Guinevere Gets Sober

Recovery news, reviews and stories, by Jennifer Matesa.

Tag: prescription drug abuse (page 1 of 6)

Finding Myself And My Voice.

A few weeks ago I went to a regional prescription drug abuse “summit” sponsored by the Department of Justice. The DEA was there, and Obama’s top drug-policy person, and the U.S. Attorney, and a bunch of pharmacists (including one who seven years ago had been robbed of OxyContin at gunpoint; she still cries about it). Also on the panel: my old pain physician, who I haven’t seen for two years.

I still have pain. Why haven’t I seen her for two years?—because the stuff I do for my pain has little relation to the therapies she recommended, most of which were drug-oriented. (The last drug she recommended made my hair fall out. I’m pretty much done with drug therapies, unless I’m desperate.)

I sat there and listened to my old doctor talk about how she uses a treatment protocol for every patient, and she tries not to rely on her gut feelings. (She was responding to the pharmacist who had been robbed, who told the audience she could tell which customers were addicts as soon as they walked through the doors.) My doctor talked about monitoring patients, requiring them to come in for pill counts. “It’s not foolproof, but it helps,” she said.

Too right it helps. Advocates for pain patients talk about pill counts, urine samples and other monitoring practices as discriminatory against those who have pain, treating them “like addicts.” If we removed the stigma from addiction, however, monitoring people for signs of another illness would be called good medical practice.

So anyway I went home and banged out an op-ed and sent it to my regional paper. The editor loved it. It’s going to run as early as he could run it—it’s long and he wanted to give it a good ride, he said. The piece outs me as a drug addict, and it calls my late father an alcoholic and my late mother a nicotine addict, and I thought about it carefully and decided I’m pretty much OK with all that, especially since the entire point of the piece is to bust down the stigma surrounding addiction and ask the public for treatment and compassion rather than punishment and censure. I keep reminding myself that both my parents told me before they died that I needed to write what I needed to write.

Dawned on me last night:

The piece is running the weekend my sister is staying here with her family.

Right away the addict in me took over. I wanted to call the editor, tell him to run it a week later. Or a week earlier, to get it over with before they arrive and I have contact with my sister, who I love and who I hardly ever get to see. And with my brother, whom I also love and about whom I never write, because he’s intensely private. Run it a different time, anyhow—because when I begin to panic about other people’s reactions, anything that’s actually happening must be wrong, I have to make sure everyone will be OK with what I say, everyone will be OK with who I am, with my point of view, because to be OK inside myself my first instinct is to make sure the people around me are OK, especially with me.

I’ve often wondered why I don’t get to say what’s real for me without being afraid. This blog is an exercise in doing that.

//

I’m noticing that the longer I spend sober, the more myself I seem to become. The more I speak in my own voice. The more I have desires and instincts that feel authentic. The more at peace I am with me.

Except when it comes to my family.

It doesn’t make a difference that my parents are dead: they’re still very much present for me.

I think of the things that happened in my family to silence me. (I speak only from my own perspective here; it’s my belief that they worked to silence large parts of all of us, but I’m only speaking for myself.) When I was little: the smackings, the beltings, the screaming. When I was older: the hours-long moral and philosophical inquisitions held at the kitchen table when I disagreed with a principle of my parents’—usually of my mother’s. Never being allowed to have the last word. Being told I had a temper that I had to squash. My mother’s jealousy of my artistic abilities. (Never mind her discourse and behavior around sexuality.)

If I gave my son that treatment, I’d expect he’d do something later in life to numb his feelings out.

My son stood in the kitchen the other day and said:

Mama, thank you for raising me well. I will never take it for granted.

He doesn’t say this for my benefit. He knows he doesn’t have to take care of me.

He says it because it’s true for him.

What a gift.

//

Many of us have been hurt in childhood.

Saturday in a meeting on steps 3 and 4 a friend told this story: A friend of his in recovery had been sexually abused. “Ultimate victim, right?” my friend said.

No way can you blame a child for his sexual abuse. No way can you hold him accountable. But my friend said: “You know what my part in this abuse is? My part is my willingness to let go of it.”

Each of us has our own ways of letting go and growing through adversity, moving closer to who we were created to be. Some people hold the hurt in their hearts and let it go silently, and other people talk about it—or write songs about it, or paint pictures about it. Or write stories about it.

Rodin: “The Hand of God Creating Woman and Man.” At Rhode Island School of Design’s museum. I love how the man has wrapped both his hands around the woman’s head. … Rodin’s pieces are always so confrontational and inviting that museums have to post signs ordering viewers not to touch.

So I’m going to let the piece run when the boss wants to run it.

To accept myself I have to accept that I’m the kind of person who lets go by expressing herself. I have to be willing to allow other people to have their responses to that.

Addiction and Recovery Stories Out The Wazoo

So a couple weeks ago I got a comment from someone who called this site “egotistical” (though to be fair, the person also said they’d gotten help from reading here while in early sobriety). Which made me think about the site’s recent content. I suppose it could be seen as more self-referential than it used to be when I started writing two years ago. Back then I was reviewing books and interpreting medical studies and conducting interviews with interesting people.

In fact I have a bunch of interesting people that I want to interview for this site. Including, for example, Dr. Abraham Twerski, founder of internationally recognized Gateway Rehab and author of a gabillion bestselling books. He has recovery stories out the wazoo. Catching up with this rabbi and addictions-specialist later today. … I have more books to review than I know what to do with. But most of the reviews, interviews, and feature stories now go into other publications that have a wider readership than this blog (plus, they pay).

For example my interview with Marianne Warnes, the mother of Carrie John, a University of Maryland Ph.D. addictions researcher whose boyfriend and lab partner helped her shoot some drugs he’d bought from an online pharmacy—and who subsequently died of anaphylactic shock, because the drugs weren’t actually drugs but a contaminant. New York Times writer David Carr (author of a memoir of addiction/recovery, The Night of the Gun) liked that story:

 

Also my review of Kaylie Jones’s helpful and eloquent book about her recovery from alcoholism, Lies My Mother Never Told Me, which appeared last week in Renew Magazine. My Q&A with Kaylie is online, but to read the review you have to buy the print edition (which rocks, by the way. Please subscribe. Next issue: Bill Clegg).

I get lots of mail from readers these days, too. An interventionist recently wrote me asking what I thought about this idea:

I am passionate about my intervention work, and I stumbled upon the following recently re: “eIntervention.”

He provided a bunch of links to studies about getting sober online that I haven’t yet looked at, but this is an interesting phenomenon—the fact that more and more people are getting sober, or at least beginning their journeys toward sobriety, via the Internet. I did the same, which is how I became Guinevere.

More stories: I’m in the process of putting faces to the avatars/usernames I’ve known for four years. I met up with one woman last month in New York; in a few days I’m meeting up with another guy who’s moving from the Rocky Mountains back to the East Coast. This summer I hope to connect with one or two more of these amazing, open, dedicated, sober people with whom I’ve been “eRecovering” for four years. It’s interesting to feel so close to people you’ve never met. Until this year I’d never met any of them, but I’d trust each one of these folks with the keys to my house.

Plus I have non-addiction stories coming out my ears. I have ideas for paintings (as well as commissions) lined up like a row of beans to be picked. I just gotta get in there and pick them. I also have to get used to planting seeds in the next bed over while the current bed is bearing.

As always, trying to take life and its opportunities and challenges one day at a time. Until last week I’d spent five weeks losing blood. Seriously anemic. Hard to do much without enough hemoglobin, you know? Tough to get oxygen. But yesterday I went running for the first time in maybe three weeks. Can I tell you how good that felt?—I could feel my lungs expanding, I could feel my muscles stretching and powering me over the hills, I felt the medicine. Drugs always worked for me (until, as they say, they didn’t anymore). And exercise works for me, too. I sometimes wonder when or if it might stop working.

If you have thoughts about beginning your journey to sobriety online, or if you have an interesting addiction/recovery story of your own, please comment below or email me at guinevere (at) guineveregetssober (dot) com.

Addiction And Self-Care.

The new puppy with my friend P, who's helping me train her.

This is the new puppy I adopted two weeks ago. Her name is Flo. She’s 10 weeks old. You want to talk about unconditional love—there’s nothing like curling up and having a nap with a puppy. I’d never experienced it before. It’s different somehow from napping with a cat.

So last week I had an emergency D&C because I was basically bleeding to death. I had been scheduled to have one this week, tomorrow in fact, but my GYN called last Thursday morning and scheduled it immediately: my hemoglobin was so low that I was on the verge of needing a transfusion.

Question: How could an intelligent woman with two degrees and an IQ north of 130 possibly let her health descend to that state? How could I allow myself to bleed to death and not take care of myself?

Answer: Self-care has nothing to do with intelligence. Neither does addiction.

Here’s a story for you. My mother had a hysterectomy at my very age: 47. I remember being on the phone with her from my office at my first reporting job: she had been having horrible long periods, basically bleeding to death, and she hadn’t had a pelvic exam in seven years. SEVEN YEARS.

In the Al-Anon books it asks us: are we taking care of ourselves? Are we going to the doctor, the dentist, are we getting haircuts?

I go to the doctor. I sometimes put off the dentist. I get haircuts every other month. But do I really pay attention to my body? Is it a place where I actually live?

A lot of the time, it isn’t. A lot of the time, I’m living in some alternative reality I’ve created in my mind. I was, after all, raised by a woman who ignored her body so effectively that she made it seven middle-aged years without a pelvic exam and had to have a hysterectomy because of the grapefruit-sized fibroid tumors that grew inside her in the interim. All the while, the rhetoric that came out of her mouth was this Catholic stuff about the body being “the temple of the Holy Spirit.” Some temple: the curtain in hers was rent, the cornerstone broken, by the time she was 58.

This was my model for being a grown-up woman.

And my dad: I won’t even get into how well my dad ignored his body.

Physical exercise helps me pay attention to my body. But still: I was bleeding for three weeks! I just told myself it’ll stop sometime it has to stop sometime just be patient just wait it out i don’t have time to deal with this so IT MUST NOT BE HAPPENING, and in the interim my hemoglobin dropped to 8.5 (the low-normal level is 11.5; the standard level for transfusion is 8.0) and I was feeling “a little bit tired.” Yeah. I believe this is called something like psychosis: refusal to acknowledge reality.

So I go in for the operation and they tell me it’ll be conscious sedation and I know what conscious sedation is, because G is a person who knows her drugs: conscious sedation (also known as “twilight sleep”) is Versed (the drug that makes you forget what’s going on) and Propofol (strong sedative: Michael Jackson’s favorite candy) and fentanyl (the drug I was on—on? I was as tall as the fucking Empire State Building on fentanyl in August 2008). I had to have these drugs because it’s surgery and they were going to open the hood and scrape me out, and I didn’t want to have these drugs because I hadn’t taken drugs in more than two years.

My sponsor said, “Sometimes we have to do things we don’t want to do.” If the alternative is bleeding to death, I guess she’s right.

I was scared because I’d had two surgeries while I was un-sober. The first was an appendectomy that was torture because they couldn’t control the pain, they wouldn’t give me the shitload of drugs I’d have needed to control abdominal laparascopic post-surgical pain, so I just put up with it. It was horrible. And then I broke and dislocated my elbow in a bike-fall in 2006, and during the conscious sedation to put the bones back into the socket the ortho guy told my husband he’d never shot so much fentanyl into one person in his life. So I was afraid I’d be in pain.

But of course I was in no pain, because I’m now what physicians and pharmacists call “opioid-naïve.” I woke up in post-op feeling as though God’s own sunlight was shining on my face, feeling sheer gratitude to all the nurses, telling all the staff how thankful I was for their willingness to take care of me. The surgery had gone well and I had no pain. And I was sent home with a couple doses of Vicodin, which I took because later when the fentanyl wore off, I had shooting needly pains below my navel.

And for a day after, I had a headache. My body getting rid of the drug metabolites.

And then on Monday it occurred to me: I had felt so good, so grateful, because I was high. I was high. Why do the drugs have to make me feel so goddam good?

“Every feeling passes,” my sponsor says. “All the ‘good’ feelings, all the ‘bad’ ones—they all pass.”

And this morning my husband goes to the dentist because he has pain in his tooth and the dentist X-rays his jaw and discovers an abscess, he prescribes Vicodin, my very favorite beloved awesomest drug on the face of the planet, especially since I’m “opioid-naive.” I just had drugs in my body last week, I can remember in my body how niiiice they made me feel.

David Foster Wallace once said, You think you’re an atheist, you think you don’t worship anything?—let me tell you, everyone worships something. Listen to the way I talk about Vicodin.

So I call my sponsor and tell her: I don’t want to use the Vicodin that is now living in my house. She says, You know what you have to do. I say, Yes, I know.

Part of that is writing it here. The truth.

The truth is, if I listen to my body, what it really wants is not drugs.

What it wants is love.

Talking to Doctors about Addiction and Recovery.

So I’ve been asked to give a series of lectures this summer about addiction and recovery to medical students who are coming from all over the country as part of a Scaife Foundation-funded program at the Institute for Research, Education and Training for Addictions (IRETA). Awesome organization, fantastic people. Great opportunity to give back.

I’m told this is one of two programs in the country that educate future doctors about addiction and recovery. The other is at Betty Ford.

The program coordinator wanted to know what I’d like to talk about. I said: 30 million Americans have a drug or alcohol addiction; only 1 in 9 people with addiction get treatment. Fifty percent of young people between the ages of 12 and 20 admit to using drugs and alcohol. Untreated addiction costs the country $450 billion in lost productivity and medical costs each year. (I personally bet it’s more if you add in nicotine addiction, which still kills almost half a million people every year.)

And lo: it’s also estimated that 76 million Americans suffer from pain.

I told her about how I got addicted to painkillers while seeking treatment for two neurological problems. How, for my work, I’d been interviewing the people who crafted the Joint Commission standards that called for assessing pain as the fifth vital sign; how I’d interviewed people like Russ Portenoy at Beth Israel and Kathy Foley at Sloan Kettering and Dave Joranson, the smart and exceedingly compassionate guy who helped found the Pain and Policy Studies Group at U. Wisconsin-Madison, the organization that calls for state policy that balances the need for substance-control with the need to treat pain. I remember the day in 2001 or 2002 that I explained my pain problems to Dave and he said, “You need to get treatment.” I wasn’t sleeping; I wasn’t able to work to the levels I wanted to work; I couldn’t concentrate because of pain all over my body, and then there were the pervasive migraines. So I went to the university pain clinic.

I told the IRETA coordinator how the neurologists and anesthesiologists there knew all about how to get me on drugs and nothing about how to get me off. How they don’t know anything at all about how to assess for risk of addiction before initiating treatment—no one ever asked me whether my father was an alcoholic; no one took my mother’s nicotine addiction seriously; no one asked how far back into my family alcoholism ran; no one explained why this might be important information and might save my life. Because no one understood.

And doctors, even pain specialists, know next to nothing about how to assess for the emergence of addiction during pain treatment. And when they catch a patient deceiving them about their drug use, rather than responding with the compassion they’d show a dying person, they respond with anger and disgust to the deceit, kicking the patient out of their practice and into a psychiatric hospital, forcing the patient to detox either in a psych ward or alone at home, dealing with both addiction and untreated pain.

And the threat of this kind of treatment makes how many patients every year reluctant to confess their problems to their practitioners? How many times did I want to tell my doctors, “Look, I have a problem here—I can’t control my drug-use, but I’m afraid if I quit the drugs, the pain will come back. Can you help me?” They wouldn’t have helped me, they would have kicked me out. Don’t let the door hit you in the ass, baby.

I told her about interviewing Russ Portenoy back in the early 2000s, how he’d told me with the conviction of certainty in his voice that the risk of becoming addicted to painkillers during treatment for chronic non-malignant pain was less than one-tenth of one-percent, and how those numbers had come from studies of opioid use in dying cancer patients, how they shouldn’t have been translated to chronic non-malignant pain patients. In my own developing addiction, my own self-deceit and my own desperation to have my pain controlled, I didn’t consider these facts carefully enough.

I remember how Dave Joranson told me that just because somebody is an addict doesn’t mean they shouldn’t receive pain treatment. That we have to figure out ways to treat both problems.

I got on a roll.

“Jeez, I wish we could have you for more than an hour per session,” the coordinator said.

“You should do a TEDMED talk,” a friend said.

I’m ready to talk to doctors. I’m ready to talk to TEDMED. I’m sick of hearing that people don’t get addicted to drugs after seeking pain treatment. It’s bullshit, and someone has to show her face and explain that, while a lot of people do become addicted by nicking drugs from their grannies’ medicine cabinets, a lot of others become addicted because they pull their backs or break their ankles or have dental surgery and are prescribed Vicodin, and they like it so much—it “works” so well for them and helps them get so much done—that they begin chewing it, and when their scripts are cut off they begin buying it on the street or stealing it from other people. Or else they turn to heroin, which is cheaper, if less reliable in quality. Or else they just suffer, they white-knuckle between hits, not knowing what the hell is wrong with them and afraid to talk to anyone about it because of the stigma. And a lot of them never go to treatment, they either stay addicted or they kick in other ways, like I did.

What would you have me say to these future doctors about addiction? Tell me in the comments, or email me.

In The God-Box: Two Guys Taking Vicodin.

P & P's sweet yellow lab, who I love and who loves me.

Last night went to a 50th birthday party for my friend P. This morning her husband (also called P) phoned to thank me for helping him in the kitchen. I didn’t do much: gave him instructions for browning his baked brie (under the broiler), taught him how to use his own convection oven, and oversaw the complex, gourmet task of heating the Costco frozen mini hotdogs wrapped in puff pastry.

Over the phone this morning, P said her husband was suffering from an infection in one of his molars. His jaw was killing him.

“Hasn’t the doctor given him anything for the pain?” I asked. “Codeine?” They’ve known I’m an addict since the summer day in 2010 that I told them at the Tate Modern in London, looking at Niki de Saint Phalle’s “shooting” paintings.

“Yes: I picked up a Z-Pac for him this morning for the infection,” she said. I sat there waiting for her to announce Which Drug he’d been given.

“And he also has Vicodin.”

Aha!

“But they didn’t want him to take it during the party last night.”

Of course. Because he’d have been drinking. Also, it might make him sleepy. Vicodin makes normal people sleepy, and sometimes nauseated. It makes addicts like me wake up and want to clean the entire fucking house from attic to basement, all the while sorting out three or four book chapters in our minds. “My house was never so clean as when I was using,” my friend L murmured to me the other day during a meeting when someone mentioned Vicodin.

Once upon a time, if a friend mentioned she had Vicodin in the house, I might have felt an immediate, overwhelming drive to invent a pretext for coming over right away, eagle eyes scouting around for the brown plastic bottle with the child-proof cap. They say you’re either moving toward a drink/drug or away from one, and today I didn’t have that compulsion—I had the memory of it, but not the actual feeling—so today I think I’m sober.

The reality is, drugs are everywhere, anyway. In order not to descend into insanity, I have to keep steering into some kind of solution.

“Has he taken any?” I asked.

“Yes,” she said, “but it’s not helping.”

“When did he take it?” I asked.

She handed the phone to her husband. He said he’d taken one 7.5mg pill two-and-a-half hours before.

“G, why isn’t it helping?” he asked.

Because the fucking drugs never take away all the pain, I thought. They just take away part of it and make you not-care about the rest.

“Because when you have severe acute pain, sometimes you need a bit extra to get on top of it,” I said. That’s what they taught me at the pain clinic: when a flare comes along, try to anticipate it and take a bit extra. I suggested he take one more, and then dose every 4-6 hours as it said on the bottle.

“Is that going to be OK?” he said.

“You don’t have a problem taking drugs,” I said, “so you’re not going to have any trouble. And that much Tylenol isn’t going to hurt you. Just don’t take more than that. And why don’t you try putting some ice on your face?”

I call him a couple hours later and the one extra has helped him get on top of the pain. “It’s just like you said,” he tells me. “It’s not all gone, but it’s not killing me anymore.”

Would P ever think of chewing the Vicodin? Hell no.

//

A couple days ago I get an email from a reader, a guy about my age. Dave from California. He’s sitting out in San Diego or somewhere waiting for spinal surgery, he’s got 16 years clean and sober, the pain is frigging driving him nuts. He NEEDS to make it go away. He thanks me for my post about Chewing Vicodin.

This post gets tons of hits. There are many, many of you out there, pills in your hot little hands, wanting to know “how to maximize the effects of Vicodin.”

“I have found myself wanting to chew the medicine,” Dave writes.

Would P ever think of chewing the Vicodin?—I ask myself again. Hell no: because P isn’t an addict. P can have one or two glasses of wine. He can choose which it’s going to be: one—or two.

“Sixteen years clean,” Dave writes, “and as soon as the pain gets too big I start to think I know a better way to take pills. Thank you. Keep doing what you do. It is a service for which I am grateful.”

//

If I had a dollar for every time someone has told me to keep doing what I do with this blog, I’d have a nice packet of dough. It’s very, very kind of people to say this. I’m grateful for you guys who read me. For the many people like Dave who check in and find help and who are generous enough to let me know about it.

Dave is having his surgery today. He’s going to be in a lot of pain. I’m holding him in the light. That’s how Quakers talk about praying for someone: “holding you in the light.” (I’ve been walking around these days, holding a bunch of people in the light. It’s quite a comforting thing to do, praying for someone else’s ass life besides my own.)

“Pain sucks, man, I know,” I write to Dave, “but one addict praying for another is a powerful thing.”

If you have a moment, maybe you’d be willing to drop a note in the God-box for Dave.

Why not also pray for P?—Actually, I pray for P, too, he and his wife are quite often on my gratitude lists, but I know P will be all right. It’s Dave I’m worried about. He’s dealing with two monsters.

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