Pill Head: The Secret Life of a Painkiller Addict

This is why people OD on pills,

and jump from the Golden Gate Bridge.

Anything to feel weightless again.

—THE HANDSOME FAMILY

The medicine cabinet is your best friend.

I don’t call that medicine,

I call it too much of too little, too late.

—HERMAN JOLLY/SUNSET VALLEY

We cannot learn without pain.

—ARISTOTLE

Epigraph

Prologue

1
The How, the Why, and Let’s Get High

2
“I Want Total Sensory Deprivation and Backup Drugs”

3
“I Meant for You to Take One or Two—Not the Whole Thing!”

4
“I Couldn’t Imagine Ever Not Doing Them”

5
“Depression Hurts”

6
“Remember Valley of the Dolls?”

7
“It Was the Worst Week of My Life”

8
“Are We Being Irresponsible?”

9
Heather Hits Rehab

10
Fight or Flight

11
How to Destroy a Doctor

12
Jared’s Turn

13
Hunting and Shutting Down

14
Horror Hospital

15
“All of This Foam Came Out of My Son’s Mouth”

16
Escape to (and in) the Midwest

17
Harm Reduction and the Future of Painkiller Abuse

18
“Boredom Is God”

19
One Year Later

20
Onward

Epilogue

Sources

Acknowledgments

Copyright

I WAS FEELING NO PAIN
.

I cared about nothing but this.

It wasn’t just an absence of pain. It was warm waves pulsating through my muscle and skin. Breathing was hard, my chest felt weighted down by my own rib cage but I didn’t panic because it’s impossible to feel anxiety about anything when every inch of your body is having a constant low-grade orgasm.

I don’t know how long I lay there on my bed, watching the blades of my ceiling fan slowly turn, lazily spinning tufts of dust before they floated down through the air around me like so much gray snow. Through half-lidded eyes I watched Ollie, my cat, go ape-shit chasing the dust balls, and it took every ounce of strength to turn my head toward the other side of the bed. I lifted an arm, ran my fingertips along the wall until they hit the mattress. I studied the blank wall. Its surface was pebbled under the paint. I’d always thought it was smooth. I got a sudden craving for an Orangina and, with a herculean burst of energy, sat up. Ollie freaked at my sudden movement, his eyes bulged out of his tiny skull and he went tearing out of my room in a manic frenzy. I heard him skid down the hallway, claws slipping on wood.

My skin itched. Everywhere. I stuffed my hands down the back of my shirt, pulled up my jean cuffs to get at my ankles, dug around the insides of my thighs. My fingernails sent jolts of red electricity down to the bone, but any discomfort washed away before it had a chance to really set in.

I kicked a pair of flip-flops out from under the bed and left my apartment. The usually harsh, trash-filled street looked soft as a meadow, and the light of the setting sun felt like a warm glow coming from inside
me
instead of the sky. In the bodega I found the Orangina and wandered up and down each aisle three times, picking up a bag of pretzels, putting it down. Opening the freezer, then shutting the door. Mr. Clean and I shared an intimate, prolonged stare. The cashier gave me a knowing smile and handed me my change.

Back upstairs I collapsed on the couch. Ollie dove into my lap, stayed there, warm against my stomach, writhing, trying to get closer. I reached for the TV remote, but it was a good six inches out of my grasp so I gave up. I felt my head roll back and hit the back of the sofa as another wave hit me, then I said out loud to Ollie, to myself: “This is what I’ve been waiting for my whole life.”

Three Vicodin. That was all it took.

I was in love.

In the summer of
2003 my coworkers at
Jane
magazine and I began receiving massive amounts of email spam offering up Valium, Xanax, and Vicodin with “No prescription needed!” I kept hitting delete until the words actually sunk into my brain. It couldn’t be that easy. My own physician wouldn’t even prescribe a sleeping pill for a flight I had to take in the weeks immediately after 9/11. (In his typically reserved way, he told me to practice deep breathing and maybe have a cocktail, but no more than one.) So, strictly in the name of journalistic curiosity, I convinced my editor to let me try to buy these pills online. I wanted to see if it was just a scam or if it really was that simple to get controlled substances without a doctor’s prescription. Everyone in the office—particularly the fashion and art departments—loved the idea
and seemed unusually eager to hear the results. The story got approved as a small front-of-book piece in our pop culture section. Even better, I was given a $600 drug budget, courtesy of Fairchild Publications.

The Xanax and Valium were easy—I just had to fill out an online form. In the section where I had to explain why I needed the drugs, I wrote that I traveled a lot for work and I had a fear of flying. Within forty-eight hours I had two FedEx packages waiting for me on my desk: one with thirty brand-name Valium (the beautifully designed kind with the negative-space
V
in the center of each pill) and the other containing thirty alprazolam, the generic equivalent of Xanax. The two lots ran me $312 together.

The Vicodin order included an extra step: one of the online pharmacy staff doctors was going to call me for a consultation. I was also supposed to provide a phone number for my primary physician. I gave them a fake doctor’s name and an unused telephone line at my office.

Their “doctor” called me first thing the next morning. The conversation went like this:

“You called to order Vicodin?”

“Hey, yeah, I, um, just had my appendix removed. I don’t have insurance and your Vicodin prices seem pretty cheap.”

“Yes, we do have good prices. We’ll send it right out. Do you want thirty, sixty, or ninety?”

Ninety, of course. And it
was
a good price, only $223.

The third package arrived the next day. I wrote up a quick 250-word blurb about how frighteningly easy it was to order meds online, making a joke about slurring my words a lot ever since, and took the bottles home. It was a Friday, and they might have remained in the bottom of my underwear drawer forever if I hadn’t received a frantic phone call from my editor around 8:00 p.m. I panicked when I saw her number on my cell phone screen, thinking that something disastrous had happened at work, especially since I knew that she was supposed to be at her place on the Jersey shore that weekend.

“What are you going to do with those pills?” she demanded as soon as I picked up the phone.

“I don’t know,” I said. “Give them away? I hadn’t thought about it.”

“I spent the entire train ride out here imagining you facedown on the floor somewhere,” she said. “I can just see the headlines now: ‘Magazine kills editor.’ It’s the last thing we need.”

It was nice to know where I stood in the scheme of things.

“Don’t worry, I’ll get rid of them,” I said.

“Promise?” she asked. “Flush them down the toilet.”

“Yes, I promise,” I sighed, but it was already a lie.

I have a problem. When someone tells me not to do something, I immediately go out and do it. It’s an anti-authority streak that has been in me pretty much since birth. It first reared its head in my Montessori school when we grew a large crystal made from Epsom salt on a string. We were told not to touch it, but it ended up in my pocket. When it was discovered missing we all had to sit in a circle on the floor and received a stern, yet oddly sympathetic speech (a trademark Montessori method) about stealing. Our teacher told us all to reach into our pockets, see if it was there, and come clean if it was. I slipped my hand inside my red Garanimals shorts and felt the smooth sides of the crystal, with its comforting, sharp points. I kept my hand tightly clutched around it. It was mine now.

When I hung up with my boss, I pulled the bottles out of my bag and stared at them. The labels were pathetically generic and looked like they’d been created on a typewriter. The originating pharmacies were located in Florida, Arizona, and Colorado, and the addresses felt strangely cold: for some reason “Florida Drive” just screamed unmarked storefront with the blinds closed shut, located in a partially deserted strip mall, an empty soda can rattling around the parking lot, pushed by the wind.

The Vicodin bottle was fat, almost two inches in diameter. I’d never seen a pill bottle that large. I opened it up and removed the cotton. The pills were pressed together so tightly that when I stuck my finger inside I couldn’t even get past the first layer. They were thick, the size of horse pills, and looked like they’d lodge directly in my windpipe if I tried to swallow one.

I took three.

That night I drifted in and out of sleep, but not in an unpleasant, restless way. It was more like a constant waking dream, and when the alarm went off the next morning I still felt a little high, but not at all hungover. That was all it took to seal the deal—I’d discovered my perfect drug.

I WAS NO STRANGER
to drug use. I was twenty-seven, and pot, coke, whippets, Ecstasy, acid, and mushrooms had been an integral part of my life from age thirteen on. I was an expert at escapism. But as I’d hit my midtwenties, three beers were enough to leave me feeling like hell the next day. Even though I’d been a huge stoner in high school, pot now made me paranoid, silent, and terrified that I couldn’t get enough air into my lungs. A lot of my friends have become unable to smoke pot after they left high school. I think there’s something about being in your twenties and still trying to figure out your place in the world that makes pot just freak you out. When you’re in high school you’re usually too disinterested to care about your future, but suddenly you’re in college and you’re, like, “Oh shit, this is
real
. I’ve got to pay bills!”

I had gone through a big LSD phase during my senior year of high school and my first year of college. My high school grades were dismal and I couldn’t get accepted anywhere except the local community college, where I suddenly started getting straight As, despite tripping my face off for most of that year. For half of it, I lived with a guy who dealt acid out of our freezer, but, like pot, acid lost its appeal once I realized I had to create some kind of real future for myself.
Plus, there was that night when I went with my friend Laura to a club where she was supposed to go-go dance on top of a lifeguard chair. While she was waving her arms around, she and the chair turned into a giant octopus as soon as “Cars” by Gary Numan came on. I was convinced that I had peed my pants in fear because it felt all hot and wet down there. Every time I looked at my pant leg I saw a dark, wet patch, but then I’d look up and see dark, wet patches
everywhere,
on every surface. For the rest of the night I would periodically stick my hand down my pants and then check my fingers to make sure they weren’t wet. The very last time I did acid was, stereotypically enough, at a Phish show some friends dragged me to at the Saratoga Performing Arts Center. At a rest stop along the way my friends bought some acid from some hippies in the parking lot. When they showed me their purchase, I laughed, because the tabs looked like torn-up bits of toilet paper. “You guys just totally got ripped off,” I said smugly. “There’s no acid on these.” To prove it I popped several in my mouth.

Six hours later, as my friends and I sat in the by-then empty parking lot, far too blasted to drive, I became convinced that the harsh concrete beneath us was actually billions of tiny needles injecting our asses with more acid. I swore off the stuff for good.

I’d only tried heroin once, when I was nineteen, and I only did it to impress a boy I thought did a lot of heroin himself. After we both snorted it, he told me that he had only done it because he thought
I
was a huge dope fiend and he was trying to impress me. I liked the warm, melting feeling it gave me, but we promised each other we’d never do heroin again. By that point I had transferred to SUNY Purchase, and in the late 1990s, it seemed like every cute person on campus was using. Heroin lost its appeal after two different girls overdosed in my bathroom, my roommate got kicked out of school for dealing, and a close friend of mine started bringing a vomit bag to class, which she would silently barf into in the back of Sociology 102.

Crystal meth was another drug I tried only once. I will never, ever touch that poison again. I thought it was like cocaine, so I snorted rail after rail at a fake Irish pub on the Lower East Side where a random friend of a friend had offered it to me. I didn’t come down for
three straight days. First I stayed locked in my room, trying in vain to masturbate even though there was absolutely nothing going on down there. On the second day I finally jumped in a cab to see an ex-boyfriend who lived in Brooklyn. He walked me around, got me soup, let me pace around his room, and basically took care of me until I came down. I went back to work the following Tuesday. I was coughing a lot, so I bought some cough syrup. I chugged some just as Jane Pratt, our editor in chief, stopped by my cube to ask me a question. I didn’t know that one of the ingredients in the cough syrup was used to make meth, and the high kicked right back in as she was trying to explain something to me. I just stared and smiled and nodded as she went on, but I could feel that same sick high feeling rushing through my veins and my head felt like it was going to explode. As soon as she left I bolted from the office and ran down to Herald Square. I got through the turnstile and down to the subway platform before I realized that I would seriously lose it if I stayed underground for one more second. So I ran back out into the street, jumped in a cab, went home, and shivered in a corner of my bed until the next day.

I couldn’t understand how anyone could become addicted to meth. It made me feel like someone had taken my brain and obsessively rolled it like a Play-Doh ball with their hands for seventy-two straight hours.

I loved cocaine, but, as with alcohol, my hangovers were always cloaked in a deep depression. Not to mention its physical side effects: my nose would spontaneously leak clear snot for up to three days anytime I went on a binge, which, around the time I discovered opiates, had been pretty much every weekend. On a typical Friday night I’d buy a six-pack of Corona, curl up by myself on my bed with the lights out, turn on my DVD of Rob Zombie’s
House of 1,000 Corpses
, and do line after line of blow while chugging my beer. The film is an homage to 1970s gore and slasher flicks; it’s filled with rapid-fire edits that, when I was on coke, made me feel like I was about to have a seizure—but in a good way. It wasn’t the movie’s violence that pulled me in. With most horror films, I become emotionally invested in the victims. I’m not watching the movie to get off on
gore. I’m watching them to see what extreme survival instincts, albeit scripted and utterly implausible ones, do to a person.

By the time the film was done I’d be in a near manic state. I’d practice a “calm face” in the mirror by relaxing my facial muscles, head out to a bar, meet up with friends, do more drugs, have mindless conversations, stay out till dawn, and stumble home, either with a stranger or alone. I’d pay for the night for the rest of the weekend.

But that was behind me now. On Vicodin I felt fantastic, even when the high was over.

Over the next few weeks, as I began depleting my bottle in earnest, I discovered the other added bonus of Vicodin for me—zero social anxiety. I’d always suffered from a mild form of it, in that slightly paranoid way where you think everyone is looking at what you’re wearing and laughing, but now when I went out in public I didn’t care what anyone thought. Instead of worrying that whatever words were coming out of my mouth were quite possibly the dumbest sentences uttered aloud by anyone, ever, I found myself slipping into conversations with attractive strangers at parties and holding my own. I’d always been shy, which is, weirdly, one of the reasons I had been attracted to journalism and writing: it forced me to talk to people. And since I had a legitimate reason to talk to them, I never had to worry about whether the person I was talking to secretly wanted to get away from me, because even if they did, they’d still have to finish the interview.

I wasn’t alone in my Vicodin abuse during this time. According to the National Survey on Drug Use and Health, in three short years, between 2002 and 2005, the number of Americans using painkillers nonmedically grew by over 3 million people; at last count that total number was 32.7 million. I started noticing certain statistics. For example, in 2004 there were more people in the United States using prescription painkillers recreationally for the first time than there were using either marijuana or cocaine combined. This wasn’t surprising to me at all. Americans take pills for everything. According to the FDA, pharmacists filled 3.1 billion prescriptions in 2003, up 60 percent from ten years prior. Add to that the fact that every year, approximately 15 percent of the top two hundred largest
selling pharmaceuticals are expensive new drugs, with no generic equivalents. Even our own beauty department at
Jane
magazine was starting to tout different pills as an effective way to treat skin problems, rather than creams or lotions. So why not use them to get fucked up too? At different times in my life I’d been put on antidepressants like Prozac, Parnate, and Zyprexa. They did little for my depression, but here was a pill that really worked, one that by curing the physical pain of simply being alive, cured my mental pain as well. Even better, it got me high.

Here’s how. Humans have opiate receptors distributed throughout the brain, with higher concentrations of receptors in areas such as the basal ganglia and thalamus. These receptors are proteins located on the surfaces of nerve cells, or neurons. Neurons communicate with each other by sending out chemical signals called
neurotransmitters.
In the peripheral nervous system, nerve endings that deliver pain signals to the central nervous system are called
nociceptors.
For example, nociceptors in your fingertips might tell your brain that you’ve just touched a hot stove, or that the joint you’re smoking has just burned down to your thumb and forefinger.

This pain signal is regulated by the rapid entry of calcium into the cells through calcium channels, cellular gatekeepers that control the release of neurotransmitters. Calcium channels concentrated in neural (nerve) tissue are called
N-type channels
. Scientists are trying to find new ways to treat pain by targeting these channels. The challenge is to control pathological pain (that is, pain that is not useful in helping a person avoid injury) without the undesirable, yet common, central nervous system side effects of respiratory depression and dependence.

Normally, opiate receptors are activated when your body produces endorphins, which are involved in a ton of normal body functions, such as respiration, nausea, regulation of hormons, and pain modulation. Morphine, heroin, and opioids (synthetic opiates) like Vicodin, OxyContin, and Percocet metabolize into replications of endorphin molecules that fit into pain receptors and flood into your body, making you feel euphoric. These endorphin replications differ, depending on the drug. Vicodin metabolizes into something
called hydromorphone, and OxyContin, a controlled-release formulation of oxycodone, metabolizes into noroxycodone and other metabolites, but for all of these painkillers the end result on your body is similar. Your pupils constrict, your pulse slows down, your breathing becomes slower, and your blood pressure falls. Anxiety melts away and you feel utterly relaxed. Of course, pain goes away too. The reason why opiates can be so addictive is because after the brain starts getting them consistently, it stops producing endorphins on its own.

All of this, of course, depends on a lot of factors. Not everyone’s body responds the same way to opioids. Variables can include age and weight, and in a lot of cases, totally unknown influences or something as simple as a sensitive stomach. I have a lot of friends who can’t stand Vicodin because it makes them nauseated. Other people can overdose and die if they drink alcohol on even one or two painkillers, while a lot of people (myself included) have taken pills as strong as morphine and Dilaudid, gotten wasted on cheap beer and champagne, and woken up fine the next day. That’s not to say it couldn’t still happen to me. It’s a total crap shoot, which makes these pills even more dangerous when used incorrectly.

Regardless of how or where someone gets their first taste of prescription painkillers (through a friend, a surgical procedure, a parent’s medicine cabinet, or, say, a journalism assignment), the one common factor that can contribute to continued, abusive intake is that there’s a presumed element of safety to prescription painkillers that doesn’t exist with any other kind of drug out there, except maybe benzodiazepines like Valium or Xanax.

Even for the bravest thirteen-year-old, smoking your first joint is going to be a little bit terrifying, but that’s part of the initiation, part of the excitement. It’s the gateway to your cool older sibling’s life or your foray into the bad kids’ world that you’ve always looked at wistfully from afar. But with pills, you know that somewhere down the line, it came from a doctor. A safe, kindly doctor who knew just what you needed and would never distribute something that could potentially hurt you.

During my years of pill abuse after that initial first bottle, I knew
I wasn’t alone in my use, so I didn’t feel much shame. All I had to do was turn on the TV or go to the movies to see that everyone else was doing it too. The media hadn’t dubbed us “Generation Rx” for nothing. In the American remake of the Japanese film
The Ring,
the doomed private-school girls in the opening scene aren’t looking to raid the liquor cabinet when their parents aren’t home—they just want to know where the mother hides her Vicodin. On the television series
House
, the brilliant doctor saves life after life while popping loads of Vicodin. The awesomely trashy ladies from
Sordid Lives
are downing Valium in practically every scene.

Pill use is a ubiquitous element in celebrity tabloids too. Witness Winona Ryder’s inexplicable shoplifting spree in 2001: she was busted with several illegal bottles of prescription painkillers. According to
USA Today,
she had used six different aliases while seeking prescription drugs. She had thirty-seven prescriptions filled by twenty doctors over a three-year span, a method known as “doctor shopping.”

Mischa Barton’s younger sister has checked herself into rehab for painkiller abuse, as have Robbie Williams, Matthew Perry, Melanie Griffith, Jamie Lee Curtis, Charlie Sheen, and Kelly Osborne, just to name a few. Conservative kingpin Rush Limbaugh was booked on charges of doctor shopping for his Vicodin addiction. When Nicole Richie was arrested for driving the wrong way on the highway in Burbank she admitted to police that she had taken Vicodin that night (citing menstrual cramps). For a while, Lindsay Lohan’s own father wouldn’t stop talking to the press about his famous daughter’s addiction to painkillers. And because the autopsy report showed Heath Ledger’s death to be an accidental combination of oxycodone, hydrocodone, diazepam, temazepam, alprazolam, and doxylamine, the specter of pills will unfortunately always hang around his name.