A re­cov­er­ing ad­dict’s story

A cau­tion­ary tale about in­sid­i­ous nature of opi­oids: “I re­ally liked that — the way it made me feel”

The Hamilton Spectator - - FOCUS - SH­ERYL UBELACKER

TORONTO — At 13, Christie was smok­ing pot daily. In time, she be­gan dab­bling in co­caine. But it wasn’t un­til she was pre­scribed Per­co­cet by her den­tist fol­low­ing wis­dom teeth re­moval in her early 20s that she be­gan the long spi­ral down­wards into a fullfledged opi­oid ad­dic­tion that took over her life.

“I re­ally liked that — the way it made me feel,” says Christie, who asked that her last name not be used for pri­vacy rea­sons.

She sub­se­quently re­ceived an­other Per­co­cet pre­scrip­tion to treat ab­dom­i­nal cramps and “kept go­ing back to my doc­tor for re­fills.”

“And then I wasn’t get­ting enough for how much I wanted to do,” she says of the pills. “So what I did is I stole the pre­scrip­tion pad ... I took the script that she gave me and just copied it.”

Christie got caught when a phar­macy checked with her doc­tor, who im­me­di­ately dis­missed her as a pa­tient.

“When it started, it was med­i­cal, it was to help me with the pain man­age­ment,” she says.

But the med­i­ca­tion had an­other al­lur­ing ben­e­fit.

“I never re­ally felt like I had fit in, and the ef­fects that the drugs gave me was that I did, like I could be that per­son that I wanted to be.”

Christie was able to score Per­co­cets from a street dealer in her south­west­ern On­tario home­town. But when she moved to Van­cou­ver, “percs” weren’t avail­able, so she turned to Oxy­Con­tin, a slow-re­lease opi­oid that could be crushed for snort­ing or smok­ing to pro­duce an in­stant high.

Liv­ing in Van­cou­ver and work­ing at a high-pay­ing job in the Yukon two weeks per month, Christie con­tin­ued to use what­ever drugs she could get her hands on, though “Oxys were al­ways the thing that I wanted the most.”

When the man­u­fac­turer pulled Oxy­Con­tin from the mar­ket in 2012 in favour of more tam­per-proof OxyNeos, her West Coast dealer sug­gested she try a new pill that “looked just like the green Oxys.”

“So I did — and I re­ally liked the way that made me feel,” says Christie, her eyes grow­ing wide at the mem­ory.

The Oxy look-alikes turned out to be il­licit fen­tanyl, a syn­thetic nar­cotic 100 times more po­tent than mor­phine that has led to an epi­demic of over­dose deaths, par­tic­u­larly in B.C.

By then in her early 30s and hav­ing lost her job, Christie was des­per­ate to stop down­ing the eight to 10 fen­tanyl tablets that were cost­ing her $200 to $300 a day.

“I had built up such a tol­er­ance. I over­dosed twice where I had to be Nar­can-ed,” she says in ref­er­ence to the med­i­ca­tion used for emer­gency treat­ment of opi­oid over­doses.

“I re­mem­ber try­ing re­ally hard to try to stop. I re­mem­ber not want­ing to have to go through that life any­more.”

She went to a doc­tor and was put on methadone, an opi­oid-re­place­ment drug used to help peo­ple man­age their ad­dic­tion or wean off their habit by keep­ing with­drawal symp­toms at bay.

“But I couldn’t stay sober, even with the methadone. I kept want­ing to go back to do­ing the fen­tanyl.”

Just why do opi­oids — painkillers that run the gamut from codeine and mor­phine to oxy­codone and the fen­tanyl patch — lead to de­pen­dence, or in other cases be­come so stub­bornly ad­dic­tive? First, let’s look at how they work. When in­gested, the drugs bind to opi­oid re­cep­tors on the sur­face of cells, pri­mar­ily in the cen­tral and pe­riph­eral ner­vous sys­tem — much like keys fit­ting into a lock — and block the trans­mis­sion of pain mes­sages to the brain.

But opi­oids also work on mul­ti­ple sys­tems in the body, in­clud­ing the one that con­trols emo­tions, giv­ing rise to feel­ings of plea­sure, re­lax­ation and of­ten eu­pho­ria.

What’s in­sid­i­ous about the med­i­ca­tions is that they cre­ate phys­i­cal de­pen­dence: over even a short pe­riod of time, pa­tients build up a tol­er­ance and need in­creas­ingly higher doses to achieve the de­sired ef­fects, says Dr. David Ju­urlink, head of clin­i­cal phar­ma­col­ogy and tox­i­col­ogy at Sun­ny­brook Health Sciences Cen­tre in Toronto.

“Let’s say I put you on opi­oids for a week or two and you sud­denly stop them,” he says. “You would feel very un­well. The symp­toms vary from per­son to per­son, but they in­clude pain — gen­er­al­ized pain, pain in the ab­domen, pain in the legs.

“When you re­sume the drug, you feel bet­ter. And so you can see how a pa­tient would con­strue that as ev­i­dence of ef­fec­tive­ness and even on­go­ing need for the drug, even after the pain-re­liev­ing ef­fects have waned with time.”

While short-term use of opi­oids can be a god­send for peo­ple with acute pain re­lated to can­cer, ac­ci­den­tal in­jury or fol­low­ing surgery, many doc­tors now re­al­ize the nar­cotics aren’t re­ally ben­e­fi­cial for long-term treat­ment of chronic con­di­tions such as arthri­tis, nerve dam­age or back pain.

“In fact, they cause pain,” says Dr. Mark Uj­jain­walla, co-founder and med­i­cal di­rec­tor of the opi­oid ad­dic­tion clinic Re­cov­ery Ot­tawa. “So you get this hy­per­es­the­sia thing,” he says. “It’s ac­tu­ally a para­dox. So the more opi­oids you get, the more painful ev­ery­thing is.”

Phys­i­cal de­pen­dence is pretty well a given for the hun­dreds of thou­sands of Cana­di­ans who have been pre­scribed an opi­oid, most of them for chronic pain.

But some peo­ple slide over the line into ad­dic­tion, in which their crav­ing for the phys­i­cal and psy­cho­log­i­cal high the drugs pro­vide con­sumes their ev­ery wak­ing hour — de­spite the of­ten life-shat­ter­ing harms.

Be­fore she lost her job in Yukon, Christie’s life ap­peared idyl­lic.

“I had the nice condo, I had the good boyfriend, I trav­elled around the world,” she re­calls. “My life ex­ter­nally was re­ally won­der­ful. But inside I felt like ev­ery­one had some­thing that maybe I didn’t have.

“I couldn’t cope, ev­ery­thing was over­whelm­ing. My life was re­ally un­man­age­able.”

Opi­oids, pri­mar­ily black-mar­ket fen­tanyl pills, were the so­lu­tion.

But she and her boyfriend, also an ad­dict, couldn’t keep up fi­nan­cially with their in­sa­tiable need for the drugs.

“At the time, we had sold pretty much ev­ery­thing we had and we were ma­nip­u­lat­ing peo­ple, ly­ing to peo­ple, steal­ing, do­ing what­ever we could to sup­port our ad­dic­tions, which were very ex­pen­sive.”

Even­tu­ally, the pair split up. Christie could no longer af­ford fen­tanyl, so she start­ing smok­ing, then shoot­ing, heroin. She lost her condo and ended up home­less, find­ing shel­ter in a crack house in Van­cou­ver’s Down­town East­side, crash­ing on the couch of a sex worker.

“I would wake up ev­ery day just think­ing ‘This isn’t my life’ ... I would prom­ise my­self ‘I’m not go­ing to use to­day,’ and within five min­utes I’d feel just the tini­est bit dope sick and I would call my dealer.”

Dope sick­ness — the re­sult of with­drawal — doesn’t only cause pain, but also nau­sea, vom­it­ing and di­ar­rhea. Christie also had vi­o­lent tem­per­a­ture swings — one minute she was shiv­er­ing with cold, the next soaked in sweat.

“It’s like the worst flu you’ve ever had in your life — times 20,” she says. “And then you have rest­less legs. You can’t sleep. I couldn’t eat ... The rest­less legs were re­ally, re­ally bad for me. I couldn’t stay still.

“So I would do any­thing not to feel that way.”

After four months on the street — ex­cept for oc­ca­sional stints in detox clin­ics where she tried and failed to get clean — Christie in des­per­a­tion phoned her fam­ily, whom she hadn’t been in touch with for years. They thought she was dead.

Her fa­ther flew to Van­cou­ver and brought her home, where she went through “two weeks of hell” as she quit the drugs cold tur­key. Ten days later, she en­tered a month-long ad­dic­tion treat­ment pro­gram. That was in the fall of 2015. Now 35 and liv­ing in Toronto, Christie has been sober for about 18 months. She gives much of the credit to Co­caine Anony­mous, a 12-step sup­port pro­gram for those strug­gling to over­come their re­liance on drugs or al­co­hol.

As part of her re­cov­ery, she has worked to make amends to her fam­ily and oth­ers whom she hurt be­cause of her ad­dic­tion.

Long drawn to yoga, Christie now teaches the dis­ci­pline and also works “with other women like me” at hos­pi­tals and in­sti­tu­tions, as well as lead­ing or speak­ing at meet­ings of Co­caine Anony­mous.

“So I started giv­ing back, and that is when I re­ally started to grow,” she says, her face re­flect­ing an in­ner con­tent­ment. “About half­way through my amends, I started feel­ing hap­pi­ness like I’d never felt be­fore.”

For the first time, she is able to build re­la­tion­ships with her fam­ily and have “real friends in my life.”

“I live a spir­i­tual life now. I’m free.”

CHRIS YOUNG, THE CANA­DIAN PRESS

A for­mer fen­tanyl user named Christie: “I re­mem­ber try­ing re­ally hard to try to stop.”

Phys­i­cal de­pen­dence is pretty well a given for the hun­dreds of thou­sands of Cana­di­ans who have been pre­scribed an opi­oid, most of them for chronic pain.

Newspapers in English

Newspapers from Canada

© PressReader. All rights reserved.