“The needle tears a hole, that old familiar sting. Try to kill it all away but I remember everything” (Trent Reznor, Hurt, 1994)
Substance abusers are lazy, hedonistic, selfish layabouts who squander money off the state to live in a perpetual state of pleasure, avoiding work to bask in the explosion of their mind’s endorphins while others pay their taxes, take out their rubbish bins on the right day, and generally are law abiding citizens.
It is New Years Eve and I am watching the fireworks go off from my bed on the eighth floor of the Royal Free Hospital where I have spent the last four days. I have no memory of what brought me here or the days preceding it but my neighbour, who had been alerted that no one could get hold of me had the horrific task of finding me unconscious on the bathroom floor. Apparently I had taken a large overdose involving heroin, crack, diazepam, clonazepam, methadone, and lithium. Addiction is so powerfully overwhelming that it bypasses even the fear of death.
Injecting drug users beg, steal, and sell themselves in order to live in a state of oblivion whereby the bioavailability of the drug is 100% and a ‘normal ‘ life with ‘normal ‘ responsibilities is bypassed and the difficulties that go with it. The term ‘junky ‘ came along with the lifestyle of injecting drug use, often associated with the William Burroughs book of the same name, a homeless, stateless place of being, ready to rob borrow, beg, or steal. The injecting addict is ‘dirty’, a slave to the drug, and is riddled with blood Bourne viruses such as HIV or hepatitis c, and is contagious even to look at, prompting members of the public to cross the street, and no possession or money is safe within their reach.
Injecting drug use is one of the most dark, lonely and shameful places you can ever find yourself. Heroin is essentially diamorphine. Diamorphine is a potent painkiller. Nobody uses it for fun. People use it for pain. Emotional and psychological pain. And the magic that it first delivers is a moment unlike any other. For the first time in my life I felt whole, I felt free. But it is a fallacy. A false promise. Because nothing can stay the same. Eventually, with it comes more pain. And by then it is too late to get out. Around 8 years ago I was in this bleak cycle. Injecting gave me terrible infections, cellulitis, collapsed veins and absesses so serious that I required 4 operations because the very use of my arm was compromised. I was alone. I couldn’t tell anyone that I was in the hospital because of the shame of what I was doing. All I wanted was my mum, but I couldn’t bring myself to make that phonecall because I feared abandonment so much, such was the stigma. This situation invoked in me the Famous line from a Neil Young song: “I’ve seen the needle and the damage done “. It has been 6 or 7 years since I last injected but the internal scars remain.
This article is one that is hard to write. Addiction has been prevalent within me throughout my life, even since childhood, in whatever form it was available. I was troubled, unhappy, and even, I believe, clinically depressed as a child. But I never possessed the language to express my unhappiness. I remember my twin sister telling me that when she saw me take my first drink, at the age of 13, she knew I had found my magic potion. One that unlocked me from the prison that was myself, the prison that was my body, the prison that was my mind. It immediately began as a means to self medicate. And right until the end, I still believed that it offered that promise. But at some point it stops delivering and starts perpetuating that pain.
It is that palpable pain, the kind that throbs at 3am as though your body is about to tear apart: “At the bottom of every person’s dependency, there is always pain and healing it is an essential step in ending dependency” (Chris Prentiss). On thinking of this agony, both physical and emotional, the following thoughts entered my mind: Once you have lost control, all that is left is a giant chasm, a big black hole. It steals your personhood, it breaks your soul. Once you have been there, never again will you be whole.
Dual diagnosis is a term that is a crux for understanding addiction, yet, ironically, is little understood at all. What it refers to is the comorbidity of a mental health condition, with a concurrent substance abuse disorder. One makes the other a minefield to treat, and accentuates the risk of death hugely. It is estimated that a huge amount of people with a diagnosed (or undiagnosed) mental health condition also struggle with addictive tendencies, in the many ways it may manifest each other. This is often an attempt to self medicate when a person is in psychological pain, especially when they are not receiving the correct treatment around one or both issues. It is a condition that is under recognised and greatly increases stigma surrounding all aspects of mental health.
I myself have been diagnosed with bipolar affective disorder, along with other labels hurled at me through the years. It has compounded everything, including my addictions. I was once abstinent for around 7 years. At one point my mental health began to be treated very badly, being given the wrong diagnosis. I was taken off my mood stabilisers and very quickly, after such a long period of time, had to self medicate with heroin, the number one painkiller.
Going back to last news years eve, my staple medication, lithium was taken out in order to clear my system. It was meant to be put back in at its usual dose but nobody took responsibility for this. For months I was walking around with my mood falling as fast as my blood levels. Apparently this was visible to those around me, and some of my workers were desperately trying to remedy the situation. As ever, I self medicated, walking around like a corpse on crack, heroin, and benzos. Eventually the depression won and in March I gave up the fight, planned my suicide, and acted on those plans. I told no one, I locked myself away, and waited for death to arrive. All I can remember, before being found, was the deep feeling of anguish that goes with the belief that I was about to die alone.
As a result of these actions I was sectioned in St Anne’s hospital, where I spent the next six weeks. Finally, the medication for my mental health conditions was altered and stabilised. The staff were amazing, and I was really looked after. As time went on I began to feel more and more like my old self. My real self, whatever that may be. Maybe I just mean that I started to feel comfortable in my own skin. As for substances I was sure that I never wanted them in my life. Those thoughts and feelings were genuine. My intentions were not for show and I had no cravings.
Unfortunately the grip of addiction proved too strong. Just 2 weeks later I wake up and I am surrounded by white walls. I don’t know where I am, why I am there, and I think maybe I am dreaming. There is a nurse there and she tells me that I am in King’s college hospital and I have overdosed. I remember nothing. I am terrified. It is a scary feeling, to have hours if not days wiped from your memory. It turns out that I was with a friend and I collapsed at a station. They had to administer cpr at the scene, and then put me on a drip containing naloxone, a drug that reverses opiates but that makes you very sick.
I cannot believe that this has happened so close to my discharge from St Ann’s hospital. I truly believed that everything would be OK after that. I am shattered. I am shattered for my family. I am shattered for my friends. I am shattered for the workers who have done so much for me, my care coördinator, my dual diagnosis nurse. I am heartbroken. Can I get up again from this fall? Or is this my final curtain call? For now I live in limbo, I am stuck between life and death. I can make no sense of this at all. These shitty substances, and their alluring pull.
Music, as ever, depicts the pain of addiction in a way no other medium can do. I am writing this article and while I do so YouTube is playing on shuffle. A song comes on that I have never heard and quite literally, it takes my breath away. It is by an hip hop artist called Collicchie and the song is called Drug Addiction. In just a few minutes it encapsulates everything that I would wish to say in this entire article. As the neurologist Oliver Sacks states, the brain has a greater capacity for music than just words alone. The coincidental play of this song at the very time of pondering similar experiences is one of those things that defies explanation:
“I wanna do better but I don’t know a different way,
I’m a servant and this heroin’s my king
I’m feeling like a slave, as I dangle from these puppet strings
I’m just a marionette, im starin’ at death
As I am carryin’ regrets, that are just tearin’ through my flesh”
The last line in particular resonates right through me. I walk around with such guilt about who I am, what I have become, what I done to others around me. It invokes the line in plan b’s song The Deepest Shame, as the key to what blocks my recovery. “I’ve been dragging myself to the lowest of low, For such a while, I just don’t know, If the path I take is something I can change, But what stands in my way is the deepest shame “. I remember something my mum said to me once that penetrated through a very thick skin at the time. I used to think that I was only hurting myself so that was ok. But she turned and said to me “everytime you hurt yourself you hurt me too “. This hit home, and hit home hard. I’ve carried guilt and shame for a very long time.
I’ve asked many other people I know who have been challenged by addiction disorders of varying kinds. Almost all have an expectation that they will be hit by a moment of ‘magic’. For some, they anticipate that, for a fleeting moment at least, they will not have a care in the world. That all their problems will melt away. And, sadly, that they will experience even a millisecond of happiness within the ruins that are left in place of what was once their life. In reality they are left with “financial ruin”, “guilt and remorse “. Another person told me that he is left in chronic physical pain that is not being adequately treated. The drugs, he says, are the only respite he gets. Layne Staley from the band Alice in Chains, who died at the age of 34 from a drug overdose, stated in one of his songs that addiction is a “slow suicide”, and is no way to go.
“Addiction is a master : It lives inside, and feeds off you, takes from you, and destroys you. It is a beast that tears you apart, rips out your soul, and laughs at your weaknesses. It is a stone wall that stands to keep you in, and the rest out. It is a shadow that always lurks waiting to strike. Addiction lives in everyone’s mind, sitting, staring, waiting.” (anon)
Just look at the legends that addiction has torn from the world : Jimi Hendrix, Jim Morrison, River Phoenix, Kurt Cobain, Lane. Staley, Chris Cornell, Andrew Wood, Shannon Hoon, Jean Michel Basquiet, Taylor Hawkins, and the list goes on and infinite.
There is a book called Necessary Losses, that describes the loves, illusions, dependencies, and impossible expectations that all of us have to give up in order to grow. That is my place, my limbo, and my decision. Nobody can make it for me. My necessary loss is that simultaneously of my best friend and my fatal enemy. Where the two meet is a place I cannot define. Either way It is time to say goodbye if I want a fulfilling life. That is my necessary loss.