Guinevere Gets Sober

Recovery news, reviews and stories, by Jennifer Matesa.

Tag: stigma

Suboxone: Addiction, Recovery, And Self-Confidence.

Hi folks, good to be with you again.

I miss writing on this blog. I used to file two or three blogs per week. That was before I got a job—several jobs, actually. I need to earn my daily bread, and I need to take care of my kid, who the other day flipped over head-first, fell on his head and shoulders, and was back-boarded off the soccer field (he’s OK but yes—shocking to watch the trainer test him for paralysis and hear her say, “We have to call an ambulance”). So sometimes the blogging goes by the boards. I’ve been filing a lot on my Facebook page, but you have to be my friend to see it. So, won’t you be my neighbor?

Been teaching writing to university students. An interesting experience: the last time I taught was four months before I got sober. The other day I was sitting in a meeting next to an acquaintance in recovery, a woman sober about two years who just got tenure at one of the universities in town, and I told her I was teaching again. “Teaching sober is AWESOME!” she said. This is someone who does not usually include the word “awesome” in her lexicon.

“I know!!!” I said. I am someone who usually does not speak with multiple exclamation points.

Teaching sober is, in fact, awesome. The best thing about it is that, having practiced Step 10 on a regular basis for four years, I now have a much better sense of what’s my responsibility and what’s not. Which enables me to relate to the kids (they’re kids: they’re just three or four years older than my kid) on a much clearer basis than when my head was wrapped up in films of fentanyl.

In other words, I have more confidence.

The root of the word “confidence” is the Latin fidere: fidelity, trust.

Sober, I can trust myself. At any rate, much more than I could when I was taking drugs.

It is 3 a.m. and I’m writing this because I got up to pee, checked my phone, and this email came in overnight. She is taking drugs to feel self-confident. She wants help.

The drug she is taking is Suboxone. She was using heroin for five months—“five long, brutal months,” she writes, “and even though that’s a short period of time compared to most people, I was really addicted”—and her doctor put her on Suboxone. Her doctor told her taking it for three months would lead to a lower “success rate” than taking it for at least eight. (I’d like to see the data behind the claim, and I’d like to know who financed the studies.) So she took it for a year—along with two antidepressants and a long-acting benzodiazepine.

No idea what kind of doctor she went to, but in fact family doctors and internists, who are generally ignorant about addiction and recovery, can prescribe Suboxone, a long-acting fat-soluble opioid that’s more powerful, milligram for milligram, than heroin. Just as family doctors and internists, who are generally ignorant about mental illness, can prescribe antidepressants—drugs that also change the brain, usually not for the better, according to Robert Whitaker, who wrote a comprehensive and almost universally acclaimed book on the subject of psych meds and mental illness. Any time-frame over six weeks is considered “long-term” treatment by most physicians and researchers, and lots of folks wind up on these drugs indefinitely.

My reader writes,

I have been living with the knowledge for about 18 months that Suboxone is this wonder drug. It turns out I didn’t know too much about it. I kept a couple of the film strips in case I felt like I was going to relapse. One day I took the Suboxone after about three months of being off of it and I felt so high that it scared me… so I tried it again after.

Of course she tried it again. She’s an addict, and she has drugs in her stash.

This person has a job, too. She’s a college student, like my students. She’s studying to be a doctor, “so I could go help people with the problems I had,” she writes. And since starting school in August, she’s been on “a Suboxone binge,” she says.

Not to get high, but because it gives me my confidence back.

She needs confidence. She has to make friends, she writes. “I became socially awkward after my addiction”—as though her addiction is “over”—“and I felt like I needed it to talk to people.” So now she’s back to taking it every day.

Just little, tiny pieces, probably like 1/9th of a pill a day, but I don’t want to take it anymore, and I want my confidence and ability to talk to people back… can you please help me?

I have news for whoever is reading this who thinks that one-ninth of a Suboxone pill isn’t a lot. If it’s one-ninth of an 8mg pill, then that’s almost 1mg of buprenorphine, and that’s roughly equivalent to 30mg morphine. Which ain’t nothin to sneeze at.

This 18-year-old girl (she is 18: she told me) is taking drugs simply because she wants to trust herself. She has a drug that gives her that fleeting feeling of self-trust. She knows it won’t last.

These emails I get from readers feel like silk threads that bind me to folks around the world who are desperate for help with their drug problems. It’s like each of these people is Spider-Man, firing out webs that reach around the world and go straight inside me and attach themselves there. And they pull.

To my reader: your addiction is not “over.” If indeed you were “addicted” to heroin, then you are an addict. Being an addict doesn’t mean you’re a low-life. It means you have an illness, and like anyone who is ill you need to learn to take care of yourself. To do this you must ask for help In Real Life. However scary it might seem.

On the other side of that reality of needing to ask for help is this problem my reader will most likely run into: she may go to her doctor and tell him that she stashed her films and she’s been using again. You know what may happen? He’ll decide she’s a “chronic relapser” and put her back on Suboxone, perhaps at a higher dose, perhaps for a longer time. She is 18. Her brain and central nervous system aren’t really even out of childhood.

She writes, in a voice that is perhaps not self-confident but certainly reaching toward self-awareness,

I don’t want to take it anymore.

“I don’t want to take it anymore.”

The famous scene with Peter Finch from the film, “Network.”

I’m mad as hell and I’m not gonna take it anymore.

Reader, there are two ways I might be able to help you. One is to suggest you call Alcoholics Anonymous or Narcotics Anonymous and get help from real people who have been through this (and worse). Don’t Take It Anymore.

The second is something I think I need to do for all the folks who write in, to me and to forums for drug addicts, saying they can’t quit Suboxone. And that is to write about Suboxone.

If you have a story you want to tell about how Suboxone either helped you or kicked your ass, please email me at guinevere (at) guineveregetssober (dot) com.

The stigma of addiction: Do addicts in recovery get better?

The stats and comments show that you guys like it when I write about current events. So I spent a couple hours trawling my Gmail news alerts this morning… Because I have an alert set for “Vicodin,” I’ve got lots of news about the new season of “House” (House apparently kicked his Vicodin habit, though at the end of last season in a moment of crisis he ran to his bathroom for a secret stash he’d hidden? and Cuddy walked in and they got it on?—I dunno).

Also big news: Lindsay Lohan has failed a random drug test (cocaine) and may be sent back to jail. This after it was “determined” a few weeks back that she didn’t actually have a problem with drugs, her problem was “just” with her erratic upbringing. So much for court-appointed psychiatric evaluations.

Also: many, many car-stops all over the country, with troopers pulling down stashes of up to 16 lbs. of brown heroin (Illinois), plus eight grand in cash and hundreds of Oxycontin pills (Ohio), and the usual odd numbers of Vicodin, Lorcet and subutex, and whatnot.

But the story I liked most was the one in the Kennebec Journal about the halfway house for recovering alcoholics they’re thinking about opening in Jefferson, Me.

Jefferson is a little town about 45 miles west of Camden, a seaside resort in what is known as “mid-coast”—north of the beaches at the southern tip of the state, and south of Acadia and Bar Harbor. Jefferson is in Lincoln County and it rang a bell because I’ve been to those parts—we’ve sometimes driven from our Appalachian-foothill town to Maine for vacations, and we usually stay near Belfast, a fishing town just north of Camden (and less touristy).

Maine pond ducks

My boy several years ago, watching the ducks on the mid-coast pond we sometimes visit.

When we go up there we fall into Maine habits, one of which: we leave the house without locking the doors.

Some of the good folks of Jefferson are afraid that having “addicts” as their neighbors will mean that they have to start using their keys. They’re afraid that if the residents get kicked out of their supervised-living situation, they’ll be dumped to roam the streets of Jefferson (which, apparently, they’ve been promised will not happen: residents who fail drug-tests will be taken to the hospital).

I was heartened to see how many comments were filed supporting the project.

Wake up—people that are addicts, alcoholics, etc. are your neighbors. You have been living a sheltered life if you think you’re any better than any of these people.

A rural facility is the best place for a bunch of drunks. I’m one so I feel safe to speak up on this. I’ve gone to AA for 13 years. Prefer to live at home, thank you. But there are many that don’t have a home in the first place. There must be a safe place to start the journey.

There were also those who had, shall we say, less sympathy:

Bring em on. My wrong answer stick is loaded and waiting.

(For godsake)

Success rates for these programs is at best about 15 percent. Addicts are not parasites, they are predators. … Trying to help an addict is a black hole that can easily suck good people in at their peril.

I’ve written something similar elsewhere: “it’s almost impossible to help an active addict who doesn’t want to be helped.”

I’ve sat across tables from people who have said to me, “I want to stop drinking, I need to stop drinking, but I can’t stop drinking—what can I do??”

When I was using and saying to myself, “I want to stop using, I need to stop using, but I can’t stop using,” I wasn’t ready to stop using, pure and simple. I hadn’t had enough. And yeah, my addiction made me into someone who sometimes manipulated, lied, and stole, but who more often was simply passive in her own life and who was by times quite emotionally unstable. A “predator”? No. A sick person.

But someone who is ready, who has put together sober time, and who wants help? Who has willingness?

These are two different people. Quite literally. The person I was when I was using bears little resemblance to the person I am now.

This is hard for me to live with sometimes. It makes me feel strange, as though I have dissociative-identity disorder—what they used to call “multiple-personality.” Is that person hiding inside me? Will she take over again? … Do I get to indulge in the loathing I have for her, because of the things she did?

I was talking to a young newcomer recently who said they had regrets. They were talking about how much they hated themselves for the things they’d done while using. … This is one of the ways I get not to hate myself. I get to tell a new person I did the same things—or the same kinds of things. They look at me: 45, articulate, put-together, married with a kid, and hear me talk about the shit I pulled, the ways I fell down, and they get to have hope that they’ll be able to pick themselves back up and also let go of the self-hatred.

And the married with a kid… I don’t take this for granted.

“Babe,” I said last night as we were drifting off at 10:30.

“Huh?”

“Oh never mind,” I said.

“I wish I had a hot dinner for every time you’ve cut yourself off like that,” he said. “Why do you censor yourself?”

“Because it’s 10:30, and I know you’re gonna just tell me it’s too late to talk about it,” I said.

“Why?” he said. “Is it a philosophical question?”

“Kind of,” I said.

“Oh Christ.”

We lay there in silence and I thought maybe he was dozing off again when he said, “Out with it, then!”

“Well…” I said. “When I told you I was an addict and was in recovery and all that, and it turned out that I’d been addicted all that time and wasn’t able to understand it, and basically deluded you and myself and everything, why didn’t you just leave me?”

He didn’t pause even for a second. “Because you were IN RECOVERY,” he said. “And people in recovery get better.”

The stigma of addiction (part n): Doctors and addiction

In Addiction and Art (a book I swear to G-d I’m going to review very very soon) the authors, professors of psychiatry and behavioral biology at the Johns Hopkins University School of Medicine, write that compared to other medical illnesses, addiction receives little attention from the medical and public health communities. The reasons: the perception that it’s primarily a law enforcement problem, not a public health problem; skepticism about treatment; and “poorly funded research, weak leadership, stigma, and stereotypes.”

The authors go on to add, “Many of these obstacles to appropriate action, however, are caused more by indifference and prejudice.”

We can see this in the kind of outburst registered last week on the comments section of the New York Times story about a piece of Washington state legislation that would require physicians to refer pain patients on increasing doses of opioids to specialists if their symptoms were not improving.

Note well, reader: not cut off the patients, but refer them for further consultation if symptoms were not improving.

Listen to the uneducated voices that went ballistic:

I would much rather have some people become addicted to pain medicine than to do anything which restricts people with legitimate pain from obtaining pain medicine. … There is not one bit of evidence to suggest that if pain medicines were not available for misuse that people inclined toward addictions would not just find another drug. That is the history of drug use.

Here we have a guy who would prefer to sentence some people to a deadly disease, rather than consider implementing reasonable regulations that might allow clinicians to distinguish who might not be benefiting from these powerful drugs.

Another:

Patients who use narcotic drugs for real pain relief need them and do not become addicts.

Well, yes, honey, I’m here to tell you that some do! Get yer head out of the sand.

Moreover, patients who use opioids for real pain relief may still be addicts. They might have ruptured discs or spinal stenosis or no cartilage left in their knees. These conditions, which may require pain treatment, don’t exempt them from having addiction as a disease.

There were a very few sane voices:

As 21-year-old who has arthritis (19 years)and fibromyalgia (6 years) and experiences widespread pain every day, I don’t really have a problem with these regulations. If a medication is not working, its use should be reevaluated, especially if the medication could cause further health problems. I’ve been on a variety of different NSAIDs (different than a pain killer, I know) over the years. Whenever the medication stops working or isn’t doing enough for me, I change meds. If a powerful painkiller isn’t making any difference, why would someone keep taking it?

And another:

During my residency I only prescribed OxyContin to terminal cancer patients. … It was abundantly clear that most primary care physicians have very little to no training in managing and prescribing chronic opiates. Many of these patients encountered were physically and or psychologically dependent. Some were addicts.

Even when physicians have training in managing and prescribing opioids for chronic non-malignant (that is, non-cancer) pain, they often do not have the first clue how to recognize addiction inside their offices. And if they can recognize addiction, usually the stigma and stereotypes take over: they see their patients as having become morally corrupt rather than as having an(other) illness.

Pain physicians are trained to get patients ONTO drugs, not OFF drugs. So, largely in fear of DEA reprisals, they kick addicts roughly out of their practices, they refer them to psychiatric hospitals, and the patient is faced not only with negotiating a disruption in continuity of care for their pain problem but also with setting up treatment for their addiction—about which they may be in severe denial—and having to do it in opiate withdrawal, while also having to work, and/or take care of kids, aging parents, etc.

Total nightmare scenario. One that every chronic pain patient who-deep-down-suspects-she’s-an-addict wants to avoid, so this is why she usually stays in denial. She does not know how to get out. She doesn’t need to be kicked out of the practice, she needs help.

I wish this kind of legislation had been around five or six years ago. All I had to do to convince my doctor I was doing well was to go in and say I was doing well. I was taking pain medication for two real, diagnosed, legitimate neurological problems (which I still have), but it had also dimly entered my awareness that it was helping me cope with psychological problems as well. (Of course, the two can’t really be separated. The wellbeing of the body is the wellbeing of the mind.) If my physician, who is diligent, had been required to submit me to a protocol of questions and demonstrations at each visit to determine my actual functionality, it might have been determined, over time, that the opioids weren’t actually helping me improve. But again, I was afraid of being kicked out, cut off, sent to the psychiatric hospital, forced to take care of my child in the interim while enduring opioid withdrawal, etc. It was a conversation I was afraid to have with my physician, because to broach it would be to puncture that can of worms and let escape The Stigma.

In my opinion, and this is just off the top of my head here, I’d really like feedback on this: every pain clinic should have a staff of certified addiction specialists who consider addiction to be a disease and not a moral failing. They would be there to protect the patient population from the risk and to help those who have the disease and who also have chronic pain (because, as above, pain patients can also be addicts).

If you’re going to call pain a disease and you’re going to be in the business of handing out opioids, you need to get real about the disease of addiction. And not in a punitive way.

Finding beauty in the battle with addiction

Sobriety gave me back my artistic practice.

That’s why I love this story in the Canadian North Shore News about women artists rediscovering their creativity after getting sober.

The story is about an exhibition called Artists of Avalon: Women in Recovery from Addiction Discover their Creativity. The mixed media show opened in Vancouver April 13 and features the work of 17 women artists who are also healing from addiction. The women have been helped by Avalon Women’s Centre of West Vancouver and Vancouver.

The story quotes artist Gwen Dirks, 48, sober for seven years:

I never felt that I had something to say, to put down in my own painting. So basically what sobriety has given me is this gift of getting to know myself sufficiently, to say ‘I have something to say,’ and . . . that what I have to say is valuable and something that I can show other people.

When Gwen was drinking, like many of us, she only ever had the courage to be creative when someone asked her to. She couldn’t be spontaneous.

Lots of people who drink or use drugs—especially people who like to write, play music or make art—start out because they think it’ll loosen up their creativity. They think it’ll help them be more spontaneous. And one myth about addiction that drives me nuts is that drugs make you more creative—and that giving up drugs and getting sober means you’ll be condemned to live a boring life.

These women blow that myth to pieces.

I’d like to hear from some sober people living interesting lives…

If you’re in Vancouver, go see the show, which runs until May 2 at the Ferry Building Gallery.

—G

Sticks and stones: On the “stigma” of addiction

I wanted this post to be a kind of second beginning, because I’ve been gone from the blog for so long. I started out writing my experience as prescription-drug addict, but you can read that at Opiate Detox Recovery (on my first thread and my second thread). What I really want to talk about is what this blog will be about.

I want this blog to be a place where addicts of all stripes—not just people like me, who became addicted to pain drugs through legitimate pain treatment, but also people who drink their pain away (like my father), people who can’t stop smoking nicotine because they feel like they’ll go nuts (like my mother), people who can’t stop copping heroin or crack or meth, or eating, or gambling, or having sex, because it makes them “feel” some way that they can’t feel otherwise—a place where these people can come to learn and talk about addiction.

I’ve been reading the daily news about addiction and alcoholism for the past few months. Addiction permeates our society. Today’s news (you’ll totally NEVER believe this): junk food is actually addictive!—who knew?? And the media are so much more keyed into this “discovery” than they are about the scores of people who die each year because of drug-addiction. I’m not just talking about heroin addicts under bridges, which is the image everyone thinks about when they hear the word “addict.” I’m talking about the half-million Americans who die EVERY YEAR because of lung cancer caused by smoking. Every two years, we lose a million Americans to nicotine-addiction-induced lung cancer. That doesn’t count the ones who die from emphysema and other lung disease caused by smoking.

Add to that the number of people who die of two common results of food addiction—diabetes (7th leading cause of death in America) and obesity (112,000 Americans per year)—and the idea that addiction permeates our society is easy to understand.

So few people understand addiction. The press about addiction, however well-intentioned, is often rife with errors, usually because journalists don’t talk to addicts who have the experience to speak with authority.

And they don’t talk to addicts because addicts are afraid to come out of the closet. An enormous stigma persists about addiction.

The word “stigma” is a Greek word for a wound or brand inflicted by a pointed instrument. It’s related to the word stick. “Sticks and stone may break my bones…” Every six-year-old knows what bullshit that old saying is. There are some names that can hurt. “Addict” is a name that can get you talked about, divorced, sacked, and generally shunned by society.

The name “Guinevere” is not my real name. It’s the name that I chose as my byline when I started writing on Opiate Detox Recovery 18 months ago. I was newly in detox, wondering if I’d done permanent damage to my body and mind, fearful that the pain that had incapacitated me six years before would come back.

It turned out that the pain didn’t come back, and I didn’t do permanent damage with the drugs. Today I cycle 50 miles per week, take care of an extensive garden, and clean a big house. My 16-year-old marriage has thrived since I got off drugs, and I’m a much better mother to my 12-year-old kid.

I wish I could write about my addiction under my real name. But for now that seems like a bad idea. But my hope is that one day society will see that addiction is an illness like other illnesses that we contract through a combination of genetics and behavior.

My experience is, talking openly about our experiences helps us and other people.

If you could talk openly about your addiction… would you? What would it take for you to be able to do it without fear?

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