“PTSD” – Post Traumatic Stress Disorder

This is when I am supposed to reference Webster’s dictionary. I can picture the bulleted item list that has been carefully compiled by doctors and psychiatrists, and craftily winnowed down by editors.

Yet words are bound to fail. PTSD creates a feeling that can not be contained by bullets or paragraphs. If forced to use words they would be: “sense of dread.”

A sense of dread accompanied by unwelcome imagery. Imagery that is not imaginary. Dread that is not unjustified.

The ring of the phone makes me ill. Physically ill.
A knock on the door? Visions of a police officer.
An envelope without a return address?  Bad news.
My daughter not texting for a few days? Relapse.
Sad song on the radio? Message of doom.
Bitter snow? Frostbitten child.
Cheap motels off the highway? Sadness, loneliness, death.

My list could be longer. But it hurts to write it. If I suffer from PTSD, how badly must my daughter suffer? I have seen the results of her use, but have not lived through the experience of it.

“Conquer your fears” is written everywhere nowadays – from business journals to self help magazines. But the kind of fear they often refer to is that of financial risk. (Or a lifestyle change: try that new vegan diet! get a new partner! make a career switch!) I am talking about a different kind of fear. A primal fear. The fear of losing your stormy green eyed child to something so unpredictable, so misunderstood, so maddeningly unacceptable. I have written my daughter’s obituary in my head. I have actually looked in my closet to see if I have an acceptable black dress. These were my attempts to conquer my fear. My attempts to claim and manage the unacceptable.

Nelson Mandela says that “courage is not the absence of fear, but the triumph over it.” That the “brave man is not he who does not feel afraid, but he who conquers that fear.”

I am not there yet. But my daughter is. She is putting one step in front of the other…. steady and straight. Even with those swirling thoughts that must exist in her head. If I had to provide a picture of bravery for Webster’s dictionary it would be of my stubborn green eyed child making her way across a tight rope.

And I am waiting on the other side.

Dunkin’ Donut Straws

Dunkin’ Donut straws are thick. You need a decent pair of scissors to cut them. Cut in four inch snippets they are perfect for snorting drugs. Crush a Suboxone pill into a perfect pile of orange dust and use your color coordinated straw. The high is similar to that of heroin, but lasts longer. My daughter used to explain it this way, “I can’t overdose you idiot. It has naloxone built in. You don’t know a fu*&ing thing.”

I know this much: finding sawed off, shotgun-style straws scattered around your child’s bedroom is not a good sign. Ditto with disemboweled tampons. (The thinner interior tube makes a pretty sturdy straw).

So what is Suboxone? It is an opioid agonist prescribed by specially licensed doctors to relieve addicts of their cravings and to prevent withdrawal symptoms. It is comprised of two ingredients: Buprenorphine (“Bupe”) and Naloxone. Bupe mimics heroin by attaching to the same receptors in the brain, but doing so “imperfectly.” Its partial attachment provides the same sense of euphoria and reduction in pain. According to its manufacturer, Reckitt Benckiser, it is safer than heroin because it doesn’t fully occupy the receptors, and it has a ceiling effect, thereby decreasing the possibility of full respiratory arrest.

Unlike heroin, Suboxone has Naloxone built in. Naloxone is an opiate antagonist because it prevents opiate receptor attachment. Its presence prevents patients from misusing the pill, which is supposed to be taken orally.  The FDA warns that if injected or snorted, the Naloxone will fill the receptors faster than the Bupe – thereby negating any intention by the addict to achieve a quicker, stronger high.  An unintended result could be precipitous withdrawal – something most heroin addicts would like to avoid at all costs.

I also know this: my daughter got high as a kite from abusing Suboxone. She did not suffer from its immediate use. She suffered from her love of it. At $20 a pill, she couldn’t afford it for long. At $5 a bag, heroin is cheaper. And when you are addicted, you are addicted.

And there are a whole lot of people addicted to Suboxone.

I will also tell you what I don’t know: the answers.  I know that the medical establishment doesn’t have them yet either. Medication assistance has its place in the pantheon of drug recovery. I sat across from a young mother at a Learn2Cope meeting who explained that she wouldn’t have made it without Methadone assistance. And I have heard many parents say Suboxone saved their children. I watched a doctor tear up because Suboxone helped his patient avoid constant relapses. But I also know that it can be abused. The pills crushed, or the sublingual film cooked down and injected. I don’t know if this was considered during its trial phase. I hope it was and that there wasn’t a pharmaceutically driven rush to profit from its marketability. But I suppose, like anything, the benefits were weighed against the risks. It’s just hard to reconcile the fact that with a single prescription you are handing a known drug addict the means to better health, or the means to further destruction. I wish the process to recovery was clearer, simpler, cleaner.  Unfortunately, I know that it is not.