Prescription opiates can cause heroin addiction: Awareness is key to prevention.

 If you are prescribed opiates prior to graduating high school, you have a 33% higher chance of misusing opioids during your lifetime (Miech R, et al. Pediatrics. 2015;136(5):e1169-e1177).

My story started like most opiate addicts, it just began a little earlier in life. Luckily, I’m clean now, so I analyze my past actions and decisions a lot. As a child, I was given high doses of pain-killers during and after emergency surgery. My father was always worried that I would have a problem with addiction, so he would try to make me hold off on taking the painkillers until I REALLY was in pain. Unfortunately, my brain saw this as a reward. “You’ve been suffering? It’s okay. Take this pain medicine as a reward for being brave until now. Do not suffer anymore.” I felt the euphoric instantaneous relief and realized quickly that not only did it make my physical pain go away, but it made my depression and emotional pain diminish as well.

Addiction is more likely to happen when you decide to not take your medication as recommended. Taking it too much can cause it, but taking it too little can as well. If

But if you take it on schedule before the pain gets severe for the first few days, you won’t have this issue. They in you don’t need it, stop taking them and recycle them at your local pharmacy.

The United States holds 5% of the world’s population, yet 80% of the world’s opiate prescriptions are for our citizens (Manchkanti L. et al. Pain Physician. 2010;13:401-435).

Drug overdoses kill more people yearly than car crashes in the United States (Road-related Fatality Statistics) (Heroin-related Overdose Death Statistics) 

Based on these statistics, it is obvious that our country over-prescribes pain medication. Most people see this and think “Well, we should just get doctors to stop prescribing pain killers! If they stop, people won’t be able to get addicted!” To an extent, this would help opioid addiction decrease; however, individuals currently on high doses of pain killers that have had to taper down will experience withdrawal symptoms and increased pain, increasing the likelihood of trying to obtain these medications elsewhere. There are also illegal drugs that have become cheaper and stronger than pain medication; however, they are way more likely to kill you. This is exactly what has been happening over the past 19 years.

Fatal Heroin overdoses in 2013 were FOUR TIMES more than in 2000 (Heroin-related Overdose Death Statistics)

As you can see, heroin overdoses have increased in recent years exponentially. Frequent users of any pain medication (illegal or otherwise) build up a tolerance quickly and require a higher dose over time until, eventually, thy can never reach the high again. That’s why it’s called chasing the dragon. You can never catch it again. Some people have switched to Fentanyl because it is extremely potent. Most heroin users will avoid fentanyl because it is easy to misjudge the dose and kill yourself; however, drug dealers have realized they can make more money by having less pure Heroin and mixing in some Fentanyl. This has caused a significant increase in opiate/Heroin related deaths. Since the color can be similar and there is no way to test the purity, Heroin addicts that unknowingly do Fentanyl will be significantly more likely to overdose.

Back in my days of Heroin use, I did not realize I had gotten a “contaminated” batch at one point and became very ill. I prepared my normal dose and immediately upon administering it, began vomiting uncontrollably. For two days after, I couldn’t keep anything down, had immediate constipation and dehydration, and became very weak. I threw it out and detoxed myself.

Below are pictures of lethal doses of Heroin and Fentanyl (depicted with salt)

(Taken from the presentation “Opioid Use Disorder: A Growing Problem” by Stephen M. Taylor, MD, MPH, FASAM)

Imagine that you believe you bought Heroin; however, it is actually Heroin cut with Fentanyl. You have no idea, so you prepare your usual dosage. You OD instantly, like the famous artist pictured above.

It is easier and more common than you think to jump from prescription pain killers to herion once withdrawals set in. The medical community and the people they care for need to be aware of the risks to protect themselves and their families.

If you’re not an addict and reading this, subscribe to this blog. You will reach an understanding of the addict mind more from this post and those yet to come than you ever could from reading a text book and research with millions of holes and missing puzzle pieces. If you are an addict, subscribe as well. Hopefully some of my future posts will help you learn how to get through withdrawals easier and realize you are not alone.

Mixing medications: Can anyone help me figure out what’s what?

I am am so frustrated. I’m losing weight and I don’t know if these side effects are normal. I’ll start with last night and then an overview.

Last night I ate a sandwich and drank some water with my meds (Prozac, Buspar, and amoxicillin) and fell asleep around 3. This morning, I woke up around 830, which has been a DAILY occurrence since a week after starting the Prozac and Buspar. I felt tired and sluggish, went to use the restroom, and proceeded to dry heavy and then vomit up a gooey foam-like spit?

As long as I’m not dying, should I tough it out and see how it is for another two weeks until I see my doctor? Or tap out?

I was in the shower, contemplating life… that’s normal, right? … and I realized I neglected to think through the timing of additions to my medication regimen. I don’t know why I think through everyone else’s illnesses and treatment plans, but then I don’t do that with myself. I have the nursing training, but… I guess I get so anxious about it, I go head first, all in, and overlook the small stuff.

I have been without health insurance for over a year, so I decided to knock out all the normal visits ASAP.

I went to the OBGYN and started Depo-Provera for birth control about a week before I saw my new psychiatrist for the first time. Normally, this wouldn’t be an issue, but I have two large cysts on my left ovary and was off of all birth control for about five years. I also am naturally low in estrogen and higher in testosterone. So starting this shot caused a hormone influx and some significant nausea after I woke up, but an increase in my appetite later in the day after the nausea subsided. It got a bit better as the days went by; however, symptoms of ovary torsion also match what I’m experiencing now. I have another appointment on Monday, so I’m avoiding the ER unless I get a lot worse.

Then I started Prozac 20mg at night and Buspar 5mg twice a day. The mania of the previous week started to tone itself down, but the irritably and anxiety were higher. The nausea and weird nocturnal eating got worse. Dry heaving started happening in the morning if I didn’t eat. If I did, I’d likely throw something up. I’d have diarrhea as well, but I think that’s because I wasn’t eating more than a few bites here and there. It started getting a little better, but was still an issue.

Flash to 2.5 weeks later. I up my Prozac to 40mg per night and Buspar 7.5mg twice a day. After four days, my irritability is less and anxiety is a little less (especially considering I had the first part of my root canal done yesterday). But the nausea is killing me. I did start amoxicillin 500mg three times a day two days ago for he second stage of my tooth repair this Friday, so maybe that’s why the nausea is worse. Since I haven’t been able to eat, I haven’t taken them today… but I will soon.

I do smoke cigarettes and wonder if that has anything to do with the heightened gag reflex. I’m so anxious that I’m smoking more, so maybe the coughing triggers the reflex… but then again, I have been walking around normally and then gag randomly.

I can’t figure out what side effects are coming from where. Anyone have any recommendations?

The first few weeks of Prozac

If you’re new to mental health, this may be above your head… but if not, maybe you’ll understand.

I feel crazy. Crazier than I have without my meds, but in a different way… I feel less manic than I have. I’m not going to go blow $200 on stupid shit and regret it the next morning. The ups and downs aren’t so bad… but I feel like I’m in a constant state of agitation and anxiety. If I don’t HAVE to leave the house, I don’t want to. If something bothers me, I’m going to speak my mind… and I won’t be delicate. But if I spoke my mind, the next day, I’ll avoid you like the plague in person. I’ll text you and apologize, but passive aggressiveness after straight aggressiveness is confusing.

This is only the second day after up-ing my dose, so we shall see…..

Taking Prescription Pain Killers Can Make You a Heroin Addict… Eventually

 

If you’re not an addict and reading this, subscribe to this blog. You will reach an understanding of the addict mind more from this post and those yet to come than you ever could from reading a text book and research with millions of holes and missing puzzle pieces. If you are an addict, subscribe as well. Hopefully some of my future posts will help you learn how to get through withdrawals easier and realize you are not alone.

If you are prescribed opiates prior to graduating high school, you have a 33% higher chance of misusing opioids during your lifetime (Miech R, et al. Pediatrics. 2015;136(5):e1169-e1177).

My story started like most opiate addicts, it just began a little earlier in life. Luckily, I’m clean now, so I analyze my past actions and decisions a lot. As a child, I was given high doses of pain-killers during and after emergency surgery. My father was always worried that I would have a problem with addiction, so he would try to make me hold off on taking the painkillers until I REALLY was in pain. Unfortunately, my brain saw this as a reward. “You’ve been suffering? It’s okay. Take this pain medicine as a reward for being brave until now. Do not suffer anymore.” I felt the euphoric instantaneous relief and realized quickly that not only did it make my physical pain go away, but it made my depression and emotional pain diminish as well.

Addiction is more likely to happen when you decide to not take your medication as recommended. Taking it too much can cause it, but taking it too little can as well. When you are in severe pain and delay taking your medication, your pain reaches such high levels that when you finally take your pain medication, you feel instant euphoric relief. This euphoria is such a incredible high, that you remember it forever; however, you will never experience the euphoria to the same extreme ever again. That’s why they call it “chasing the dragon.” You can never feel that high again.

The United States holds 5% of the world’s population, yet 80% of the world’s opiate prescriptions are for our citizens (Manchkanti L. et al. Pain Physician. 2010;13:401-435).

Drug overdoses kill more people yearly than car crashes in the United States (Road-related Fatality Statistics) (Heroin-related Overdose Death Statistics) 

Based on these statistics, it is obvious that our country over-prescribes pain medication. Most people see this and think “Well, we should just get doctors to stop prescribing pain killers! If they stop, people won’t be able to get addicted!” To an extent, this would help opioid addiction decrease; however, individuals currently on high doses of pain killers that have had to taper down will experience withdrawal symptoms and increased pain, increasing the likelihood of trying to obtain these medications elsewhere. There are also illegal drugs that have become cheaper and stronger than pain medication; however, they are way more likely to kill you. This is exactly what has been happening over the past 19 years.

Fatal Heroin overdoses in 2013 were FOUR TIMES more than in 2000 (Heroin-related Overdose Death Statistics)

As you can see, Heroin overdoses have increased in recent years exponentially. Frequent users are not able to reach the same extreme high, so dealers have started cutting Heroin with Fentanyl, causing even more deaths. Most Heroin buyers do not realize that they are doing Fentanyl, as they are a similar color. I did not realize I had gotten a “contaminated” batch at one point and became very ill. I did not get the high associated with Heroin and was vomitting everything I ate or drank for two days after, had immediate constipation and bowel blockage, and became dehydrated and weak.

Below are pictures of lethal doses of Heroin and Fentanyl (depicted with salt)

(Taken from the presentation “Opioid Use Disorder: A Growing Problem” by Stephen M. Taylor, MD, MPH, FASAM)

Imagine that you believe you bought Heroin; however, it is actually Heroin cut with Fentanyl. You have no idea, so you prepare your usual dosage. You OD instantly like the famous artist pictured above.

It is easier and more common than you think to jump from prescription pain killers to herion once withdrawals set in. The medical community and the people they care for need to be aware of the risks to protect themselves and their families.

My Crazy Grandmother

I have always judged my grandmother for her craziness. Her craziness, unfortunately, ended up manifesting as the racist and paranoid type. But I realized today that maybe she and I may not be so different. I’m definitely not racist and not too overly paranoid, but I do have my own craziness. My grandmother was a nurse, just like me. She got out of it, just like me. Now she runs her own business and I’ve been thinking about going back to school for an MBA. I can’t help but wonder if she left because she didn’t feel like she could be controlled and regulated by someone else?

I have never asked her about why she left nursing. If she ever told me the reason, I don’t remember it.

I don’t talk to her often because of her racism, but maybe I should try to figure it out and address it… again. Before it’s too late.

Near death and my prayers were answered

In July of 2014, I was more scared for my life than I had ever been before. My boyfriend and I were on a road trip with my grandparents. We had decided to walk from the RV to the beach, which was less than half a mile. The previous day, a riptide had carried a teenager out to sea. They still hadn’t been found by the time we decided to embark on our adventure.

A riptide carried me out on Carolina beach and my significant other (We’ll call him Sig) nearly drowned trying to save me. We had gone to the beach for the weekend with my grandparents and Sig decided we needed to walk the 2 minutes to the beach while my grandparents rested from the long drive.

We walked to the beach and secured our clothes and towel onto the wooden pier off the boardwalk, tying them onto a beam so they wouldn’t hit the sand. We decided to get in the water up to our shoulders, no further. Two teenagers had gone missing the day before after a riptide drug them out to sea. I joked with Sig, saying it would be horrible if we shared their fate. Sig insured me that this couldn’t happen during high tide when the waves push you towards the beach. We saw the lifeguard riding past on a four wheeler, patrolling the beach. He passed by about every 5 minutes or so.

That’s when it hit us… A huge wave knocked my sunglasses off, which I surprisingly caught with my other hand. Sig’s glasses flew from his face and he luckily managed to catch them as well. After doing a few flips underwater, I resurfaced. To my dismay, I realized that I could no longer stand on my feet. The sand was no longer accessible to my toes. We laughed nervously and began paddling towards the shore. Another wave hit, pulling us under and even further out. I started to get a stitch in my side from holding my breath while being pulled under repeatedly. I have never been a good swimmer and my decreased lung capacity was not helping.

I looked at Sig, fear apparent on my face, and told him I couldn’t make it to shore. He chuckled briefly before a look of horror began to creep onto his face. He realized that I was not joking and he thought I was going to drown. I yelled at him to swim towards shore and get help, otherwise we were both going to drown. I could see him hesitate, trying to determine if he would lose me forever if he left me. I knew he wouldn’t be able to make it with me slowing him down, so I told him to go because it was our only chance. Sig began to panic and tried to swim against the current. I couldn’t use my arms to swim anymore, so I decided to flip onto my back and float.

A few waves hit me as I tried to catch my breath, an anxiety attack was about to hit and I couldn’t breathe. I was crying now, lifting my head up to look at the beach. Sig was far away and looked like a slightly bigger ant than the people on the beach. The waves weren’t carrying me under anymore, but I still couldn’t breathe and I was being dragged out further than I have ever been before. I prayed for the first time in a long time, floating on my back, asking God for our lives to be saved. Promising to be a better person for myself, Sig, and my family if we survived. Sig’s frantic screams for help floated back to me on the wind. I finished my prayer while looking up at the sky. “I’m going to die,” I kept thinking. “I’m going to die and drown alone at sea.” I hate the ocean, why was I even out there?

Oddly enough, I heard screams of relief shortly after this and a bystander was able to get Sig back to shore. Later he would tell me that the white Coca-Cola visor I had given him had saved us. He had been frantically waving it with his arms and someone finally noticed. The man swam out to save Sig on his boogie-board. I had drifted down the beach and hearing him getting saved gave me strength and hope . I flipped over and frantically started paddling towards the lifeguard that was paddling towards me. When he finally reached me, I collapsed. I couldn’t stand on my own two feet. I was exhausted, breathing hard, and wide-eyed panic was evident on my face.

I staggered towards Sig at the beach, three medics assessing him. I told the medic I was a nurse, I was fine and was just beginning to have a panic attack. They gave me oxygen, Sig was still being assessed. His oxygen was low, he swallowed too much water. He was hypothermic (low temperature) and needed to go to the hospital. I rode in the front of the ambulance, glad that they would notify my grandparents and allow me to ride with them, as this was usually prohibited. I felt sick, but I was fine overall. Scared, but fine.

Sig was hospitalized overnight due to the amount of salt water he inhaled. Salt water inhalation can dehydrate you and make your lungs collapse on themselves as water is pulled into the lungs to get rid of the salt. They put a warming blanket on him, gave him medication to help him cough up the salt water, and gave him warmed fluids to raise his core temperature. He saved my life and without him, I would be dead. There is no way that debt can ever be repaid. I hate the beach, more so than before.

We went back the next day to see if our clothes and his glasses were still there. Someone had set them up on the beach, the towels positioned around his stuff. It looked like a memorial in case he didn’t make it, but luckily he did. I wish I knew the name of the person that saved his life in order to thank them. Unfortunately, I will never know. I am forever grateful to him for saving us both.

Now, I never really believed in God, but so many little things went right that led to our survival…. So I’m blessed even though I can’t always see it…

My Butterfly Effect

So, today I created havoc with the butterfly effect caused by my actions.

I go up to the counter at the gas station to buy cigarettes and a SoBe green tea. Apparently, I grabbed the wrong card. So the transaction declines and I leave the drink on the counter while I drove back to the house to get the correct card.

Upon my return:

“When you leave, I think you take the drink.”

“Oh no, I didn’t…”

“I know, let me tell you… This guy come in after you leave and he fight with his girlfriend. He get mad and throw bottle over her head at door. He pay me $2 for the drink before he go, so it okay.”

He smiled at me and we laughed while I apologized for creating chaos. It was only amusing because no one got hurt.