Answer Addiction

Tag: Overdose

  • Dear William: A Father's Memoir of Addiction, Recovery, Love, and Loss

    The last time David Magee saw his son alive, William told him to write their family’s story in the hopes of helping others. Days later, David found William dead from an accidental drug overdose.

    The officer standing in the doorway raised his arm when I stepped forward, blocking my entrance to my son’s apartment. I tried to peer over his blue-uniformed shoulder to gaze around the corner to where the body of my son sat on the couch. My precious William—I saw him take his first breaths at birth, and I’d cried as I looked down at him and pledged to keep him safe forever. Now, within a day of his final breath, I wanted to see him again.

    “Please,” I said to the officer.

    “Listen,” he said, and I dragged my eyes from straining to see William to the officer’s face. His brown eyes were stern but not unkind. “You don’t want to see this.”

    “I do,” I said. “It’s my son.”

    He glanced over his shoulder, then back at me. “Death isn’t pretty,” he said. “He’s bloated. His bowels turned loose. That’s what happens when people die and are left alone for a day or more.”

    I didn’t say anything. I couldn’t.

    “And there’s something else,” he said.

    “What?”

    “He’s still got a $20 bill rolled up in his hand used for whatever he was snorting.”

    I felt the pavement beneath my feet seem to tilt. I reached to steady myself on the splintered doorjamb one of the officers had forced open with a crowbar just minutes before.

    At his hip, the officer’s radio squawked. I knew the ambulance would be here soon. “Your son—we found him with his iPad in his lap. It looks like he was checking his email to see what time he was due at work in the morning.”

    Yes, William was proud of holding down that job at the Apple Store. He was trying to turn things around.

    “It’s typical, really,” the officer continued. “That’s how addicts are. Snorting a fix while hoping to do right and get to work the next day. It’s always about the moment.”

    This past year, William had been the chief trainer at the Apple Store, and he’d been talking again about heading to law school, the old dream seeming possible once more now that he was sober. He seemed to have put the troubles of the previous year, with his fits and starts in treatment, behind him. They’d kicked William out of one center in Colorado because he drank a bottle of cough syrup. Another center tossed him out because he and a fellow rehabber successfully schemed over two weeks to purchase one fentanyl pill each from someone in the community with a dental appointment. They swallowed their pills in secret, but glassy eyes ratted them out to other patients, who alerted counselors. When asked, William confessed, hoping the admission might move the counselors to give him a second chance. But they sent him packing back to Nashville, where his rehab treatment had begun. One counselor advised us to let William go homeless. “We’ll drop him off at the Salvation Army with his clothing and $10,” he said. “Often, that’s what it takes.”

    We knew that kind of tough-love, hit-rock-bottom stance might be right, but our parental training couldn’t stomach abandoning our son to sleep at the Salvation Army. Instead, my wife and I drove five hours from our home in Mississippi to Nashville to pick him up. He was fidgety but he hugged us firmly, looking into our eyes. We took him to dinner at Ruth’s Chris Steak House, and, Lord, it felt good to see his broad smile, our twenty-two-year-old son adoring us with warm, brown eyes. We told stories and laughed and smiled and swore the bites of rib eye drenched in hot butter were the best we’d ever had.

    The next morning, after deep sleep at a Hampton Inn under a thick white comforter with the air conditioner turned down so low William chuckled that he could see his breath, we found a substance treatment program willing to give him another chance.

    “This dance from one treatment center to another isn’t unusual,” a counselor explained at intake. “Parents drop their child off for a thirty-day treatment and assume it’s going to be thirty days. But that’s just the tip of the iceberg.” My wife and I exchanged a look; that’s exactly what we’d thought the first time we got William treatment. Thirty days and we’d have our boy home, safe and healthy.

    The counselor continued, “If opiates and benzos are involved, it often takes eight or nine thirty-day stays before they find the rhythm of sobriety and self-assuredness. The hard part for them is staying alive that long.”

    When we left William in Nashville for that first thirty-day treatment, weeks before Thanksgiving, we imagined we’d have him home for Christmas. In early December, we bought presents that we expected to share, sitting around the tree with our family of five blissfully together. But William needed more treatment. Thanksgiving turned into Christmas, and Christmas turned into the new year, and the new year turned into spring. We missed William so much, but finally, the treatment was beginning to stick. We saw progress in William’s eyes during rare visits, the hollowness carved by substances slowly refilling with remnants of his soul.

    Now, when parents ask me how they can tell if their kid is on drugs, I say, “Look into their eyes.” Eyes reveal the truth, and eyes cannot hide lies and pain. In William’s eyes, we saw hopeful glimmers that matched improved posture and demeanor. Progress, however, can become the addict’s worst enemy since renewed strength signals opportunity. Addicts go to rehab because substances knocked them down, yet once they are out of treatment and are feeling more confident, they forget just how quickly they can be knocked down again.

    Yet we, too, were feeling confident about William’s prospects. He’d always been scrappy, a hard worker. In college, he ran the four-hundred-meter hurdles in the Southeastern Conference Outdoor Track and Field Championships, despite the fact that he had short legs for a college hurdler. He overcame that by being determined, confident, and quick. And all the time he was competing at the Division 1 level, he was an A student in the Honors College. He’d set his mind on law school and people had told us that with his resumé he could get into most any law school in America.

    During that year after his graduation, in 2012, when William was in and out of treatment, I decided to quit my job as a newspaper editor to spend more time with him. I wanted to keep an eye on his progress and be there if he started to slide, so I visited him in Nashville every other week. He worried I was throwing my career away, but I would throw away anything to help him. Also, I had a plan. Instead of the daily grind of editing a newspaper, I thought quitting might provide the opportunity to return to a book project I’d abandoned. The Greatest Fight Ever was my take on the John L. Sullivan versus Jake Kilrain bare-knuckle boxing match of the late 1800s. The Sullivan-Kilrain fight was an epic heavyweight championship held in South Mississippi, lasting seventy-five rounds in sultry July heat, part showmanship theater and part brute brawl. I had researched the story for years and was once excited about explaining its role in the playing—and hyping—of sports today. I enjoyed sharing anecdotes over the years, like how the mayor of New Orleans served as a referee. Or that the notorious Midwestern gunslinger Bat Masterson took bets ringside on the fight, which set the standard for sports’ bigger-than-life culture that continues today.

    I had written other books by then, including some that found commercial success, but looking back at them from a distance, I judged none to be as excellent and useful as they could have been. I wanted the Sullivan-Kilrain fight story to change that. But William noticed as we visited that my enthusiasm for the story had evaporated. I wasn’t spending time crafting the manuscript.

    “You need to finish your book,” William said that April when I visited him in Nashville. We were eating breakfast at a café known for pancakes, but I was devouring bacon and eggs as William wrestled with a waffle doused with jelly.

    “I’m trying,” I said between sips of coffee. “It’s easy to tell a story, but it’s more difficult to tell a good story. That’s what I’m working at.”

    “You are a good writer. You can do it if you get focused.”

    “It’s hard to immerse yourself in a championship boxing match from the 1800s when you and your family are in the fight of a lifetime,” I said.

    William looked at me over his jelly-slathered waffle. He knew I wasn’t just referring to his struggles. I was referring to my own as well. Two years earlier, I’d almost destroyed our family completely through a string of spectacularly bad decisions, and we, individually and collectively, were fragile.

    “William,” I said. “I’m worried about you. I’m worried about me. I’m worried about all of us.”

    We hadn’t talked so much about my own self-immolation. But now William turned to me. “I’m sorry if the mistakes I’ve made were what made it worse for you. I mean—” he looked off and took a breath. “For so long, I thought drugs were for fun, and I didn’t realize how deep I was in. And then it was too late. I needed them. I’m sorry for making it harder on you and Mom.”

    “No, William, don’t put that on yourself. I caused my own problems. And I want to apologize to you too. I’m sorry for when you struggled in college and I was so caught up in my own life or career that I wasn’t there when you needed me. I failed you.”

    We went on that way for a while, saying the things that had burdened us, the things we’d needed to say for a long time. That weekend was our best, most direct connection in years. I was glad to sit beside my son over coffee and a breakfast we could live without for conversation we’d been dying for, glad I’d quit a decent editing job, glad even to stop pretending I was writing a book that no longer held my interest.

    “Maybe there’s another book you should be writing, Dad,” he said.

    “About sports?”

    “About us.”

    I looked at his plate, the waffle barely eaten. I looked at his eyes, shining with encouragement.

    “Do you ever think maybe other people could learn something from hearing about our story? I mean, when we were growing up, no one would have looked at our family, this all-American family that pretty much lacked for nothing, and predict how bad we’d crash. But maybe hearing what happened to us could help people. Maybe that’s the story you should tell.”

    “Maybe we should tell it together,” I said after a bite.

    “I’m not ready yet,” he said. “But one day, we’ll do it.”

    “Yes,” I said, clutching his hand in mine. “One day, we’ll do it.”

    We said goodbye then and told each other we loved each other, and I walked to my car.

    “Dad,” William called out.

    “Yeah?” I turned over my shoulder.

    “Make sure you finish that book,” he said.

    I stopped. “What book? The Greatest Fight Ever?”

    He smiled and waved goodbye.

    I wiped tears away, then drove home.

    That was the last time I ever saw my firstborn child.

    Five sleeps later, William died. He didn’t plan on dying. But the early days of sobriety can be the loneliest days. And it’s never hard for an addict to find an excuse.
     

    Excerpted from Dear William: A Father’s Memoir of Addiction, Recovery, Love, and Loss by David Magee, available November 2, 2021 at Amazon and elsewhere.

    View the original article at thefix.com

  • One Hit Away: A Memoir of Recovery

    Even though I know a lot of junkies who walk these streets with no life left in them, this is the first dead body I’ve ever seen.

    Sprawled across the side entryway to Beth Israel Congregation, I roll onto my side and wipe a palmful of dew off my clammy face. Everything about this morning is brittle, cold and still. Suspended in limbo, I’m drained from squirming all night on the slick ground like a caterpillar in a cocoon. As first light swirls around me and creeps into the shadows, I’m in no rush to greet it—there’s no point jump-starting the engines until the street dealers kick off their rounds. Having suffered through too many of Portland’s sunrises in recent years, the art on the horizon has either lost its beauty or I’m too jaded to see in color anymore. 

    Peeling my head away from an uncomfortable makeshift pillow made of rolled-up sweatpants, I see that both Simon and the surrounding streets are sleeping in. We’re nestled in darkness, lit only by the headlights of an occasional car that turns down Flanders Street. My sleeping bag is bunched under my hip to help relieve the pressure from the cold stone beneath me, but it’s not the only reason I had a hard time sleeping last night. 

    A few hours ago, I woke up to the alarm of Simon snoring and rattling away in his sleep—it was an eerie and guttural sound like an empty spray-paint can being shaken. I was still fighting to fall back asleep, long after his sputtering faded and drifted away with the breeze. So, while he put another day behind him, I was reminded that long nights take a toll and this life never pays.

    We both went to sleep with full bellies and a shot, so we’re fortunate that neither one of us will be dope sick. It’s nice to catch a break now and then and wake up without wishing I would die already. But it’s never enough—I’m still skeptical about how hard Simon crashed out and wonder if he’s holding out on me. Though if I were in his shoes, there’s no doubt I’d do the same. Riding high comes naturally in a free-for-all where everyone looks out for themselves. We all have it—a grizzly survival instinct to take what we can, when we can and figure tomorrow out if it comes. 

    This isn’t our land, but we periodically come here to stake a claim in the covered alcove guarding the ornate entryway. If unoccupied, I prefer this location because it’s a reasonably safe place to hang my boots. Not only is there protection overhead from the frequent rain that tends to ruin a good night’s sleep, but it’s also set back from the street enough that being noticed, roused and moved by the police is a rarity. 

    The groundskeeper here is a man of quiet compassion. It isn’t in him to run us off outside of business hours, and he refuses to call the police on us. For the most part, we are often gone before he would have to step over our bodies to open the temple doors. Scattering like roaches, we are sent packing by an internal alarm that forces us to get up at first light and attend to our bad habits.

    Simon is still asleep. He’s had it easy after spending all day yesterday collecting free doses from every street dealer he could pin down. This is common for any junkie recently released from a stint in jail. Any time after I’ve been arrested, all I have to do is show one of my dealers my booking paperwork and they’ll set me right. A freebie from them is a cheap investment in their own job security, reigniting the habit that was broken by an unpleasant jailhouse detox. Our dealers also need us back up and running again, racking up goods and on our best game. It’s no secret that a dope sick junkie is unprofitable.

    I pull myself together and pack with purpose, grabbing the dope kit I stashed in a tree nearby and then my shredded shoes that I left out to dry. I often struggle to tell whether my insoles are wet or merely cold, but when water oozes out of my shoelaces as I double-knot them, I take note that at some point today I need to steal fresh socks. 

    “Time to go,” I call out. 

    Simon, in one of the few ways that he is needy, often depends on me rousing him. He’s never been a morning person and is still sound asleep, his face buried in his sleeping bag. 

    “Come on, get up.” I spin in place and scan the ground to make sure I’m not forgetting anything. Eager to start the day, I nudge him with my toe a bit harder than I intended to. 

    When that doesn’t wake him, I reach down to shake his shoulder and feel an unnatural resistance. Something, everything, is wrong. His whole body feels stiff, and as I pull harder, Simon keels over, his rigid limbs creaking out loud like a weathered deck. There is lividity in his face—his nose is dark purple and filled with puddled blood. A pair of lifeless, open eyes stare through me and into nothingness. Instinctively, my hand snaps back and Simon sinks away.

    I stumble back and try to make sense of my surroundings. Nobody is around yet, but soon, the world will rise.

    “No, no, no.” I lose control of the volume of my voice and squeeze my throat. “Don’t be dead, please, don’t do this to me,” I chant as I drop to my knees, pleading over his corpse. 

    My hands hover over him as if trying to draw warmth from a smothered fire. I desperately grasp for a way to fix this. My heart is racing as though I just sent a speedball its way, but the surge doesn’t stop. A decision needs to be made, and fast, but before I can make sense of anything, a wisp of breath rolls down my collar and an invisible hand clutches my cheeks, forcing me to stare down death. 

    I snap the clearest picture in my mind and my eyes sting. Even though I know a lot of junkies who walk these streets with no life left in them, this is the first dead body I’ve ever seen. Looking down at Simon, I finally understand how pathetic this existence is and how lonely this life will always be. I see nothing beyond this moment for Simon, other than being hauled away like trash on the curb. We are forever trapped here, alone and useless, likely remembered only for our crimes, selfishness and former selves. Heaven is out of the picture, and because of that, I am okay with what I have to do next. I know the act is irreversible and unforgivable, but then again, if God has abandoned us, he’s not around to judge me.

    Dropping my sleeping bag onto the ground, I slide my backpack off my shoulders and let it fall like a hammer. I kneel over Simon’s body, steal one last look around and wince as I rummage through the front pocket of his jeans. I know he always keeps a wake-up hit on him. His pocket is tight and fights my hand as I dip into them. My fingers scratch around but keep coming up empty-handed. Time is running out and traffic is increasing. 

    I reach into his back pocket and soon realize the dope isn’t in his wallet either. The longer I search, the more determined I am, but I can’t bring myself to roll him over and disturb him further. By the time I give up, I sit back on my heels. I can’t believe what I’ve become. 

    “I’m so sorry, Simon.”

    Please stop looking at me. I can’t take it. Pulling my sweater cuff over my palm, I reach out with a shaky hand to close his eyes. My hand gets close, then backs off as I turn my head away to exhale. When my hand reaches forward once again, my palm lands on his face but fails to brush his frozen eyelids closed.Backing away, I grab my belongings and shrink into the distance.

    Excerpted from One Hit Away: A Memoir of Recovery by Jordan Barnes. Available at Amazon.

    View the original article at thefix.com

  • Intervention

    I did not know that the next time I held her body, it would be chips of bone and gritty ash in a small cardboard box.

    The following is an excerpt from The Heart and Other Monsters by Rose Andersen.

    I cannot remember my sister’s body. Her smell is gone to me. I do not recall the last time I touched her. I think I can almost pinpoint it: the day I asked her to leave my home after I figured out she had stopped detoxing and started shooting up again, all the while trying to sell my things to her drug dealer as I slept. When she left, she asked me for $20, and I told her that I would give it to her if she sent me a picture of a receipt to show me she spent the money on something other than drugs. “Thanks a lot,” she said, sarcastically. I hugged her, maybe. So much hinges on that maybe, the haunting maybe of our last touch.

    The last time I saw my sister was at an intervention at a shitty hotel in Small Town. Our family friend Debbie flew my stepmother and me there in her three-seater plane. The intervention was put together hastily by Sarah’s friend Noelle, who called us a few days beforehand, asking us to come. There were little resources or time to stage it properly—we couldn’t afford a trained interventionist to come. Noelle told us she was afraid Sarah was going to die. I agreed to fly with Debbie and Sharon because Small Town was far away from home and I didn’t want to drive.

    Debbie sat in the pilot’s seat, and I sat next to her. My stepmother was tucked in the third seat, directly behind us. It wasn’t until takeoff that I realized with my body what a terrible decision it was to fly. I am terrified of heights and extremely prone to motion sickness. I was not prepared for what it meant to be in a small plane.

    I could feel the outside while inside the plane. The vibration of chilly wind permeated through the tiny door and gripped my lungs, heart, head. It would have taken very little effort to open the door and fall, an endless horrifying fall to most-certain death. From the first swoop into the air, my stomach twisted into a mean, malicious fist that punched at my bowels and throat. For the next hour I sat trembling, my eyes shut tight. Through every dip, bounce, and shake, I held back bile and silently cried.

    When we landed, I lurched off the plane and threw up. I do not remember what color it was. My stepmom handed me a bottle of water and half a Xanax, and I sat, legs splayed on the runway, until I thought I could stand again.

    My sister vomited when she died. She shit. She bled. How much is required to leave our body before we are properly, truly, thoroughly dead? I dreamed one night that I sat with my sister’s dead body and tried to scoop all her bodily fluids back inside her. Everything wet was warm, but her body was ice-cold. I knew that if I could return this warmth to her, she would come back to life. My hands were dripping with her blood and excrement, and while begging her insides to return to her, I cried a great flood of mucus and tears. This I remember, while our last touch still evades me.

    My sister was late to her intervention. Many hours late. Seven of us, all women, five of us in sobriety, sat in that hot hotel room, repeatedly texting and calling Sarah’s boyfriend, Jack, to bring her to us. I realized later that he probably told her they were going to the hotel to get drugs.

    The hotel room was also where Sharon, Debbie, and I would be sleeping that night. It held two queen-size beds, our small amount of luggage, and four chairs we had discreetly borrowed from the hotel’s conference room. I sat on one of the beds, perched on the edge anxiously, trying not to make eye contact with anyone else. I didn’t know many of the other people there.

    When I told my mom about the intervention days before, I had immediately followed with “But you don’t need to come.” There were so many reasons. She has goats and donkeys, cats and dogs who needed to be taken care of. She didn’t have a vehicle that could make the drive. She could write a letter, I said, and I would give it to Sarah. The truth was, I didn’t feel like managing her now-acrimonious relationship with Sharon. I didn’t want to have to take care of my mom, on top of managing Sarah’s state of being. It occurred to me, sitting in this crowded, strange room, that I might have been wrong.

    Sitting diagonally across from me was Sarah’s close friend Noelle, who had organized everything. Sarah and Noelle had met in recovery, lived together at Ryan’s family home, and become close friends. They had remained friends even when Sarah started using again. Helen, a fair-haired middle-aged woman who was not one of the people Sarah knew from recovery but rather the mother of one of Sarah’s boyfriends, sat on the other bed. Sarah’s last sponsor, Lynn, sat near me. I had to stop myself from telling her how Sarah had used her name on her phone. Sitting in one of the chairs was the woman who was going to run the intervention. I cannot remember her name now, even though I can easily recall the sound of her loud, grating voice.

    The interventionist had worked at Shining Light Recovery, the rehab Sarah had been kicked out of about a year and a half before, and was the only person Noelle could find on short notice. She had run her fair share of interventions, she told us, but she made it clear that because she hadn’t had the time to work with us beforehand, this wouldn’t run like a proper intervention. She smelled like musty clothes and showed too many teeth when she laughed. She talked about when she used to drink, with a tone that sounded more like longing than regret. When she started to disclose private information about my sister’s time in rehab, I clenched my hands into a fist.

    “I’m the one that threw her out,” the woman said. “I mean, she’s a good kid, but once I caught her in the showers with that other girl, she had to go.” Someone else said something, but I couldn’t hear anyone else in the room. “No sexual conduct,” she continued. “The rules are there for a reason.” She chuckled and took a swig from her generic-brand cola. I felt hot and ill, my insides still a mess from the plane ride. We waited two more hours, listening to the interventionist talk, until Jack texted to say they had just pulled up.

    Intervention

    When my sister arrived, she walked into the room and announced loudly, “Oh fuck, here we go.” Then she sat, thin, resentful, and sneering, her hands stuffed into the front pocket of her sweatshirt. Oh fuck, here we go, I thought. The interventionist didn’t say much, in sharp contrast to her chattiness while we were waiting. She briefly explained the process; we would each have a chance to speak, and then Sarah could decide if she wanted to go to a detox center that night.

    We went in turns, speaking to Sarah directly or reading from a letter. Everyone had a different story, a different memory to start what they had to say, but everyone ended the same way: “Please get help. We are afraid you are going to die.” Sarah was stone-faced but crying silently. This was unusual. When Sarah cried, she was a wailer; we called it her monkey howl.

    When we were younger, we watched the movie Little Women again and again. We would often fast-forward through Beth’s death, but sometimes we would let the scene play out. We would curl up on our maroon couch and cry as Jo realized her younger sister had died. For a moment I wished for the two of us to be alone, watching Little Women for the hundredth time. I could almost feel her small head on my shoulder as she wailed, “Why did Beth have to die? It’s not fair.” She sat across the room and wouldn’t make eye contact with me.

    I addressed Sarah first with my mom’s letter. I started, “My dear little fawn, I know that things have gone wrong and that you have lost your way.” My voice cracked and I found I couldn’t continue, so I passed it to Noelle to read instead. It felt wrong to hear my mother’s words come out of Noelle’s mouth. Sarah was crying. She needs her mom, I thought frantically.

    When it came time to speak to her myself, my mind was blank. I was angry. I was angry that I had to fly in a shitty small plane and be in this shitty small room to convince my sister to care one-tenth as much about her life as we did. I was furious that she still had a smirk, even while crying, while we spoke to her. Mostly, I was angry because I knew nothing I could say could make her leave this terrible town I had driven her to years before, and come home. That somewhere in her story there was a mountain of my own mistakes that had helped lead us to this moment.

    “Sarah, I know you are angry and think that we are all here to make you feel bad. But we are here because we love you and are worried you might die. I don’t know what I would do if you died.” My sister sat quietly and listened. “I believe you can have any life you want.” I paused. “And I have to believe that I still know you enough to know that this isn’t the life you want.” The more I talked, the further away she seemed, until I trailed off and nodded to the next person to talk.

    After we had all spoken, Sarah rejected our help. She told us she had a plan to stop using on her own. “I have a guy I can buy methadone from, and I am going to do it by myself.” Methadone was used to treat opioid addicts; the drug reduced the physical effects of withdrawal, decreased cravings, and, if taken regularly, could block the effects of opioids. It can itself be addictive—it’s also an opioid. By law it can only be dispensed by an opioid treatment program, and the recommended length of treatment is a minimum of twelve months.

    “I have a guy I can buy five pills from,” Sarah insisted, as if that was comparable to a licensed methadone center, as if what she was suggesting wasn’t its own kind of dangerous.

    “But honey,” my stepmother said gently, “we are offering you help right now. You can go to a detox center tonight.”

    “Absolutely not. I am not going to go cold turkey.” Sarah was perceptibly shaking as she said this, the trauma of her past withdrawals palpable in her body. “I don’t know if I can trust you guys.”

    She gestured to my stepmom and me. “I felt really betrayed by what happened.” The heroin in her wallet, the confrontation at Sharon’s, Motel 6, breaking into her phone. “You guys don’t understand. Every other time I’ve done this, I’ve done this for you, for my family.” She sat up a little straighter. “For once in my life, it’s time for me to be selfish.”

    It was all I could do not to slap her across the face. I wanted desperately to feel my hand sting from the contact, to see her cheek bloom pink, to see if anything could hurt her. She wasn’t going to use methadone to get clean. She just wanted us to leave her alone. 

    I made an excuse about needing to buy earplugs to sleep that night and walked out. I did not hug her or look at her. I did not know I would not see her again. I did not know I would not remember our last touch. I did not know that the next time I held her body, it would be chips of bone and gritty ash in a small cardboard box.
     

    THE HEART AND OTHER MONSTERS (Bloomsbury; hardcover; 9781635575149; $24.00; 224 pages; July 7, 2020) by Rose Andersen is an intimate exploration of the opioid crisis as well as the American family, with all its flaws, affections, and challenges. Reminiscent of Alex Marzano-Lesnevich’s The Fact of a Body, Maggie Nelson’s Jane: A Murder, and Lacy M. Johnson’s The Other Side, Andersen’s debut is a potent, profoundly original journey into and out of loss. Available now.

     

    View the original article at thefix.com

  • Pandemic Presents New Hurdles, and Hope, for People Struggling with Addiction

    “There’s social distancing — to a limit…I think when someone’s life is in jeopardy, they’re worth saving. You just can’t watch people die.”

    Before Philadelphia shut down to slow the spread of the coronavirus, Ed had a routine: most mornings he would head to a nearby McDonald’s to brush his teeth, wash his face and — when he had the money — buy a cup of coffee. He would bounce between homeless shelters and try to get a shower. But since businesses closed and many shelters stopped taking new admissions, Ed has been mostly shut off from that routine.

    He’s still living on the streets.

    “I’ll be honest, I don’t really sleep too much,” said Ed, who’s 51 and struggling with addiction. “Every four or five days I get a couple hours.”

    KHN agreed not to use his last name because he uses illegal drugs.

    Philadelphia has the highest overdose rate of any big city in America — in 2019, more than three people a day died of drug overdoses there, on average. Before the coronavirus began spreading across the United States, the opioid overdose epidemic was the biggest health crisis on the minds of many city officials and public health experts. The coronavirus pandemic has largely eclipsed the conversation around the opioid crisis. But the crisis still rages on despite business closures, the cancellation of in-person treatment appointments and the strain on many addiction resources in the city.

    When his usual shelter wasn’t an option anymore, Ed tried to get into residential drug treatment. He figured that would be a good way to try to get back on his feet and, if nothing else, get a few good nights of rest. But he had contracted pinkeye, a symptom thought to be associated with the virus that leads to COVID-19, so the evaluation center didn’t want to place him in an inpatient facility until he’d gotten the pinkeye checked out. But he couldn’t see a doctor because he didn’t have a phone for a telehealth appointment.

    “I got myself stuck, and I’m trying to pull everything back together before it totally blows up,” he said.

    Rosalind Pichardo wants to help people in Ed’s situation. Before the pandemic, Pichardo would hit the streets of her neighborhood, Kensington, which has the highest drug overdose rate in Philadelphia. She’d head out with a bag full of snack bars, cookies and Narcan, the opioid overdose reversal drug.

    She’d hand Narcan out to people using drugs, and people selling drugs — anyone who wanted it. Pichardo started her own organization, Operation Save Our City, which initially set out to work with survivors of gun violence in the neighborhood. When she realized that overdoses were killing people too, she began getting more involved with the harm reduction movement and started handing out Narcan through the city’s syringe exchange.

    When Pennsylvania’s stay-at-home order went into effect, Pichardo and others worried that more people might start using drugs alone, and that fewer first responders would be patrolling the streets or nearby and able to revive them if they overdosed.

    So, Pichardo and other harm reduction activists gave out even more Narcan. A representative for Prevention Point Philadelphia, the group that operates a large syringe exchange program in the city, said that during the first month of the city’s stay-at-home order, they handed out almost twice as much Narcan as usual.

    After the lockdowns and social distancing began, Pichardo worried that more people would be using drugs alone, leading to more overdoses. But Philadelphia’s fatal overdose rate during the pandemic remains about the same as it was this time last year. Pichardo said she thinks that’s evidence that flooding the streets with Narcan is working — that people are continuing to use drugs, and maybe even using more drugs, but that users are utilizing Narcan more often and administering it to one another.

    That is the hope. But Pichardo said users don’t always have a buddy to keep watch, and during the pandemic first responders have seemed much more hesitant to intervene. For example, she recently administered Narcan to three people in Kensington who overdosed near a subway station, while two police officers stood by and watched. Before the pandemic, they would often be right there with her, helping.

    To reverse the overdoses, Pichardo crouched over the people who she said had started turning blue as their oxygen levels dropped. She injected the Narcan into their noses, using a disposable plastic applicator. Normally, she would perform rescue breathing, too, but since the pandemic began she has started carrying an Ambu bag, which pumps air into a person’s lungs and avoids mouth-to-mouth resuscitation. Among the three people, she said, it took six doses of Narcan to revive them. The police officers didn’t step in to help but did toss several overdose-reversal doses toward Pichardo as she worked.

    “I don’t expect ’em to give ’em rescue breaths if they don’t want to, but at least administer the lifesaving drug,” Pichardo said.

    In her work as a volunteer, she has reversed almost 400 overdoses, she estimated.

    “There’s social distancing — to a limit,” Pichardo said, “I think when someone’s life is in jeopardy, they’re worth saving. You just can’t watch people die.”

    Even before Philadelphia officially issued its stay-at-home order, city police announced they would stop making low-level arrests, including for narcotics. The idea was to reduce contact overall, help keep the jail population low and reduce the risk of the virus getting passed around inside. But Pichardo and other community activists said the decreased law enforcement emboldened drug dealers in the Kensington neighborhood, where open-air drug sales and use are common.

    “You can tell they have everything down pat, from the lookout to the corner boys to the one actually holding the product — the one holding the product’s got some good PPE gear,” said Pichardo.

    More dealers working openly on the street has led to more fights over territory, she added, which in turn has meant more violence. While overall crime in Philadelphia and other major cities has declined during the pandemic, gun violence has spiked.

    Police resumed arrests at the beginning of May.

    Now when she goes out to offer relief and hand out Narcan, Pichardo packs a few extra things in her bag of supplies: face masks, gloves and gun locks.

    “It’s like the survival kit of the ’hood,” she said.

    For those struggling with addiction who are ready to start recovery, newly relaxed federal restrictions have made it easier to get medications that curb opioid cravings and stem withdrawal. Several efforts are underway among Philadelphia-based public health groups and criminal justice advocacy organizations to give cellphones to people who are homeless or coming out of jail, so they can make a telehealth appointment and get quicker access to a prescription for those medicines.

    During the pandemic, people taking medication-assisted treatment can renew their prescription every month instead of every week, which helps decrease trips to the pharmacy. It is too soon to know if more people are taking advantage of the new rules, and accessing medication-assisted treatment via telehealth, but if that turns out to be the case, many addiction medicine specialists argue the new rules should become permanent, even after the pandemic ends.

    “If we find that these relaxed restrictions are bringing more people to the table, that presents enormous ethical questions about whether or not the DEA should reinstate these restrictive policies that they had going in the first place,” said Dr. Ben Cocchiaro, a physician who treats people with substance-use disorder.

    Cocchiaro said the whole point of addiction treatment is to facilitate help as soon as someone is ready for it. He hopes if access to recovery can be made simpler during a pandemic, it can remain that way afterward.

    This story is part of a partnership that includes WHYY, NPR and Kaiser Health News.

    View the original article at thefix.com

  • Long Term Effects of Overdoses on the Brain

    Long Term Effects of Overdoses on the Brain

    Despite what we know about how overdoses can kill, there is scant literature regarding chronic health outcomes for people who have survived multiple overdoses.

    Drug overdoses are a leading cause of preventable deaths in the United States. We know the dangers of overdoses; generally, they can kill. Opioids make up a large percentage of these deaths. In 2016, opioids made up 69 percent of drug overdose deaths. For people ages 25 to 64, drug overdoses cause more deaths than car accidents. Overdoses caused by opioids can be reversed if quickly countered with naloxone, an opioid antagonist.

    In states like Massachusetts, opioid overdose deaths are on the decrease, but overdose emergency calls are on the rise. More people are surviving, but only 3 out of 10 people are receiving medical treatment for substance use disorder. What is happening to the other 70 percent of individuals?

    Non-Opioid Overdoses

    It is technically possible to overdose on nearly any recreational or medicinal drug available.

    Cocaine overdose can involve seizures, heart attacks, strokes, and/or stop a person’s breathing. Amphetamine overdose can lead to seizures, cardiac arrest, and/or a huge spike in body temperature. Psychologically, high doses of stimulants can cause severe psychosis. MDMA overdoses have some similarities to stimulant overdoses, including increased body temperature, kidney failure, and hypertension. Alcohol overdoses most often occur when a person engages in binge drinking which can lead to breathing problems and interfere with cardiac functioning. 

    The Mechanics of an Overdose

    Heart problems and oxygen deprivation are two common symptoms of an overdose that we see in many drug-related deaths. But what happens to the brain during an overdose? Are there lasting effects? Can an overdose cause permanent brain damage?

    The body is being poisoned during an overdose, and it’s usually not obvious to the person who ingested the substance. Someone who has just taken a lethal amount of opioids is unlikely to recognize what’s happening, although others may. As described by Maggie Ethridge for Vice, signs include “extreme drowsiness, cold hands, cloudy thinking, nausea and/or vomiting, and especially slowed breathing (fewer than ten breaths per minute).”

    Once ingested or injected, an opioid makes a beeline through your heart and into your lungs. While in the lungs, your blood gets a dose of oxygen and that “now opioid-rich blood is pushed out to the rest of the body, where it plugs into the system of opioid receptors all over your body.” As the opioids enter the brain, they cause the neurotransmitter dopamine (the feel-good chemical) to overflow. That’s where the feeling of euphoria comes from. After repeated use, reaching that blissful state becomes harder, requiring increasingly larger doses of the same drug.

    If you’ve overdosed, the next thing that will happen is that your brain’s basic systems that control breathing will be affected and your breathing will slow before stopping entirely. Circulatory functioning is next to be affected; your heart rate will slow as the opioid dampens neurological signaling in the brain. As your oxygen levels reduce, your heart begins having irregular rhythms and this can lead to a cardiac arrest.

    Opioids are a depressant, decreasing heart rate and breathing. Overdosing on opioids essentially causes the central nervous system to go into such a depressed state that the body forgets to breathe. Without enough oxygen (hypoxia), the brain can become severely damaged. The longer someone goes without oxygen, the worse the damage can be.

    Certain parts of the brain are more sensitive to the immediate effects of oxygen deprivation. The frontal lobe is particularly at risk of damage when experiencing anoxia (zero oxygen reaching the brain), resulting in problems with executive functioning. Executive functioning refers to a set of mental skills in the areas of working memory, inhibitory control, and cognitive flexibility. If a person experiencing an overdose has a seizure, this can cause further damage to the brain.

    Toxic Brain Injury

    Substance use disorders and brain injuries go hand in hand. An estimated 25 percent of people who enter brain injury rehabilitation have had problems with drug use and half of people entering substance use treatment have experienced a brain injury. Each of these conditions makes the other worse. 

    Toxic brain injury is a term that has been coined to encapsulate the type of injuries that occur after an opioid overdose. It is also referenced under the category of acquired brain injuries, which include instances of brain damage that occur after someone is born but are not connected to degenerative or congenital diseases. 

    The white matter of the brain can sustain damage from repeated oxygen deprivation. The consequences of toxic brain injury increase if someone experiences multiple non-fatal opioid overdoses. Despite what we know about how overdoses can kill, there is scant literature regarding chronic health outcomes for people who have survived multiple overdoses. What research does exist focuses on brain injuries due to hypoxia/anoxia.

    From what we do know, certain areas of the brain are most likely to be harmed and can “lead to the development of severe disability.” These areas affect neurological processes; short-term memory loss, disorientation, even acute amnesia have been observed. Survivors may develop physical problems such as loss of control over bodily functions, lack of coordination, nerve damage and subsequent reduction in the ability to use a certain limb or body part, or even paralysis. Less severe but still serious symptoms include slower reaction times, motor skill disturbances, memory problems, and overall “diminished physical functioning.”

    Medical Treatment

    Only 3 out of 10 people who overdose on opioids and survive seek medical treatment for addiction. For every reported overdose death, there “may be five nonfatal overdoses, many of which go unreported.”

    This isn’t to say that anyone who has ever survived an overdose has brain damage, but rather that more research and advocacy needs to focus on surviving overdoses and how to best move forward with healing and increasing rates of recovery.

    NASHIA (National Association of State Head Injury Association) recommends that substance use disorder treatment services should be available and accessible for people who have sustained a brain injury. They also recommend that medical providers regularly screen patients for a history of brain injury and to ensure that people can receive treatment for any cognitive, behavioral, and/or physical disabilities due to a brain injury.

    Reducing overdoses is a critical aspect of preventing these kinds of chronic injuries. Once a person has one overdose, they’re more likely to have another, and that likelihood increases with each overdose. When available and implemented, harm reduction principles work to reduce this likelihood and improve outcomes. There is no one-size-fits-all approach to recovery from substance use disorder that will work for everyone. Harm reduction strategies like widespread use of naloxone improve the long-term health effects of an overdose.

    View the original article at thefix.com

  • How "Wired" Betrayed John Belushi's Legacy and Misportrayed Addiction

    How "Wired" Betrayed John Belushi's Legacy and Misportrayed Addiction

    While Belushi’s family and friends would prefer that “Wired” be forgotten, the book provides a fascinating glimpse into how we didn’t understand addiction and harshly judged people who struggled with it.

    “Woodward – that cocksucker!”

    You can’t blame Jim Belushi for being upset. In fact, many of John Belushi’s friends and family members were infuriated with the book Wired, which was written by Bob Woodward, the legendary Watergate reporter.

    Published by Simon and Schuster two years after Belushi’s death from an overdose, Wired was a stark and frightening portrait of drug addiction, but those close to Belushi felt its focus was too narrow, that it didn’t contain any of Belushi’s humanity or good qualities. Woodward put together the cold hard facts of Belushi’s addiction and piled up a number of horror stories, without capturing the whole picture of who the man really was.

    “Exploitation, pulp trash” – Dan Akroyd Describing Wired

    A swift counter attack on the book came from Belushi’s widow, Judy Jacklin. Dan Aykroyd denounced the book as “exploitation, pulp trash,” and Al Franken told Variety, “I hated Woodward’s book because I don’t believe he made an honest attempt to understand John, who despite his sometimes gruff exterior was a gentle soul. My former partner Tom Davis put it this way: ‘It’s as if someone did your college yearbook and called it ‘Puked.’ And all it did was say who puked, when they puked and what they puked. But no one learned any history, read Dostoevsky for the first time, or fell in love.’”

    The controversy made Wired a major best-seller, and the people close to Belushi, who spent untold hours telling all to Woodward, felt burned and betrayed. Woodward was seemingly befuddled by the controversy, and many found his obtuseness infuriating. Woodward told People he was sorry that Jacklin was upset, but “what is important is that Judy is not alleging inaccuracy.”

    While Belushi’s family and friends would prefer that Wired be forgotten, the book provides a fascinating glimpse into how many of us, like Woodward, didn’t understand the nature of addiction and harshly judged people who struggled with it.

    Today, the rise and fall of John Belushi would be written differently, and much more sympathetically.

    Robin Williams once joked that if you remember the seventies, you weren’t there. Not only was it an exciting time for comedy, but many in the entertainment business were out of their minds on cocaine. No one thought the high times would ever end.

    Belushi: A Regular Guy Who Became a Star

    John Belushi was a regular guy who became a star, thanks to the success of Saturday Night Live and Animal House. He was relatable and appealing. The public loved him.

    But his private life was more complicated. Belushi could be brusque and awful, and like many people with addiction, there was a terrible Mr. Hyde that came out when he used. But just as frequently he was kind, decent, and generous.

    Despite his talent and confidence as a performer, offstage Belushi was vulnerable and unsure of himself. Bernie Brillstein, Belushi’s manager, once said that the comedian was “sometimes good, sometimes bad, sometimes in need of a swift kick in the ass, more often in need of a hug.”

    When Belushi died at age 33, it shocked the public. In the pre-internet, pre-TMZ eighties, Belushi’s addiction to cocaine and heroin was mostly hidden from the public. 

    Belushi’s death hit hard. He was a major counterculture hero and a whole generation felt the loss. It was also a big indicator that the seventies were finally over. As Paul Schrader, screenwriter of Taxi Driver and American Gigolo, told journalist Peter Biskind, “The game was up. Some people quit right away, but the feeling was, the rules have changed.”

    In the world of journalism, Bob Woodward was a major star in his own right. He came from the same hometown as Belushi, Wheaton, Illinois, and his reporting on Watergate turned him and his partner Carl Bernstein into household names. He was portrayed by Robert Redford in the big screen adaptation of All the President’s Men, further cementing his legendary status.

    Was His Death a Sting Operation Gone Bad?

    As a political writer, drugs and the Hollywood fast lane were not in Woodward’s usual wheelhouse, but when Judy Jacklin reached out shortly after her husband’s death, he was intrigued. Jacklin felt there was more to her husband’s death than a simple drug overdose, and she believed Woodward, who was already admired by the counterculture for bringing down Nixon, could get to the bottom of it.

    Michael Dare, a former dealer and film critic who knew Belushi well, started asking around to find out what happened. There was apparently a rumor going around that Belushi’s death was “a sting operation gone bad.” Cathy Smith was a groupie who sold heroin to Belushi and gave him the speedball injections that killed him; some believed she was an informer for the LAPD.

    Robin Williams and Robert DeNiro were with Belushi briefly at about 2 a.m. the morning he died, and some suspected the LAPD were hoping to set up a big bust where all three would get nailed. According to the rumor, the drugs that killed Belushi were given to Smith by the police. Dare even claimed he heard that a cop “prepared the scene the way he wanted it to be found, then went down the block and waited for the body to be discovered.”

    Woodward never found any evidence of this, “not even as a wacko theory,” Dare said, and in retrospect the theory does seem ludicrous. But this was the primary reason Jacklin reached out to Woodward in the first place, and Wired is the result: a hard rebuke to that “wacko theory.” (Where Deep Throat told Woodward to “follow the money,” Dare told the reporter to “follow the drugs,” which he probably now regrets.)

    As far as personalities, Woodward and Belushi couldn’t have been any less alike. Many who worked with Woodward found him cold, aloof, an uptight authoritarian workaholic without much of a sense of humor. In other words, he was the wrong person to write Belushi’s story from the get-go. But could be disarming, and many people confused the real Woodward with the version of him they knew from the big screen: Redford-as-Woodward.

    In fact, when one of Belushi’s friends, Anne Beatts, was contacted by Woodward, “my secretary thought it was Robert Redford on the phone. Woodward was so charming, such a good listener, and we were so impressed meeting him. It was like, would Robert Redford lie to you?”

    Woodward was so good at getting sensitive information out of people, most of Belushi’s friends didn’t catch on to him until it was too late. (“None of us knew what he was really up to,” Aykroyd recalled.) In hindsight, Belushi’s peers realized they were naïve. Considering Woodward helped topple the White House, what made them think he could be trusted not to reveal anything they didn’t want to see in print?

    Woodward Wasn’t the Best Person to Write About Belushi…or Addiction

    There were other reasons why Woodward wasn’t the best person to capture a complicated personality like Belushi, or the complexities of addiction. Jacklin said that he took a complicated story “and made it very simple,” and one of Woodward’s colleagues told Rolling Stone that he “isn’t all that introspective. He’s a wonderful machine for gathering facts. He’s not good at insight…He wanted to go beyond the facts, and the gray areas were too immense…the facts about Belushi became his only refuge.”

    What was especially infuriating to Belushi’s survivors was that Woodward blamed the Hollywood system and many close to him for enabling his death. But for Woodward, who was accustomed to tackling American corruption, condemning Hollywood came naturally: “There was no friendship and a safety net in that circle to save him,” Woodward told journalist Alicia Shepard. “I think it would have been morally offensive for me to try to please.”

    Bernie Brillstein was one of Belushi’s peers who objected to Woodward’s characterization of show business. In his memoir, he wrote, “Woodward blamed John’s death on what he thought was a morally corrupt business that indulges its stars with reckless disregard for their well-being because so much money is on the line. That really offends me. We’d have to be scum. Inhuman. No amount of money in my pocket would have made me ignore John’s health for my own gain.”

    When celebrities like Belushi needed help, it was a different world. In the early eighties, we didn’t have rehabs on every corner or TV shows like Intervention. The underlying causes of addiction were not well understood by most doctors, and treatment options were still in the dark ages. (There’s speculation in Wired that Belushi’s addiction and mood swings could have been from a chemical imbalance like “manic depression,” but he was apparently never diagnosed.)

    Belushi’s Death Signaled a Need for More Addiction Treatment

    “We’d talked about institutionalizing Belushi but never did,” Brillstein explained. “The choices at the time were limited to hospital psychiatric wards and white-bread joints for alcoholics. Belushi’s death, perhaps the first high-profile cocaine casualty of the ‘80s, certainly signaled a need for drug rehab centers.” (The Betty Ford Center opened the same year Belushi died.)

    Aykroyd added, “Intervention back then was not a tool that was used. Today if we had a problem like this, we’d get six to ten people together, we’d get the guy in the room, sit them down and say, ‘It’s gonna stop. You’re going into rehab and that’s it.’ Back then that was not a technique that was wide-spread.” For a while, Belushi had a sober companion hired from the Secret Service who did a good job keeping the drugs away, but it was a triple overtime job that wasn’t sustainable.

    Years after the Wired fall-out, Jacklin and Tanner Colby wrote an authorized Belushi biography, and it’s fascinating to read both books back to back because together they give you a good idea of the intense highs and lows of John’s life. Jacklin’s book gives you the good memories, the brilliance of Belushi’s comedy, and the good side of his personality. Then when you pick up Wired, you realize what terrible, terrifying lows Belushi sank to in his addiction.

    If Belushi had lived, he would be 70 today. His comedy still stands the test of time, but he had so much more to give. Not long after he died, a fan left a note on his grave: “He could have given us a lot more laughs, but NOOOOOOOOOO….”

    If any good came from Belushi’s passing, it was that it scared a lot of people straight. SNL producer Bob Tischler recalled in the book Live From New York, “When John died, it changed me. I gave up doing drugs. And I haven’t done any since.”

    He Made Us Laugh, and Now He Can Make Us Think

    And while many felt that Wired gave an incomplete picture of Belushi’s life and legacy, Woodward definitely got one thing right: “Nonetheless, his best and most definitive legacy is his work. He made us laugh, and now he can make us think.”

    Or as Brillstein summarized, “Four years of television, seven movies, and we’re still talking about him. Isn’t that amazing?”

    View the original article at thefix.com

  • 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

  • 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

  • My Journey from Heroin to Prison

    My Journey from Heroin to Prison

    As soon as I was out of prison, it took one argument with a girlfriend for me to go running right back into the arms of the one that always made me feel better: heroin.

    I have been a man of many realities. I’ve been a son, a student, a friend, a lover, a brother and finally a drug dealer. Well, at least, I thought that was my final phase. But then I shot heroin for the first time and I entered a new world. I felt warmth comparable to a mother’s embrace. It was something in my life I no longer received. It was a feeling I craved desperately, setting me on a course of destruction and pain that I tried to blot out with even more heroin. And every time I came to, the pain seemed to get worse.

    I didn’t start off as a heroin user. I found my niche in high school selling weed. But when I was forced out on my own, I knew I needed a better source of income. So, I started selling the Adderal and Atavan that I was prescribed. In that life, it really was only a matter of time before I started abusing the drugs I was selling. To support my growing habit, I started selling cocaine. It was fast and easy money from an older crowd. I didn’t plan on using it myself; my biological mother was addicted to crack cocaine and I was afraid of following in her footsteps.

    But there came a day when I gave in to temptation. Coke took me to another level. After cocaine it was Percocet and then, eventually, at the prompting of the girl I loved, I tried heroin. As I pushed the plunger, I felt all of the pain in my life fade away as the warmth of the dope enveloped me. It was a night of warmth and sex. When I woke up in the morning, all I felt was sadness that the feeling was over. Reality came crashing over me and all of the feelings that I had so desperately tried to bury came rushing back to me. It was a toxic mix of guilt and anger and disappointment. Pain.

    I never liked dealing with my feelings, and heroin helped me to avoid them. But I tried to avoid them too much. Two nights before Christmas 2009, I overdosed for the first time. The life I had been living took its toll on me, mentally and physically. I was alone and the pain of losing my family and my friends to my addiction became too much for me to handle. All I wanted was to keep running from it. I ended up using too much heroin to blur out the pain.

    I didn’t want to die but I just didn’t know how to live.

    When I opened my eyes, it was like a dream. Ambulance lights flashing, people overhead asking questions. All of the voices seemed as if they were under water. Christmas morning, when I came to in the hospital, my family was there at my bedside. I hadn’t seen my brothers and sisters in a long time because my mom wanted me to stay away. She wasn’t my biological mom, of course. The woman that gave birth to me was too in love with crack to be a mother to me. She abandoned me when I was five. But my mom, she took me in and looked after me until I was 14. Then she kicked me out too. 

    When I woke up in the hospital bed and saw her face and the looks on my siblings’ faces, I broke down. At that point in my life, I thought I had forgotten how to cry. But I cried because they cried. I cried because I realized my siblings were seeing their hero at his worst. I cried because I felt bad for all the things I did to my mom. I always wanted to make my adopted parents proud. I felt like I owed them my successes because they gave me a second chance at a decent life. I had to show them it wasn’t for nothing. But looking into my mom’s eyes that morning, all I saw was the pain and disappointment I had caused her.

    When I was released from the hospital, I was too ashamed and embarrassed to show my face to my brothers and sisters. I didn’t want to deal with the pain of what I had done. Instead, I crawled backed into bed with my new love, heroin, who kept my emotions nonexistent as long as I stayed with her. I turned away from my family and searched for a new one – a family that would accept me without me having to change my destructive behavior. I found that sense of belonging with the Latin Kings.

    My “Original Gangster” – the Latin King member who took me under his wing – showed me a side of gang life that I hadn’t ever expected. He told me the Nation was dedicated to uplifting the Latin community from poverty, oppression, and abuse. He showed me broken families, homeless people and how my life would be if I continued on the path I was on. He was a man who didn’t owe me a thing but tried to show me a better way. At least, that’s what I thought at the time. And I wanted what he had: respect, power, and the ability to make a difference in the lives of the people who looked up to him. I had no direction and nothing going for me so I agreed to be a part of his world, with no consideration of what that really meant.

    I began living a lie. I pretended to be clean, but anyone who stayed around me long enough could see that I was on drugs. My OG would ask me occasionally if I was using and I would always make up a story. He never pushed me any further on it. But the other Kings knew. They didn’t care, though, as long as I did what they asked of me. Some of them even supplied me with drugs to make sure I was ready for a “mission.” In our world, a mission involved shooting at the opposition or robbing someone.

    In my heart, though, I was never a gangster. I never wanted to hurt people. The things I did on my missions made me feel like I was a losing a part of myself. My life became an endless cycle: wake up, get high, complete my mission, get high, be with my girlfriend, get high, black out, wake up, repeat. Then one day I was given a mission that no amount of drugs could ever convince me to do.

    I had sworn loyalty to my gang but when they told me to kill my OG for being a suspected police informant, I couldn’t do it. Three members of my gang beat me unconscious for violating their order. When I came to, I was in the hospital with a concussion and my phone was ringing. My OG’s wife was crying on the other end. He was dead. My heart sank and hardened at once. I detached myself from the machines and left against medical advice. I needed to get back to heroin. It was my love, and at that point, it also became my life.

    Supporting my habit got harder. I was using too much to be able to sell and still have enough left for myself. So, I found a new profession as a male escort. It was during that time that I was raped by one of my drug dealers. I was unable to live with myself after that happened. For the first time, I intentionally overdosed and ended up on a friend’s front porch. He brought me back to life. Throughout the night, he talked to me about life. He told me “life is good, good is life.” I eventually had those words tattooed on my forearms to serve as a reminder. He not only gave me a second chance at life but also a new outlook. From that day forward, I tried to fight my addiction.

    It wasn’t easy and I didn’t manage it very well. I tried my first stint at rehab at 17. That lasted two weeks. Soon after rehab, I caught my first case for armed robbery. Strangely, when they put me in the cop car, I was relieved. My first night in jail put me in a bad place mentally. All the pain I was running from was suffocating me. I had the phrase “life is good, good is life” in my mind but, at that moment, I had no idea what was actually good in my life. All I knew is that I wanted to live.

    I served three years and change on my first sentence. I was in the best shape of my life, both physically and mentally, and I thought I had everything figured out. But nothing had really changed for me. As soon as I was out, it took one argument with a girlfriend for me to go running right back into the arms of the one that always made me feel better: heroin. I wasn’t out of prison four hours before I had a needle in my arm.

    Seven months later, I caught my second case and that’s what I’m serving now. Since going back to prison this time, I’ve worked hard to better myself, gain an education and become someone. But I still carry around the fear that I might not be strong enough to stay clean and make something of myself when I get out. In the past, that fear would have stopped me from even trying. But during this sentence, I’ve learned that the only way for me to succeed is to have the courage to fail and pick myself back up without having to turn to my old love for support. I used to believe I was nothing and that meant my life would amount to nothing. But I don’t believe that anymore. I believe that I have the tools I need to succeed. And that gives me hope that, maybe this time, everything will be different.

    View the original article at thefix.com

  • Kicking Heroin Cold Turkey Changed My Life

    Kicking Heroin Cold Turkey Changed My Life

    Nobody ever tells you how it feels, especially for the first time.

    This was the most pain and anguish I had ever experienced in my life, and I had given it my best shot, but there was really no point in going on.

    There were three of us.

    Eric was dashing and handsome, with eyes that cut through you, even as a child. He’d walk into a room and own it, immediately, and he knew it. He had leading man features that greatly resemble Chris Pratt, after he got sexy.

    James was the athlete, gifted with a physique that a teenager shouldn’t have been allowed to have. He was also kind to a fault, and loved God in the way that a puppy loves anything. If being a charismatic, fun-loving priest didn’t work out, he would have settled for being the NFL’s hottest running back.

    And then me: two years younger, two heads shorter, with eyes twice as wide when I’d look at my cousins, whom I worshipped. I thought of myself as their sidekick, but to be honest, if they were both Superman then I was a bundle of kryptonite around their necks, weighing them down. They didn’t mind, though. It kept them human.

    Musketeers. That’s what our family called us, and we were inseparable. We came from a prototypical Irish-American Catholic family (which means lots of kids). If you’re at all familiar with that demographic, you know that such families are tightly knit. Since the three of us were so close in age, our parents made sure that we spent time together, every single day. “Protect each other!” They’d always say.

    Even though Eric and James were two years older than me, they always encouraged me to hang out with them and their friends after school, but only after all my work was done. Ironically, it was my cousins more than my parents who forced me to get my homework done, but that could have been because they needed me to help them with theirs. I could never have hoped to be as cool as my cousins, but book smarts came easily to me. Together, we were a perfect team.

    And then we lost Eric.

    Not immediately. Acute myeloid leukemia works quickly, but it still gives you plenty of time to wait for the inevitable. After chemo failed, the doctors gave him two months. Eric gave them four. He frequently joked that he was going to live forever, despite having leukemia, just out of spite. In fact, he probably put up the most convincing happy face during the whole ordeal. In a way, this helped a lot of us. If Eric wasn’t scared, then why should we be? But underneath, he had to be frightened to death.

    Eric died in his senior year of high school, a few weeks before Christmas. I can’t believe that we found enough tissues for his funeral. My family doesn’t pick favorites, but deep down, I think everybody knew that Eric was the most beloved of any of us. He was the all-American boy we loved to boast about. Despite the tears, though, something felt dignified about his funeral. I think my whole family was proud that he put up a fight, that he went down swinging. That’s the kind of people they are.

    James and I took it harder, though. Family mattered to us more than anything, but what we had with Eric was something else. It was like a family within a family. And Eric was always our fearless leader. I thought he was invincible. As for James, I think he felt like a knight with no prince to follow.

    “Always protect each other,” our family would say.

    How?

    ***

    A few months earlier, James hurt himself playing football; torn ACL, his senior season cut short. To be honest, I wasn’t surprised when he did. As I watched him play, I thought he seemed angry. This was during the waiting game with Eric. It was while treating this injury that James received his first prescription of painkillers.

    Even after Eric died, James and I were still inseparable. I think I was the first one to notice that he was particularly fond of his medication. Besides numbing the pain from his injury, I think it helped him feel numb to the situation, and made him seem stronger than he was. Despite this, he got even more active than he already was in the church. If his plan B of being an NFL superstar was out the window, he’d have to work extra hard to make sure that the priesthood worked out. We sang songs together at church. Even though I was angry that Eric had been taken from us, I loved God more than I ever had. I had to. Eric was somewhere better, and that’s all there was to it.

    Two years went by, and James was still taking his pills. He mainly avoided taking them around family, but we were together too much for him not to do it around me. I wasn’t stupid, I knew his prescription ran out a long time ago. Without a prescription, opioids can get expensive, and it was only a matter of time before James found a cheaper, stronger substitute.

    And that’s how we both started doing heroin.

    At this point, I was a fairly upstanding high school citizen. I attended school full-time and worked an after-school job. Schoolwork came easy to me, and grades and test scores followed. On top of that, I still sang in church with James and volunteered with the Catholic Services food bank. I was responsible to a T, and I hated it.

    There’s not a lot of glamor in being the responsible one in a family that tells stories of war and fights, and values adventure above all else. Sure, the whole family would throw a barbeque every time an acceptance letter came in the mail, and they never showed anything but pride and support. But I wanted experience. I was young and stupid and had a thirst for everything that I couldn’t have. So when James switched from the pills to the heroin, I took some and tried it on my own (you can learn anything on the internet).

    Nobody ever tells you how it feels, especially for the first time. To this day, I can promise you that the most euphoric moments in your life cannot compare to the rush that heroin will give you; not love, not sex, not pride, nothing! Literally, it’s chemically impossible. Heroin forces your receptors to overload, giving you an overwhelming feeling of pure pleasure.

    One time, and I was hooked.

    At first, James was furious with me, although I suspect he was more furious with himself. At that point, though, we both already knew what it felt like, and neither of us was going to stay away.

    For the next six months, we both used regularly whenever we could. James had a full-time job, and I had a part-time one with no expenses. On top of that, people always expected us to be around each other. There were no obstacles in the way of our continued drug-fueled lethargic shenanigans. During this time, I maintained my grades, my job, my church activities, and my relationship with my girlfriend, who was in the dark about my darkest habit. Somehow, I had convinced myself that I could maintain everything I had while still being a heroin addict. Anyone who couldn’t figure it out was just too foolish.

    There is a cost to such pleasure, though. Due to the amount of dopamine that is released in your brain when you do heroin, your brain starts to get complacent, and won’t produce any new dopamine without the stimulation of heroin. Over time, this meant that I couldn’t feel pleasure, or giddiness, or satisfaction, unless I had recently used heroin. Towards the end of school days, I would get irritable, getting restless for my next fix.

    James realized this before I did. He never excelled in school, but he always had much more emotional wisdom than me. It’s because of this that he told his parents about his addiction. I first found out from my parents that he had told them, and I selfishly was terrified that he had ratted me out. But James would never do that without my consent.

    “Always protect each other,” they’d say.

    James, with the help of family, started getting treatment. In the meantime, I continued to shoot up in his bedroom while he tried to convince me to do the same. Near the end, I was strongly considering it. Even at the point when heroin had the strongest hold over my life, I still loved and trusted James more than pretty much anything in this world. And truthfully, he was doing well. He hadn’t used for nearly a month.

    But then I made a mistake.

    One night, I took the bus home from James’ home and went to bed. Early in the morning, though, I shot awake with the realization that I had left my bag in his room, and in that bag was the thing that James most needed to stay away from. As I hurried to get back to his home, my stomach was already filling up with a sickness of certainty.

    James was already long dead when I walked into his room.

    I thought my heart was going to pound out of its chest. I’m ashamed to admit that my first thought was that I needed a fix, and then my second was how long it would take to bleed out if I cut my wrists. At that moment, I probably could have found the courage to cut my own throat. Somehow, I did neither of these things, and managed to call 911.

    And then there was one.

    If he had never have gotten help and stopped using, the dosage wouldn’t have killed him, but he didn’t lower it to compensate his reduced tolerance. This irony never escaped me, even when I first found him.

    This funeral was harder than Eric’s. It was harder to find the dignity, to justify the purpose of this loss. Eric’s death brought sadness to my family. James’ death ripped the rug out from under them.

    Everybody blamed themselves. His parents thought they didn’t try hard enough. His older siblings thought they weren’t good enough influences. My grandparents felt they didn’t talk to him enough after Eric died.

    But it was me. If there was a metaphorical trigger to pull, then I was the one who did it. Not only was it heroin that I bought that killed him, a fact my family was woefully ignorant of, but I was the one who continued to use in the environment that he needed to be a safe space. I was too proud to think that I needed help, and it cost the life of a far kinder person and gentler spirit than me.

    As I looked at his open casket, all I could think was that I was the worst fucking scum on the planet, and that I should follow him into the ground.

    But as everyone I love wept around me, I could practically hear their hearts cracking. And then I had a realization would define every molecule of my existence for the coming days: I would not be the next one to hurt my family. I couldn’t bring myself to tell them that I was also an addict, so I decided there was really only one option, something I had never done before, but had heard about from TV shows and online articles. I had to go cold turkey.

    Because of how close James and I were, it was easy to get a few days to myself that I would need to completely detox. My family would simply think I was grieving. They were right, but only half so. That thought at the funeral put me into a mode of complete obsession, and I was determined to follow through with my plot.

    ***

    I bought a couple cases of water, a few bags of salted jerky, and a rotisserie chicken, and then locked myself in a spare room at my grandparents’ home. There was a lot of family in town, so they would be busy for the next couple days. I felt ready for anything.

    But, just like nothing could prepare me for the pleasurable feeling that heroin washed over me, neither could reading about the cold turkey process ready me for how horrific it really was. Below is my attempt to be as straightforward about the process as I can be, and to tell it as factually as I can…

    Once I was 14 hours in from my last fix, I consider the withdrawals to have truly begun. First, it starts with intense cravings. You want heroin more than you’ve wanted anything in your entire life, or at least you think you do. I constantly reminded myself that this was a trick, but I’m not sure I believed it at the time. Remember, after you’ve become dependent on heroin, your brain is practically incapable of producing positive thoughts. I tried to remember happy memories of James, but they were fuzzy in my mind. Beyond this, my concept of time began to blur for the next several days.

    After I had neglected my strong desire to use, I began to get uncontrollably irritated. Every time I clattered my teeth or made a sound, I would frustrate myself to the point that I wanted to punch a wall. I started to scream into pillows to let off steam. However, this got harder once the nausea set in. I was prepared for this. I had read all about the physical effects that would happen to me. However, reading did little to mitigate the sickness and dizziness. Pretty soon, standing became a difficult task.

    I stayed in bed and attempted to control my breathing. For a little while, I was even almost able to relax. This was short lived, though. Again, I knew that the skin crawling sensations were coming, but I didn’t realize how sporadic it would be. Everywhere on my body felt like it was on fire. I tried to hold my breath and keep still, but pretty soon I was scratching everywhere I could reach. After a matter of minutes, my arms were bleeding. I wrapped my fingers in duct tape to prevent myself from doing further harm.

    I knew that I would eventually start vomiting and purging everything in my body. I had readied myself for all of the physical effects. However, the true hell of heroin withdrawals isn’t in the physical aspects, it’s the mental side effects that really get you. At this point, my irritability had climbed to a full-scale anger. I kept clenching my jaw so bad that my gums started to bleed. All I could do to let out the energy was to continue screaming into a pillow, but I was starting to get tired. Then, out of nowhere, the vomiting started.

    I vomited and dry gagged in a throbbing cycle that lasted about an hour, but would continuously rear up throughout the whole process. While the initial vomiting was quite painful, it actually provided me some relief from the thoughts in my head. Afterwards, I was so overcome with exhaustion, that I was actually able to sleep for several hours. To my memory, this was the only continuous sleep I would have for about two days.

    Although I very much needed these few hours of sleep, it almost wasn’t worth it because of the nightmares that started at the end and woke me up. Up to this point in my life, I wasn’t very prone to nightmares at all, and could probably have counted the number of nightmares I had had (or at least remembered) on one hand. However, the dopamine from my last hit was finally hitting the dregs, and my brain couldn’t produce anything to balance itself out, chemically.

    I woke up in a cold sweat and felt paralyzed with fear. For the next several days, every time I would start to fall asleep, nightmares and partial hallucinations (waking nightmares) would jolt me awake in terror. After a few times of trying to doze off, I began to question my own sanity. We tend to hear a lot about the physical aspects of heroin withdrawals, but one of the most dangerous threats to people going cold turkey is suicide.

    Somewhere at this point, although time was a bit of a blur, my mind hit rock bottom. My dopamine receptors were doing nothing at this point, and my brain began to fall apart, unable to produce a single happy thought. The world was a bleak pit, and I was just washing around at the bottom of it. I had felt small bouts of depression before, but this was soul-crushingly different. Out of instinct, I began to pray. I begged God to make the pain end. I begged for a light at the end of the tunnel. I begged for some sort of sign or to be saved from my own thoughts.

    Then, it occurred to me how easy it would be to simply end it all right there. It wasn’t hard to reason myself into it. I could be with Eric and James. We could be the three musketeers again! This was the most pain and anguish I had ever experienced in my life, and I had given it my best shot, but there was really no point in going on. I’m sure that God would understand. I knew that he would have mercy.

    It was then that I remembered the thought that saved my life. I didn’t need a happy memory. I needed the memory of feeling the worst I had ever felt. I needed to remember the self-loathing that washed over me at James’ funeral, as I heard the people I cared most about bawling uncontrollably in pain, because of me.

    And then it hit me as if the sky fell down: God wasn’t there.

    I don’t expect everyone to have this same revelation. It was an incredibly personal moment to me. Addiction recovery programs frequently talk about needing to surrender to a higher power, and this was my own special ‘higher power’ moment.

    It wasn’t that God didn’t care, or that he was cruel, or that I couldn’t understand his grand plan. He wasn’t there. There was nothing above me or below me that wasn’t a meaningless abyss. A void of space that stretched beyond what my brain could conceive for absolutely no reason. There was no cavalry coming to save me, and there was nothing waiting for me if I were to die now; just more pain for my family.

    I had gotten myself in this situation, and only I could get myself out. I was going to have to do this Eric’s way: survive, out of spite. I abandoned every notion of meaning I had ever put on the world, and replaced it with this one simple purpose. For the rest of this battle, that would be my single function. I may have wanted to die, but I had too much hate to give in. If you can’t find happiness, hate can be a powerful motivator.

    The only thing I knew was that I would not be the next reason my family grieved and hurt. I would survive. No cancer, or heroin, not even God himself would stop me. If I died and woke up in heaven, I would have killed every last angel to get back to Earth; to get back to my family.

    Dramatic? Yes. But the mind of an addict suffering from heroin withdrawals is hardly a place for subtlety.

    From this point on, I sat against the wall, and remained there for about a day, just staring and drinking water. I wouldn’t let myself fall asleep and be the victim of yet another night terror. Every craving and thought of suicide filled me with more and more spite, and I sat there, stewing in it, until finally, I could feel the physical effects wearing off.

    I had survived.

    The cravings continued to last for months. Even years later, I sometimes have a sharp, discernable memory of how good the pleasure of heroin felt. But I can say with certainty that I don’t have the temptation to use. If I sat in an empty room with an ounce of heroin, I wouldn’t even have the slightest desire.

    In that room, I burned down who I was as a person, and built something else with the pieces that I had. Truth be told, going cold turkey is a horrible idea, and isn’t safe to try under even the best of circumstances. Please, if you or a loved one find yourself struggling with heroin dependency, get professional help and stick with it. This is by no means a road map to fighting addiction. It doesn’t really feel like a feel-good story, either. Hell, I’m not even sure if this is a happy ending.

    But it’s my story.

    *Names have been changed for the sake of anonymity.

    View the original article at thefix.com