Chris is a full-time drug addict who has been in and out of prison, often homeless, and is continually seeking whatever high he can find. During his last stay at the hospital, he finally got clean. He had wanted drugs, but the doctor refused, instead offering him Suboxone (off-label), which eases dope sickness.
Suboxone occupies the opiate receptors to prevent withdrawal symptoms but also helps with pain. Because suboxone binds so tightly to the same receptors as other opiates, including heroin, it makes it difficult to get high. Users say “you can’t shoot over it”.
“Most of the time they treat junkies like crap,” Chris says, referring to his hospital stays. “They won’t do anything for you. I wanted methadone. I’m a junkie; it doesn’t mean that I don’t have pain. The doctor just said no. Try this. It will help you with the withdrawal symptoms and also with the pain.”
So Chris tried it, although he admits he was extremely mad, and the doctor remembers him being loud and abusive at the time — a common reaction of addicts to this course of treatment.
“I had an option to have a friend come over and visit me and bring me some dope and drive me off, or take Suboxone. I said, ‘I’m gonna try it.’ But if it weren’t for her, I wouldn’t be on it. And I wouldn’t be here today.”
Suboxone is a good option for those who can get it. But the insurance is tricky outside of a hospital setting, and it’s still pretty rare — although it is available on the streets, if you can find it.
“Nobody wants it,” Chris says. “But if you’re dope-sick, and you can get it…”
He says people are addicted to that also, but that the ones who get high off of Suboxone aren’t heavy addicts.
“I take three a day and I have no issues,” he says. “I still have everyday life, but I’m at that point where instead of hiding behind drugs I can go ahead and deal with it. You can wean off Suboxone, but these people who’ve been going to hospitals for years, they’re not gonna quit overnight. They’re not gonna be able to stop just because the doctor tells them to stop. It doesn’t work. It’s like ‘OK, the pain’s gone, you’ve been on this drug for 5 years, see you later. You’re fine. You’re cured.’ Well, no I’m not. I’m dope-sick now.
“Ninety percent of the people who come here [pain clinics] are addicts. They just don’t know it yet. And the problem with that is these new people, who’ve been on [opiates] forever, they didn’t decide it: The doctor decided it. And when it’s not your decision, it’s harder to get clean. The doctor doesn’t want to go to jail, so if the doctor knows you’re not in pain anymore —a legitimate doctor — they’re gonna tell you, ‘Look you’re not in pain, you don’t need this, we’ll detox you.’ But you’re still gonna want the drug.
“You’ve been high for 4 years? How does someone who’s been high for 4 years straight just quit??
“Everyone I know who is in pain management,” he says, “Is a drug addict.”
Chris has been clean for nearly two weeks. He’s going to meetings two or three times a day, but says it’s too soon to make any personal relationships.
“I got family that’s helping me right now. They’re pretty much supporting me. It’s the first time I asked for help. I’ve never tried to get clean before. I never wanted to. This time, and since I got out of prison, this is my fight to be clean.”
He admits that the powerful draw of opiates is always there.
“Statistically, I’m gonna fail,” he says, referring to his detox. “Once you bite the apple, it’s over. I’ve never loved anything like I love that drug. There’s nothing in the world that can compare to it. I love it more than my children, more than my mother and father, I love it more than anything. I would pick that over everybody. And I did.”
Without his father’s help, Chris wouldn’t have the Suboxone. It’s not approved for pain patients in the U.S., as it is in Europe, so Medicaid doesn’t cover it. He estimates that it costs him about $1,000 a month to get clean this way, but if he’d had a million, he says, he’d spend it.
“My dad’s got throat cancer, lung cancer, and prostrate cancer. He’s 80 years old. He’s had surgery on his back. He can barely walk. He screams in pain every day, and will not touch a pain pill. Because of me, he’s in pain all day long, and he deals with it, to show me that if he doesn’t need it, then I don’t need it. And I respect that. Because I know he’s right. Here’s a man who’s dying of cancer, and if he can get through his day without drugs, then I sure as hell can get through mine.”
I tried several times to reach Chris after he granted this interview. I never saw him again.
Posts by Melanie Rosenblatt, M.D.
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