Thursday, June 30, 2011

Be Here Now


WE'RE HAVING FULL-ON SUMMER HERE. It's been sweltering. I have behaved myself most of this week (haven't stabbed myself in the foot for a few days and am not intending to stab myself anywhere ever again).

I have switched to drinking my methadone in the morning rather than at night. This seems to prevent excessive sweating. I'm less "peeved" with methadone than I was a few days ago. That was depression talking. I find it hard to accept that it's supposedly "better" to drink a sticky gloop to get off street heroin, when the gloop's a lot more addictive than the heroin.

Knowing that heroin is used extensively in British hospitals as a first-line treatment for serious pain and that a small number of addicts (and a larger number in central Europe; Switzerland being the only country prescribing heroin to addicts as a matter of course) muddies the waters. It would be far easier to convince myself that heroin is pure evil and I'm better off without it. I console myself that I'm better off without it, and whether or not heroin is evil, or how evil it is, doesn't matter. Because I don't want it any more.

I believe it's better to be off heroin than on it and I want to get off it. The practicalities of heroin involve placing your wellbeing in the hands of ruthless criminals and being treated as a social pariah ~ especially by the medical profession. It's true that most of the damage caused by heroin is a direct result of "prohibition"; but as I say, I'm moving on from wanting anything to do with heroin at all. So the ins and outs of legalization and heroin prescription to addicts concern me no longer.

As Shane of MemoiresOfAHeroinHead fame pointed out, methadone clinics are no more "caring" (or reliable, for that matter) than your friendly neighbourhood drug dealer. They're often little more supportive. Shuttling "clients" at whom from worker to worker. Motivated more by box-ticking than any true measure of your personal welfare. My fellow blogger Sid has run up against the NHS's predictable "one size fits all" mentality in drug treatment clinics. He's worked for years and feels the system is set up for "junkies". I would say it's worse even than this. I shambled into my old clinic for years with pretty obvious "mental health" symptoms that were never, ever addressed. Nobody ever asked how I was. They were totally obsessed with drugs. Only interested in what drugs I had and hadn't been using. Never asked about me or my history. One was surprised to learn I'd "only" been a heroin addict since 2000. I'd had depression for many, many years before I ever got involved in heroin.

I used to marvel at the fables some of my friends told down the drug clinic. About how little they were drinking. About how little they used. People on the gear and crack constantly, who the clinic appeared to believe were doing ever so well. Until the Heroin Drought last year, in fact, everybody I knew used heroin at every opportunity. Most of my own circle had given up on crack or never really been into it. That drought gave a lot of us the option, at long last, of putting our weariness into practice and finally giving gear a miss. I know at least three people who are still clean to this day. One is in her fifties. The other two are in their sixties.

I was always pretty frank down the clinic about my using. I wanted a bad record so when diamorphine prescription got brought in I'd be first in line.

Now I see things the way everyone else always did. You help your worker out by saying all the right things. Then they can tick the right boxes and look like a successful worker. You take your methadone scipt and go. You sort out your own life yourself. The tedious group therapy they costantly try and bully you into is yet another cosmetic exercise. Sounds good on paper. In reality I found selected fellow "service users" too exasperating for words. Parroting what they knew was expected of them. I don't remember ever going to such a meeting without drinking heavily first and hitting up smack afterwards. That's what drug-talk does to you. Makes you wanna use.

I'm fortunate in that my new worker is Africian. I'm hoping she'll be to teach me whatever mysterious language she speaks. That's the best use of our time as far as I'm concerned. Considering I'm not intending to be ON any drugs, there won't be any drugs to talk about. And I'm not considering group therapy yet again. I've had enough therapy to last a lifetime..

I think the standard of personnel these clinics take on has actually gone DOWN in recent years. When I first got scripted methadone nearly ten years ago I got the distinct impression most people working down the clinic were ex-junkies themselves. That does not seem to be the case now. My new worker didn't even know what schizoaffective disorder WAS. I wouldn't expect a normal person to know this, but I would expect it of a drugs worker. Also, they seemed obsessed by the suspicion that I must surely be using something else apart from tiny bits of heroin on top of my script, which just isn't true and which irritates me, because I'm so over cannabis, crack et al that the mere thought of them offends me. Both the doctor and the new worker pushed this point. They seem to have this expectation that the more drugs you take the less together you will be. When in actuality most opiate users (in contrast to stimulant users) take their drug to hold themselves together. So of course, when they stop taking it, they crack up big time.

I gave up on Intuitive Recovery when the course leader talked about "self-medicating" on crack. Self-medicating, as I understand it, means gaining a very real symptomatic improvement through taking an illicit drug. Not getting high or losing yourself in an excitingly new criminal lifestyle. I only accepted I had been self-medicating after I stopped doing it! The whole issue makes me angry. If they knew I was self-medicating, why the hell didn't THEY medicate me properly?! I suppose I always had low expectations of the methadone clinic. It's just that now and then I get these little flashes of what is supposed to be. And a methadone clinic is supposed to offer psychosocial therapies. Which they never did.

Anyway I'm beyond all that. And trying to STAY beyond it. And never again allow depression to mire me in such a morass of bitterness. I was getting to the state where I couldn't distract myself with anything at all. Whatever it was my mind chose to occupy itself with, something about it would irritate the hell out of me.

I have tried to focus on finding out all I can about methadone therapy ~ something I never bothered about before because I had so little enthusiasm for it. I'm going to have to wait and see whether it agrees with me in the longterm. I found it so extremely difficult to stick to the stuff before because the moods I experienced on methadone were so intensely nasty I continued to use heroin at every opportunity. Even tiny doses on top of my script produced marked "improvement".

My mood was exaggeratedly good earlier on, which is why today I'm able to view the situation with some detachment. The more I think about the whole situation the more motivated I am to just get OFF opiates of all varieties. I know heroin made me miserable. However you want to argue it, whether I was or was not self-medicating and whether or not I was successful it's a simple law of life that whatever you do, you'll get used to it. You can develop "tolerance" to rollercoasters if you ride one every day. If you marinade your brains in hard drugs, your brains come to accept such pickling as "normal".

I don't know what would have happened if I hadn't gone on heroin for over ten years. I suspect I would be a lot less messed up. To be fair, the drug gave me something I'd never really experienced before. It killed the multifarious discomforts I'd entirely got used to living with because they were parts of me. For a brief while I had the luxury of not being me. But I still don't think heroin made me happy. What I really wanted was to kill myself off ~ both literally and metaphorically. In a metaphorical sense I think I've achieved my object, because I'm a different person now to who I was then. Totally different. I'm very glad of that.

So now the truly mysterious part begins: I have to start from here, not knowing where I am. I've somehow to learn Mastery of Life. That's my goal.

I never set my sights low, except when I don't want to be doing something anyway.

I do want to live and be alive, because I have chosen life. If I hadn't, I wouldn't be here now.

I'm reminded of one of NA's sayings about accepting life on life's terms and living in the moment.

It's all about being here now ...

Just Be Here Now ...


Link of the day ~ Drug Abuse: UK Guidelines for Clinical Management

7 comments:

  1. Well I'm glad you're still doing methodone even if you reduce the amount. Cold Turkey can't be fun. Giving up smoking is hard enough I can't imagine what it's like giving up herion.

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  2. I shouldn't feel anything at all reducing methadone. It's less than 10% per week. I've reduced it before and never felt anything. I think some people get overly neurotic about it. Others are taking something that just isn't right for them. We're back to the "one size fits all" not working again. I feel really sorry for that small minority. Methadone does work for me physically; it's just the equivalents they judge doses on are ridiculously under. So it only worked properly when the quelity of gear plummetted. Then the methadone held me really well in comparison! I just can't wait to get off this stuff and not to have to think ever again about HEROIN. Ukh. How did I ever get into HEROIN. The mere idea of it is ridiculous!!

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  3. Gleds love, I need a favor. Here in the U.S. there is a pervasive belief that an addict, when on methadone, doesn't use on top of the methadone. there are thousands and thousands of parents out here who believe that their beloved baby is in methadone treatment, and therefore not using.

    Since i know for a fact that my daughter used, and got high on heroin when she was/is in a methadone program. I also know that when she brags that she has tested clean every single time...
    that she has called the hotline to find out when her group is called for drug testing, and then she just 'has a car breakdown' or some other manufactured problem so she doesn't report that day to the clinic.

    It doesn't matter to me anymore with my daughter, it is what it is with her and it is her life.

    but i am concerned about all the innocent parents who think because their child is on methadone or suboxone or subutex, that they aren't using because heroin wouldn't work anyway.

    if you can get high from heroin while on methadone or subutex or suboxone, please, comment back and i will post it on my blog.

    xxx dawn. p.s. i am glad you are feeling a bit more up!!

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  4. Glad for a happier post here. You can do for a day what would seem impossible for a lifetime.

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  5. Fractaldawn: in my experience most people used on top of their methadone. In the worst cases they used just as heavily as before. In the best cases, the people had got tired of heroin and only used it perhaps a couple of times a week, relying on methadone to see them through the rest.

    I think the attitude is slightly different in America. Methadone seems slightly harder to get hold of, and people pay for it. Here after a few weeks nearly everyone takes their dose home, so it's a much more informal system and people seem to expect less of methadone. Probably because it's easier to get scripted and they're not paying, they appreciate it less.

    Up until perhaps 5 years ago British clinics gave relatively small doses. The typical dose was 50mg, maybe 60mg a day. Then the philosophy changed and they started giving up to 200mg a day with most clients on between 80 and 120mg.

    The optimum dose for most people is said to be between 80 and 120mg. At this dose, methadone is said to have a blockading effect on heroin. I once ended up drinking 2 doses in one morning (it's a long story to do with my pharmacy being closed due to snow and the emergency clinic insisting I drank my dose on premises), so I had 180mg and that did seem to block the high when I used later that day.

    I have found that when I was younger I could cope on far far lower doses of methadone than I need today. While the amount of heroin I used went DOWN over the years. I am sure opiate addicts gain more tolerance to methadone than to heroin, due to some mysterious mechanism that hasn't been taken account of.

    Since the quality of street heroin fell drastically last year, methadone has been finally been holding me the way it's SUPPOSED to. Which made me realize despite a supposedly "high" dose they'd been underprescribing for years!

    I remember a friend of mine tellig me years ago that 60mg was equivalent to a £10 bag and me thinking at the time "no that's not right". What I hadn't considered was how much longer this person had been using than me. Eventually I got to a point where that was true. Meaning I needed over 120mg to substitute for a very average habit on heroin.

    Nowadays the clinics are prescribing lower doses. But a lot of the clients seem to smoke heroin now, meaning a LOT less enters the blood stream. Also their main drug tends to be crack. In my day it wasn't that unusual for someone to inject £100 worth of heroin in a day. I think that would be pretty unusual these days. So maybe the clinics are right. But God help anyone with a major habit!

    Syd: that's true. What I'm NOT going to do is "just for today" and yet counting the number of days I've done! I always saw that as a major contradiction and hwen I DID dump heroin for weeks on end I felt truly liberated not having any idea how long I'd gone. Because I just didn't care. Didn't want to care. Didn't want to think about heroin (at least not in any detail). And basically wanted nothing at all to do with it ever again!!

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  6. Gleds,
    I think I'd love to sit in on one of the NA meetings, must be lots of interesting characters there.
    I copied the whole AA booklet a few times so I could have it memorized.
    I wouldn't do it today but had to occupy myself with something when I'd been in-patient detox and felt like a prisoner in there.
    I admire your determination,
    j.

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  7. You mean the AA big book? That's a LOT of words!

    I haven't been to Aa for ages because I felt more at home with th eaddicts at Na than the drinker at Aa.

    I've found what sounds like a far better group called DRa ~ "dual recovery anonymous" which sounds FAR more promising. I noticed most of the case studies involved clinical depression but there was a lot of schizoaffective disorder. I have a certain suspicion that schizoaffective may be more sensitive to be kicked off by drugs than schizophrenia or bipolar. It is after all a mix of the two and wasn't all that heard of until fairly recently.

    Then again I think a lot of schizoaffectives would have been diagnosed bipolar in the past. Or plain schizophrenic.

    I'm still not entirely sure I'm not really bipolar. Only thing is I get the so called negative symptoms of schizophrenia (avolition) ~ sometimes even when manic ~ which bipolar people wouldn't get, especially when manic when they tend to be extremely goal-oriented. When I was full-on manic I was so incredibly disorganized it was unreal. I was wondering abour with o glasses, clothes inside out some days, a total mess... I like being a BIT manic ~ but not a walking haystack like that!!

    I'm DETERMINED to lick this addiction and I'm glad today my ENERGY has come back. Yes I'm a bit hyper but I can use that hyperosity to BEAT the sluggishness I get stuck in. I hate being in a rut and do not intend to live in one ever again..!

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