As I entered my fiftieth year of life, I decided I would take up indoor soccer again. A few months later, that decision led to a torn ACL and meniscus injuries, and in March this year I went under the knife to have the ACL reconstructed. My surgeon prescribed a 30 day supply of oxycodone for pain relief. As I sat in a chair or lay on my back over those first few days post-surgery, I was grateful for the relief, and that the drugs also allowed me to get straight into physical therapy.
Around day 4 or 5 I noticed a difference. Every six hours I popped a pill, but on this particular occasion, within a short time I was feeling something new. A focusing of the mind that I had not had because of sleepless nights from my inability to sleep on my back. I suddenly felt like all those writing projects bouncing around in my head were possible. And I felt a feeling I can only describe as something like euphoria.
And I really, really, liked that feeling.
But then the feeling went away. Just thirty minutes later and I was back to my fatigued, incapacitated self. Where everything looked bleak, when all those ideas that had come into sharp focus returned to their jumbled selves, and all I wanted to do was watch hours of original programming on Amazon Prime (The Grand Tour, actually, of which my daughter observed, “Since when have you been interested in cars, papa?”). As I glanced up at the mantelpiece in our bedroom and saw the line of orange bottles containing all the prescription medication I was taking, the smallest – the one with the Oxycodone in it – began to take on an almost mystical glow. “I could feel that feeling again, if I just took another one of those.” I didn’t need it for pain in that moment, but I wanted that feeling back. And then I had a moment of clarity: This is why people get addicted to opioids.
Many of the victims of the opioid epidemic in the USA are people not that different than myself. Perhaps they, too, had surgery, or began to experience chronic pain, and a doctor or surgeon prescribed a 30 day supply of opioids, and just like that, they began to chase that same feeling. Because, I confess, it is pretty wonderful. And I am familiar with all the mental games we can play to shut down the voice that suggests this might not be a good idea. “The doctor prescribed them, so they can’t be that bad, right?” “I’m heading out and need to feel OK, so why wait another 3 hours for the next dose?” “Look how much work I can get done – I’ll just keep taking them till I catch up…” Yes, I understand why people can become addicted to opioids.
I also understand why people stay addicted.
I developed a staph infection post-surgery, and ended up in the hospital for a week, with a couple more surgeries to try and deal with the infection. I was still taking Oxycodone, but also receiving morphine through an IV “as needed” following the third surgery. The pain in my knee from both the infection and the surgeries was pretty significant, and again, I was glad to experience the relief the drugs provided. When I was discharged, IV drugs were obviously no longer available, and my surgeon increased the amount of Oxycodone I was taking “to compensate.” I was now taking three times as much as when I first began taking it two months earlier.
The pain dropped off pretty quickly, and about 10 days after I was discharged, I reduced the amount I was taking to the initial dose. And immediately went into withdrawal, as I had become physically addicted to the drug. I can only describe the experience as similar to a really bad bout of flu. My body ached, I had chills, I stumbled rather than walked and my speech became slurred. I was curled up in a ball on the couch, utterly miserable. And I didn’t understand what was going on. It didn’t cross my mind at first that I was in withdrawal as I was still taking the drug. But the dropoff in dosage had been precipitous, and that triggered withdrawal. What I did understand all too well was that when I took the next dose, I felt so much better within just a few minutes. Until it wore off, and I felt like death warmed up again. And sometime in the next few days I had another moment of clarity: This is why people must find it so hard to get off opioids – because I know that this misery will go away if I pop another pill or two.
I ended up seeing a pain management specialist, who helped wean me off the drug gradually over a period of six weeks or so. I was highly motivated to stop taking them, but when I finally stopped taking them, there were definitely moments in those last five days of misery when I thought about taking a pill, “just to take the edge off.” But I didn’t, and have not taken one since. And I’m pretty determined that should I ever need that kind of pain relief in the future, I won’t be using opioids or any other narcotic to seek it.
I took my first dose of Oxycodone on March 2, and my last on July 2. Four months of daily putting opioids in my body, several weeks of which were long after I actually needed them for pain. I understand – in a way I didn’t before this experience – why people both get addicted to opioids, and why they find it so hard to get off. But there’s so much more contributing to the epidemic of people experiencing opioid addiction than what I’ve described here.
In my next post I’ll explore why this is indeed a national crisis.