Two Women Tried Using Drugs to Get Off Drugs. It Worked For One of Them.

When Prince died of an apparent opiate overdose, a specialist was on his way to Prince’s home with buprenorphine – a drug, like methadone, administered by doctors to wean addicts off opioids.

The use of those medications is controversial. They work for some people, they don’t work for others, and they’re no panacea: Getting off of them still involves a pretty hideous period of withdrawal.

We talked to two recovering heroin addicts about their experiences with Medication-Assisted Treatment. MAT worked for Keah. It didn’t work for Laura.

Getting hooked

The first time Keah did heroin, she couldn’t move for hours. But she loved it. “I remember thinking to myself, ‘This is it. This is going to be a problem,’” she said in an interview. “I knew immediately it was what I was looking for my entire life, this feeling that I’d never felt before.”

Then she got sick for two days. But she pushed through it. She was already hooked.

Laura started using painkillers she found in her grandparents’ medicine cabinets when she was 18 or so. She used them to come down off of cocaine so she could sleep and not feel so edgy. She found she preferred the opiates to cocaine anyway. Within a few months, she was using heroin off the street. 

“At first [the high] lasted a really long time for me,” said Keah. “Once you’re using regularly, you don’t even really get high, honestly. It’s just to feel normal, so you can function. At the end there was really no pleasure in it at all, it was just to get through the day.”

Withdrawal

They both had multiple attempts at rehab, suffering through the acute phase of withdrawal -- vomiting and diarrhea, stomach cramps, chills, runny nose, insomnia, and utter exhaustion. “It’s like the worst flu you’ve ever felt,” said Laura.

The sickness starts within eight to 12 hours after the last dose. Sometimes they’d go through withdrawal just because they couldn’t get their hands on any drugs; sometimes because they were trying to get clean.

After the violent physical illness, it got even worse. “I had absolutely no energy, no drive to accomplish anything,” said Keah. “I could handle being sick, but this feeling would drag on for months for me -- this feeling of not having any drive to live.”

“That’s where I ran into problems,” she said. “I could get clean, but I couldn’t stay clean. Why would I want to get clean to feel like that? I felt like it was never going to end.”

Each worked on and off in restaurants and retail, eventually getting fired for stealing money or just not showing up.

“You get exhausted from doing the same things day after day that you have to do to get high: hustling money and then going to get it,” said Laura. “It got to the point where I didn’t even want to do it anymore but continued to do it because I would be sick if I didn’t.”

“Then it’s like a moment of clarity,” said Laura. “A desperation and a loneliness and a pain, and you’re just like, ‘I can’t keep doing this.’”

Getting put on suboxone, and then kicked off

Laura's family had read an article touting suboxone as a “cure” for opiate addicts. Suboxone is a mix of the opiate buprenorphine and naloxone, which is an opiate blocker that keeps you from feeling the effects of the drug.

“[My family] had known I’d tried a lot of different routes and nothing was working, so they naively thought this was going to be the answer,” said Laura. But she was always supplementing the treatment drugs. She failed her drug tests week after week. Opiates wouldn’t work while she was on suboxone, so she did other things. Finally, her doctor kicked her off the suboxone. She was going through a messy breakup at the time, too.

“What happened was the worst detox of my life,” Laura said.

“The way suboxone is touted, I don’t think people realize that you still have to detox from it,” Laura said. “Even when you taper down to a really low dosage, I don’t think people get that you still have to go through withdrawal.”

“That’s the danger that I find in it,” Laura said. “It just prolongs the inevitable: that you just have to stop using drugs.”

Methadone and suboxone are time-released, so it takes a couple days for withdrawal symptoms to hit. But then they last longer. The illness that takes three days with heroin withdrawal is less violent with methadone and suboxone, but lasts for "a solid week," according to Laura. 

“It’s almost worse, because it’s longer,” she said. “It’s mentally draining to go though that.”

Once the opiate blocker was out of her system, Laura went on another tear, shooting dope again -- but only for a few weeks.

“I finally was just exhausted,” Laura said. “And that’s when I went to treatment and got clean and stayed clean.”

She says a 12-step program worked for her. After detoxing, she lived in a recovery house for a year and a half, where at the age of 26, she learned how to pay bills and go grocery shopping and make dinner like a normal person.

Methadone – because “I didn’t have luxury to go to rehab.”

Keah was just about to enter a rehab facility to start methadone when she got arrested for a parole violation. Once you’re in jail, you get kicked to the bottom of the list for rehab. When she’d walked in herself, they’d promised her a bed the next day. But she spent six months in prison detoxing the hard way before she could get rehab once she was arrested.

She stayed clean for several years that time, but then relapsed when her boyfriend started using again. At that point, they had two babies – one they had together and one he’d had with another woman who was worse off than they were.

“That’s how I ended up on methadone,” said Keah. “I didn’t have luxury to go to rehab. I had two babies. He wasn’t going to get clean, and he couldn’t take care of the kids even when he was clean. He could barely take care of himself.”

She wasn’t ready to tell her family that she’d started using again -- after four years clean, with two babies in the house.

Keah was supposed to go on methadone for nine months to detox, going up to 60 milligrams and then down to 6.  Just before she was supposed to stop, she says her kids’ father physically assaulted her and she ended up in the intensive care unit with a ruptured spleen. She was sent home with two bottles of oxycontin. 

Pretty soon, she was getting heroin on the street again.

Finally, she decided enough was enough. She had to take care of her babies. Her methadone clinic had a branch in a different town, and she transferred for a fresh start and ended up staying. She went back up to a “therapeutic dose” of methadone – enough that she wasn’t getting high but that she wasn’t having cravings and wasn’t sick.

“I stayed at that to level off, get my s*** together a little bit, and then as soon as I felt comfortable, we started slowly going down and tapering off,” Keah said. “That took another year. Something that was supposed to take nine months took almost two years.”

Withdrawal from methadone

“Getting off methadone wasn’t the easiest thing I’ve ever done,” Keah acknowledges. Even doing it at a slow pace, with a lot of support from family and doctors, detox wasn’t trivial.

“Because it was so slow, I wasn’t in pain,” Keah said. “But I had diarrhea for three months straight. Night sweats. I don’t think I slept a full night for close to a year.”

It took both women years to realize that not every sneeze or yawn meant withdrawal was coming on. Those used to be the first warnings. It took them a while to remember that “those things happen in normal people, too,” said Keah. “I had to retrain my thinking to realize that every time I had goosebumps it wasn’t because I needed to do heroin.”

Laura says chills are still a trigger for her.

Plus, Keah says, it took a long time just to remember what it feels like to go through life without substances to help you through. And sometimes it’s hard.

“That’s what I got from opiates, that feeling like now I can go clean my house and organize my things,' she said. "Having to do that on normal human energy was a struggle for me.”

Judged in Narcotics Anonymous

Keah doesn’t go to a 12-step program like Laura does. “I never felt welcome back there,” she said.

“It was such an important part of recovery that first time, because it held me accountable,” she said. “Unfortunately I never got that again.”

She felt there was a stigma in NA against people who take substitutes to get off of drugs. They say you’re not really clean if you’re on methadone or suboxone.

“Everyone I know who’s successfully taken methadone and gotten off of methadone and stayed clean, they don’t go to NA,” Keah said.

“I didn’t want to deal with that judgment,” she said. “It took me a long time to just be OK with myself and being on methadone, because I did feel like, ‘I’m taking the easy way out; I’m so weak; why can’t I just do this?’ But I just felt like [methadone] was my only option at the time. And it worked wonderfully for me.”

Laura said she went to her 12-step program while she was on suboxone and didn’t feel that judgment. “People explained, ‘You’re not clean, but we love you, keep coming here,’” Laura said.

Epilogue

Keah continues to raise her two 8-year-olds alone – the child she bore and the child born of the woman who had an affair with her boyfriend. Keah says that woman is still wrestling with her addictions. She hasn’t been in the child’s life since he was a newborn. 

It’s been four year since Keah came off the methadone. She’s stayed clean.

Laura is married to a man with his own history of addiction, but they’ve both been clean as long as they’ve known each other. The strongest drugs they do are cigarettes and coffee.

She’s a stay-at-home-mom to a son who just turned two. She still goes to a 12-step program. “I’ll be at a meeting sometimes and someone will be like, ‘You don’t look like you were a junkie,’” Laura said. “And I say to them, ‘I hope I don’t look like a junkie anymore.’”

She’s been clean 12 years.