Pill Head: The Secret Life of a Painkiller Addict (3 page)

In order to market the drug, Purdue targeted thousands of private-practice doctors and invited them to all-expenses-paid seminar weekends in warm locations like Florida and California to talk about pain management. The seminars stressed treating pain with their product, unfortunately a standard practice among some drug companies.

When the FDA approved OxyContin, Purdue’s biggest painkiller was MS Contin, a controlled-release form of morphine. But there was resistance to treating chronic pain with morphine. It’s a very strong narcotic derived from opium with a lot of stigma attached to it, and it wasn’t too popular with doctors because of its potential for abuse. But OxyContin was a
synthetic
(man-made) form of morphine called oxycodone, and that somehow made it all right.

Like MS Contin, OxyContin is a controlled-released formula, so it lasts for twelve hours. Another advantage was that doctors could increase the patient’s dosage over time because the drug didn’t contain acetaminophen, which in larger doses can damage the liver and cause gastrointestinal bleeding. The FDA approved OxyContin for people with moderate to severe pain that went on for more than a few days. It’s most often prescribed to people with severe pain brought on by cancer, a prolonged surgical recovery, or chronic pain syndromes, such as back pain.

What was quickly discovered was that if you chewed the tablets or crushed them and either snorted the powder or injected the dissolved product, the time-release aspect of the pill was destroyed and what you got was the full effect, all at once. Meaning you could get a giant rush similar to the effect of heroin, rather than the longer-lasting, gentle rolling waves of pain relief. No one is exactly sure how people got the idea to crush the tablets. But it’s standard practice that if there
is
a way to abuse a drug, drug addicts will find it.

The U.S. Department of Health and Human Services has admitted as much:

It’s debatable whether painkiller junkies got the idea to shoot the drug just by reading the label.

Caleb’s first steady OxyContin supply—those friends of friends who were robbing the trucks that delivered the drugs from the manufacturer to a supply center—came from another fairly common form of diversion. The DEA recently handled a case where a group of thieves stalked the driver of an eighteen-wheeler as he left a drug manufacturer. They followed the truck, and then waited until the driver pulled into a truck stop. There is no official requirement for pharmaceutical companies to use GPS systems in their trucks, but many do so anyway because of the high value of their product. Sometimes they will place it with the truck, sometimes they will place it with the drug load. In this particular case, the thieves were smart enough to know about the truck’s GPS device and disabled it. But they weren’t sure if there was another one in the load, so they separated the trailer from the cab and parked it a few miles away in a vacant lot and left it there. The plan was to wait a few days to see if the cab was collected, and if not, make off with the haul. But before this happened, another trucker noticed the cab just sitting in the lot and called the police. Too bad for the thieves—the load was 16.6
million
hydrocodone pills. The DEA believes the robbers had no idea just how large their haul would have been.

Caleb’s friend who knew the guys who were robbing OxyContin delivery trucks kept up a successful diversion business for about eight months before it all came crashing down, though not through a typical bust. The man who was in charge of distributing the pills to buyers overdosed on methadone in Caleb’s friend’s house. Someone
called an ambulance, but in his panic stupidly warned 911, “don’t bring any cops.” So of course the police showed up, searched the house, and found guns, $14,000 worth of marijuana, a hundred methadone pills, and tons of drug residue.

“He got locked up in the harshest of prisons,” Caleb says. “He was the only white kid there, he went through withdrawal there, and I know he got fucked with. I don’t know what eventually happened to him. But all I could think at the time, was, ‘Damn, that was our hookup!’”

After the bust, Caleb got sick from Oxy withdrawal too. Since opiates stimulate the endorphin receptors in your brain and curb the release of the neurotransmitter norepinephrine, withdrawal symptoms are brought on by a surge of norepinephrine in the brain. (Most attention deficit disorder drugs, like Ritalin, are designed to
boost
norepinephrine and dopamine in a person’s system.) But in an opiate user going through withdrawal, this norepinephrine surge can cause agitation, nausea or vomiting, abdominal pain, diarrhea, insomnia, increased blood pressure, and sweating. The first time I went through withdrawal it just felt like a bad cold. I was able to drink it away with hot toddies. By the time I was several years into my use, withdrawal became a full-on muscle spasm on the floor situation. But most people report feeling like they have the flu mixed with a crippling depression, muscle spasms, and, at least for me, the sensation that a razor blade is scraping away at your bones.

“But the withdrawal only lasted for a few days,” Caleb says. He didn’t consider himself to be addicted. Neither did I, in the beginning.

These days, pain specialists continue to feud over the distinction between dependence and addiction. Some experts believe the word
addiction
has negative connotations and should not be used. Others point out that a person who is physically dependent on a medication may not necessarily exhibit addictive behaviors. Having two terms allows clinicians to differentiate one kind of patient from the other.

The current edition of the
Diagnostic and Statistical Manual of Mental Disorders
, DSM-IV, does not recognize this distinction, however. Unfortunately, this blurring of the line has actually ended up
stigmatizing patients with legitimate pain by encouraging physicians to view drug-dependent patients and addicts through the same lens. The definitions are being reconsidered and may be revised for the next addition of the DSM, which will come out in 2012.

I personally believe that, for the most part, there is a difference between the terms. I define
dependence
as the body’s normal adaptation to repeated dosing of a central nervous system medication. It’s an expected pharmacologic response characterized by increasing tolerance over time and by withdrawal symptoms if the drug is withheld. I define
addiction
as the compulsion to continue taking a drug despite the negative consequences of doing so. Addiction, which seems to have a genetic component, is characterized by an escalating loss of control as physical tolerance develops.

My own body is a perfect storm of these two situations. Addiction, as it’s described above, runs deep in my family on both sides. But I never became dependent on any of the substances I’d abused in the past until I discovered painkillers. That’s when addiction and dependency met inside me, becoming the chemical equivalent of Sid and Nancy.

But there will always be room for exception, and Caleb’s case is a prime example of why this feud between pain specialists exists in the first place. After he went through withdrawal, he could go weeks without physically needing pills, but he was
always
on the hunt for them.

“Once the withdrawals were over I started asking around at parties to see if anyone was holding,” he says. “But when that didn’t pan out, a friend and I decided to take a trip down to Tijuana to see if we could score there. I was on a mission. I at least had to find some Vicodin, if nothing else. I didn’t know anyone who had bought pills in Mexico before, but I heard that it was possible.”

Officially, narcotic drugs are also classified as controlled substances in Mexico and require a doctor’s prescription. But that didn’t stop Caleb.

“We drove down, parked in San Diego, and walked across the border. We got a beer and I noticed that there were three pharmacies on every block. So I walked into every pharmacy, one by one, and said,
‘Yo necesito OxyContin, Vicodin.’ And they all said, ‘No, no, no.’ Then like, after the twenty-fifth pharmacy, they were like, ‘Yep.’ They sold me eighty-milligram OxyContins for $40 a pill. We bought thirty, and after that, started making regular trips down to TJ.”

Caleb started a tradition with his Tijuana trips. “My friend and I would always go to the pharmacy first,” he says. “It was so easy to buy. I even asked them once if they were scared of the cops, and they’d flat-out say no. After we’d scored, we’d go have a taco and a Corona and snort one pill to make sure we had a nice buzz going for crossing back over the border. Going in was never a problem—they don’t give a shit what goes on there. All the security is coming back out. We kind of felt a little like James Bond, keeping the drugs hidden in our socks, going through the checkpoints, answering questions. But it was scary, too. Mexican prison is about the scariest thing I can imagine.
Any
prison is the scariest thing I can imagine, but a Mexican one would be worse. My life would be over.”

Since walking back over the border to the United States always took longer than coming in (about an hour and a half on foot), Caleb and his friend found a quicker way to get across. One day, when the line stretched on forever, it was going to take them about five hours at least to walk it. “We were shitting ourselves,” Caleb says. “Then we noticed these people riding little children’s bicycles alongside the line. The cars were on the left, the sidewalk with the huge line was on the right, and in between we’d occasionally see someone ride by on a tiny pink bike. So we traced the path backward and found this little bike stand where you could rent a little girl’s bike for $5 and skip the whole line. There was a person on the other side of the border who would collect the bikes once you crossed.” Caleb’s friend, who was six-foot-four, got the smallest bike of all, one that still had training wheels and ratty old streamers spilling out of the handlebars. The two of them whizzed past the line, high out of their minds under the Mexican sunset, cracking up the whole way.

AFTER ABOUT SEVEN MONTHS
of taking Vicodin steadily, I quit my job at
Jane
and moved upstate to work on a documentary series for the Sundance Channel about transgender college students, called
TransGeneration
.

When a heavily researched story I wrote about the subculture of death fetishists, people who make fake snuff films, was killed (heh) for being too controversial (despite being photographed by legendary photographer Stephen Shore), I decided I wanted to turn it into a documentary. I teamed up with a director and used my original resources and contacts in the death fetish community to create a fifteen-minute trailer that we shopped around, to no avail. It was deemed, pretty much all around, that the subject of sex and death together was just too dark. But on the basis of that trailer reel, I was hired as a field producer on
TransGeneration
by one of the production companies we had sent the project to. Basically, this meant that I collected raw footage of our subjects to send to the director in Los Angeles.

On December 23, 2004, I moved to Hudson, a small town about 120 miles north of New York, with the idea that I would drive to Northampton, Massachusetts, whenever we had to film. I slowly
tapered myself off pills and went through minor withdrawal for about a week, but I drank heavily every night to get through.

I was also reeling from a brutal breakup with a guy named Joey whom I had fallen hard and fast for. He was best known in my circle of friends for burning his own initials into the inner thigh of a male fashion assistant at
Jane
. He was bearded, with a hairy chest and a penchant for wearing a raccoon tail from one boot. He was kind of evil, and I was insanely in love before finding out that he already had another boyfriend he had been keeping a secret from me. I was determined to use the isolation of a small town to clear my head and get over Joey.

I was 100 percent pill-free for the entire shoot. I was excited about getting to work on a documentary and I didn’t want to mess it up. Without pills, my shyness had returned, but again I was able to fall back on the excuse that my subjects had to talk to me, since they had signed on for the project.

After we wrapped up shooting for the year, there was nothing left for me to do in Hudson. I suddenly found myself out of money and working as a landscaper, literally shoveling shit into the lush backyard gardens of mansions in Dutchess County. I actually really liked the hard labor, but loathed the class issues it was bringing up for me. Whenever some fabulously wealthy housewife would come out and yell at me that I’d accidentally ripped out all of her rare, hybrid perennials instead of the ragweed, I wanted to scream, “Fuck you, I’ve interviewed Patti Smith!”

It was time to get back into publishing.

My apartment on the Lower East Side was still being sublet by a friend of mine, so I ended up temporarily moving into a room in a house in Bushwick, Brooklyn, with a girl I knew named Zoe, a tattooed lesbian who worked at a sex shop. I didn’t have a job lined up yet, but I’d been commuting down to the city from Hudson and going on interviews at various magazines. I had about enough money saved up to last me one month in New York.

I called the entrance to my new home the Tunnel of Terror. From the street, the row house looked like any other Bushwick building—wan yellow aluminum siding, bars over the windows, trash strewn
among small patches of weeds trying to break through the concrete sidewalk. You had to avoid piles of feces, some of which looked disturbingly human.

Our place didn’t have a typical front door; instead, a six-foot-high wooden box jutted out into the street, creating what looked like a small outhouse. You entered through that door, and found that the additional space where the sidewalk should be was an enclosed garbage room, the smell of which was your normal rotting food stench mixed with heavy top notes of baby diapers. There was another door four feet ahead, which led to a basement tunnel that stretched into darkness when the overhead lights were burned out. But sometimes the dim bulbs worked fine, providing enough light to watch four-inch cockroaches and rats the size of a cat part like the Red Sea as you walked through. The hardest part was getting to the end of the tunnel, where there were four concrete steps leading up to a heavy metal back door. The ceiling was so low that no matter how far down you stooped, the top of your head always grazed the exposed beams above. If you were lucky you’d just get a tiny bump. On bad days you ended up with a spider or a roach hitching a ride in your hair.

The door opened up onto a cement garden courtyard and a free-standing, three-story house smack in the center of the block. From the street, it was hidden from view. My new roommates had planted morning glories at the base of the fences that separated us from our neighbors’ backyards, and several plant boxes held tomatoes, basil, and mint. There’s no mistaking the industrial feel of a garden trying to grow in Bushwick, but the added green against the stark concrete ground made the journey through the Tunnel of Terror feel like a test of strength to reach Nirvana. There were two other people living in the house, along with two dogs who would constantly play in the cement garden. I wasn’t worried about my cat Ollie getting along with the dogs, since he’d always been pretty dominant.

On my first night in the new apartment, I was feeling nervous after being gone so long from New York. I knew that Zoe had recently recovered from a nasty bout of stage 2 Hodgkin’s lymphoma, so I asked her if she had any Vicodin or other painkillers left over.

“Sure,” she said. She went into her room, came back, tossed me a half-full bottle, and walked out.

I sat on my bed, surrounded by unpacked boxes. It was the Fourth of July and booming explosions seemed to be coming from all directions, making Ollie freak out and cower with me on the bed. I emptied a few pills out of the bottle and rolled them around in my hand like dice. They were generic hydrocodone, 7.5/325 mg. I swallowed them and got to unpacking.

My new bedroom window gave me a view of the Chrysler building. It also looked out over the backyards of the neighbors on the other side of the block. I discovered the next morning that the yard just below my window was full of roosters. They started crowing at four thirty in the morning, and their piercing screeches sounded like they were in the room. Rage seared through me. I fantasized about picking them off one by one with a gun, but later felt guilty because Zoe told me they were being kept for cock fighting, so they were already on their way to a worse death.

While working on getting my room unpacked the next morning, Emily called. She’d made a point of coming to visit me while I’d been living in Hudson, something only one other friend ever did. But that was the point, I had needed to disappear for a while. She was the only one who understood just how badly I had been hurt by Joey and how much I had needed to get away.

She told me she had a surprise for me, and we made plans for her to come over later that evening.

When I hung up the phone I noticed Ollie sitting at the foot of my bed, scratching furiously at his neck. Shit. He’d only had fleas once before, when I’d taken him on a road trip with me down south with an ex-boyfriend. Along the way, we’d stopped overnight and stayed in the basement of a friend. We spent the whole night slapping our bodies every time we’d felt another flea jumping on us from the infested carpet.

I picked Ollie up and ran my fingers through his short curly hair and saw a black wormy-looking bug wiggle away from me. I jumped an inch ahead of it inside Ollie’s fur and it bumped right into my waiting fingernails. I snatched it off him, pinching its head between
my forefinger and the flat surface of my thumbnail. I used my other thumbnail to crush it until it made that horrifying, yet so satisfying “pop” as its body snapped. I knew that wasn’t enough to kill it completely, so I went into the bathroom and poured liquid hand soap over its still squirming body. For some reason, fleas’ bodies can’t take soap, so I went down to the kitchen, filled up a bowl with warm soapy water, and headed back upstairs to my room. Ollie had been following me the whole time. When we got up to my room I put the bowl on the floor, leaned up against the bed, and scooped Ollie up and onto his back. The hair on his belly is sparse, and I saw about six different black dots swarm back into the safety of his longer fur.

I put him back down and grabbed the bottle of pills Zoe had given me, opened it up, took a few more, and got to work.

I scooped him back into my lap and made soothing little noises to keep him calm. He was purring—he thought he was just being held and scratched. I hunted the fleas like big game, stalking my prey, predicting their every twist and turn on his body. Each pop between my thumbnails was my reward. My fingers were covered in flea guts, the bowl floating with dying victims, still twitching as the soapy water finished the job.

My skin started to itch from the pills, a nasty side effect when you’re pulling live bugs off your pet. I was convinced that I was covered with fleas too. I probably was. My sense of failure at protecting Ollie was crushing. Rationally I knew it wasn’t my fault. The dogs must have brought them into the house, and the stairs were carpeted. But I couldn’t shake the feeling that this infestation on my first day back in New York could only be a bad omen.

Emily arrived around 7:00
P.M.
My bedroom was set up, and I’d given Ollie a break for the day after he’d lost patience and started squirming too much. I’d told my roommates about the fleas. They seemed nonplussed but agreed to treat all the pets and call the landlord to get the place fumigated. I didn’t tell Emily. I figured she’d probably freak out and leave immediately.

I escorted her through the Tunnel of Terror and up to my bedroom, where she flopped on my bed, rolled over onto her back, up onto her elbows. “I’ve hit the mother lode,” she announced with a certain mischievous pride.

She reached into her Marc Jacobs bag, pulled out a large bottle, and dumped about 150 tiny, oval yellow pills onto my bedspread. I flopped down next to her, careful not to disturb the pile.

“What are they?” I asked. They didn’t look familiar. A dusting of yellow powder surrounded the pills, sinking into the fibers of my black bedspread.

“Norco,” she said. “I asked an online pharmacist for Vicodin, but they sent me this instead. I love it. It’s stronger. Here, take two.”

I swallowed them, without telling her I’d already been on hydrocodone all day. (Even though she was being generous, I didn’t want to share my own small stash.)

She’d found an online pharmacy that was selling her these but she was running low on cash. She wasn’t sure if she could make her credit card payments that month, so she offered to sell half the pile to me. I reached for my wallet.

The high kicked in fast. My vision became blurred around the sides and I could barely breathe, but the warm tingling feeling all over my body canceled any fear of overdose. We caught up on New York gossip and sat on my bed all night watching movies, even though I kept having to force my eyes to focus. At one point we ordered food, but by the time it arrived I couldn’t even swallow, and mine sat uneaten on the floor by the side of the bed.

Around one in the morning, Emily got up to leave. We stumbled through the Tunnel of Terror and I walked her down to Bushwick Avenue and hailed her a cab. We hugged good-bye and our skin stuck together in the July heat.

I stood on the corner for a long time after her cab drove off. I walked into the nearest bodega and bought a 7Up, then leaned up against the building outside to smoke a cigarette. Packs of roving kids would rush by, screaming and pushing each other into the street. I must have handed out about four cigarettes to people who’d stop and ask for one. I don’t know how long I stood there in the middle of
the night. I just knew I didn’t want to go back through the Tunnel by myself.

Forty-eight hours later,
two things happened. I got a call from
V Life
magazine,
Variety
’s monthly glossy. They hired me as their East Coast editor, which meant I would get to work by myself in the
Variety
offices, since the rest of the staff was located in Los Angeles. It was still an associate editor position, but because it was technically freelance, I’d be making more money than I’d ever made in my life.

The second thing was that Zoe popped her head into my room and said, “Hey, do you have that bottle? I need to give some pills to a friend who’s got a migraine.”

I’d finished the entire bottle off the day before.

“Um, there’s nothing left,” I said, reaching for the empty bottle that was sitting on my dresser. “I’m sorry, I thought you gave me the whole thing.”

“I meant for you to take one or two, not the whole thing!” She seemed flustered and pissed, but reluctant to really ream me out. In retrospect, what I should have done is offered her a matching amount of Norco to replace the hydrocodone that I’d eaten. It’s what I would have done normally. But for some reason, this time around the thought never even crossed my mind. It wasn’t like me, but I implicitly understood now that once they were in my possession, any and all pills belonged to me and only me. I had become rewired. No one needed to know what I was holding. It marked the beginning of a greed I’d never known myself capable of.

I met back up
with Zoe recently to ask her about that day, and her own experiences with painkillers as a cancer patient. The Tunnel of Terror had been renovated and was now brightly lit and had a real floor. We sat in the concrete garden and split a six-pack while her dog played at my feet. I tried not to get too close to him, no matter how cute he was. I didn’t want to catch any fleas.

Zoe grew up in Beverly Hills and had gone to school there as
well. In the 1970s, her father had been the head of one of Hollywood’s most successful studios and produced some of film history’s most loved and respected films. He was also a raging cocaine addict with a small army of close friends who also happened to be doctors.