A Casualty From Our Recent Heroin Bust

I knew it wouldn't be long before folks who had been copping their opiate dope from the source that was recently busted here in Nashville started showing up at the methadone clinic, but I am a bit surprised at how fast someone got in touch with me about getting something better going in their life than chasing that dope bag. "Layla" came to me on Friday after having heard from others on the street that I'd been in the program at MTTC for a long time and she felt comfortable talking with me about what was going on in her life that made her consider methadone as an option. She was dopesick when we visited, but was maintaining with Dilaudid (hydromorphone) and handfuls of Lortab 10s (Vicodin / hydrocodone). By the way, when I say handfuls, I mean handfuls; when I was strung out on heroin and needed to stay well until I copped again, I could easily eat 20-30 Vicoprofens (7.5 hydrocodone and Ibuprofin - high risk damage for the kidneys but didn't have quite the danger of an Acetaminophen overdose) at a time and would have to do that about every 3-4 hours until I was able to get some real dope. I don't think Layla was at that level - yet - but she was definitely on her way. So we chatted a while about her addiction and what she'd already been through fighting it, trying to manage it, living with it. She started on opiates when she was 17. She said she loved the slow buzz and euphoria produced by them, and discovered quickly what "peashooter" opiate users know all too well; with the right number of pills, you become filled with energy and good will towards humanity. Whodathunk that an opiate would hype you up? But filling you with an odd sort of energy is common to those who use them with any regularity; they make even the drudgeries associated with life fun, at least temporarily. Unfortunately, after a few weeks of fun and frivolity, the piper begins demanding his due. Interestingly, if there's any benefit at all to abusing narcotic pills, it has to be the resultant increase in math skills associated with taking them. As the addict becomes increasingly dependent upon their pills, they begins to count them obsessively, calculating the hours between dosing while tallying on the fly how long the stash will last. Clock-watching becomes their favorite pastime as they tick off the minutes before they can munch another handful. A pill addict always knows exactly what time it is and how many days are left before they can refill their script - or cop more from someone who has the script.... But Layla is in trouble because she doesn't have a script, nor does she know anyone with a script. Pills can sometimes be difficult to come by on the street, especially in the quantities needed by a hardcore heroin junkie. They're damned expensive, too; most of em go for about a buck a milligram of active ingredient, unless you're talking about morphine or Dilaudid, since 10 milligrams of morphine are much more powerful than 10 of hydrocodone. Dilaudid can cost upwards of $20 a tab for the 4 milligram tabs; methadone "biscuits" (40mg wafers) are a bit cheaper than a buck a milligram, unless the person selling them to you knows you're sick, in which case the price goes up from $25 to whatever you're willing to pay to get well. Layla is 25. She says she's tired of living the doper life, but I don't see that in her eyes. When she talks about using, she doesn't seem to be done yet; she's still way too focused and animated about the highs, the types of dope available, the tracks on her arms. Fact is, I think she's far from tired and just sick of being sick - no surprise there. I could be wrong of course, I often am. But if there's anything I know well, its opiate addiction and addicts. So I'm working with Layla to get her into the clinic. There's a program in town, used to be called Project More, and it paid the cost of going to the clinic so long as you jumped through their hoops, as well as the clinics'. It ran out of money a couple of years ago and stopped taking in new clients, but they apparently received another grant or pot of money from somewhere and have been able to start up the program once again - just in time too, if you ask me. The thing is, I'm not sure yet what their criteria is for admission. Layla is going to find out on Monday and you can bet that, provided she hasn't been able to score elsewhere, she'll be on the phone at 7:59am calling the numbers I gave her. If things go well for her, she should be enrolled in the program by Tuesday. This will be her second time at a methadone clinic - she doesn't really need me, but knows I might be able to help her pay for it. She's done this gig once already, which adds additional credibility to my initial suspicion that she's probably not ready to get truly clean just yet. I worry too that she is going to choose maintenance this time, rather than detox. The worry here is that longterm narcotic use damages the body's ability to produce natural endorphins in enough quantity once the drug is stopped to keep a person feeling "normal." Since she's still young and really doesn't have a super-long history of abuse, she probably could make a full recovery and go on to a normal life once she got clean and decided to stay clean. If she spends any length of time on Methadone, however, she may ultimately be destroying her only chance at getting completely clean in her lifetime. Granted, progress in addiction therapy is being made daily and who knows, at some point there may be something better in the future that overcomes this longterm use issue, but I worry that she'll end up being married to a clinic and a daily dose for a long time to come. Worse yet, she has an affinity for Dilaudid. Most dope fiends aren't aware of this, but Dilaudid is the only narcotic that Methadone doesn't displace in the brain's receptors. What this means is that while you can shoot all the heroin you can get your hands on while you're on Methadone and never feel it, you will feel the effects of a Dilaudid while on Methadone. Sigh. So many worries about a young lady I barely know. What I do know, however, is the life of misery that awaits her if she devotes much more time to opiate fun and games. It used to be oh-so-cool to get high on heroin, Demoral, morphine, hell, even Tussonex was fun to drink back in the day. Today it's a goddam ball and chain around my ankle, sucking $360 a month out of my wallet, forcing me to plan around diversion control and dosing pickup days, witnessed UAs, and dosing every morning. It's strange as hell; I owe my current successes in life to the drug, yet I've come to hate it, but am doomed by my own stupidity in my younger years to be tied to it until either I die or something better comes down the road, and this is the fate I do not want Layla to have to share. However, if it's a choice between Methadone maintenance and uncontrolled drug addiction, I'd run, not walk her to the clinic and get her started, and this is where I'm at with her at the moment....