by Joshua Lyon
Next up was Joseph Rannazzisi, the deputy assistant administrator of the DEA Office for Diversion Control. He talked about the evils of Internet pharmacies. Then we heard from Sharon Brigner, the deputy vice president for the Pharmaceutical Research and Manufacturers of America. She talked about how PhRMA had partnered with DARE (ahem, useless) to create a curriculum for fifth, seventh, ninth, and twelfth graders about abusing prescription products. PhRMA also joined up with Partnership for a Drug-Free America to talk with health-care providers who encounter prescription drug abuse to find out what kinds of resources they need. A good step, I think. Dr. William Jacobs Jr., the president of Nexstep Integrated Pain Care, Inc. (a chronic-pain facility in Florida) emphasized the importance of getting opioids to those who need them and called for mandatory training in medical school curriculums on how to better assess the risk of substance abuse in patients. According to him, this doesn’t currently exist. He also talked about NASPER, the National All Schedules Prescription Electronic Reporting Act. This is a nationwide prescription-monitoring program that would replace the current patchwork of individual state programs. NASPER was passed unanimously by Congress and was signed into law by George Bush, but so far remains unfunded.
The American Pharmacists Association sent Michael Moné to advocate on behalf of giving pharmacists access to patients’ universal electronic medical records. No! This idea flies in the face of all privacy and ethical issues in the book. The only people who should have access to your medical records are your doctors, and in certain specific situations, members of your family.
Francine Haight is a nurse and mother who lost her son Ryan to a prescription drug overdose from pills he bought online. She formed a nonprofit organization called Ryan’s Cause that focuses on education for families and communities about online pharmacies. Which is great, except that when Francine spoke about her son’s overdose, she said he overdosed on Vicodin. This simply isn’t true. Ryan Haight died from a combination of generic hydrocodone (Vicodin), morphine, Valium, and oxazepam. Francine’s vilification of Vicodin alone at this national symposium, which was being broadcast live on television and picked up by media outlets everywhere, is, frankly, irresponsible. Misconceptions like this only contribute to the world’s fear of using opioids for chronic pain relief. I feel terrible about Francine’s loss, but she should have been clearer, especially in this massive forum, that the biggest danger comes not just from buying drugs online, but mixing the illegally bought prescription drugs together and with other substances.
Lastly came Lieutenant John Barnes from the Prince William/Manassas Narcotics Task Force. Barnes spoke about trying to quell the sale of prescription drugs by the people who were legally prescribed them.
There was a Q & A session afterward. Unfortunately, since the symposium was open to the public, it attracted a bunch of student activists who used this opportunity to get close to DEA officials in order to bitch about why medicinal marijuana hadn’t been legalized everywhere yet. I had my hand raised constantly, but was never called on.
The main point that I wanted to raise was why isn’t anyone focusing on the actual nature and study of addiction itself? Isn’t that where the heart of all this is?
A few months later, during the Super Bowl, I saw one of the new educational diversion control commercials that the symposium had promised would be coming out. In it, a drug dealer was complaining that business was down because his customers were now dipping into their parents’ medicine cabinets.
They still weren’t getting it. This was just one small fraction of diversion. Any drug dealer worth his salt carries at least benzos on him these days. It was “Just Say No” all over again.
It turns out that what may actually be the future cure of addiction is a vaccine. In the March 3, 2008, issue of Newsweek, the cover story’s author, Jeneen Interlandi, wrote, “In the current jargon of the recovery movement, addiction to alcohol, drugs or nicotine is a ‘bio-psycho-social-spiritual disorder.’” Sounds about right to me. She continued, “The emerging paradigm views addiction as a chronic relapsing brain disorder to be managed with all the tools at medicine’s disposal. The addict’s brain is malfunctioning, as surely as the pancreas in someone with diabetes.”
It’s too bad that paradigm didn’t exist back in 2000. Dr. Alexander DeLuca might still have his job at Smithers.
The National Institute on Drug Abuse’s director, Nora Volkow, is quoted as saying, “The future is clear. In 10 years we will be treating addiction as a disease, and that means with medicine.”
An addiction vaccine would work the same way as a normal vaccine, but instead of targeting bacteria and viruses, the new vaccines would go after addictive chemicals. The proposed vaccines have drug molecules that have been attached to proteins from bacteria, and it’s that bacterial protein that sets off an immune reaction. A cocaine vaccine has already entered its first big human trial, and vaccines against nicotine, heroin, and meth are also in the works.
Forget for a moment that this development raises all kinds of serious ethical questions. I know that if my mother had come to me at age nine to be vaccinated against future drug use instead of just having me sign that lame Nancy Reagan card, I would have run away. I’d probably have ended up somewhere a lot worse off than I am today. The real issue is that, no matter what, we are a supply-and-demand economy, whether it’s for something legal or not.
No vaccine is going to change that.
CHAPTER 18
“Boredom Is God”
IT’S BEEN THREE YEARS since Heather left rehab, and her relationship with Derek couldn’t be stronger—they’re expecting their first baby. “I have to say,” she tells me, “that being pregnant is better than any narcotic. I have no cravings for pills at all, and I feel relaxed and calm all the time. Which is weird for me, because I’ve always had so many panic issues my whole life. There’s a part of my brain that’s, like, ‘When is the other shoe going to drop?’” She laughs.
Her pregnancy has healed her relationship with her mother too. “We talk every day now, it’s been a total 180 degrees.”
The big concern for both Derek and her has been whether to have an epidural, because of her past experiences with narcotics. There is a nonnarcotic version of an epidural, so I put Heather in contact with my childbirth-expert sister Erica to help explain all the different options that are available to her.
“My mom tells me, ‘You can’t say now if you’re going to take the pain medication or not, and it’s not like you’re taking it to get high,’” Heather says. “I’m just not making any promises right now. I’m open to all options. I mean, I was never one of those girls who sat around and was, like, ‘Oh, one day I’m going to have a baby.’ But obviously, I am super, super excited.”
Caleb is still living in the one-bedroom apartment located inside his parents’ garage, but now his girlfriend has moved in too. “We don’t have to pay rent, and I have a measure of independence,” he says.
He’s still getting his methadone and Oxy from the Christian with a love for booming sermons, only now Caleb has graduated to selling pills himself. The man sells Caleb 80-milligram Oxys for $25 apiece, way below their street value. Caleb, in turn sells them to other people at a markup, to make extra cash.
“I have one customer who is in the military, and somehow he gets around their drug testing. He’s sort of a hokey guy, so I mark the pills up for him. But then I have another guy who is really sharp who buys them off me for $30, but he’ll buy in bulk so I walk away with a lot more cash. He in turn drives out to the suburbs, marks them way up, and sells them to kids out there.”
I ask Caleb if he gives any sort of kickback to his original source, since he’s making so much money off him.
“No, but I probably should. We’ve developed such a good friendly business. I’m the only one of his customers that he still only charges $25 a pill.”
Caleb originally planned that half of the profits he made from his drug deals would go into the bank and the ot
her half would go to his own recreational use. But it’s been more like an twenty-eighty split. He still does methadone when he’s between Oxys to stave off withdrawal.
“The idea is for me and my girlfriend to eventually save up enough money to buy a house, instead of living in apartments and having all our money flow out into rent and bill expenses.”
But with his drug money basically being pissed away, his main source of income is music, creating sample beats that get bought up by large television corporations for use as background music on programs.
“With the music publishing checks, I put about 90 percent of that into the bank and spend the 10 percent on Oxys,” he says.
I ask him if he wants to quit.
“I totally want to stop,” he says. “But for me, it’s not because I’ve fucked up anything major, it’s exclusively about my pocketbook. I feel like I function really well, and I love being on it. But I hate not being able to save money the way I want to. I want to have kids someday, have the home and everything. I have about $40,000 saved up already, but I shudder to think how much more I’d have if I didn’t do pills. I don’t even want to think about it.”
The trouble is, Caleb and his girlfriend are utterly codependent. He’ll argue that they’ve already spent too much money one week on pills; she’ll pressure him and his resolve will weaken. And vice versa.
“Neither of us have the option of doing any kind of treatment,” he says. “Our families know nothing about this lifestyle. If we want to stop, it will have to come from total willpower.”
This sounds like bullshit to me. “What about going on Suboxone?” I ask. “It’s easier to get off than methadone.”
“I have a bottle of it in my drawer,” he tells me.
“So why aren’t you taking it?”
“I guess,” he says, “because deep down, I don’t really want to stop.”
Jared has been completely sober for four years now. He’s been promoted to a full editor within his Boston publishing company and his specialty is acquiring comedy books. He’s been in a steady relationship for two years, remains on the antidepressant Effexor, and attends AA or NA meetings once a week.
He worries sometimes about what would happen if he ever had a medical condition that required him to take painkillers. “If it was absolutely necessary and impossible to get by without them,” he says, “I would make sure I had someone else who knows about my history administering them to me and hiding them.”
“There were times where I didn’t go to an AA or NA meeting for months,” he says. “But now I’m strictly once a week, including additional therapy.”
Like Heather, Jared is still bothered by all the higher power talk that goes along with AA and NA, but he has stuck with it anyway.
“The thing that got me was that you don’t have to do anything you don’t want to. You can go and sit and still be using. Just because someone tells you to do something, it doesn’t mean you have to do it. It’s just good to go and listen. For me, I know that these people know something about the subject, and it’s worth listening to what they have to say.”
This surprises me, because I’d always been under the impression that if you are on something, you should not show up at a meeting.
“The rule is that you’re not supposed to speak if you are on something,” Jared explains. “You’re supposed to listen. But the rules are also pretty meeting-specific. If it’s an established meeting that has been around for a while, it usually develops its own culture. There’s one group I go to where you can’t even mention drugs, and another where it gets down and dirty and people say anything they want. It’s a matter of finding the right one where you feel comfortable with the level of disclosure.”
Jared still doesn’t believe in God, but that certainly doesn’t stop him from attending meetings. “God is defined as your understanding,” he says. “The whole idea is putting your trust into something that isn’t your own brain, because your own brain is all messed up. The language of the meetings says ‘God’ a lot, and I think that drives people away. It certainly drove me away in the beginning. But now I look at the higher power stuff as simply a tool for living after you’ve stopped doing drugs. The primary goal of these groups is to stop using, so even if you can just take away a sense of belonging and an understanding that these people have experienced things similar to you, well, I think that’s worth something.”
Out of everyone I interviewed for this book, I worry about Elliott the most. He has dropped out of the psychology department at Kent State University and signed up for an associate’s degree at a branch school for graphic design. “I can’t draw, so I can’t get into the bachelor’s program at Kent,” he says. “The branch school is almost like a community college for people who just want regular local jobs, so I’ll probably just find me a little job around here or something.”
Instead of doing opiates, Elliott has switched back to Adderall, in addition to Celexa, his antidepressant. He now has a legitimate prescription for both, but is taking double the prescribed dose of Adderall. Whenever he goes out, he also caps it off with Soma, which he gets from his friend Sam for $2 a pill. “It just sharpens my senses somehow,” he says. “It makes me able to talk to people and then not take rejection too hard.”
I ask him if he really feels like he’s getting constantly rejected when he doesn’t take pills.
“I don’t try without them, that’s the thing. If you don’t try, then you can’t fail, right?”
The night after our last phone interview, I got a series of texts from Elliott. I knew he had been speeding hard on several Adderalls when we’d spoken earlier that day, and on top of that, he texted me that he had just drunk an entire bottle of Robitussin and taken a Tylenol 3 (the kind that contains codeine). I’m rubbing God’s belly, he wrote.
I tried to convince him to stay with his friends and not go off by himself, but he was insistent on going home to listen to Velvet Underground alone. We texted throughout the night; I was terrified he was going to overdose. But by the next day he was fine. It had felt like he had been reaching out to me, and I remembered something he had told me the day before.
“I think I have the emotional response of a serial killer,” he’d said. “You know how they say they kill so they can feel something? It’s like that with human relationships for me.”
Elliott wants desperately to connect with someone so he can feel. He can’t connect with someone unless he’s on pills, but when he’s on pills, he doesn’t care about anything. It’s a vicious circle, and in his case, one that is still in continuous motion. The last I’d heard he had taken to snorting Imodium to get high. Apparently he read somewhere online that it was possible.
A few months after Emily and I returned from Ohio, Jess left her for another woman. She was totally blindsided. Even though it had been a long-distance relationship, it had felt solid to her. She’d known him since college, and during our trip they’d started talking marriage. But almost as soon as it was on, it was off. He ended it over the phone.
I went to her apartment the day it happened. A few of her other friends were there consoling her too, so I palmed her a Dilaudid and she smiled gratefully and disappeared into the bathroom for a moment.
Pills, in a way I hadn’t even realized, had primarily defined her relationship with Jess. Emily and I had both retreated so deeply into our own heads that there wasn’t much communication going on between us anymore. She was the female me. She was high every time she had been with Jess, on hydrocodone provided to the two of them by Julia and morphine provided by me via Candyman (morphine had become my latest favorite, and I’d wanted to make it hers, too). Whenever Jess had come to New York to visit her, they’d take pills straight away, splitting an 80-milligram morphine, the effects of which would last about two full days. They would stay in bed the entire time, their pupils too pinpointed to face the outside world. Appetites nonexistent and muscles limp.
“Believe me when I tell you that at the time, it felt like we w
ere the only two people on Earth,” she tells me now. “We were on the edge of something—maybe it was death—but it felt bigger than us and we were humbled by it. When we took away reality, essentially, that’s when he could love me. Or that’s what it feels like now.”
I can still taste the reckless jealousy at this thought. At no point in my life, besides the occasional nights with Everett, had I had a partner who did pills as much as me and would want to disappear into the fog together.
Before meeting Jess, Emily used to tell her shrink that if she could just fall in love, she wouldn’t need the pills. Of course that was a lie. Our need for pills made us immune to anything resembling real love. All it did was temporarily fill the void, and when the high wore off, we were the same depressed, pathetic people. She would pick endlessly at her spilt ends, and I would stare endlessly at any blank surface I could find.