Using dark comedy, “Dopey” promotes recovery and pushes back against the stigma associated with addiction.
The NPR weekly radio/podcast series This American Lifefeatured a segment on its February 1st broadcast about Dopey, a podcast about addiction and recovery heard by more than four million listeners.
The podcast began as a forum for creators and hosts Dave and Chris—as well as guests ranging from Marc Maron and Dr. Drew Pinsky, to My Fair Junkie author and The Fix contributor Amy Dresner—to share “war stories” about their struggles without judgment and with a degree of humor.
But with the overdose death of Chris in July 2018, Dave has shifted the focus of Dopey to promote recovery while continuing to address the stigma of addiction.
As a result, the podcast has grown both in terms of the number of fans—also known as the “Dopey Nation,” who have helped to boost downloads to more than 1.2 million to date—and as a community for listeners in all stages of recovery, as well as family and friends, to come together.
As Vice noted, the roots of Dopey began in 2011, when hosts Dave and Chris—who do not give their surnames—met at Mountainside Treatment Center in Connecticut while undergoing treatment for substance use disorder.
The pair became friends, and after acquiring and losing various periods of sobriety, they decided to launch a podcast about addiction that focused on what Dave called “the last bad thing”—tales from their past including “using stories, open-ended drug discussion and debate over addiction philosophy,” as the pair wrote on the podcast’s website.
Dopey soon caught on with listeners, who submitted their own recollections. The result was a podcast where those in every stage of recovery could share their experiences and gain support.
Then in 2018, Dopey Nation was rocked by the news that Chris had been found dead of an overdose. He had been sober for five years at the time of the incident, working as a manager at a sober living facility and studying to earn his doctorate in clinical psychology.
In the wake of Chris’s death, Dave was determined to carry on with Dopey, but as he told Vice, “It’s apparent now more than ever that Dopey‘s main focus will be addicts living in recovery. Chris’s legacy will live on through these episodes, and the lives he touched all around the world.”
The new approach has also brought a wealth of new guests, including Jamie Lee Curtis, Beautiful Boy author David Sheff, and musician and recovery advocate Bob Forrest.
For Dave, continuing the podcast means giving individuals in the grip of addiction a place to go, to listen, and to share.
“[They] are not just showing up for Dopey, they’re showing up to support one another,” Dave said.
The youngest Jonas Brother revealed that he and his brothers were in therapy together for a year before reuniting to make music.
After a decade-long hiatus, Nick Jonas has reunited with his brothers to release new music. While promoting their new song and upcoming album, Nick, who recently married actress Priyanka Chopra, spoke with The Huffington Post about the benefits of therapy on his mental health.
Being that Jonas has type 1 diabetes, staying in shape physically and mentally is important for him to stay in balance. “Your emotional health is wholly connected to your physical health,” Jonas explained. “If you take that time [to] spend some time with family and friends, prioritize your emotional state of mind, you’re going to be in a way better spot physically.”
The Jonas Brothers were in therapy together for a year before they reunited as a band. Nick explains, “I think the thing that was so great about this next chapter was that it really began with us getting to the healthiest place we could be as brothers and as family before we decided to work together at all, given that the way it ended before was not the best.”
Nick and his brothers thought, “Let’s dive in, let’s really open up and pull this thing apart and see what would need to be different for this to work this time around for a healthier relationship. I think that honesty, that transparency, really was the key factor.”
Late last year, Nick Jonas, Queen Latifah, and Ted Danson appeared in ads for Cigna Health about the importance of taking care of your mental wellness. In Jonas’s commercial, he spoke about anxiety, and how he escapes to his “happy place” in his mind when things get tough—a comfortable room with guitars and puppies.
The commercial journeyed into Jonas’s mind, and as he explained to the viewer, “If we let tensions run the show up here (in our minds), then our bodies won’t perform at our best out here. How you’re doing emotionally affects you physically and vice versa.”
He concluded that when you get your check-up every year at the doctor, “Be open about everything you’re feeling physically and emotionally.”
Morning to evening, nearly seven days a week, Karen and Michelle endure taxing commutes to bring harm reduction services to drug users in North Carolina’s hard-hit, rural areas.
It’s a bitterly cold afternoon in early March as Karen Lowe and I pick our way down the broken sidewalks of a semi-abandoned neighborhood in Statesville, North Carolina. All around us, squatter houses stretch for blocks. Every window is busted or boarded up. Thin, dirty mattresses lie on sunken porches and feral dogs scrounge in the trash-strewn yards for scraps. Some residents are huddled inside for warmth, though in most of these homes, there is no electricity.
The neighborhood is a depressing sight, but it’s hard to feel blue when you’re on outreach with Karen Lowe. Co-founder of the Olive Branch Ministry, a faith-based non-profit that brings harm reduction services to the seven foothill counties of North Carolina, Karen is the embodiment of love.
Harm Reduction in the Deep South
As I burrow into my thin jacket, Karen strolls down the middle of the street extending warm greetings to the few brave souls who venture outside. Though the pockets of her cargo pants are bursting with clean syringes, naloxone, and other supplies to prevent death and disease among people who use drugs, she doesn’t flaunt her wares.
“I just want people to see me,” she explains. “It’s about building trust. They know why I’m here. If they need something, they’ll come to me.”
As we walk, the 52-year-old fills me in on the colorful cast of characters who call this neighborhood home, including a man who claims he hasn’t bathed in a year and an old woman who pees on the sidewalk. Karen describes everyone with great affection.
“There is a certain kind of love that goes with being an untouchable,” she says. “And [the people of this community] have it. But it’s not allowed to grow.”
There certainly isn’t much growing in this neighborhood. Judging by the columned porches on every house and what looks like abandoned flower gardens, this was probably once a desirable place to live. But shifting economic winds have devastated entire cities in the South and Statesville is no exception.
A small inland city—population 26,000—Statesville boasts neither North Carolina’s green mountain range nor its sparkling coastline. It’s stranded in the flatland area of the state, mostly buried under strip malls and fast food restaurants. But despite so few bragging rights, Statesville embraces its Southern pride, describing itself on its website as “a city where fish is fried (as our Lord intended they be) and a bottle of Kraft French Dressing is good enough for anybody — so get over yourself.” Also true to its Southern roots, while Statesville has recently invested in a splash park and a $330,000 home for veterans (more than double the average price of a house in the area), the city has allowed this particular neighborhood, in which residents are almost all black, to fall into ruin. The only people who venture into this place are the churches who occasionally come evangelizing and of course, the police, who make neighborhoods like this one their second home.
But Karen brings cheer to this desolate area. Twelve years ago, she was homeless herself, struggling with mental illness and depression, and searching for both a literal and metaphorical place to set down roots. She found a surrogate family and a calling in a faith-based organization in Greensboro that provides services to people living with HIV. The community welcomed Karen with open arms and she became a regular at meetings, outreach events, and retreats, which she describes as “mad love and dealing with yourself, everybody crying and snotting.”
Not Your Typical Faith-Based Outreach Organization
Karen says she knew then that her life was about to change in remarkable ways. And was it ever. A couple years into her involvement with the faith community she met the love of her life, Michelle Mathis, a woman who shared her passion for helping people in need. Though they have the same heart for harm reduction, the pair is about as opposite as two people can be. Michelle exudes elegance with a powdered face and coiffed hair that somehow survive even in the god-awfullest North Carolina humidity. Her partner is more salt-of-the-earth.
“I did the make-up and heels thing when I was young…somebody should have stopped me,” Karen laughs.
The yin to the other’s yang, the two married in a private ceremony in 2009 where they exchanged olive branches instead of rings, thus creating what would become their joint life’s work, The Olive Branch Ministry.
Olive Branch is not your typical faith-based outreach organization—and not just because its founders are an interracial queer couple spreading the word of Jesus in the Deep South. True to the tenets of harm reduction, whose guiding philosophy is “meet people where they are at,” Karen and Michelle serve without pretense or expectation.
“We say faith is why we do [this work], but it’s not what we do,” Michelle explains to me over the phone. “If someone asks us to pray for them, we will pray for people…We take the message of harm reduction to faith communities…but we don’t evangelize.”
During afternoon outreach with Karen, she utters not a whisper about faith. And yet, if God’s love for others were perfume, you’d smell her coming from blocks away. Helping others comes as naturally to her as breathing. Several times during our conversation she offers to assist me personally with everything from community partnerships to my writing career, and after I mention casually I’ll be traveling abroad soon, she offers me money to buy a goat or chicken for a family in need.
Morning to evening, nearly seven days a week, Karen and Michelle endure taxing commutes to bring harm reduction services to drug users in North Carolina’s hard-hit, rural areas. They ask nothing in return for their services. In fact, they seem critical of faith-based groups who use community outreach programs as a carrot to boost membership.
“It’s hard to be trusted in a neighborhood like this [because people think] everyone wants to take them to church,” Karen explains, adding that this is why she maintains such a low-key presence on outreach. Instead of rolling up in a van stashed with free giveaways, she roams the streets where people can see her, offering nothing but a greeting unless she is asked.
The Intersection Between Faith Communities and Harm Reduction
The Olive Branch Ministry’s approach could serve as an example for how faith-based communities and harm reduction can work together. The relationship is not always harmonious: some in the faith community accuse harm reductionists of enabling drug use or not doing enough to discourage problematic behavior. Conversely, many harm reductionists criticize faith groups for the hypocrisy of claiming to serve “the least of these” while refusing to help drug users, who belong to one of the most stigmatized and marginalized of all groups. Even when faith-based organizations do offer assistance, some peddle a strict, abstinence-only agenda or approach outreach with an attitude that appears to place more importance on gathering lost souls into the flock than on addressing people’s immediate needs.
But despite the tenuous history between the groups, there is much cause for hope. Across the country, faith-based groups like The Olive Branch Ministry, Judson Memorial Church in New York City, St. Paul’s Episcopal Church in Arkansas, the national Interfaith Criminal Justice Coalition, and many more are forming active partnerships with harm reduction groups. Other organizations, including the United Methodist Church, Presbyterian Church (U.S.A.), United Church of Christ and National Council on Jewish Women have publicly proclaimed their support for harm reduction programs.
The relationship between the faith community and harm reduction shows promise and room for growth. Especially in the South where faith is so important and drug users have so few services, these alliances are critical to stem the tide of deaths and disease caused by an unregulated drug supply, draconian laws, lack of sterile equipment, dearth of adequate treatment, stigma, and misunderstanding about what causes drug use to become problematic for many people.
“I feel that faith communities in general think that harm reductionists are a bunch of left wing radicals,” says Michelle. “They think that we will come in and demand that the church hold drug user union meetings and do syringe exchange, but they don’t realize that we meet the congregation where they are…we figure out where they are comfortable and [decide] how to go from there.”
Harm reduction groups and faith communities need to work together rather than at cross-purposes in order to reach and help as many people as possible. It’s not always easy to find common ground; an olive branch is a good place to start.
For the third straight year, the U.S. has dropped in the rankings of the World Happiness Report.
The United States is now the 19th happiest country on Earth, its ranking falling for the third consecutive year.
This is according to the most recent World Happiness Report, released on Wednesday (March 20) or the United Nations’ International Day of Happiness.
The Washington Post reports that the seventh annual report surveyed 156 different countries and took into account six factors: GDP per capita, healthy life expectancy, the freedom to make life choices, social support, generosity and perceptions of corruption.
The top 10 countries in the report were Finland, Denmark, Norway, Iceland, Netherlands, Switzerland, Sweden, New Zealand, Canada and Austria.
“We finished 19th on the list behind Belgium,” Jimmy Kimmel said on his late night show. “The people who feel the need to put mayonnaise on their french fries are happier than we are. Cheer up, everybody.”
While the report doesn’t specify why each country ranked where it did, the authors of the report have speculated in a news release that substance use disorder and the opioid epidemic contributed to America’s ranking.
“This year’s report provides sobering evidence of how addictions are causing considerable unhappiness and depression in the U.S.,” said Jeffrey Sachs, a Columbia University professor and the author of the “Addiction and Unhappiness in America” section of the report.
“The compulsive pursuit of substance abuse and addictive behaviors is causing severe unhappiness. Government, business, and communities should use these indicators to set new policies aimed at overcoming these sources of unhappiness,” Sachs added.
Sachs also noted that the results of the report serve as building blocks for countries moving forward.
“The World Happiness Report, together with the Global Happiness and Policy Report offer the world’s governments and individuals the opportunity to rethink public policies as well as individual life choices, to raise happiness and wellbeing,” Sachs said. “We are in an era of rising tensions and negative emotions (as shown in Chapter 2) and these findings point to underlying challenges that need to be addressed.”
According to the news release, this year’s report specifically honed in on happiness and the community, taking into account how technology, social norms, conflict and government policies have played a role in shaping each country.
“The world is a rapidly changing place,” Professor John Helliwell, co-editor of the report, said in the news release. “How communities interact with each other whether in schools, workplaces, neighborhoods or on social media has profound effects on world happiness.”
Some expressed concerns that the rule was designed to hinder the growing presence of medical and recreational marijuana businesses.
An IRS rule adopted in January 2018 could be blocking drug policy reform and advocacy non-profits from receiving tax-exempt status, in what some are calling a violation of the First Amendment due to the fact that it would specifically target cannabis-related businesses.
In an IRS bulletin, the rule reads that “the Service will not issue a determination letter when the request concerns an organization whose purpose is directed to the improvement of business conditions of one or more lines of business relating to an activity involving controlled substances (within the meaning of Schedule I and II of the Controlled Substances Act) which is prohibited by Federal law regardless of its legality under the law of the state in which such activity is conducted.”
The “determination letter” refers to a confirmation of tax-exempt status that the IRS issues to eligible non-profits.
Multiple cannabis-focused publications, including Leafly and Cannabis Now, expressed concerns that this rule was designed to hinder the growing presence of medical and recreational marijuana businesses, noting that on a federal level, cannabis is still a Schedule I controlled substance.
California accountant Jerry Chin told Marijuana Business Daily in March 2018 that the IRS rule means “if your trade association’s main purpose is the advocacy of a Schedule I substance, then we’re going to deny your application for that fact alone.”
According to the publication, the New Jersey Cannabis Industry Association (NJCIA) was one of the first organizations to be denied tax-exempt status under this rule after it was announced while the association was in the middle of seeking this exemption.
“At the 11th hour, we were informed, ‘Sorry, there’s been a procedural rule change, we’re not giving these types of letters to your type of company,’” said NJCIA President Hugh O’Beirne. “And that happened within a week of when this procedural rule change was announced.”
The NJCIA’s stated mission is to advance the legalization of cannabis.
There were fears that existing cannabis-related non-profits, such as the National Cannabis Industry Association, would lose their status under this rule change. However, the NCIA appears to have retained non-profit status.
Jacob Sullum of Reasonbelieves this rule could be a violation of the First Amendment, citing a 2015 D.C. Circuit case which ruled that the IRS “may not discriminate on the basis of viewpoint” in the administration of its tax code. This, however, was in reference to whether hate groups could receive tax-exempt status rather than those involved with controlled substances.
The IRS appeared to widely decline to comment on the new rule throughout 2018. As of January 2, 2019, the policy still stands.
“It’s a triumph owed to the relentless advocacy of Floridians who refused to be silenced,” said the state’s Agriculture Commissioner.
Nearly two years after the state approved a medical marijuana program, officials in Florida have made it possible for people to smoke medical marijuana by lifting a ban on selling marijuana buds in the state.
Republican Gov. Ron DeSantis signed the bill that removed the ban on Monday (March 18). He had been pushing for the legislature to pass such a law that would lift the ban, after a court in Florida ruled that prohibiting smokable medical marijuana violated the state’s constitution, which was amended to allow medical marijuana use.
“Over 70% of Florida voters approved medical marijuana in 2016,” DeSantis tweeted last Monday. “I thank my colleagues in the Legislature for working with me to ensure the will of the voters is upheld.”
Because of the change to state law, Florida will not appeal the court ruling, DeSantis said.
“Now that we have honored our duty to find a legislative solution, I have honored my commitment and filed a joint motion to dismiss the state’s appeal and to vacate the lower court decision which had held the prior law to be unconstitutional,” he tweeted.
Agriculture Commissioner Nikki Fried said in a statement reported by CBS News that the removal of the ban was a victory for voters who had come out in favor of medical marijuana.
“It’s a triumph owed to the relentless advocacy of Floridians who refused to be silenced,” said Fried. “Our state must not disregard the voice of its people—when the people’s will is nullified by those with authority, liberty cannot survive.”
The law takes effect immediately, but in practice it will take time for the Florida health department to set standards for prescribing smokable marijuana, so there could be a delay for patients, CBS reported.
With the new law, medical marijuana patients who are older than 18 will be able to access 2.5 ounces of marijuana every 35 days.
Yet, by Thursday, at least one medical marijuana patient in Florida was able to purchase marijuana flower, according to Kim Rivers, CEO of Trulieve, the dispensary that made the first sale.
“Offering these whole flower products to our patients in their purest, most-effective form is something we—and patients—have been looking forward to since we opened the doors of the state’s first dispensary,” Rivers said in a statement, reported by The Orlando Sentinel.
Doug Dixon, 59, was the first patient to make a legal smokable marijuana purchase in the state.
“I didn’t know if I would ever see it in my time,” he said. “But it is good to see it. It is good to have the alternative. These pharmaceuticals are killing people. I have lost so many family members.’’
The recently approved drug is said to relieve symptoms of depression as well as suicidal ideation in a short timeframe.
Veterans Affairs officials are now allowing VA doctors to prescribe Spravato, a medically viable variation of ketamine, to service members who suffer from depression.
The drug has been known to beat some symptoms of depression extraordinarily quickly—taking just a few short days, or hours instead of weeks. Suicidal thoughts have been seen to dissipate in a timeframe as short as 40 minutes.
“That first skyrocket up was my first infusion,” said Matthew Ayo, a 23-year-old who underwent ketamine treatment. “I went from severe depression to no depression symptoms.”
“We’re pleased to be able to expand options for Veterans with depression who have not responded to other treatments,” said VA secretary Robert Wilkie.
Of the United States’ 20 million veterans, an estimated 14%—or 2.8 million veterans—are diagnosed with depression. Of those veterans, one-third to one-half may suffer from treatment-resistant depression, which is why it was so critical to find something new and fast.
“Controlled clinical trials that studied the safety and efficacy of this drug, along with careful review through the FDA’s drug approval process, including a robust discussion with our external advisory committees, were important in our decision to approve this treatment,” said Dr. Tiffany Farchione, acting director of the FDA’s Center for Drug Evaluation and Research Division of Psychiatry Products.
Spravato isn’t without side effects, however—including sedation, blood pressure spikes, and dissociation, including feeling paralysis or out-of-body sensations. Ironically, misuse may lead to suicidal thoughts and behaviors. Hence, the FDA approved the drug for VA prescriptions with restrictions.
Veterans approved for the treatment would use the nasal spray under medical supervision. Afterwards, medical staff would monitor the patient for two hours. The patient would have to return for two doses a week for the first month, and one dose every two or three weeks in the months following. To prevent potential misuse, there is no option for home treatment.
Ketamine’s new role is a far cry from its former life as “Special K,” an anesthetic that saw use on the dance floor as well as the battlefield. In the latter usage, military medical staff found that those prescribed with ketamine for pain also had fewer symptoms of PTSD.
Actress Lena Dunham, who has been sober since May 2018, went on Twitter to acknowledge the celebrities who had recently opened up about their sobriety.
“First Lala Kent and now Wendy Williams—so proud of all these strong sober queens,” Dunham wrote on Twitter. “It’s a bumpy path for us all, but admitting you need help is the beginning of true freedom. Sometimes it’s stronger to be weak for a moment.”
“For some time now, and even today and beyond, I have been living in a sober house,” she said on The Wendy Williams Show. “And you know, I’ve had a struggle with cocaine in my past and I never went to a place to get the treatment. I don’t know how, except God was sitting on my shoulder and I just stopped.”
Also this month, reality television star Lala Kent of Vanderpump Rules publicly said that she was in a 12-step program for alcoholism. She had previously mentioned that she was getting sober, but didn’t talk about having a substance use disorder.
“Five months ago, I came to the realization that I am an alcoholic, and I am now a friend of Bill W., which you will never know how much this program means to me [and] has given me new life,” Kent wrote on Instagram.
Dunham, writer and director of the HBO series Girls, is familiar with the struggles of early sobriety. She spoke on Dax Shepard’s podcast Armchair Expert in November about how she has been adjusting to life without anxiety meds. Initially, she said, the medications made her feel “like the person I was supposed to be.”
“I was having crazy anxiety and having to show up for things that I didn’t feel equipped to show up for. But I know I need to do it, and when I take a Klonopin, I can do it,” she said.
However, over time, she realized that her drug use was becoming problematic.
“It stopped being, ‘I take one when I fly,’ and it started being like, ‘I take one when I’m awake,’” she said at the time. “It stopped feeling like I had panic attacks and it started feeling like I was a living panic attack. During that time I was taking Klonopin, it wasn’t making it better but I just thought, ‘If I don’t take this, how much worse will it get?’”
At the time, she said her brain was still adjusting to its new normal.
“I still feel like my brain is recalibrating itself to experience anxiety,” she said. “I just feel, literally, on my knees grateful every day.”
Television personality Wendy Williams has been living in a sober home, previously having struggled with cocaine.
Wendy Williams, host of The Wendy Williams Show, is doing well in the sober home where she’s currently staying, according to her husband, Kevin Hunter.
Williams recently revealed that she has been residing in a sober house on her show.
“For some time now, and even today and beyond, I have been living in a sober house,” she said. “You know I’ve had a struggle with cocaine in my past. I never went to a place to get the treatment. I don’t know how except God was sitting on my shoulder and I just stopped.”
She didn’t specify exactly what made her seek treatment at this time. But for those worried for her health—especially after she fainted on live TV during a Halloween episode—her husband had reassuring news.
“Wendy is doing well,” he said to Entertainment Tonight. “We’re doing well as a family. We are moving forward with working on her sobriety and doing the work to help others, not just ourselves. It is a family process. Anybody that has to deal with this knows this a family process… and we are dealing with it and moving forward.”
“After I go to Pilates, I go to several meetings all around town… and I see my brothers and sisters caught up in their addiction and looking for help,” she said. “They don’t know I’m Wendy, they don’t care I’m Wendy.”
Her days also end the same.
“I am driven by my 24-hour sober coach back to the home that I live in, here in the tri-state with a bunch of smelly boys who have become my family,” she revealed. “We talk and read and talk and read and then I get bored with them. Doors locked by 10 p.m., lights out by 10 p.m., so I go to my room and stare at the ceiling and fall asleep.”
Williams recently took a two-month break from appearing on television to deal with thyroid complications that arose from her Graves’ disease, an autoimmune disorder.
I felt confident that I had no desire to use opioids again, not because the Suboxone had eliminated my cravings, but because I had changed my life. The pain I worked so hard to anesthetize with heroin had been addressed.
Suboxone, while often controversial among addiction treatment professionals and people in recovery, has moved to the forefront in discussions about opioid treatment. The recovery community has no shortage of naysayers insisting that medication-assisted treatment (with drugs such as Suboxone, buprenorphine, and methadone) is simply trading one addiction for another, characterizing it as heroin in legal form and just another way for the big pharma companies – who are already blamed for the initiation of the opioid epidemic – to pull in profits. But Suboxone is not an illicit street narcotic with fatal overdose rates surpassing even automobile accidents, it’s a life-saving tool that many experts insist is our best hope for the current public health emergency.
Medication-Assisted Treatment Is Effective, But Stigmatized
According to Dr. Gavin Bart, Director of the Division of Addiction Medicine at Hennepin County Medical Center and Associate Professor of Medicine at the University of Minnesota, opioid addiction requires long-term management; behavioral interventions alone have extremely poor outcomes with more than 80% of patients returning to drug use.
“Extensive literature and systematic reviews show that maintenance treatment with either methadone or buprenorphine is associated with retention in treatment, reduction in illicit opiate use, decreased craving, and improved social function,” Bart writes. “Extensive research shows that each of the three available medications used to treat opiate addiction have superior treatment outcomes to non medication based therapies. Increased retention reduces mortality, improves social function, and is associated with decreased drug use and improved quality of life.”
Abstinence proponents may be skeptical about Bart’s research, but for me, it rings true. Reduction in illicit opiate use? Check. Decreased craving? Check. Improved social function and improved quality of life? Check, check. Abstinence-based treatment did not save my life. Medication-assisted treatment paired with specialized addiction therapy helped me save my own life.
As an active member of the recovery community, I am mostly outspoken and typically very candid, even when it comes to mortifying revelations. And even for me, Suboxone is a touchy subject. I am more comfortable discussing random substances I’ve injected than I am discussing how Suboxone was a key player in my opioid addiction treatment. I think my discomfort is a result of the negative rhetoric that surrounds the medication, and ironically enough its harshest critics are often other people in recovery. The prejudice against medication-assisted treatment is harmful, and even deadly when the negative discussion derails someone from seeking the help that, according to the evidencebase, may give them the best chance of staying alive.
Is medication-based treatment the perfect fix to a horrific and increasingly deadly addiction? No. Suboxone has its burdens. I grappled with those too. When I first started taking Suboxone, I’d take it for a week and then relapse on heroin. I did that a handful of times before I was finally serious about getting clean.
My Suboxone Journey: From Relief to Frustration
My initial Suboxone dose was 8 mg buprenorphine with 2 mg naloxone. It was an orange strip with a tangy taste that I’d place under my tongue and wait while it dissolved into my bloodstream. Because I essentially switched directly from heroin to Suboxone (taking the first dose when I began experiencing opioid withdrawal symptoms), I didn’t have to suffer the weeks-long detox that frequently triggered my repeated relapses.
Taking my daily dose of Suboxone was like a sigh of relief at the beginning: one more day that I didn’t have to suffer through withdrawal. But after a few years, the sighs of relief eventually turned into sighs of disdain. My once-considered reprieve from the consequences of my addiction was starting to feel like a rusty pair of shackles. I was sick of going to the doctor and refilling my prescription, I was sick of keeping this secret from everyone in my life, I was sick of being terrified to travel. This thing that had once made me feel normal now had me feeling like I was still, after so much time, tied to my painful past of addiction.
Nothing else in my life reminded me of my past. There were no remnants of my previous addict self. I didn’t associate with any of my old using friends, I hadn’t seen or spoken with any dealers in ages, I never even got pulled over for traffic stops. I didn’t look like a junkie anymore and I didn’t act like one either. I had nurtured and repaired the ties with my family, I had a loving, healthy relationship, and I was well on my way to getting a college degree. I had successfully restored myself to sanity, as good ol’ Bill would say.
Fear kept me stagnant, which didn’t feel fair. I had come so far and was nothing like the junkie I once was, but I still had this inevitable withdrawal from Suboxone hanging over my head. My one final detox. The big whopper. How would I go through with it? I was in school so I couldn’t miss two to four weeks of classes, and anytime a summer or winter break neared, I’d chicken out, despite telling myself it was time and trying to prepare for it. In the meantime, I’d slowly been cutting down. I went from the initial dose of 8 mg buprenorphine/2 mg naloxone strips to 4 mg/1 mg, and then even further to 2 mg/.5 mg.
Suboxone Withdrawal
I had no idea what to expect. Like many of us, I have some form of post-traumatic stress disorder from my time in active addiction, and a major part of that was the horrendous withdrawals. I was completely fixated on these impending withdrawal symptoms, and there was nothing I could do — I had to pay the debt.
I finally made the decision to go through with it. I made the appropriate arrangements and was prepared to suffer for a couple weeks minimum, several weeks or maybe even months maximum. I watched YouTube to try to ease my frazzled nerves, but the videos pacified my anxiety like a game of Russian Roulette. Do not watch YouTube. Some videos had people detoxing, drenched in sweat and sobbing into the camera and others had people after just a week saying, “Not so bad guys!”
The night before I took my final dose, which was a teeny tiny square cut from a buprenorphine 2 mg/naloxone .5 mg strip, I curled up into the fetal position, buried myself under my duvet and cried myself to sleep. I couldn’t believe I was about to enter junkie limbo after living as a functioning member of society for so long.
The first few days weren’t pleasant, but it was nothing like I’d experienced in the past. I couldn’t sleep, I tossed and turned, I had tingling chills and clammy sweats, general anxiety and a sense of unease. I once detoxed from a $100 a day heroin habit and it was like I was the star of an exorcism horror film; compared to withdrawals like that, this one wasn’t nearly as bad as I’d anticipated. I think spending so much time tapering down to as small a dose of suboxone as I could handle really paid off when it came time to detox.
Another big fear I had, mostly thanks to Google and YouTube, was post-acute withdrawal syndrome (PAWS). After the initial detox, the last time I felt any symptoms I knew were directly related to my withdrawal was about a month and a half after day one. I had a mini-panic attack when Target was too crowded. I started pouring sweat, rushed to my car, and burst into tears. And after that, I’ve simply felt normal. That thing we all desperately want to feel: “normal.”
What If?
The detox was tough, it was emotionally taxing and physically draining. But I realized that it was the fear of the withdrawal that had me suffering the way I was. It was a fear of the symptoms and a fear of the unknown. I felt confident that I had no desire to use opioids again, not because the Suboxone had eliminated my cravings, but because I had changed my life. The pain I worked so hard to anesthetize with heroin had been addressed. I did deeply introspective work in therapy and I changed my social environment, all while using Suboxone. I built up my self-worth by investing in myself and investing in healthier relationships, things I never could have done while still using heroin. I fixed my broken coping mechanism, I knew how to handle stress and sadness. Yet, there was still this tiny sliver of me that wondered, “what if?”
What if it was all some magical mask that Suboxone created and none of this was reality and as soon as I stopped taking it I would revert to my old tormented life?
That is what prompted me to finally write this piece — realizing that regardless of the discomfort I feel discussing Suboxone, there are other people in recovery using medication-assisted treatment right now, scared to talk about it and scared to get off, experiencing the exact same fears that plagued me. Once I made the leap and decided to go ahead with my final detox, and then when it was complete, I felt free. Finally free. Not because Suboxone had me stuck, but because Suboxone helped me move past the hardest time of my life. This withdrawal was the final chapter to that saga and it was finally over — and I survived.
