Can We Maybe Cool It with the RXs?

Lately it seems like the fun never stops around here. Yesterday I turned my family's world upside down (sort of) by accepting a new job that will eventually require us to relocate. Today I went to an oral surgeon for what I thought was going to be a consultation on having an aching wisdom tooth extracted. Except that a few minutes into the appointment, I was informed that they were actually pulling my tooth today.

Who knew?

Needless to say, I was completely unprepared. Thankfully, though, everything went off without a hitch. It's been a couple of hours since my tooth was yanked out, and my mouth is still pretty numb. The same goes for my my cheek, chin, tongue, and wallet (no dental insurance). When you throw in the gauze I'm biting down on, I kind of look and sound like the second coming of Marlon Brando in The Godfather. Except I'm guessing he didn't drool like I have been.

I felt no pain whatsoever during the extraction. I guess the combination of three shots of novocaine and some nitrous oxide did exactly what it was supposed to do. (Whew!) Of course, the doctor told me I wouldn't be getting off totally pain-free, so he was sending me home with a couple of prescriptions for pain relievers. "They don't let us phone these prescriptions in anymore, so we'll give them to you now in case you need them."

When I got home, I took 800mg of Motrin, changed my gauze, and opened up the envelope the doctor had sent home with me.

What I found made me mad.

In addition to a sheet of post-op care instructions, some more gauze, and a prescription for amoxicillin, there were two other prescriptions: one for thirty Norco tablets and one for 20 Percocet tablets. In case you didn't know, Norco contains a combination of acetaminophen and hydrocodone (an opioid); and Percocet contains a combination of acetaminophen and oxycodone (a stronger opioid). The instructions told me to take the Norco first, and if that didn't help relieve the pain then switch to the Percocet.

I was kind of surprised to see that I had been prescribed a total of 50 opioid pain relievers for the extraction of one wisdom tooth. I understand that I might experience some pain in the next day or two (or three or four), but isn't 50 pills a bit much? And why not just prescribe one pain reliever, with the caveat that if it doesn't do the job, call our office and we'll discuss it? It seems to me that pills are being overprescribed in the interest of convenience. Doctors can't phone in prescriptions for narcotics anymore, so they give you prescriptions you may not need...just in case.

That's wack.

I plan on sticking to just Motrin if at all possible. (If you follow this blog, you may recall that my son did that a couple of years ago when he had two wisdom teeth pulled.) I figure there's no sense in going overboard if I don't have to.

I wish doctors shared the same philosophy.

Did you know?

• Health care providers wrote 259 million prescriptions for painkillers in 2012, enough for every American adult to have a bottle of pills.
• More people died from drug overdoses in 2014 than in any year on record. The majority of drug overdose deaths (more than six out of ten) involve an opioid.
• Since 1999, the rate of overdose deaths involving opioids (including prescription opioid pain relievers and heroin) nearly quadrupled. From 2000 to 2014 nearly half a million people died from drug overdoses.
• Since 1999, the amount of prescription opioids sold in the U.S. nearly quadrupled, yet there has not been an overall change in the amount of pain that Americans report. Deaths from prescription opioids--drugs like oxycodone, hydrocodone, and methadone--have also quadrupled since 1999.
• 78 Americans die every day from an opioid overdose and overdoses from prescription opioid pain relievers are a driving factor in the 15-year increase in opioid overdose deaths.
• The United States has less than 5% of the world’s population, but uses 80% of the global supply of opioid drugs.

(Source: Centers for Disease Control and Prevention)

Goodbye, Klonopin

Almost a year ago, I wrote a blog post entitled "Held Hostage by a RX Drug: My Klonopin Nightmare." In it, I talk about my horrific experience with Klonopin, a benzodiazepine (or "benzo") prescribed by my psychiatrist for anxiety. I took the drug--as prescribed--for years. Unfortunately, I also spent years trying to stop taking the drug because my body had grown so dependent on it.

Now for an update.

I'm happy to report that after years of weaning off of Klonopin, I finally stopped taking it entirely on August 7th. I've been Klonopin-free for more than three months, and I couldn't be happier.

The beast is finally out of my system.

Benzos are some of the hardest drugs--prescription or otherwise--to quit. So I'm pretty damn proud of my accomplishment. For a while, it was hard to see a light at the end of the tunnel. Klonopin was my ball and chain. But with the help of an awesome nurse practitioner, who helped me with the weaning process, I was able to break free from the nastiest medication I've ever ingested. (Thanks so much, Kim!)

If your doctor ever wants to prescribe a benzodiazepine for you, please be extremely cautious. These drugs--which include alprazolam (brand name: Xanax), diazepam (Valium), lorazepam (Ativan), triazolam (Halcion), clonazepam (Klonopin), and several others--are not to be taken lightly. Yes, they can be beneficial; but they are seriously strong and can cause some nasty side effects that can really kick your ass.

Lastly, if you're taking a benzo and want to get off of it, never, ever quit "cold turkey." The results can not only be hellish, but dangerous as well. Always wean off of the drug under a medical professional's supervision.

Goodbye, Klonopin. You will not be missed.

"Klonopin is a horrible, dangerous drug." --Singer Stevie Nicks (who struggled with Klonopin addiction)

An Interview with "The Bitter Taste of Dying" Author Jason Smith (Plus a Book Giveaway!)

(Note: A shortened version of this blog post also appears on The Huffington Post's blog site as "An Interview with Jason Smith, Author of 'The Bitter Taste of Dying.'")

When I reviewed Jason Smith's addiction memoir, The Bitter Taste of Dying, I called it "a gripping, no-holds-barred memoir," "a riveting story of addiction and recovery," and "a story of self-discovery and hope, too." Smith's book is all of those things, and more. From the first page of the Prologue, I was hooked. Smith's brutal honesty and transparency allowed me to enter into his hellish world; a world where being high--whatever the cost--was all that mattered to him for 16 years.

I recently had the pleasure of interviewing Smith and, just like in his book, he did not mince words. Read the conversation below, and at the end of the interview find out how you can win a free copy of The Bitter Taste of Dying.


The title of your book, The Bitter Taste of Dying, comes from the taste you first encountered while trying to perform CPR on your Uncle Mark after he overdosed on heroin when you were 14. You later experienced that same taste after overdosing yourself. I take it that taste had quite an impact on you?

Yeah, it's not really something that can be untasted. Or unremembered, for that matter. Or Unlearned. The day I found my uncle dying was so chaotic on so many levels, both internally and externally. That taste attached itself to that memory, making everything one. My memory and that taste--it's all one blur. Same with my own overdose in France. Pure chaos. Looking back, there’s some really dark comedy woven in there somewhere, the image of this 6'-2" American stumbling through the streets of Nice, parents gripping their children nice and tight as I passed, on my way to collapsing on the patio of some romantic cafe. But at the time it was a chaotic scene. It really was the point at which everything came full circle. Both experiences--despite being in different countries, on different continents--unified by the taste of the body dying.

You describe so many lows in your book. Your mother telling you that you were "dead" to her, you sucking on Fentanyl patches that were supposed to be stuck on your arm, etc. Looking back on everything that happened to you, which one incident comes closest to being your definitive "rock bottom"?

I've come to my own personal conclusion that there are two types of bottoms: a physical one and a spiritual one. And when I say "spiritual," I mean spirit as in the Human Spirit, that thing inside of us that tells us to keep fighting when we're losing, that id, fight or flight spirit. I'd been to a lot of physical bottoms. Jail in Tijuana, living outside of a French train station. Those were by far the darkest physical places I went to. But the funny thing is, throughout both of those, I still had fight inside of me. Life. That same voice that told me I could keep using and just control it better was the same voice that kept me alive at times. But when I tried to end it all that night in my little bathroom after my Thanksgiving overdose, that voice was gone. It was dead. That voice that used to tell me to just keep pushing a little more, that I could get a handle on this situation, I could run from the courts, the judges, the police, the addiction--that voice was gone. And to me, that was the deepest bottom for me because it was as if my human spirit had simply vacated my body, leaving just a shell of a human being behind. It was dark. Really, really dark.

One of the most powerful lines in your book is: "It took me losing everything to appreciate anything." What role does gratitude play in your life now?

Gratitude is key because it allows me to truly appreciate things I would have taken for granted before. I cherish my time with my family, holding my kids, because I've had my child removed because I was incompetent--as both a parent and a human being--of raising him. That shit stings. That's a reality check if ever there was one. To lose that right, only to gain it back slowly, has made me truly grateful for the opportunity to be a parent. I didn't have that before. Before I was a self-entitled little child, the perpetual victim. I'm grateful that I don't live or feel like that anymore. I’m grateful for the type of shit that normal people don't even realize they have. I'm grateful to wake up without being dope sick. I'm grateful for having money in my bank, and it staying in the bank. I'm no longer putting my drug dealers' kids through college.

What is one the biggest struggles you face in your ongoing recovery, and how do you deal with it?

Writing can be tricky. Especially writing about addiction. I have to be 100% accountable for my past actions, my decisions, and have to deal with those consequences without blaming everybody around me. It wasn't the doctors that got me hooked, or the pharmacists, or the dealers, or the system. It was me. I could’ve walked away at any time, and I chose not to. That's how I have to view things for my own recovery, for my own sanity. As long as I'm accountable, then I can work on it. As long as it's your fault, I can’t do shit with it. I just can't. Having said that, as a writer, I have to step back from just my own experience and look at things from afar, at the big picture. And when I do that, I see a system that is totally and utterly fucked. Seriously. A system where pharmaceutical companies sponsor their own safety studies, lie to doctors about the dangers of certain drugs, admit to lying in court, pay a fine, and then go on with life while society is left picking up the pieces. It's crazy. I feel like I have an opportunity and a platform to talk about these things, but I have to do it in a way that isn't blaming them for my own situation. Sometimes those two things bleed dangerously close together. I have to always keep those two things separate, and that’s probably the most difficult thing for me at this point.

I know they were certainly tested over the years, but how are your relationships with your family members now?

Surprisingly well, actually. Time heals all wounds, which isn't something you want to hear when you're first getting clean. But it's true. As an addict, I was so used to instant gratification. When I was after a certain sensation, I got it immediately through some substance. So when I got clean, I wanted everybody just to forgive me. Just move on, like none of that shit just happened. But it doesn’t work that way. The first two Christmases after I got clean, my family was skeptical, all wondering "Is Jason going to make it? Is he going to get high?" Because that was my thing. Holidays, I'd just get tore up. There really is no way to make them stop fearing that other than getting a few Christmases under your belt clean. Let them see it. So far, by doing that, my family relationships have been mended. Even with my son's mom. Today she and I have a great relationship, she and my wife get along great, we're able to co-parent. But that took a few years, and still takes work. Unfortunately, the only thing that mends these relationships is time. There is no quick fix, at least not in my experience.

What aspect of your life are you most proud of today?

Being a father. I’m fairly involved in a 12-step program, and one of the running themes you see, regardless of your location, is the effect of dads not being around. It's sad, and it has profound effects on kids. I almost made my own son one of those statistics, a boy growing up without a dad. I’m so thankful that I got my shit together before he was old enough to know what was going on. Today I'm a father to him and his sister, and I love that. I love being a dad. I love letting the kids climb on me, teaching them to swim or ride a bike. All of it. I’m that guy. Dad bod and all. And I'm good with that.

What's one important truth you've learned through the recovery process?

There's a right way to live and a wrong way. And we always have the choice of which one we decide to go with.

Friedrich Nietzsche said, "That which does not kill us, makes us stronger." How are you stronger because of your addiction?

I like what [Bob] Dylan said, when he sang "He not busy being born is busy dying." It's the same concept as Nietzsche, in a sense, but in reverse. I kind of look at my life today--and I try to do it daily, although I have a far from perfect track record--and ask whether I'm busy being born, or if I'm dying. For whatever reason, the simplicity of the two options resonates with me. And it works.

Based on your experiences, how do you think we could improve treatment for people suffering from substance abuse?

I think we're seeing the tip of the tip of the tip of the iceberg when it comes to substance abuse in this country. The prescription drug epidemic changed the game. We have such a large segment of society addicted to prescription drugs, which is funneling a decent percentage of addicts into street drugs. We're giving children amphetamines for fuck's sake, and then we act like we're surprised when meth use explodes. We choose not to see the connection. We've gotten an entire generation hooked on opiates via doctors, and now we've decided to just cut them off, with treatment only available to those who can afford it. And we wonder why heroin has spiked the way it has. At some point, we're going to have to start answering some very uncomfortable questions in this country.

We’re something like 4% of the planet's population and we consume 90% of the planet's opiates. This is a uniquely American problem. I don't mean that America is the only country with drug problems. I'm saying our approach to living life. It's unique compared to any of the countries I've visited. At some point, Americans decided we didn't want to feel anything that was even slightly uncomfortable. We didn't want to feel pain or hurt or discomfort, on either a physical or emotional level.

Ironically, the most difficult time I ever had scoring prescription drugs was in Amsterdam. I went into the hospital at like 4:00 in the morning after a night of cold sweats and shaking from running through two month's worth of drugs in two weeks, and I waited to see a doctor. Pills and patches were my thing, and those were like the only two types of drugs you couldn't find on the streets of Amsterdam. So I lifted my shirt for the doctor, showed him my scars, and to my surprise he seemed unimpressed. I made up some shit about how it hurt when I lifted my arms over my head, and demonstrated the appropriate amount of faux pain--but this guy wasn't buying it. "It hurts when I do this," I told him. He just looked at me deadpan serious without even blinking. "Den don’t do dat." It was so simple, yet so foreign. The idea that discomfort could be lived with, that pain was a way of your body communicating with you. The concept that pain is sometimes a very necessary and beneficial part of life. Today in America I think we've lost touch with this.

I had a friend who broke up with his girlfriend and he was all bummed out and sad. His doctor put him on anti-depressants! Huh? You’re supposed to be sad. You just lost a partner with whom you'd built a life and now it's over. Be sad! It’s okay! Feel that shit. Feel it, own it, grow from it, and move on. You're supposed to be sad, that's part of the grieving process of any breakup. But today, it’s like, "Nah, just give me a pill to make it stop." And I think we do that in many areas of life. You have acute back pain? Maybe you need to change the way you sit, or stand, or walk. Numbing the pain doesn't really help the actual problem. You're treating symptoms, chasing your own tail. We've turned to pharmaceuticals to perform normal human functions. Pills to wake up, pills to sleep, pills to feel happy, pills to bring us down. And I think it’s this mentality, more than the actual drugs themselves, that we're going to have to face up to if we really want to start the process of treating drug addiction. We have to get out of that mindset that pain or discomfort is the enemy. Sometimes it’s a very necessary part of life.

I just realized I didn't come close to answering your actual question. Sorry. I rant sometimes.

As a father, what do you think are some of the best ways to educate kids about the dangers of drugs and addiction?

I think being completely honest about it. Don’t hide things or sugarcoat things, but don't go the "Scared Straight" route either. I'm completely aware that one day my kids will read my book, and that's a little strange. But I don't think I glorified my drug use. Nor did I demonize it. I just shared my experience. I think sharing our own experiences, in the tone of "Look, I’m not telling you not to do drugs. I'm telling you that if you do them, this might happen to you, because it's what happened to me." Enough with the "Just Say No" or DARE or "Scared Straight" or "This Is Your Brain on Drugs" approaches. None of them worked. We need something different. A whole new approach.

Knowing what you know today, if you could go back in time and give your teenage self some words of advice, what would you say?

Buckle up, man. It’s gonna be wild.

Hypothetical: The Bitter Taste of Dying ends up being made into a major motion picture. Who’s playing Jason Smith?

You realize there's no good answer to this question, right? If I answer it, I come off as a bit pompous and self-absorbed. If I don't answer it, I look like I'm trying to project faux modesty. I'll say this: You know who I really enjoy watching act now? Colin Farrell. I don't know much about his background, but he looks like he's seen some shit. Been through some shit. He has that presence about him. He's much better looking than me, but Hollywood's taken greater liberties than that before. I have a hunch that if he had to dig deep down to find the bottoms expressed in the book, he could do it. But it's just a hunch.

(You can find Jason Smith on the Web, on Twitter, and on Facebook.)

**************

Would you like to win a copy of The Bitter Taste of Dying? Here's your chance! Jason Smith has been kind enough to provide three copies of his book to give away to readers of this blog. To be eligible for the random drawing, just send me an email via the "Contact Form" that appears in the column on the right-hand side of the Web version of my blog (under the "Most Popular Posts" section). Just tell me that you want to be in the drawing. At 6:00 PM EDT on Saturday, August 1st, I will put the names of all the people who have entered into a hat and choose three winners at random. Note: I understand that some of you may be reluctant to share your name and email address with me, but it's the only way I can get in touch with you to let you know if you've won. I assure you that your information will be safe. (Of course, that's what Target told you, too, right?)

Held Hostage by a RX Drug: My Klonopin Nightmare

I'm breaking up with Klonopin.

Klonopin is the brand name of a drug that belongs to a group called benzodiazepines, or "benzos" for short. Benzos are psychotropic drugs used to treat a number of disorders, including anxiety, insomnia, seizures, and muscle spasms. Other brand name benzos include Xanax, Ativan, and Valium. (FYI: Rohypnol--widely known as "the date-rape drug," but not available legally in the United States--is also a benzodiazepine.)

These drugs are depressants/tranquilizers and work on the central nervous system by affecting chemicals in the brain. They are among the most commonly prescribed medications in the U.S. and are deemed to be effective for short-term use. Unfortunately, according to a story in The Boston Globe, "Doctors and patients say physicians often prescribe benzodiazepines with no discussion of the dangers and the drugs' declining effectiveness over time."

Welcome to my world.

Let me be clear about one thing: I've never abused Klonopin (generic name "clonazepam"). It was prescribed to me by my doctor, and I always followed the dosage instructions to the letter. But many people who take benzos for a long period of time become psychologically or physically dependent on them.

I am one of those people. My body became physically addicted to this awful drug.

I was first prescribed Klonopin by my (former) psychiatrist about nine years ago. My son was struggling with depression and addiction and it was adversely affecting our whole family. My anxiety level skyrocketed and sleeping was very difficult for me. My psychiatrist suggested I try Klonopin, and at that point in time I was open to trying anything that might help make me feel better. And it did.

Funny thing, though (not really): My doctor never told me that long-term use could be harmful.

My initial prescription had me taking a 0.5 mg Klonopin tablet five times a day, and I thought nothing of it. I figured my doctor knew what he was doing. After all, he kept refilling my prescription and never said anything about it.

A couple years later, though, I felt depressed and started seeing a therapist. When she found out how much Klonopin I was taking, she said I was "grossly overmedicated." She even suggested that my depression could be directly related to my Klonopin use.

That shocked me, and I decided I didn't want to take Klonopin anymore. One afternoon I went home and did something that turned out to be incredibly stupid: I flushed my remaining pills down the toilet and quit "cold turkey."

Big mistake.

The next morning, I felt like I was dying. I had chills, my head hurt, and my body was shaking uncontrollably. I couldn't even get out of bed. Naïvely, I thought I had come down with a bad case of the flu. But I eventually wondered about the possible connection between my symptoms and my having stopped taking Klonopin.

I had my wife call my psychiatrist to ask him if the two things could be related. He said they were, and that I never should've stopped taking my Klonopin cold turkey. It turns out that when you stop taking benzodiazepines suddenly, you risk a boatload of horrible symptoms, including anxiety, depression, dizziness, headaches, irritability, muscle spasms, nausea, heart palpitations, seizures, and tremors.

Funny thing, though (not really): My doctor had never mentioned that to me.

I got my Klonopin prescription refilled and felt better almost immediately after I started taking it again. I can't even begin to tell you how scary that was. This medication, which was prescribed to me like it was no big deal, had hijacked my body. That was incredibly frightening to me. I felt like Klonopin was holding me hostage. So much so, that after my "dopesick" experience I didn't even want to wean myself off of the drug. I was terrified that I'd go through withdrawal again.

I did some research online and learned that benzos can be quite nasty. They are also some of the hardest drugs--prescription or otherwise--to quit. I made the decision to slowly taper off my dosage. No matter how long it took, I had to get clonazepam out of my system.

I've been tapering my dosage for several years now. Yes, years. I've gone from taking five tablets a day to taking just a little more than half a tablet daily. In a few months, I plan on being completely Klonopin-free.

Recently I was pretty sick--physically and emotionally--for a couple of weeks. I knew it was related to the Klonopin tapering, but I fought through it. It wasn't unbearable and I was bound and determined to keep going. A huge part of my motivation was an article I read entitled "How Worried Should We Be About Benzos?" Among the things cited in that article is a new study published in The BMJ (originally called the British Medical Journal) "strongly linking 'benzos' to Alzheimer's Disease."

How horrifying.

Our society is drug crazy. Too many doctors prescribe too many medications willy-nilly, without warning their patients about side effects or long-term implications. And they don't seem to care that unsuspecting folks like me can end up in a place we never wanted to be because of it, even if we take the drug as prescribed.

I'm breaking up with Klonopin. And I can't wait until it's totally out of my life.

Postscript: As the father of a son in long-term recovery, this was a tough piece for me to write. It almost feels hypocritical, or like I'm "outing" myself. But I decided to tell my story to help educate others. If a doctor wants to prescribe a benzodiazepine for you, please discuss it with them at length. I don't want what happened to me to happen to you.

Peace.

P.S. For an update on my experience with Klonopin, read my 11/11/15 post "Goodbye, Klonopin."

Evil stuff. Very, very evil stuff.

On the left: My former prescribed daily dose. On the right: What I've
tapered it down to.