The need for an answer to that question, as well as a desire for closure, is what inspired Lowenthal to pen "One-Way Ticket: Our Son's Addiction to Heroin" (Beaufort Books, $14), a memoir that compiles her experiences and correspondence with her son and his journal entries while in and out of San Quentin State Prison.
Despite years of treatment, Josh Lowenthal never broke the heroin addiction that eventually took his life in 1995.
"It looked like our family had all the blessings, so I wanted to figure out what happened," Lowenthal said.
At a time when celebrity drug use and failed rehab attempts are all too prevalent -- and even joked about -- "One-Way Ticket" illustrates the cruel reality of drug addiction. "It is a disease, and it needs to be treated that way," said Lowenthal, who wants to make the idea of knowing or loving an addict less shameful.
She first noticed a shift in her son's behavior when he was 13, when the family lived in Pittsburgh. Along with her first husband, David, and their older son, Mark, Lowenthal quickly dismissed the change as teenage arrogance that would be addressed after the bar mitzvah.
"In 1969, Josh was 12, crazed with excitement about The Beatles, long hair, guitars, jazz and psychedelic paints that transformed his cute little boy's bedroom with the cowboy bedspreads into a teenage den," Lowenthal said. "He was beginning to bring home different, somewhat older friends, and he quit saying 'goodbye' in favor of 'one mind.'"
Heroin was the furthest thing from her mind.
"Josh always appreciated a thrill and was always looking for the next excitement," she said. "He was fun to be around. We never thought it would come to this."
After the family became aware of the problem, Josh would spend the rest of his life in and out of recovery and rehabilitation centers.
Because he started using at such an early age, Lowenthal believes Josh's body and mind never had the chance to fully develop independently of heroin, thus making the path to sobriety increasingly difficult with age.
Josh never liked many of the facilities, Lowenthal said. He went AWOL from several institutions, many of which preached "tough love," an idea that had little effect on Josh and a concept extremely difficult for Lowenthal to embrace.
In a journal entry from 1985, Josh wrote about a particularly frustrating rehab experience: "This rehab is no good. Better off in jail if I want to be clean. I don't know if I could stand to brown nose my way through this for months ... more concerned with table manners than wrenching guts.... One thing is for certain, if I could be successful in this program I wouldn't need it."
Looking for a fresh start, Lowenthal and Josh moved to Los Angeles after her marriage ended. She found work as a professor in social work at Hebrew Union College-Jewish Institute of Religion (HUC-JIR), while Josh struggled to find a college that would accept him. But no matter where they moved, "he was never far from drugs," Lowenthal said.
Of all the treatment facilities, both Josh and Lowenthal acknowledged that Beit T'Shuvah was by far the most effective and encouraging.
"They know relapses will happen; they only hope the addicts will return to the program when they do," Lowenthal said.
After frequent relapses and periods in and out San Quentin for petty theft, Lowenthal explains that Josh was finally realizing the futility of his addiction. While he craved a normal life, Josh was scared by a world without drugs -- a sentiment expressed by many addicts close to full recovery.
In an unsent letter to his brother, Mark, written just a year before his death, Josh shows a disturbed, yet more self-aware, side while serving time at San Quentin:
"Realistically, I expect that in approximately two-and-a-half more years on parole, the state will probably squeeze another year out of me. Six months out, six months in, seems nearly unavoidable.... I imagine with hindsight that, more or less, we all reflect on -- with misgivings -- precious time squandered as so much spare change."
Lowenthal said she sensed that Josh was extremely close to ending the nightmare of his addiction. In a video interview with Beit T'Shuvah, recorded one week before his death, Josh admits, "Like I said, I've been a junkie for 25 years. I'm 38, and I'm tired, and it's over. These are my friends.... This is the end of the story -- at least for the moment."
She believes Josh committed suicide when he overdosed on heroin, although no note was found.
Lowenthal is now retired from HUC-JIR, as well as from the USC School of Social Work, where she was a charter member of the Betty Friedan Feminist Think Tank. She worked on the 2000 ballot initiative, Proposition 36, which changed California's law to permit substance abuse treatment, as opposed to a jail sentence, for first- and second-time offenders guilty of nonviolent, simple drug possession.
She currently serves on the board of the Progressive Jewish Alliance as chair of the Drug Policy Committee of the Criminal Justice Task Force, in addition to being a member of the Community Action Committee of the Progressive Christians Uniting.
While Lowenthal has learned to turn her depression into political action, she said she's still haunted by her tragic loss of Josh. For many years while Josh was using, her only comfort was a statement made by her son, which she said had become like a mantra for her: "There is nothing you can do, Mom; you can't compete with heroin."