An image that has gone viral is one of a man lying in an open casket. Standing before him are three people — his wife, his young son and daughter. They are smiling. He is not. The 26-year-old Ohio man died in September as a result of heroin addiction and drug overdose. Although Mike Settles entered treatment and was discharged from an inpatient program in December of the previous year, believing that he had kicked the habit, what began as prescription drug abuse took a sharp downturn. When using opiates to treat dental pain, which he declared that he could manage without spiraling out of control once again, he experienced a relapse that signaled the end of his life. His wife, Eva Holland, made a bold move and posted the picture on her Facebook page as a way of highlighting the gravity of the situation she and her family found themselves in and to help prevent the same tragedy from befalling anyone else. The response was decidedly mixed. Some people applauded her courage. Addicts and their families appreciated her shining a light on such a dark subject. Others decried that it took what they perceived to be a private matter and made it public. Still others viewed it as tastelessly sensationalistic to pose for the photo and insisted that it would be detrimental to the children. Bill Walker, M.Ed., a counselor at The Right Step, treats adolescents who face substance abuse and behavioral problems that impact academic, peer and family systems. Many were living in homes in which either one or both of their parents were dealing with their own substance abuse at a time when their young brains were still in the early stages of development, Walker said. These young people benefit from help outside the family of origin, and “community support which could include social organizations, neighbors and church,” can make a difference, Walker said. But the primary support during those formative years is the school. “It falls to teachers and counselors within the school setting,” Walker said. “That’s where the struggle will show up and where educators can intervene and get them professional, licensed help.” If not, it is easy for a child’s issues to slip through the cracks. “We see it often,” Walker said. “Even agencies that are designed to intervene and protect children are unable to, which is often very frustrating.” Walker’s initial response to the photograph was, “Nobody that young with a hopeful future and a beautiful family” should have to experience death in that manner. “Addiction is senseless. I have lost people I have worked with due to addiction. Looking at those children, that’s really where my heart goes. Knowing the struggle of having grown up in that addicted home, those children have most likely experienced a stressful environment. What we know about stress or trauma in the first six years of development is that it has a significant negative impact on brain development and the ability for the child to develop the necessary skills to effectively manage life’s struggles.” Although it’s possible that the children have been irreparably harmed, given the history of domestic violence and the resulting parental separation and reconciliation in the midst of the addiction, Walker holds out hope for them. “I don’t think it’s something they can’t come back from.” “But without intervention,” according to Walker, “they will likely have struggles.” Walker cites the work of Stuart Ablon, PhD, known as “collaborative problem solving,” which holds that the skills that are lacking can be developed and restored because the brain is continuing to develop and get better. Explaining death to a child is daunting enough, without the complications of the senseless and preventable passing of a parent. “Every situation is unique,” Walker said. “It would depend on the age and emotional maturity of a child. I don’t know that there would be a step one-two-three approach.” Using the passing of a parent as an object lesson could provide the young person with the encouragement to make more life-affirming choices. “The point of the picture is that Mom was trying to say, “I cannot run from this. I cannot hide from this or my children are likely to repeat it.” “That’s the controversy she is exposing. I do believe that to live in ignorance of what had happened could be detrimental to the child.” Walker says it’s important for a parent to face substance use in the home head on. “Every child I have ever worked with who has experienced a person in a home dealing with substance abuse has always reported, “all I want them to do is get better.” He adds: “It’s not like they don’t know. That’s the reality this picture helps support. These kids already know this. Standing by that open casket, they already knew that Dad had a problem. They had seen the yelling, the addiction. They had been there. I really applaud the woman. Putting it out there is kind of refreshing.” By Edie Weinstein, LSW Follow Edie on Twitter at @EdieWeinstein1