Sometimes I get caught up in research a little more than what I intended.
With a resident's question on heroin and NARCAN use, I've opened up a larger investigation that I thought perhaps might actually wind up helping a few people, and so I've decided to write it.........
Cause writing's what I do......
So here is a story of two addictions, with two very different outcomes....
I'll start my story with a woman that for the purpose of this story, we'll call Jane.
Jane was interviewed via telephone from her home.
Jane was a precocious child. She was daring and brave. She didn't ever take any guff from anyone and she was prone to doing crazy things like driving through the backwoods at 80 miles an hour and crashing into a tree "just to see what would happen." Her friends all knew that Jane would always be the first to try the new rope swing, jump from the bridge into the river, or jump from a 2nd story window into a waiting pile of leaves or snow. The people at the local emergency room new Jane and her parents on a first name basis. Broken bones and surgeries for injuries were commonplace.
When Jane grew older, the injuries began to catch up with her. Arthritis came to stay in many of her joints and bones, and new injuries were added to make matters worse.
After one surgery in 2008, Jane began a what would become a lifetime of disability, pain and medications.
It started with Vicodan and Percocet, and when that was no longer enough, there was Oxycontin and then Morphine, Methadone (yes, methadone is a very strong pain killing medication), and Fentanyl. There were muscle relaxers, anti-inflammation meds, and meds to deaden nerve sensations. The pain meds made Jane very sedate, and it wasn't long before she found herself crying a lot. The doctors remedied the sadness with anti-depressants, and when those made it hard to sleep, sleeping medications. When Jane was sleeping too much, Amphetamines were added to wake up with in the morning. The doctor next noticed that Jane's thyroid was slow, so meds were added for that, and then cholesterol medications and blood pressure medications and medications for tummy and bowel problems along with one or two for controlling the high sugars in her blood.
In October of 2012, Jane found herself needing more surgery and entered the hospital. When the nurses were prepping her for surgery, they gave her a medication in the IV to help her stay calm before surgery. Just that little bit of nothing sent Jane into an overdose, with the complications of 3 days worth of cardiac arrest, several jolts with the defibrillator, and a family at bedside wondering if Jane were ever coming home again.
But Jane lived, and she did come home. With a handful of prescriptions for the very medications that had jeopardized her life to begin with.
But while at Portsmouth Hospital, a nurse had a talk with Jane that would change her life. The nurse told her that taking pain killers did not actually kill the pain. It only stopped Jane's brain from recognizing the pain through chemical means that stopped her BRAIN, not her PAIN. She said, "If a child suffers a bruise, and it's the worst pain they've ever experienced. Is their pain any less than an adult who has suffered a broken bone or two?"
Now this is where Jane's story takes a turn from where you expect it to go. A family holiday dinner was coming up, and Jane was not invited. Speaking to the host, Jane was told she could not attend. There would be in-laws and guests, and frankly, Jane with her drooling, stuttering, and improper conversation topics was an embarrassment. But her family promised to save her a plate and come for a visit in a few days. Jane went to bed with a heavy heart.
The next morning, Jane phoned her doctor asking how she could get off of some of the medications. The doctor told Jane that he was sure she could not manage the pain without the medications. He forbid her to stop taking them, and told her that without the medications, he was sure that suicide would be her future. That talk sent Jane into a tailspin. Suicide?? That was not an option in Jane's mind. She decided that the medications needed to stop, and being a willful person, on November 15, 2012, she took all the pill bottles out of her drawer and walked to the bathroom and flushed every pill down the toilet. All of them. No matter what they were prescribed for.
The days that followed Jane's decision were some of the hardest of her life. She lay alone on her bed, shaking, throwing up, sleeping, crying. There were many times she thought she was having heart failure. There were cramps that felt like her body were twisting in two. There were times when she thought she should call 911, and the only reason she didn't is because living life as a legal drug addict was worse, to Jane, than the possible alternative.
As of Summer of 2015, Jane is healthy. She has moved on with her life from the worries of what pill is due at what time and how she will make the money to pay for her prescriptions (over $280 a month in co-payments). Jane sees a doctor regularly to check blood levels for her thyroid, cholesterol, sugar, and heart enzymes and they remain well within normal levels. The pain. Oh yes. The pain is still there. But Jane went to a holistic doctor and learned to control the pain by other methods. Exercise, proper eating, and keeping busy have helped Jane to learn to stop her own brain from recognizing the pain instead of relying on chemical means to do so. There are days when it is not easy and the pain is more than others around her could imagine. But a good cry and then a long sleep seem to do the trick until the next time.
So let's leave Jane's story and focus on another woman only months apart in age from Jane. For the purpose of this story, we'll call the second woman Wanda.
Wanda was interviewed via internet, also from her home.
Wanda was just as curious, daring and brave as Jane.
When she was younger, she had suffered an accident that had left one arm paralyzed, and then a few years down the road she was diagnosed with pancreatic cancer.
Wanda was started on pain meds during treatment for the cancer. Very similar to Jane, she was started on Percocet, Darvon, and the need progressed to stronger medications such as Oxycontin, Morphine and Methadone. Due to side effects, medications were added for depression, hypothyroid, blood pressure, tummy and bowel troubles, sleeplessness and amphetamines in the morning to wake up with. When the pain outweighed the medications, Wanda supplemented with a few extra pills from friends, neighbors and family, or purchased them from people she knew. There was also alcohol for when Wanda was feeling lonely and needed to have a party to surround herself with friends. There was marijuana, cocaine, and crack. Wanda met a man and they began a relationship. He was an alcoholic and there were domestic disputes where one or the other, or sometimes both of them, would wind up in the emergency room.
When the actions got out of hand, Wanda's doctor, perhaps detecting a problem, decided that he would stop her from legally obtaining the medications, but by then, it was too late. Wanda knew all the right people and all the right pills to take. She went to other doctors and got more pills and she was introduced by friends to heroin.
"I started out small," Wanda says, "only a half a gram or so, but the more heroin you use, the more you need to not be sick. You start small, but every day you need a bit more just to feel good." Before long, Wanda says she was using 2 grams, then 5 and she started to drive to Boston to get the drugs as Portland was more expensive. When her heroin habit got to be to expensive, Wanda began selling the heroin in order to be able to afford hers for free. "By then I was using a couple of fingers worth," she said, explaining that a "finger" is about 10 grams and about $450 worth of heroin at street value, "So I was using $800-$900 worth a day, but going to Boston, I could get that for about $500 and sell some to wind up getting mine for free."
"You just get sucked up into the life," Wanda explained. "You're running, buying, selling, and all the time trying not to let anyone around you know what's happening to you."
In the early months of 2013, Wanda was taken by ambulance, to the Emergency Room, 5 separate times due to drugs and/or domestic assault. In August of 2013, she was having a cookout and overdosed on a mixture of morphine, pills and alcohol, falling onto the floor of her apartment. Her boyfriend, also high, left her on the floor and went in to take a shower. A guest at her cookout found Wanda and called 911. Wanda was administered NARCAN (which works on all opiod medications not just heroin), and she was rushed to Maine Medical Center in Portland. For 6 days Wanda lay in a coma, experiencing cardiac arrest several times. "I was basically DOA," she says.
When I asked Wanda if she were arrested for the overdose, she said "No. There are no charges for overdosing. Basically a call to 911 is a safe call. If you would get arrested for overdosing, no one would ever call 911 and there would be more deaths." Wanda went on to explain that although the police were present, "they left all my stuff right on the table and just took me." stating that when she returned home from several days in the hospital, all her drugs, pot, pills and alcohol were right there on the table waiting for her. "It's not against the law to overdose, it's not against the law to have it in your system," she explained. "If there's stuff on the table, usually they (the police) just take your stuff and take you to the hospital, there are never any charges involved, unless you get caught with a lot of it, and then there may be charges."
Wanda has decided that she needs to get help with her recovery. As of Summer 2015, Wanda attends an outpatient drug recovery program and is doing well. "It took me from February until June 24 just to find a place that had room for me," she says, talking about how being on Medicaid, she had to wait a very long time for Medicaid approval before even beginning to search for placement for herself.
Wanda is hoping for a bed to come open in a residential treatment facility, and is currently taking Suboxone, which has the main ingredient of narcan in it. While Suboxone is also a narcotic medication, it is has a special effect that reverses the effects of other opiod narcotic medications. While some people take Suboxone and are weaned slowly from narcotic addiction, because of the damage done to Wanda's intestines, kidneys, stomach, and liver, and because of the continued pain from pancreatic cancer, Wanda says that she's been told she will be on Suboxone for the rest of her life, on what they call a "maintenance program". Wanda also contracted MRSA. Although she suspects it was from the hospital itself, she's not sure how.
"They never told me if I followed doctor's orders I would become a junkie," Wanda stated. "It's just not fair, what happens to you."
We wish both women well in their efforts to stay away from both prescription and street drugs, and thank them both for their honesty and candor about their addiction. But this is a story we hear all too often. An injury, surgery, or disease brings pain and the doctors freely hand out bits of paper with their signature scribbled across the bottom, and because of the very nature of the medications being handed out, legal drug addicts are born. Once a person is addicted to the opiod pain killer medications, if their medication prescriptions are ended, they either get past it on their own, or they go looking for something to replace the narcotic need that has been created in their bodies.
While some people believe that drug addicts walk down the street and stop a drug dealer and ask for drugs, that's not usually how it all begins. Usually drug addiction is begun through a need. A physical need, left empty from the absence of another chemical in the body.
This has been a very interesting part of the furthering investigation into the rampant drug use that has not only gripped our area, Maine and New England, but what appears to be a growing problem across our entire country.
We hope the stories of Jane and Wanda have opened some eyes, given you some pointers and some things to think about when you, or a loved one, are prescribed narcotics over a long period of time.
