Pennsylvania House. Looking at the moronic ideas around mental health and addiction, that it’s once and done, or maybe you don’t get coverage at all, and you’re going to have to fix this on your own, some sort of an outpatient, good luck, get to meetings.

Fortunately, I think healthcare providers and insurers are learning, but we’ve got a long way to go. We have an insurance company in our area that was a leader in making sure addiction was covered and in the event of relapse that it was covered, but we have to really learn that it is not seven days and then get to your private meetings or group meetings. Or 28 days and then get onto it, or… As you say, there are rare people who do it on their own or do it by way of meetings.

But healthcare is learning about this disease, that it’s a rewiring of the brain in terms of addiction, especially when it’s a young man. My husband and I noticed that his maturity was just arrested in those final years leading up to confronting him with what we found out to be the truth. The rewiring of the brain, the maturation that comes along with the hard work of recovery, and I want to say, I’m so proud of Harry. This is hard work. But boy, is it rewarding when you put the work in, and he’s just… an even more beautiful person than he was as a young child, and he was a pretty beautiful child.

But we have to learn. Society has to learn. Healthcare, insurers have to say, “It’s not once and done.” As you say with breast cancer, if a friend of ours has breast cancer, and there’s a recurrence, it’s not like you’d say, “Well, okay, we helped you once. We’re not going to be working with you again.”

Elizabeth Vargas

Right. There’s no other disease where we do that.

Madeleine Dean

No.

Elizabeth Vargas

And hospitals, for other situations, are regulated and have to pass all sorts of inspections, and we don’t have that same onerous regulation of rehab facilities. I mean, it goes on and on and on, the ways that we fail. The treatment’s too expensive, there aren’t enough beds, the insurance company gives you a hard time and says, “Well, can we…” I remember this. There was a colleague of mine, and they had to do an intervention with her. They did this big thing, and they sat her down and said, “You really, really… We want you to go get help. We want you to go check yourself into rehab.” They had done all the things and found a place that she could go to right away, because, as I’m sure both of you know from your personal experience, you got to do that fast before the person who suffers from this disease begins to think too much. It’s just, get them into treatment quickly.

And the insurance company said, “Well, we need a couple of weeks to examine the case,” and then the insurance company said, “We really would… Why not try outpatient first?” And of course, all she wanted to do was outpatient. She didn’t want to go to get treatment. It’s easy to go twice a week and tell them you’re getting better when you’re not. And there are a million stories like this, of the insurance companies actually undoing the hard work that you have done legislatively by making it difficult to bring it to fruition.

Madeleine Dean

Oh, we have seen that, and I know Harry can speak to it in his own current work.

Elizabeth Vargas

Exactly.

Madeleine Dean

We have seen that personally, where you’re trying to help someone, and maybe it’s a Thursday, and they say, “Well, maybe we’ll get back to you and see if we can find you a…” Finding a bed, for example. Just the resources to have beds available. “Maybe we’ll see if we can get you in somewhere next week.” “Well, no, I’m trying to save this life now, and he or she’s willing to go now.” It is incredibly frustrating. Sure Harry can tell you better from his perspective.

Harry Cunnane

Yeah, we see it all the time. As you mentioned, sometimes they want you to start at this lower level, and you almost have to fail your way up to better treatment and pray that nobody dies along the way, which is just such a dangerous approach. The other thing that is such a big issue in my eyes is we’re looking at addiction, right? Substance use disorder, but they break it down depending on which substance you’re using and what the criteria is, where if you’re using alcohol, you might have a higher likelihood of getting into treatment, but if you’re using meth, which is massively on the rise right now, because of the difference in the physical withdrawal symptoms, it’s a lot harder to get residential treatment. For the same disease, the same issue, but depending on what you’re using, you might not be able to get in, or you might just have to go and, like you said, kind of fail your way up through outpatient, and then maybe you’ll get bumped up if they’re able to keep you and keep you engaged. But that window of when somebody’s willing can be really small, and you got to be…

Madeleine Dean

Really small.

Harry Cunnane

Yeah. Right away.

Elizabeth Vargas

Well, thank you so much, Congressman Madeleine Dean, Harry Cunnane. Your book, “Under Our Roof: A Son’s Battle for Recovery and a Mother’s Battle for Her Son” is just amazing, and any family who’s been through recovery or is going through recovery or hopes to go through recovery should read it, because you’re going to help a lot of people. And I know it’s a podcast, and our listeners can’t see you, but Madeleine, you’re wearing your starfish pendant. Just tell the story really quick around the starfish.

Madeleine Dean

Well, and thank you, Elizabeth, again, for having us, and thank you for your powerful work in this area. I wear this pin because I think it symbolizes my work, and I have a feeling it symbolizes yours and Harry’s as well. You know the story of the little boy on the beach. Early one morning, little boy’s walking on the beach, and a particularly high tide washed up thousands and thousands of starfish. And so he’s dutifully picking one up and throwing it in the ocean, picking one up and throwing it in the ocean, and an older, wiser man comes along and says, “Oh, little boy, what are you doing?” He says, “Well, they’re going to dry up and die. I’ve got to throw them in the water. I’ve got to throw them back.” And the old man says, “Sonny, there’re thousands of them. Don’t you see you can’t make a difference?” And he picks up one, and he throws it in the water, and he says, “I made a difference for that one.”

That’s what I feel like I do in my work every day. If I’m serving a constituent, I hope that’s what… I know Harry is doing, helping people connect to recovery. But if we can just… Sometimes, when a problem is so overwhelming, and it just seems to big to tackle, remember the difference you can make for a single person, a single starfish. So, that’s my line of work. I’m saving starfish.

Elizabeth Vargas

Save them. Save them. Keep saving them. Thank you so much. It was great to have you. Thank you so much for listening today to “Heart of the Matter.” You can find this podcast on Apple Podcasts, Spotify, and on our website at drugfree.org/podcast. And as a reminder, if you need help with a loved one who is struggling with substance use, you can text 55753 or visit drugfree.org. We’ll talk to you soon.

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