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The Opioid Overdose Epidemic Ep 4 – The Addict’s Perspective

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The Opioid Overdose Epidemic Ep 4 – The Addict’s Perspective

By Lauren Brande | Published 12/4/17

Listen On: SoundCloud | Youtube | iTunes | Google Play

Welcome back to Let’s Talk Drugs, where we learn about drugs and addiction by looking past the stigma and into the research. We’re presented by ProjectKnow.com (that’s project k-n-o-w dot com), which provides important information about all kinds of substances in simple language that everyone can understand. If addiction or drug abuse has impacted your life or the life of someone you care about, please reach out for help at before it’s too late.

I’m Lollie, and in today’s episode we’ll continue our exploration of the current opioid overdose crisis. We’ve talked with Detective Nicole Lucas, who does incredible work in keeping the recovery market safe for people seeking help, and Dr. Stephen Grinstead, whose passion for helping people cope with chronic pain without using opioids has saved countless lives.

The Addict Perspective

This week we sat down with a young woman who has suffered the weight of this crisis firsthand.

Stephanie Muzzy: My name is Stephanie Muzzy, I’m originally from right outside of Boston, Massachusetts, and I have been sober for a little over 5 months. I was always an emotional person growing up and I was introduced to drugs at a pretty young age and I realized that it helped cover my emotions and made me not feel the things I didn’t want to feel. So, I realized that I could change my mood, so I continued to do that for quite a bit of years until I realized that I was absolutely addicted, not just mentally but physically. And anytime I tried to stop I would always end up going back.

I’ve been in treatment, long-term residential treatment, 7 times. And I’ve been in detox well over 10 times. I was never able to fully stop until now. I had some points of sobriety but I was never actually ready to really quit and stop until I started getting my life back together, and getting the things that I lost, and realizing that life is a lot better without drugs.

Stephanie’s story resonates with many people who are facing, or have faced, an opioid addiction. It’s rarely a simple story. For Stephanie, the struggle with heroin addiction started with prescription painkillers and quickly escalated.

Stephanie Muzzy: Heroin actually, I didn’t start until I was 25 years old. I had been doing opiates before that, I had started with 2.5mg of Percocet—just a half a little pill—and eventually my tolerance kept building up that I moved to a whole Percocet, 5mg, and then 10mg, and eventually I was doing Roxies which were 30mg, and a friend introduced me to the needle and said that if I shot the Roxy that it would feel a lot better. So, I tried that and he was right, it felt a lot better and it hit me a lot quicker and shortly after that, probably a week after that, he introduced me to heroin. And the first 2 times I tried heroin I overdosed.

The first time I woke up on my couch in my living room with the EMTs there and I was in denial about the fact that I overdosed. I kept saying, “No, I was just asleep, I took a nap.” And then I went in the bathroom and I cried because I realized that I’d actually just overdosed on heroin. Heroin is like, that’s the drug that you hear growing up that’s like, “Oh that’s so bad, I’ll never do that,” but I did it and, to be honest, even though I overdosed I absolutely loved it and I knew that it was going to be a problem from then on, and I didn’t stop until probably about 6 years later. I was doing it on and off for about 6 years.

I’ve done so many horrible things for drugs. I’ve stolen from stores, I actually went to jail for 9 days because I got caught stealing at Kohl’s. I’ve stolen from friends, I’ve stolen from family. I’ve lied about everything, I’ve made up the craziest excuses just to get money for drugs. Losing my family was a lot of it. My mother, she basically disowned me for a while, she wouldn’t talk to me, she didn’t want anything to do with me because she’s not an addict and she doesn’t understand how physically and mentally addicting it is. She just doesn’t understand. So she thought I was just doing this for fun and that I could stop at any moment and the truth is I couldn’t.

Addiction doesn’t just go away, it’s an ongoing challenge that often involves multiple cycles of relapse and recovery before landing in lasting abstinence. Rates of relapse for addiction rival those of other chronic medical conditions, like type I diabetes, high blood pressure, and asthma.1 Nearly 40-60% of addicted individuals will face relapse at some point during their recovery, and heroin relapse can be particularly tragic.1

Stephanie Muzzy: Being in and out of treatment I make a lot of friends in the recovery community. The recovery community is also a relapse community. So, every other day, I would hear of another friend overdosing and dying, and that’s hard. And you’d think that hearing about all these people dying would have stopped me from doing drugs but in reality it didn’t, I kept going. The more emotional and the harder my life got, the more drugs I did, the more I fought to not feel those feelings anymore, and it was a never ending, viral, downward spiral. Until you make the decision that you really truly want a better life, it’s just going to get worse and worse and worse. And every time you get sober, when you relapse, you pick up right where you left off. You can, not just tolerance-wise but in the struggle where you were, you don’t start off at the top again and work your way down, you start off right at the bottom where you were.

Trying to predict who will develop addiction and who won’t is incredibly complicated. Many factors come into play; it’s not only using drugs that sets a person up for addiction. Individual risk factors can include personality traits, physical health, psychological health, stress levels, school difficulties, prenatal exposure to substances (including alcohol and nicotine), exposure to trauma, employment status, income, and the big one: genetics.2

Stephanie Muzzy: Addiction is, I feel like once you know you’re an addict you know you’re an addict and you will never be able to not be. But I feel like in the beginning, you’re just in denial and you’re very naive to the fact that you could possibly be an addict. Alcoholism runs in my father’s side of the family and I did not grow up with my father, so I knew nothing about it except what they teach you in health class.

However, my mom did always warn me, alcoholism runs in your side of the family so be careful. And I was like, “Yeah mom whatever, I’m not going to become an alcoholic.” But I never thought that drugs and alcohol were similar in that way. Alcohol is legal and everyone drinks it. I didn’t think that I could become a drug addict. I didn’t know anything about it and I didn’t know that taking half a pill one day would lead me to life of rehab and detox, overdoses. And I feel like when you’re young, I have a co-worker who, she’s 20 years old and I see every single characteristic in her that I had in me at that age. And I see that she has no idea what she’s up against.

Like you said, some people don’t have that genetic disposition where they could ever become addicted to stuff. I mean, I partied with people in high school, they’ve never overdosed on heroin. But we used to party hard in high school and college and, now they’re all normal happy, married with kids and a great job, and a beautiful house and a career, all this stuff, and here I am 5 months out of rehab.

These individual factors are not the only things that can influence a person’s vulnerability to addiction. Family, community, and society all play critical roles in a person’s risk of developing an addiction.2 The term socioeconomic status refers to an individual’s family income, education, financial security, perceived social status, privileges, and general quality of life. Socioeconomic status, or SES, something which a child has little to no control over, can play a major role in substance abuse and subsequent addiction.3-5

Many times, addiction reflects the accumulation of many different risk factors, many of which are well beyond the individual’s control. One person could try a drug an enjoy the high without experiencing the compulsion to use again. Another may take a pill for an injury and end up changing their entire life.

Stephanie Muzzy: It’s crazy because you look back at some of the people I was in high school with and there are a ton of us that are in recovery now. One of my closest friends from high school just picked up 6 months last weekend. And I never would have thought he was an addict, ever. But it started with an injury for him and he was in the army and he took painkillers and eventually the painkillers just aren’t enough and you move onto heroin. Heroin is horrible. It just takes over every single cell in your body. It starts in the brain, it’s not even the physical part, it starts in the brain and it blocks the receptors. The pleasure that you feel, it gives you all of that pleasure at once.

It’s not a feeling you can get in any other way, shape, or form. It’s incomparable and the mental part alone is—I don’t want to say it’s the worst part because the physical is definitely horrible as well—but it just takes over your whole body and you will do anything for that drug. And that’s how I knew I was absolutely an addict, hands down, because I would do anything to get money for drugs. Or do anything to get those drugs.

I did things I said I would never do. I would never steal from my mother right now, being sober, ever, ever, ever. I would never steal from anyone being sober right now, but when you’re on that drug, you don’t care. And that’s how I knew that I was suffering from addiction. I could never stop myself when I wanted to. I would say to myself this is bad, I shouldn’t be doing it, don’t steal from your mother. The last few times I overdosed, I broke into her jewelry cabinet again and I stole her jewelry. 6 years later after I said I would never, ever, ever do that again and I did it.

I would never imagine doing something like that sober, hurting my family like that. When I’m sober I am fun, I’m outgoing, I’m social, I am nice. Ok, well I’m not always nice, because I’m still mean sometimes. But, when I’m doing drugs, like I said, my mom can always tell when I’m, not even when I’m high, but just when I’m in the midst of using. She can tell because I have a different tone in my voice, I have a different attitude, I don’t care as much about things, I sleep a lot.

When you’re a drug addict you just don’t care. You don’t care about anything except getting that drug. You don’t care who you hurt, you don’t care about hurting yourself, you don’t care about the consequences, about going to jail. Anything like that. You need to get your next high. And it’s not even about getting the high at that point, because you’ll never get that first high again, it’s just about feeling normal. If you don’t do the drug, you feel terrible, you feel sick, you feel tired, you feel depressed, and once you get that drug back in you, you feel normal again. And at that point, that’s all the chase is, to feel normal.

Experiencing withdrawal symptoms when not using the drug, or using the drug to avoid these withdrawal symptoms, is part of having a physical dependence. The opioid withdrawal syndrome has been described by many as one of the worst flus imaginable: you vomit, have diarrhea, headaches, your muscles and bones constantly hurt, you have a fever but feel cold, your blood pressure and heart rate are constantly high, and to top it all off you have insomnia, depression, and anxiety.6 Most people would do almost anything to escape that symptom hell, and for many this means turning to the quickest cure: relapse.

Stephanie Muzzy: It gets to this point where all you care about is not feeling sick anymore. All you care about is getting that feeling. I mean, heroin is like a warm blanket over your whole body. It’s disgusting but it’s all you care about. You don’t care if you’re going to die, you don’t care if your whole family is going to have to mourn you for the rest of their lives. You don’t care about that at all. You’re so depressed in the addiction and the terrifying feeling that you have every single day of this that dying sounds easier.

I was to the point where, I wouldn’t say I was suicidal, I wasn’t purposely shooting up heroin so I would die, but I did not care if that next shot was going to kill me because I didn’t care if I lived or died. I didn’t want to feel these feelings anymore. I didn’t want to have to wake up and feel sick or who am I going to get the drugs from, all that stuff is such a tedious life to live.

It’s when you get to the point where you just don’t care, you don’t want to live anymore. So, yeah let me try the heroin that’s going to make me feel better and if I die, oh well. It really comes down to that. It’s a matter of, “If I die, oh well.”

Tragically, that possibility is all too real. Overdosing on an opioid like heroin or prescription painkillers can be deadly. Not just dangerous, deadly. Opioids slow your breathing and heart rate down, which is part of their relaxing effect.7 If you take a dose that is too high or too potent for your body to handle, which happens frighteningly often with the recent influx of laced super-potent heroin, your breathing and heart rate will get progressively slower, and slower, and slower until they eventually just… stop.

Opioid overdose generally isn’t as eventful or chaotic as Hollywood presents it to be. Often, to the overdosing individual it can simply feel as if they fell asleep for a while. What they don’t realize is that during that time they were completely unconscious and unresponsive, verging on death.

Stephanie has experienced opioid overdose multiple times. I want to go ahead and issue a quick warning: the experiences she is about to describe may be disturbing for some listeners.

Stephanie Muzzy: The first overdose I experienced, like I said, was my first time injecting heroin. I don’t remember anything about what it felt like, it was instant. Like I said, I remember waking up with the EMTs in my apartment, my friends were all crying because they saw me, they thought I was dead. And I guess since I didn’t feel anything, the feeling of the heroin outweighed the feeling of the overdose.

So, the next day I did the exact same heroin that I overdosed on the first time. I did it again the next day. And I was in a parking lot in my car and I specifically remember this time. I didn’t know how to use the needle myself, so I had a friend do it for me, and the second he did it, I just remember him saying, “Are you ok?” and I remember looking out the window and I leaned my head against the window and I said, “I’m just going to close my eyes.” And he said, “No, don’t do it, don’t do it,” and again the next thing I know, I woke up with the EMTs pulling me out of the car. My friend had a warrant for her arrest, so she was getting arrested. My car got impounded, they cut my sweatshirt off of me, keep in mind it was a zip-up sweatshirt and they still cut it.

I lost my shoes, I had to pay $380 to get my car out of the impound. It was just, horrible. And I think at that point, that’s when I realized that I could possibly geographically get away from the drugs. So, I didn’t overdose again until a couple years later. I had moved to Florida and I went home to Boston to visit and I was with a friend and I didn’t even use the needle this time, I hadn’t done heroin or any drug for that matter—I had been sober for about 18 months. This time when I did it, I wouldn’t say it was a mild overdose because it was still very bad, but I didn’t actually pass out this time. I sniffed 2 lines of heroin, which my tolerance hadn’t been built up because I hadn’t done drugs in so long. So those 2 lines affected me like I had done, many, many more.

And I remember throwing up all over the parking lot. I remember my friend brought me into the Dunkin’ Donuts bathroom so I could throw up and I could not get off the toilet. I was just sitting there fully clothed just sitting on the toilet not being able to move my body. This lasted for a long time, because we went to a grocery store and they had to walk me in that bathroom too. I had no control over my body, I could not move.

The past year, besides the 5 months that I’ve been sober, I overdosed 4 times on heroin, one time on cocaine. The 4 times on heroin, one of the times was actually at my drug dealer’s house. I had done a little bit in the bathroom before I left and I walked out into his bedroom and I just collapsed and I fell into his tv, I actually broke his tv. And he caught me, kind of, and he just laid me on his bed and I don’t know what this guy was thinking, I could have been dead, but he laid me on his bed and I just lay there. I guess 2 or 3 hours had gone by because by the time I woke up I realized I was late for work and it was my first full day of work at a new job. And I went in there right after I overdosed on heroin.

A couple other times I woke up in the bathtub with a blanket and a pillow. I woke up on the toilet again, again late for work because I had fallen asleep on the toilet. It basically just feels like you’re falling asleep sometimes and you just wake up and you have no recollection of what had happened. The time I overdosed on the cocaine was the worst. I had been injecting cocaine for 12 hours straight. I lied to my family, I told them I was working because I worked overnight.

And the next morning and I said to my mom I need to go to the hospital. And I already have a heart problem. I had surgery when I was 16 so, injecting cocaine is definitely not the best thing to do. And I did it, all night for 12 hours straight and my heart was about to fail. It was popping out of my chest, by the time I walked in and sat on the couch I could not move my body again. I felt that I was going to be paralyzed, I kept asking the EMTs, “Am I going to be able to feel my legs again?”

And they put me on the stretcher—my mom had to call the ambulance and the EMTs came put me on a stretcher—and they wanted to take off my sweatshirt and my mom didn’t know at this point what I had been doing. I had lied to her and told her I was sober, she knew I was up to something, she always knows, she didn’t know exactly what. So the EMTs wanted to take off my sweatshirt and I didn’t want them to because I didn’t want my mom to see all the bruises and track marks all over my arms. I had been literally injecting a needle in my arm every 20 minutes for 12 hours and my arms looked like a pin cushion. It was absolutely mortifying and I didn’t want my mom to have to see that.

I got in the ambulance and I was convinced I was never going to walk again, I was never going to be able to move my body again. And they brought me into the hospital and they ended up giving me Ativan or something to calm me down. And eventually the feeling started coming back into my body and I was like, “I’m never going to do drugs again, that was the scariest thing ever.” I was in the hospital for 6 days after that and I got out of the hospital and I gave my mom my car keys and my debit card and I said, “Please, while you’re at work, I don’t want any way to be able to get out and go get drugs or anything.”

And when she went to work, I searched the house, I found my debit card, I found my car keys, I drove an hour to go get more drugs. And I did cocaine one last time. And this time, it was like, I had that thought of the overdose in my head and how hurt my mother was. Seeing her look at me while I’m being carried out of her house on a stretcher, that was the first time my mom had ever seen me like that. And I didn’t want her to see that ever again.

My mother and I call it the 911 moment. It was also the moment where she was able to distinguish her life from my life and realize that she can’t save me. And that she can’t dedicate her whole entire life to me, that she needs to do what she needs to do and she needs to let me be on my own.

Opioid overdose doesn’t just affect the person who is struggling with addiction.

Stephanie Muzzy: I’ve lost so many people from overdoses, from close, close, close friends to, when I worked at a treatment center, patients that I had, acquaintances and it’s astonishing how many people are dying from drugs. I can count at least 75 people in the last 5 years that I have either known or been acquainted with that have overdosed on heroin specifically and died.

Just last week one of my really, really good friends died from heroin overdose and heroin was never even her thing. She drank alcohol, that was her thing, but the disease of addiction it progresses and progresses and eventually she was shooting heroin and it killed her. And not only does it kill the person but it kills the family.

I’ve spoken to a lot of people’s families of people who have overdosed and hearing the pain in their voice, addiction is a family disease and it takes over the whole family. Everyone suffers, but I think that the epidemic of the overdose it’s greatly contributed to what people are doing with heroin these days. There’s fentanyl being put in it—the smallest amount of fentanyl can kill someone.

But it’s also the fact that people’s tolerance builds up and builds up and builds up, and the heroin that you start with, you don’t end with. You end up doing 10 times that much in one shot and sometimes you don’t know what’s in that heroin or you don’t know exactly how much you’re putting in. You don’t know what it’s cut with and you think you’re doing just your normal dose and it’s something way stronger and it kills you instantly.

And the really sick part is that if you overdose from heroin and make it through, usually that’s not enough to scare you and you’ll go back like I did and do the exact same heroin again. Knowing that it could possibly kill you but at that point you just don’t care.

The fallout of this overdose epidemic extends beyond the user to family, friends, emergency responders, treatment center staff, doctors, law enforcement, and countless others who are simply heartbroken at the fact that tens of thousands of people are dying every year. This is part of why it can be so upsetting to hear someone suggest that people struggling with addiction should be punished rather than helped.

Stephanie Muzzy: This is such a controversial subject and people post about it on Facebook all the time. And the people that are posting about it on Facebook are the ones who are not addicts, they don’t know what it’s like, they don’t understand. Someone posted the other day, “If drug addicts get Narcan for free, why can’t cancer patients get chemo for free?” That is not the same thing. Oh no, this person actually posted, “Why can’t a person get a kidney for free?” They wanted to compare Narcan to giving an actual organ to somebody and I could not comment because I just would have gone off. I mean, there is no comparison between an organ and a medication.

The medication can be made in mass quantities, organs are not. And this girl, I couldn’t believe how naive and how just in denial she was about this. Overdose is a thing and it happens and it’s not because we choose to try and kill ourselves, it’s not like that. Addiction is a disease centered out of the brain. I’ve learned so much about it being in treatment so many times and Dr. Bradley wrote a book about it. And the fact that it is a disease. Yes we make the choice to get high, yes we make the choice to do the things we do, but we don’t make the choice because we want to, we make the choice because the chemicals in our brain are telling us to.

It stops us from having any sort of conscience and I think that people saying that drug addicts should go to jail for overdosing is absolutely ludicrous because I didn’t overdose because I wanted to. I didn’t ruin my life because I wanted to, I ruined my life because I have the disease of addiction and I can’t stop that. I can’t tame the chemical make-up of my brain and just not be an addict anymore. I can change what I do and I can change my life so that I don’t do the same behaviors, but I will always be an addict. Just like a person with diabetes will always have diabetes.

It’s something you have to live with and deal with for the rest of your life and putting someone in jail is not going to help that. Would you put someone with diabetes in jail? If everyone wants to make comparisons and stuff, it’s a disease, you don’t put someone with a disease in jail. Well, I mean, you know what I mean.

The stigma surrounding addiction and rehab is pervasive. It creeps into politics, healthcare, and everyday life, reinforcing misconceptions and leaving the people who are actually struggling out to dry. Most people probably know someone, either firsthand or secondhand, who has struggled with opioid addiction or overdose at some point. More than 1 in 25 people used opioid pain relievers or heroin illicitly, meaning illegally, in 2016 alone, and almost 20% of these people struggled with an opioid addiction.8

Healthcare costs for pain management options have also reflected the fallout of this epidemic. As drug control crackdowns fall heavily on prescription pain management, the costs associated with healthcare have increased.9 As Dr. Grinstead pointed out in our last episode, the U.S. swung from overprescribing opioids to potentially undertreating pain, leaving many to face unnecessary suffering and doing little to curb the high rates of abuse and addiction.

Because addiction can be so poorly understood, the “solution” for this epidemic can be extremely difficult to pin down. One of the biggest debates surrounding the opioid crisis in recent years pertains to a particular drug called naloxone, or Narcan. Narcan is a drug that can immediately reverse the symptoms of an opioid overdose, and it has made a major difference in the current crisis.10

Stephanie Muzzy: I believe that Narcan is, I want to literally say the word “lifesaver” because it is. I would have lost one of my best friends from an overdose about 2 months ago if Narcan wasn’t readily available. I would have been dead numerous times if Narcan wasn’t available. I think that having it readily available and having people have the awareness of how to use it and the benefits of it, I think that, I have a bunch of friends who are getting Narcan certified who are legally allowed to carry Narcan with them.

And I think that, I mean, I need to get some for my house because god forbid I ever have anyone overdose in my house. If I have Narcan, I could possibly save their life and I think that Narcan and naloxone and all of that, I think it’s probably the closest thing to, I don’t want to say cure, because that’s not at all what it is, but the closest thing to battling the overdose epidemic. I think it’s the closest thing that has come to being able to even put a dent in the overdose epidemic. And I think it’s great. I think it’s saving lives every day and it’s something that I need to get my hands on, actually.

Despite the life-saving benefits, many view Narcan as a drug that enables opioid abuse. In Ohio, city councilman Dan Picard proposed a three-strike policy for people who repeatedly experience opioid overdose, meaning emergency responders would resuscitate two times, but on the third overdose they would not intervene, leaving the person to die.11 Many other punitive approaches have been proposed, from high fines that most struggling people can’t afford, to extended jail time that doesn’t offer any kind of help or treatment.12

Should these disciplinary policies go into effect, they could potentially do more harm than good. There are many different sides to the current crisis, but the fact remains that the U.S. is in the middle of an epidemic with tens of thousands of people needlessly dying every year. Many view addiction as a choice rather than a disease, but this point of view often fails to reflect the deep complexities that lie behind the development of an addiction.

Stephanie Muzzy: I think the most poorly understood thing is that there’s this disease vs choice model and you’ll notice that most people who choose the choice model are the ones who are not addicts. They think that we do everything we want just to get high and that we do it all because we’re pieces of crap and we’re scum and we don’t care about anybody, and that’s not the case at all.

I could steal my mom’s jewelry right now if I were high or if I wanted to get high and I would feel terrible about it, but it would not stop me from doing it, because it’s the brain make-up. And I think that the most common misconception is that we choose to live like this, we choose to be miserable, we choose to continue to do the same things over and over despite negative consequences, but that’s a symptom of addiction. That is literally a symptom of addiction, choosing to do the same things over and over despite negative consequences and it’s not something that we just choose.

* * *

If we want to help, I mean actually want to help save lives, we first need to take the time to fully understand why this crisis is happening. We’ve taken a close look at the current situation from the perspective of three people who interact with this crisis every day:
Detective Lucas, Dr. Grinstead, and Stephanie.

All of them offered excellent advice on how we can work together to help those in need, from vital policy changes to daily practices that can not only help those who are already in the throes of opioid addiction, but also help prevent future generations from continuing to suffer the weight of this crisis. In the next episode we’ll talk about their advice on the various ways that everyone can help alleviate the current crisis. Take a second to subscribe to our channel so you don’t miss out, and let us know what you think on the ProjectKnow Twitter or Facebook with #letstalkdrugs.

If you are worried that opioid abuse has taken hold of your life or the life of someone close to you, we are here to help. Call to speak with a treatment support advisor about finding help.


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Sources

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