The U.S. is in the midst of a heroin crisis. It’s estimated that tens of millions of Americans are addicted to some kind of opiate, with heroin overdose deaths reaching unprecedented heights all across the country and… You know what? This topic is so depressing that the only way we’ll get through it is if I call “heroin” by some other, friendlier name, like “Jeffrey.” So, the thing about Jeffrey is that he gets really angry when you try to stop being his friend and the best way to combat this is by befriending another, weaker version of Jeffrey (so… Jeff?), which here stands for methadone. I wanted to learn more about this process so I talked to Bob who works at methadone clinic, and he told me that…
5. Methadone Doesn’t Just Magically Cure Addiction
The common knowledge about methadone therapy is that it’s basically replacing one addiction with another, less-crippling addiction but here’s the thing about common knowledge: it’s an idiot.
According to Bob, “Methadone is used to remove the pain of withdrawal. That’s it … One of the ideas behind methadone is that it allows people to go through treatment while still living their lives. Thanks to it, people who can’t check out of the world for 90 days to sweat the heroin out of their systems in rehab can now get the help they desperately need.”
In other words, methadone “only” stops patients from feeling like someone wrapped barbed wire around their bones, and that’s when the real healing can begin.
“Without counseling once people don’t have the methadone, they just go right back to using illicit drugs because they never fixed the underlying issues that made them an addict to begin with.” It’s unfortunately never as simple as “Heroin just feels really good,” but part of the cure can be as straightforward as just encouraging the addicts. To stop, in case that wasn’t clear.
“Some of these people have never had anyone tell them they were proud of them. That little bit of encouragement, the knowledge that they matter to someone, can make all of the difference in the world. That is why no matter what happens I never get mad at my patients. I have a patient, who I started out seeing every day, and now months later, he pops in once a week, we talk for a few minutes, and goes about his business. He is sober for the first time in his adult life, and it started with the daily knowledge that someone was offering them positivity. Because positivity and hope are the best weapons against addiction.”
4. It Often Starts With Doctors
The best place to nip a problem is in the bud, even if “bud” is the last word you’d want to use when talking about drug addiction. So, what makes a person seek out Jeffrey’s company?
“Most people got started because their doctor gave them a prescription that just read ‘ALL THE DRUGS.’”
“We have known that opiates/opioids are addictive forever, and we know that they should not be used to treat long-term pain, but doctors hand out scripts like candy because it makes the patient stop whining.”
According to a study from Stanford, some doctor offices have turned into such proficient pill mills that “the top 10 percent of opioid prescribers account for 57 percent of opioid prescriptions.” Bob has seen this firsthand:
“There is a doctor who is well known in our area for writing patients’ any prescription they want, as long as they can pay … What happens when the pills stop working because a person’s body eventually adapts to the dose? Well they start taking more pills of course, which quickly leads to having to buy them or straight-up heroin on the streets. That’s how most of my patients got their start.” So, the obvious question is, how do we stop these pain doctors? Or better yet, how can we identify them? Besides by the black, empty darkness in their dead eyes.
“Patients will generally tell us which doctors in town have turned into pill mills … from there all we can really do is encourage our patients to avoid them, and keep track of people who start going to them. The DEA or CARF would all be possible resources, the problem is that like anything involving the government, very little actually gets done.”
It’s the worst thing about working in a methadone clinic – the feeling of not being able to really fix the problem you’re fighting. Well, alright, maybe the second worst thing.
3. A Big Part Of The Job Is Watching People Pee
“We do drug screens on our patients,” Bob says. “The worst part of my job is watching people pee. I hate it. I hate it so much. Thing is we have to do it. The law says patients have to provide a certain number of observed drug screens, as a result, people have come up with many ways to fake it. One way is to use fake rubber penises filled with clean pee. They are called Whizzinators, and we all hate them.” Now available in all possible skin tones because Whizzinator understands that anyone can be a drug addict:
“Thing is, if someone is on a rock star cocktail of drugs and we give them their medications it could hurt them,” because it turns out that methadone doesn’t really play nice with other drugs, legal or otherwise. In some cases, these bad interactions can even lead to death. But that rarely stops people from trying to cheat on the pee test, with an emphasis on “trying.”
“I had a patient who bought synthetic pee online, but it doesn’t fool anyone, except the poor soul buying it. My co-worker once had a guy who put on a condom, peed, and then kept it on until it was time to give his drug screen. All he had to do was put a hole in the tip and bam, pee. It didn’t work, by the way – just splashed all over the place.” I bet the person who had to clean it up was pissed.
And it wasn’t just men. Women too tried to get out of the piss test. “Without getting into an anatomy lesson, let’s just say it involved a balloon of pee, and a sharp finger nail. That one didn’t work either.”
2. Addiction Is Now A Multigenerational Problem
Opiates and opioids have a certain, let’s say, “inner city” image but, in reality, they have been wrecking havoc on white, middle America for years now with the drugs’ victims looking less like the cast of The Wire and more like a Sears catalog cover. How did it get so bad? According to Bob, most people get hooked on pharmaceuticals and Jeffrey by simply watching their folks.
“When your parents are addicts, every problem can be solved with drugs, ‘Oh you fell, here have a pill. Girlfriend cheated on you? Hit this and chill. You got a test? Well, I got meth.’ That sort of mindset leads nowhere positive. The other hard part is when you grow up with only addicts as role models, it becomes a lot harder to see addiction as bad thing. Someone loves their dad, and dad is an addict so drugs can’t be all bad, that’s just good logic.” Also, when only one member of a family of addicts starts to try and get clean, they suddenly find their entire support system is gone.
Then again, some parents do take a more active approach to turning their children into addicts. “There was a patient who’s mom was an addict and when they were three, they had not been fed in god knows how long, so they were crying, a reasonable response,” Bob says. “So since all that noise was ruining the mom’s high rather than make the kid a sandwich, she gave them an arm-full of heroin to take the edge off.”
And now, kittens, because God Almighty do I need them right about now…
1. Fighting The Epidemic Changes You
If you spent a few weeks counseling, say, chronic masturbators, seeing up close how self-pleasure destroyed them both physically and mentally, you’d probably have to fight the urge to chop off your own hands so you never feel tempted to work Satan’s Butter Churn. It was basically the same for Bob.
“I will do anything to avoid taking pain medication, I don’t mind to hurt, but I have seen too many people get their lives wrecked to risk it. I have been really lucky in that I have avoided a major car wreck, which is how most of my patients first got hooked on opioids to begin with. When offered anything stronger than aspirin, I reject the offer immediately.”
You might think that this doesn’t apply to you, that you don’t have an addictive personality, and that you don’t have anything to worry about. Well, damn near every patient that Bob treated thought the same. “The weird thing to think about is that some of my patients would have lived their whole lives without knowing they were addicts if they had been lucky enough to not get hurt in the first place. So, how many people are one pill away from ruining their lives and have no idea? That thought haunts me.”
That’s why Bob begged his mom to reconsider when her doc prescribed her Xanax. She might have desperately needed it, but dealing with so many addicts who started with prescription meds has made Bob suspicious of how easily some doctors pull out the prescription pads.
“I have similar thoughts any time a prescription is offered to someone I care about. Is the doctor doing the right thing, or is he just tossing pills around?” Is your doctor doing the same thing? Probably not but there’s almost no way to know for sure.