Drug Addiction - confessions

Just came back from a DRUG ABUSE lecture. Here are some very interesting excerpts from the confessions of addicts. These are all health care professionals, in their middle age.

“…I find it funny when people talk about the signs of addiction as being poor attendance at work and not showing up. That’s alcoholism, just the opposite of what happened to me.

With “Fentanylism” it’s showing up and working 24 hour days and relieving somebody of their cases, especially if it was a heart patient and a lot of fentanyl was used. I would offer to relieve you, let you get a cup of coffee. Then I would sample from the large amount of Fentanyl we had in the case" (MD, age 48)

“…I used to read the PDR like it was a novel. I looked for new controlled drugs, and when I found one that sounded great, I would mail order a 1000 of them. I could order a 1000 barbiturates for 20-30 dollars. If I liked them, I’d order 5000. Access was no problem for me" (MD, age 38)

“…At the worst period of my addiction, I was taking 150 Percodan tablets just to get through the day- 25 at a time without water. After a while there was no high involved. I used them just to get rid of the withdrawal symptoms. I had built up my tolerance to these narcotics that I could take 25 at a time and still function. It ate a big hole in my stomach. When I went to rehab I had a huge ulcer that they treated as life-threatening. But I didn’t care about killing myself. I needed those drugs. I had pain." (PharmD, age 41)

“…When an order came in for Demerol, I would steal the Demerol and put water back into the bottle. The obsession was terrible. I would come in every morning pledging that I’m not going to do it. But I did I’d feel guilty as hell thinking about the patient getting watered-down Demerol. Im a good pharmacist, a good person, Despite my shame and guilt, the same thing

happened all over again." (PharmD, age 46)

“… The thought of living without drugs was enough to drive me crazy. My mental condition focused constantly on getting through the day. OK, I know I need 150 Percodans to get

through the day but I only have 140. I would plan how to steal them. And God help me if I had to go out of town. I would need 1,000 pills for a five-day trip. I had to find them

and take them with me. I had stashes all over the house, the car, the garage. There are still hundreds of pills out there. God only knows where they are." (PharmD, age 41)

“…I shot up a lot with Demerol. Once I passed out and fell into the cabinet; another time I shot up and fell into the toilet. I had lost everything-my license, my wife, my family. I had nothing left and nowhere to turn. It was either get straight or die." (MD, age 50)

“…I remember taking massive doses of valium and cardiac pills the second time I tried to commit suicide. They should have killed me… I woke up with my AA sponsor slapping me in the face. For some reason I saved all the empty bottles-that saved my ass. I had 32 different

drugs in my system and for 24 hours they didn’t know if I would make it or not.” (PharmD, age 49)

“….During a stressful day in dental school a classmate gave me a few 10 mg Valium tablets. The feeling that came over me was far better than any I ever had while drinking. I had never felt so good. I also discovered that drinking a few beers later that day potentiated the wonderful feelings I had experienced earlier. I justified my drug usage by rationalizing that if I worked hard I would treat myself. I would ‘treat’ myself to a Demerol cocktail at the end of the day. Then after a few weeks, I would not only treat myself to one after work, but one just before bed time. By this time I had begun taking both Valium and Demerol during the day just to maintain a certain feeling of being ‘normal” (DDS, age 42)

"The Spirit Catches You and You Fall Down" - "The Big One"

Here is the chapter that is just awesome, even to a pharmacy student! Again, Lia Lee, the little Hmong girl, suffers a refractory epilepsy.

From "The Spirit Catches You and You Fall Down," by Anne Fadiman,

Chapter 11. The Big One

On November 25, 1986, the day before Thanksgiving, the Lees were eating dinner. Lia, who had had a mild runny nose for several days, sat in her usual chair at the round white Formica table in the kitchen, surrounded by her parents, five of her sisters, and her brother. She was normally an avid eater, but tonight she had little appetite, and fed herself only a little rice and water. After she finished eating, her face took on the strange, frightened expression that always preceded an apileptic seizure. She ran to her parents, hugged them, and fell down, her arms and legs first stiffening and then jerking furiously. Nao Kao picked her up and laid her on the blue quilted pad they always kept ready for her on the living room floor.

"When the spirit caught Lia and she fell down," said Nao Kao, "she was usually sick for ten minutes or so. After that, she would be normal again, and if you gave her rice, she ate it. But this time she was really sick for a long time, so we had to call our nephew because he spoke English and he knew how to call an ambulance." On every other occasion when Lia had seized, Nao Kao and Foua had carried Lia to the hospital. I asked Nao Kao why he had decided to summon an ambulance. "If you take her in an ambulance, they would pay more attention to her at the hospital," he said. "If you don't call the ambulance, those tsov tom people wouldn't look at her." May Ying hesitated before translating tsov tom, which means "tiger bite." Tigers are a symbol of wickedness and duplicity - in Hmong folktales, they steal men's wives and eat their own children - and tsov tom is a very serious curse.

It is true that, whether one is Hmong or American, arriving at an emergency room via ambulance generally does stave off the customary two-hour wait. But any patient as catastrophically ill as Lia was that night would have been instantly triaged to the front of the line, no matter how she had gone there. In fact, if her parents had run the three blocks to MCMC with Lia in their arms, they would have saved nearly twenty minutes that, in retrospect, may have been critical. As it was, it took about five minutes fro their nephew to come to their house and dial 911; one minute for the ambulance to respond to the dispatcher's call; two minutes for the ambulance to reach the Lee residence; fourteen minutes (an unusually, and in this case perhaps disastrously, long time) for the ambulance to leave the scene; and one minute to drive to the hospital.

Ok, I will continue tomorrow. My therapeutics midterm is coming up next week! You know, it's the title of the chapter. "The Big One."

"The Spirit Catches You and You Fall Down" - haunting descriptioon

I'm only half way on the book. It contains many subjects, history, health care system, cultural differences in healing, and epilepsy. From Hmong's perspective, an ethnic group from SouthEast Asia, having an epilepsy seizure is like "the spirit catches you, and you fall down." Lia, the little girl, who was otherwise robust and lively, had been fighting epilepsy, but medications had not been able to control her increasingly frequent seizures. Her pediatrician feared a deadly seizure episode was inevitable. Here it is on pg. 140, "The Big One"

I will continue to post tomorrow. Though the description was haunting, I am just too sleepy.

Blogging before therapeutics lecture!

Time of blogging? Does it matter? Why is it worth noting that this blog entry comes the night before a therapeutics lecture? As a student pharmacist, therapeutics series is the MOST IMPORTANT life-and-death type of classes for us. If we do well, life will be rosy. Otherwise, you can come up with your own antonym for rosy. I have one for you, "bleak."

Sacrificing time to study and re-study just to post a blog about a topic that NO ONE (even my mom; though to be fair, her native language isn't English) is interested in? WHY???

My philosophy about having this blog is that I want to share with I learn as a student pharmacist. In addition, you will see that what I learn in school can be sometimes useful in your life. You never know!

Yea!!! Now I get to study my therapeutics - this quarter we're studying cardiovascular stuff...you know, hypertension, dyslipidemia (disruption in the amount of lipids in our blood), and diabetes.