Expert: Crystal - 1/5/2008

Question
QUESTION: I cannot believe the journey I've traveled to finally arrive at this website, typing these thoughts and questions to a complete stranger, but I am desperate and lost and it's time to do something besides worry and struggle to deal with this on my own.

I've been with my boyfriend for just over 4 years now.  His name is also Josh and he's now 25.  Josh was born to a heroin addicted mother who supposedly only takes methadone everyday now.  His dad smokes crack and always has.  When he was 6 years old, he demonstrated for a jury how to construct a crack-pipe in a custody case and was subsequently legally adopted by his grandparents.  All that to explain how deep his addiction runs.  His aunt and at least 2 other family members I know of have died from overdoses.

When I met him, he was just a marijuana smoker.  Or so I thought.  We dated for a year before I realized something more serious was going on.  I also knew he was eating a lot of pain pills, but for some reason I thought it was harmless.  He seemed to be doing it recreationally.  I don't smoke or do drugs of any kind and don't drink alcohol anymore because I thought it would be helpful for him to have a drug and alcohol free house.  But we were young and I thought it was normal to a certain extent for kids to smoke pot or in his case, pop pills to party and have a good time once in a while.  Coming up on a year, I discovered he was buying a pain pill called "dilaudid", diluting it with water, and shooting it up with a needle.  I freaked out and told him it had to stop.  He promised it would.  That went on for a few months as far as I know, but in retrospect, it's possible it was going on for much longer.  I decided to move to California and told him that if he wanted to stay with me, he would have to be clean from drugs of any kind before we drove out of town, or he couldn't come.  He got clean.

Once we got to California, he started popping pain pills again.  I caught him and kicked him out.  We were separated for 8 months until he begged me to get back together with him and promised that he'd grown up and things were better.  I loved him so much that I took him back on rather blind hope that he was telling the truth.

Things have never been worse.  I caught him shooting up heroin for the first time.  He's since told me he used to smoke heroin occasionally when he was a teenager.  We checked him into a methadone clinic where he took 100mg a day until we decided it wasn't working and that the methadone clinic was just a racket in business to make money off heroin addicts.  Maybe I was totally wrong about that, but he was paying them over $100 a month, was still pissing dirty when they checked him, and there didn't seem to be any repercussions.  He seemed to be able to dictate the terms of his methadone treatment however he wanted.  I don't understand that.  I thought this was a "program" that was supposed to help him get off drugs, not addict him to something else on top of his heroin.  So we checked him into a 12-day detox.  I wrote him a letter every night before bed and mailed it to him telling him how proud of him I was.  After 6 days, I called to check on him and they told me he wasn't there anymore.  According to him, his roommate who was also detoxing tried to escape through a window but then had a change of heart, so Josh put together sheets to make a rope to get him back into his bed, but was caught and told that it didn't matter what he was doing--he'd violated the rules and had to go.  So back home he came.  But he said he'd already been through the worst of the detox and was going to make it.  He seemed fine and we went through 2 glorious months of happiness and sobriety.  He met with a councilor every morning and talked with her.  Then his grandfather passed away.  He flew back to Flint, MI where he was picked up at the airport by him mom and relapsed immediately.  He stayed in Flint for almost 2 weeks and became completely dependent again.  He returned home a mess, but said he wanted to get right back to his councilor.  He was home for 4 days and his Grandmother (adopted mom) died.  He had to return to flint for the funeral and was there for another 2 weeks.  Now he's home again and he's worse than I've ever seen him.  He went back to his councilor and she put him on 30mg of methadone, which he says isn't enough.  According to him they filed paperwork to raise the dosage and now it's up to 40mg.  He says it's still not enough.  He takes the methadone every morning, then heads to downtown LA where he buys heroin and shoots up multiple times a day.  He lies to me almost every other sentence.  I don't know what to believe anymore and I don't understand addiction or how it works or whether any of the people who he sees are really trying to help him or not.  

In all the years I've been with him, I've never known him to steal anything, but he took money off my checkcard a week ago, and then stole money off my credit card 2 days ago.  I just figured it out when the fraud department called from the bank yesterday.  Last night his employer called me and told me that he was caught stealing a backpack of things from the job where he's been working and was fired.  He didn't come home last night, which is the first time in 4 years that has happened.

I seriously don't know what to do.  I don't know how to help him anymore and I don't know how to help myself.  We've fought and yelled and gone round and round the last few weeks.  He does nothing but cry and tells me that with the death of his grandparents, he has no one in the world left but me and that he'll kill himself if I walk away.  He says he thinks about dying everyday and that he cries every time he puts the needle in his vein, but can't stop.  He wants to check into a detox clinic again, but we have no money and apparently there are long waiting lists.  I don't know whether to call the police and have him arrested where he can come off the stuff, or keep him in the house for a day until he's really sick and then take him to the emergency room and beg for help.  I don't know whether he can come off the stuff on his own here at the house.  Is that dangerous?  Will he die?

I honest to god don't know what to do anymore or where to turn.  Does methadone work?  I've also read about suboxone.  Where can I get some and is it something we can administer to him ourselves?

In the interest of being completely thorough, I'm enclosing a letter that he wrote to me the day before yesterday so you can assess to the extent possible from a letter his state of mind as you interpret it....   here goes.

         (begin letter from him to me)


    Dear Josh,

I have so much running through my mind-so many thought, feelings...
    First and foremost I hate myself for hurting you, for involving you with all of this, stressing you out, worrying you, lying to you, hiding things from you, angering you - and worst of all, damaging the way you feel about me.
    Josh - THIS IS NOT ME!  I am not in the drivers seat.  I am not in control.  Josh, you KNOW ME.  The REAL ME.  The boy you fell in love love me.  That boy isn't gone Josh.  He's fighting hard, but losing.  Physically I'm a slave to this.  I have no choice or control over my actions - when my body screams for this I have to do what I have to do.
    You don't understand the pain.  It hurts so bad being sick.  There is absolutely nothing like it.  Your mind no longer has any say in the matter.  Josh, I can't make it clear enough how badly I DON'T want to be on drugs.  I hate it.  I hate doing them.  I hate myself every time I do them.  I cry in the bathroom every time I have to do it.  I hate going down into the dangerous ghetto and risking my life on a regular basis.  I hate spending money on it.  I HAVE no money to spend on it.  I LOATHE myself right now.  I am so humiliated and ashamed of myself.  I can't believe I've come full circle - I just went through this - and I was doing great!  My life was perfect!  Eating healthy, clean, looking good, getting lots of exercise, our relationship was great.  I was working hard and enrolled in school.
    Then - I went home to face the two most traumatic events possible for me back to back and I buckled.  I relapsed.
 It's nearly a month later, I'm back in California, and my program isn't working this time.  I need help and I can't do this on my own.  Josh...I want this so bad.  I can't live like this anymore.  I am not going to waste one more year of my life on drugs.  I know I can clean up.  I know I can and will stay clean as long as I'm not physically addicted to it and as long as I don't go back to Michigan.  I can and will do this.
   Baby, I am so so so sorry.  I hate that we're here again.  Josh, this is the last time.  I swear to god and on all that I know and love.  You deserve so much better than this.
    I am so lucky to have you and that you've stayed by my side.  Josh--I will be worth it.  I swear to god if I relapse again after this treatment, I will leave, but PLEASE OH PLEASE give me one more chance.  I won't let you down.
    When I get out, I'll be myself again.  I won't be my mother and I don't want to become my father.
    I love you...<Josh

        (end of letter)

I know you provide your thoughts and time for free and that is amazing.  I will be ever so grateful for any thoughts you can share with me.  I don't know how much more of this I can take but I'm worried that he's fragile right now and might hurt himself if I give up on him.

Sincerely,
Josh


ANSWER: Josh,

Addiction is so ugly and it can eat at you and everyone around you until you don't know where you start and where they begin. It is so hard especially when you come from an environment that is nothing but drugs and addiction. and heroin unfortunately is one of the most dangerous because when you detox off of it it becomes so easy to overdose if you use again. It is hard to measure how much they are using when they are shooting up. One thing you have to understand about Narcotic addiction (pain killers,heroin and methadone) is that it changes the brain chemistry over time and it stops the natural receptors of the brain which are in charge of the happy responses that we have on our own so when people are using narcotics and come off they can have dangerous side effects as well as other things. Depression is a major part of this withdrawal and it lasts long after you stop because sometimes the body can't reproduce the dopamine that produces in the brain for a very long time if ever again and it makes them feel like they are going crazy, they can have seizures which is why methadone is a popular treatment and it can cause them to have psychotic breaks in extreme cases, which is another reason for the methadone. After a period of time some people just can't come off narcotics and have to titrate off very slowly which is where the methadone comes in and it is used in place of the heroin/narcotics until the body can adjust to the new amount and then it is changed and that is why methadone treatment takes so long but it can help, it just depends on the person and their individual response to the treatment.
You also have to realize that sobriety is a life long commitment that is hard to achieve,you have to change everything about your life that you did when you were using and you have to walk a different path to be successful. Unfortunately, relapse is a part of the treatment process and it happens more often then not and traumatic events are a huge cause for it.
I am not a doctor and I can't cure him over the Internet but my advice would be to get him back into treatment and on the right dose if that is what he needs so he can get back off the streets and try to achieve life again. I understand too that you have been through a lot and maybe you can't handle that anymore and need to let go but that is something YOU have to decide. I know that loving someone with addiction is hard and it can eat you alive inside and sometimes you have to let go to see a real change, it just depends on the people and the motive as well as the will to survive. Does that make sense?

---------- FOLLOW-UP ----------

QUESTION: Yes, it makes a great deal of sense and I can't begin to tell you how much I appreciate your taking the time to help me.  I feel like I at least have a direction to head.  Tomorrow morning, we will go together to see his councilor at the methadone clinic and we'll sit down and talk about all the things you and I discussed here today and see if we can get him on a dose that will actually help--and I'll try to be more patient with his treatment.  I believe he is really heartfelt in his desire to quit.  Sometimes I can be a little harsh with him and get annoyed because the people at the clinic won't tell me anything or keep me in the loop because we're boyfriends and I don't have any legal rights to his medical information.  Thank you so much.  <Josh

Answer
Josh,

You are so welcome and I hope you get what you need to make your relationship and both of your lives successful. I would also like to suggest that you go to alanon for some outside support as well. Remember too that if he asks his counselor to include you in a session as well as signs a consent form to include you in some of his treatment plans then it may give you more of an understanding of his treatment. I am not sure what type of boundaries the center has when it comes to that so I can't answer for them but I hope they will include you. Good luck and take care.
Crystal