Topic : 09/04 Ask Dr. Phil

I watched Angel on Dr. Phil today with tears in my eyes, I felt her pain. I've been opiate-free since August 17, 2006. That was the day I took my last 1 mg dose of methadone. I attended a methadone clinic for 4 years, the last 3 spent tapering down off of the methadone. So many people are uneducated when it comes to addiction, some blurt out things such as "you're trading one addiction for another" or other one-liners that they might have even heard someone else say. It's much easier to wean off of methadone, which is a synthetic opiate, as opposed to hydrocodone pills.

I have had severe back pain for 32 years and could have milked that all of my life for pain medication. I chose not to, because I saw the road I was headed down. I cut it off at the pass, as when I fast-forwarded into wondering what my future might have been like, it was very bleak. And compared to most patients at the methadone clinic, I was on a low dose of opiates. Many couldn't believe I was even on methadone, said you can kick that yourself. I would think to myself, "Speak for yourself."

At the height of my addiction to opiates, I was taking 20 pills per day of 10/500 (10 mg hydrocodone - the opiate/500 mg of acetaminophen). What hurts the liver is the acetominophen.  Usually, doctors write scripts for 5/500 mg or 10/1,000 mg, trying to keep the patient from becoming dependent on the opiate, treating with the lowest amount of opiate possible and very short-term.

I was prescribed 3 pills per day, 10/500 mg hydrocodone/acetaminophen, #90 per month. It was for  herniated disk pain, three herniated disks. The excruciating pain that I eventually grew to have wasn't touched by any other pain med except opiates. 

I've worked for two psychiatrists in the past and am now a medical transcriptionist at home, typing radiation oncology patient notes. I'm familiar with drugs and my family doctor knew this.  He has been my doc for 34 years (I'm 51 years old, saw him first at age 18), he told me before prescribing it for me that I should know this is intended for short-term use, it's a very powerful narcotic and that he couldn't keep treating my symptoms, that I needed to take care of the problem, surgery on the three herniated disks.

Long story short, I couldn't have the surgery done because I couldn't take time off work.  I don't get paid unless I work, as I am paid based on my production, paid per line that I type.  After two years, which was way past what my doc said he would prescribe it, he said I just can't continue this anymore.

By then, I saw where I was headed, told him I was addicted and he said he knew that, because it has been two years.  He knew I had a higher tolerance since I had been taking it so long. He doesn't know I used to buy it from my friends' friends, some friends gave them to me, knew I had a problem but knew I had to take care of it. 

My doctor sent me to a pain clinic. That doc cut my pills back to #30 and gave me an injection in my spine which worked for about 3 days with keeping the pain at bay. I knew I was in trouble.  I'm a big weenie and can't stand that uncomfortable feeling you get when you need more opiates in your system JUST TO GET THROUGH THE DAY, NOT EVEN TO GET A HIGH.  When I starting waking up and the first thing on my mind was "where am I gonna' find 20 pills today" - that's when I knew I needed help big time.

I phoned a friend I knew had gone to the same methadone clinic years prior and I called the clinic. They said I had to be in withdrawal when I came for my appt in order to be accepted, and this was a Friday afternoon. I made an appt with the doctor at the methadone clinic for an intake physical exam, blood work, and to start on methadone for Monday morning.  They told me to stop taking my pills at 3pm Sunday afternoon.

That Sunday was the longest night of my life. No sleep, that wasn't gonna' happen.....out of the question, uncomfortable to say the least, could not sit still... pacing, muscles aching, I stood in a cool shower most of the night..... alone.  I live alone.  I was 45 years old at the time, this was 2001, the year my Mom died. 

I had to be at the clinic at 6AM Monday morning, driving across a bridge enroute and I hate bridges! I got so used to that bridge, I could drive across it in my sleep after so many trips. You have to attend the methadone clinic and receive your daily dose of methadone each day in front of the nurse, $12 per dose, no matter what the dose is, 1 mg cost $12 and 150 mg cost $12.  It was red liquid.  You have to go every day, 6 days a week for ONE YEAR until you get clean urine tests and don't miss days, then you earn the privilege to take home two doses and come back every two days.  You then keep earning more take-home doses as you go along.

I never missed a day.  Every morning, 6 days a week (they gave you one take-home dose for Sundays and holidays. I was able to take home two-weeks of methadone after a year.  I went up to 84 mg, starting at 5 mg and going up 5 per week until I felt "comfortable." I felt comfortable at 84 mg. After six months on 84 mg, I started weaning down, per the doctor's instructions 1 mg per week. Doesn't sound like a lot.  I said, "One mg?  You mean 10 mg?" He said, "No, one mg per week."  I then found out why. 

This is powerful, methadone. Some people take it for chronic pain all of their life and it works great. Some are prescribed methadone by their physicians, but not many. There is such a stigma on addiction, especially methadone, it makes me so mad.  I saw so many peoples' lives turned around at that clinic. Girls who I first saw in their pajamas, dirty, hair messed up, they started looking better each week. They started wearing clean clothes, they started fixing their hair and wearing make-up, then they started talking about job interviews, then jobs! I saw lives saved by methadone, families saved, that's what I saw!

Opiate addiction is so, so scary. The person on opiates is not the true person. I never doctor-shopped, but I would have. I never bought off of the street, but I would have. Eventually, I would have done anything to get them, I saw that down that bleak road.  I judge NOBODY.  I've been there.  I know how horrible it feels to need to take pills just to get through the day. I needed them so I could keep my apartment clean, do the housework, do my typing all day, run errands.

But I could have said I needed them forever. I see so many people who need help, but they just don't hit the bottom or else they rationalize their use, which I what I was doing.  "BUT MY BACK PAIN! MY BACK PAIN!"

As I weaned off methadone, the doctor told me to come down to 60 mg and stop for a month, start down 1 mg per week again and stop at 40 mg, this to allow your body to adjust. I got down to 10 mg per day and hit a brick wall. I started having mild withdrawal symptoms, not feeling comfortable in my own skin, just not comfortable. Not sure how to describe it. Wasn't able to focus on my typing/my work. My paycheck dropped really low because I wasn't producing enough work. However, I got through it and stopped at 10 mg for a few months.  I then started the wean down to 0 mg per day, 1 mg per week.  That last week of 1 mg doses contained a dropper-full of methadone, like a dropper-ful of water. That's how powerful it is.

I took my last 1 mg dose of methadone on August 17, 2006.  It wasn't easy either. And it cost me a LOT of money, to the tune of $30,000 over 4 years.  BUT, I had to think about how much money it would have cost me if I DID NOT GET OFF OF OPIATES. Maybe my life.

I do back exercises to strengthen the muscles down each side of the spine, and this helps support my spine more and makes the pain tolerable. I've learned to be very, very careful in my movements, as one little misstep and I'm flat on my back for at least 4 days with excruciating pain, and constant. But that rarely happens.  Now I only take naproxen for pain and it works. I would have laughed at that in the past.

But the opiates change your brain, it's a chemical thing, it's proven. And also it's hereditary, opiate addiction. I learned that my grandfather had been an opiate addict which I never knew. Hmmm.

So I felt Angel's pain and I'm so glad she got the help.  I wish her the best.  As involved as she is as a parent with the school, I know she is just as involved in her recovery programs. 

I never connected with NA or AA. Could be because I worked for psychiatrists and helped them conduct group therapy and therefore was more on the clinician side rather than the patient side and felt uncomfortable in any group setting. I did attend Al-Anon when an ex-boyfriend was inpatient in rehab. It really helped me at the time.  The methadone clinic asked me to volunteer at the clinic, to talk to others since I was one of their 'success' stories. I apologized but told them I couldn't since I live alone and on my single income and am paid by production. Plus, it was quite a distance to drive.

Sorry this post is so long, but I type for a living and I just type fast! I won't apologize for that, it's MORE MONEY! LOL.

Thanks for the update on Angel. And people need to get educated on addiction so that they can help those in their family with addictions. People don't WANT to be addicts.  I never met one who CHOSE that. Sure they might have made a mistake at the start, or like me prescribed legally by a physician, but nobody wants to be an addict.  Most hate themselves and get in so deep they can't find their own way out.  Don't judge them, help them.  And never, ever enable them.  Just my opinion.

Before you start to judge Angel, I think there is something you all must know.  This episode of Dr. Phil was actually taped over a year ago.  Angel did go to rehab shortly after the taping of this show.  It has been a year since Angel admitted herself to rehab, started working a program of recovery and is one of the strongest individuals I know in the program and with her faith in God.  Angel has worked through the challenges with her husband and their relationship has grown and become stronger.  She is a wonderful mother to her children and puts their needs and wants above her own.  Angel works a very strong NA program and is now sponsoring others to help them in their recovery process.  Angel has turned her life around, faces her challenges on a day to day basis with the support of her family, friends and most importantly God.  As you watch the show tomorrow and find yourself judging Angel, feeling sorry for her family, keep in mind that Agel has turned her life around and you can too.,