Guinevere Gets Sober

Recovery news, reviews and stories, by Jennifer Matesa.

Tag: Vicodin (page 1 of 6)

Hydrocodone Homebrew and MIT Bullsh*t.

Ken Oye

Dr. Kenneth Oye, MIT prof of political science and engineering.

Listen to Dr. Kenneth A. Oye, a professor of engineering and political science at M.I.T., saying this in the New York Times this morning:

Hydrocodone doesn’t give you the high that other compounds do.

I agree. It gives you a MORE AWESOME high! Like/share this link if you agree.

I’d like to send Oye some of the mail I’ve received over the years from folks whose genetic predisposition was turned on by hydro and who have spent tens of thousands of dollars buying Vikes through the internet and on the street.

Now Stanford scientists are homebrewing hydro. Hydro Pale Ale! Hydro lager, Hydro stout, Hydro ESB. So eventually we won’t need to buy bricks from the poor Afghan farmers!! In the name of American technological innovation and self-reliance.

I’d like to see Stanford, MIT, and other schools spend the money on researching effective treatment standards and educating medical students about how to recognize and treat this illness.

The Stanford High-Tech Homebrew Team.

The Stanford High-Tech Homebrew Team.

Trapped on Suboxone: A Woman Who Can’t Say No.

My comrade-in-arms Jason Schwartz, who blogs at Addiction & Recovery News, has a good post today on harm reduction. I filed a comment on his post and was compelled to cross-post it here, in greater detail, just because I have to start sharing this information I’ve been collecting or I’m gonna burst.

A Suboxone film.

A Suboxone film.

I’ve been interviewing people who are part of the new state of American harm reduction: Oxy and Vike addicts who are “stabilized” on enormous doses of Suboxone. (If you’re part of this trend and want to share your story, please email me.)

Over the weekend I spoke to a woman who, for a 50-75mg/day Percocet habit, was prescribed 16mg Suboxone per day. She had emailed me in desperation for advice about how to quit. She’s been at this level for 7 years. She has gained 75 lbs. and has gone into menopause. She feels emotionally dead.

I can’t tell you how crazy it makes me when I hear 1) that doctors are “treating” a 75mg Percocet habit with 16mg buprenorphine (you don’t need to atom-bomb a small Oxy habit; this is how to quit); and 2) that harm reduction advocates think these prescribing practices improve people’s lives.

An ad for a Florida Suboxone doctor. Suboxone ads promising to "free" people from addiction crowd the back pages of city alternative weekly newspapers and are posted on signs across the hillsides of poor urban neighborhoods.

An ad for a Florida Suboxone doctor. Suboxone ads promising to “free” people from addiction crowd the back pages of city alternative weekly newspapers and are posted on signs across the hillsides of poor urban neighborhoods.

Here are her Suboxone doctor’s prescribing practices: she has a five-minute visit with him every two months—via Skype. (This is one of the “good” doctors—one of the ones who doesn’t charge exorbitant cash fees for twice-monthly visits.) And when she told her doctor she wanted to quit taking Suboxone, this physician told her that, if she wanted to quit , she would one day just “forget” to take it and then she would be done.

“I think he just doesn’t get it,” she said.

He’s never taken it, so he’s in this la-la land that people can come in with an addiction and take Suboxone, and boom—they’re cured.

She’s desperate to get off Suboxone, but she knows she can’t do it by herself. She looks back at her previous Percocet habit with longing and regret—withdrawal from that level would have been comparatively easy.

She recently had surgery, and the anesthesiologist and nurse told her that they’re seeing more and more OR patients on bup—it’s the new wave. … After her surgery she took 2 Percocet every 4-6 hours as directed, and within five days a devastating withdrawal descended upon her. She described it as a band of fire belted around her abdomen, along with all the other symptoms of withdrawal, magnified. She managed to abstain from Suboxone for almost two weeks, hoping she could stick it out—and it only got worse, despite taking 3-4 Percocet every 3 hours.

In the end she couldn’t hack it. Within half an hour of taking one strip, the belt of fire disappeared.

I told this woman that there are public health experts and media mouths who think she’s better off because she’s no longer doctor-shopping or significantly threatened with overdose. I asked, How would you respond to them?

“I’ve lost my freedom to choose,” she said.

I’ve lost my personality. I’m more quiet and withdrawn. I feel like part of me is dead. And I’m a slave to it. I have to have it. I’ve lost the ability to say no.

A woman caught in a system that doesn’t let her say no. Don’t we call that “rape,” or “coercion”?

Suboxone revenues, 2005-2011. A curve generally thought of as "exponential."

Suboxone revenues, 2005-2011. A curve generally thought of as “exponential.”

And, please, Jason, let’s talk about the money. Reckitt Benckiser pulled in $1.4 billion from Suboxone products in 2012. A Harvard researcher who is looking at American Suboxone prescribing and reimbursement tells me much of it is paid by Medicaid.

So, though my middle-class, employed, insured source gets her Suboxone through Cigna, and though her doctor does not accept Medicaid or other public assistance, taxpayers—you—are indeed underwriting a great deal of this system.

It’s mostly poor people who are trapped on this drug.

Reckitt and Titan (who is developing the implants—the ones recently rejected by the FDA for not delivering enough drug to to the patient) see Oxy and Vike junkies, along with heroin addicts, as a deep mine of insurance and taxpayer revenue, just as Purdue saw pain patients—potential OxyContin buyers—10 years ago.

And, finally, let’s talk about how “people can’t abuse Suboxone.”

melted_suboxone

A melted Suboxone film, ready for injection.

 

People can and do abuse Suboxone.

Red Bull And Radical Self-Acceptance.

Sincere thanks to everyone who has written in asking where in the sam hill G has been. WTF, G?? A month without a blog post? Where the hell are you? You are my sunshine, etc.

You are mine as well. I think about you readers every day. I love the mail I get from you. I mentally formulate blog posts for you as I go about life maniacally trying to patch all the holes in the bricks, and the blog posts back up inside my head and break through the logjam and rush downstream like the water in the Niagara Riverbed in a high-water spring, whitecaps peaking over the eternal bedrock, powering the entire region.

Where G has been: G has been enrolled in Elite Acceptance Dojang.

In April, as she was winding down a spectacularly successful semester of teaching writing, G decided that on May 1 she would quit caffeine, gluten, and (cough) sugar, in all its forms: fructose, sucrose, HFCS, white flour, the whole bit. And G also decided that, on May 2, she would Feel Awesome. G has been learning that this is her SOP: she makes the plan, she secretly writes the story, and then she has to deal with the seismic shocks that arrive when Real Life doesn’t mesh with the narrative. (Back in the day this used to be an awesome excuse to use. Reality not matching narrative = migraine = instant need for drugs.)

In fact G has been having many migraines. In fact, G did not, after quitting sugar and caffeine and gluten on May 1, feel awesome on May 2. She didn’t (yet) feel like fkn shite, either. But early in the morning of May 3, at about half past midnight, as G slept peacefully without the dregs of sugar and caffeine oozing through her blood, G’s leggy, towering 15-year-old son woke, washboard ribs convulsing, screaming that an explosion was taking place inside his skull. He pointed to his right ear.

“Come on,” said G, thinking, Stroke? No, ear infection, sliding into jeans and running shoes. “We’re going to the hospital.” The only place where, in the middle of the night, you can get Auralgan.

“I don’t wanna go to the hospital, Mom,” whined the boy, regressing to age 3, pulling a shirt on.

The boy, age 3.

The boy, age 3.

The boy, age 15. Plus ça change, plus c'est la même chose.

The boy, age 15. Plus ça change, plus c’est la même chose.

“We’re going,” G said, grabbing her keys and poking the boy in the back—the best she can do these days to enact physical force on a young man of five-foot-nine-and-a-half.

It was an ear infection. Diagnosed not by the (young, male) resident, who missed the signs, but by the (middle-aged, motherly, female) attending pediatrician, after we had sat in the ER for two hours.

“You’ve got an ear infection, pal,” she said. “Let’s just say I’ve seen a lot more ear infections than the resident has.” She wrote scripts for antibiotics and Auralgan.

The next day, G decided she needed to renege on her austerity commitment. She drank a cup of strong Yorkshire tea to “get started.”

//

Did you know caffeine is the most widely used psychoactive drug in the world? Fact.

Did you know that when we drink coffee or tea, we’re enacting an ancient method of extracting drugs from plants? We’re steeping, with boiling water, legal psychoactive herbs that release their drugs when the steam hits. In old-timey medicinal terms this is called an “infusion.” If you boil the herbs for a long time, it’s called a “decoction.” (I quite like that word: de-cock-shun. There’s the sound of a gun in there, somewhere.) If you let the herbs stand for a long, long time (say, a week, or even a month) in ethanol—which also brings the drugs out of the plants, but more slowly and more thoroughly, like a kindergarten teacher carefully leading her kids out on a field trip—it’s called an “extraction.”

But just because, with coffee or tea, we’re not using booze to do the trick—that doesn’t mean we’re not taking a drug.

Caffeine ain’t gonna kill you, but it can cause significant problems: insomnia, bruxism (tooth-grinding), headaches, chronic anxiety, and adrenal system disruption and depletion. The walnut-sized adrenal glands, one capping each kidney, are key to controlling our metabolisms, hormonal systems, moods and sleep cycles. Sugar stresses out the adrenals in the same way.

Adrenals—meaning, "above the renals," or the kidneys. They help run the metabolism. They crap out on us when we endure too much stress.

Adrenals—meaning, “above the renals,” or the kidneys. They help run the metabolism. They crap out on us when we endure too much stress.

I used to love my morning ritual: a Vicodin, crushed and swallowed; a cup of strong tea; and toast with butter and jam. Opioids, caffeine, and sugar. Dopamine score; adrenal drain. I’d be content for about five hours, then feel like crashing—so I’d take more: Vicodin with afternoon tea and cookies. The drugs would power me through. A lot of women take painkillers this way—to muscle, to steamroll through a big daily agenda. The same way most folks use caffeine and cookies.

Without caffeine and sugar, the pile of cells called G’s Body is not the same as it is when it’s loaded up on caffeine and sugar. My body has become tolerant to the chemical effects.

This bothers me. It means I’m not accepting my body as it is. I push it, with my will, to do things it can’t do, with destructive effects: when I drink caffeine, I crave sugar, so I get several drugs at one time. Processed sugar is a drug. I crash with migraine, fatigue, PMS, and other physical problems.

//

G's new touring bike.

G’s new touring bike.

I’ve spent more than half the days since May 1 without “getting started” on a cup of caffeine, and it feels good. On those days, I’m not constantly monitoring myself, wondering if I “need something” to keep going.

I accept myself more.

But it’s so habitual not to accept myself. It’s so habitual to do things—carry out actual acts, however seemingly inconsequential (they accrue; their value and power accrues)—that show I REFUSE to accept myself. Drink more tea. Eat more sugar. Beat the shit out of myself mentally, emotionally, tacitly, for wanting to do things (and, actually, doing the things) that I believe I can’t.

So I’m carrying out some contrary actions. My program of recovery asks me to act in ways that grate against the grain of my habits, ways that carve new paths into the neuronal structures. I’m making space for myself where I can do what I’m made to do. I’m investing in that space. I’m cleaning out old spaces and letting things go. (I have to do more of that. It’s like inventory: I don’t feel like mucking out the Augean stables; I’m afraid of what I’ll find; it’s tiring.) I’m working, and I’m trying to get reasonable rest and exercise, despite being extremely anemic.

British-made leather saddle to conserve my body.

Split leather saddle to conserve my body.

Because I’m anemic, and because I’m (habitually) afraid, I sometimes feel numb. It occurred to me the other night while walking the dog that I’ve done everything to get rid of this numbness, this fear, except two things: to use, on the one hand; and, on the other, to accept it. The teacher at the Buddhist center where I meditate advised us, in a workshop on Fearlessness in Everyday Life, to sit with fear, to feel it, to care for it, to sink into it and then finally through it to another place where we are all held by a divine something—who knows what it is or how to talk about it, but it holds us.

sober-mercies

I’ve also been reading fellow blogger and sober woman Heather Kopp’s memoir Sober Mercies: How Love Caught Up with a Christian Drunk. I love this book. What I appreciate most about it is the candid way Heather talks about finding God—how she talks about the source of her sobriety. She is not a typical Christian. I’ll be reviewing her book here soon and giving away copies to readers who comment, so stay tuned.

I’m also reading Dave Sheff’s Clean and Dirk Hanson’s Addiction Inbox. I have lots of other adventures planned for the summer. Stay with me.

Sanjay Gupta’s TV Special and G’s SAMHSA Fellowship.

Thanks to Sanjay Gupta and CNN for this evening running “Deadly Dose,” about the skyrocketing problem of painkiller misuse and addiction in the U.S. since 2000.

Dr. Gupta brought Bill Clinton onto the show as one of his primary sources. Clinton had been friends with a young man who had overdosed from a combination of prescription opioids and booze. “I’m sure he never knew that he was turning the lights out,” Clinton said. Gupta focused mainly on accidental overdoses: at one point Clinton said,

People are dying in large numbers every year because they do not know that if you drink four or five beers and then pop an Oxycontin, for example, it shuts down the part of your brain that tells your body to breathe while you are asleep.

At one point, however, Gupta interviewed a guy who didn’t identify his name but allowed his face to be shown on camera—a guy who had begun taking Vicodin for back pain, and who eventually climbed up to taking eight to 10 “eighties,” or 80mg tablets of OxyContin, per day. Which would be up to 800mg—”without loss of ability to function,” he said. Of course, because when our bodies develop tolerance to opioids, we can function pretty much as well as most people—opioids are not like alcohol that way.

Gupta is breaking new ground in outing this subject, which garnered him overwhelming praise and a tiny bit of criticism on the Twitter live-chat (#DeadlyDose) from folks unwilling to consider that the prescribing of opioids may need to be more strictly regulated. During the show I found myself wishing he could call the problem what it is–addiction—and not just “accidental overdose” or “prescription misuse.” The guy who was using 10 “eighties” was definitely not accidentally doing so. I kept hammering away on Twitter: “Doctors need to learn to spot signs of addiction.”

Because I’ve done so many live-chats, for example with The Fix‘s staff and associates, I’m used to live-Tweeting, and I was one of three people Gupta himself retweeted to his 1.5 million followers during the show:

Which is cool because one of my jobs in the next year is to get more media attention for recovery from addiction. I’ve been so damn busy but I’ve meant to tell you that, the day after my 48th birthday, on Halloween, the Substance Abuse and Mental Health Services Administration (a branch of the federal Department of Health and Human Services) emailed to say I am the recipient of a year-long fellowship, which comes with a cash award and training in Washington, D.C. to help me become “a voice for recovery.” Which, they acknowledged, I already am because of this blog and the other writing I do.

And I owe you, my dear readers, a great deal of thanks. You flock to this site for “news, reviews and straight talk about addiction and recovery,” and you show there is an audience out there who wants reliable information and good stories about this illness. You rock.

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.

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