Drugs

by J. R. Helton

  “Jake? Jake, you need to get into bed.”

  “What happened?”

  “I don’t know. You just passed out but you were standing up. I don’t know why you didn’t fall down.”

  “It’s that Xanax. That shit really works.”

  “You’re not supposed to drink with it,” she said and helped me to her bed. I wasn’t supposed to mix four hydrocodone with it either but I didn’t mention this as she didn’t know how much I took and respected my privacy with most all drugs anyway.

  So I took a chance with Dr. Garza, and he gave me a thirty pill once a day half a milligram script of Xanax in addition to the two 10/500s of Vicodin a day. Just before I left though, I found out he was no sucker as he told me first to be careful with the Xanax, that they snuck up on people, and second, that I would have to come in to see him every two months for my refills. This gave him a thirty dollar co-pay each time from me and another hundred bucks or so from the insurance companies, or whatever he could wrangle out of them. My insurance plan’s co-pay had me spending another ten bucks to fill the script, so I was looking at, coupled with Dr. Kungwale, about twenty bucks a month at the pharmacy for one hundred and twenty of the strongest Vicodin, which sold for maybe four bucks a pop on the street if you were stupid enough to sell them. I was feeling good, doing these calculations in my head, when Dr. Garza put a form in front of me to sign.

  “What’s this?” I asked.

  “All of my regular patients who take narcotics have to sign that release,” Dr. Garza said, making light of it.

  I hesitated, reading it. The form said I would not go to any other doctor besides him for this medication, that I would not take more than prescribed, that I would submit to a random drug test, as well as more restrictions that, if I broke any of them, would force me to go into a rehabilitation program. If I broke one of the rules after that, I could face charges.

  “Don’t worry,” he said. “I’m not accusing you of anything. This is mainly just to cover my ass as a doctor. They’ve got some physicians on San Pedro, these little clinics over there where people end up lining up around the block to get narcotics. They busted a doctor over there last year with 50 drug addicts filling up his tiny little waiting room. The cops finally figured something was up, you know? This little old doctor and he’s got lines of people around the block?” He laughed.

  The guy was good. He’d sprung this on me at the last minute after writing me both scripts that were in my hands already. He knew I probably had some real pain from examining me and the story I’d given of my injury, but I had yet to show him my MRI for some reason so he was letting me know I could easily just be another drug addict liar looking for a legal high. To split now would be a dead giveaway so I signed the form and figured I’d take my chances.

  -13-

  Once you take opiates for an extended period of time, most other drugs fall by the wayside. There is simply no comparison to the opiate high. The body relaxes completely. You truly have no worries, no anxieties whatsoever, as long as you are under the influence of the drug. The mundane daily realities of life no longer bother you, and they can even take on a special happy significance. And most importantly, you yourself feel physically pain-free, confident and happy, ready and capable to do whatever task is necessary. Or you are simply content to lie in your backyard hammock for two hours straight, staring up at the bright green hackberry leaves moving slowly in a warm summer wind. In my case, it was just to kill the physical and psychological pain of getting through my job every day. I had my setup with two doctors going at two different pharmacies but I didn’t like the fact that I could get in trouble for this. Also, by taking four 10/500s a day now, consistently, week after week, month after month, year after year, I was developing a mild tolerance to the opiate’s effects.

  They wore off quickly now, so I began to just chew them up and swallow them to get the drug into my system faster. I had also begun to take two of them at a time, as when one pill wore off, I not only lost my moderate, invigorating, everything-is-gonna-be-okay buzz, but my back would also begin to throb. Even worse, the chronic joint pain in my knees, hips, and shoulders, which the hydrocodone had masked, had suddenly become noticeable to a new and uncomfortable degree once the medication wore off. Besides my back, these were just the average aches and pains of an aging once active man, but the Vicodin covered them up so well that I felt young again, able to do more physical activities and exert myself at a level I had lost years ago.

  Like most modern Americans, I had been conditioned to seek immediate satisfaction, to get on demand whatever I’d been pre-conditioned to believe I desired. This was my god-given right as a citizen, a part of my “freedom” to get whatever my senses told me I needed. I always wanted more of any drug I had ever had on hand. Conversely, whenever I did have a decent backup supply of any drug, when I really knew I wouldn’t run out of pot or alcohol, it never failed that I would then smoke and drink less, content to know that it was simply there if I ever needed it.

  This concept is much different with opiates. When one does become dependent—that is, you are still functioning well at your job and in your personal life—it means you still need to have whatever set amount of the opiate you were already taking on a daily basis, no longer so much to get high as to maintain your daily routine. This is probably the number one reason never to use any opiate to excess. In my case, four pills a day still killed my pain, but they only got me vaguely high. By the time I took the last one in the evening, I needed alcohol to increase or prolong the feeling of soft euphoria that Lortab gave me to get through another night. Soon, after taking my four pills so quickly every day in order to get through the soreness of standing at my lectern for several hours straight, or sitting hunched over my computer for hours, or to be able to give the same lecture six times in a row, I found myself exceeding my ration again, taking even more hydrocodone in the evenings to feel pain- and boredom-free.

  I wanted more. I went to the Internet and found a number of pharmacies that worked as intermediaries with foreign countries. A lot of these companies operated out of Florida, a huge passageway for drugs into America. With relative ease, I found a fairly “reputable” online doctor consultation and drug supplier service. The way the gig worked was you filled out a form, promised to be eighteen, an adult, and then you sent in a copy of your latest medical records from just one doctor’s visit for your condition within the last six months or so. A doctor supposedly looked at them and then called you at home and did an over the phone “checkup” and then wrote you the script for his cut of the take on the drug deal. I simply used old records from visits to Dr. Kungwale since he seemed like more of a desperate low rent doctor who really needed his pill popping clients to keep him going.

  I also gave the online drug company Kungwale’s old office number for a doctor contact as Kungwale had recently been booted out of his partnership with Dr. Christianson on San Pedro. He was working out of an old abandoned bank building on the edge of town with even fewer clients. Like Dr. Garza, he was still insisting I come in every two months for my refills and a checkup to get even more money out of my insurance company and me. This checkup mainly consisted of Kungwale asking me about my writing or telling me about his desire to be a writer. I listened and smiled, told him he had some great ideas, and got my script. Garza’s checkup involved me touching my toes once, walking on my heels, and that was it.

  With my Internet connection, once I had my records on file, I was able to score another ninety Watson 10/500 Vicodins a month. Of course, the Internet drug companies were also running a medical con, but they stayed just a step ahead of the federal government and existing laws. They charged a lot of money, ten times what I paid for Xanax (for which I also got an online prescription based on my first Garza visit). The Internet hydrocodone came as a Watson Vicodin, which was only listed at fifty bucks on the site. It was the doctor’s consultation that really stung yo
u, with a charge of 100 to 150 bucks for a thirty-second phone call. The good news was that once you were in the system with a consultation, you didn’t need another one for six months or so, and then, they’d ask you to fax in the new records from just one real doctor visit and you could start again. When you talked to these doctors on the phone, they either sounded high themselves or simply very harried, trying to just get through the drug deal as quickly as possible. Between the three doctors, I could now take seven pills a day if I so chose.

  At first I merely hoarded them, satisfied just to have more than I needed. I still took what I felt was a safe, self-monitored dosage of four a day, and that was sufficient to kill my back and joint pain and give me enough enthusiasm to pretend to care about my day job. That dosage left me a small yet growing backup supply if I ever needed more or if something happened to my connections. The last had become a constant thought now on my mind, really my only worry: what if I run out? I was becoming completely psychologically “hooked,” as well as physically dependent on the drug, and now I definitely felt the pain and discomfort of withdrawal whenever I made the choice to cut down or stop. It is always easier of course not to stop, just as it is always very easy to find another reason to pop another pill.

  Soon, I found myself delving into my “backup” supply every day, to pop an extra HC to go to a party I didn’t want to attend to make it more interesting, or pop an extra pill if I had a function I did want to attend to make it more interesting, or pop an extra pill if I had a bad day, or pop an extra if I had a good day, or pop an extra if I had to simply mow the lawn, now taking me up to exactly what I had at seven 10/500s steady, a day. Just one of these pills would knock a new user off his or her feet for hours. I gave Patricia one of my 10/500 Lortabs one afternoon after she complained about having hurt her neck at work. Before I could tell her to stop, she began to chew the pill up, as that was what she’d seen me do. Within fifteen minutes, she could barely hold her head up, and I took her to the couch where she immediately fell asleep for hours.

  Cocaine and speed have more devastating long-term as well as short-term effects on the body than opiates. The former wear out your metabolism more quickly than heroin, Oxycontin, Vicodin, or any generic hydrocodone, all of which slow down the body and mind; your breathing becomes shallow and slow, your intestines proceed at a crawl . . . But all of this only happens if you take substantial amounts for extended periods of time. Like heroin, one does not get “hooked” on pills with only a few uses. It takes maybe a solid year of steady use to become truly dependent. In the past, where for so many years I had always wanted to go up, now all I wanted to do was go deeper and deeper down. Falling out of my truck with the death wind in my ears after snorting coke had scared me away from any uppers for good. I couldn’t even drink one cup of caffeinated coffee without feeling uncomfortable and getting the jitters (caffeine, yet another legal speed-like drug that is being used even more today by young people, especially in combination with the chemicals in the fairly new “energy drinks,” which are nothing other than a nerve-jangling, sleep-depriving upper).

  If you have a habit, the amount of opiates you consume over time makes a big difference, mainly when it comes to the euphoric high and then the withdrawal. Thus there is probably no real “safe” dosage of Vicodin for many people, except for short-term pain treatment. Most people who’ve taken opiates for a substantial length of time, even those who experience legitimate chronic pain, begin to rationalize in order to take more. Rationalizing, besides the initial drug acquisition con, is one of the pill addict’s greatest skills as your mind is slowly altered by the pleasure the opiate provides, the bliss, relief, escape. If you’re not careful, before you realize it, the drug is whispering in your ear, making you say or do anything in order to keep it in supply to the mind and the body. Heavy duty heroin or Oxycontin or Vike addicts who try to get clean oftentimes end up on anti-opiate antagonist drugs like Suboxone or Subatex instead which are alternatives that I would not recommend to anyone. These drugs also give a buzz or high to the clean, non-opiate body system, engender dependence, and the user may need them for the rest of his or her life just as they needed the original opiate to feel normal. Like methadone with heroin, or heroin which was initially supposed to be the cure for the “soldier’s sickness,” that is, civil war veterans addicted to morphine, the cure for the initial drug dependency can be even worse and more difficult to quit than the original drug.

  If you do become dependent, you can plan on taking the opiate for the rest of your life, a sobering thought, but one that is actually okay as long as your dosage doesn’t increase and your supply is maintained. Regardless, no matter what, you will build up a tolerance. This is not subject to debate, just simple chemistry; the physical laws of science. Even if you do have the willpower to somehow resist the pleasure of your prescribed amount, once you’ve become truly tolerant, you will either want or need more. Most of us don’t have such willpower to resist this want, the desire for more. Most of us would be stuck on the Island of Lotus Eaters; we don’t have the strength. We are weak and can’t withstand the powerful mental and physical pull of the opiate. Like nicotine, since the cravings are physical, they run deep, throughout every part of your body and mind, every cell in your body.

  Because I had been taking six a day for years, even when I tried to cut down to just three again, I would begin to feel the lousy side effects of withdrawal: the diarrhea, the stomach cramps, the depression, the nausea. When they kick in, they will make most anyone take a pill on hand and chew it up to stave off the symptoms. Four pills a day had me floating on a cloud of energy and happiness for over a year, but soon I needed six for the same effect. Because I didn’t space these pills properly, one every four to six hours, I began to go through the beginnings of withdrawal almost every morning now on campus.

  I started with a nine o’clock class on Mondays and came to work early for the inevitable onset of morning diarrhea and cramps. I had this down to a science on campus and was able to find a close and rarely visited bathroom on the top floor of a near building to try to have some privacy. The bottom floor bathrooms that the thousands of college students used on a daily basis were foul smelling places that made me want to gag just walking past them, the smell of feces and urine emanating out into the hallways for yards. Fellow professors mainly used the same top floor office crappers as me. Even though their numbers were smaller, it was a foul, noxious, olfactory killing experience to have these professors next to me. I began to stuff toilet paper into my nose then as I sometimes had to endure two or three professorial shits in the stall next door during my extended cramps. I also noticed that at six pills a day, the constipation that accompanies any opiate use had caused me to develop hemorrhoids. I noticed large clouds of bright red blood now filling the toilet daily, like a feeding shark in the water. I began to get dizzy and tired easily, which worried me enough to mention it to Dr. Garza, who sent me to my gastro guy, who sent me in for a colonoscopy, which ended up telling me that my colon was great and I had fucking hemorrhoids, 1500 bucks later. I also asked my old office mate, Bill Johnson, about the bleeding.

  Bill used many more opiates than I did. He said that the bleeding was nothing and called me a “baby” because I took so little Vicodin and still complained, mainly about this one side effect of constipation. Bill was about sixty or so and had had a number of very serious, life-threatening illnesses. His back was much worse than mine with many surgeries behind him. Though some said he was something of a slacker as a professor, I liked the man. He was a huge, black-bearded, barrel-chested person with a dry sense of humor; he looked exactly like Bluto from Popeye. He was very quiet; we could go days, weeks, sharing an office without talking to one another. He was the perfect office mate for me.

  For his many injuries and illnesses, Bill took something like six 20 to 40 mg Oxycontins a day, a true hardcore addict who wouldn’t shit for a month. He gave me just one of his 40 mg Oxycontins one
day and it knocked my socks off. I was itching and scratching and floating like a real H addict for hours. It was close to the same feeling I’d had when first smoking heroin in high school, or that very first Lortab I’d taken. Bill was eventually forced to kick because of complications with his heart, that is, it was failing. The last time I saw him, he told me (speaking more energetically than I’d ever seen him), that a specialist had put him on Subatex, the opiate antagonist, which he said was merely an okay if not worse substitute for his Oxycontin habit. He said he became violently ill from the transition, throwing up for twenty-four hours straight during the switchover. Worse though, his pain—very real, chronic, and constant physical pain—had returned.

  It is often in the nature of the opiate user to be a liar. You lie to your friends, your family, and especially to yourself as your “special time” with the drug becomes the most important part of your day until you develop a tolerance and are fucked, getting little pleasure or pain relief. Worse, if you are truly dependent, when you do cut down or even quit, sober life takes on a flattened out quality upon return. Though you realize you have more energy and clarity of mind, life itself seems to be missing something special; a dull filmy veneer upon one’s perception that seems to last in correlation to the amounts ingested and the duration of time of their use.

  -14-

  Within a couple years’ time, I was beginning to lose some of my usual self-imposed control, I was tearing through my 180-pill-a-month supply and running out by taking eight or ten, twelve, fifteen 10/500 Lortabs to get through the day. I often forgot how many I’d taken. The opiates were also leeching out of my system regularly at about four am which caused me to toss and turn and sweat and get the “jimmy legs” to a much greater degree than the ridiculously titled Restless Leg Syndrome advertised on television as yet another new symptom or “illness” for which to take state sanctioned drugs. As a child and a teen, I had a problem with restless energy in my arms and legs, but healthy exercise was all I needed to get rid of it then and now. The jimmy legs of withdrawal were different and the constant kicking and twitching was driving my girlfriend Patricia nuts to the point that either she or I went downstairs to sleep. One of the side effects of opiate withdrawal is also severe insomnia, along with your limbs jerking, your intestines twisting, the muscles, ligaments, and bones all churning and pulsing to push out past your flesh.