Monday, 17 June 2013

The Joys of Being in Recovery

On rolls another year. And like each year "in recovery", life goes on with an array of challenges, changes and temptations. 

I have not touched anything now for many, many years with the exception of a beer about a year ago, an occasional glass of red wine with dinner and I smoked a bit of ice one sunny day. I have an excellent work contract, a steady relationship and an above average health. But something is missing and I still feel like my life is on hold.

Each year my life gets better in some aspects but worse in others. Well, not actually worse but more complex and frustrating. It's often said that issues that affect our lives are relative to our current situation. What stresses us out today might be minor compared to a decade ago. And the problems we may see as insurmountable to us are just minute compared to what others have to contend with. I'm sure that even if I was stinking rich, married to the Minogue sisters and healthier than Chuck Norris, I would still be worried out of my mind. Like I said, our problems are relative.

My daily dose of Slow Release Oral Morphine (SROM) has halved since this time last year. SROM is the magical medication that keeps me away from heroin. It's been a hell ride but overall, I am in a much better position now than anytime since my headlong dive into junkism. But there is a problem and one that is more frustrating than heroin addiction itself … the mess they call recovery.

Recovery is subjective and depending on who you talk to, it must be done a certain way. Some people insist that cold turkey is the only way out while most recommend substitution treatment like methadone. Others swear by the 12 steps program while a lucky few like myself receive something more practical. And then there's the naltrexone cheer squad who have their own ideas. So who is right? 

Forget the multitude of research showing that each person has unique needs. Forget the constant stories of users relapsing. In fact forget it all. If you're in the system, you are at the mercy of whoever you get burdened with regardless of their knowledge and success rate. For all the talk and money spent on recovery, it seems that our medical system is just not geared up to deal with individual needs. Not once have I been asked what I think is best (for me) or if I feel comfortable proceeding with a particular course. If my doctor and the specialist had it their way, I would be totally clean in a just few short months. Who cares if I relapse or my life becomes unbearable?

When I first approached the specialist pharmacotherapist to cut my dose nearly two years ago, he came up with a simple plan. Drop 50mgs every two weeks and soon I would be magically opiate free. Even I knew that was a big ask. And after voicing my dismay at such a rapid tapering he told me it would be fine. Of course it wasn't. 

Dropping 50mg every two weeks is just ridiculous. I have been on some form of opioids for nearly 20 years and every forced attempt to drop my dose just resulted in chaos. The upside is that when I initiate the reduction, it works.

It was me who suggested an initial drop of 100mg then maybe 50mg every month. I knew I was ready to start this long, painful journey and reducing my dose by a whopping 100mgs was a show of good faith that I was serious. Silly me! This enthusiasm was quickly exploited and the "maybe" drop of 50mgs each month became fortnightly. Of course it was a massive failure and after several pleading emails it was changed to monthly reductions.

I stop exercising and put on weight. I smoke more. I stop interacting with my family and hide myself away in my office. I stop contributing to the household (cooking/cleaning/caring for the pets etc.). I neglect family and friends. My focus on work deteriorates which costs me my income and the bills pile up. Even simple tasks such as showering becomes a drag.
-Extract from a letter to my specialist

Eventually, the monthly reductions started taking their toll. Dropping my dosage was causing too many problems and heroin was again becoming an attractive alternative.

The pressure to keep lowering my dose by my largely ignorant doctor and the specialist has been intense. It takes several long winded emails and some major pleading just to keep my dose fixed for another month. Sometimes I wonder if they actually understand that I am on a maintenance dose to keep me stable. If it was methadone, there would be no pressure whatsoever. 

It is a medical fact that forced recovery simply does not work. For some folks the idea of forcing junkies to rapidly drop their maintenance dose is appropriate punishment for being an evil druggy but for doctors it is just not good enough. There is ample research readily available and anyone, including a doctor, can just Google it. So why does my doctor and pharmacotherapist keep insisting that I constantly drop my dose?

It gets really tiring trying to explain the affects of lowering my dose when I am not ready. I have repeatedly explained to them that just prior to my dose dropping my clinical depression gets worse, I become very anxious and it causes me incredible stress. This falls on deaf ears. Even saying that I fear I may return to heroin isn't enough to reassess my situation. What is that about? You would think this would send off alarm bells. You would think…

The last 12 months have been pretty scary at times but I have somehow managed to get through. But as I have mention many times, each reduction causes incredible stress and distress. I manage to get through it but now it's proving to be counter-productive.

Each month as it comes time for my dose to drop and for weeks afterwards, I become extremely apprehensive and anxious. I feel that every everything is just too daunting and I loose any motivation I may have. It also makes me depressed. Naturally, I want this to stop. When I loose my motivation and feel depressed, everything suffers. At my age, this is not an acceptable situation especially after putting in so much hard work to get this far.
-Extract from a letter to my specialist

I can't help but question the reasoning behind the current policies for prescribing opiates. There are no major physical health problems with long term opiate use which only leaves the problem of dependance and any psychological issues. If SROM improves my ability to lead a normal productive life without causing any physical problems then why are the so called experts hell bent on dropping my dosage when I'm not ready? The physical health advantages from having a steady supply of SROM are glaringly obvious; 20-30kgs lighter, a regimented exercise plan, a healthier diet, a massive reduction in smoking and much less back pain. These benefits alone should justify my monthly script. Then, of course there's the huge benefits to my mental health; participating in work, socialising, integrating into the local community, reduced depression and anxiety, increased mental aptitude.

I wonder why diabetics are not forced to reduce their insulin? What about those on Ritalin or other medications to deal with specific mental health issues? Why are opioids singled out? If these medications help benefit our lives then they should be readily available for recovery as well.

We all know what causes the extreme paranoia around prescribing opiates and it should not exist in our advanced, modern society. The war on drugs -encouraged by sleazy politicians, the trash media and the anti-drug nutters- is probably the single most destructive policy in modern history. And when it affects the process of recovery you know it has really just gone too far.

Living life whilst in recovery is not pleasant although it's better than the constant cycle of heroin addiction. I suppose I shouldn't complain but it's hard when I know there's an easier route. I just want to know why those people and governments departments who are supposedly experts in addiction and recovery seem to know so little about addiction and recovery.


Jim Brown said...

Good to see you back writing. An excellent post and I agree with the sentiment entirely.

For some time I've felt there has to to be a range of treatments available to suit individual needs and situations. The one-size-fits-all methadone prescribing here in the UK is a disaster for most people - yet it's described as the 'gold' standard! In truth it's cheap.

As you rightly say, abstinence does not suit many people either, however there have been a few experiments with opiate prescribing and very slowly some politicians appear willing to listen to reasoned argument.

Hope all goes well,


Jim Brown

Terry Wright said...

Thanks Jim, much appreciated.

I agree. Methadone is an ugly drug but serves a purpose I suppose. Pushing addicts into it as a default is just silly. The real key is providing options to suit individual needs including SROM and diamorphine.

David Clark said...

Hi Terry,

You are not experiencing recovery-based care and clearly you not in a recovery-based care system. Recovery-based care is person-centered, not system or practitioner centred.

The doctors should NOT be doing things that you do not think is right. Medication-assisted recovery is just as important as any other form of recovery. There is no right way to do recovery. There are as many paths to recovery as there recovering people.

Sadly, anyone can use the term 'recovery', but far too few people provide genuine recovery-based care. These may be helpful if you have not seen this:
and various other papers on medication-assisted recovery in Bill White's papers.

My best


David Clark said...

PS. I forgot to say that I am sorry to hear of your troubles, but sadly not surprised.

Your writing about your recovery journey is great and of great value. It will help us create much-needed change in the system.

My very best, David

Terry Wright said...

Thanks David.
We desperately need more people like you.

Keep up the great work.

The_Pirate_Blues said...

I have only just come across your blog and it is a godsent! I cannot seem to find any good sites about recovery or networks to help me now that I'm in recovery and have been for some time.

My situation is that over about 10 years I was on and off "the horse" in some pretty hardcore doses - using a gram everyday for a few years on end (except maybe a handful of days). I eventually found a great supportive partner, upped and left for the other side of the country and went on suboxone. I have been able to keep on the suboxone and stay off the gear for a good two years now. But I am also a dual diagnosis patient. Before I became and addict I was diagnosed with bipolar and soon after was the victim of a violent and life-threatening kidnapping and sexual assault. After this my family turned my back on me, my psychiatrist was useless - so I started using and fell into addiction fast. After years of stripping, putting up with a violent boyfriend who was leaching off my money for his habit, ending up homeless, getting mugged, ripped off etc. etc. I was able to reconcile with my family and tell them about my problem. I found a good doctor and was diagnosed with PTSD. Unfortunately there was a lot of unfinished business with my family. They tried to help by getting me into rehab etc. but were emotionally unavailable. It wasn't until I got away from them and away from my user friends by going interstate that I had a chance to "get clean".

So now I have been unemployed for many years, I haven't used for years and have been stable on the suboxone. However I now have to deal with the sometimes daily problems that PTSD presents (and that my heroin use was thankfully -at the time- suppressing).

I don't know where to go from here. Have tried NA and it is not for me. Have no idea of how to get back into work and being a part of "normal" society. Oh, and I have a record for shoplifting, which doesn't help.

I live in Victoria. Do you know of any organisations and/or support groups that can help me build my life skills and confidence and help reintegrate into society/get a job etc.?

jas said...

After 25 years Of chasing the dragon its good to read bout Someone out there talking sense I cant even do "recovery" at all anymore to many wanker psyches and frrsh out of uni never had a problem ....doctors are shit and the dealers no better...being an addict and a functioning one employed and all cant stand the negative shit I have to put up with . Jas