Step by Step
A mother recounts her daughter’s years-long struggle with addiction, from overlooked warning signs to small victories on the path to recovery.
by Bill Donahue

When a child hits teenagerhood, most parents brace for the sure changes ahead. “Expect the unexpected,” as the saying goes. Christine Pisera Naman and her husband, Peter, expected a surprise or two with their three children—two sons, Jason and Trevor, and a daughter, Natalie. 
The trouble came from not being able to differentiate the normal ups and downs of adolescence from something far more sinister. In a newly published memoir called About Natalie: A Daughter’s Addiction. A Mother’s Love. Finding Their Way Back to Each Other., Naman details the tribulations and one-day-at-a-time victories associated with her middle child’s years-long struggle with addiction.
“It started with pills, and the pills escalated,” Naman recalls. “I had no idea of the things she was doing, even though there were a lot of signs there I didn’t see or I attributed to normal aspects of growing up.”
Naman, a writer and stay-at-home mother from western Pennsylvania, spoke with us about the road from addiction to recovery, a dark journey too many American families have to take. She talked about the signs of drug addiction that often go overlooked, the role stigma plays in a family’s willingness to seek help, and how Natalie is faring these days.
I understand Natalie started experimenting with pills at age 12 or 13 or so. At what point did you realize she had a serious problem? 
At 15, she was caught with heroin at the high school. That was a shocking moment. I was blindsided. … I was in the dark too long, and I really regret that. I didn’t know the average age for a kid to start experimenting [with drugs and alcohol] was 12 or 13. I think I did what a lot of people do; I thought she was much too young. We talked about it often, and she had some education on the topic in school, but it wasn’t enough. 

Natalie struggled in childhood. She’s a gifted, bright girl, but she had problems with socialization, bullying, fitting in—normal childhood stuff. When my father passed away, she was looking through some of his possessions, nostalgically. She stumbled upon these [pain] pills among my father’s things, and I think she was curious, because she had heard that substances made you feel better. I believe that was very much how it started, her wanting to escape. 
She has always been very curious, and had too fearless of a personality. I think that led into it a little bit. The other part is that drugs and alcohol do an amazing job of promoting themselves, in music, movies, and TV. You’re led to believe they can do things for you, make you feel better about yourself. We need to be the bigger, louder voice to counteract those messages. 
A friend of mine has a son who has struggled with addiction for nearly a long time, including multiple overdoses, multiple arrests, and time in prison. Did your family have similar struggles?
Unfortunately, it comes with the territory. The police were involved. There was an arrest at the high school. Kids, whether good or bad, introduce you to people you never met before. In this case, it was police officers, judges, lawyers, and probation officers. Overdoses and calls from the ER were all part of the journey. 
Does shame play a role in delaying help? 
The shame and guilt and regret can be suffocating; it can overwhelm you. The first thing you do after you know is go into denial about not knowing. It was the first time. It was somebody else’s. You make it smaller than it actually is. … When you finally realize you’re not going to sweep it under the carpet, that’s one of the bigger steps. Saying “I need help” is a big step for all of us so you can get support from all those people who want to help—the helpers. 

Like everything else in life, the whole journey from active addiction to health is not a straight line. Medical doctors, therapists, support programs, I have to say you have to meld that all together, because nobody is walking around with a magic wand. In retrospect, with hindsight more clear, Natalie benefited a little from everything that was offered to her. There were so many heart-to-heart conversations we had, and times we got closer to the heart of the matter. You have to help someone visualize the future, look toward that, and work on that, which was hard because she had been in active addiction for so long. I remember asking her, “What did you dream of for the future?” She said, “I never dreamed of anything because I never thought I’d live that long.”
You mentioned not knowing the signs, and having some shame about that. Can you provide a few examples of things to look for that might help other families? 
There were so many of them: bloodshot eyes, eating erratically, a few dollars missing here and there, pulling away, secretiveness, mood swings, too much of a range of emotions. If you’re not really looking for it, you can chalk everything up to another explanation, to a teenager just being a teenager. It can be normal growing pains, or it can be something much darker. 
Writing can be cathartic, especially when you’re processing some kind of trauma. How did you get through the tough times as they were happening?
I made a decision to write about it before Natalie was clean. I thought: If I put good words out there, it will make a difference one day. It wasn’t a matter of: When I get my happy ending, I’m going to write about it. One day I was in so much pain—the isolation, all that stigma—and I felt alone. Logically, I knew otherwise. I’m not alone. There are so many people who are right where I am, in the middle of all of it. Part of conquering anything like this is getting past that isolation. I wanted to allow people to get to know me. I thought if they get to know me, they will get to know that we’re just regular people. 

I asked Natalie, “Are you OK with it, with me writing this down?” She was wonderful and said, “Yes, go ahead.” I told her, “I would love to hear your voice, too.” She surprised me by showing she had a gift; she turned out to be quite a poet. We placed her beautiful poems between the chapters.
Natalie was 15 when you learned she was doing heroin. She’s 24 now. How is she doing, and how is life for your family now?
She is two years clean now, and you have to take every step as it comes. It had gone on so long, and been so severe, we all suffered because of it; every member of our family definitely struggled in our own way, all differently. I would say, “It’s my fault because I was here.” My husband would say, “It’s my fault because I wasn’t here.” We all suffered in some way, all collectively.

I’m doing as much speaking as I can, and the proceeds [from the book’s sale] are going back to the Highmark, Allegheny Health Network’s addiction medicine program. I’m also comforting others where I can. I volunteer as a cuddler at a local hospital; I cuddle babies who are dependent, babies who need comfort. It’s hard, but I try to focus on the fact that I’m helping the baby and freeing up the mom so she can focus on getting healthy. I’m just too blessed not to give back.
Prepared to Help
As Christine Pisera Naman suggests, individuals who struggle with substance use disorder need support from “the helpers.” The Philadelphia area has a number of notable resources to help people progress from active addiction to recovery. Whether someone would be best served by outpatient services or an inpatient/residential treatment program, the following organizations are devoted to helping people overcome their disease and reengage with life.
Huntington Creek Recovery Center 
Pocono Mountain Recovery Center
Recovery Centers of America
The Retreat at Sheppard Pratt
Photograph courtesy of Christine Pisera Naman
Published (and copyrighted) in Suburban Life magazine, December 2021.