On Oct. 30, Harry Cunnane, the middle son of U.S. Rep. Madeleine Dean (D., Pa.), celebrated his ninth year of recovery from addiction. To mark the occasion, Inquirer reporter Rita Giordano sat down with Cunnane and Dean to discuss Under Our Roof: A Son’s Battle for Recovery, a Mother’s Battle for Her Son, their harrowing, joint account of a horror lived by too many American families.

Published last spring, Under Our Roof chronicles Cunnane’s struggle, as a teen and young adult, with opioid addiction and substance-use disorder and its impact on the Dean-Cunnane family. The duo have also co-authored You Are Always Loved: A Story of Hope, a children’s picture book to help young people deal with the absence of a family member due to addiction.

Cunnane, 31, now works as a regional vice president with Caron, the treatment center where he received help nine years ago, and lives with his wife and three children in Audubon, Camden County. Dean, 62, represents Pennsylvania’s 4th Congressional District; she is vice chair of the House Judiciary Committee, serves on the House Financial Services Committee, and co-chairs the House’s Bipartisan Women’s Caucus.

Q: Under Our Roof is such a deeply personal, painful story. What led you to write it?

Madeleine Dean: We had one thing in mind: If we told our story and it helped someone, it would be worth it. Until I read Harry’s portion of the book — and we started writing this when he was six-plus years into recovery — there were stories I had no idea of. I knew we had been through something very, very difficult and yet I didn’t know the real ugliness of the addiction, how it steals and hollows a person out.

Harry Cunnane: Everybody knows somebody who is impacted; the more we talk about it, the more we break the stigma associated with substance-use disorder. But we also wanted to tell a story of hope, to remind people that recovery is possible.

Q: What advice would you give to families in your situation?

Dean: I would say to parents, “Trust your instincts and get informed.” My gut was telling me there was something terribly wrong. But I had older brothers; growing up, they had experimented with smoking, pot, and drugs. There was this tug of war between my wondering “Is this normal adolescence?” and fearing this was clearly not normal.

Cunnane: In terms of advice, it’s so important to find somebody to talk to — a professional who’s been through this who you can lean on. Too often, people don’t recognize this as the disease it is and they don’t reach out for help.

Dean: I wish I had had direct, honest conversations with Harry. We were battling so much — truly, I was scared to death for him — that calm conversation was hard to come by.

Cunnane: My mom wished she could have talked to me, but I was unwilling to open up; I felt such shame. From a very young age, I was taught that drugs are bad, experimenting is bad. By the time I needed help, I felt that if I let anyone know, it would bring shame to everyone around me.

Q: Harry, what would you say to a kid who thinks he or she might need help?

Cunnane: In the mind of a young person, it’s daunting to not only stop using drugs and alcohol but to completely change their social interactions and everything about what they’re doing. The life I had built — all of my friends and social interactions — was so based around drugs and alcohol that I was afraid I would lead this boring life. But I’ve had more fun in recovery than I ever had when I was using. To be freed from that opened me up to do so much more and to meet incredible people. I built stronger relationships than any of the friendships I had before.

Q: How could schools improve their prevention education?

Cunnane: Teach it in a way that lets kids understand the actual consequences and risks of drug us, make it more scientific so it’s not this emotionally charged, right-or-wrong thing; talk about it like they would any other disease. I remember leaving one of those prevention classes, and swearing I wasn’t even going to smoke a cigarette because it was so bad. By the time I started everything, it was so reinforced in me that it was the wrong thing to do that I couldn’t let anyone know what I was doing until it got to a point where I had no control. We need to understand that kids will likely experiment. That’s the reality. And it’s OK for a parent to say, “I understand you or your friends might experiment, but we love you and we’re here to help you.” That might open up the conversation sooner.

Q: What advice would you offer parents about treatment and early recovery?

Dean: You don’t go for 28 or 30 days, and then all’s fine. Recovery requires an entire shift in one’s physical health, mental health, and world view. I knew right away that one month wasn’t going to do it. And that was a fight we had with Harry, about two or three weeks into his treatment, when he learned Caron was going to recommend aftercare. It takes time. So don’t judge if relapse occurs. And I’m saying this in the light of day: We saw the statistic last year — 93,331 people lost their lives to overdose during COVID. That’s a staggering, horrible number.

Q: The Affordable Care Act has increased the availability of substance-abuse treatment, but access is still uneven. What reforms — legislative or otherwise — could help?

Dean: Congress’ Bipartisan Addiction and Mental Health Task Force has multiple pieces of proposed legislation. One piece addresses access. When Harry went into treatment, I remember analyzing where he could get the most effective treatment possible and recognizing that we were able to look at expensive places; many people don’t have that chance. And we have to make sure more than just detox is available because recovery takes months and months of work. So we have to do more in terms of affordability. One bill I have is the MORE Saving Act (Maximizing Opioid Recovery Emergency Saving Act), which will eliminate cost sharing like copayments and deductibles for opioid treatment and support long-term treatment.

The other piece is criminal justice. Too many people are met with an arrest rather than a plan for recovery, so they wind up with a record, which then harms their future economic ability. What happens to their family when this happens? We have to decriminalize the behaviors around substance use disorder. I co-sponsored the PREP Act (Promoting Reentry through Education in Prisons Act) with the now-late Elijah Cummings to help people get education and treatment both while incarcerated and as they get out. Sadly, we were in a hearing recently where one of the members on the other side of the dais on Judiciary — a former prosecutor — said he thought the inside of a jail cell is a good place for somebody to recognize they have a problem and they should just stop. I said to him, “That is not an effective treatment plan.” We have to change the thinking that incarceration and a criminal record is a deterrent to addiction.

I have another [bill], the END Stigma Act (Education for New Dispositions on Stigma Act), that funds college and university programs that educate students about the reality of substance use disorder, helping to remove the cloak of shame around addiction.

Q: What is your position on safe injection sites, such as the one that had been proposed for Philadelphia?

Cunnane: We need to do whatever we can to save lives, and maybe getting to recovery is a different part of that journey for later.

Dean: When I think about safe injection sites, I think about places like the Love Lot in Kensington [a parking lot on Ruth and East Clearfield Streets where volunteers offer free food and other services to those in need]. One day, I was down there, and a young woman was in serious trouble. These wonderful volunteers took her aside, monitored her health, and made sure she wasn’t going to die of overdose. But help shouldn’t be so random. I think the data support that [safe-injection sites] actually help. The purpose is not to encourage people to use; it’s to connect people to treatment and recovery. It’s looking at them as a human being, not as an addict unworthy of help.

I remember being in the state house and fighting for Narcan — eight, nine years ago — and how that conversation originally began. Literally people on the floor of the Pennsylvania House were arguing, “Well, how many times shall we reverse an overdose for somebody?” Until that person gets to recovery.