Better Luck Next Time


Now that some of the craziness surrounding the big loperamide story break has died down, I think it’s safe to start writing more about myself again.

I’ll be honest with you: the past few months, not being able to write here about my personal situation, have been really difficult. The Sobrietyland blog has always been a safe place for me to discuss my feelings and struggles anonymously, so without it — well, you wouldn’t think it would make that much difference, but it has. I don’t have a therapist anymore, and I really need to talk about some stuff.

So here I will put my toe back in the water and see how it goes.


It’s about time you called me, fraülein!

I used to write about my personal therapist nazi, the Square-jawed NP (nurse practitioner), with some frequency. I don’t speak with him often anymore because he — as my long-time readers know — has moved away to NY’s Southern Tier. I called him a few weeks ago to let him know how I was doing. I didn’t tell him everything, just the good news which mostly includes my schoolwork. He’s proud of my accomplishments but really wishes I’d start writing in the journal he bought me. I wish I could, but I just can’t bring myself to do it. And I wanted to tell him so much more but… There doesn’t seem to be much point.

As you might be able to pick up on, I’m struggling with my depression again pretty badly. If you’re an old reader of my blog, you know how bad this can get. If you’re a new reader or someone who knows me in real life as a high-functioning person with depression, you have no clue! Just trust me, this can get ugly. It’s like the old story about the frog and the boiling water; if you turn up the heat slowly, the frog doesn’t notice how hot the water is getting until it’s too late. That’s depression — it sneaks up on you. Some days, it’s just another day, and on other days, it’s hard just to get out of bed and function in the world. A lot of everyday things have begun to slip into the cracks as I take less and less proper care of myself. Joy slips away slowly…. insidiously… I have to find reasons.

200_sOne reason IS school. I really, truly enjoy learning, and I’m doing very well at it! My college is in the next city over (about a half-hour away), so the early-morning drive is no fun at all, but once I’m there, things generally go well. My primary class is chemistry. I love chemistry! I truly believe it’s the key to everything in the universe, and even though it’s an introductory class (and frankly, a bit remedial), I’m remembering all the reasons I loved it when I was in high school. Even the math part of it — which, mind you, I was NEVER good at math — has taken on the same challenge as a tough puzzle. And I have found that if I am challenged to learn a really hard puzzle, then overcoming that challenge fuels my self-esteem engine and gets me through the day.


Then on the polar-opposite end, there’s work. Now normally, I wouldn’t speak of things like this, but as I mentioned, traffic here has died down so I think it’s safe to say that not that many people are reading it for articles about anything except the lope crisis.


As I have mentioned before, I work at a local “second-hand” store. Because my classwork is in the morning hours, I had to switch to night-shift register work, which my boss was really nice about and accommodated my request for the move. The night shift wouldn’t be all that awful except the vast majority of my time is spent cleaning, not interacting with customers. As the last person to leave, it is my responsibility to make sure the store is neat and tidy and ready for the next day. Some days this is completely impossible, but every other day, it’s simply virtually impossible. I knew it would be hard, but I had no idea that it was, in fact, entirely futile.

Every day, I pick up after piggy customers — and I’m sorry, but people are the most inconsiderate swine. In addition to the mangled clothing and merchandise they leave everywhere for me to pick up, they leave empty coffee cups, spilled drinks, cookies, candy, food, gum (holy shit! lots of gum!), puddles of pee, poop, used underwear, old socks, mud, dirt, mystery spots, and used diapers. I literally (and this is no exaggeration) spend 95% of my time cleaning up. Most slow shifts I can be found going up and down the aisles picking up after customers, throwing things away, and organizing our merchandise back on the sales floor. And on big sale days when the register is running non-stop? Nothing gets done, and I get my ass handed to me.

And — now this is a true story — while I was being reprimanded for not doing all of this well enough or fast enough, management informed me that they are adding several mandatory duties such as sweeping and mopping the entire store. All this while still doing normal tasks such as running register and gleefully attending to our customers. If there is anything on the list that I don’t get done, I can expect to be punished. When I can’t meet management’s unmeetable standards, I’m reprimanded for my idiocy and even more work is added. The stress in that measly four-hour-a-day, part-time, minimum-wage, no-benefits-earning job is overwhelming and has made the situation absolutely untenable. Maybe my boss is right and I’m just not a good fit for this job. I’ve been there five years and I’m at the end of my rope. I’ve given it a fair shot. To wit: I have learned to hate my job and have decided it’s time to move on.

So in that light, I am full-steam ahead in job seeking mode again. This time is different because I’m just desperate enough to take a lateral move just so I can find a job where I might actually be able meet my daily goals. Three jobs so far have resulted in job offers, but for various (good) reasons, the fit was not right. The one job I have my fingers crossed for is at a local “entertainment mecca” where I would work in retail (yes, again!). [Hey, it’s an entry-level job that pays more than I make now, so don’t knock it.] I had one interview so far with the recruiter. From there, another person has to call and interview me, then… there’s more. There is one big hurdle though that I cannot discuss here (because I’m not 100% anonymous) but trust me, it’s a big one. So this isn’t a done deal by any stretch. If I can get over that, I could have a new employer before Christmas. And even with the stress of starting a new job and having to drive further for work, it’ll still be less stressful than what I’m feeling now.


I can also add that there’s been someone “special” in my life now for almost a year. I feel okay talking about that now. After all, what is he gonna do if he sees this? Leave me? HA HA!

That relationship has finally broken down, and I’m forced to get used to being alone again. Great timing, right? Ha-ha indeed. Joke’s on me.

The truth is, he and I were never a good fit together for a number of reasons that, again, I’m not sure I want to get into here.

You know how there’s that moment when your friends start rolling their eyes when you say, “And guess what HE thinks about that,” and they’re all like, “yeah, quit talking about that asshole like he’s not an asshole.” Yeah. I was that person.

Suffice to say, when it was good with this guy, it was great fun, and once it started to suck…. but it’s not entirely his fault. He worked overnights and had a habit of calling me on his midnight breaks or on his days off at, like, 2am. And when he was drunk? Yep, piles of drunk texts and calls. And me, I would dutifully pick up the phone like a dumbass telling myself it was all cool. Or he would text or call for hours at a time with no consideration of what I might have been doing or thinking. And most of the time, he would talk at me, not with me. He’d tell me stories about his day or his life, rarely asking me about mine.

So you could argue, was it his fault for calling me, or my fault for picking up? He may have been the bulldozer, but I was the one letting myself be the dirt.

I have not been true to myself throughout any of it. Any. Of. It. One thing I discovered about myself is that I fell into old codependent patterns of behavior. I let him run roughshod into my life very fast. I was too loyal too soon. I forgave the unforgivable. I didn’t challenge things that were suspicious. I acquiesced instead of fighting. I wanted things to work out so badly that I compromised a surprising amount of who I am to try to make things fit — when in truth, he and I would have never fit no matter what I did. We are very different people. I wanted him to pick me — choose me — not realizing I shouldn’t have even been a choice to be picked.

Good things came out of it though, for which I will always be grateful. I had a lot of fun. I did things I didn’t think were possible. He made me challenge old belief systems. He made me fight a little harder when I didn’t feel like it. He opened my eyes to new ways of living and gave me insight into a world I would normally not be invited into.

As often happens with bad relationships, what is fresh and new eventually begins to rot. Where we used to call or text or see each other nearly every day, it’s now been almost three months since we’ve spent time in the same room together. Ages since we talked on the phone. And texting — the lowest form of communication if you ask me — is the only way we’ve sustained any conversation at all for weeks.

Then! There was light! It looked like he was finally making time for me. But for all his sincere promises that we were going to spend time together again at long last this week, he lied. Again. Nothing happened. Not even giving me the courtesy of lame excuses this time. Just nothing.

So…. I just stopped.

Maybe he really meant it. Then maybe when the time came, he just wasn’t in the mood or decided there was something else he’d rather do. Or maybe he’s met someone else. I don’t know. Doesn’t matter.

It’s time for me to move on — and even though I’m putting on a brave face, I’m really broken up about it. I still care even though I shouldn’t. I’ve lost someone I felt was my best friend. My phone rings, and I hope it’s him. The text chime comes on, and I wonder if he’s texting me. Who can I call now when something goes wrong — or goes well — just to shoot the shit about it and commiserate over shared memories? Yep, nobody. Now I get to just go home and go to bed like I used to.

I think that’s one of the worst things about losing a relationship — feeling like you’re going back to “The Before Times” — before this fun person entered your life and shook things up and made them great. Well… Then bad. Then great! Then bad again. Then more bad. Then …

Why do we spend so much time trying to make it work with people who are clearly not right for us?

simpsons-tv-show-blog-280In my plight, I have returned to familiar ground. I’ve been a longtime fan of Susan Elliott, author of the blog “How to Get Past Your Past” (and subsequent book, “How to Get Past your Breakup”). And thanks to modern technology, she has a number of YouTube videos that are helping guide me through this process. Again. Thanks for being there (again!) Susan! With her guidance, I am slowly remembering that I am, in fact, not the shittiest person on earth. And that even if I am, maybe — just maybe — I deserve a little more than a 2am drunken text. Even if I’m the worst person ever… I mean… well, hell! Even Hitler had Eva Braun.

So that’s where my life is now, folks. I’m pretty much a mess, but at least school is going well. And if I can sustain things long enough, maybe a new job and a new year full of new adventures with new people who can do more than text me at 2am!

“The truth is that our finest moments are most likely to occur when we are feeling deeply uncomfortable, unhappy, or unfulfilled. For it is only in such moments, propelled by our discomfort, that we are likely to step out of our ruts and start searching for different ways or truer answers.”– M. Scott Peck (as quoted by Susan Elliott)

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… and Upstate Health Magazine

The accompanying magazine article is also now available online. I’m on page 10 telling my story of opiate and loperamide abuse.

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Radio interview available online


Hi folks!

Though it hasn’t aired yet, the interview is in the can and ready for your online listening pleasure. I hemmed and hawwed and generally dorked my way through. At least Jeanna was as professional as always. And wow! Hey — I guess gone are the days of my neutral American TV accent. That Upstate NY nasal thing has absolutely taken over. Sheesh! Oh well. I guess that’s something I can work on.

Thank you to host Linda Cohen for her guidance and for gently encouraging me to speed it up (haha!) and to James Howe, from Upstate Public Affairs, for generously inviting me to speak. Hopefully we hit our mark to educate and inform people about the dangers of loperamide abuse!

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Radio Interview on October 23 [updated]


Heads up! I’ll be doing a radio interview next week with rockstar toxicologist Dr. Jeanna Marraffa from Upstate Poison Control Center and University Hospital regarding the opioid addiction crisis. (My part is about Loperamide/Imodium.)

This is your big chance to hear me giggle like a monkey and “um…” my way through a bunch of questions on air. Don’t miss it!

“HealthLink on Air” will air at both 6 a.m. and 9 p.m. Sunday October 23 on NPR station WRVO (89.9 and 90.3 FM and HD in the Syracuse area, and also live online at, and the interviews remain available at the show’s website ( and are available in podcast form through iTunes.

[Note: Updated to include the correct date.]

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Many more loperamide articles

loptab3Loperamide-Induced Life-Threatening Ventricular Arrhythmia

Ankit Upadhyay, Vijaykumar Bodar, Mohammad Malekzadegan, Sharanjit Singh, William Frumkin, Aditya Mangla, and Kaushik Doshi
Jamaica Hospital Medical Center, Department of Medicine, Jamaica, NY 11418, USA

Abstract: Loperamide is over-the-counter antidiarrheal agent acting on peripherally located 𝜇 opioid receptors. It is gaining popularity among drug abusers as opioid substitute. We report a case of a 46-year-old male that was presented after cardiac arrest. After ruling out ischemia, cardiomyopathy, pulmonary embolism, central nervous system pathology, sepsis, and other drug toxicity, we found out that patient was using around 100mg of Loperamide to control his chronic diarrhea presumably because of irritable bowel syndrome for last five years and consumed up to 200mg of Loperamide daily for last two days before the cardiac arrest.We hypothesize that the patient’s QTc prolongation and subsequent cardiac arrest are due to Loperamide toxicity. Patient experienced gradual resolution of tachyarrhythmia and gradual decrease in QTc interval during hospitalization which supports the evidence of causal relationship between Loperamide overdose and potentially fatal arrhythmias. It also provided the clue that patient may have congenital long QT syndrome which was unmasked by Loperamide causing ventricular arrhythmias. This case adds one more pearl in the literature to support that Loperamide overdose related cardiac toxicity does exist and it raises concerns over Loperamide abuse in the community.

Hindawi Publishing Corporation
Case Reports in Cardiology
Volume 2016, Article ID 5040176, 3 pages

loptab3Electrocardiographic Abnormalities, Malignant Ventricular Arrhythmias and Cardiomyopathy Associated with Loperamide Abuse

St. Vincent Medical Group, Indianapolis, IN

Abstract: A 20-year-old man presented with recurrent syncope and abnormal ECG. His evaluation revealed a prolonged QT interval > 600 ms, witnessed Torsades de Pointes (TdP) and dilated cardiomyopathy. At his initial admission, an ICD was implanted and atrial pacing at 80 beats per minute suppressed ventricular arrhythmias.  The patient was readmitted with device infection and recurrent TdP leading to intubation. This led to the discovery of a hitherto unrevealed loperamide abuse and his cardiac arrhythmias and LV dysfunction were determined to be related to large doses of loperamide. Following abstinence, his ejection fraction and ECG returned to normal.

Journal of Cardiac Electrophysiology
27 July 2016 Accepted Author Manuscript. doi:10.1111/jce.13052

loptab3Loperamide-related Deaths in North Carolina

Sandra C. Bishop-Freeman, Marc S. Feaster, Jennifer Beal, Alison Miller, Robert L. Hargrove, Justin O. Brower and Ruth E. Winecker
North Carolina Office of the Chief Medical Examiner, Raleigh, NC 27607, USA

Abstract: Loperamide (Imodium®) has been accepted as a safe, effective, over-the-counter anti-diarrheal drug with low potential for abuse. It is a synthetic opioid that lacks central nervous system activity at prescribed doses, rendering it ineffective for abuse. Since 2012, however, the North Carolina Office of the Chief Medical Examiner has seen cases involving loperamide at supratherapeutic levels that indicate abuse. The recommended dose associated with loperamide should not exceed 16 mg per day, although users seeking an opioid-like high reportedly take it in excess of 100 mg per dose. When taken as directed, the laboratory organic base extraction screening method with gas chromatography-mass spectrometry/nitrogen phosphorus detector lacks the sensitivity to detect loperamide. When taken in excess, the screening method identifies loperamide followed by a separate technique to confirm and quantify the drug by liquid chromatography-tandem mass spectrometry. Of the 21 cases involving loperamide, the pathologist implicated the drug as either additive or primary to the cause of death in 19 cases. The mean and median peripheral blood concentrations for the drug overdose cases were 0.27 and 0.23 mg/L, respectively. Furthermore, an extensive review of the pharmacology associated with loperamide and its interaction with P-glycoprotein will be examined as it relates to the mechanism of toxicity.

Journal of Analytical Toxicology
doi: 10.1093/jat/bkw069; First published online: July 29, 2016


loptab3Conduction Disturbances and Ventricular Arrhythmias Associated with High-Dose Loperamide

Galen Leung, Diana Altshuler, Ronald Goldenberg, David Fridman and Eugene Yuriditsky
New York University School of Medicine, New York, USA

Abstract: Although loperamide has been widely used for the treatment of diarrhea, there is growing popularity over its abuse potential in alleviating opioid-withdrawal symptoms and achieving euphoria. Toxic levels of loperamide have been associated with life-threatening ventricular tachyarrhythmias and cardiac arrest. We report a case of high-dose loperamide ingestion in a patient presenting initially with unstable bradycardia followed by episodes of polymorphic ventricular tachycardia, and an unmasked Brugada ECG pattern. This is the first such report of the Brugada pattern being unmasked on ECG with loperamide ingestion. The patient stabilized with supportive care without the need for inotropic support. We discuss potential mechanisms of toxicity leading to conduction abnormalities and provide a literature review of all published cases of loperamide toxicity to describe proposed treatment options. Recognition of the abuse potential and hazards of this over-the-counter anti-diarrheal therapy will alert the clinician of associated toxidromes and management strategies.

Journal of Clinical Toxicology
doi 10.4172/2161-0495.1000309; First published online: June 30, 2016

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Personally speaking

moiFor those among you who have missed my personal stories and adventures, I do apologize. For obvious reasons — namely, that people I know personally now know about this blog — I have to edit myself a bit. But I’d still like to provide an update on how things are going.

I can tell you that things are generally going well. There are some major issues going on behind the scenes, but I’m managing.

I continue to be employed at our local thrift store. Yay! Employment! Tonight I am changing over from morning crew hanger/pricer to night crew cashier in preparation for this fall’s onslaught of day classes at the local community college. It’s something of a step down, but I requested it. Much as I would have loved to keep my day hours at work, it simply wasn’t in the cards. The specific classes I require for Nursing (right now, chemistry and psychology) are only available during the day, and only in Utica. UGH. Then, once the nursing-proper classes begin, they don’t even begin to offer night classes, so I might as well get used to that now. And getting used to being paid a lot less at work (but at least I’ll be employed).

That’s the part I’m really worried about. Since one of my two jobs cut my paid hours in half back in April, my personal financial matters have started slumping south. And as a person already living on the poverty line, this additional loss in wages will bump me significantly below that poverty line. I will have to invent a way to make up the deficit. Suggestions are welcome!

chalazionPersonally, my health is good (and yes, I’m still clean) but I could be doing a lot better — I have not been taking my own health very seriously lately, and I really need to. I’m tired and worn down most of the time, and my depression has been slowly creeping back (so far so good though). One particularly bothersome problem is that I’ve been plagued by a rash of chalazions lately; they’re rather like styes that take a ridiculously long time to go away (months!). I have never experienced these before, but they’re rather disfiguring and deeply upsetting. While I need to address the issue (and some others), instead, I keep finding excuses why I don’t have time. My own hesitation to deal with it frustrates me!

I have also been working for a local non-profit as their Promotions Chair. I’m enjoying it very much (aside from the fact that I’m not being paid). I’m allowed to bring my dog to the office  — so he’s not home alone all day — and I get to do some work (that I’m actually good at) in the comfort of central air conditioning and big windows.


I’ll probably be featured in the fall issue; this is the summer issue.

I was interviewed this past week by University Hospital’s “Upstate Health” magazine staff regarding my experience with Loperamide abuse. They were wonderful! Jim Howe, the reporter, reassured me and listened while I chattered on during the interview itself. When it came to the photography part, I was worried about one new chalazion on my eye, but their photographers made me feel at ease, and with some good eyeliner, the bump should be hard to detect. Instead you’ll likely see a photo of me cross-eyed with my mouth agape while I’m blabbering on about something! Hah! (FYI: I also made sure to go easy on the eye makeup, avoiding that copper eyeshadow again. Eeeechh.) I still look like a dork though, so you’ll know it’s me.

And as always, I remain in touch with my doctors in Syracuse as well as my former therapist who you may recall was a regular and entertaining character on this blog. I miss him a lot — as I’m sure many of you do as well. In case you were wondering whatever happened to him, last I knew, he was doing very well for himself now and has a big office with an espresso machine and a big window. And a secretary! Woo!

I continue to regularly attend my 12-steppie meetings. We had a picnic this past week that was amazing! Way too much food! But lots of good times. It was kinda fun to attend an event where people weren’t getting slobbery drunk and acting like fools.

Speaking of which, a very dear friend of mine has fallen back into alcoholism (they may or may not ever see this blog). I pray for this person every day even though I’m absolutely certain they couldn’t care less. This person seems to equate my worry as if I’m being a pest, and I don’t know what to do about that. In the program, we often talk about dealing with loved ones who have active addiction issues. We remind ourselves that no addict/alcoholic can be helped unless they want it for themselves. This stand-by-and-watch attitude is extremely distressing for me though. I feel as if I am deserting this person in Hell. So, unable to follow them, I end up remaining in Limbo. Unfair.

I had a recurrent dream last night — the second dream in two days — where I’m back at my old house and my mother is there arranging to have her possessions moved out because she was leaving the house. She told me to gather my things, but there were too many to carry and I couldn’t choose what was important enough to take and what to leave behind. In the first dream, the house was being sold off; in the second, it was going to be torn down. I reacted to all this by being angry, yelling, screaming, pleading to be heard, but no one was listening. I was dismissed. I wanted to save the house — I insisted the house belonged to me! They can’t take it away — it’s mine! But nobody listened.

So that’s all the news that’s fit to print. Sadly, I must leave you now, dear reader, having completed my update. I have to get ready for my new night shift at work. Pleasant dreams, and well wishes!

“The fact that you live in a broken-down house in the midst of restoration makes everything more difficult. It removes the ease and simplicity of life. It requires you to be more thoughtful, more careful. It requires you to listen and see well. It requires you to look out for difficulty and to be aware of danger. It requires you to contemplate and plan. It requires you to do what you don;t really want to do and to accept what you find difficult to accept. You want to simply coast, but you can’t. Things are broken and they need to be fixed. There is work to do.”

— David Paul Tripp







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