Answer Addiction

Tag: withdrawal

  • Suspect In Deadly Rehab Shooting Taken Into Custody

    Suspect In Deadly Rehab Shooting Taken Into Custody

    The suspect denied responsibility for the shooting.

    A suspect in Monday’s shooting at a California recovery center is now in custody, according to authorities.

    Authorities believe Davance Lamar Reed was the person who opened fire at Helen Vine Detox Center in San Rafael early Monday morning (Nov. 5).

    Helen Vine, on Smith Ranch Road, is a licensed 26-bed co-ed residential detoxification program for people with alcohol and drug addiction as well as co-occurring psychiatric problems, according to the Sacramento Bee.

    Three people were shot—leaving one dead and two with life-threatening injuries.

    The deceased victim was identified as Nathan Lamont Hill, 52. The two injured are 32-year-old Anthony Dominguez Mansapit, an employee at the facility, and 30-year-old Brittney Kehaulani McCann. As of Monday, they remained in intensive care at Marin General Hospital.

    McCann is said to have a dating relationship with Reed, according to the Marin County Sheriff’s Office. The Marin resident, who friends say has a 7-year-old son with the suspect, was trying to drop Reed off at the recovery center, but instead he began shooting, according to her father and sister.

    The shooting victim is a “genuinely empathetic person” who wanted to help Reed, a friend told KTVU.

    Reed was arrested for an unrelated incident that occurred about an hour after the shooting. Police began pursuing Reed after spotting his Hyundai Elantra, which belonged to the mother of shooting victim Mansapit, weaving on the highway, according to KTVU.

    It was not until later that police learned that Reed was a suspect in the shooting at Helen Vine Detox Center.

    According to the sheriff’s office, Reed “made admissions that tied him to the crime scene” at Helen Vine.

    The suspect denied responsibility for the shooting. “I didn’t shoot nobody. I shouldn’t be here,” he told KTVU from jail. He said he is withdrawing from a dependence on Xanax. The anti-anxiety drug was discovered in the vehicle he was in during the police chase that ended in his arrest.

    Reed is being held at Sonoma County Jail. His next court appearance is scheduled for Nov. 15.

    Buckelew Programs, the non-profit organization that oversees the program at Helen Vine and other facilities in Marin, Napa and Sonoma counties, expressed its condolences in a social media post: “Our hearts are with the staff, clients and families affected at Helen Vine Recovery Center.”

    View the original article at thefix.com

  • How to Taper Off Suboxone: A Survival Guide

    How to Taper Off Suboxone: A Survival Guide

    “Fear is common and normal for a number of reasons, but the fear usually gives way to a sense of confidence and optimism when a taper is done correctly…Be patient.”

    Note: This article is not intended as a replacement for medical advice. This is merely the experience of 21 people interviewed by the author who have successfully tapered off buprenorphine-based medications (Suboxone, Zubsolv, Bunavail, Subutex, etc.) or significantly reduced their dose. Please consult your doctor before beginning a taper. 

    After two and a half years of taking Suboxone, I’ve decided that it’s time to start the tapering process. I don’t like having to rely on this little orange film strip each morning to get out of bed, the tidal wave of nausea, being constantly hot, the restless legs, and the constipation. This is an incredibly difficult decision because Suboxone has saved my life. Additionally, studies have demonstrated the effectiveness of Suboxone and found it’s reduced overdose death rates by 40 percent. 

    Some people decide that it is best for them to take Suboxone for life. Shannon has been taking 16 milligrams of Suboxone for 17 years and has no intention of tapering. She said: “I’m never getting off, why fix something that isn’t broken? I love life now. I’m a great mother, wife, daughter, sister, aunt, and trustworthy friend to all those that know and love me. I have absolutely no shame being a lifer. I’ve been to the depths of hell and now I’m in heaven. I believe without subs, I would be dead.”

    Like Shannon, fear of relapse and withdrawals makes me terrified of coming off Suboxone. I imagine waking up panicked and glazed in sweat, running to the bathroom to puke and worst of all, the black hole of depression and existential dread that is common with opioid withdrawal. These are common fears for people coming off opioid addiction treatment medications. In order to help others like me who are interested in tapering, I researched this topic and surveyed 21 people: 13 have successfully tapered off Suboxone and eight have significantly lowered their doses and are currently at or under six milligrams per day.

    Slow Taper

    Sixteen of 21 people I surveyed reported using a slow taper to come off or lower their dose. Dr. Jeffrey Junig of the Suboxone Talk Zone Blog suggests that the optimal dose to “jump” or quit taking Suboxone is .3 mg (about 1/3 of 1 mg).

    Junig writes: “I have had many patients taper successfully off buprenorphine. Fear is common and normal for a number of reasons, but the fear usually gives way to a sense of confidence and optimism when a taper is done correctly…Be patient. Tapering by too much, or too quickly, causes withdrawal symptoms that lead to ‘yo-yos’ in dose.”

    Amanda* agrees with Junig’s advice not to try to jump from too high of a dose. She said that when she jumped from 2 mg cold turkey it was “40 days of hell.”

    To avoid a hellish experience like Amanda’s, Junig advises reducing your dose by 5% or less every two weeks or 10% every month. Sound confusing? Junig simplifies: Use scissors to cut half of an 8 mg film. Then cut half of that, then half again. Put the doses in a pill organizer so they don’t get lost or accidentally consumed by children or pets.

    Holistic Remedies

    There are a handful of holistic remedies that can help with the tapering process. Folks I surveyed said that yoga, meditation, and healthy eating are pillars of their recovery. Studies have confirmed the benefit of yoga for improving quality of life in those withdrawing from opioids as it alleviates anxiety, restless legs, insomnia, and even nausea.

    Sarah said: “I tapered with a clean diet with digestible nutrient-dense food and smoothies and stayed hydrated. I got plenty of sun, used yoga and exercise too.”

    Others recommended vitamins and other supplements including: L-Tyrosine, DLPA, Vitamin C, Omega 3 Fish Oil, and ashwagandha. They used melatonin for sleep and Kava tea for relaxation. (Consult your physician before taking any supplements. Even benign substances may interact with other medications or have unintended side effects.)

    Marijuana

    Four out of 21 people polled used marijuana to deal with the difficult side effects of tapering off Suboxone. Barry said: “I know that some people may not see marijuana as a way that should be used to taper, but for me I was desperate to try anything that worked. I consider marijuana a lesser of evils. It helped with restless legs, nausea, pain, and anxiety.”

    Marijuana may now be a viable option for those who wish to try it, because it’s now legal for medical use in 29 states and for recreational use in nine states plus Washington DC. Unlike opioids, marijuana provides pain relief with a lower risk of addiction and nearly no risk of overdose. Plus, comprehensive studies like this one from the American Pain Society found that medical cannabis use is associated with a 64 percent decrease in opiate medication use.

    While studies have supported the use of marijuana to reduce opioid use, further research needs to be done as reported in the The Daily Beast. Dr. Junig also advises that patients should not start new mood-altering, addictive substances in order to taper off Suboxone.

    CBD Oil

    Three of the Suboxone patients polled were able to taper with the help of cannabidiol, also known as CBD oil. Experts emphasize the distinction between marijuana and CBD oil: CBD oil is not psychoactive, meaning that it doesn’t make patients feel “high” like the THC in marijuana. CBD oil may be a more viable option for people in states where marijuana has not been legalized and also for those who do not want mood altering affects, but strictly relief from physical symptoms. “I used CBD oil during the taper because pot isn’t legal in my state and it helped with restless legs, sleep, and anxiety,” Pablo said.

    A 2015 study in Neurotherapeutics examined the therapeutic benefits of cannabidiol as a treatment for opioid addiction. They found that CBD oil is effective in reducing the addictive properties of opioids, mitigating withdrawals, and lessening heroin-related cravings. Specifically, it relieved physical symptoms such as: nausea, vomiting, diarrhea, runny nose, sweating, cramping, muscle spasm. Additionally, it treats mental symptoms like anxiety, agitation, insomnia, and restlessness. The study states CBD oil is effective with minimal side effects and toxicity.

    Kratom

    In our survey, the people who tried kratom claim that the herb is a controversial yet effective way for tapering from Suboxone. Some experts agree. According to the Mayo Clinic: “In Asia, people have used kratom in small amounts to reduce fatigue or treat opium addiction. In other parts of the world, people take kratom to ease withdrawal, feel more energetic, relieve pain, or reduce anxiety or depression.”

    Four of the individuals surveyed used kratom for tapering off Suboxone. Christine said, “I was very tired when coming off Suboxone, so kratom helped give me the energy to work, clean my house, and take care of my kids.”

    Cristopher R. McCurdy, PhD, a professor of medicinal chemistry at University of Florida’s College of Pharmacy in Gainesville, studies kratom. McCurdy told WebMD: “I definitely believe there is legitimacy to using kratom to self-treat an opiate addiction.”

    Despite these positive reviews, the Mayo Clinic and Web MD caution that kratom can also lead to addiction and withdrawal. According to an article on WebMD, “There’s little research on the herb’s effects on people, and some experts say it also can be addictive. The herb is illegal in six states and the District of Columbia, and the Drug Enforcement Administration is considering labeling it as a Schedule I drug…For now, the agency calls it a ‘drug of concern.’”

    Pharmaceutical Remedies

    Five of the people surveyed said that they tapered with the support of medications prescribed by their doctors to treat individual withdrawal symptoms. It is best that patients talk with their doctors and addiction professionals to see if a particular medication is right for their situation.

    Happy tapering! I plan on writing more in the future about my experience and progress tapering off Suboxone. If you’re embarking on this journey, I wish you luck!

    The names of some individuals have been changed to respect their privacy.

    Have you successfully tapered off Suboxone or methadone? Or are you a “lifer” like Shannon? We’d love to hear your thoughts, experiences, and tips in the comment section.

    View the original article at thefix.com

  • Can Eating Less Junk Food Cause Withdrawal Symptoms?

    Can Eating Less Junk Food Cause Withdrawal Symptoms?

    A new study examined whether cutting back on junk food could produce symptoms similar to those experienced when quitting tobacco or pot.

    A body of research on the effects of highly processed foods has suggested that cutting down on regular consumption of such items have resulted in physical and psychological symptoms.

    The latest research to support this theory comes from the University of Michigan, where a study has suggested that reducing the amount of highly processed foods in one’s diet may produce symptoms similar to those experienced when quitting tobacco or marijuana.

    The study, which utilized a modified questionnaire used to assess symptoms for other dependency-forming substances, may offer a new means of measuring and understanding the impact of processed foods on individuals.

    In the study—published in the September 2018 edition of the online journal Appetite—a group of 200 adults aged 19 to 68 who’d been on diets that involved cutting down on junk food in the past year were given a questionnaire, called the Highly Processed Food Withdrawal Scale which is modeled after a similar tool used to measure symptoms that occurred after individuals quit smoking or using marijuana.

    Based on the study group’s self-reported information, withdrawal symptoms, including mood swings, cravings, anxiety and headaches, were determined to be most intense between the second and fifth days after making an attempt to reduce junk food intake—which according to study lead author Erica Schulte, echoes a timeframe similar to one experienced by people who undergo drug withdrawal.

    Researchers noted that the study did have several limitations, most notably a lack of information on the intensity of withdrawal symptoms or which methods participants used to change their intake, whether through gradual reduction or complete elimination from their diets.

    The study also did not ask participants to record their withdrawal symptoms in real time, but instead asked them to only recall the scope of the symptoms as a whole. 

    Still, the study did contribute to growing awareness of the possible dependency-forming aspect of highly processed foods, and the results may help individuals who consider reducing such items from their diets to prepare for the possibility of side effects.

    According to Schulte, it may also provide some insight into the barriers that may cause people to stop making such changes, or even leave treatment to address dependency issues altogether.

    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

  • A Dopeman's Grocery List

    A Dopeman's Grocery List

    The reality and gravity of the entire situation was this: if I don’t steal this shit, I’m not getting high. If I’m not getting high, I’m dying. That’s how bad I was strung out on opioids; that’s how much of a slave I was to the drugs.

    The following story is based on actual events. In an effort to protect anonymity as well as keep people out of potential legal trouble; names, places and identifying characteristics have been modified. I hope you enjoy these stories. Whatever you do. DO NOT try this at home.

    What happens when you run out of money and need a fix bad?

    What happens when you just don’t have it in you to stick someone up on that particular day?

    What happens when you run out of shit to pawn?

    What happens when there’s nothing left to post on OfferUp, LetGo and Craigslist?

    You can always go grocery shopping for your drug dealer like I did. I mean, I didn’t have any money at the time and I already traded my food stamps for dope that month but I knew there were a few items that “D” needed me to pick up from one of those big-box-retail-stores. If I could get the items he needed, he would trade me 50% of whatever it cost in cash or trade me 75% of what it cost in dope. This was a no brainer. Get the grocery list, steal the items, get the dope and get high.

    I’ve always been a fan of “heist” movies. Mission Impossible, Ocean’s Eleven and Catch Me If You Can come to mind when I think about the excitement I felt when the “bad guys” got away with whatever it was that they were taking. Sometimes rooting for the bad guy feels good. Every time I received one of these lists via text message from D, I felt like Ethan Hunt accepting some kind of grand mission that was of the utmost importance. The reality and gravity of the entire situation was this: if I don’t steal this shit, I’m not getting high. If I’m not getting high, I’m dying. That’s how bad I was strung out on opioids; that’s how much of a slave I was to the drugs. When opioids told me to jump, my response was always: how high?

    It’s been four and a half hours since I last shot up. My stomach is beginning to turn like that sensation you get when a roller coaster takes its first plunge, except it felt like it was my life that was diving into utter oblivion. My palms have begun to get clammy. I got the cold-sweats and it’s pissing me off. It’s 73 degrees in my room but I’m soaking wet like “Dollar Debbie” taking a stroll down MLK in the middle of August. Life sucks and I need to get “one” in me… like yesterday.

    BEEP! BEEP! A text comes in. God I hope it’s D. I unlock my phone and see the good news I’ve been waiting for:

    1 bottle of Pine-Sol
    2 boxes of Huggies
    Peanut Butter and Jelly – not that shit with the peanuts in it
    1 Mop
    1 Case of Ramen Noodles
    5-10 assorted girl’s tees
    1 pair of white sneakers, size 6 – I don’t care what the brand is

    Oh, I also need a new Bluetooth speaker, some crackhead stole mine last night. See if you can get one of those dope ass Dyson vacuums too.

    And hurry the fuck up, I’m trying to go to the casino. You got one hour!

    Finally! I got the grocery list! Now I have to find a ride. That means I have to cut somebody in on the payoff, which means fewer drugs for me. Fuck it, I’m hurting bad. At this point, I’m not going to argue over whose half of a dilaudid is bigger. It doesn’t matter anymore.

    I scroll through my contacts and find the guy I’m looking for. I just hope he’s awake. It’s three in the afternoon, a little early for Tony. He usually gets up around four or five because he’s been up all morning trying to come down from the “shards” he shot up the night before. I know an offer to score some dope to come down off the shit will lure him into my latest scheme.

    “But what color vacuum does he want?” Tony asked, dazed.

    “Does it fucking matter?!” I yelled back. Tony had a way of asking questions that didn’t matter. He was slow, he was sloppy, and he smelled like a piece of toasted Chore Boy. It’s mind boggling to me that this guy was ever successful at pickpocketing when he lived in New York. He had been down here in Florida for only six years and had already visited the local jail well over 12 times. Thing is, he always stayed high, had a car, and was just as sick as I was.

    “I’ll be there in five minutes.” he murmured. “Meet me two streets over by the bando,” he instructed before hanging up.

    Twenty-five minutes later, Tony pulls up in a hurry, looking annoyed like I’m the asshole who’s twenty minutes late. I’m livid. He always does that; he’s worse than a drug dealer and I hate waiting. I need a fix bad. My nose is beginning to run and I’m getting these random sensations in my stomach. Feels like someone is taking a blade and stabbing me erratically. My body is telling me that I’m supposed to eat but the appetite isn’t there. The worst symptom I get when withdrawing is when I smoke a cigarette: I gag every time I hit it and they don’t taste the way they normally do. It doesn’t help that the cigarettes I’m smoking are the ones I’ve collected from all the public ashtrays around town. They already taste bad. This life sucks. I need a pill, now.

    “Here’s the plan,” I say to Tony as I get in the passenger seat. “We have a half hour to grab the shit and meet D at his place before he leaves for the casino.” Tony is already driving to the store. Like me, he knows which one to go to at any particular time of day. We know when loss prevention does their shift change, we know which side of the store the greeters are on, we know which store we hit last time and that dictates which store we hit next.

    “Five minutes or less!” I say assertively. “If it takes longer than that, we’re going to the other store.” I know that if I have to come up with a story to buy more time with D, it shouldn’t be a problem.

    “Flip a coin to see who’s building the cart this time?” Tony asks.

    “Run it,” I reply.

    “Heads!” He yells as I flip the coin. “Yes!” He screams. He gets to build the cart. I’m getting excited. As we near the store, the symptoms of my withdrawal seem to lessen. I’m getting turned on over the idea of committing a crime. Sounds crazy, doesn’t it? Not only am I addicted to drugs, I’m in love with the crazy and dangerous lifestyle that comes along with it.

    Let me break down the lick for you.

    This is a two man job. Park near the front and keep the car running. Pop the trunk but leave it down so it looks shut. Leave all the doors unlocked. First man goes inside alone to “build the cart.” Building the cart is the easy part, that’s why we flipped a coin for it. You basically go in the store, acquire the items on the list, and place them inside a shopping cart. This must be done in five minutes or less. The other man, the one in the car, is on the phone with you, the cart builder, talking in your ear while he looks through the store window, informing you on what the employees are doing. Are they watching you? Is there an undercover loss prevention guy following you? These are things that must be known.

    General rule of thumb when building a cart: look like you belong there. Just go shopping. Smile; say hi to an employee; maybe ask them where you can find a particular item. You’re the customer, act like one.

    Tony gets everything on the list in less than five minutes. His slow ass must really need a pill as bad as I do. If he’s hurting, he’s not showing it. I think he’s as excited as I am.

    Once the cart is built, head to an aisle that runs along the cash register that’s nearest to the exit. Ditch the cart. Leave it in the aisle and get the fuck out. Once you get back in the car, look your partner in the eye, wish him luck, light a cigarette, sit back and relax. Your work is almost done.

    Here’s the dicey part. It’s the driver’s turn to enter the store. I exit the whip and walk to the entrance. Tony keeps his earpiece in and puts the car in drive while he keeps his foot on the brake. I almost forgot to mention, never pull into a parking space. Back in, so when it’s time to make the getaway, you just let off the brake and get the hell out. No one is trying to get into a little fender-bender while trying to elude potential law enforcement. I mean seriously, if my ass goes to jail over a fucking bottle of Pine-Sol, I’m killing somebody.

    I’m in the store. My heart is racing! Do I look like I belong? Do I look like a junkie? I know I showered. My shirt is wrinkled but my shoe game is on point. I don’t look homeless but I feel like shit. Do the employees notice? Keep walking. Eyes forward. Listen for Tony on the phone. It’s going to be okay.

    I find the cart. My palms are sweaty as I grab it and head towards the exit. I dig into my pocket and pull out an old receipt from the gas station. This is what I’m going to use as I walk out the door with my head down. I’m going to make it look like I’m going over the items I “just purchased” as I walk out; never mind the fact that nothing is bagged up.

    “How’s my back, T?” I ask nervously.

    “I don’t see anyone behind you, bro. Just keep coming. The trunk is already open.”

    We chose the correct side. As I near the exit, I notice there aren’t any greeters, AKA receipt checkers. This is expected but I still don’t get it. There are two entrances, spaced out on either end of this store, but they keep a greeter on only one side. Idiots. I’m about to walk out; just a few more steps.

    “Excuse me, Sir!” I hear behind me. I ignore it and keep on walking.

    “Sir! Excuse me, hey sir!” I hear again. She sounds cute. I stop and begin to turn around. I got to be honest, my heart is racing and I’m extremely turned on at this point. Why does crime excite me so much?! I can hear Tony screaming and yelling expletives in my ear.

    “What’s up?” I casually ask while making eye contact with this cute employee. She can’t be older than 22 and she looks perfect, like those black pants and blue vest were custom made to wrap around her beautiful figure. I wish I wasn’t a junkie. She seems like a good girl. If I wasn’t so concerned with getting high, maybe I’d ask a woman like her out. I don’t have time for women. They get in the way of my using. Just give me a crack-whore that wants to fuck before or after we get loaded. That’s all I have time for.

    Shit. I forgot what’s happening here. My ADHD gets the best of me sometimes. I’m supposed to be walking out of a store with a shopping cart full of stolen goods.

    “Sir, are you forgetting something?” She asks. I stare blankly back at her. I don’t have a response and I kind of just want to stare at her before she calls the authorities and I have to turn around and make a break for it. The only thing I can muster up to answer her question is “I don’t know, am I forgetting something?”

    She raises a fist and begins open to up her cute little hand. I quickly picture her cute fingers with the chipped nail polish dancing all over my body. Focus!

    “Get the fuck out of there!” I hear Tony screaming in my ear.

    She opens her fist. “You dropped your lighter, Sir,” she says as she hands it back to me. Tony can hear her on his end and I hear him let out a sigh of relief.

    “Okay we’re good” I hear him say as I thank her and head out the door.

    I throw the items in the trunk and we head over to meet up with D. We’re in a hurry to get high; he’s in a hurry to get to the casino. Both parties are bitching at each other. We engage in the usual small talk that really is just a load of bullshit. D doesn’t care about me or my well-being, and I could give a shit about him and his family. I just want my dope and I want to go home. He just wants his shit and wants me to leave. We do the same shit every day. Act like we’re family. Like there’s some “street code” of honor or something. The truth is, nobody cares. Everyone is out to get theirs and theirs only.

    Tony and I head home and split the shit we scored. As soon as I get mine in me, all in the world is right again. For those brief ten seconds of numbness and euphoria, as the opioids flow into my bloodstream, I forget that I am a slave. I forget that just ten seconds ago, my body was writhing in pain. I forget that I was almost stopped inside of a store for shoplifting while on probation. I forget that if I violate, I’m going up-the-road for at least five years. I forget about that girl that broke my heart. I forget that I’m a lying piece of shit that steals from my mother every time she goes to sleep. For ten seconds, I’m free…

    And in four hours, I’m doing it all over again.

    If no one told you today that they love you, fuck it, there’s always tomorrow. 😉

    View the original article at thefix.com

  • Should You Breastfeed Your Baby If You're on Methadone?

    Should You Breastfeed Your Baby If You're on Methadone?

    My daughter was born with neonatal abstinence syndrome but I was not allowed to nurse or have her in the room with me; the hospital staff said the methadone in my breast milk could be dangerous. They were wrong.

    Earlier this summer several news outlets reported on the death of an 11-week-old infant in Philadelphia by what appeared to be a drug overdose. The mother, who has been charged with criminal homicide, blamed the drug exposure on her breast milk. Although an autopsy revealed that the infant’s drug exposure also included amphetamine and methamphetamine, many news outlets chose to focus on the fact that the mother was a methadone patient. The death of an infant by drug exposure is unquestionably terrible; unfortunately, misleading articles make what is already a tragedy even worse by insinuating or directly stating that the methadone content in the breast milk was involved in the infant’s death.

    Stigma around methadone use in the United States has a long shadow. Prescribed primarily to treat opioid use disorder (but also sometimes for pain management), methadone is a long acting opioid that builds in the patient’s bloodstream to create a stable, non-euphoric equilibrium when used correctly. It is a highly effective form of both addiction treatment and harm reduction, shown to reduce overdose deaths by 50% or more. Unlike short acting opioids like heroin or morphine, methadone prevents patients from experiencing the physical chaos of sedation and withdrawal, and can help re-balance neurochemical changes that take place during active addiction. For decades, methadone has been considered the gold standard of treatment for opioid use disorder, including during and after pregnancy.

    But in spite of the demonstrated benefits of methadone and its pharmacological differences from commonly misused opioids, it has, for many years, acquired a popular status as “legal heroin.” Social media is flooded with memes mocking methadone patients or complaining that they don’t deserve “free methadone” when other drugs cost money (in fact, methadone has a price tag like any other medication). Even other people in recovery or the throes of active addiction disparage methadone, sometimes referring to it as “liquid handcuffs” because of the stringent regulations requiring daily trips to a clinic during the first several months of treatment.

    This stigma leaks into every aspect of patient care. For me, it prevented me from seeking treatment for years. I was terrified to get on methadone. Who would volunteer to be “handcuffed” by a treatment system? But when I learned I was pregnant, my doctors urged me to get on methadone. They said that attempting to withdraw from heroin would be dangerous for my developing baby, and continuing to use would be even riskier.

    I was reluctant, but I enrolled in a methadone maintenance program as my doctors advised. Because of that, I had a healthy, full-term pregnancy. But at the Florida-based hospital where my daughter was taken after a speedy, unplanned home birth, I was not allowed to breastfeed. My daughter suffered neonatal abstinence syndrome (NAS), a condition caused by opioid withdrawal that occurs in some babies whose mothers used methadone or other opioids while pregnant; she was dosed with morphine to wean her down from the methadone she received in utero, and the hospital staff told me that adding my methadone dose via breast milk could be dangerous. Because of that, my milk production dwindled, and my daughter—who stayed in the hospital over a month—never learned to properly latch. After she came home, she suffered colic, constipation, and sleep disturbances as we worked through various formulas trying to find one that was gentle on her stomach.

    But these negative ideas about methadone distribution in breast milk are flat out wrong. We know that methadone is a highly potent, long-acting opioid that is extremely dangerous if given to infants and children directly. No amount of methadone syrup should be administered to an infant or child by a parent or caregiver without physician approval. But studies have demonstrated that the amount of methadone that gets passed into breast milk is negligible, and will not harm an infant, even a newborn. A 2007 study of methadone-maintained mothers in addiction recovery found that methadone concentrations in breast milk remained minimal in the first four days postpartum, regardless of maternal dose, time of day after dosing, and type of breast milk being expressed. The daily amount of methadone ingestible by the infants did not rise above .09 mg per day. To help prevent even that slight fluctuation, John McCarthy, a practicing and teaching psychiatrist who has treated opioid-dependent pregnant and postpartum women for over 40 years, suggests splitting nursing mothers’ methadone doses in two—a measure that should have begun during pregnancy to help minimize the risk of NAS. “It’s not dangerous to nurse on a once a day dose, but it’s not the best way to give the medication. The baby should be given a smooth level of methadone.”

    Some people believe that breastfeeding an infant with NAS while on methadone will help decrease withdrawal symptoms by providing a minute amount of the same drug from which the infant is withdrawing. According to experts like Jana Burson, a doctor specializing in the treatment of opioid addiction, this belief is also false: “some mothers erroneously think their babies won’t withdraw if they breastfeed—that’s wrong. There’s not enough methadone in the breast milk to treat NAS.” Of course, breastfeeding a child who experiences NAS is beneficial, both because of the health benefits of breast milk, and because maternal contact is important for babies in distress. “Breastfeeding will help in the general sense that babies like to breastfeed and it’s calming, but not because babies are getting methadone in the breast milk.”

    Sandi C., a methadone-maintained mother based out of Massachusetts, breastfed her son for two and a half years, and plans on breastfeeding the baby she is currently expecting. Like me, Sandi was addicted to heroin when she learned she was pregnant. She began on buprenorphine, a partial-opioid agonist used similarly to methadone, and switched to methadone partway through her pregnancy. But her postnatal experience was different than mine.

    “I’m really fortunate that my area is really encouraging of breastfeeding,” says Sandi. “Actually, I wasn’t sure if I could breastfeed and [my doctor] said ‘definitely breastfeed, we encourage it.’” Like my daughter, Sandi’s son was diagnosed with NAS. But instead of being sent to the Neonatal Intensive Care Unit (NICU), her son was allowed to be in the hospital room with her, where Sandi could hold and breastfeed him as much as he needed. Her son was released after just two weeks, less than half the time my daughter spent in the NICU at our hospital in Florida. She continued to breastfeed at home until he was over two years old.

    “He never got sedated,” she recalls. “Everything was fine.”

    Just because methadone is safe for breastfeeding moms doesn’t mean the same is true for other drugs. If the Philadelphia baby’s death was in fact caused by what many outlets have called “drug-laced breast milk,” it would have been due to the amphetamines, not the methadone. Methamphetamine breast milk exposure has not been studied as extensively as methadone, but current recommendations are that lactating women should wait 48 hours after their last use of methamphetamine before resuming breastfeeding. Experts like Burson and McCarthy agree that mothers on methadone maintenance who are not using other substances can safely breastfeed. “All of the major medical groups recommend it,” Burson said, adding, “even on higher doses they all recommend that mothers on methadone breastfeed.”

    View the original article at thefix.com

  • A Month of Heart Attacks: Withdrawing from Antidepressants

    A Month of Heart Attacks: Withdrawing from Antidepressants

    My doctor tells me not to worry. The medication is safe. I worry he doesn’t know what he’s talking about. I worry this was a big mistake I made at 18 and am paying for the rest of my life.

    My obsessions start as small thoughts. Random sparks catching kindling in my mind, eventually blazing into a wildfire. I’ve always been this way. I couldn’t run for fun, I had to run marathons. I couldn’t go to school for one degree, I had to get my PhD. I couldn’t write a few articles related to my work in digital design, I had to write a book. I couldn’t drink a little bit of alcohol, I had to drink until I passed out. This same thinking led to my decision to stop taking my anti-depression and anti-anxiety medication.

    I began taking medication to treat depression when I was 18. Melancholy was my constant companion the last two years of high school. It stuck around after my graduation as well. Depression had me incapacitated and numb to self-improvement. My first adult visit to a general practitioner took me 30 seconds to describe how I’d been feeling for years. I left with a prescription for Zoloft. 

    I didn’t start taking the medication immediately. I was smoking and drinking to self-medicate. Taking a pill seemed weak. I grew up as part of a generation over-exposed to and under-educated on anti-depressants. Particularly Prozac, which seemed to enter the lexicon of my peers overnight in the early 1990’s.

    “Quit being a spaz! Take a Prozac.” we’d tease each other. Even worse, “Her parents put her on Prozac.” we’d whisper in the hallway. We didn’t know what that meant. Only that being on Prozac meant you weren’t normal. Commercials and TV shows told us it was used for depression. You had a mental illness if you were depressed. Mentally ill people are crazy.

    I knew crazy was bad. My father had a mental illness. He took lithium for a good part of my childhood. He hallucinated aliens were sent to kidnap him. He was crazy. I constantly worried this secret would be exposed. I was the son of a mentally ill man.

    I struggled with what the decision to take medication would mean for my future. What would my future partner think? What would my future children think? Maybe I’d only need to take if for a few months, I thought. I wanted to feel better. I wanted to live up to the potential I’d always been told I had. I decided to take the medication.

    ———

    Medicated

    Zoloft worked. I could get out of bed easier. I could deal with the ups and downs of everyday life. I functioned. My thoughts dwelled less on negative aspects of life. But the stigma of taking medication for a mental illness was always present in my mind. The elephant in the room when I was getting to know new people. What if they wanted to get closer? Would I have to disclose I took medication? Was it worth it to cultivate relationships if I were going to lose them? Or, should I stop taking the damn medication?

    Over the next 15 years I ran through the alphabet of anti-depressant/anti-anxiety medications. Zoloft stopped working at low doses. Larger doses left me unable to sleep. It was on to Paxil, Wellbutrin, and finally Effexor. I constantly questioned my decision to take medication. During this time, I moved from Maryland to rural Ohio, I got married, had kids, got divorced, worked multiple jobs while attending school, and eventually enrolled in a PhD program. I promised myself I’d stop taking medication when life settled down.

    My quest to live medicine free started in May of the last year I was getting my PhD. I always feel positive in springtime. Sunshine removes my spirits from winter’s chest of darkness. You should stop taking medication, an inner voice whispered. At first a dew-covered bud, the thought bloomed alongside my uplifted mood. I have to admit these thoughts were assisted by the confidence of nightly drinking. Soon it was all I could think about. I’m a man earning a PhD. I’d been through marriage, divorce, and poverty over the years and not cracked.

    My life wasn’t perfect. It never would be. I had two kids with my ex-wife. She had custody. Worrying about them was my most ingrained behavior. But I should be able to handle things. I’m a good dad. I didn’t need medication to stay that way. The pills were a crutch. I’m strong. Medicine is for the weak. These thoughts cycled in my head for weeks.

    ——–

    Unmedicated

    I didn’t contact my doctor when my Effexor prescription ran out. I went cold turkey. I immediately found, to my surprise, my depression wasn’t as severe as it had been when I started taking medication. I also found out the medication had been masking crippling anxiety I’d developed.

    I wasn’t a stranger to the nausea and dizziness that accompany the first 72 hours not taking Effexor. I’d missed doses more than a few times. Forgetting to take medication for a day or two was not unusual. I’d realize I’d missed a dose when my gums would start feeling numb near the end of the day. Not taking a dose for another few hours would lead to what I called the snaps in my head. Bright pops that brought me in and out of reality. Micro explosions of light going off behind my eyes. I imagined it was my synapses going nuts. I have a powerful imagination.

    I figured I’d get over the brief withdrawal period and move on to whatever normal was. I powered through work keeping to my daily routine with manageable discomfort. Kind of. I laid my head on my desk quite a few times as the snaps passed over in waves.

    A few nights into my new life as an unmedicated, unstigmatized member of society I woke from an unsettled sleep. My first thought: my finances are in ruins! I had gone to bed thinking about bills I had coming due. I would need to dig into my savings. This fact disturbed me. But by no means would I have no money.

    My worry about finances had festered and grown while I slept. I felt it crushing me. Sitting on my chest. I inhaled and exhaled through my nose counting 10 second intervals. My brain wouldn’t stop. My body was exhausted. I looked at the clock. 2:15. More inhaling and exhaling. I fell back asleep.

    I woke again at 3:15. I felt pricks of stinging pain throughout my brain and body. As if fire ants had been biting me in my sleep. I’d stood in a fire ant nest once as a teenager. My legs burned for days. The pain I currently felt wasn’t enough to distract from the panicked thoughts – I’m going to be poor. How will I survive? How will I pay child support? I’m going to go to jail. I inhaled and exhaled slowly.

    I woke up hourly for the remainder of the night. My eyes popping open as intense fire-tingles raged throughout my body. Repeatedly falling back asleep while trying to assure myself dipping into my savings wouldn’t lead to my financial demise.

    The next few nights unfolded in much the same way. I broke the cycle with a binge drinking session that left me passed out and then hung over the next day. The alcohol washed away my anxiety. My anxiety resurfaced as vomit in the light of day.

    Still, I refused seeking more medicine. I was going to be normal. Not weak. This pain was temporary. Being strong and off medication would last forever. I knew I’d feel better once I had a few weeks under my belt.

    ——–

    A Week Off Medication

    I’m having a heart attack. This is it. I’m going to die. I was staring at a murder mystery show on Investigation Discovery. I’d stopped taking medication a week ago. Constant noise comforted me. Living alone, I craved hearing voices. I kept talk radio on, or the TV set to this channel constantly playing murder mysteries. My favorite. The show did not comfort me as I thought I was dying.

    I’m having a heart attack. The thought grabbed my throat, choking me. I’d never felt powerless over my survival. I’d been feeling tight in my chest all day. Sure, I’d been lifting weights and doing pushups throughout the week. This tightness was coming from deeper than my muscles. Tightness that started to burn. This is what dying feels like. Battery acid surged up my esophagus.

    Should I go to the hospital? I thought. No. Hospitals are the only thing I hate more than dying. I felt a surge of adrenaline as I imagined dying alone on my living room floor. It was still a better option than dying in a hospital room. Surrounded by the nauseating smell of sterilization and cleaners. Hospitals crystalized the concept of mortality. I stayed away at all costs.

    The pain in my chest continued through the afternoon. I’d been invited to meet up with a group of friends for a sushi dinner to celebrate a birthday later that night. I wanted to live long enough for that. I’d go to the hospital if I still felt chest pain after dinner. 

    I looked around the table at dinner. Everyone else seemed so happy. I’d been able to choke down a few edamame. I felt terrible. Maybe I should mention the fact that I was having chest pain. My jaw felt tight. My arm tingled. Classic heart attack symptoms. I knew this from WebMD and numerous medical-topic message boards I’d checked out to see what my symptoms meant. Unfortunately, I could make my symptoms match both a drop-dead heart attack, or a panic attack, depending on which outcome I thought it should be.

    I didn’t bring up my troubles over dinner. Verbalizing a fear was often the final step off a cliff into a panic attack. I’d learned that from my previous experiences with milder anxiety. Expressing my fears made them real. Bottling them up kept my mind racing, too busy for full blown panic. I kept my mouth shut and avoided eye contact with my friends.

    My chest still hurt after dinner. I didn’t go to the hospital. It must be something else. Surely a heart attack can’t last hours. I fell asleep convinced I’d never wake up. But I did, again and again. My chest still hurt a week later. I started referring to it as my week-long heart attack with my inner-voice. A week later it became my two-week heart attack.

    I was unable to sleep for more than an hour straight during this time. I’d stopped worrying as much about my finances. I was dying of a heart attack! I worried I’d never wake up. I also found other things to worry about. This wasn’t hard for a divorcee with two kids. I stayed up worrying about their future if I were to die. About our future relationships if I were to live.

    ——–

    Five Weeks Off Medication

    It was 11 pm. I was dying. I stood in front of my bathroom mirror. I stared at my bare chest. I watched my chest muscles pulsing in rhythm with my heart. Was this normal? I’d never noticed before. Never had a reason to. I imagined my heart fluttering to a stop.

    The joke was on me. You really can have a heart attack lasting an indefinite period of time. Four weeks to be specific. I knew this was the grand finale. Time to go to the hospital.

    I called up the girl I’d been dating for a couple years while I walked to my front-door. I’d made her aware of my panic and that I’d stopped taking medication during the first week I’d stopped. She was concerned I wasn’t doing well. She said I should take medication. I should look at it as part of who I am. I take antidepressants, like a diabetic might take insulin. She didn’t like who I was when I didn’t take medication

    “I’m having a heart attack.”

    I slid down to the floor with the phone at my ear.

    “What? Are you OK?” she asked.

    “I don’t know. I’m so confused.”

    I laid down with my head on the ceramic-squares making up my front doorway. They felt cool. So refreshing. My mind stopped racing. I caught a whiff of lemon scented floor cleaner. A familiar scent. Not one I usually found pleasant. Tonight was different. The scent smothered me in comfort while the floor’s coolness eased my tension.

    “I need to hear your voice.” I mumbled. “I’m so tired.”

    I rolled my head to the side to distribute the coolness across my forehead. “Will you keep me company for a bit over the phone?”

    I woke up at 3 am. The phone had fallen from my hand. The screen was lit. I was still on a call with my girlfriend. The timer stated 4 hours and 24 minutes had elapsed.

    “Hello?” I asked into the phone.

    Nothing. I hung up. I couldn’t believe she had been kind enough to keep the line open. I noticed my chest felt better as I slunk up the stairs to bed.

    ——–

    My Last Day Off Medication

    I made an appointment to see my doctor as soon as the office opened. I couldn’t handle what my life had become. I was falling apart in ways I didn’t know were possible. A constant feeling of having a heart attack. Fixating on small problems until I can’t see a way past them. I was used to overcoming adversity daily in my medicated life. I couldn’t face an uneventful day without a panic attack while unmedicated.

    “It’s going to take a couple of weeks to really feel the effects.” my doctor said. He scrawled Effexor XR 150 across his prescription pad.

    “I think I can handle it.” My body flooded with a sense of relief. I knew I’d feel better the next day. The placebo effect is strong with me.

    I stayed at the pharmacy while they filled the prescription. I took the pill while downing a bottle of acai berry juice. Promotes heart health boasted the bottle’s label.

    Just in case, I thought.

    ——–

    Six Years Later

    I’ve continued taking Effexor. I frequently think about stopping. I’ve expressed my concerns to my doctor each time I’ve had my prescription renewed. My doctor tells me not to worry. The medication is safe. I worry he doesn’t know what he’s talking about. I worry this was a big mistake I made at 18 and am paying for the rest of my life.

    I’ve spent over 20 years on some type of anti-depressant/anti-anxiety medication with only the one month break. I’ve spent more years alive taking medicine than not. I wonder what the medication is doing to my mind. Will I have memory loss at an early age? I wonder what the medication is doing to my body. Am I poisoning my liver?

    It’s been six years since my month-long heart attack. It’s been six years since I stopped taking medication for slightly over a month. I haven’t had any more everlasting heart attacks or phone calls lasting till 3 am. I haven’t fixated on a small problem like my finances until I become incapacitated. I haven’t had my body feel like fire ants had spent the night gnawing on me. I am functional. I love my job. I am remarried with another child. I am generally happy.

    Anyone taking an antidepressant has been told it takes more than medication to properly treat a mental disorder. Counseling, behavior modification, meditation, and other self-help activities need incorporation into your life. However, I use medicine as my main line of defense against depression and panic attacks.

    I understand the importance of going beyond medication to treat depression and anxiety. I know and occasionally practice many anti-anxiety techniques. Nothing I’ve committed to doing on a regular basis. Perhaps I’d try harder at these activities if medication wasn’t such an easy and accessible option for me. I feel good most days. I love many more aspects of my life than I don’t. The medication seems a fair price to pay.

    View the original article at thefix.com

  • Suboxone: A Tool for Recovery

    Suboxone: A Tool for Recovery

    With medication-assisted treatment (MAT), people with opioid addictions are given the chance to rebuild their lives—often from the ashes and debris of drug-induced destruction—without having to fight cravings and withdrawal.

    Suboxone is a prescription medication that treats opioid addiction. It contains buprenorphine and naloxone, active ingredients that are used to curb cravings and block the effects of opioids. Although a major player in addiction recovery today, and often referred to as the gold-standard of addiction care, many in the recovery community remain resistant and even wary, including a large portion of rehab facilities and many members of the 12-step community.

    How does Suboxone work? When an opioid like heroin hits your system, it causes a sense of euphoria, reduced levels of pain, and slowed breathing. The higher the dose, the more intense the effect. Buprenorphine and heroin are both considered opioids, but the way they bind with the opioid receptors in the brain differs. Heroin is a full agonist, meaning it activates the receptor completely and provides all of the desired effects. Buprenorphine is a long-acting partial agonist. While it still binds to the receptor, it is less activating than a full agonist, and there is a plateau level which means that additional doses will not create increased beneficial effects (although they may still cause increased adverse effects). In someone who has been addicted to opioids, buprenorphine will not cause feelings of euphoria—the sensation of being “high.” Naloxone is paired with the buprenorphine to discourage misuse; if Suboxone is injected, the presence of the naloxone may make the user extremely ill.

    Jail Physician and Addiction Specialist Dr. Jonathan Giftos, M.D. offers this analogy: “I describe opioid receptors as little ‘garages’ in the brain. Heroin (or any short-acting opioid) is like a car that parks in those garages. As the car pulls into the garage, the patient gets a positive opioid effect. As the car backs out of the garage, the patient experiences withdrawal symptoms. Buprenorphine works as a car that pulls into the same garage, providing a positive opioid effect—just enough to prevent withdrawal symptoms and reduce cravings, but unlike heroin, which backs out after a few hours causing withdrawal—buprenorphine pulls the parking brake and occupies garage for 24-36 hours. This causes the functional blockade of the opioid receptor, reducing illicit opioid use and risk of fatal overdose.”

    Critics and skeptics of medication-assisted treatment (MAT) believe that using Suboxone is essentially replacing one narcotic with another. While buprenorphine is technically considered a narcotic substance with addictive properties, there are important differences between using an opioid like heroin or oxycontin and physician-prescribed Suboxone. Similarities between using heroin and Suboxone are that you have to take the drug every day or you will experience withdrawal and likely become very ill. Aside from the physical dependency, which is without a doubt a burden, Suboxone offers people in recovery the opportunity to live a “normal” life, far removed from the drug culture lifestyle they may have been immersed in while using heroin.

    People are dying every day from heroin overdoses, especially now in the nightmarish age of fentanyl. People in recovery from opioid addiction are living, free from the risk of overdosing, on Suboxone. Suboxone is a harm reduction option that while initially raised some eyebrows is gaining more traction, and considered an obvious choice for treatment by addiction medicine professionals. While someone using heroin is tasked daily with coming up with money for their drugs, avoiding run-ins with police or authorities, meeting dealers and often participating in other criminal activity, someone using physician-prescribed Suboxone is not breaking the law. They are able to function normally and go to school or get a job, and they are often participating in other forms of ongoing treatment simultaneously. People are given the chance to rebuild their lives—often from the ashes and debris of drug-induced destruction—without having to fight cravings and withdrawal.

    There is a common misconception about Suboxone, and medication-assisted treatment in general, that it is a miracle medication that cures addiction. Because of this idea, many people use Suboxone and are disappointed when they relapse, quickly concluding that MAT doesn’t work for them. When visiting the website for the medication, it reads directly underneath “Important Safety Information” — “SUBOXONE® (buprenorphine and naloxone) Sublingual Film (CIII) is a prescription medicine indicated for treatment of opioid dependence and should be used as part of a complete treatment plan to include counseling and psychosocial support.”

    So, as prescribed, Suboxone is intended to be only part of a treatment plan. It is but one tool in a toolbox with many other important tools such as counseling or therapy, 12-step meetings, building a support system, nurturing an aspect of your life that gives you purpose, and practicing self-care. It is medication-assisted treatment, emphasis on the assisted.

    With that being said, the type of additional treatment or self-care a person participates in should fit their own individual needs and comfort level and not be forced on them. Like a wise therapist once said, “Everybody has the right to self-determination.” Twelve-step meetings, although free and available to everyone, are not the ideal treatment for many people struggling with addiction. Therapy is expensive. People using Suboxone or other MAT shouldn’t be confined to predetermined treatment plans that have little to do with an individual’s needs and more to do with stigma-imposed restrictions.

    It’s unlikely that you’ll find a person claiming that simply taking Suboxone instead of heroin every day saved their life. It is not the mere replacement of one substance for another that is saving lives and treating even the most hopeless of people who have opioid use disorder; it is the relentless pursuit of a new way of life, a pursuit which includes rigorous introspection and a complete change of environment, peers, and daily life. Through the process of therapy, 12-step, using a recovery app, or whatever treatment suits you best, a person can face their demons, learn healthy coping mechanisms, and build confidence without the constant instability of cravings and withdrawal. Suboxone is giving people a chance that they just didn’t have before.

    So why is there such a stigma tied to the life-saving medication? Much of it comes from misinformation and is carried over from its predecessor—the stigma of addiction. It is hard for people who have a pre-existing disdain for addiction in general to swallow the idea that another “narcotic” medication may be the best form of treatment. In addition to addiction-naive civilians or “normies” as 12-steppers might call them, many members of the Narcotics Anonymous community are not completely sold on Suboxone’s curative potential either. Some members of the 12-step community are accepting of MAT, but you just don’t know what you’re going to get. You may walk into a meeting and have a group that is completely open and supportive of a decision to go through the steps while on Suboxone, or you may walk into a meeting of old-timers who are adamant that total abstinence is crucial to your success in the program.

    Another reason people are unconvinced is the length of time Suboxone users may or may not stay on the medication. Again, there is a stigma that shames people who use Suboxone long-term even though studies have shown long-term medication-assisted treatment is more successful than using it only as a detox aid. If Suboxone is helping a person live a productive life in a healthy environment, without the risk of overdose, that person should have the right to do so for however long they need without the scrutinizing gaze of others. While their critics are tsk-tsking away, they may be getting their law degree or buying their first home.

    Suboxone is a vastly misunderstood and complex medication that has the potential to not only save the lives of people with opioid addictions, but also allow them to recover and rebuild lives that were once believed to be beyond repair.

    View the original article at thefix.com

  • Dope Sick: Breaking Down Opioid Withdrawal

    Dope Sick: Breaking Down Opioid Withdrawal

    The strength it takes for a broken down, tormented person, feeling sick and hopeless every single day, to say, “No more” to their source of relief is something many people cannot even fathom.

    Dope sickness (from opioid withdrawal) or even just the fear of dope sickness can trigger a desperation and panic unlike any other. This fear, in large part, drives the addiction that has led to the opioid epidemic, which claimed 64,000 overdose deaths in 2016 and is now classified as a public health emergency. Or some say it’s the high that keeps opioid users chasing the dragon all the way to hospitals, jails, and institutions. Much like an abusive relationship that long overstays its welcome—often by years and even decades—it starts with love and butterflies but then transforms into a much darker animal, tethering a person in place not with love but with the fear of what happens when you leave it behind.

    How does someone know when their dose is wearing off and they need another fix? They’ll start to feel hot and cold at the same time, getting goose bumps and perspiring simultaneously; their eyes begin to water and they yawn repeatedly; they feel intense cravings coupled with severe anxiety, and their stomach starts to turn. These early onset symptoms of withdrawal work like an internal alarm in the brain, signaling to the nervous system that it desperately needs what is missing. These symptoms typically occur 6-12 hours after the last dose, and their intensity varies based on how often and how much of the drug the person is using. Opioid (painkillers such as oxycodone, vicodin, and codeine, as well as heroin) addiction is a progressive disease in which tolerance builds, so the required dose grows larger, and the withdrawal worsens. The deeper you are in the hole, the farther out you must climb.

    Once someone begins to experience the first stage symptoms of withdrawal, panic sets in. There is an overwhelming sense of impending doom because, as most seasoned junkies know, the only thing worse than the first stage of opioid withdrawal is the second. Muscle aches, pains, and spasms can cause a person to kick their legs and flop around like a fish out of water. Just as a fish longs for water to breathe again, the person in opioid withdrawal longs for a hit to end their agonizing race toward what feels like death. Vomiting, diarrhea, and severe stomach cramps keep them crawling to the bathroom, if they even make it, if they even have access. These physical symptoms are paired with deep depression, anxiety, and the torture of knowing that the hell could simply cease if they get their fix. And this typically goes on all 24 hours of each day that it lasts—typically just over a week—because insomnia prevents any relief that sleep would bring.

    It is the fear of that torment, which words can’t really do justice, that shackles people to a substance which indefinitely curses them with relief and pain. It is also that fear that compels them to lie, cheat, and steal. People who have become addicted to opioids wake up one day, deeper into their addiction then they’d ever anticipated, and look in the mirror only to see a stranger. They look at childhood photos of themselves and feel overcome with sadness, asking themselves, What happened? Their mothers do the same thing, looking at their baby’s photos and asking themselves where they went wrong. It’s difficult to separate the person from the addiction: although one entity does seem to overtake the other, that can be reversed and they are, in fact, two distinct realities.

    In most cases, a rotten egg is not born into this world destined to be a thief, robbing to feed their addiction. What once was a promising honor student, the girl next door, the boy working behind the deli counter, or the kid who loved fishing has now slowly, pushing the limits a bit farther each time, transformed into that thief overcome with fighting the terror of withdrawal. It’s as if they’ve sold their soul to the devil, stealing for it, lying to loved ones, to anyone, cheating people just to survive, just to feel well. When someone with an addiction hits rock bottom, and they hate themselves at this point, they think they’ve had enough and they want their soul back. But they can’t just stop. There’s a debt to pay.

    The strength it takes for a broken down, tormented person, feeling sick and hopeless every single day, desperate enough to do things they’d never imagine themselves capable of doing, to say, “No more,” is something many people cannot even fathom; it is standing up to the fear of the agony of withdrawal, of feeling like you’d gladly crawl out of your own skin if you could. For many people, it’s also facing the fear of life unaltered, buffer-less, possibly for the first time.

    There are different methods of withdrawing from opioids. Doctors sometimes offer benzodiazepines or clonidine, a blood pressure lowering drug, to temper the misery. There’s the good old fashion “cold turkey” which comes from the cold flashes and goosebumps you experience, or “kicking dope” which comes from kicking your legs around in weird spasms for over a week. And of course, we can’t have this discussion without mentioning the two big whoppers, Suboxone and methadone. These are known as medication assisted treatment (MAT), and they work wonders for many people. But one day you might want to get off of them, and that’s another opioid detox.

    Something worth mentioning about MAT is that if you take it long enough, you have the chance to rebuild a “normal” life. You can go to school, kickstart your career, do all the things that being a full-fledged junkie makes impossible. Stay on as long as you need; I even heard about one guy who got himself through law school on Suboxone. So there are upsides, incredible advantages really, but at the end of the day, after you’ve obtained your PhD, you still have to pay that debt.

    I once heard someone say, close your eyes and picture an addict. Whatever picture came into your mind, that’s the stigma of addiction. But there’s not just one static image, because addiction comes in layers. There’s the first layer, how it originated. Maybe a doctor prescribed Norcos for an ankle sprain and neglected to mention what you might be signing up for. According to drugfree.org, almost 80% of people who shoot up heroin started with the misuse of prescription medication. The next layer is when the drug takes over, and your identity—who you are—is now overwhelmed by the addiction, hiding your actual self somewhere beneath. And finally, hopefully, there’s the detox—the week or two of pure hell as the drug leaves your system and you start learning how to function without it.

    But when you do, finally, make it to the other side, however worn and broken down you may feel, it feels like the first day of the rest of your life. It’s a terrifying feeling, but you come out triumphant, and victorious.

    View the original article at thefix.com