Answer Addiction

Tag: opioids

  • 5 Ways That Methadone Maintenance Treatment Changed My Life

    5 Ways That Methadone Maintenance Treatment Changed My Life

    When you’re an IV drug addict, you risk overdose, HIV, endocarditis and other infections, amputations, abscesses, and more. When I was stable on methadone and stopped using, these risks just disappeared.

    Telling someone that you take methadone is a big deal. You’re not just telling them that you’re taking responsibility for your recovery and your health, you’re also telling them that in your pre-recovery life you probably stole, lied, and did some other terrible thing to support your addiction. You’re not just revealing you had an addiction, you’re saying that it got so bad that going to a clinic every morning to take medicine in front of someone is preferable to the life you were living.

    I am not here to argue about whether MMT (methadone maintenance treatment) is the solution to the opioid crisis because it’s not for everyone. But for me, it was a chance to have a normal happy life. Here’s why:

    1. It Gave Me Accountability

    When you start off as a new patient at any methadone clinic, you have to come every day. You also have to submit to drug testing and therapy, both individual and group sessions. These are all requirements if you want that little cup with your medicine that keeps you from getting sick. As an active drug user, I would have done absolutely anything to keep from getting sick. Show up someplace between 5 and 10 a.m.? No problem! Let someone watch me pee in a cup? Sure thing!

    I, like many people, started MMT as a way to keep myself from crippling heroin withdrawals. I wasn’t at all ready to get clean and stop using. But I had to make and keep appointments with the doctor at the clinic if I wanted to get more methadone, and I had to have bloodwork done if I wanted to keep being an active patient. 

    Slowly, after months of going to this clinic every day, the methadone built up in my body. My opioid receptors were full of methadone and the heroin that I was still putting in my body was no longer getting me high.

    Once I passed my first few drug tests, I was allowed to take a bottle home with me for the next day, which motivated me to keep attending my therapy sessions and to go to work so that I could afford transportation to the clinic. When I was using, the only accountability I had was to my drug dealer. I never would have gotten checked for diseases or spoken with a mental health professional.

    Without even realizing it, I was keeping commitments and getting the help that I desperately needed. Now, years after initially becoming a patient, I have other responsibilities like making sure my rent is paid and not forgetting that I need to renew my license plates next month. My priorities have shifted.

    2. My Health Improved

    I know that this one might sound like a contradiction to everything you think that you know about methadone. A lot of media still portrays people who go to methadone clinics as underweight, shaking, pale, and covered in track marks. This image accurately described me when I first started going, but over the years I’ve been able to change myself internally and externally. When I first started treatment, I was required to get bloodwork to check for the diseases that IV drug users expose themselves to. When I was injecting, I would occasionally get infections in my arms and sometimes end up in the hospital due to these or one of my many overdoses.

    Almost instantly after getting on a therapeutic dose of methadone, I started to care about my body and what I was putting into it. I started taking vitamins and eating food other than what I could steal from a gas station. I felt stable enough to look towards the future and start doing what was required for me to have a long and happy life.

    When you’re an IV drug addict, you risk overdose, HIV, endocarditis and other infections, amputations, abscesses, and more. When I was stable on methadone and stopped using, these risks just disappeared. I became lucid enough to take care of myself and to fix my body and the incredible damage that I had done to it. I’d had a terrible diet and had stopped caring about myself. Now, I take daily vitamins, get a flu shot, get an annual check up at an OBGYN, and try to eat healthy when I can. I also got extensive dental work to fix damage to my teeth from years of neglect.

    3. I Became a Wife and Mother

    This is a very specific and personal way that being on methadone has changed my life. In my addiction, I was in a toxic relationship that revolved around using together and endless dishonesty. We were together because it was easy. When I decided to stop getting high, he wasn’t ready to quit and the relationship ended abruptly. I met my husband shortly after and he took a chance on getting into a relationship with someone new in recovery. I wasn’t using anymore but I still had a lot of addict behaviors.

    I navigated through this new relationship, trying to be honest with my new partner. I wasn’t familiar with honesty in the beginning and he was aware of this and very patient with me. I learned what kindness and love really were for the first time without drugs involved. We also learned early into our relationship that we were expecting a baby boy. I stayed clean throughout my pregnancy, took my methadone as prescribed, and discussed my fears and worries with my therapist at the clinic.

    In two years, I went from living in a car, unable to feed myself, to a wife and mother. None of this would have had the chance to happen if I didn’t take the first step and start treatment.

    4. I Have a Relationship with My Parents

    It has taken years to earn back my parents’ trust. They’d stopped answering the phone when I called because I always asked for money. It became too painful for them to be an active part of my life. They were just waiting for that final phone call telling them they’d lost their daughter to her addiction.

    When I first started going to the methadone clinic, they were skeptical; they knew very little about how the medication worked. Then, after about six months, the begging for money stopped and the tone of our conversations changed. I called just to talk about my day and for the first time I didn’t ask for anything. They noticed that my living situation had changed – I’d gone from living in a car to staying in a cheap motel, then finally I moved into an apartment. I was awake during the holidays and not spending a half hour at a time in the bathroom trying to shoot up. I was gaining weight and smiling again.

    After I passed my first drug test, I wanted everything to go back to the way that it was before I started using. I had a hard time understanding why they didn’t trust me. Then I realized that it didn’t take a month for me to lose their trust, it was years of lies and heartbreak.

    I am now able to look back and see the hurt that I caused and ask for their forgiveness. I am a mother now and I couldn’t imagine watching my sweet happy child deteriorate the way that I did. I am grateful for this real second chance to have them be proud of me. But I didn’t get clean for them, I had to do it for myself. The great relationship that I have with them now is just an extra benefit.

    5. I Have Goals for My Future Self

    During my addiction, the only goal I had was to come up with enough money to stay high that day. I felt like queen of the world if I was able to have enough heroin for two days. That was my life for years: After finding money and drugs, I would work on shelter and then maybe food.

    Once I became stable on a therapeutic dose of methadone, I didn’t have to spend energy and time finding drugs because I wasn’t worried about withdrawal. I suddenly had all of this time to spend on making money and cleaning up all the messes I’d made.

    My primary goal for the first few months I was clean was to make sure I got to the clinic on time. It might sound like kind of a sad existence but without my medicine, I wasn’t going to be able to function. I know the term “liquid handcuffs” is used a lot in reference to methadone treatment and I understand the frustration of having to go to the clinic every day. But if you are completing all the requirements of your clinic, you get to work up to going biweekly or even monthly. The program is designed to give you a normal life.

    My next goal was to have a stable place to live and to be someone who others could count on. There were a ton of baby steps I had to take to get there and I was only able to do that initially because I started MMT. I did the rest of the work with my counselor, my church, and my husband.

    It’s been three years since I started treatment and I’m in the middle of my third term in college and my husband and I are looking into buying our first home this fall. My next goal will be to get off methadone completely, but I will not rush this process.

    I am so thankful that this form of treatment was available to me. Methadone should always be an option for those of us who have had a difficult time getting clean with other methods. There is still a huge stigma attached to MMT patients and clinics and I could say that another goal of mine is to help break that. It’s not a magical cure for opioid addiction, but it played a vital role in my recovery.

    What are your thoughts on methadone maintenance treatment? Share with us in the comments.

    View the original article at thefix.com

  • The Magic and the Tragic: Falling in Love in Recovery

    The Magic and the Tragic: Falling in Love in Recovery

    I wondered if the bitter taste of the endings would overpower all the other memories of my first sober loves.

    I met C at the most inopportune moment imaginable: I was a full-blown heroin addict. He was not. We met on a video chat website called ChatRoulette, both of us drunk with our respective friends; he lived in California, I in New York. After a few months of daily phone calls and video chats I was head-over-heels in love and flew out to San Diego to meet him, doing my best to appear healthy and normal. I hadn’t told him and didn’t plan to.

    C was less a boyfriend than a hostage, an innocent pulled onto a rollercoaster he didn’t yet realize was brakeless. The only reason I was able to hide my addiction from him for a while was because he was so impossibly normal—he surfed, played guitar, had a tight-knit group of equally normal friends. What he saw in me, tattooed and cynical, I still don’t know; perhaps, like me, he needed something different. He’d never known any heroin addicts in his idyllic suburban life, so he missed all the tell-tale signs. Naturally he would think the marks on my arms were inflamed mosquito bites and not track marks, because who would lie about something like that?

    I’ll never forget the look on his face when he finally caught me. I get why using heroin would be unfathomable to someone who has never tried it. It must be near impossible to understand the kind of pain and self-loathing that makes heroin seem like a viable solution. By the time he’d caught me I had been making half-assed attempts to get clean for months, but the look on his face was the final push I needed. I left New York and moved in with him in California and despite some false starts, despite the odds, I got better.

    In the cold hard light of my fledgling sobriety, the fantasy guy I’d created in my mind began to crumble the way real-estate euphemisms do when you see the actual apartment. You really want to believe that they actually meant cozy and not suffocatingly claustrophobic, but they never do. Never. In my heroin haze I’d romanticized all his flaws: instead of being emotionally repressed with awful communication skills, he was pensive and mysterious. He wasn’t living at home to save money, he was too cheap and emotionally enmeshed with his mother to move out. I loved him even so, tenaciously, holding onto him with white knuckles as the relationship unraveled over the next few years.

    The night it finally ended, I felt like I’d been thrown off a cliff. I’d gone straight from drugs to love and for the first time it was just me, unadulterated, crying alone in my car in an empty parking lot. For the first time, I was really, truly sober.

    After the breakup, I decided to move back east to go back to school to study film, or writing. A few days before Christmas I stopped by a college in Brooklyn to figure out admissions, and, smushed into a packed rush-hour train on my way back, happened to look up and lock eyes with a guy a few rows away.

    An electric current pulsed through me. He looked tired and messy—two days of beard, deep circles under his eyes, terrible posture, dark-blonde hair stuffed into an awful neon orange ski hat. But there was something about him.

    I took my notebook out of my bag and started writing about him, unfiltered stream-of-consciousness, private thoughts I’d typically never share with a stranger, especially one I was so attracted to. I filled over a page and then decided to give it to him. Why not? What’s the worst that could happen? With this burst of confidence, I wrote my number at the bottom of the page but even before I’d finished folding it up, I lost my resolve. The note was still in my palm when the train slowed and he walked towards me, mumbling something unintelligible and thrusting out his hand: he had written something for me. I handed him my note and he looked down at it, then back up at me. We grinned at each other. Just like that, I’d somehow stumbled into a cute first-meeting worthy of Nora Ephron herself.

    At dinner a few nights later, he spoke slowly, deliberately, eyes crinkling when he smiled. He told me his name—E—and that my note had made him laugh. He was a musician, and like most musicians I’d known he was a bit of a disaster. Maybe more than a bit: a self-diagnosed narcoleptic, a diabetic who struggled to stay on top of his blood sugar, an ex-cocaine addict. (He didn’t specify how long. Weeks? Days? Hours?) As he told me all this, I knew the sensible thing was to make up some excuse and book it the hell out of there, yet there I was, moody and self-absorbed, a writer (enough said), an ex-junkie. I was an insecurity-ridden raw nerve fresh out of a spectacularly painful breakup, far from the picture of perfect mental health. So I didn’t book it; I stayed put.

    After that first date we saw each other constantly. We listened to records, played Scrabble (I always won), talked late into the night, laughed, made out in his driveway. I met his friends; he sent me albums he thought I would like. One night I sat on his kitchen counter eating a yogurt and he stood there with the refrigerator door open, staring at me with a big, dumb smile.

    “What?” I said.

    He shook his head and closed the refrigerator door, still smiling. I’ve never felt more beautiful than I did right then.

    “What are you scared of?” he asked me once after we’d had sex.

    “Failure. Success. Mediocrity. Rejection. You?”

    “Well, everything, I guess,” he replied. “I’m afraid of everything.”

    We both had piles of baggage, but there was a major difference—I was in recovery, depressed but going to therapy, an addict but a clean one who went to meetings, afraid of everything but doing it anyway. In his bed when he thought I’d fallen asleep I felt him pull away, back into a dark part of himself he didn’t want me to see. I couldn’t help but remember the way C did the very same thing.

    After I returned to California we continued to talk, but over time he stopped answering my calls, calling back days later at odd hours sounding distracted and paranoid. He would tell me he didn’t believe I was actually moving back to New York and I’d repeatedly reassure him that my return ticket was already booked. Eventually he stopped calling back at all, and though I was angry, I also felt something else, unmistakable and undeniable: dread. After a month of radio silence, I Googled his name.

    “Tappan Zee Jump: man’s family ‘blindsided’ by death.”

    He must’ve been so cold, I remember thinking. It was the beginning of April—temperate in San Diego, but miserably wet and chilly in New York. Over the next few weeks I jumped from denial to anger and back again, unable to comprehend the amount of pain he must have felt to justify jumping off a bridge. I thought about what my mom’s face would look like if someone told her I’d killed myself, or the way she’d feel if she found out I had died of an overdose. I realized it wasn’t all that different.

    That summer, I was compelled to google another name: C’s. We hadn’t spoken since the breakup and I’d thought up all kinds of reasons as to why he had never reached out. Interestingly enough, none of these reasons included him having a pregnant new girlfriend. I didn’t feel all that different looking at C’s baby registry than I did when I saw E’s obituary. Both felt devastating and permanent; both had nothing to do with me. I wondered if the bitter taste of the endings would overpower all the other memories of my first sober loves.

    In AA they often talk about “selective memory”: Play the tape through, they say. Instead of just remembering that one perfect drunk night, play the tape through to how you felt the next morning, to the shame and panic of waking up after a blackout. Instead of just remembering little moments of a relationship, look at the whole thing, the magic and the tragic. I knew the tragic parts by heart, but as the years passed I began to see the magic, too: C and I on motorcycle trips together, holding hands in the dark, recording songs in his bathroom (the acoustics were better). Then, the magic of learning how to love someone; the way I felt on the train on that cold winter day when I met E; the way he looked at me in his kitchen, his big smile illuminated by the white light of an open refrigerator. The note he gave me: “to me you’re perfect and I LOVE your hair” in a loopy script on the back of an old business card. I still have it, somewhere.

    Those are the things I remember now, not because I’ve forgotten the endings or the sad bits, but because at almost eight years sober, I’m beginning to finally see the big picture: the sad parts are gifts, too, maybe more precious than anything else. I play the tape through, and all I feel is grateful.

    View the original article at thefix.com

  • On the Job and on Drugs: Police Officers Who Struggle with Addiction

    On the Job and on Drugs: Police Officers Who Struggle with Addiction

    A police officer who is using opioids illegally is breaking the very laws that he or she has sworn to uphold. This makes it even more difficult to reach out and get help for an addiction that may be spinning out of control.

    No one ever said being a police officer was easy. The job alternates between crushing boredom, bizarre situations, and unimaginable danger. When you’re a cop, much of the population that you’re paid to protect is afraid of you. You’re always being judged, whether it’s in the media or when you go to the corner store. Your hours are usually pretty awful, which means you don’t get to spend as much time with loved ones as you want to. You see things, horrible things, that mess up your head. If you talk to your peers about how traumatized you are, you’re seen as weak. The pressure can be intense.

    Police officers are human, so they seek ways to cope with the stress. Sometimes they find relief in opioids. And sometimes they become addicted.

    Two recent deaths of police officers due to drug overdose are stark reminders that no one is immune to addiction. In fact, police officers may be more at risk than others.

    Under Pressure and Self-Medicating

    Dr. Michael Genovese, a clinical psychiatrist and chief medical officer at Acadia Healthcare, told The Fix, “Not only are law enforcement officers not immune to addiction, but they are also more susceptible to addiction because the stress of their jobs renders them so. Police officers to whom I have spoken, who suffer from addiction, are not generally using drugs to get high or have fun; they are using them to numb emotions they find painful. Every day, police officers witness things that are outside the scope of normal human experience, and the frequency and intensity of traumatic events are overwhelming to the officer’s brain, even if he or she thinks they’re not.”

    While outsiders don’t think of Lewiston, Maine, as a hotbed of crime and drug use, locals know the old mill town has long been a place where heroin and crack are bought and sold. Officer Nicholas Meserve was attempting to stop the flow of drugs into this small Maine city, until he died of an accidental overdose.

    When announcing Meserve’s death by fentanyl overdose, Lewiston’s police chief Brian O’Malley said,“I hope it’s a reminder that the opioid epidemic touches the lives of many in the community, regardless of their wealth, race, religion or profession.”

    In Baltimore, Officer Joseph Banks Jr. died at a local motel after overdosing on heroin. His girlfriend, who was with him when he died, told police the two had been hanging out at the motel, using drugs throughout the day. Banks was suspended from the police force at his time of death. A police spokesman refused to state the reason for his suspension.

    Vernon Herron, who runs safety and wellness programs for the Baltimore Police Department, said, “Like a lot of police officers, sometimes we are so hyper-vigilant that we medicate ourselves. I’m not talking specifically about him [Banks], but I see officers over-medicate themselves to deal with the stresses of police work.”

    Michael Koch was a police officer for 15 years, 10 of them as an undercover narcotics detective. Over time, he started using heroin and became addicted, eventually to such a degree that he was arrested after taking heroin from an evidence room.

    Finding Relief in Opioids

    Koch told The Fix, “Drinking was always a part of my life. It was an unhealthy coping mechanism, but it’s what I did. At one point, I hurt my knee badly and I got a scrip for Vicodin. As soon as I took that drug the reaction in my body was amazing, like it was sent from heaven. So then my drinking dropped off and I got more into the pills. I was part of the SWAT team and evidence team, and kept getting injured at work and when I did I would go to the doctor and get more pills. So then I started using it recreationally; instead of drinking, I took pills.”

    Koch’s addiction continued to progress. As he told me, “I was dealing with immense pressure at work. We would see things the average person wouldn’t see. Bodies cut open, heads on the ground, all of that stuff just stacks up. I might have looked like I had it together at some of these scenes but inside I was dying. So I started using more and more pills and became dependent on them.”

    Koch kept sinking deeper into his addiction and he felt like he had no place to turn. Letting your fellow officers know that you might have a problem is just not how it’s done. A police officer never wants to appear weak amongst his or her peers.

    It got worse. As Koch relates, “In 2010 a lot of heroin was on the streets and we were doing a lot of busts where we confiscated heroin, and also things like Oxys. I crossed the line and started taking things out of evidence for my personal use. I justified it by saying it was going to be thrown out anyway, but by that time I’m an addict and living a double life as a well-respected undercover cop and also as someone that was smoking a ton of heroin. Eventually, I got caught taking drugs out of evidence.”

    He was charged with second-degree burglary, which was pled down to a misdemeanor and he was placed on probation. He now works as an addiction counselor at True North Recovery Services and has been clean and sober for years. He also has a podcast where he and guests discuss issues of addiction and mental health that affect first responders.

    He told The Fix, “It was devastating being found out but I was relieved that this secret hell was done. In the first six months of sobriety I went to rehab, lost my career, went through criminal charges, got divorced, went through bankruptcy, lost my reputation and friends and stayed sober. I have five and a half years of sobriety thanks to the support of 12-step recovery.”

    Other officers were not as lucky as Koch. They lost their lives to addiction before they could get clean.

    Overcoming Stigma and Acknowledging Vulnerability 

    Police officers are often thought of as brave protectors who work tirelessly to keep us safe, putting themselves at risk in the process. While true, police officers are also regular people who have the same amount of everyday stress in their lives as the rest of us, who at the same time are experiencing and processing traumatic experiences that most people couldn’t dream of. For some, death and violence are part of a day’s work. They spend less time with their loved ones and in other traditional support systems because they often work irregular hours, leaving them even more isolated.

    And then, of course, there is the issue of the drugs being illegal. A police officer who is using opioids illegally is breaking the very laws that he or she has sworn to uphold. This makes it even more difficult to reach out and get help for an addiction that may be spinning out of control.

    Even legally, police officers have fewer barriers to drug use. Mark Restivo was an NYPD officer who was forced to retire because of a severe injury to his knee after he was thrown down a flight of stairs and badly beaten while attempting to stop a thief from stealing a woman’s purse. He quickly became addicted to opioids. He told The Fix, “There is a sense of inherent trust in officers; while dealing with my injuries, I firmly believe that I was prescribed so many prescription painkillers because of my status as former NYPD officer.” After a stint in a First Responder rehab, Restivo has been sober for almost six years. He credits his sobriety to 12-step programs and Vivitrol.

    Police officers might sometimes seem intimidating, and like they always have a situation well under control. But addiction affects everyone, sometimes with tragic results.

    Changes are on the horizon. There are numerous treatment centers and recovery programs focused on helping police officers, whether they’re a first responder or not, and many police organizations are working to develop programs to locate and help cops who might be struggling with addiction.

    View the original article at thefix.com

  • Doctor Calls For Caution In Reducing Opioids

    Doctor Calls For Caution In Reducing Opioids

    For some patients who have been doing well on opioids long-term, it makes sense to “leave well enough alone,” the doctor said. 

    Today, much of the medical community is focused on reducing opioid prescriptions after decades of overprescribing, but one doctor is an outspoken critic of weaning patients who are doing well on long-term or high-dose opioid prescriptions. 

    Dr. Stefan Kertesz, a primary care physician who focuses on addiction medicine and works with the homeless population, told STAT News that he is challenging the idea that even people who are doing well on opioids need to have their medications reduced or replaced. 

    “I think I’m particularly provoked by situations where harm is done in the name of helping,” said Kertesz, who is also a professor at the University of Alabama at Birmingham School of Medicine. “What really gets me is when responsible parties say we will protect you, and then they call upon us to harm people.”

    In particular, Kertesz takes issue with the CDC’s 2016 opioids prescription guidelines. The guidelines were interpreted very strictly, and have led to many pain patients—even those who have not abused their medications—seeing their care regimen change. 

    For some patients who have been doing well on opioids long-term, it makes sense to “leave well enough alone,” Kertesz said. 

    He believes that the general recommendation to be careful when prescribing opioids is sound advice. However, when the recommendations are taken as a mandate, problems can arise, he said in a written response to the guideline. 

    “This is a guideline like no other… its guidance will affect the immediate well-being of millions of Americans with chronic pain,” Kertesz wrote.

    In another written response he said, “Most of us wish to see an evolution toward fewer opioid starts and fewer patients at high doses,” but doctors need to be able to leave some patients on opioids as clinically necessary without feeling like they are putting their careers at risk. 

    Kertesz encouraged the CDC to clarify that the guidelines were recommendations only, not policy proclamations. 

    “It is imperative that healthcare professionals and administrators realize that the Guideline does not endorse mandated involuntary dose reduction or discontinuation,” he wrote in one letter that he co-authored. “Patients have endured not only unnecessary suffering, but some have turned to suicide or illicit substance use.”

    Now, Kertesz is hoping to secure funding to study suicides caused by reduction in pain medications. 

    “You have three things that are potentially simultaneously associated with harm: Pain itself. Opioid dependence, the dependence itself. And the event, however we wish to interpret it clinically—as resurgent pain or untreated opioid dependence—in patients who are having opioids taken away,” he explained. 

    Despite his dedication to speaking out against uniform opioid reductions, Kertesz sometimes still feels nervous about standing against the mainstream medical community.  

    “Every single bit of it involves ambivalence and driving myself crazy,” he said. “Like, am I making a mistake? Am I going to blow up my career?”

    View the original article at thefix.com

  • The Evolution of Dopey: How a Podcast Is Showing Us How to Live and Laugh While Sober

    The Evolution of Dopey: How a Podcast Is Showing Us How to Live and Laugh While Sober

    We wanted to do something that gave addicts a feeling that they weren’t alone, that they were in the company of people who had been through what they had been through, and also have a few laughs.

    Dopey podcast has been around since early 2016, and it has a steadily growing audience of people from all across the spectrum of addiction. In addition to appealing to people in recovery, it draws in people who need help, and those who have family members suffering from addiction.

    As Dr. Drew told The Fix last year, “If you’re an addict and you listen to Dopey, you will find your people and your story here. Listen to it, and you’ll see what I mean.”

    Dopey attracts fascinating guests: recent episodes have featured Artie Lange, Dr. Drew, Marc Maron, Jamie Lee Curtis, gossip columnist AJ Benza, Justin Kreutzmann from the Grateful Dead, Amy Dresner, and others discussing a wide variety of topics such as Game of Thrones, seizures, booze, pills, cocaine, heroin, and more.

    These days, it seems that practically everybody has a podcast. But when Dave and Chris created Dopey, they didn’t have a master plan to be the dominant podcast on addiction and recovery. Initially they were big fans of the Howard Stern Show and wanted to create something similar, but with two people who had experienced addiction and recovery at the helm.

    Dave met Chris at Connecticut’s Mountainside Treatment Center in 2011. They kept in touch after getting out, eventually launching the podcast. At Dopey’s inception, Chris had a year and a half of sobriety under his belt, and Dave had three months.

    Dave and Chris didn’t know where Dopey belonged in the podcast landscape because as Dave explains, “I didn’t even know what a podcast was back then. A friend of mine told me I should do a podcast. I didn’t know anything about them, I just knew I liked radio, I loved the Howard Stern show, and I thought this was an opportunity to do a show like it. I still barely know anything about podcasts!”

    People who have struggled with addiction often have hilarious, insane, and unbelievable stories of the misadventures they get into when they’re high, and Dave and Chris wanted to share those stories on their podcast.

    “Originally the show wasn’t going to be about recovery at all,” Dave explains. “At first I thought it would be funny to do a podcast about the dumbest stuff that we had done in our addiction. That was the idea, and we stuck with that until we recorded an episode where we talked about some of the dumb things we had done, and I realized that we had to say we were in recovery, otherwise we’d be championing drug use. It was never supposed to be a recovery podcast; it became one and the recovery had to be part of the show to keep our conscience clear.”

    Dave adds that with the Dopey podcast, “We wanted to do something that gave addicts a feeling that they weren’t alone, that they were in the company of people who had been through what they had been through, and also have a few laughs. That was the idea…The show was mostly about the ridiculous stuff we had done, all the money it cost us, the life it cost us, and it was our pain and ridiculous decisions that were helping other people from making (the same) decisions.”

    It turns out that humor was a powerful draw, bringing listeners to the show. “Chris had a great phrase for that called the ‘rope-a-dope,’ where you’d rope-a-dope people into recovery through the debauchery. We wound up helping people as a byproduct of the show.”

    Dave is happy that Dopey is giving the world a realistic portrait of people suffering from addiction. “When you watch TV and see addiction commercials, it doesn’t really portray it in a real way. I’m very proud that Dopey did that. If you listen to the show, you hear about real people, and you really get to know what addicts are like. And when I say that, [I mean] they’re like everybody, they’re just unfortunately dependent on drugs and make terrible decisions. I do feel very, very good in playing a part in de-stigmatizing addiction and showing the world what addicts are really like.”

    You don’t usually hear about humor as a treatment for addiction, but Dave realized it was an important tool in his recovery arsenal.

    “For me, humor is just a tremendous part of my life, and I like to see the dark, funny side of things. I don’t think a sense of humor is required to get sober, but I think it’s an amazingly helpful tool if humor makes you feel good. There’s a lot of weirdos out there who don’t have a sense of humor. They can still get sober, but I think if you have a sense of humor, it’s a great tool in recovery. Chris and I discovered that to take away the stigma, there’s nothing better than to laugh at yourself. If you can laugh at yourself, chances are you can get better.”

    The Dopey audience grew larger in response to a recent episode of This American Life that featured the podcast in-depth. But as this new and larger group of listeners began to tune in, Dopey suffered a tremendous blow. Chris relapsed and died on July 24, 2018 at the age of 33. (Chris had nearly five years of sobriety and was working on becoming a clinical psychologist at the time of his death.) Then Dave took another hit when he lost Todd, a close friend.

    “I think the show really started to change when Todd died,” Dave says. “Todd was somebody I had known since I was 19, and I used more drugs with him than anyone else. He died six or seven weeks before Chris died, and it was in those six or seven weeks that I started to change the way I wanted the show to be. I just couldn’t laugh with a clear conscience in the same way because my friend had just died.”

    The show revolved around Chris’ death “for a good five or six weeks. It was a very sober, very sad, freaked-out time to try and get some sort of vibe back. In a way, it was like, the show must go on. We had an audience, and we had an audience of people who benefitted from the show. I did not want the show to fall apart because Chris had died.”

    Dave didn’t realize it at the time, but by pushing forward with the show after the deaths of Chris and Todd, he unintentionally showed his audience how to keep moving forward after a tragedy without using drugs or drinking.

    “When Chris died, I was torn apart. I’m still incredibly upset about it. [But] I think in the end, his death carried a message of recovery. It didn’t occur to me at the time, but I heard a lot of feedback over this, and continuing the show after Chris died made people understand that they can stay sober through adversity, heartache and loss.”

    When Chris was alive, he and Dave often talked about their ambitions for the show, and Dave still feels Dopey could be “a monster. I still think it can be bigger because there are so many people that are affected by addiction. That’s just one piece of it. The other piece of it is stories around drug addiction are so entertaining, and if you put those two things together, the audience could just be gigantic.”

    As Dopey continues to grow, reaching an ever-widening and changing listenership, Dave’s hopes for the podcast’s future don’t seem so outlandish:

    “I want it to be the biggest thing in the world, I want it to cross over in a major way where Robert Downey Jr.’s on it, where Eric Clapton’s playing “Layla” on the show, I want it to be as big as it can be.”

    Click for more Dopey.

    View the original article at thefix.com

  • Finding Recovery and Support for Opioid Addiction on Social Media

    Finding Recovery and Support for Opioid Addiction on Social Media

    The rules state: We support everyone’s path to recovery, including Suboxone, Subutex, Methadone, Vivitrol, cannabis and kratom. We do not allow any debate as to whether or not being on maintenance meds means you are or aren’t clean.

    Four years ago, Dorothy had no support for her opioid addiction. As a mother and stepmother, she was afraid to be open about her struggle; if her children’s father or stepchildren’s mother found out, they might question her ability to be a good parent. She thought about attending recovery meetings but was worried they would shun her for being in active addiction or, some years later, for taking Suboxone, a partial opioid agonist, to manage her chronic pain. Luckily, she discovered a private Facebook group that supported people like her with opiate addiction.

    For the sake of full disclosure, I’m also a member of this group. While I enjoy my social media fill of cats dressed in dinosaur costumes, babies getting slices of Kraft singles thrown at their heads, and I love dad jokes just as much as the next person, I value this group the most.

    Addiction Support…on Facebook?

    The group quickly became a refuge for Dorothy and me, a digital safe haven where we could share our pains and joys behind the privacy of a screen.

    “I have made friends that I’m sure I’ll have for the rest of my life. I feel supported and secure here. What I love the most is how diverse we are. We run the gamut from people who are using to people who are totally abstinent and everything in between… All we ask is that people respect each other and everyone’s path to recovery,” Dorothy said.

    After participating in another group where members were shamed for taking Suboxone or methadone to manage their opioid addiction, I found Dorothy and the group’s perspective on harm reduction refreshing. In order to join the group, members must agree that they will not bash medication-assisted treatment (MAT). According to the official group guideline: “We support everyone’s path to recovery, including Suboxone, Subutex, Methadone, Vivitrol, cannabis and kratom. We do not allow any debate as to whether or not being on maintenance meds means you are or aren’t clean.”

    Another administrator added, “If you hate the fact there are active addicts in this group, if you don’t support MAT or [you] want to be a douche canoe to everyone you meet who doesn’t live up to your standards, LEAVE.”

    After nine months of participating in this group, Dorothy became a volunteer staff member, then administrator. On an average day, she spends six hours involved in the various tasks that keep the group running. Dorothy, along with eight other administrators and nine moderators, approves each post before it hits the page, ensuring that the posts follow group guidelines. The guidelines mirror that of an in-person support group: members must maintain each other’s confidentiality and privacy, be respectful, and refrain from giving medical advice, selling or seeking drugs, asking for money, or posting links to treatment centers.

    Sarah Burbank has also been a volunteer group administrator for four years and spends four to eight hours on the group each day. Sarah considers the members of the group to be family. “The group is a touchstone and an inspiration. I have watched some group members pass away and have to announce to the group a loved one or cherished member has passed away from the disease. Those are the darkest of days. But there are little milestones that we share that make it so special. Day 1! 30 days! Years clean! Getting children back and jobs and lives back. Those are the truly beautiful things that keep me here.”

    Dorothy and Sarah are not alone. This particular Facebook group has blossomed to 22,000 members. Members are hungry to share their stories, to be supported, validated, and encouraged. Posts reveal a complex tapestry of emotions: of recovery, struggle, pain, joy, heartbreak, victory and defeat, often all in a single post.

    Using Social Media to Forge Connections in Marginalized Groups

    It may seem contradictory to turn to social media for support for addiction. According to a 2018 Fix article based on research from Penn State, social media use is correlated with increased rates of depression and loneliness. Similarly, in 2011, Researchers Daria J. Kuss and Mark D. Griffiths systematically reviewed psychological literature and found that social media can be used for connection, but also that it may negatively impact relationships, work, and academic achievement. This and other evidence suggest social media can be an addiction just like alcohol and drugs.

    While it’s important to acknowledge this research and the potential negative impacts of social media, this critique fails to recognize the power of online social networks, especially for marginalized people. Toronto-based mental health professional Krystal Kavita Jagoo says, “For some, authentic human connection may only come online. Sometimes you don’t have those options in person.” Jagoo pointed out that social media or internet forums can feel safer for people of color, queer, trans, and non-binary folks, and people of differing abilities.

    Jagoo continued, “If you’ve had a traumatic experience and are able to hear from others about things someone has struggled with, you don’t feel as alone. Sometimes it’s just knowing that others understand what you’re going through; they can offer strategies or things that have worked for them that you might be more inclined [to try] than a professional who doesn’t have lived experience.”

    Jagoo herself has found valuable support online. “I think of how healing it has been to connect with folks of color around the world with respect to surviving oppression.” In order to maintain balance in our lives and avoid social media burnout, Jagoo recommends finding a group that is anti-oppressive, accepting, and feels rewarding. Setting and maintaining boundaries is important, as is making sure that you only check notifications when you have time and energy to engage, and unfollowing or leaving groups if they are feeling more draining than helpful.

    Both Dorothy and Sarah mentioned that it is difficult to be a group administrator while balancing their work and home lives. But by far, they feel the benefits outweigh the challenges of spending hours volunteering in the group. “The online community is really important because it allows people to connect in the safety of their own homes, anonymously if they choose. It gives us the ability to reach so many more people, people that we wouldn’t have otherwise had any contact with.”

    View the original article at thefix.com

  • Doctor Receives 20-Year Sentence For Reckless Opioid Prescribing

    Doctor Receives 20-Year Sentence For Reckless Opioid Prescribing

    The Manhattan doctor was convicted on 10 counts of unlawful distribution of oxycodone without legitimate medical purpose.

    A family doctor based in Manhattan’s Upper East Side was sentenced to 20 years in prison on Tuesday (April 30) for recklessly prescribing opioid painkillers that played a role in one patient’s fatal overdose.

    Dr. Martin Tesher, 83, was convicted in July of 10 counts of unlawful distribution of oxycodone without legitimate medical purpose to five patients, including 27-year-old Nicholas Benedetto.

    In March of 2016, two days after visiting Tesher and receiving prescriptions for oxycodone and fentanyl patches, Benedetto fatally overdosed on the drugs.

    According to SILive.com, one month before his death, Benedetto’s mother called Tesher asking him to stop giving her son prescriptions because he needed treatment. She told authorities that her son was smoking the fentanyl patches.

    Tesher prescribed oxycodone and fentanyl patches to Benedetto and four other patients “after he learned, or had reason to believe, that these patients were addicted to drugs,” according to the Justice Department.

    An expert witness testified that none of them “had verified medical conditions that would require the prescription of Schedule II opioids.”

    Benedetto, while under the doctor’s care, tested positive for cocaine, heroin, morphine and methadone in addition to the oxycodone and fentanyl prescribed by Tesher.

    Twenty years was the minimum sentence Tesher faced for his crime. The maximum was life in prison.

    “In the midst of an unprecedented opioid epidemic, Dr. Tesher used his medical skills to harm, not heal and in doing so he cost a young man his life,” said U.S. Eastern District Attorney Richard Donoghue. “Such criminal conduct is an utter betrayal of the trust our society places in doctors and it warrants the severe sentence imposed today.”

    The DOJ has recently cracked down on health care providers and drug companies accused of playing a role in fueling the opioid crisis.

    Also last month, 60 people were indicted for the illegal prescribing of painkillers including doctors, pharmacists, nurse practitioners and other licensed medical professionals.

    According to the Washington Post, the indictment included “doctors who prosecutors said traded sex for prescriptions and a dentist who unnecessarily pulled teeth from patients to justify giving them opioids.”

    View the original article at thefix.com

  • Lower Prices Contributed to Opioid Crisis, According to White House Report

    Lower Prices Contributed to Opioid Crisis, According to White House Report

    A new report by the President’s Council of Economic Advisers examined the driving forces of the national opioid epidemic.

    A drop in out-of-pocket expenses for prescription opioids helped drive the first wave of the opioid epidemic, according to a new report released by the White House.

    The report, written by the President’s Council of Economic Advisers, found that increased insurance coverage for opioids resulted in lower costs on the legal market and the black market.

    “Out-of-pocket prices for prescription opioids declined by an estimated 81 percent between 2001 and 2010,” report authors wrote. “The falling prices were a consequence of the expansion of government health care coverage, which increased access to all prescription drugs—including opioids. We argue that these falling out-of-pocket prices effectively reduced the price of opioid use not only in the primary market but also in the secondary (black) market for diverted opioids, from which most people who misuse prescription opioids obtain their drugs.”

    During this time, more people had their prescription drugs covered by government insurance programs through Medicare and Medicaid. In 2001, 17 percent of prescription opioids were covered using government insurance. That rose to 63 percent by 2015.

    This increased access made opioid use more affordable.

    “A person on Medicare would only pay $9.78 per gram, or between $1,785 and $3,570 per year (in 2007 dollars), to fund an opioid addiction,” the report authors note.

    The authors estimate that lower prices can account for between 31 and 83 percent of the rise in opioid deaths between 2001 and 2010, but other factors were also at play during this first wave of the opioid epidemic.

    “Falling out-of-pocket prices could not have led to a major rise in opioid misuse and overdose deaths without the increased availability of prescription opioids resulting from changes in pain-management practice guidelines that encouraged liberalized dispensing practices by doctors, illicit ‘pill mills,’ increased marketing and promotion efforts from industry, and inadequate monitoring or control against drug diversion,” they wrote.

    Cost also played a part in the second wave of the epidemic, when people who had become hooked on pills turned to even less expensive street drugs, including heroin and fentanyl, to get their fix.

    “The reduction in prescription opioid misuse had the unintended consequence of raising demand for cheaper, more readily available substitutes in the illicit market and thus opened a market opportunity for illicit drug suppliers to fill,” report authors wrote.

    Today, access to opioids is tightly controlled for people on Medicare, following legislation passed in 2018. 

    View the original article at thefix.com

  • Programs Aim to Bridge Addiction Treatment Gap After Jail

    Programs Aim to Bridge Addiction Treatment Gap After Jail

    Treatment programs both public and private are working to keep newly-released inmates on the right track.

    Programs are popping up around the country aiming to help people with substance use disorder stay sober after they are released from jail—a time that can be especially dangerous for those who have been in forced sobriety while behind bars but were not given the necessary treatment to stay sober on the outside.

    “A lot of people come out of prison, and they don’t have anything, and it’s really hard to be successful,” Judge Linda Bell, who presides over an opioid court in Las Vegas, Nevada, told News3 Las Vegas.

    The program that Bell oversees helps people released on parole stay sober by connecting them with medication-assisted treatment, housing, counseling and other supports.

    “If it’s still available, I’d like to stay an extra month and continue to stay in sober living,” parolee Clayton Dempster told Bell during a recent court hearing.

    Bell does her best to help people like Dempster stay sober, but also imposes consequences if they’re not adhering to the terms of their release by staying in recovery.

    “I have frequent status checks to make sure all of that is going well. If it’s not, I might impose community service or even a short jail sanction,” she said.

    While programs like the one Bell runs, which is grant funded, are part of the criminal justice system, other programs outside the system are also trying to help newly-released inmates stay sober.

    In Baltimore, a privately-funded van parked outside the city jail helps people connect with many of the same services provided in Bell’s courtroom, like medication-assisted treatment—bridging the gap that opens when people are released from jail but not put in touch with ongoing services.

    “This program works,” Michael Rice, a client of the van, told Vox.  

    Without a functioning government system to help people, especially in cities like Baltimore, private organizations and foundations are left providing lifesaving treatment to people at risk.

    “There are plenty of high-threshold options, but not enough low-threshold options,” said Natanya Robinowitz, executive director of Charm City Care Connection, which provides treatment services in Baltimore. “If you had a functioning system, it would be very low-threshold.”

    Because access to treatment can be prohibitively expensive, especially for people who don’t have insurance, jails have become the default detox and treatment facilities for people with substance use disorder.

    Because of that, there has been more recent support for evidence-driven treatment options like medication-assisted treatment, but still only about 12 percent of jails provide it. Fewer still provide services after a client leaves. However, even in the law enforcement community people are beginning to realize that treatment provided in jails and after release can be lifesaving.

    “We know if you are an opiate user you come in here, you detox, and you go out—it’s a 40% chance of OD-ing,” said Carlos Morales, the director of correctional health services for California’s San Mateo County. “And we have the potential to do something about it.”

    View the original article at thefix.com

  • Harm Reduction vs. Gentrification in Asheville, North Carolina

    Harm Reduction vs. Gentrification in Asheville, North Carolina

    “Harm reduction is on the front lines [of drug overdose] but we have to argue for our existence and the lives of the people we serve. That is unconscionable.”

    In August 2018, Hillary Brown received a bizarre notice from the city of Asheville. The small syringe exchange program that Brown ran three hours a week in the backroom of a bookstore was ordered to shut down within 30 days for operating an illegal homeless shelter.

    At first, 31-year-old Brown, the sole employee of harm reduction nonprofit Steady Collective in western North Carolina, thought it was a joke. Every Tuesday since 2016 the Steady Collective had visited the backroom at Firestorm Books to hand out sterile syringes, condoms, and overdose prevention supplies to people at risk for overdose and drug-related infections.

    Syringe Exchange or Homeless Shelter?

    Separated from the bookstore by a curtain, the backroom is dimly lit and bare except for a couple of red-cushioned church pews against a wall and two gray folding tables where Brown lays out the supplies. The room contains no food, no beds, no bathrooms, and no showers. People who stop by to stock up on supplies rarely linger more than five minutes. And many of them do have homes.

    Brown followed up with the notice, which had been served to the building’s other tenants as well: Firestorm Books & Coffee, 12 Baskets (a small free-lunch program operating in the basement), and Kairos West, a community center run by the Episcopal Church. All four tenants were accused of violating zoning laws having to do with the operation of a homeless shelter in the city’s rapidly gentrifying west end. A $100 per diem penalty would be levied against all tenants if the Steady Collective did not cease operations within 30 days.

    The initial notice of violation seemed bizarre, but it was only a hint of the ongoing legal battle it would spark.

    Within the 30-day grace period, the city withdrew the notices of violation from 12 Baskets and Kairos West, leaving Firestorm Books and the Steady Collective to face the legal hurdles alone.

    Remarkably, Firestorm Books, which could have easily saved itself by asking the Steady Collective to stop coming on Tuesdays, chose to dig in for a fight, risking its 10-year business history and the livelihood of its four employees.

    Beck, one of Firestorm’s co-owners, explains that the Firestorm team see themselves as “community organizers first and business people second.” Throwing a community nonprofit out to save their own skins would run counter to their business and personal ethos.

    Lucky for Firestorm and Steady Collective, local attorney John Noor offered to take the case pro bono. Noor has worked the case since September and helped secure meetings between city management and the Steady Collective.

    Attracting the Wrong Kind of People

    According to Brown, during one meeting to make the case for why a small once-a-week syringe exchange should not be classified as a homeless shelter, a city official commented: “It’s less about what you do and more about who you serve.”

    Brown considers this a rare—and likely accidental—moment of honesty. The city wasn’t arguing against the need for the program or its efficacy. (There are mountains of evidence that point to syringe exchange programs as safe and effective for reducing bloodborne disease transmission and overdose death). And Asheville is in desperate need of help. Its surrounding county, Buncombe, has one of the highest overdose rates in western North Carolina. The Steady Collective, one of the few programs in the city that attempts to mitigate the overdose crisis, reported 719 successful overdose reversals since 2016—no other program in the county can claim those results.

    But as the city official admitted, it’s not about what the program does. It’s not about science or results or lives saved or providing resources to a population in desperate need. No, the city’s concern is the program attracting the “wrong kind” of people to a rapidly gentrifying part of the city; the eyesore of folks who might look homeless gathering on a street that is trying hard to look hip. And the fear of what “those people” might bring.

    Asheville’s tactics mirror similar efforts by other cities and states, including Los Angeles, Charleston, Claremont, and Lawrence County, to shut down syringe exchanges. “Zoning violations” are a favorite tool, as are concerns about discarded needles (a problem that can be addressed through syringe disposal bins) and policymakers’ personal discomfort with the idea of harm reduction.

    “At a time of crisis we are having resources taken away,” says Brown. “Harm reduction is on the front lines [of drug overdose] but we have to argue for our existence and the lives of the people we serve. That is unconscionable.”

    Fighting City Hall to Help Drug Users

    Earlier this month I traveled to Asheville to witness the state’s largest legal battle over syringe exchange with my own eyes. The day I visited, Brown and a volunteer were in Firestorm’s backroom riffling through bags of packaged syringes, condoms, Band-aids and naloxone, a medicine used to reverse opioid overdose.

    Although Brown remained calm throughout our interview, the past few months of legal battles have taken an emotional toll.

    “What is really exhausting is to hear [the city] debate people’s dignity,” Brown said. The legal process “has undone me in ways I wasn’t prepared for.”

    Brown described the frustration of having people come into the exchange crying over the loss of a loved one to overdose who “can’t talk about the loss [outside the harm reduction program] because they are engaged in a criminal activity.”

    And the whole process hasn’t exactly occurred in the open.

    “The city of Asheville wants to talk behind closed doors and go through their rules. They don’t want the public to know [what they are doing],” said Brown.

    In March, after months of legal wrangling, the city finally made an offer: the Steady Collective could operate under the classification of “medical clinic” if they kept a physician on site during all hours of operation.

    Brown described the offer as a slap in the face. The tiny exchange can barely afford a single employee to run operations. To pay a supervising physician—when the only real task is to hand out non-prescription supplies from the back of a bookstore—is a non-starter. (Notably, the Steady Collective operates another exchange on Wednesdays out of a church in a non-gentrifying part of town; the city has not required that location to keep medical personnel on site.)

    Thanks to legal help, the Steady Collective was able to counter the offer and settle for an agreement to keep a nurse on site. They are the only syringe exchange in the state with such a requirement.

    The day I visited, Vanessa Bourgeois was the on-site nurse. Bourgeois works weekends at a local hospital but volunteers on Tuesdays for the Steady Collective where she puts packets of syringes and condoms in plastic bags and hands them across the table to participants—hardly work that requires a nursing license.

    The absurdity of the predicament is not lost on her.

    “This is not a situation that needs a nurse,” she says bluntly. “Harm reduction is appropriate for laypeople.”

    Though she is happy to support the Steady Collective’s work, she denounces the city’s actions as “part of the narrative to make people who use drugs seem dangerous or scary.”

    Because Bourgeois volunteers her time during exchange hours, the Steady Collective and Firestorm Books are no longer under threat of being shut down. But to Brown, their work is far from over.

    Asheville Impedes Harm Reduction Efforts

    Asheville, a city often touted as one of North Carolina’s “most progressive,” has shown little evidence of progressive thinking towards drug users in any of its major government facilities. When North Carolina legalized syringe exchange in 2016, Asheville police responded aggressively, ripping up the ID cards that syringe exchange participants are required to carry by law.

    In 2018, Mission Hospital, the largest medical facility in Asheville, implemented a draconian policy against drugs users: If any patient is suspected of IV drug use, regardless of the medical condition for which they are being seen, hospital staff will confiscate their electronic possessions, refuse them visitors, and keep a staff member in the room at all times to supervise them.

    And the City of Asheville Planning Department has not given up their war on harm reduction. The city plans to write syringe exchanges into the zoning code, which would allow the city to impose restrictions on their locations. Brown believes fighting against such legislation is “the most important issue facing harm reduction in the state” and urges other programs not to be complacent.

    Asked what the Steady Collective would do differently if faced with the situation again, Brown says that the organization would be more aggressive about raising public awareness of the city’s actions and mobilizing people to fight back. At the time, the concern was that drawing too much negative attention to the city would disrupt the negotiation process. But now Brown sees that there was never much negotiation to begin with.

    To other harm reduction programs facing similar threats, Brown advises: “Be more vocal about the process. Invite other people in. Organize the community to fight back. Mobilize medical professionals and faith leaders.”

    North Carolina accomplished a great feat when it legalized syringe exchange programs in 2016. But the real work still lies ahead. We still live in a world that stigmatizes and devalues the lives of people who use drugs. Until this changes, every harm reduction program in every community is at risk. People who use drugs and their allies must stick together. Stay vigilant. And be ready for the fights when they come.


    Maribel Lopez and Hillary Brown at the church location

    View the original article at thefix.com