pt.2: fentanyl is the cure to the opioid crisis
[Part two of our four part series on the opioid epidemic]
Editor’s note: Please know that the opinions in this piece are just that — opinions. They reflect only the views of the author, who happens to have over ten years of experience as a heroin and fentanyl addict, and who also happens to have had a few years spent in recovery from said addictions as well. He would like it noted that he has personally lost over twenty loved ones, friends, and acquaintances to overdose, so he understands the tragedies of the opioid epidemic through first-hand experience. Further, he would like it said that he knows the views expressed in this piece may hurt, harm, or anger those who have also lost people to fentanyl. However, this was not his intent.
We at The Paradox Press appreciate his ability to find a ray of sunshine, no matter how narrow, amid this dark, and terrible storm of The Substance.
I present to you a paradox.
Fentanyl will be the cure for the opioid epidemic.
Okay, I know…. You’re saying, “Oh wow, Mr. Contrarian, Mr. Devil’s Advocate, how cool of a title. Stupid f*cking clickbait…” But wait. Give me a second of your time — allow me to explain why this claim that fentanyl, the opioid that happens to currently be killing the most Americans in the United States, has also had many positive effects in our current epidemic, and may end up curing many of those suffering from addictions to opioids + opiates in the years to come. I’ll try to be straightforward, sharing how my views were shaped through my personal experience; no flowery, or overly medicinal language here. For as you may have guessed, I am no f*cking doctor.
I can not in all good conscience even claim to be a fully-fledged treatment professional, though I do hold several largely bullsh*t CCAP certifications, and have spent a couple years of my life working in the field. However, there are people out there far more qualified than I, with far more experience in the field, and I would not sodden their well-earned good names by including myself as one of them.
Because truthfully, I’m just an addict. A true f*cking gutter junkie. Seriously. A sober junkie, yes, but a junkie just the same — for I have spent far more years in active addiction than in recovery. This means I have spent years in and out of Malibu rehabs (at first), sober living, private-PPO-insurance accepting rehabilitation “institutes”, HMO-based in-network programs, Florida-Model IOP + sober living solutions, as well as state-insurance-based detox and residential programs for the indigent (at the end).
I honestly believe that I have seen every type of treatment that is available to the opioid addict, outside of ibogaine + other hallucinogenic-based treatments (though I did spend a fair amount of time trying to self-treat my addiction with micro-dosing psilocybin under the care of an ultra-qualified dark-net vendor), and new age, Rapid Opioid Detox solutions (I wish).
Some of the practical, therapeutic, and medicinal methods I have tried include (but are definitely not limited to): detox-only attempts, thirty day programs, spending the better part of a year inside an in-patient treatment center, long periods of Medically Assisted Treatment (buprenorphine), as well as rapid tapers with the same, the long acting naltrexone shot (Vivitrol), both CBT and DBT forms of psychotherapy (twenty-two therapists at the time of this writing; far from proud of that…), psychodrama therapy groups, EMDR therapy, cranial electrotherapy stimulation, twelve step groups (various types), refuge recovery, strictly relying on the ‘God’ of my own understanding, focusing less on GOD and more on varied spiritual practices, using devices which train the brain through neuro-feedback, spending significant periods of time inside Native American Sweat-lodges, equine-therapy, acupuncture, yoga, breath works, regular deep tissue massages, harm reduction (Cali sober, brah..), essential oils (haha okay, maybe not really to cure my addiction but I have bought quite a few oil diffusers), as well as white knuckling it (you just ‘gotta toughen up and stop giving in…’).
In short, there have been f*cking astronomical expenditures spent on trying to help me through my dependencies (sincere thank you to my family, numerous private insurance companies, CA Medi-Cal, and a less-sincere thank you to the NY State Correctional System). However, while many of these modalities were extremely helpful, none proved to be a ‘cure’ to my addiction.
[I must pause to say that, on a practical note, I do happen to be of the opinion that a forty-five to sixty-day treatment episode, followed by a sincere buy-in to twelve-step groups is probably the most effective treatment method currently available. This is strictly based on my own experience, and what I have seen in the hundreds of other addicts I have known through the years as well. Still, twelve-step participation is a grey area at best, considering many only attend groups, and do not work the twelve-step program, so results will likely be mixed according to the level of participation. However, would I ever call this a cure? No. At best, this type of treatment program is capable of putting opioid + opiate addiction into long-term remission. However, fall out of the program, and you usually fall off the wagon. Therefore, uncured, but given the “daily reprieve” of remission.]
Okay, by now hopefully I have built at least some form of credibility to be talking about the realities of suffering through and treating opioid addiction. Perhaps not. Perhaps I am the least credible person on the planet to be talking about such things, due to my numerous failures. I will let you decide that.
But the bottom line is that I have lived through, and experienced the f*cking horrifying loneliness and hopelessness of long-term opioid use disorder.
That, I will not allow you to argue with.
So, how could an ex-fentanyl addict, with multiple overdoses to his name, ever think that the very substance which has caused him, and so many others so much harm, ever be a cure? Well, let me start with the personal; what I have seen through my first-hand experience.
Out of the six or seven years I spent in and out of both prescription opioid and heroin addiction, I never, not once, sat around talking with other addicts about how desperately I wanted to get off the junk. F*ck no. I may have genuinely shared such sentiments with my family, girlfriend, sober friends, and various members of my extended family and/or the general church-going public….but not to other heroin addicts. We just don’t talk about such things while in active addiction. In fact, we actively avoid talking about such things. Nothing mellows out a silky smooth shot of heroin quite like some preppy little sh*t with a name like “Marlowe, spelled with an ‘e’!” talking about how much he can’t wait to withdraw and get sober. That’s about as much fun as getting well alongside your sober mother. So, it doesn’t happen. If it does, it happens once, and Marlowe learns to shut the f*ck up about his inner-most desires.
The other reason we do not talk about it is that oxycontin, heroin, and the like are EFFECTIVE at producing the desired result. Sure, there have been many heroin addicts who will report that “the stuff just stopped working”, but this is far from the normal experience. Normally, an oxycontin aficionado, Dilaudid dickhead (seriously, you all suck), or IV heroin user will likely report having to raise his or her doses over time, but will also report still feeling the dopamine + endorphin rush, and the sense of loving relief that we rely upon to dull us from the sharpness of modern life that our constitution simply strongly disagrees with, to put it lightly.
However, in my most recent years of addiction spent as a fentanyl addict, I can report to you one commonality. After three to six months of usage, every fentanyl addict has the same experience: the stuff just stops working. At least, it stops producing pleasurable effects. Sure, it can cause them to nod, put them to sleep, stave off sickness, or even overdose them…but, does it still truly deliver the promised FEEL-GOOD result that all other opioids + opiates have always delivered? No. It does not. Not after a three to six-month period of moderate to heavy usage. And, if my original needs had just been to put myself to sleep, I would have tried a sleeping pill. If it was to overdose myself, I would have started swallowing all of the pills in the family medicine cabinet. No, I became an opioid addict because I wanted to feel good for a change.
Now, you may be saying “well what about all the people that originally got onto opioids for pain relief purposes? Not everyone is just a f*ckin junkie like you are…” And you would probably have a bit of a point there, but I would respond that if you research the pharmacological process of the way that opioids work on pain, you would find out that they do not block pain signals in the brain. In fact, ibuprofen is probably more effective in blocking pain than opioids are. When a patient takes an opiate or opioid, the dopamine makes them feel good to the point that they simply forget or don’t notice the pain. So, if after three to six months of fentanyl usage, I am no longer getting feel-good feelings, I would say that the pain patient is forgetting a hell of a lot less about their pain.
Now, what is your average conversation like among these fentanyl addicts? Well, they are full of disgruntled and confused, openly expressed inquiries as to…like…what the f*ck is going on here. At my favorite local, five-star yelp-rated trap houses, it became commonplace to hear openly voiced questions such as:
“Wait….why am I suddenly locked into two modes, either tired or sick?”
“What happened to the warm, loving feelings…is it that I’m f*cked, or has this sh*t just f*cked me?”
“What happened to the glory years of my pill form, and f*ck it, even heroin addictions?!”
“Why am I lying, stealing, and otherwise talking my way into the means with which to buy a substance that is no longer providing me any benefit?”
Okay, so a few junkies are openly mulling getting sober, big deal… Yes, it is a BIG F*CKING DEAL, because this was a thought which originated within their own mind, from their own experience. These are the seeds from which sobriety grows — because unfortunately, the seeds of sobriety are not grown from the water of our loved ones’ tears, nor are they germinated from external pressure from employers, dire financial situations, or even courthouses. The desire for sobriety must come from within. You must internalize how deeply your situation is, like…. permanently and totally f*cked. Because while external forces change daily, our internal belief systems tend to grow roots and have much greater staying power.
What is so different about fentanyl? Well, fentannyl is such a supercharged synthetic that it truly was never meant to enter the human body. It lures addicts in with promises of financial savings, stronger effects, or being able to put down the needle. For those who purposefully tried to stay off the stuff, it has taken over the illicit market and is found in pretty much any non-pharmaceutical opioid available — so whether you intended to buy heroin or oxycontin, you are, in fact, buying and absorbing fentanyl, you just don’t know it. I would say about 80% of non-pharmacy-dependent opioid users are currently using fentanyl, whether or not they are aware of it — that means the lion’s share of current opioid addicts in the United States are currently using fentanyl, in one way or another. What this supercharged synthetic is, in turn doing to this population, is withering their opioid receptor’s ability to effectively absorb any other opioids, or said differently, it is raising their tolerances to levels where no other opioid can ever touch them again. It is thus permanently closing the door on an addict’s ability to remain an opioid addict on anything but fentanyl. And, as I said above — with the vast majority of opioid addicts reporting a complete cut-off in the positive effects they receive from absorbing the substance, could this not be a gigantic reason many opioid addicts are eventually cornered into finding another solution?
Think of it this way — say an alcoholic starts on beer, then moves up to liquor, but ultimately graduates to just drinking like pure, eighty percent Everclear. Their best thinking told them this made sense — it was cheaper, fewer calories, got them where they wanted to get quicker, and they were no longer having to pour beers down their gullet out of a funnel and silicone tube just to catch a buzz. Well, say they realized that their Everclear regimen wasn’t quite working out the way they thought it was going to. They decide, “you know what? I think I had it better when I was back on beer, I think I’m going to go back to just pounding brewskis…” — but yet they find no solace, no relief whatsoever, in that return to beer. Well, that’s because your average beer is maybe 4–6% alcohol, whereas their body had become accustomed to drinking 80% Everclear. They will not be able to rewind their decisions, as beer has now become useless to them.
Much the same, I have finally accepted that opioids have become useless to me. This is because I know that I have ruined my opioid receptors. I could toss back an entire bottle full of hydrocodone and it wouldn’t have any effect. I seriously try to drive more safely, now that I know the standard doses of hospital pain medication would bounce off of my receptors like a ball on a racket. I would be punching my morphine button every two minutes, the nurses would create a big f*cking stink about it, and I would be left in excruciating pain. Think I’m being hyperbolic? Nope. Remember, morphine is one-one-thousandth as strong as fentanyl.
This is the reality that I, and many others, exist in now. There is no turning back. Relapse is always an option, but a much less alluring one, when you know that a week in, you’ll be right back where you were, wondering why you were creating a new physical dependency to a Substance which has become useless to you.
Fentanyl has ruined my desire to stay addicted opiates and opioids. And it is raining on the parades of my comrades just the same. We have been forced to drop a new sail, find a new heading, and brace against the tide, as we journey into waters unknown.
Fentanyl is, or will be, the cure for the opioid crisis.
