Pill Head: The Secret Life of a Painkiller Addict (13 page)

Every night, members of the local AA chapters would show up to lead group sessions. “One of them kept hitting on me in this really
pervy way. I was in fucking detox—I couldn’t believe he didn’t have any other available choices,” she says.

Heather was also seeing a therapist every day, one she was initially distrustful of, mainly because she didn’t feel like she could trust anyone. But about halfway through the detox, she started to connect with her therapist. At this point she had met so many people who had been inside the detox system and knew how to manipulate it that she realized she didn’t want to be that person.

“This was already my second time in, and it just hit me that if I kept it up I’d be back again and again and again, just like the rest of the people in there. I knew my family didn’t have the money to help me out, and Derek’s family certainly wasn’t going to pay for me to go again. I knew that Derek would leave me if I didn’t start taking this seriously, and then I’d have no one.”

So Heather admitted to her therapist that she had been lying to the nurses. The therapist warned the nurses not to give Heather anything else, but it was a moot point because she stopped trying to get anything else besides what was already being prescribed for her.

At the end of her detox, Heather had the choice either to go back home or to go to a rehab center. Many of the people whom she’d befriended told her she should just go home. “They’d say, ‘Come on, look at all these other people in here. You’re so much better than them,’” she says. “But that was the game I’d been playing my whole life. I knew I wasn’t.”

Heather met with “ambassadors” from rehab centers around the state and selected one that offered morning meditation and yoga. “I was like, that’s the one for me, that’s the stuff that’s going to keep me sober.”

The center was located in Fort Pierce, Florida. “It should have been called Fort Piss,” Heather says, “because it was seriously the armpit of Florida. There should have been an old blues man on every corner, wailing about how horrible life is there. Maybe there are some parts of upstate New York that
might
compare to how shitty and rundown and left behind this town was. The rehab center was in another strip mall, but the living quarters were in an apartment complex called Virginia Gator Park. It was a gated complex, but also a
disgusting nightmare. There was a pool you’d never want to even put a toe into and rows of apartments for the rehab people, right next door to apartments inhabited by drug dealers.”

The yoga and meditation that Heather had been so looking forward to consisted of rising at 6:00
A.M.
, making her way down to the beach with the other patients, and standing in a circle while praising Jesus. “I was furious,” she says. “There was a Jewish guy in the program and he and I just clung to each other.”

Heather resisted the program’s twelve-step leanings every step of the way. But she knew she had to figure out a way to make rehab a positive experience for herself, especially since Derek was begging her over the phone to stay. But her experiences at this particular facility were pretty horrifying, starting with the brutal gang rape of a new patient whom Heather had befriended.

“It was her first day at rehab,” Heather remembers, “and she was being admitted for heroin addiction. There was something about her that reminded me of Janis Joplin and I was just drawn to her. While she was checking into the apartment complex, we started talking and getting along and I invited her over for coffee. I wanted to take her under my wing.”

The apartments in the complex designated for the rehabbers were monitored by what Heather describes as “a group of awesome big fat sassy black ladies, who were really sweet but had no real training.” Their job was to get people settled in their rooms, wake them up in the morning, ferry them back and forth between the complex and the strip mall rehab center, and do random room checks for contraband material.

Heather said good-bye to the new girl, Tina, as she finished her check-in. She noticed some of the local drug dealers hanging out nearby, but didn’t think anything of it. They were always around. After Tina had checked in and was waiting for her room assignment, she was left alone on the porch.

Heather came back after a while to see if Tina had finished check-in so they could hang out, but she was nowhere to be found. Heather asked Missy, the woman who had admitted her, if she had seen Tina, but she hadn’t. After a few hours had passed and there was still no
sign of her, Heather became frantic. She forced Missy to come with her to knock on the apartment door of the dealers she had seen lingering nearby.

The door opened and there were several men inside who claimed not to speak English and shut the door in their faces. They were on the second story of the apartment complex and were standing outside the door when a wayward, flea-ridden, three-legged Chihuahua hobbled up the stairs toward them. The dog’s owner ran up after it and whispered to Heather and Missy that he had heard through the grapevine that the men had a girl inside their apartment. Missy pounded on the door again and yelled that she was calling the police. She and Heather ran to the office to make the call, when the apartment door opened and all the men ran outside, hopped into a van, and drove off. The apartment door locked behind them. When the police arrived, they knocked it down and found Tina cowering naked in the bathroom. She had been raped repeatedly after being lured inside with the promise of a fix.

“It was just this awful, horrible realization that even though we were in rehab, we weren’t safe,” Heather says. “When I got upset about it, one of the counselors made some crack to me about how I must have seen worse on the streets. I was, like, ‘I’ve never been on the fucking streets. My streets were carpeted doctors’ offices with old copies of
Parenting
magazine on the coffee tables.’”

Heather wasn’t learning the skills she needed to live. She began to develop relationships with other patients and tried to help them through their recovery, but she kept getting called out on it from the therapists because she wasn’t focusing enough on herself. She also never got used to the common AA mantra about working the twelve steps: “It works if you work it, so work it, you’re worth it.”

“It was just this dumb cheerleading chant we had to do every morning before going into group therapy, which never even really focused on addiction issues,” she says. “It was more about resolving really fucked-up high school issues, like one patient getting upset that two other patients were sleeping together, because everyone was suddenly discovering their sex drives again after getting clean.”

To make matters worse, the main therapist with whom Heather
had been working, with whom she was just beginning to develop a bond, suddenly had to leave because her son died.

By the time her twenty-eight days were over, Heather was more than ready to go home. Derek flew to Florida to pick her up, but it wasn’t the happy reunion they’d both imagined. Derek was furious to discover that the rehab center was still keeping her medicated. She was taking Cymbalta, an antidepressant, Lyrica for anxiety (which was being prescribed off-label), trazodone to help her sleep (an antidepressant, also being prescribed off-label), and Seroquel to ward off panic attacks (an antipsychotic, once again, being prescribed off-label). She was on more medications coming out than she had been on going in. This is fairly standard with rehab because of the anxiety, depression, or sleeping issues that can arise with newfound “sobriety.” But Derek hadn’t been expecting all these new medications. He associated Heather’s problems with pills, and now she was taking more than ever.

In
High Society
Joseph Califano discusses the biggest problem with rehab facilities: The twenty-eight-day cycle that almost every residential treatment program functions on is not determined by any sort of medical need; it is simply the reimbursement cap set up by commercial insurers. He claims that even higher-end facilities like Betty Ford and Hazelden only have success rates of around 30 percent. Both centers refute that claim and boast much higher success rates, but they also only monitor their patients for one year after leaving.

Heather arrived home with no follow-up therapist. Her rehab center advised her to get a low-stress job (“moron job,” as Heather puts it) when she returned home. “It actually makes sense,” she says. “If I had taken on a stressful job I would have slipped up for sure. I needed to take it easy for a while, let myself be a dummy, because I couldn’t think straight. I couldn’t form sentences, and I had tremors in my hands from the combination of pills I was on. I slowly tapered off all of them over the course of about six months.” During this time, she was under the care of an osteopathic doctor who was monitoring her decrease.

When she was feeling stronger, Heather took a job helping to
run a high-end spa in Manhattan. It was the last time she would slip up. She was stressed and tried to order Xanax online, but Derek had been monitoring her email and busted her. She canceled the order. “I’d been thinking to myself, if I just had one Xanax, I can get through this week. But in reality there is no way: one would quickly become ten. Getting busted by Derek was the best wake-up call, because even after rehab, I don’t think you’re ever out of the woods. Especially with pills.”

She isn’t even sure she would have taken the pills if Derek hadn’t caught her. “I might have gotten freaked out and thrown them away. I might have gotten them and done them all at once. But I think I’m too scared to go back to that lifestyle again, because I know there would be no coming back. Derek would leave, my family wouldn’t help me again, and I would just be alone with my drugs. That’s where any addiction is going to take you.”

For people who don’t
want to deal with rehab, or even just a weeklong detox, there are many different companies in the United States that offer anesthesia-assisted rapid detoxification, AARD, more commonly known as ultra-rapid detox. The person is put under anesthesia and given a medication like naloxone, which strips opiates off the brain’s receptors by shoving them aside and taking their place. Because naloxone is an antagonist, it is drawn to these receptors, but can’t do anything once it gets there. It’s kind of like the situation of a drunken stud who does everything he can to get someone in bed, but is too wasted to perform once he’s actually in the sack.

Patients usually wake up feeling groggy and hungover, but the cravings are gone. The procedure isn’t covered by insurance and can cost anywhere from $10,000 to $20,000. Detractors of AARD argue that patients need a much longer amount of aftercare and therapy, since many are simply released back to their homes after just a few days. And on July 8, 2008, a popular medication used in ultra-rapid detox called Revex (nalmefene) was discontinued by its manufacturer with no explanation. AARD can seem like an easy solution for
people who can afford the process and don’t believe they have the time to go to rehab, but anyone who chooses this method should make sure to have proper aftercare set up, for example, a therapist or regular attendance at NA or AA meetings. Otherwise, AARD seems like an expensive and ineffective way of dealing with the problem. Sure, you won’t suffer the same amount of withdrawal pain, but there is virtually nothing stopping you from going right back to taking whatever it was you were taking before you went under anesthesia.

Caleb eventually cut down
on his daily OxyContin use and saved the pills for special occasions. “They’re just too expensive,” he says. “I can’t afford them.” Now he takes illegally obtained methadone to stave off his cravings. According to the DEA, prescriptions for methadone have increased by 700 percent from 1998 to 2006—just another example of more pharmaceuticals being out there to be diverted. Caleb eventually stopped using the drug dealer who made him drive around to different places to pick up drugs. “If he’s not on crack, then there’s something seriously wrong with him,” Caleb says. “He’s just crazy as hell, and it got to be such a pain in the ass picking him up in the heart of the ghetto, then driving around to find some other person that he has to hassle with. The guy I use now is just a godsend.”

And, apparently, the dealer believes that himself. “He comes to town three times a week,” Caleb says. “He drives around in this giant old green Cadillac convertible, blasting this Christian gospel sermon out of the radio. You know the kind: ‘And the Lord will strike down his enemies,’ blah blah blah. He usually has methadone, OxyContin, and Valium, and he just drives around all day making his deliveries. He’s always glad to see me, and he gives me a preferred-customer status. He’ll let me hold a few of whatever I’m buying until next week, or work with me on pay, or give me an extra pill for free.”

But the Christian hookup doesn’t always work out to Caleb’s advantage, because product availability fluctuates. “Recently he was
out of methadone, and I couldn’t find it anywhere else,” Caleb says. “So I had to take OCs every day just to maintain and not get withdrawals. I wasn’t very happy about it. It cost way too much.”

If I were an enterprising drug dealer with a regular customer like Caleb, I would make
sure
I consistently ran out of methadone and only had OxyContin available. It just makes sense from a business standpoint, especially if you were having a slow week in your other drug arenas. I’m just saying.

Caleb has been on methadone for well over a year now. “There’s absolutely no high to it,” he says. “It just delays my withdrawal symptoms.”

But at this point going off methadone would be almost as bad as going off OxyContin. “It’s just that I never wanted to go through withdrawal in the first place,” he says. “The ’dones are really cheap, it’s been relatively easy to maintain a steady supply, and I’ve been able to delay taking everything out of my system. It’s hard to say, ‘Okay, I’m going to set aside a week when I feel worse than I’ve ever felt in my entire life. I’m going to put aside my friends, my family, my job, everything—just to check out. It’s just so much easier to keep saying, ‘Oh, next week, next week.’”