How a Distant Epidemic Came Home to Roost: One Man’s Opioid Addiction

A front page New York Times story read, “Every year, thousands of people addicted to opioids show up at hospital emergency rooms in withdrawal so agonizing it leaves them moaning and agonizing on the floor.” The article then goes on to quote a heroin addict.

I would have stopped reading the article just then if I did not have an interest in the drug that was the subject of the story (buprenorphine). I admit it—I am one of those unenlightened neophytes who cannot fathom heroin addiction. As fate would have it, I would soon have my comeuppance.

In the spring of 2017, after a long run on an uneven beach, I lost all feeling in one leg and was hit with wrenching double nerve pain in the other leg. An MRI showed that the nerve bundles that run through the lower spine were completely occluded and I had met a most fierce opponent: spinal stenosis.

I was the first patient scheduled for endoscopic back surgery in July. By the time I was scrubbed and ready, the spinal surgeons at UCLA hospital had further reviewed the MRI and concluded that the operation would be more dangerous than they had originally anticipated. They wanted permission to fully open the back to get better access to the spine. It proved to be a tough, long surgery. I was bleeding so badly that they accidentally nicked my spinal cord, but were confident that they had repaired the damage.

I returned home after about four days. Within hours, intense pain and subsequent paralysis set in. Manhattan Beach paramedics took me down my stairs on a sled and rushed me to a local hospital, where they didn’t know what to do with me. I was shaking with pain as two techs stuffed me flat into an MRI tube, the most painful position imaginable. After fifteen minutes of a scheduled one-hour MRI, I couldn’t endure another moment and they took me out.

Luckily, they had captured the image we needed. It showed that the surgery had gone haywire and I was bleeding internally. A private ambulance rushed me back north to UCLA Medical Center, where I underwent two emergency surgeries within days of one another, resulting in a “natural” spinal fusion of my lower back. They put two large drains into my back that filled every few hours. I was on a Dilaudid drip for ten days and have no memory whatsoever of seven of those days.

I have been a highly athletic person for most of my life. Running, Pilates, and yoga have been integral to my mental and physical welfare. This won’t stop me, I said to the open air. I made a bet with myself: At the one-year anniversary of my three surgeries (July, 2018), I would be back practicing yoga.

Before I could win that bet, my back flared-up, causing searing pain. I had little choice but to open my black medication safe and withdraw the Vicodin painkillers and Robaxin muscle relaxants. My doctor, who had seen me through those back surgeries in 2017 and massive shoulder surgery in 2016, confidently added Oxycontin for “breakthrough pain.” She had known me a long time and was confident that I would never abuse any prescription drugs, much less opioids.

With a ruler and a black flair pen, I neatly created a medication grid to track the date, time, and type of medication I took in real time. Three weeks later, I began physical therapy in so much pain that I needed a walker to get to the treatment room. Light massage was about all I could handle for those first weeks. I began to advance rather quickly over the summer, finally graduating to a stylish hickory cane that my fiancé, Sonya, purchased for me.

At the eight-week mark, I was managing the side effects of the opioids as best I could. There was little I could do for my scrabbled brain except watch CNN for hours on end in our zero gravity bed. Without noticing, life became an irritant. My conversations were muddled. Even the dogs slunk away from me with great regularity. I had reached a juncture where I was barely alive, all under the guise of “pain management.”

At the 12-week mark, I decided to discontinue the pain meds that had become my constant companions every four hours. I committed to stopping cold turkey; why suffer for four steady weeks if I could be over it in five days?

I was nonplussed, but foolishly confident. After all, I was doing everything right, I comforted myself: Physical therapy twice a week and countless sets of perfectly formed back exercises. I even made a rule-lined chart where I scrupulously noted my every-four-hour use of pain meds and muscle relaxants in a steady hand. What could go wrong? How could I know that my fancy chart would one day be a souvenir of my impending opioid addiction? A better question would have been how could I not have known?

In January of 2017, I quit taking Klonopin, a benzodiazepine that I took under physician supervision for two decades. I quit cold turkey, which I do not recommend. (nb. My dose was 1 mg. bid. For those people who take a higher dosage, the sudden discontinuation of benzos could lead to stroke and death.) Let me suffer for a week and be done with it. It was difficult to quit the Klonopin, but I accomplished the drug discontinuation with little fuss—right on schedule.

I assumed the same strategy when I stopped opioids. That was my first mistake.

I recently wrote a book called True North, A Son’s Memoir, in which I reveal publically for the first time that I have bipolar disorder. Since my late twenties, I have taken more psychotropic medication than I can count.

Why am I telling you this? So you will know the full extent of my opioid addiction, and, perhaps, be more wary of opioids than I was. If this subject confounded me with my many years of drug “expertise,” you can bet it won’t be pretty if/when it should ever reach your doorstep.

Writing this was a kind of therapy; it took a long time, then, before the haze burned off and I could string some sentences together. Still, my guts were a mess, my stomach was bloated beyond recognition, and I could barely sleep a night through. When I first discontinued the opioids and muscle relaxants, I felt as if my skin was crawling with microscopic animals. That most uneasy feeling seemed to echo in my bones, especially at night. I soon found out that quitting opioids, even after a mere 12-weeks, made discontinuing Klonopin a walk in the woods.

Finally (I am shamed to admit), I submitted to the addiction. I began to take a single Oxycontin at 3:30 am if I was still awake. Like magic, 20-minutes later I was sleeping deeply.

After a few weeks, I thought I had it beat. Suddenly, at 3:30 am sharp, I was up and thrashing about to the sound of CNN’s early New York broadcast. How could this be? Could this be a relapse of some sort? Finally, I submitted to fate.

If you’ve read this far, odds are it is because you have been following with interest the opioid epidemic that has stricken about every inch of our nation. Tens of thousands dead … unstoppable smuggled opioids from China … maternity wards filled with mothers giving birth to seizing newborns. The epidemic is so acute that it is easy to dismiss as a sickness of heroin addicts.

Don’t make the same mistake I did and turn the page yet. I wasn’t expecting the opioid conundrum (dead if you do, in severe pain if you don’t) to come home to roost at my house, either. It snuck up on me with gut wrenching insidiousness.

My story is without a “moral” ending; it is just one man’s tale. Take it for what it’s worth. If there is uniqueness to this story, it resides in the admission that it happened to me. I hope you will reflect on these words for just a moment, lest it happen to you.

—James M. La Rossa Jr.

 

By |2018-09-12T14:58:24+00:00August 23rd, 2018|Brief Bulletins from the Field, We Know Psychiatry|0 Comments

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