Three Addicts Talk About Kicking Opiates in Jail With and Without Suboxone
Will My Insurance Pay for Rehab?
Three Addicts Talk About Kicking Opiates in Jail With and Without Suboxone
Nobody strives to become a heroin addict. Even misguided souls with a romanticized notion of H never intended to go through the nightmare of withdrawal on a jail cell floor. But that’s what happens to many users caught in the whirlwind of our nation’s opiate crisis. Science is teaching us that addicts are not morally flawed or weaklings. Addiction is a mental illness that needs treatment. The Fix reached out and found three formerly-incarcerated addicts willing to talk under pseudonyms. We were especially interested in whether Suboxone was provided and if it helped.
Mike, 63, has a lovely Irish accent but sounded world-weary. “I moved from Ithaca to Burlington, Vermont where I lived this double life: well-paid bank executive by day, heroin dealer by night. In 2002 I got arrested in my 40s for dealing. I’m from a middle-class family and had never spent a night in jail [so it] was a shock to my parents, both retired college teachers, and my brother, who I’m very close with.”
Mike is unmarried and childless.
“In jail I was extremely sick for four days, puking and shitting; a miserable existence. The only medical attention was a gallon of lemonade to make sure I didn’t dehydrate. It took a week until I was human enough to interact with inmates.”
Transferred to prison, he lived there for a year and a half. “In retrospect,” Mike said, “it was a good thing because it got me clean.”
For a while, anyway.
“I made the most out of prison. I was college educated and did jailhouse lawyering, which was enjoyable. When you do that, though, you become an enemy of the system so I got moved around—a grand tour of Vermont prisons.”
After prison, Mike returned to Cornell University. “I arranged financing to go back full-time to finish my undergraduate degree, 30 years late. But after six months, I went back on the juice [heroin] during school.”
He tried 12-step meetings. “But the minute I was using I no longer went” and he never stopped drugging voluntarily. “The only thing that ever got me clean was being taken away in handcuffs or being on probation with the threat of jail.”
He’d been shooting heroin on and off for four years when he got arrested again. Mike had dealt to an undercover cop. “It was either a drug court or a long prison term.” He chose drug court where he had close supervision by a judge, a probation officer, mandatory intensive outpatient treatment and 12-step meetings. “After graduating from drug court, I admitted to a lesser misdemeanor rather than a felony.”
Mike said he finally realized he’d been limiting his life’s options and became serious about staying clean. That didn’t last. “You think you have choices but you don’t,” he said. “You’re in a self-built prison. I told myself, ‘I could stop tomorrow’ [but] opiates are so different from other drugs; the purpose isn’t to get high anymore, it’s to be un-sick. The minute you stop, within 24 hours, you’re in withdrawal. You can’t go to work and you can’t get out of bed.
He said he was “a big believer” in Suboxone: “One of the clinics in Vermont [was] doing human testing in the last phase before it became legal. I was a guinea pig and it worked.” But then he relapsed a year ago. “I had a knee injury and went from [opioid] pain pills to heroin.” He couldn’t get Suboxone legally so found a way to buy some. “I’ll be on Suboxone for a while but I’d like to get off it eventually. For now, I’m sure I’ll stay clean today and probably tomorrow. What will happen from there I don’t know.”
Chuck was 49 (but looked over 60), clean-shaven and attractive with skin the color of coffee with milk. We met in a government-run residence for men with AIDS. His gaze darted around like a manic squirrel.
Living in Los Angeles in 1989, Chuck was arrested and sent to a county jail. “They didn’t provide any type of maintenance for addicts, like methadone,” he said. “I had a hard time and it was messy. I was curled up around the toilet and people were standing over me urinating. I wasn’t regarded as somebody worth anything.”
He served 60 days. “First they tried to charge me with possession and intent to distribute but they dropped it to just possession after a public defender pleaded my case. I hadn’t ever tried to stop [shooting heroin]. I couldn’t wait until I hit the streets so I could get high again.”
After jail, he wasn’t given probation nor sent to rehab. Without any program or anyone to answer to, Chuck went right back to using.
We asked how many times he went to jail. “I can’t count,” Chuck said. Five times? “Yeah.” Ten times? “Yeah.” More than 20? “Yeah, and I did some state time for armed robbery, that was five years for a violent felony. Inside, I got jumped; I fought. Once, waiting in line for the phone I seen this guy who got stabbed. It was a really traumatic experience because it wasn’t like the movies. He was hit in the neck and it must’ve hit a main artery because the blood shot out five feet.”
Chuck joined a gang. “It’s not just a matter of protection,” he said. “You also have to prove yourself and…make certain moves—beat somebody up, or worse.” When asked if he ever raped anyone. “Nah,” he said, “that wasn’t my thing and I myself never got raped. They left me alone because I didn’t seem like I was afraid, which was all an act.”
The only time he smiled during our interview was when he said, “I just got cured from Hepatitis C!” He spoke of meetings in prison. “Missionaries came bringing Christianity and there were groups by a certified alcohol addiction treatment counselor based on 12-step anonymous [sic],” he said. Then his shoulders slumped and he curled in on himself. “When I had five years [sober] from ’93 to ’98, I was in a relationship. The lady was struggling with drugs. I was clean but codependent—chasing her around the streets, worrying. I wasn’t paying no attention to my recovery, too preoccupied with her. That ended when her family found out I had AIDS and she left me. I didn’t relapse right then but I was in deep shock and deep depression. A year later I relapsed.”
We asked about Suboxone. “I tried it once. I had an appointment for today but I didn’t go because I don’t have any money to pay for it.” He has no dreams of ever getting sober again or of romance and is estranged from his only child, a daughter in her 30s. “I think only five percent of my problems is the drugs. I think the other 95% is the experiences I’ve had—all the trauma. I don’t see any light at the end of the tunnel.” Then Chuck said he had to leave. “I need to go steal something so I can get high.”
Julie, 37, sounded street-tough. She began with only brief “yes” or “no” answers before she let her guard down to tell more of her story. Arrested with enough drugs to garner a B felony, she was 26 when she landed in jail, then was transferred to prison.
“I was shooting up multiple times a day [when] I got arrested. I was lucky they had Suboxone in jail. They didn’t give it out to everyone, it was based on who the nurse liked.”
Julie said it’s important to understand how helpful even short-term detox medication can be “because most people assume Suboxone or methadone are helpful for deterring relapse but only when they’re used for long-term maintenance.” For Julie and other addicts, having access to Suboxone during withdrawal makes a big difference.
“I wasn’t consumed every minute thinking about how I could get more [opiates]. I wasn’t writhing in pain. I wasn’t trying to…get some smuggled in…. It gave me the opportunity to think about whether [heroin] was something I wanted to be doing at all.”
Julie began doing drugs at age 17. Before that, she and her parents had tried family therapy. “I had issues with eating disorders but therapy didn’t seem effective. I’m not sure that I was in a place where I was going to be receptive to it. I was a stubborn shitty teenager, you know.”
We asked if she began with pot and pills before escalating to injecting drugs. “No, I pretty much went straight to the hard stuff. I was…self-destructive. I smoked pot once, then did Ecstasy once, and then went right to heroin. I was dealing with some serious depression [and] wanted to be numb or dead. Heroin seemed to be a good vehicle for either.”
After going to a rehab, she was able to stay clean from age 18 to 19 but then she tried to commit suicide with an overdose of heroin. “I had such a high tolerance by then, it didn’t work. Another time I jumped off a bridge but still did not manage to succeed in killing myself.”
Julie said she went to a few AA meetings in jail, but prison was different. “People didn’t always show up. Prison can be a very difficult environment to have much in the way of 12-step support.”
She has stayed clean for her 11 years since prison. “In the beginning, I could’ve gone either way but I had a few moments of clarity. One was when the guy I was dating at the time was still using. He was visiting me and was noticeably high, doing and saying embarrassing and shitty things, and telling all the lies you tell as an addict. I was watching him doing this when I was sober, and looking at everything from that other side was one of the moments that made me realize I didn’t want to be that person anymore. I didn’t want to be the one putting people through this or embarrassing myself in that way.”
Regarding post-prison Julie said, “I was required by parole to do an outpatient program but that turned out to be counterproductive because I was in a new area and wouldn’t have known where to get drugs but I met people in that program who knew where to get them…. At that point, I was almost two years clean and was suddenly being drawn into that program with people who were only, like, two days clean. I did that for nine months then that was it.”
She said about 12-step meetings: “It’s not for me. I think there’s some principles of it that can benefit anyone who’s in recovery but it wasn’t a good fit. I don’t think that abstinence is the only approach, and it bothers me the closed-mindedness of the belief that it’s the only thing that works. I’m not trying to use, but I know people who decided to smoke pot and I don’t think that diminishes the fact that they are in a good place and they’re not doing heroin.”
Suboxone seems the obvious answer for assisting opiate addicts through withdrawal yet it remains elusive to most. According to The National Center on Addiction and Substance Abuse, “Each year federal, state and local governments spend close to $500 billion on addiction and substance abuse, but for every dollar that federal and state governments spend, only 2 cents goes to prevention and treatment.”