Random Quote of the Day

unreq

“A most mediocre person can be the object of a love which is wild, extravagant, and beautiful as the poison lilies of the swamp.”

— Carson McCullers “Ballad of the Sad Cafe and Other Stories”

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An Ordinary Kid on an Ordinary Day

candblo

This week, a young man died. In many ways, he was just like most kids his age. He was 27-years-old, the only child from a loving family in a suburb near the midwest; he loved gaming and was a sales clerk. He loved technology — the kind of kid who could probably fix your computer, teach you what to do with that iPad you just bought, and set up your new surround sound system, all while updating his Facebook page, texting a friend, and simultaneously calling another. I don’t know if he had any particular dreams or goals, but I bet he had them. Maybe his dreams never extended beyond wanting to be happy and laugh at funny jokes. He was a handsome kid with bright blue eyes and sandy blonde hair.

Then, on one quite ordinary day in May 2015, that young man died from cardiac arrest, suspected secondary to loperamide abuse/overdose. He’d been hospitalized twice before and almost died from the same thing. Neither his doctors nor his family could understand, didn’t know what was going on.

Like most addicts, this handsome, sandy-haired young man tried to hide the fact that he was sick. He lied to people and hid and denied his addiction the best he could. His family was helpless against this unknown enemy. His final post on Facebook detailed his frustration as, apparently, his parents were taking steps to try to control his usage and help him. Ultimately, it didn’t work. He died the next day.

I didn’t know this young man. I wish I had. I would have noticed his pinned pupils. I would have noticed the bottles on his shelf or empty in the trash. I could have talked to him about the loperamide. I could have tried to shake him out of his tree, addict-to-addict. I could have provided hope and encouragement. I want to reach out to him and reassure him that there’s a life beyond addiction that honestly does not suck as much as he thinks it will. That he’ll be okay! It’ll all be okay! Say something. Anything. But sometimes, despite all efforts, it still doesn’t work.

I receive quite a bit of mail like the one that prompted this article. Parents worried about their kids, sisters, brothers, aunts, uncles, friends — most from the addicts themselves, worried, scared, and needing help where there appears to be none at all.

This week I also received a letter from a new mother who was addicted to loperamide and whose baby was born also addicted to it. Again, doctors are baffled. I’m not.

Loperamide abuse, unlike pain pill addiction or heroin (and other hard drug) addictions, is an underground disorder. It’s sneaky and quiet. And perfectly legal. As a drug-of-choice, it isn’t flashy like bath salts, nor is it well known or respected within the medical community as the “public health danger”1 it is, like heroin. This is partly because it’s relatively new, but also because, loperamide addicts are afraid to speak up for fear of being laughed at — or at the very least, not being taken seriously — so they rarely report. Who wants to be known as a poop-pill addict? But as noted by character Walter White in the series Breaking Bad, “you must respect the chemistry”.

Loperamide, the active ingredient in Imodium, is an over-the-counter medication marketed and widely used as an anti-diarrheal. It also happens to be an opiate — though, theoretically, it can’t make you high. However that hasn’t stopped people from trying. Suggestions have been disseminated among internet discussion groups for how to “mega-dose” loperamide — take it in extremely high quantities — to achieve a high of sorts. And it works. Some try to use loperamide like this recreationally (sometimes combined with something like grapefruit juice or Tagamet in an attempt to ‘boost’ the euphoric effects); others use it as a “poor man’s Methadone” to ameliorate the symptoms of opiate withdrawal. Many end up hopelessly addicted to it.

Each bottle has 200 pills, equaling 2800 pills in one sold package.

Each bottle has 200 pills, equaling 2800 pills in one item offered through Amazon. If you took one pill (a normal dose for diarrhea) and decided to do that every single day, it would take you 3 1/2 years to finish this much! Does anyone using it normally really need that much at once?

And it’s perfectly legal. And cheap! And sold in quantity. Compare one pill being the normal dose for diarrhea, you will find addicts commonly taking 72 tablets or 144 tablets at once (this is the largest size commonly sold in drug stores and at Walmart). Some take much more. You can order loperamide online at Amazon right now in quantities as large as 2800 tablets at once for the low-low price of about $25 bucks (though I’ve personally seen offers of 10,000 pills and up). And yes, anyone can buy them with just a press of a button. They make it easy to get addicted to those mega-doses. All very quiet, secretive, and “normal” arriving in a plain brown box right to your doorstep. (I used to tell people they were vitamins.)

Aside from gross availability, the medical community has only been spottily aware of the problem of loperamide addiction for the last two years. My doctors at Upstate Medical University Hospital in Syracuse NY were the first to widely disseminate their research after my case was reported at the Clinical Toxicology conference in 2013. Since then, there have been other cases seen throughout the country including several more at Upstate — nearly all with life-threatening arrhythmias. Some die.

It happens often after chronic overdose use of loperamide. The usage itself, relatively uneventful, growing or maintaining over months. Then one day, you’re feeling sick, as if you’re getting the stomach flu. Sometimes in just a day. Sometimes two. You’re sleepy all the time. You get this sinking, cold feeling in your gut. Then suddenly, you wake up gasping for air. You’ve fainted. Your heart rate has slowed to 30 beats per minute or less. The heart’s electrical system short-circuited. You’re in a cardiac arrhythmia (most often ventricular tachycardia). Sometimes it degenerates further into an even worse arrhythmia called Torsade. Unaided by medical intervention, the heart stops and you go out again. Sometimes the heart restarts spontaneously, but if it keeps up without medical intervention, you will die.

A hospital visit is the only way to survive.

But, sadly, if a person addicted to loperamide were to actively seek help from an addiction specialist at a rehab or detox center to get off the drug, they’d likely be turned away. Why? Because many working in the field of addiction still don’t know about or understand loperamide. It isn’t their fault — the word just hasn’t gotten out yet. If a patient presents in an ER in cardiac arrest, loperamide won’t show on a normal tox screen, so it’s often overlooked during the differential. It’s happened. I’ve seen it. They just don’t know to ask. They don’t know what they don’t know.

I have been haunted by some of the letters I receive, especially lately. Some people send letters that I respond to but I never hear back. Some write back and update me on how they’re doing (both good and bad). And still others — ones like this — get under my skin. I’m angry and saddened; I’ve actually cried for this young man whom I have never met, and I’ve felt his pain and the pain of the parents and loved ones who had to bury him this week.

I know because I was just like that young man once. I was taking 144 tablets a day when I went into cardiac arrest at home. At the hospital, I was defibrillated 28 times wide awake and lucid for the experience. I had to be put on life support for three days. I crawled back to life through a soupy, thorned hell of my own creation. If it weren’t for the quick-thinking ER physicians at my town’s Memorial Hospital and the incredibly intelligent staff, doctors, and toxicologists at Upstate, I wouldn’t be here today. With aftercare provided by my own Square-Jawed NP who has closely monitored my recovery — I owe them all my life. Literally.

It is survivable. You can recover. Spread the word. Start the discussion.

If you are addicted to loperamide, see your GP or someone in the recovery field. Bring a printout of the most current Loperamide Medical Articles (PDF) with you to your physician, therapist, nurse, or rehab person.

Recovery from loperamide follows the same approach as normal opiate withdrawal only it lasts longer due to the drug’s prolonged half-life. Supportive medications such as Clonidine, Hydroxyzine, etc. ease the recovery. No suboxone necessary. You can tell that to your medical professional as well.

If you recover with help from the medical community both sides win — they learn, you live — and it saves other lives as well. Like some sandy-haired young man of 27 that you have never met.

He was just an ordinary kid on an ordinary day. It could have been someone you love. It could be you.

Be safe, and God Bless.

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“It’s getting critical
Takes a minute for it to set in
I’m unpredictable

And I’m dyin’ just tryin’ to feel alive again.”

                                            –“Critical”, Travie McCoy
(among that young man’s list of favorite musical artists)

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Tender Mercies

drshrink.jpgI have a problem. A guy problem. One from an unexpected source.

Let me preface this article by saying that what you are about to read is a very sensitive subject for me to discuss. It may raise your eyebrows. You may think I’m being ridiculous. You may get angry. Please set this aside and realize that I am bringing the topic here because I need to record it, think it through rationally, and I need to breathe and consider my options carefully.

This is a no-judgement zone.

It should come as no surprise to anyone following my blog that my feelings for the Square-Jawed NP are, at best, complicated. For those not in the know, NP is my medication management guy who occasionally dabbles in some therapy. We recently concluded some serious therapy to get to the bottom of some of my worst issues (articles are here).

Sometimes my affection for him is very strong. This has been something I’ve understood to be the likely result of a phenomenon called transference — I’ve known this for some time and have battled it accordingly.

Personally, I don’t believe in transference as an exclusively-psychiatric phenomenon. It happens in everyday life. Transference is officially defined as follows: “the redirection to a substitute, usually a therapist, of emotions that were originally felt in childhood.” Now come on? Who hasn’t met someone who reminded you of an old boyfriend? How many times were you attracted to someone who laughed like your brother did? You meet someone who reminds you of someone else, and you act accordingly. Had a bad experience with someone with a bushy moustache and you’ll likely to be extra wary the next time you meet someone similarly adorned.

Another term that comes into play here is countertransference, defined as: “redirection of a psychotherapist’s feelings toward a client—or, more generally, as a therapist’s emotional entanglement with a client.” This is what the other party feels for you — you remind THEM of someone they once knew or related to. But Jesus, who doesn’t find that in everyday life too?

To me, transference and countertransference have their respective places. I see it happen in other people. For me, it feels different. Maybe I’m making excuses. Or maybe I’m just trying to figure out how I really feel.

Anything I felt for the Square-Jawed NP prior to this, I blamed on the transference phenomenon and decided my attraction must not be worth considering. I thought it through, acknowledged it, and moved on confident that there’s nothing going on between the NP and me but the rent.

But things may have changed.

Around Christmas time, there was a conversation between the NP and me that became quite intimate and involved him telling me how attractive I was and his incredulous reaction that I was single, and, well, frankly humble about my appearance. Despite it being so personal, strangely enough, I didn’t comment on it here because the twinklings of romance I felt, I decided were ridiculous. Yet, because I didn’t remark about it on this blog, I can’t remember virtually anything that was actually said. I just remember thinking, “Jeez, this guy really, really likes me.” It was a bit scary to consider that maybe somebody out there not only knew me, but liked me anyway!

After the session, as we left, he offered a hug. He’d never done this before. I chalked it up to the Christmas Season. But this was no ordinary hug. I tried to remind myself that I was likely reading too much into it. But I knew it wasn’t just a hug. It was a hug and a nuzzle of sorts. Hard to describe, but it wasn’t “just” a hug. Not really. Still, I told myself I was being ridiculous. Was he just being nurturing? Maybe. Or maybe not. After all, the Square Jawed NP is not exactly a bad looking man. Then again, he could get anyone he wanted, much younger, and with fewer complications, so why would he pick me?

I drove home in a daze deciphering what I’d just experienced. At some point in the next day or so, while going over the ‘data’ that flooded my brain and gut instinct, I became convinced that the NP was in love with me — this set off a thousand-and-one feelings in my gut, mostly confused. I liked him — nay, I’d say I held a seriously deep affection for him, and this news was both welcomed and feared. The overarching question being, now that I had him as I wanted him, now what?

I indulged this idea for approximately 24 hours before I shook my head and came to my senses. Convinced I was reading too much into it, I dropped the subject. I refused to read any more into it and simply chalked it up to a mere friendly gesture.

I should also mention that I’ve done my homework on NP. I may have mentioned previously that I tend to vet the people I work with. I perform what they call in the military, “information mining” techniques through reconnaissance. You ask one who knows the other and bingo-bango-bongo, within a short period of time, you get an overarching picture of a person and can better determine who they are and how they’ll act. Where I live is a small-town situation where if you ask one or two people, you’ll usually get the deep skinny on whoever you’re trying to spy on.

My recon on the Square-Jawed NP proved him to be a fine clinician. Nothing I could dig up could tell me what he did prior to getting into nursing except an address reference to an FPO/APO in New York — possibly military background? But as a nurse/nurse practitioner, his references were excellent. Not a great team player, apparently, but someone who was considered by most to be quite good at his job. Personally, his life is what could best be termed “complicated”. He has a penchant for dating 20-somethings. No crime in that of course, but it painted an interesting picture of someone who played the serial monogomist with women less than half his age. He also had an ex-wife with three kids, and one of this more recent ex-girlfriends has a two year-old by him and a baby of “unknown” parentage. Seems a bit sloppy if you ask me. There were also random reports of him being, at best, a flirt, and at worst, a man whore with staff in places he worked previously. Pretty, smart young women all. According to sources, that is.

None of this, of course, had anything to do with me for the past two years that I’ve seen him. I laughed about it in private, but since it didn’t effect my treatment, what do I care what he does in his private life? He’s been professional, has had excellent boundaries, and while we’ve had a good time together, nobody could ever accuse either of us of anything untoward.

It started around Christmas. Then the interrogations, albeit, with the NP in the role of serious, no-fooling-around Nazi therapist. Then recently, since I ‘graduated’ therapy, back to being a fun-loving and charming medication management professional.

Even though I felt overwhelming attraction to him at times, I was always able to calm myself down and write off the emotions as your average-everyday transference nonsense. I researched warning signs and the ethics behind dating someone in the psychiatric field (when you are the patient). I read the reasoning behind it. I talked myself down off the ledge of ‘falling in love’ if for no other reason than I refused to be “one of those” sad, pathetic women in therapy who gets a silly crush on her therapist.

So this past appointment, NP called me in as last appointment of the day. I’d seen Therapist Barbie first, then he cleared his schedule, and into his office I marched. He was so happy to see me, and to be honest, I was really glad to see him too. Since we don’t see each other now for four or five weeks at a time, there’s always a ton of news to report. And the longing, apparently, is mutual.

As soon as I sat down, we exchanged niceties, then NP pronounced, “I have a present for you.”

I thought he was teasing me and giving me more homework to do or some such ungodly task, so I moaned, “Oh jeez, now what did I do?” and laughed.

“No.” He laughed, “It’s a real present.” He handed me a brown book and a folded white sheet of paper. Both confused and excited to be getting a present, I reached for them and found the book to be a leather-bound handmade journal. How typically very old-fashioned of him. Utterly charming.

“What a thoughtful present!” I said with honest delight. NP beamed with pride. I unfolded the sheet of paper to discover a letter written inside. I won’t reveal its contents verbatim here, but suffice to say it was incredibly tender, sweet, and complimentary. I stopped midway through and looked at him seriously. “Are you leaving or something?” His letter was the kind of thing you write when you’re leaving someone, i.e. I’m wishing you all the best life has to offer, etc.

“No! I’m not going anywhere!” He said, “Is that what you think? No. You’re too suspicious!”

“Oh good. Well, it just seemed like that. Good.” I kept reading. I was genuinely touched by the sincerity and tenderness of the gifts. I gushed. “Awwwww! This is so sweet!! Thank you so much!!”

“You’re welcome!” NP just beamed ear to ear.

“I just can’t get over it. This is so incredibly sweet. What a thoughtful present. Thank you.”

I don’t remember what he said after that. My mind was reeling. It was a sweet gesture, true, but why?

We talked for the next half-hour or so about this and that. I told him about The Stalker, and if I didn’t know better, I’d say NP acted a little… I don’t know… jealous? It was an odd reaction. Normally I would expect him to be pleased, but somehow, his reaction wasn’t what I was anticipating. He encouraged me to meet people face-to-face since it’s much easier to get a feel for who they are that way.

When all was said and done, he asked me to hand him the evaluation sheet that they’d given me at the front desk to hand to him. I accidentally gave him his letter back and he teased me “What? That meant so little to you that you’re giving me my own letter back?” and he laughed. I laughed apologizing and just excused myself for getting mixed up.

Then something really odd happened.

He guided me out the door and stopped in the hallway. I asked if he was going to walk me out, so he did. We went to the receptionist’s area — where by that time of day, there was only one person left as everyone else went home. He popped his head in her office to confirm she was there and came back out. I offered him a hug. He came in and hugged me, but it was no ordinary hug. Again. This time, he nuzzled. He stroked my hair and back. It went on. He didn’t let go. It was… tender.

For my part, I stood there with one arm holding my purse and the other around his back, my cheek on his ear, innocently thinking, “Huh. That’s odd.”

A few seconds later, “Did he just stroke my hair? Huh. That’s odd.”

Then I realized he wasn’t letting go and thought, “Huh. This is lasting a long time.”

He finally released the hug, bid me a happy afternoon, and we parted — me to the receptionist, him to his office.

My mind was like a cop at a crime scene muttering, “Okay folks, move along. Nothing to see here. Move along.” I arranged for my next appointment one month out and walked out into the sunshine in a bit of a daze, trying my best not to think about it. My brain was a blank —

“Keep moving along. Nothing to see here.”

“Don’t read too much into that.” I scolded myself as I walked to my car. I stood up taller. I walked a bit quicker and with more purpose.

“Stop thinking about it.”

The book. The note. The hug. What did it mean?

Now folks, nothing to see here. Keeeeeeep moving.

But that hug. That stroke. That nuzzle —

Nope. Nothing to see here. Not your business. Keep moving.

No really.

Just a sweet man saying something nice. That’s all. Keep moving.

On the ride home, I reminded myself of NP’s penchant for twenty-somethings. Such a move means nothing in light of that, right?

But…

Nothing to see here.


I got home and talked to a couple of friends about it, having convinced myself that there was nothing going on of any consequence. When I mentioned it to Kit, she went nuts. “He’s got the hots for you Margaret!”

“No, he can’t possibly!” I claimed. “Not possible.”

“Read that letter. That means something [meaning the last line of the note]. He’s in love with you.”

“No! He can’t be!” But my resolve was crumbling under the dawn of possibility. “Wait. Do you think?”

“I think so.” She took the matter up with another mutual friend who initially sided with me until she heard about the hug.

“Oh my God, Margaret. He is in love with you. What are you going to do?”

I honestly don’t know.

They think I should definitely ask him for coffee. But I know it’s not that simple. First things first, I’d have to terminate my clinical relationship with him. Even then, from an ethical standpoint, it’s not only frowned upon, but he could lose his license. (If someone turned him in, of course.)

I’m playing with fire here, but it’s really clear to me now that something has to be done.

Whatever happened that day, it’s clear that he violated his own boundaries by giving me that gift and letter. Then the hug? It’s a clear shot across the bow; rather amusing that I didn’t even understand that at first. I guess I’ve just been considering it so impossible prior to this that it wasn’t even on my radar.

As to what to do, the literature clearly states that nothing should happen. Ever. But right from the start, with all the research I did, I don’t believe in transference — if transference exists, it’s simply a way of explaining all human interaction and affection as someone reminding us of someone else and falling in love with that. Transference isn’t exclusive to clinical relationships. But as a concept in the clinical world, it is meant to protect vulnerable individuals from attacks by less-than-scrupulous clinicians.

The literature says that if something like this happens, it should be brought up in the therapeutic setting and discussed in the light of day, frankly, and openly. It is a problem to be worked through and would prove useful to both patient and therapist.

Confrontation seems to be my best option at this point. But I’m not sure I want to find a “resolution” that is anything short of couplehood.

Regarding such “converted” relationships, there are horror stories out there. Women seeking help from therapists for sexual problems who are subsequently told that sex with the therapist is the only way to solve the issue. Married therapists who seduce and begin affairs with emotionally crippled patients. Others who use their power position to force patients to have sex with them. And even more to self-disclose to an uncomfortable degree as a means of manipulating patients into falling in love with them. It’s a crazy world full of shitty people.

But it’s the stories you don’t hear about that often. The ones who really fall in love. Who get married. Who have the little house and white picket fence. It does happen. One man was brought up on ethics charges which were later thrown out — he kept his license because it became clear that the couple was in love, had married, had children, and were living a responsible, healthy life.

Which one would I end up being if I went forward with this?

I don’t know. I have a month to figure it out though, and I’m honestly not sure at this point how I’ll approach the issue. But surely, I need to make some decisions.

Let’s examine why I might want to go for it:

– NP is good looking.
– NP has a good job and is financially secure.
– NP has affection for me.
– NP might be in love with me.
– NP makes me laugh
– We share many mutual interests
– We think alike.

Let’s examine why I might not want to go for it:
– NP could lose his license
– I could lose my dignity
– Neither most of my friends/family nor his friends/family will likely be accepting of this if they know the true genesis of the relationship, which sets up a pattern of lying and covering up the truth (generally considered unhealthy).
– I don’t know him personally, so for all I know, NP might actually be a lying, cheating, scumbag motherfucker who’s rude to waitresses, tips badly, squashes ladybugs, and punches kittens.
– I could end up heartbroken. Again.

One friend of mine thinks the possibility exists that he’s just acting ‘nurturing’ and I’m reading way too much into it. She read the letter, I explained (and demonstrated) the hug, and she still maintains that, given his normal level of professionalism, he’s just being a nurturing, caring person.

Another friend, who used to work with the NP at a local hospital (when NP was just a nursing student) disagrees and told me that she thinks, in no uncertain terms, that he is flirting with me. For realsies. No foolin’. Serious.

I guess I have a month to consider my options. I can do nothing and just chalk it up to me misunderstanding his motives, or I need to confront the situation and determine an appropriate course of action.

Right now, the plan is to confront the situation and see what happens. In the light of day, I can get to the bottom of this. Either way, I don’t want to continue wondering and wishing and waiting. That’s maddening. I owe it to myself to handle this like a grownup no matter how terrifying the idea might be. I’m not some starry-eyed teenager anymore so I refuse to act like one.

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“If that’s true, if you don’t know who I am, then maybe your best course… would be to tread lightly.”– Breaking Bad
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NEW Loperamide Articles in the Literature, May 2015

lopemicroAh! It’s the first of the month — and means it’s New Article Publishing time! Three new loperamide abuse articles to report on for May.

Be sure to check out the full list of articles in the ARTICLE CLEARINGHOUSE.

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loptab3Loperamide toxicokinetics: serum concentrations in the overdose setting.

Eggleston W1, Nacca N, Marraffa JM.
Clin Toxicol (Phila). 2015 Mar 30:1-2. [Epub ahead of print]

Clinical Toxicology

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loptab3Reply to: “Torsade de Pointes Associated with High‐dose Loperamide Ingestion”

Jeanna M. Marraffa, PharmD, Dabat, Michael G Holland, MD, Michael J Hodgman, MD, Upstate Medical University, Syracuse, New York, NY
Accepted 
March 16, 2015.
Journal of Innovations in Cardiac Rhythm Management, 5 (2015), 1958

“These reports underscore the need for further investigation of the cardiac effects of high‐dose loperamide. Further research into the mechanism of both QRS widening and QTc prolongation is warranted. Clinicians need to consider loperamide abuse in otherwise healthy patients with syncope or ventricular arrhythmias, especially those with a history of drug abuse or opioid dependence.”

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loptab3CASE REPORT: Loperamide dependence and abuse
Ryan MacDonald1, Jason Heiner2, Joshua Villarreal3, Jared Strote2
1Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, Washington, USA ; 2Division of Emergency Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA; 3Department of Pharmacy, University of Washington Medical Center, Seattle, Washington, USA
Published 2 May 2015

BMJ Case Reports 2015; doi:10.1136/bcr-2015-209705

“Summary: …. A 26-year-old man who was taking 800 mg of loperamide per day presented requesting detoxification referral. Loperamide has potential for euphoric effects and information on how to facilitate such effects is easily available. It is important for physicians to be aware of the potential for misuse of and dependence on loperamide, with symptoms mimicking opiate use.”

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Alcoholic Snobbery

beerAbout a month ago, I was invited to be the guest speaker at my AA group’s monthly speaker’s meeting in May. It’s a big deal to be asked to do this; it would be considered insufferably rude to turn down such a generous invitation.

I had no idea what I was going to say — after all, alcohol isn’t really my problem, though it was years ago. I’m not a hardcore boozehound like most of the people in AA. So, given that I didn’t know what to do, I put off planning my speech.

With all that had happened last month, I got distracted. I finally realized it was only one week off, and thought, Oh crap. What am I going to say? Well, certainly I’ve told stories before. Certainly I’ve told MY story before. I could wing it. Right?

Except yesterday, I was not in the mood for winging it. If I had my druthers, I would have stayed hom. I’d had a shit day at work full of stupid people and tension. My boss is mad at someone. My co-worker Kit is mad at my boss (and is subsequently quitting). And me? I’m caught in the middle trying to keep “Mom and Dad” from fighting and getting a divorce. Add to that all the usual foolishness and by the time I was ready to go home, I was crumbling.

So after work, I left, went to the store, and bought a pack of cigarettes.

OK, here’s the thing: I don’t smoke. Back in my 20’s when I used to drink, I smoked a bit, not seriously, so I’m not really sure why. Maybe I thought it made me look worldly or something. It didn’t. Maybe it was some kind of punishment. I don’t know. The only real result was, when combined with booze, I would wake up the next day with a hangover, cotton mouth, and smelling like a stale ashtray.

Still, I sat out in that beautiful sunshine yesterday, pissed off at myself and the world, and I lit up. As I took a deep drag on that cigarette, I was immediately mentally immersed right back into 1990 while I lived on the lake at the height of my alcoholic experience, expecting to hear Bonnie Raitt singing Love Has No Pride over the stereo speakers while I took a long sip of an ice cold Coors Light, the first of at least a dozen that night. Oh! How I loved to sing out my blues songs when I was feeling bad and needed to feel worse!

But yesterday, just the smoke. No beer. No lake. No music.

They teach us in AA that we need to watch out for hunger, anger, loneliness, and tiredness — HALT is the acronym. Well, I’d hit the quadfecta. I was all of those things yesterday.

The cigarette made my mouth feel like an ashtray. I didn’t care. I wanted to feel like shit. I wanted to be covered in it. Who cared? What did it matter? It was the only legal drug I had left in my arsenal — nicotine — and I intended to use it. Kit had been trying to quit smoking; she’d been using the patch all week and finally caved yesterday because of all the stress in the air. I guess I figured I’d join her in spirit if not in person.

I felt alternately light-headed and awake. Very awake. I realized that I needed to get my act in gear because cancelling my Speaker’s meeting wasn’t going to be an option. So I closed the pack of smokes and prepared for the meeting.

I scribbled a few notes, nothing much, just trying to remember a few key incidents so I didn’t get off on too much of a tangent. Speakers are expected to use up the better part of an hour — and for me, getting storytelling, I could easily take up that time without blinking.

But what to talk about? I wasn’t much of an alcoholic. Frankly, I wasn’t much of an opiate addict either. But what did they want as an audience? A few laughs? A few tears? I’ve been to a few speaker’s meetings, and they all are a little different.

I arrived about 10 minutes early and was hurriedly escorted inside upon arrival with the leader concerned with my tardiness. What tardiness? I was early! Apparently not.

The meeting began almost right away. They did the usual readings and led right into me. I took my notes and went to the head of the room where no podium or table had been set up for me (guess maybe that’s why I should have been there early). So I started talking. Luckily for me, I’ve never been afraid to speak before a crowd. Public speaking has never been the source of any fear for me. But I could tell almost from the very start that I didn’t have these people. Not one bit. They looked miserable like they all wanted to go home. One lady turned her chair toward me with a smile on her face — there was someone I could talk to. Most of the rest never turned their chairs. One lady walked out about five minutes in.

So I told my story. I was born, I grew up, I was a teenager, I drank, I went to work, I drank some more, then I got into pills. Then I got sick and got more pills. Then I quit work, sold my house, lost all my things, used loperamide, died and came back, used lope again, then almost died again, got into AA, got clean, life is better now, the end. All in all, about a half-hour. I told my substance abuse story, not my life story. So I made perfect time.

How did I do? Pretty badly in my opinion. Nobody looked at me. I cracked a couple of jokes which received a smattering of giggles, but it was a tough room. How do you talk to a room of people when half of them are eating and not even looking at you? Rude!

Afterward, very few people stopped me to say anything. Most left. One lady backhandedly made excuses for me saying “It’s 2015; not everybody just drinks anymore.” Uh-oh. I screwed something up. I thought. Another gentleman came up to me and accused me of all the usual AA-related shit — needing to be more involved, do more service, etc. He actually pointed to the women in the kitchen who were doing cleanup and said “That’s the most important job here — you should be doing that.” Now I was getting mad. I wanted to snap at him and tell him if it’s so important, why isn’t HE in there cleaning up? The utter gall of some of these old timers!

I talked to one of the guys from my home group when I left and said, “Look, I did the best I could. I’m only sharing what they said they wanted: Experience, Strength, and Hope.” He agreed and assured me I did a fine job, but I know otherwise.

But I don’t care. My story is my story. If it’s not good enough for them — if I didn’t drink enough, get DWIs, kill people, destroy more lives — and my inability to commit more chaos in my life isn’t enough, then that’s their problem. Funny how these drunks can get so friggin’ fussy about whom they consider a real addict — and how snobby they are about people who are addicted to more than one thing. They draw this invisible yet distinctive line between themselves and those scummy drug addicts as if there is a line to be drawn in the first place. Oh for God’s sake, get over yourselves!

The good news is, they’ll probably NEVER ask me to do that again. And if I get kicked out of AA today at noon for not being what they consider a true alcoholic, let ’em kick. Go ahead; make my day.

So no, I do not feel guilty or badly that I was unable to meet their expectations. They asked for my story, and they got it. Can’t relate? Too bad. What’s true is true.

I can only be who I am. And if that’s not good enough for the world, then they can all go suck it. Trust me, I can stick my nose up in the air too and shut the whole world out.

Why should anyone be defined by their drug of choice? Substance abuse isn’t the beginning nor should it be the end of my story. My life is full of plenty of life experiences. Some good, some bad. Drinking didn’t cause nor destroy who I am — and neither did opiates or loperamide. Why so many alcoholics and addicts define themselves primarily as one or the other and let this become who they are is beyond me. I have no interest in such things. I don’t want to go to every meeting. I don’t want to attend every conference or be at every event. I have a life now. I’m glad my life is moving forward and away from those things. I have goals. I have dreams that I’m working toward. And yes, not everything is working out, but I keep trying. Isn’t that what we’re all supposed to do? Really?

I want people in my life — people I care for. People who are funny and charming and think the world is a weird place like I do. People who aren’t liars or cheats or assholes. Who don’t define themselves by the worst they’ve done but by the best they can do.

It is with great sadness and grief that I have had to leave some very extraordinary people behind — often without my own consent — but others… they’re just a few steps away.

Now where’s that cigarette pack? I need to find someone else who can use it

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“Fine times have gone and left my sad home
And the friends who once cared just walk out my door
Love has no pride when I call out your name.”

— “Love Has No Pride” by Eric Kaz, Libby Titus

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Posted in AA, addiction, depression, loperamide abuse, music | Tagged , , , , , , , , | 5 Comments

A Conversation Between Girl Friends

gis

What I look like under excellent lighting.

On Tuesday of this past week, my friend and work partner Kit and I had a conversation that went something like this:

Kit: So did you hear from The Stalker? [The Stalker is cutesy name for a gentleman friend I’d been corresponding with for the past few weeks.] Is he coming up here this weekend?

Me: Nope. He’s gone ghost again.

Kit: What?!? Why?

Me: He stopped calling, texting. Nothing. And I have no idea why.

Kit: Seriously?

Me: …as a heart attack. Gone. Poof. Thin air. Last I knew, everything was going fine. He texted me “Mornin!”, I texted back, I called him, everything was fine. He was on his way back home to [redacted] and asked me if I could call him later to keep him company on the road. I said I probably wouldn’t be able to because I was working, but I’d call him when I got home that afternoon. I texted him as soon as I got home to ask if he had arrived safely. He texted back, and I quote, “Yes, thank you!” … and that was the last thing I heard. I tried calling him a couple of times, but nothing. No answer.

Kit: Well, maybe he’s just busy. He’ll call you.

Me: Nope, I don’t think so. Not this time. It’s too weird. This is way out of character. I’m pretty sure this is it.

Kit: Why would he do that?

Me: Beats me.

Kit: You said he was divorced, right? Maybe he was lying about that and went home to his wife.

Me: No. The ex-wife is remarried.

Kit: Then he’s got a girlfriend he doesn’t want you to know about. That’s it. She’s waiting there when he gets home, and poof! You’re out. That scumbag!

Me: Could be, I suppose. I mean, he mentioned that he’d broken up with some 20-something girl, but…

Kit: That’s it! Ugh. What a shithead! Men are such scumbags!

Me: But that’s the thing Kit. He’s not a shithead, and he’s not a scumbag. He just… stopped. I really don’t know what happened. I think somewhere on that trip, in the six hours or so between the time I talked to him and the time I texted him, he utterly and completely changed his mind about me. Maybe I said something… or didn’t say something… I must have done something really wrong, except I can’t think of what. He seemed like he was really excited to be back home. He said he’d be free to Skype and be in contact more often. He had talked, well, kidded, that he might drive straight here. But I’m sure he was teasing. At any rate, he really seemed happy about it. And positive. I don’t know what happened. It has to be me.

Kit: That’s bullshit. It’s him.

Me: Yeah I know. But it’s driving me crazy, not knowing. Maybe I gave him some indication that I was overly-invested. Maybe I pushed too hard. I mean, I do that sometimes. I really liked him, but I wasn’t, like, nutso writing our names together or anything. Jesus. I was being a mature adult about the whole thing, I swear to God!

Kit: I still think he’s got some hoochie girlfriend. [I chuckled at this — I love that Kit knows the word hoochie and was able to use it in conversation!]

Me: All I can think of is, whatever happened, it was bad enough to make him cut off all communications and go dead silent. That usually means… repulsion. What the fuck is with that? Why would a guy do that? It’s so stupid.

Kit: Asshole.

Me: Maybe it’s karmic payback. I did that to a guy once. A friend of mine was trying to set me up with her brother, and the guy completely creeped me right out. Then I saw his picture and he looked like a girl with a beard. Oh God! No! I shut that shit down and deleted his emails. It was a long time ago, but I was pretty cold about it.

Kit: Yeah, but you guys weren’t talking and Skyping and all that, right?

Me: True. We’d exchanged a couple of casual emails, but nothing intimate or anything.

Kit: So it’s not the same. Besides, this guy really liked you, right? He seemed into you.

Me: Obviously not. Maybe I overstepped. Moved to fast or something and spooked him. I thought more could be built on the friendship we’d formed, but maybe… well… he did seem amenable to the idea. I just don’t know, Kit. I felt like I was following his lead on things. It’s… just so weird. Really weird.

Kit: Maybe he got in an accident or something. Did you check the obituaries?

Me: Pffft. No.

Kit: You know what? This weekend, let’s drive down to [city name redacted] and just show up on his doorstep. I’ll bet that ho girlfriend of his answers the door, then we’ll know!

Me: (laughing) That might be slightly crazy, Kit.

Kit: And we can be all, like, “Whatup, bitch? Where’s your ol’ man? Is he dead, or is he just an asshole?” And I’ll punch him for you, Margaret! I will! And I’ll take the ho out too.

Me: (still laughing)

Kit: But you have to drive the getaway car, okay?

Me: (still laughing) Kit, now, that’s just stalkery and crazy… But could be fun. (We laugh again.) I’m not going to show up on the poor guy’s doorstep. Jeez, we were only in contact for about three weeks, you know. Let’s save that idea for some guy I go out with for three years instead, okay? Let’s just shelve it for now. Good idea; wrong time.

Kit: I could stalk him online for you. Find out if he’s got that ho living with him.

Me: Kit, I’m starting to think you’re a bit more invested in this thing than I am. Seriously, I’m trying to handle this with a bit of grace and dignity.

Kit: Fine. (Sighs)

Me: You know, I wouldn’t be completely surprised if he sent some PI up here to spy on me and take pictures of me picking my nose or something.

Kit: Eww.

Me: I’m just sayin’. Remember, when he and I Skyped, I had good lighting going for me. (Laughter) I was always worried that he was going to visit me up here and see me under overhead fluorescent lighting. Worse, see me in-person as I really am.

Kit: Oh quit it. You’re pretty and you know it.

What I look like under fluorescent lighting.

What I look like with no makeup under fluorescent lighting.

Me: Come on, Kit. Get real. This isn’t my best look. (I point to myself with no makeup on, in my uniform, and my frizzy hair gathered in a ponytail.)

Kit: You clean up really well though. (We both laugh)

Me: So yeah, I don’t know. I’m thinking about sending him an email in a day or two.

Kit: NO!!

Me: What do you mean, no?

Kit: NO! Don’t do it! It puts you in a position of weakness. Let him come to you. That’s what I would do.

Me: I know, I know, but he’s not coming. And I really think I should just try one last time.

Kit: Margaret, I’m telling you. It’s a bad idea. You’re only humiliating yourself.

Me: Yeah, I know. But I need some kind of closure. This whole thing is driving me crazy. You know, I think it’s me. It’s me. [I gesture toward my body.]

Kit: Oh, stop. Do you think he’s that shallow? I thought you told him about it. And he’s seen you on Skype. So what’s the problem?

Me: It’s different in person. I didn’t say exactly how much I weighed or anything, but I told him how that medication caused me to gain weight.

Kit: So he knew. So?

Me: Well, you know I was worried about that.

Kit: Yeah, but you’re losing weight. Even so, who cares? It’s not like he’s perfect either. That chewing tobacco thing? Gross. Please. If he likes you, he likes you as you are. This guy sounds like a shithead. Let’s go find him! Come on! Roadtrip!

[Laughter ensues]

The reason I was unceremoniously dumped: The Stalker's PI spies caught pictures of me waiting for the bus.

The reason I was unceremoniously dumped: The Stalker’s PI spies caught pictures of me waiting for the bus.

Me: I just wish I knew what it was that caused him to disappear. It’s driving me crazy. On the other hand, the good news is, I can go home and wipe down all my makeup and not worry about looking good for Skype time anymore.

Kit: You’re funny. And I won’t have to follow you around with a flattering flashlight if he comes to town? Dammit. I was looking forward to that! (we laugh)

Me: Yep. And I don’t have to have you looking out for outfits for me to wear anymore. I can go back to wearing–

Kit: No.

Me: (laughing) What?

Kit: Nope. I’m still picking out your clothing. And finding you cute shoes. You’ve gotta get out of those sneakers and stop dressing in your uniform all day like you don’t care.

Me: Fine. But — hey! — in other good news, I don’t have to worry about running out of minutes on my phone anymore.

Kit: Yep. That’s true.

Me: But… dammit. Why do men do stuff like that? Why? Why not be a grown up and say “Listen, I like you, but I don’t likeyou-likeyou.” Or “Why did you say such-and-such because it freaked me out?” Where’s the honesty? Where’s the trust? I was trustworthy. I was honest. I didn’t lie to him about anything. Not anything. No games, no lies. Just trust. That’s what I get. Jeez, what was I thinking anyway? I’ve gotta just stop talking about this. It’s just… I just really liked this one Kit. I really did. He was smart, clever, funny, intelligent, well-educated. Handsome. Hmph. There’s the problem right there. Obviously WAY out of my league. I told you that before. I hate it when I’m right. Well, whatever. Maybe I just wanted it to work more than it actually could have. Well, obviously. Duh. I just wish it wasn’t bothering me so much… Kit?

Kit: [Messaging on her cell phone]

Me: Kit?

Kit: [Still typing] Huh? What? Sorry. [My fiance’s name] just messaged me.

Me: Oh nevermind. I need to just stop talking about this, anyway. It’s stupid. It was only three frickin’ weeks for Pete’s sake. Three weeks is a drop in the bucket, right?

Kit: [Typing again]

Me: [To myself] Yep. Right. Damn skippy. Whatever, yo. Toodles. Goodbye, farewell, and amen.

Kit: Do you feel like going out this weekend? You need to get drunk. Wear that dress I picked out for you to meet the Stalker in, and we’ll go to the club. Best way to get over one man is to get under another, you know. I’ll pick you up around 10 on Saturday?

Me: 10 — at night?

Kit: Margaret, I have so much to teach you.

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“The absence of a message sometimes is a presence of one.”― Hasse Jerner

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Posted in Humor, memoir, random crap, relationships | Tagged , , , , , , , | 2 Comments