How I Went to Rehab for Alcohol and Found Out I Was a "Heroin Girl"

Nov 29 2016

How I Went to Rehab for Alcohol and Found Out I Was a “Heroin Girl”

November 29th, 2016

When my parents somewhat overreacted and sent me to a very traditional 12-step rehab after I got into a spot of trouble with alcohol, the last thing they expected was that I would become a passionate advocate for the legalization of all drugs.

I pitched up at rehab at the age of 40, as an innocent “alcoholic.” (A term I now reject and regard as hate speech.) I had never done “drugs” in my life, and I still haven’t. A child of the Reagan years, I never even got the chance to “Just say no”—I was so “good” that no one even offered me illegal drugs! I was the kind of girl who could walk past an apartment where folks were smoking weed and say, “How did a skunk get in here?” I briefly dated my local pot dealer in Philly and didn’t realize he was a pot dealer. I thought he just managed his money well.

That all changed when I went to that rehab outside the city for a 28-day stint. The woman who took me under her wing on the first day had been a crack user. A suburban mother of two, she told me that crack can make you paranoid, and that crack users often have kinks in their window blinds from peering out to look for the cops. It sounded like a different world. But she was just a normal, friendly, loving woman, who also happened to use crack in a problematic way.

But most of the women on my floor—the 26-to-60-year-old floor—were Alcohol Girls, often as inexperienced with illegal drugs as I was. The rehab didn’t take insurance, so most of us there were well off. Most of us were meek, afraid. Many of the women spent the first few days crying. Many were addicted to Xanax.

We were told to identify by our drugs. So: I’m an “alcoholic.” She’s an “addict.” Some were “an addict and alcoholic.” We followed orders, confessed our sins, read from the Big Book.

I was a very good girl, so good in fact that the others called me “Recovery Supergirl.” I was appointed Leader of the Floor. Twice. We Alcohol Girls seemed inclined to play the game.

But then there were the Heroin Girls: Kara and Jamie.

Kara and Jamie didn’t play the game. Kara and Jamie sat outside on the benches, trading stories, while the rest of us dutifully assembled for night-time meeting. When I tapped on the window to remind them to come in (in my capacity as Floor Leader), they ignored me.

Jamie threw up blood in withdrawal, even though they medicated her. Kara had lost a brother to overdose. Jamie looked like she’d be more at home on a college cheerleading squad than buying heroin, but her husband had overdosed in their bedroom.

These women, bruised and rebellious, made the rest of us look like paper dolls.

And I, for one, felt like a paper doll. The identity that they told us to adopt in rehab didn’t fit me. I dutifully filled in my Jellinek curve, but I had to make up stuff to fit it. I was having some troubles, to be sure. But I didn’t identify at all with Bill Wilson or Dr. Bob, or any of the stories in the Big Book. Nor did I particularly identify with the other women on my floor.

Except the Heroin Girls. They reminded me of the spirit and resilience I’d once had on the outside, before I came into this place to be told I was powerless.

Kara didn’t like me at first. I think she saw straight through my Good Girl act and realized I was a phony. So she pretty much ignored me, until one day at our trauma group I shared the story of how I’d been raped in a hospital.

Afterwards she came up to me and gave me a hug. We formed an uneasy alliance. She was, for me, a link to an authentic voice, one that would take me almost a year to find for myself.

I got out and did my 90 in 90 like the Recovery Supergirl I was, but I also started to read. I read Marc Lewis, Carl Hart, Johann Hari. One day early this year, The Influence somehow appeared in my Facebook feed (and no, they’re not bribing me to say this).

I read Stanton Peele and others, and the world started to spin in the opposite direction. A story started to form with which I could identify. A story of addiction as a part of the normal continuum of human experience, not a disease but a reaction to circumstances and personal history. A story of recovery not as a permanent identity but as a phase through which one moves on.

That’s when I suddenly began to move forward in my life, in a direction that now made perfect sense for me. I became a SMART Recovery facilitator and volunteered at the local needle exchange where I live in Philadelphia: Prevention Point. Among the former and current heroin users there, I met the most vibrantly alive people I’ve ever known. I found myself caught up in their stories, and profoundly affected by the ways that criminalization, rather than the drug, was hurting them. Their struggle rapidly became my struggle.

That’s how this innocent Alcohol Girl from Philly found herself at the National Harm Reduction Conference in San Diego earlier this month, along with the country’s foremost advocates for legalization and safer drug use. I stood and chanted Black Lives Matter chants with people who have lost their children, wives, brothers, sisters, to overdose. I shared ideas with people whose work I’ve long admired from afar. My friends now are radical harm reductionists, and my PhD research is in harm reduction approaches in the health care system.

Not quite what my parents intended.

Or was it?

When I entered rehab, I told my parents that I might not come out the way they expected. Their goal for me was not so much that I be “sober,” (though it would take me months to realize that) but that I be safe and happy. That I become again the strong, excited, sometimes impulsive, creative woman they had known before multiple traumas beat me down.

That rehab seemed designed to convince me that I had to apologize for who I am, to be constantly identifying as “alcoholic” and doing “service” to prove I have worth in the world. But Kara, Jamie and my discovery of harm reduction taught me that I matter just as I am right now. That I don’t have to be perfect, or anywhere near it, to matter. That I matter when I’m speaking at a health care conference and I matter when I’m crying on the floor of a hotel room.

Read more from The Influence:

Macklemore’s Song “Drug Dealer” Demonstrates His Damaging Ignorance About Drugs and Race

“A Family of Drug Users”—Meet the New Leader of the Harm Reduction Coalition

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That’s why today, I’m ignoring the tap at the window telling me to come in and be a Recovery Supergirl at the night-time meeting. I’m insisting on the right to make my own choices, and if necessary, my own mistakes. Instead of chanting “Thanks for sharing, we support you,” as we did at those meetings, I support my sisters by being the one who’s there with that hug that Kara gave me.

I support them by fighting to legalize their drugs. Just as I can have a glass of wine in a bar, if I choose, without fearing that it will be contaminated with fentanyl or that the cops will lock me up, so they should be able to use their drug of choice, if they choose, without those additional risks.

I refuse to separate myself, ever again, from my brothers and sisters whose drug just happens to be illegal.

That’s why I am a Heroin Girl.


April Wilson Smith is an epidemiologist who lives in Philadelphia. She was previously a union organizer for 18 years. Her last piece for The Influence was “Overcoming Problems With Substances Is Great—But ‘Recovery Month’ Rubs Me the Wrong Way.

  • Don’t be so quick to embrace the “Heroin girl” moniker. To me it smacks of ‘black widow’.

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  • James DuMouchel

    I agree with your negative opinion of our counter-productive drug war. Until the general population understands that abuse of ANY dangerous drug is made more severe by its prohibition, we will continue to piss, moan, and cry, but the situation will not improve.

  • Really Interesting…. The alcohol rehabilitation, drug treatment every one need to aware of this.

  • Jenni Brunner

    Have i told you lately how wonderful you are? How much i admire your stance in the world and your proactive fight for what you believe in? You are awesome April. I am genuinely lucky to know you and the world is lucky to have you in it. Rock on.