Tuesday, March 31, 2009

Why, why, why do people insist on spewing information that is not only false, but that they OBVIOUSLY know nothing about? I realize that drug addiction is a very controversial topic and that many people have many ideas and feelings on the subject. I suppose being a recovering addict myself makes me a little sensitve to some of the negativity out there. Well, I CAN'T HELP IT!! So many people think that addiction is a choice, a moral failing, or we just do it for fucking fun. I can tell you right now, I did not wake up one day and say," Gee, I'm really bored today, so I think that I will become a drug addict so I can stir up some drama. Ruining my own life and everyone's around me sounds like a fabulous idea to get rid of this boredom bug!!" Seriously? I have caused not only myself, but my family, friends, and certain strangers a tremendous amount of misery and pain because of my actions during my addiction. The things I did under the influence were things that I would NEVER even consider doing in a non-addicted state of mind. I look back now and can't even believe some of the lies I told and shit that I pulled in order to get what I needed. I can laugh at some of it now, but man, when I was telling those lies back then, I think I might have actually believed my own bullshit!! Example: My parents came to visit me in Missouri and on the second day that they were there I ran out of Oxycontin. That morning I got up, ran to a doc that I knew would give me a script, and came home because my parents were coming to the house. I waited as long as I could before I pulled my dad aside and asked him if he could take me to Oscos (a pharmacy chain) because there was this miniature collection of golf figurines that I could ONLY find at Oscos and I wanted to get them for my mom because she loved stuff like that. (likely) Well, we go on about our merry way and I tell my dad to stay in the truck because I didn't want him to see them until my mom did. I ran up to the pharmacy counter, handed the script over, and was told they were out of that particular strength! WHAT!! So I preceded to go out to the truck and tell my dad that the lady that stocks this particular set had sold out of them at this location, but would be at another location so could we go there? He said yes and we got to the next one, SAME THING, they were OUT!! I knew that my dad was bound to get suspiscious if he wasn't already, but I went out and said I told him the wrong place, it was over at this other Oscos. Needless to say, we went on like this until I finally got what I needed. And once I got the pills and my dad asked about the gift, I said," Oh, yeah. They must not be selling them anymore. I'll see if I can find them and I'll mail them to mom." My dad just looked at me and shook his head. I found out later that he knew the whole time, but just didn't have the heart to call me on it. The lengths that I went to make me cringe. But at the time, I didn't know any other way to act. I was being driven by my addiction and let me tell you, when you are in the midst of an addiction like this, you will say anything to just about anyone to get what you want or to get out of what you got yourself into. My husband at the time would get so frustrated because he would put his Oxycontin (he was on it for a legitimate reason) in a fire-proof safe only to have me call a locksmith after he left for work, take out the pills I needed for the day, and re-lock it. When he would come home to discover the missing pills, I would deny, deny, deny, all the while my pupils are pinpoint and I can't walk a straight line to save my life. I told him we must have left the door unlocked and someone came in and took the pills. He asked me how they would get into the safe. I told him they must have brought lock picking tools, how else?? I mean, use your common sense!! All thieves that sneak into others homes to take medicine out of locked safes ALWAYS carry their lock picking tools or a stethascope if it is a combination safe so they can hear the click!! Didn't he know this?? Anyhow, I'm just grateful that I am no longer like that. I guess what I'm trying to say is just because I was addicted doesn't make me a bad person. It made me a sick person with a disease that I needed treatment for. I know I will never change all those people's minds, but maybe someday, someone will help other's to understand that addiction is not a choice. Take care.

Monday, March 30, 2009

Discouraged

I don't think I am EVER going to get a damn job. I go and fill out application after application and NOTHING. I went on a great interview last week and the woman I interviewed with told me that she wanted to offer me the job, she just had to check my references. Ok. No problem. I didn't hear anything from her all last week so I emailed her on Friday and she replied,"Still screening applicants." WTF?? I'm beginning to wonder if my references are saying,"Hire her? Are you crazy? That girl is wack!!" I mean really. Why can't I get a job. So I went to this place called Stenocall, which is where they take inbound calls for Dr.'s offices after hours and all different kinds of places and I had a friend tell me they hire everyone that walks through the door. Yeah. Okay. I did the tests, passed them, and talked to the lady. NOTHING!! She even asked me," Why haven't you looked in the field that you are trained in?" I told her I had and she just looked at me like I was dumb. I wanted to tell her," You think I think I would apply here if I hadn't already exhausted all other options??" Then on top of that, this guy with greasy, long hair, pants sagging down to his knees, dirty shirt, etc came in, took the same test I did, talked to the same lady I did, and left with a f***ing job!! What has this world come to?? Maybe if I don't bathe for four or five days, get some really crappy clothes that are dirty, and forget to wear deodorant, then maybe she'd hire me. Who the fuck knows. It is just so discouraging to see stuff like that and know that I'm just as able and qualified as he was and they didn't hire me. And it isn't just there. I have applied at all kinds of places from fast-food to pawn shops, retail places, music stores, everywhere and NOTHING!!! It is unreal. Then, when I think I may have a chance, forget it. I don't think I smell as I shower daily and wear deodorant, my clothes are clean, I brush my teeth so it can't be my breath, and I always check to make sure that I don't have a panty line. Also, I don't pick my nose or my ass for that matter, I don't spit when I talk, I don't have stuff in my teeth or hangin' out my nose, and I keep my gas to myself. (most of the time...hehehe) I've gone over and over these things and I just can't figure out what it is that is repelling people from me. Well, that's enough bitching and moaning for now. Take care!! And be grateful for your jobs, no matter how crappy!!

Friday, March 27, 2009

It never fails. Just when I think my life just might settle down for a little while, BOOM!! The past comes to bite me in the ass!! I was going through the mail yesterday when lo' and be-fuckin'-hold, there was a letter from an attorney. Of course, it came in a very plain, normal, white envelope which gave me a sense of ease, until I decided to open it. That envelope gave me NO WARNING as to what was waiting for me on the inside!! How dare they lull me into a trusting, comfortable place only to shock me into a frenzied, worried, crazy place. So what was inside the envelope you ask? Well I will tell you. It was a letter informing me, ME, that I had a warrant issued for my arrest from a check that I allegedly wrote (and apparently the bank said I didn't have the money actually IN the account and they didn't like that too much) to Wal-Mart in Plano, Texas in 2005. Seriously? 2005? WTF!!  What, were they housecleaning there in the Plano Wal-Mart and found this supposedly "bad" check for a whopping $28.16 and decide it was finally time to call the police because damnitt, they want their fucking money?? TWENTY-EIGHT DOLLARS and SIXTEEN CENTS!! Did they not have better things to do? I had absolutely NO idea that I even bounced a check, possibly due to the fact that I actually closed the account and moved away, but still. Here I am, over four years later and this little letter says I owe $650.oo. WHAT! Wait a fucking minute! How in God's holy name did $28.16 turn into $650.00? I mean, even with the return check fee from Wally World, the total is only $58.48. That leaves $591.52 unaccounted for. Is that how much it cost for that law firm to write the letter that they sent me? If so, I wonder if they are hiring, because I'm obviously really good at swindling people out of money! (although it seems I do eventually get caught, so that wouldn't work, DAMN!) So after making all the phone calls that needed to be made, I was told that I must pay Wally World the $58.48 and then they will recall the warrant for my arrest. How nice. THEN, and only then, will the judge decide how much MORE I have to pay in order to be humiliated enough for the $28.16 worth of merchandise I "stole". I'm finding all this very tedious. Why ohhhhh why is this happening?? Hey, I don't remember asking to become a responsible, reliable, HONEST adult. Is this really part of it? Man, and I thought it was going to be video games, cotton candy, and all you can drink soda!! How horribly wrong I was. MOMMMM!!!!! You SO lied to me!! Lol! Now I will tuck my tail between my legs, go pay for the stuff I should have paid for over four years ago, and go on about my life. I'm thinking that the moral of THIS story is: Hey, better late than never!! Peace~                                                                                                                                                                                                                                          

Thursday, March 26, 2009

Why in the name of Jesus of all things holy did they EVER come out with Super Mario Brothers to begin with? Last night I was looking for something to do on the internet because I was bored, so I thought it would be neat to Google my old favorite Nintendo game, the original "Super Mario Brothers". Yeah, great idea!! Not only did I find it, but I found a place that you can PLAY it!!! Suddenly, I was transported back to when I was 12 years old and we got a Nintendo for Christmas. There I was, glued to the screen, playing that damn game!! My shoulders were all tense like it was the most stressful thing in the world and if I didn't save the princess then all the world was going to hell!! And on top of that, since I'm an adult now, I sat here and cussed at the screen like it would change anything. Back when we had the controllers, we would move our hands back and forth when we were jumping and since I can't do that now, I move my head!! Oh My God!!! This is true insanity. I have amazed myself at the level of my addictive personality. I get addicted on the first try!! Just give me a little taste and from then on I'm yours!! All the while, my common sense is screaming at me to give it up!! I have conversations with my common sense quite often. This is what we talked about last night. 


Me: Oh cool!!! Super Mario Brothers!! I LOVED this game when I was like 12.

Common Sense: Don't do it. Don't do it. It will just be one more thing you'll have to quit!!

Me: Playing it once for old times sake won't hurt. This is so cool!!

Common Sense: Don't say I didn't warn you!! 

Me: Whatever....shut-up so I can play!!

20 minutes later...........

Me: DAMN!! F**CK IT ALL TO HELL!! SHIT SHIT SHIT!! Get over the damn gap stupid Mario!! Shit, there goes another life. Just one more time now. 

Common Sense: It doesn't help to yell at the screen! What are you getting so upset about it's just a game. See, you just killed your last man. Let's do something...........

Me: SHUT UP!! One more time. Quit bothering me!! It's my turn!!

Common Sense: One more time? You said that 25 times ago!! 

Me: I can stop anytime, I'm just not ready. I HAVE to beat this level!!

Common Sense: Always one more level, one more level. STOP IT FOOL!!!

Needless to say, in the end I ended up getting pissed at this stupid little game and turning the computer off. Why do things like this piss us off so badly? I felt SOOOO stupid after I sat and thought about it.  Damn games!! Next time I get a great idea like that, I'm going to get up and get away from the computer until the urge leaves me!! I suppose the moral of this story is: Don't play Super Mario Brothers. You may have loved it when you were 12, but you have a much BIGGER vocabulary now and you don't want to scare the kids!!

P.S. If you would like a piece of this insanity, just click on the title of this post and it will take you to Super Mario HELL!!!! AHHHHAHAHAHAHAHAHAHAHAHA!!

Wednesday, March 25, 2009

Her name is Brianna and she is the most beautiful thing I have ever done. I haven't seen her in almost three years and NOT by my choice. Her father and I have joint-custody and he decided almost three years ago that I no longer had the right to not only see Brianna, but he decided I didn't have the right to know how she was, where she was, or anything else. All the custody crap started in September of 2004 when I made the foolish decision to trust my very best friend in the whole world to watch Brianna while I went on a job interview in NYC. I didn't take Brianna because this was an interview to be a live-in nanny and I didn't want to take her into an environment that I knew nothing about. I didn't know the people except for the small amount of communication we had had on the internet, so I wanted to check everything out and make sure they were legit before I brought her half way across the country. Well, the person that I entrusted with my heart, my soul, my child, thought it would be ok to call my ex, who up to this point had wanted very little to do with her, and tell him that I had abandonded Brianna, run off to NYC to either arrange for her adoption or sell her for drugs, or whatever it is that she told him and his CRAZY wife of the moment. Well, when I returned from NYC, instead of ST bringing me my daughter, I was served with papers stating that BB was suing me for FULL custody of Brianna. I thought, "This is crazy!!" It was at this moment that my life was shattered into a million pieces and has never been the same again. During the first court date, I was able to see Brianna for the first time since I had returned from NYC. I hadn't seen her in about two and a half weeks. She was ECSTATIC to be with me again. When it was time to go into court, I went to hand her back to her father and she literally screamed and clawed at him to get away from him and back to me. That was a breaking point for me. Up until then I had held my emotions in, but when she was screaming,"MAMA, MAMA, MAMA, MAMA....." over and over again trying to get back to me, I just got down on my knees and hugged her in my arms and PROMISED her that I wasn't leaving her, that I loved her, and that we would be together very soon. It was and still remains one of the most heart wrenching moments of my life. You could see the hurt and confusion on her little red face. She didn't understand WHY she was being taken away from all she had ever known. From the mother she adored and who adored her. At first I had visitation every other weekend during the temporary custody order, and then KB, my ex's white-trash, crazy bitch of a wife, brought Brianna for my two week Christmas visitation and she asked me for my driver's license. Well, I didn't have it on me because I wasn't driving, so KB rolled up her window with my baby girl screaming for her mama once again and drove away. I didn't see her again for over a year. When we finally found them and got them back into court, it was decided that I should have SUPERVISED visits because I hadn't seen my daughter in so long. Fine. I'll jump through your gawd damned hoops. At the end of this time period when it came time for regular joint-custody to start, they took off and disappeared again, and that was almost three years ago. I just recently found a phone number and email address for my ex and have tried to do the adult thing and contact him, but he hasn't responded of course. I pray every single night that she is safe, that she knows that I have thought about her every single minute of every single day since I saw her last,  that she knows that she is loved by me more than any words can ever say. In case you are wondering why my attorney didn't fight for me, well, I didn't have the money for an attorney, couldn't get legal aid, so I tried to do it myself and got fucking steam rolled. Now that I know where he is, I'm going to see my daughter no matter what it takes. Granted, I WILL go through the proper channels, but I am going to make sure that BB pays for hiding for all this time. Ok, I've vented enough for now and I can't keep typing through all the tears. Brianna, baby, I love you and I WILL see you soon!! That I can promise!!

Dear God in Heaven why is it that there is ALWAYS so much damn drama surrounding women? I mean, when I have just had friends that were guys, there was NEVER the kind of shit that goes on when you have a group of girl friends. 


Ok, so I one of my best friends happens to be the manager of a convenience store. Yes, I know, not the most glamorous job, but a job nonetheless. Well, through knowing her and all I have met and gotten to know the other girls that work up there and I get to see first hand the drama that surrounds this group of women. It's not so much LB that is involved in the drama, but the girls that work for her. It is a never-ending source of entertainment for me. The latest fiasco has been with a young lady ( if that is what you can call her) we will call SM. Well, SM started out ok, but then there was a constant emergency with her kids or her "man" in jail, or her baby daddy, or the daycare, or whatever. That got old really quick. Then she got her tax refund, bought a car (FINALLY) and things calmed down til the crack-head, I mean SM, started stealing. Of course, we should have seen this coming. In the end, she gets fired, cries, blames it on everyone else, tries to get everyone else fired, and on and on it goes. Now customers have been coming in all day today apparently telling LB that SM was always coming out of the cooler "geeked" out. I suppose if I was smoking crack in the cooler I would be a little "geeked" out too!! I mean really! Who does that?  Needless to say, this is just an example of drama that I see on a daily basis in the places that I go. Being in sobriety, I was hoping to get away from all the drama, but I guess that is not going to happen because I have a vagina. Which really sucks. Somedays, I would so trade in my vagina for whatever you wanted to give me just to get away from all the shit!! I only wish it wasn't embedded in us to be mired in drama all the time. I know that some women are not happy unless they are stirring the drama pot. Those types of drama queens drive me to insanity, but it is like a wreck, I can't stop watching. I am definately a drama rubber-necker. I admit it. Now, I guess it is something I could work on seeing as how I have spent an entire post on how much I hate it!! I suppose the moral of this story is stay away from crack-heads!! Have a great day!

Tuesday, March 24, 2009

So Nice!!!

Being a recovering opiate addict that is on a Methadone Maintenance program, I have personally encountered a TON of stigma and discrimination, so it is very nice to finally see some positive stuff out there. I came across a couple of letters for families and loved ones and one for physicians. They are both very well written, very informational, and they cut right to the point. They don't make excuses or anything like that. They just get to the freakin' point. The following is the first letter to families and loved ones to help educate them and reduce stigma and myths about MMT. I copied this letter from the following link: http://www.readybb.com/watchdog/viewtopic.php?t=7301


I decided it might be helpful to make this a sticky in case anyone needs it or wants to use it to help educate their family members about MMT--several folks have told me it was helpful to them, so here it is again: 


Dear Family member or Friend; 

This letter will attempt to address some common concerns of those of you who have loved ones on MMT (methadone maintenance treatment). There are many misconceptions and common misunderstandings surrounding this treatment, which education and knowledge about the treatment may alleviate. Methadone, unfortunately, is surrounded by unfair stigma and prejudice based on fears and assumptions, not science and medicine. Family members quite naturally are concerned about their loved one's health and future and want the best for them, and they may have heard some things about MMT that cause them alarm. 

One of the most commonly voiced concerns is that MMT is "just trading one addiction for another". Many feel that the only way to truly recover from addiction is to abstain from all mood altering substances. At one time this was thought by most to be true. However, science has discovered that with long term opiate addiction (opiates meaning heroin, vicodin, morphine, oxycontin, etc), the brain's natural production of endorphins is shut down. Endorphins are the chemicals we all have that enable us to feel pleasure and happiness. We all have opiate receptors in our brains for these chemicals to attach to. The word "endorphin" comes from "endogenous", meaning coming from within, and "morphine"--i.e., morphine from within. These chemicals are released when we eat delicious food, make love, enjoy a beautiful sunset, exercise (runner's high), or even when we are injured, as natural painkillers. Without this natural chemical, life can be very difficult and painful. 

When we flood our systems with exogenous (outside) opiates, our bodies recognize that we have plenty on board and cease to manufacture our own natural endorphins. This results in the patient feeling extremely ill when withdrawing from opiates. They experience depression, irritability, exhaustion, anger, sleeplessness, hopelessness, etc. This happens to all opiate abusers when they cease taking opiates and is to be expected. Some patients, especially those with short term addiction histories, will be able, after a few weeks or months of abstinence, to get their natural endorphins back into good working order again, and will begin to gradually improve. However, for many, the damage done is permanent. This has been demonstrated in many scientific studies involving CT scans of the addicted brain. For these patients, no amount of abstinence, group therapy, meetings, will power, or good intentions will undo the fact that their brains simply will no longer produce endorphins in sufficient quantity to enable them to live a normal, happy life. This is, in fact, very similar to the way in which diabetics require supplemental insulin because their pancreas no longer manufactures insulin. In addition, there are some patients who have never had a normally functioning endorphin system, who have struggled since birth with crippling depression, and who became addicts in an effort to relieve their constant emotional and mental misery. For them, too, abstinent recovery works poorly or not at all. This is where MMT comes in. 

Methadone is a synthetic (man made) opioid drug, used to treat pain and addiction. It has some unusual properties that make it well suited to addiction treatment. It is a long acting drug, remaining active in the tissues for up to 72 hours after ingestion. It does not cause the high or euphoria caused by other, short acting opiates because it is taken up gradually by the brain, not suddenly and sharply. In fact, many overdoses involving this drug are due to people seeking the high they have come to expect with other opiates and not getting it, so they take more and more. A stable methadone patient who is not mixing the medication with other drugs--particularly benzodiazepines, which can sometimes be a very dangerous mixture-- and who is on a medically appropriate dose will not be "high" or sedated. These patients are able to work, operate a vehicle, care for children, and do anything else a normal person can do. Their minds are not "clouded". Some of these rumors may come from observing patients who are abusing other drugs, or are taking more than prescribed. 

Methadone, properly administered and taken, balances the chemicals in the brain so that the patient feels normal. Unfortunately, standard antidepressants generally do not work well for those with dysfunctional endorphin systems because they target serotonin, not endorphins. 

Methadone is also unique in that it does not attach to all the opiate receptors in the brain, leaving some open to encourage production of natural endorphins if possible. This may contribute to the healing of the addicted brain. Methadone is commonly referred to as "replacement" or "substitution" therapy, and most think that this means it is replacing the heroin, etc that the patient was abusing, when in fact, it is replacing the natural endorphins no longer being manufactured by the patient's brain, in the same way synthetic insulin substitutes for that not being made by the diabetic's own organs. Methadone treatment enables the patient to return to a normal, productive, law abiding life in a great many cases, and even when the patient continues abusing other drugs, etc, it may lower their chances of contracting a disease by reducing their drug use, and enables them to see a medical professional for assistance and referrals on a daily basis. 

However, for many (not all) MMT patients, long term therapy--even life long--may be needed to maintain recovery. Addiction is a chronic, incurable disease. We do not tell diabetics, blood pressure patients, and epileptics to discontinue their medications because we know that if they do, the active disease will return. Why, then, do we encourage recovering, thriving MMT patients to do so, when the relapse rates for those discontinuing MMT is greater than 90%? Methadone is the most effective modality of treatment for opiate addiction available today--far more effective than traditional rehabs and 12 step groups alone. By no means is it the treatment of choice for every opiate addict--however, if abstinent methods have failed many times over, there is little point in continuing to try the same thing expecting different results "this time". 

Most experts recommend that a patient remain in MMT a MINIMUM of 3 years after they cease illicit drug use. At that time, if, and only if, the PATIENT themselves wishes to begin a taper program, one can be attempted. Tapering must be done on a slow and gradual basis--no more than 10% of the dose every 2 weeks to a month. If the person begins experiencing severe cravings or withdrawals, they should stop and return to an adequate dose until symptoms subside. If the person relapses, this should not be seen as failure or weakness, but only as evidence that they may require ongoing therapy to control their symptoms. Family support is ESSENTIAL to the patient's successful recovery on MMT, and continued questions of "When are you going to get off that stuff? It's just a crutch!", etc undermine treatment efforts and sabotage recovery, leaving the patient confused, sad and frustrated instead of feeling proud and happy at the improvements in their lives. Addiction is a deadly disease and there are few effective treatments for it, so please support your loved one's recovery efforts and praise them when you see improvements. There is nothing positive to be gained by forcing them off treatment before they are ready. 

If you would like more information about MMT, please seek out reputable sources such as WWW.SAMHSA.Gov, the American Assoc. for the Treatment of Opioid Disorders (AATOD) website, the White House Office of Drug Policy, etc. 



_______________
_________________
Zenith 
Director, ARM-Texas Chapter 
C.M.A. (Certified Methadone Advocate) 


"Question Authority!"


This next letter is the one for physicians copied from the following link: http://www.capqualitycare.com/dear_doctor.htm

Opioid Treatment Program Name  ADDRESS · CITY, STATE · ZIP · TEL NO. · FAX: NO.  · EMAIL      (Revised  11/18/05)

Date:                                                   RE: (Patient's Name)  

Dear Doctor:

This is a general letter in reference to our mutual patient(s) maintained on methadone in our Opioid Agonist Treatment Program (OTP).

Methadone maintenance has been used in the treatment of opioid dependence since the 1960's. The stabilized methadone-maintained patient usually develops complete tolerance to the analgesic, sedative and euphoric effects of methadone. The patient also avoids the opioid abstinence (withdrawal) syndrome and craving for opiates. Sedation in the stabilized methadone maintained patient is almost always attributable, concurrent medical conditions or to methadone’s interaction with other drugs, and far less frequently to the non-compliance with treatment goals and abuse of methadone.

The best policy is to coordinate your medical treatment of the patient with his/her Outpatient Treatment Program (OTP). Confidentiality regulations that apply to substance abuse treatment are unique and restrictive; a signed release of information is required before our staff can acknowledge a person is a patient and discuss specific issues about his/her treatment. However, even without a release of information, our medical personnel can direct you to appropriate resources or answer questions regarding major drug-drug interactions, cardiac considerations, safety of breastfeeding, methadone and pregnancy issues, et cetera.

Pain management in the methadone maintained patient is frequently misunderstood. The stabilized patient may experience some analgesia for 2-6 hours from their daily maintenance dose but there is substantial individual variation, and the analgesia is often inadequate even during that brief interval.  Substantial pain relief will most often require prescription of additional medication appropriate for the nature of the pain, including long and short acting opioids. Methadone can be an excellent analgesic but to be effective for pain management it must be administered in divided doses, 2 to 4 times a day, and in a total daily dose that exceeds the patient’s usual maintenance dose for the avoidance of craving and opiate withdrawal symptoms.

For the medical provider treating a methadone maintained patient for pain, coordinating and documenting treatment with the OTP is best from both medical and legal perspectives. It is essential to obtain a release of information from the patient and contact his or her clinic in order to establish coordination of treatment with the Medical Director or his designee. While some methadone maintenance patients can be managed similarly to patients  without an addiction history,  others  must be monitored closely.  Personnel at the clinic can provide information on methadone’s significant reactions with other medications, induction protocols, maintenance dosing, and metabolic differences from other opiates.  This information is available on the internet at the links indicated, below.

 We suggest that you ask for a letter from the methadone maintenance clinic  or make a note of our verbal interactions, in addition to using a standard pain contract and documenting the source of pain and the history of its treatment. When considering analgesia, as already noted, some methadone-maintained patients can be managed the same as those without an addiction history.  Others must be monitored closely when utilizing medications associated with neurobiological reward mechanisms either as a stand alone euphoric affect or use in combination with methadone. There will always be some individuals that will abuse any number of substances, such as stimulants, or benzodiazepines with methadone maintenance therapy. Judgment about a specific patient can be made, more accurately when information is obtained from the OTP personnel.

If opioid medication is required for pain, it is widely recognized that the required dose will be at least 10% to 50% greater than that required for non-opioid tolerant individuals. This is due not only to high opioid tolerance encountered in our population, but also to the reduced pain thresholds of methadone-maintained patients. Also, administration of opioid analgesics may need to be more frequent than usual (q 3-4 Hr versus q 4-6 Hr for non opioid tolerant individuals).  

If it is necessary to prescribe opioids for self-administration, long-acting drugs are preferred for chronic pain treatment, including methadone. When short-acting opioids are indicated, a week's supply or less of medication with a small number of prescription refills, if any, serve the needs of most methadone maintained patients. Talwin, Stadol, Nubain, and buprenorphine can precipitate severe opioid withdrawal (abstinence syndrome). Many patients experience discomfort with Ultram (tramadol). Also be aware of the abuse potential of this medication and seizures associated with high doses of tramadol. Darvon (propoxyphene) and Demerol (meperidine), cause seizures in methadone maintained patients. Naltrexone, and naloxone precipitate severe withdrawal. 

Some anticonvulsants, tricyclic antidepressants, SSRIs, etc., can be used adjunctively for the treatment of pain. However, NSAIDs, might promote cirrhosis in patients with Hepatitis C, and should be used with caution when HCV is known to be present. Dilantin, phenobarbital, Tegretol and rifampin should be avoided because they strongly induce CYP 3A4 metabolism of methadone. If necessary, use of these drugs without causing undue suffering can be accomplished if the methadone dose is increased, even doubled, to balance the rapidly increased metabolism. Caution must then be used when such agents are discontinued to avoid overdose or intoxication when such metabolism rapidly diminishes. Valproic acid, divalproex, and gabapentin are useful alternatives for anticonvulsants.  For tuberculosis treatment, ethambutol may substitute for rifampin, when not contraindicated by hepatitis.

Methadone maintenance treatment is NOT a contraindication for the appropriate use of psychotropic medication in the 60% or more of patients with addictive disorders having Axis I psychiatric comorbidity. While most psychotropic medications have interactions with methadone, some of which can be consequential, and others have the potential for abuse, most can be used with proper monitoring and awareness. Making individual determinations in each patient regarding the use of benzodiazepines or stimulants is preferable to precluding their use entirely in methadone-maintained patients. OTP clinical staff can help you assess risks of diversion, drug abuse, or medication interactions.

Regarding patients whose stabilization of significant psychiatric pathology  or chronic pain is attributable or has occurred in the course of methadone maintenance, discontinuation of methadone is relatively contraindicated.   Substantial evidence exists that methadone itself may engender potent psychotropic benefits as an antidepressant, antipsychotic, and stabilizer of labile affective states.

Finally, there are few contraindications for stabilized methadone-maintained patients regarding treatment of hepatic disease, HIV-related illness, or organ transplantation.

Useful information about methadone’s significant interactions with other medications and its metabolic differences from other opiates (such as its metabolism by CYP450 2D6 enzymes, propensity for accumulation, slow onset of action, etc) is readily available on the Internet or upon request from our clinic. Please see the following resources from the www.atforum.com web site concerning methadone-drug interactions, cardiac considerations, and dosing and safety issues:

http://www.atforum.com/SiteRoot/pages/addiction_resources/Drug_Interactions.pdf,  http://www.atforum.com/cardiacmmt.shtml  and   http://www.atforum.com/dosingandsafety.shtml

Additional information on methadone metabolism and dose ranges required for effective treatment appear on the “Articles” or “Links” pages at www.capqualitycare.com. If discussion of clinical issues or transfer of records regarding our mutual patient is required, please have the appropriate release of information forms signed and contact us.

Sincerely, 

(Medical Director)

Monday, March 23, 2009

In an earlier post I talked about doing this new journal called "40 Days and 40 Nights: Taking Time Out for Self-Discovery". Well, today is as good a day as any to begin, so here we go. Day One:


1. Write a list of fears and anxieties that might bring you down or stand in your way of self-discovery:
      This is an easy list. Some of my most persistant fears are 1)I'll lose my job/I won't be able to get a job, 2) CJ will not make it back to sobriety and we will have to bury him, 3) my depression will totally take over and I will never make it out of this black hole, 4) I'll use again.

         Some of my anxieties include 1) not being able to pay my bills, 2) not being able to hold onto my sobriety, 3) I'm afraid of finding a good sponsor and actually working the steps in a rigorous and honest manner because I'm terrified of what I might find. 4) letting someone close enough to actually know me because I don't even know me, 5) really learning who I am and not liking what I find.

2. List the positive inklings and "good feelings" you have about what you are doing.

             I honestly do feel good about what I'm doing despite my fears and anxieties because it means I can actually start to heal from a lifetime of shit. I just can't carry all this around anymore and still live a productive life. Doing this also gives me a sense of empowerment because I'm choosing to do this for ME and no one is making me do this. I need to get my life together and finally get healthy not only physically, but also emotionally and spiritually as well. If I don't do this, I'll continue making horrible choices, I'll never be able to hold a job, and I will NEVER get Brianna back in my life. I need to deal with all the pain, shame, guilt, and other crap I've run away from for so long. This is MY journey and I'm ready!!!

3. Today................
     
              Today I will pray for guidance, strength, understanding, and willingness to be honest, open-minded, and willing. I will stop focusing on everyone else so that I don't have to look at me. 

Ok, so that's all for today. Hopefully it will get more interesting as the journey continues. If anyone IS actually reading this, I could use lots of comments and support!! Thanks so much for reading and remember:

                                              
        

Twelve Keys...

The Twelve Keys of Interholics: 

We... 
F1: ...admit that we have no life. 
F2: ...believe that a Power greater than ourselves can either restore us to sanity or provide us with unlimited, no-cost Internet dial-up. 
F3: ...made a decision to turn our lives over to that Great Webmaster In The Sky ("GWITS"). 
F4: ...performed a searching moral inventory with the Web search engine of our choice. 
F5: ...admitted to GWITS, ourselves and another human being (even if only by eMail) the exact nature of our obsession. 
F6: ...were entirely ready to have GWITS remove our shortcomings and remedy our lack of knowledge about the latest IRC chat technology. 
F7: ...humbly asked GWITS to allow us to FTP the file updates. 
F8: ...made a list of all persons we had neglected, and posted it on our personal home page. 
F9: ...made direct amends to such people wherever possible, except when to do so would cut into our scheduled netsurf time. 
F10: ...continued to take personal inventory, and when we were wrong, blamed it on our outdated software. 
F11: ...sought through prayer and meditation to improve our contactwith GWITS, by utilizing higher modem speeds and improved bandwidth. 
F12: ...had a spiritual awakening as the result of these Keys, tried to carry the message to other Interholics, and ended up making complete pests out of ourselves. 
(Post from Billy S)  
I found this on a GREAT recovery website called   http://dryblog.blogspot.com 

Saturday, March 21, 2009

I found this great journal called "40 Days and 40 Nights: Taking Time Out for Self-Discovery". Perfect right? That's exactly what I am trying to do. I'm going to really try this and see how it goes and if I totally screw it up, I will only have me to blame. :) So here we go. 


The Journal says that I have to choose an Intention. My intention is to find myself. See, that was easy!! NEXT!! Well, now that I have an intention, I can begin. Each day I will work on this and see where it takes me. If you actually read this drivel I call a blog, comments would be greatly appreciated. Otherwise, it's just me and the dog!! Hooray!!

So I didn't get to have my interview yesterday. That sucks. But I do get to go on Monday to have it. Man, I hate waiting. I'm terrible at waiting, especially if it is for something that I REALLY want or need. Let's just say I am beyond desparate at this point, so my patience for waiting is non-existent. When I am impatient for something, CJ gets really irritated with me. Of course, if I were him I would probably feel the same way. He always tells me," Doing that more (whatever annoying thing I am doing at that particular moment) is NOT going to make Monday get here any faster. Why don't you do something to take your mind off of it, instead of that." Umm, NO!! I WANT MONDAY HERE NOW!!!! He should want Monday to hurry up too because he is chompin' at the bit waiting for me to get a job. I don't blame him. I wouldn't want to have a girlfriend that lost job after job and I had to support her and pay for her SHIT! He has been wonderful to tolerate me as much as he has. But, I have dealt with his on again off again attempts at sobriety too. And that is enough to drive the sanest person INSANE!!! 


On that topic, I don't like being on the receiving end of an addicted person. I have always been the addicted person wreaking havoc on everyone's lives and now I'm the one having havoc wreaked on me by an addicted person. I suppose the phrase," Payback's a bitch!" is appropriate right about now. Being on this side has opened my eyes to all the crap I put everyone in my life through without a second thought. Addiction is such a selfish disease. Those of us that are afflicted with this horrible disease go through life like a bull in a china closet. We don't care who we use or hurt or trample on as long as we get what we want and feel we need so badly........our fix!! Needless to say, my list of people that I need to make ammends to has grown exponetially since having this eye opening experience. And then there are those nights when I want to say, "Ok!! I get it!! I don't need anymore examples!! Please make it stop!!" And I know I have no control whatsoever over whether or not he drinks, but dammnit, I'm gonna try to control it every which way I know how. INSANE!!! And who knows the definition of insanity better than those of us that are insane?  For those of you that don't know, the definition is this: doing the same thing over and over again expecting different results! I do this consistently before I stop and realize how utterly stupid I can be! Well, I think I have rambled enough about nothing for now. Hope ya'll are having a wonderful Saturday!! Until next time....................Take care!!

Friday, March 20, 2009

Ok, so I have ANOTHER interview today and there is a part of me that doesn't even want to bother. I mean, what's the point? Really. I have just come to believe that I will never get a job and if I do it will be somewhere like the dog shit factory. Seriously, what am I doing wrong? I have a great resume, really good qualifications, and letters of recommendation. I'm guessing that it is something in me. I only wish that I could figure out what the hell it is and get rid of it!! I am just so tired of the rejection that comes with job-hunting. I don't know how much more my self-esteem can take. Not that I really have any self-esteem to speak of, but you know what I mean. Every morning I have to get up and look in the mirror and I can barely stand the person I see looking back. Most times I wonder,"Who the hell is that?" I don't even know anymore. What I want to know is when I lost myself? Or rather, was there ever a ME to lose? I know that's what this whole journey is supposed to be about, but the addict in me wants what I want and I want it NOW!! Of course, I know that I didn't lose myself over night, so I'm certainly not going to find myself overnight. The journey can be slow and painful at times, but what doesn't kill us makes us stronger, right? Well, then I should be the freakin' strongest person alive!!! Anyhow, I'll let you know how the job interview went. Take care until next time.  

[ATT510719.jpg]

I swear I must have had gas for a really long time because this seems to be true of most of the ideas I have had in the last..........who knows how long!! LOL!!

Thursday, March 19, 2009

Well, I thought for about five minutes that I had this job in the bag and then she said that I had to have a car. See the dilemma there is that CJ and I share a car and he has to have his for his job as he drives all day long. JUST MY LUCK!!!! So, this job, like all the others is a no-go. Why am I not surprised? I'm really not trying to feel sorry for myself, it just happens. LOL! I mean, it's actually kind of pathetic. On Friday, I went to this place called Stenocall, which is a call center type place that takes inbound calls from all kinds of places. They generally hire whatever and whoever walks through the door. I go, take the tests, pass with flying colors, and the lady looks at me like I have grown two heads. She asked me,"Why aren't you looking for something you are more accustomed to doing?" Really? Don't you think I've tried that? Do you think I'd be here if I had had ANY success whatsoever in my own field? I just need a damn job!!! So then she tells me she will check my references and get back to me. Of course, I have yet to hear from her. What really sucks is that as I was leaving, this really greasy looking guy with pants down to his f***ing knees, dirty t-shirt, and greasy long hair is being told that he has just been hired for the EXACT same job I was applying for!!! WHAT???? Are you kidding me?? Where is the justice?? I felt REALLY good after that. I mean my God. He can walk in and get hired and she has to check MY references? WTF!! Sorry, I'm just a little discouraged at this moment.

So, today when I got home from my interview, I decided that I was going to have a beer. A beer you say? Yep. Me. Drinking. A Beer. CJ almost freaked out. Not only did I have one, but I had three and that was way more than enough. I have spent the rest of the afternoon trying to get the room to stop spinning. I was trying to see what it is about getting drunk that is so appealing to him. I absolutely hate feeling that out of control. The whole time CJ is telling me how he feels guilty and he thinks he's gonna make me an alcoholic and how he shouldn't have let me have any. Like I'm not a 31 year old woman and if I want alcohol I just have to go to the bar right around the corner. I CHOSE to drink. No, I'm not an alcoholic, but I am in recovery from pills and he thinks that now that I have had a couple of beers I'm destined to relapse and just fall off the deep end. Not gonna happen. I may have a desire to hide away from the world and sleep my days away, but I have NO desire to live like I did when I was using. I'm too old for that and that kind of lifestyle is too difficult to maintain. I've been on Methadone for almost seven years now and thank God for that, because I don't know where I would be otherwise. Yes, I know that a lot of people don't agree with Methadone Maintenance, and that's ok. It is what works for me. I take it once a day, as prescribed by my doctor. That's all that really matters. I don't know why I feel the need to justify myself every time I reveal this to someone. I guess it is because I have had so much backlash when people find out that I automatically think that everyone is going to shun me. I remember I went to an NA meeting once and made the mistake of sharing that and right in the MIDDLE of the meeting, one of the people that chairs meetings asked me to speak with him and said that I was NOT welcome to share as long as I was on Methadone as I was under the influence. He said that I may sit and listen, but I MAY NOT participate. I could not believe my ears. Needless to say, I never went back to that meeting. Now, when I go to meetings, I always feel like I am carrying this big secret around. I guess that is one thing that keeps me away. I don't like feeling like I have secrets. If there is one thing I have learned and learned well in recovery that is honesty. When I was using I would lie to you rather than tell you any amount of truth whatsoever. Not anymore. That is just something my conscience can't deal with anymore. So going to meetings and feeling like I'm not being honest is hard. Sorry, didn't mean to get off on a tangent. One of those days. Anyhow, I have another interview on Friday so I guess we'll see what happens. Take care and until next time............be safe!!

I have been wondering lately if things will EVER get better. I go to AA meetings and I sit there and look at all the people talking and laughing and just being "happy". I have been sober for almost seven years and I'm more miserable now than I ever remember being during my addiction. (of course I don't remember a lot of the time during my addiction.....lol!) Here I am, 31 years old, no job, no prospects, a daughter I don't get to see, living with an alcoholic who tries sometimes and doesn't other times, I mean, is this all there is? I don't know how much more of this I can take. I apply for every job that I am qualified, I go to interviews that I think go great, and then nothing. Is there something wrong with me? It certainly feels that way. I had a GREAT job working with an orthopedic surgeon in his office, but he ended up letting me go because he thought that an RN could do a better job than me. Well, I talked to the receptionist that is still there and she said that the RN isn't even doing as much as I did. See, in an office environment, it doesn't matter whether you have an RN, LVN, or you are a medical assistant. You all work under the Dr.'s license. I worked really hard, was always the first one there and the last one to leave. When he let me go he wrote me a letter of reference. He told me that I had a very strong work ethic, I was very smart and skilled, but he was more comfortable with an RN. I just don't get it. I have been through so many jobs in the last four years. Some I quit, others I lost. All of them I should have just stuck it out, then I wouldn't be in this position. I'm so depressed that I barely get out of bed anymore. I can't do this much longer. I feel worthless, useless, and pretty much like a failure at everything from being a daughter to being a mother! If this is all there is, then what is the damn point? All I want, all I've ever wanted, was to be self-supporting, not relying on a man in any way, shape, or form. I have NEVER lived alone. As stupid as it sounds, I dream of having my own apartment or little house with my own things, my own rules, and no one to answer to. At this rate, that will never happen. I try and try and try, but I just can't seem to get anywhere. What do I do? Even if I did have Brianna, what kind of mom would I be? I seem to have failed or screwed up everything else, so maybe it is a good thing Brianna isn't with me no matter how much it hurts. Well, that's all for now. I'm going back to bed!!

Where I Am Now

I spend quite a bit of time reading others' blogs and one that I have been reading is like looking into a mirror of my life. It is incredibly eerie, sad, and surreal. You go through life and situations and think that you are the only one in the world experiencing what you are only to find out that you are not UNIQUE!! Imagine that. I have found that in recovery, there is NOTHING unique about any of us. Our personalities, maybe, but as far as what we've done, how much, to who, etc, it has all been done before and of course more and better. I finally quit trying to compare myself to everyone and just accepted that I'm not special. I never have been never will be.

Anyhow, I actually had a pretty good job interview today. Keeping fingers crossed!! I can't go without a job much longer. Day after day, I sit, scouring the want ads online and in the newspaper, looking, hoping, praying only to be disappointed once again. I'm destined to live my life in loneliness, in my pajamas, curled up under the blankets hiding away from reality, because reality is too hard to face. When I first got sober I had all these visions of good job, paying my own bills, and independence with my beautiful angel of a daughter that I haven't seen in almost three years now. Oh how each of those visions have crashed and burned only to take a little more of my heart, my soul, my self with them. Each day that passes is another day to remember as a failure. I wake up every morning with hopes of something new and exciting only to be plummeted back under the covers by mid-afternoon, cowering and wondering when this will end, if it will EVER end. I'm afraid to even hope of getting this job because it is inevitable that the call will come (or no one will ever call) and they will say, "Thank you for your interest, but we have decided on another candidate." Then he will come home from HIS crappy job once again and tell me how my credit is almost up, I'm not trying hard enough, or whatever tangent the alcohol has sent him on that day. Even with him in the next room, I am alone because he is not actually here. He is only here in body. In mind and spirit he is off, floating in a haze of alcohol somewhere, lost in his guitar and wishing for death. I hate that. The smell, the look, the feel of the atmosphere when the alcohol takes over. Too many days and nights have been ruled by that smell, that haze, which is why I stay away, tucked safely away in my bed, under the covers, again, away from reality. I'm beginning to wonder what reality really is. I'll tell you what I want for my reality, him to be sober, my daughter to be in my arms so I can tell her I didn't leave her, and a purpose. That's it. I want a purpose. Endless days wondering around with no purpose is what is killing me, minute by agonizing minute. I think I will go now and try to sleep away some of those minutes and hours. That seems to be the best remedy for me, then I don't have to think or feel or face anything at all. Just the images in my mind as I fall into deep, fitful sleep. Goodnight.