A reader writes:
Hi G,
I know there is no magic bullet or simple answer, but I thought you may have a suggestion for me. I’ve been taking perc or ox for five years, for the first 3 it was only 30-50mg/day but now it’s between 150 and 180.
Suboxone scares the shit out of me, but at the same time, every time I try to taper, I fail and I’m starting to go broke. I lost my health insurance.
I go to meetings 4 or 5 times a week, all helpful, but the physical part keeps me hooked.
I heard suboxone may be ok if used very briefly (like a month or less), as when taken for longer, the withdrawal is way worse than the oxy itself. I wish I could go to a 7-day detox or something, but I just don’t have the money and I don’t have insurance. I also freelance so I need to be able to work and I can’t lose more than a few days.
Anyway, I started trying to find low-income or sliding scale suboxone programs in NYC, but it’s slow going and I don’t want to just get hooked on something else. I have read long term effects of suboxone are bad too.
I guess my Qs are:
if I were to do suboxone briefly, a few weeks, would I just then have the same withdrawal as I would going cold-turkey from the oxy anyway?
is there something else in my area (or anywhere) where someone could go for opiate detox that costs nothing or very little?
I want to be clean so bad, but every time I try to taper I just fail.
Any thoughts/suggestions appreciated – I know you’re not a doctor or professional, you just seem to have a lot of info and I know how we like to help each other.
Thanks in advance.
B
Dear B,
There is no magic bullet, but in my experience there are simple answers.
The first was to know that I wanted to get clean. (Which you say you do.) First problem solved: I was telling myself the truth. The truth was, I was willing to do what it takes. And It Takes What It Takes.
The second was to ask for help. (Which you have. Keep doing it.) Nobody, but nobody, does this on his own. Even the people I know who don’t go to meetings have put together communities of other people trying to stay sober.
The third was to use my willingness and my growing community to decide on a path, and walk the walk.
For some people, Suboxone is the solution. They’ll tell you they don’t mind eating an opioid for the rest of their lives—it’s “like a diabetic taking insulin.”
In my opinion the diabetes analogy is worn out. I wanted my solution to be real freedom. When I reached out for help I met people who had shot heroin and who had gone bankrupt buying drugs over the Internet and who had drunk themselves into blackouts—people who drank and used to the excess I had, or worse—who were clean and sober. I wanted to break ties with all drugs that cause physical and psychological dependence. For me taking drugs is signing on for slavery. Just my reality.
I really wanted to go to rehab but I knew I couldn’t leave my kid for that long.
Here’s how I decided on a Suboxone taper.
I knew I couldn’t detox off full-agonists like oxy. Too alluring. (More truth-telling.) I needed to change all my habits. So I asked for help—I found a detox doctor who was willing to oversee a Suboxone taper for me.
I told him at the outset that I wanted to taper. When my resolve flagged, he reminded me that the project was to get free.
I put the taper in his control. I never had more than one week’s worth of drugs in my possession. He wrote out the taper, I wrote out the check, we shook hands. I waved the white flag and gave up.
I did what he and a bunch of other people—Dani, Allgood, Sluggo, Bonita, all online friends; and my new real-life sponsor and community—told me to do. I put my faith in the people who were sober and who told me I could be, too. I burned a script for more drugs. I went to meetings and opened my mouth and let myself cry on people. I kept collecting sober people around me.
Several weeks later I was drug-free for the first time in years.
And yeah, I ain’t a doctor, but I’ll offer this anecdotal caveat: if you’re taking 180mg Oxy, they’ll try to start you out at 8-12mg Suboxone (or maybe even more). But that would be increasing your tolerance. If you really want to get clean, you’ll start at 4mg and taper to 3mg within two days. You could do a 2-week taper, cutting to 1/4mg—the equivalent of 1 Percocet—at the end and have a relatively smooth landing.
Post-acute withdrawal.
I ain’t gonna kid you: staying clean was a slog. Tapering off suboxone was not nearly as bad as detoxing cold-turkey from fentanyl or oxy, but it wasn’t painless—I shivered, I kicked in my sleep, I sneezed 20 times in a row. Keep in mind, my tolerance was more than twice yours, and I’m probably a little smaller than you. I spent each day telling myself if I made it to bed without having stolen drugs (because yes: I used to steal drugs) or used anything, including alcohol, I was a success.
The best treatment for drug-cravings was vigorous exercise. It helps the body produce its private supply of morphine and dopamine. Dr. Steve Scanlan told me research shows people who exercise cut their recovery time in half. I made playlists that helped me drag my body around the neighborhood. Walk, run, cycle. Do pushups. Lift weights. Start small and grow bigger. I exercised, and my body and mind recovered.
Healthy. (Mostly.)
A 180mg oxy habit is totally beatable. With a stick, my friend. Dude, if I can get clean, you can. I was on more than twice that and I’m free today. And I did not use insurance to get clean. But I paid what it took—the first of several critical investments I’ve made in myself over the past few years. Paying that doctor made me realize that, for a long time, maybe all my life, I’d withdrawn a great deal without putting very much back.
The most important information here: Get to a meeting. Tell them you want to get clean. Ask them to help you.
If you feel you need inpatient or other professional help, try Phoenix House, a large NYC-based treatment system with detox facilities in Long Island City. Or try the “free and affordable” resources listed on this website.
I wend my way down Third Avenue away from the Lex Ave subway stop (I call them “stops,” not “stations,” because that’s what I’ve trained myself to call them—I learned to ride the Tube in London and native Londoners on the street laugh at me when I ask where the nearest Tube “station” is—It’s a stop, innit? This is how afraid I am of being laughed at: I change my language, change my shorts, change my shirt, change my life, as Tom Waits sings, so that I can avoid even minor disapproval) and toward the midtown offices of this famous treatment center whose headquarters are in my state but which also maintains a location here. I wonder what it looks like.
It’s small. It’s narrow. It’s a little glass door sandwiched between skyscrapers in the tall steelconcrete windtunnel that is Midtown.
Caron, midtown.
The meeting is downstairs. It’s big. Lots of people, it turns out, are “family and friends” of alcoholics and addicts in this town. I arrive five minutes late because the train was running late, I’m not used to building in time for the constant subway delays in this city, actually I’m not used to building in time for any malfunction ever, I always expect myself to be running at top speed in perfect condition, nuts tightened, pump primed, engine lubed and idling, ready to go. That perfectionism, in fact, is one reason I’m here, sitting at the back of this meeting, digging my knitting out of my bag and listening to the speaker give a “qualification.”
This is a meeting whose weekly theme is “intimacy.”
The speaker talks, to my great surprise, about sex.
No one at any meetings in my town talks about sex.
But sex, sober sex, truthful sex, Real Sex, is so important and so critical to this process they call “recovery.” Why doesn’t anyone ever talk about sex? I wonder to myself. The answer is obvious: people are embarrassed to be open about their sexual “issues” in what used, in my parents’ cocktail era, to be called “mixed company.”
But I need to know what sober sex means. Honest sex.
What does it mean? What does it look like?
(My sponsor says: Making love doesn’t always have to mean sex. It can be other things.)
The speaker makes an analogy that sounds crazy and gross but is actually, upon second thought, fairly sane: this person wants a relationship that’s so intimate that it looks the way primates look when they’re grooming each other, weeding through each other’s hair and cleaning each other down.
Total acceptance.
We’re primates, aren’t we? I think. Don’t we have this instinct somewhere in our DNA, this need to be so accepted and cared for not just by ourselves but by someone else as well?
//
I raise my hand. I talk about sex. I cry afterward, unwillingly. I don’t take long to talk, the “spiritual timekeeper” doesn’t even signal me to shut up, but I feel stupid, like a stupid freak as I root my Kleenex out of my bag and blow my nose. I’m the only one crying—at least, I think so.
Stupid freak. This is the language that my mind uses to address myself when I talk about dangerous subjects, the language that is second-nature and feels comfortable, like a threadbare flannel shirt. It’s garbage but it keeps off the draft.
I’ve been thinking about language all day. I’ve spent the day writing for an editor I like, a guy in this city in fact. But I also, paradoxically, found myself going to Mass. I’d gone to another meeting at a church, it happened to be the holiday they call (I used to call) Holy Week, I’d gone inside the cool stone nave to be quiet and “maintain conscious contact,” and suddenly the priest showed up. He said Mass. And I knew all the responses. I spoke the language. It burbled out of some deep well inside me that I thought I’d banged the cover on long ago. I am taken aback by some of the phrases. Particularly:
Lord, I am not worthy to receive you
But only say the word and I shall be healed
I shall be healed. Healed. Had I ever thought about that idea, that this “sacrament” could Heal Me? Not as such; I’d gone to church to please my parents, to look like a Good Girl, to maintain appearances, keep the varnish bright, and to somehow Meet God in “God’s house”—my mother’s term for church. I’d memorized the responses to the Mass the way I memorized my “times tables” in fourth grade; later all this memorization helped me commit calculus to short-term memory, and the Prologue to The Canterbury Tales to long-term memory, in Middle English, with spelling, and accent:
Whan that Aprille with his shoures soote
The droghte of Marche hath perced to the roote
And bathed every veyne in swich licour
Of which vertu engendred is the flour …
Aprille. It’s April already. I’m ahead in getting my taxes done but already behind in so many other things. In Work. In Money. In Appearances. In Sex. In Life.
//
After the meeting I thank the speaker. Women and men alike express appreciation for my “share.” A guy tells me not to feel alone, that what I said about sexuality is probably a lot more common than I think. I nod my head and thank him and climb the stairs to the lobby.
I ask the woman behind the desk if Dr. Paul works here.
Paul Hokemeyer, MD, JD, clinical consultant to Caron Treatment Centers, NYC.
She regards me with a patient smile usually reserved for very young children. “He’s not here right now,” she says kindly, checking her watch—it’s 8:30 p.m.—“he’s left for the day.” Of course, I say; I just wondered; I’ve talked with him several times over the phone; I’m a journalist and sober blogger and I’d just wondered if these were his offices. I’m rambling a bit. I’m out of business cards; I don’t take myself seriously enough. I’m looking around at the lobby. People routinely do business over distances these days but something in me likes to place people, place faces, I’ve got quite an earthbound mind, I like to look into people’s eyes, I’m an artist
I paint portraits.
but I also wind up defending myself in situations where I needn’t. Why explain myself with the receptionist?
(because i explain defend myself with everyone)
Isn’t it time to open up a bit? to trust? … I think back to the interview I held with the Famous Author the day before. I was showing him my paintings on my new iPad; I felt as though I was not supposed to be showing him art on a fancy expensive consumerist design tool, I could hear the voice of my mother
(goddammit, who the hell do you think you are?)
but I showed him anyway; he said he recognized one of the paintings from my blog.
You read my blog? I asked.
I told you I read your blog,
he said.
I didn’t believe you, I blurted, placing my fingertips on his arm. He regarded me with slight reproach. He’d guessed my age as younger than his, though in fact I’m six or eight years his elder.
I try to live a life of rigorous honesty these days, my friend,
he said.
//
Wind whipping Bloomingdale’s flags. Photo by Woody Campbell.
I walk out of the Midtown treatment center offices. The wind through Bloomindale’s flags has built to tornado force. I mechanically scan the sliver of sky for tornadoes, but of course they never experience cyclones here. I’m blowing up Third Avenue in Midtown. I’m steadying myself to keep from pitching over when a hand touches my left shoulder. I turn; it’s a woman from the meeting where they talked about sex. She asks the name of my blog. She has heard me speaking with the receptionist, saying I’m a sober blogger. She plugs the name of my blog into her smartphone and it comes up, smack, right there, in the wind, on the corner of 58th and 3rd, in Midtown.
She smiles and tells me this was her second meeting and she was glad to hear me speak. Both of her parents are addicts. Both of my parents were addicts, too, I say. She says her mother has just gotten out of rehab and her father is on methadone—not “really clean,” but still.
I tell her I’m glad they’re alive.
I touch her hand. People are so alone in this town—in this world—skin rarely touches skin. We’re evolved to receive these electric charges. We need them to power up.
She tells me that she’s been trying to change her attitude and give back to people by being a clown.
A clown? I say.
“I dress up as a clown,” she says, “and I meet people around town.”
Her face is beautiful—round cheeks, full lips, framed by dark curls.
Actually, I remember, all faces hold beauty—experiencing it requires deep looking, a witness.
The other day I get an email from an English guy who says he has a story about Subutex, if I’m still collecting stories about buprenorphine (I am still collecting them and will be talking to folks starting in May—if Suboxone saved your life and/or kicked your ass, please email me).
This guy spent 10 years on buprenorphine after a devastating heroin habit. He took methadone to get off heroin, and he thought that in Subutex he’d found a painless stepping-stone off methadone. But bupe has given him all kinds of problems with his intellect, emotions, creativity, ambition, passion. He writes,
I cannot feel joy.
He jumped off Subutex two weeks ago and writes that he has already had a couple slips because he’s so impaired that he can’t stand it.
I have a loving wife, two beautiful sons, supportive friends, an ok job and yet I have been wanting to die for a few years now—not actively suicidal (you can’t be actively anything on long-term sub maintenance) but quietly hoping that fate would off me.
I know what he’s talking about. So does my jump-buddy, Bonita, who kicked Suboxone days ahead of me in 2008. So do thousands of other people who have had trouble either being on or kicking buprenorphine, or both.
//
So, but here’s where it turns “most uncanny,” as Nigel said: In writing back, I mention I’ve spent tons of time in the UK, mostly in London and Yorkshire.
Nigel replies: he was raised near Kensington High Street (London), and he was educated at the Catholic boarding school, Ampleforth (York).
I know where Ampleforth is, I say, because I’ve been practically everywhere in the North from the Lakes to Robin Hood’s Bay, and all the dales and moors in between.
And I’ve lived in London. I tell him about a very unhappy, lonely winter I spent in London 15 years ago. “To combat a serious case of depression,” I tell him, “I used to push my son up Marloes Road toward Ken High Street and into Holland Park every day I could. I retain a great affection for Holland Park, and for a little tiny key-garden called Edwardes Square.”
Edwardes Square, West London. Photo by Londonholic.
Most Americans visit St. James’s Park, Regent’s Park, Hyde Park. Holland Park is an underrated treasure, appreciated mostly by Londoners, who, on warm summer nights, enjoy outdoor concerts and pick-up footie matches on the lawn. And friggin nobody knows Edwardes Square. I get blank stares when I mention it to anyone. It’s just a little tiny square in West London. When people get that far they make the cab fare worth their while by visiting Kensington Palace, the V&A Museum, the boutiques on the Kings Road. You can’t even get into Edwardes Square unless you live in one of the houses facing it. I myself couldn’t get in. But it was my little psychic refuge that long-ago early spring.
Nigel, however, says: his parents live off Pembroke Gardens Close, adjacent to Edwardes Square:
I know the area intimately.
Then:
He says he himself used to live on Marloes Road across from the Devonshire Arms.
Devonshire Arms pub.
(Nigel has lived in some fancy places. Not Belgravia, but still.)
I picture the Devonshire Arms: big corner pub; patio paved for pleasant outdoor boozing. (I never drank at the Devonshire Arms; I had my baby with me, always, and my codeine back at the flat.)
Nigel tells me,
My bedroom window overlooked Marloes Road, and I spent some of the darkest days of my heroin addiction in that ivory tower. I would have been there in 1998.
So. While I was struggling with killer postpartum depression the winter of 1998, walking several miles per day with my boy in a stroller, up Marloes Road and then Campden Hill Road to Notting Hill Gate, then west to the northern entrance to Holland Park—I was passing Nigel in his house every day.
G was rationing out her American codeine.
Nigel was banging his British smack.
And now here we are, on opposite sides of the sea, talking about how to live sober.
Most uncanny,
Nigel writes.
Definitely a very small and funny old world.
Thank you, Nigel.
Today I’m borrowing this title from my good friend Dani, who has written under it for four years (click here to read her in Freedom From Hell). Thanks, Dani.
//
My friend Jacques’s dad died four days ago in Tucson.
I’ve known Jacques for 25 years. When I met him in 1988, he had gotten sober two years before, at age 22, and was dating Ben, who was studying in the same writing program I was attending. Jacques and Ben are still both poets and English teachers. We were all born in the same year.
Ben’s mom has been living with terminal cancer for several years; by incredible coincidence, the day after Jacques’s dad died—just three days ago, in other words—Ben’s mom had a setback and began actively dying. These former lovers are losing their second parents within days of each other. I find the resonance strange and beautiful.
When it became clear to Jacques that his dad would not last very long, he told the hospice staff that his dad needed a Catholic priest. The hospice worker told Jacques she’d send a minister, a social worker, they had all kinds of resources.
“I need a CATHOLIC PRIEST,” he said. “My dad wants last rites in the Catholic tradition. Can we please get a Catholic priest?”
“I had no idea why I said that, my dad and I didn’t talk about what he wanted at the end,” Jacques tells me today on the phone. “But my dad was a strict Catholic, G, it was serious with him, it wasn’t mumbo-jumbo.”
Jacques, one of three brothers, was born at St. Francis Hospital (Rabbi Abe Twerski and the nuns later turned it into the city’s haven for drunks and junkies; my cousin Danny spent some time there, I believe—it was notorious in our family that you had hit shameful low-bottom if you were at St. Francis; meanwhile, I was born at Braddock General, which, for a number of years until it closed in 2009, served as a detox and rehab for the river valley’s addicts). Jacques lived around the corner on 44th Street till he was in second grade, when his dad started making enough money to move them out to the suburbs, where they had the split-level and the country-club membership.
On the drive back to his hotel four days ago, the hospice worker called his cell and said the priest had arrived and was ready to give his dad the sacrament, and that she’d put the phone on speaker so Jacques could hear his dad’s responses.
“And this is no shit, G, OK?” he said. “On the very last word—on the ‘Amen’—the hospice worker said, ‘Your dad just took his last breath.’ He died on the last word of the sacrament.”
We sit there in silence, absorbing this.
Jacques and I were raised strict Catholic in the 1960s and ’70s. Jacques was an altar boy (dunno what my thing is with altar boys, but I can just picture Jacques in red robe with white lace surplice, holding the censer and cracking jokes under his breath). Jacques and I know what sacrament means, even though we no longer receive them ourselves.
“You did that because you were sober,” I remark. “If you hadn’t been sober, do you think you’d have had the presence of mind to be so certain about what your dad wanted, and to act on that leading?”
“You know, I have goosebumps on the back of my neck when you say that,” he says. “Because I’ve been thinking about that. He didn’t tell me he wanted that—I just knew.”
“How old was your dad—86?” I ask. “That’s a hell of a long time to live, and you made sure your dad had what he needed at the end of that long haul in order to let go and be at peace. In doing that for him you showed him great compassion and kindness.”
“I’ve been realizing something about love,” he says. “It’s not a feeling. It’s a commitment, a desire for the other person’s wellbeing such that you’re willing to sacrifice yourself.” Not in a codependent way, he emphasizes; not in a way that fosters the other person’s weakness and insecurity and one’s own security and vanity, but in a way that fosters the other person’s growth and peace.
Jacques has racked up large bills flying from his home in northern Michigan to Tucson every month since August, when his dad fell and had to move into nursing care.
“Love is hard, G!” he says. “It’s so hard!”
We pause, considering this weighty truth.
“Well,” he says, and I can hear him stretching, “I’m standing here in the 75-degree sun and I’m gonna go take a swim now.”
“Fuck you, darlin,” I say fondly.
//
So this is part of the way I stay sober. People in The Program talk about “helping others,” reaching out to the newcomer, and I do that, but I also interact with several people in my life who are oldcomers, who count their sober-time in decades, and I stay active with principles I’ve learned from many years in Al-Anon. Long-time sobriety doesn’t guarantee any results—serenity, peace of mind, happiness, even a good night’s sleep. It starts out one day at a time, and it stays that way.
Meanwhile I tell Ben I’ll take some of his classes if he can’t get back from Dallas in time.
In the process of getting rid of stuff. Cleaning out drawers, collecting bags of trash. Things I once valued are now discarded. Things I once used, or thought I could use but never did and saved for years in hopes I might one day use them—or simply because they are beautiful—I now give away to people in my life who I think might like them.
I’ve found some journals I thought I’d lost. Not that I’ve inventoried every journal I’ve ever kept. I have journals going back to age 10, 38 years ago. When I teach journal workshops I sometimes haul cartons of them in, to impress upon students the sheer quantity of material a life can produce.
But this one journal, a small Italian-made book bound in fake red leather, I thought was gone forever. It has some important stuff in it. I started it at the beginning of 2000 and wrote till my mother’s birthday on April 19. Then, in grief (she had died less than a year before, at 58), in despair about my craving for painkillers, and in confusion about whether to have another child (I didn’t want to and felt guilty about not wanting to), I stopped journaling in that book.
But a few pages later I began a record of the eccentric utterances of a 3-year old boy, and that of his “cousin-twin,” a little girl just five days younger than he.
“Laura,” I asked my 3-year-old niece at a nighttime bonfire at my brother’s land in the country, “do you see the stars?” The Milky Way spread its veil above us and the mound of orange logs threw sparks into the night air.
“No, Aunt G,” she said, “I see FIRE BEES!”
Fire bees. These are the moments that infuse the language of family and friendship, the poetics of connection. When I look into her 15-year-old face I see traces of myself—dark eyes tilted upward at the outer corners, dark hair, high cheekbones, olive skin, even little dimples on the septums of our noses that no one else in the family has but us two. And she sees herself when she looks at me. It’s comforting: “I look like her.” I put a photo of us on Facebook and people wrote in: “Uncanny.” Physical, emotional, even intellectual and linguistic resemblances make up the net that holds us together. We might find these resemblances and resonances in blood ties, and we might find them in kindred spirits.
“I remember walking up the hill and seeing the light of the fire,” she tells me on the phone today. We call, we text. She sends me photos of herself before and after (“My new hair! xoxo”) cutting eight inches off her long brown locks. I tell her I will send her the scarf I bought for her the last time I was in New York. We hang up, and I leave her with a text:
You look beautiful, darling
It’s in her phone. So she can look at that idea over and over.
//
My son is in Colorado, skiing, but he is also here with me. (It’s a scientific fact that when a woman bears a child, she forever—FOREVER, till she dies, no joke—carries the microscopic vestiges of that child inside her body. Which is to say, cells from the child’s body continue to course throughout her blood and lymph and flesh, even her brain.) My phone buzzes:
We made it safely to Denver
I text back with photos of the dog.
My dog, Flo, 1 year old. She loves me unconditionally. We give each other unlimited kisses.
I run into his friends on the street, shoot a photo of their smiles, text it to him. From the mountains a text threads its way back to me:
Hahaha, fine young gentlemen
I know we’re close. I don’t need journals or texts to remind me. Why, then, do I page through these old conversations?
Here is a story in the red journal: in 2002, when he was 4, I came home after his bedtime, having spent a late night judging a literary contest. I rarely missed putting him to bed (one of my signature “codependent” guilt-trips: I always needed to be the one who was “on”; Owl Babies was a book I frequently read to myself as much as to him). I crept into his room to kiss him goodnight, and he woke up. I wrote,
He wraps his arms around my neck and kisses my cheek three times, quick.
“You are back,” he says.
“Yes.”
“Can I have a cuddle?”
I bend down next to him.
“I knew you would be back in time,” he says.
“I always come back—and, you see? I always give you a kiss and a cuddle.”
He sighs. “You are so Mama-ish.”
“What does that mean—Mama-ish?”
“You sound like Mama. You smell like Mama,” he says, pressing his nose into my cheek.
We humans are pack animals. We’re driven to get next to each other; there’s something healing in hearing each other’s howls, in rolling in the texture and scent of each other’s skin the way animals do. We need each other. The trick for me is to accept that need, to allow myself to satisfy it, and even to enjoy it, without allowing it to overtake the rest of my life and make me sacrifice myself.
