Needle (33 page)

“I know, man. I’m sorry.”

I couldn’t believe it, and if I didn’t hate the job so much I might have protested a little further. Of course, in the end it wouldn’t have mattered because I was just a number, one that could be replaced 20 times in ten minutes.

64

Psychiatric News / April 16
^th,
1999

“When New York City Mayor Rudolph Giuliani announced last July that he was planning to phase out all city methadone programs, the reaction of the addiction treatment community was in some cases unprintable
.

But through a combination of highly public criticism and quiet diplomacy, New York's outspoken mayor was persuaded that he was wrong, and announced that he had changed his mind. The addiction treatment community and methadone addicts who had come to rely on the drug to function normally breathed a collective sigh of relief
.

The story, unfortunately, does not have an entirely happy ending, as U.S. Sen. John McCain rushed into the breach this February with federal legislation that would, if approved, drastically curtail access to methadone treatment. The provision that would
terminate treatment immediately if an addict had dirty urine, that is, urine that showed evidence of illegal drug use
,
is of particular concern to methadone advocates
.

‘Methadone is a tool—it’s not a cure—but anyone who knows anything about methadone treatment knows you are going to have relapses,’ explained Dr. Donald Vereen Jr., Deputy Director of the Office of National Drug Control Policy. ‘The critical issue is how you deal with those relapses.’

While some politicians would like to tighten the circumstances in which methadone or other addictive drugs could be dispensed to opiate addicts
,
the mainstream addiction treatment community appears to be moving in the opposite direction
.

‘The idea of less restrictive dispensing of methadone or similar drugs is consistent with the notion that addiction should be treated like any other clinical problem,’ Vereen continued. ‘Why is it if you're an opiate addict and you're a [treating] doctor, you have to go to the one place that gives methadone every day and is only open from 10 a.m. to 2 p.m.?’

‘Some addicts may have to be on methadone indefinitely,’
Vereen said. ‘Medicine doesn't yet know enough about who is best suited to achieve abstinence and who is most likely to need methadone indefinitely
.
The current system doesn't encourage physicians to make that distinction,’
Vereen observed.”

So, may the streets run orange with the meth of the non-believers.
*

*
Author’s remark

###

After getting the boot from Ellen’s, it would be weeks before I’d manage to land another miserable restaurant gig. Though Perry had just gotten hired at Oasis, a Mediterranean cafe on the Upper East Side, he was in the midst of an unpaid training period and we were forced to fund our drug habits with the carefully rationed-out proceeds of a pawned guitar. This was perhaps the best indication of the condition we were in. Our instruments had long been considered sacred, not only as indispensable tools of the trade, but as future artifacts from a period of suffering and sacrifice—just prior to a grand and inevitable destiny. But a few stomach cramps and a little bit of diarrhea was all it took before an East Village pawnbroker became the proud owner of Perry’s beloved, twelve-string Rickenbacker.

As the cash continued to dwindle, we could no longer afford to get high and had to settle for not getting sick. Soon, I realized that my tolerance for heroin had clearly increased, as a single bag booted every 24 hours was now just barely enough for me to avoid serious withdrawals. Due to these extended bouts of borderline sobriety, I was beginning to experience an altered state of self-awareness. For really the first time I could no longer ignore my surroundings or even momentarily look away, as I was forced to come to terms with my sordid condition. Whereas in the past, salvation could be found at the sharpened end of a loaded syringe, now I was beginning to think that being a junky wasn’t so cool anymore. The starving artist thing was finally getting old, and the never ending words of praise as well as the countless predictions of success were beginning to wear thin. We hadn’t recorded a note in well over a month, and as the recent spate of job dismissals and arrests disrupted our lives, it was one step forward and two steps back with no end to the slide in sight. I was already 26-years-old and it seemed the anticipation of becoming a
junky-rocker
had at last given way to the reality of being a
junky-waiter
, and I wasn’t very happy with the transformation.
“I didn’t go to school for this shit!”
became the shriek of the week, as I sat in squalor surrounded by hundreds of dope wrappers, dozens of dirty needles, and 44 bottles of piss.

I was down to my last 20 bucks. That amounted to a two-day supply of heroin, after which I’d be staring directly into the face of a dopesickness that I’d luckily managed to elude for years. Beyond that
we were a week behind on rent, and I knew the only way to really improve the situation was for both of us to be working and making money. However, before that could happen I would not only have to find a job, but ultimately survive a dopesick training period during which it would be impossible for me to leave the bathroom—let alone impress anyone with my passion for serving assholes and being treated like shit. Of course, had it been Saturday—also known around meth clinics as “take-home day”—I would have been able to purchase a bottle of methadone on the street and avoid withdrawals. Unfortunately, it was Monday and besides, a single dose of meth would only eliminate the physical aspects of withdrawal, and I’d still have to deal with a deep depression and the psychological cravings until I could afford to reengage my habit. Maybe a more drastic measure finally needed to be taken. Regardless, I saw only two options available to me: score some dope, remain straight for a couple of days, and hope that Perry generated some cash by Wednesday or—spend the money registering for one of the city’s methadone programs, something we swore never to do only moments after we swore never to pawn our instruments.

Though I had taken methadone before, it was purchased illegally on the street as a last minute and temporary substitution for heroin. Until now, I had never seriously considered joining a long-term maintenance program, which is how the drug is typically and legally administered. This was something very different and a good indication of my mental state as I knew that meth maintenance programs had a well-earned reputation for turning desperate junkies into permanently-tranquilized zombies. Each day as they report to their local clinics for monitored treatments, the vaguely sedated but clearly condemned carry on as they imitate the living. It’s a dimension of existence reserved for the truly forlorn, as they wander through Methadonia without any real hope or aspirations for the future—and it’s about as close to a lobotomy as you can get.

The attraction of methadone to a recovering addict is that it not only blocks the physical withdrawal symptoms, but also the depression and psychological cravings—which is at least partially because it replaces heroin with its own intoxicating effect. However, once the meth wares off and physical symptoms have subsided, the more enduring psychological symptoms return unless followed-up by another dose. Unfortunately, methadone is even more addictive than heroin and as a result, another dependency with almost identical
withdrawal symptoms can develop more rapidly and be harder to overcome. The bottom line is that junkies hoping to escape the horrors of heroin by resigning themselves to a methadone maintenance program are simply substituting one addiction for another.

Of course, in theory, the program is supposed to conclude with a detoxification period of an indeterminate length, during which daily doses are gradually reduced until the patient is completely weaned off the drug. Unfortunately, that seldom seems to happen and many relapse at some point during the process. This is evidenced by the methadone flea markets that pop up around clinics every Saturday which, as previously mentioned, is referred to as “take-home day.” On take-home Saturday, addicts are dosed and then provided with a sealed, prescription bottle of meth to be self-administered on Sunday when the clinics are closed. However, for many, Saturday tends not to be
take-home day
but rather,
sell-your-meth-to-a-dopesick-junky-and-use-the-money-to-buy-heroin day
.

Even those who managed to avoid relapse rarely permitted their dosages to be reduced, and counselors quietly looked the other way—just as they did for program violators with traces of heroin or other forbidden substances in their randomly administered piss tests. I’m not exactly sure what the clinics’ policies and penalties were with respect to such infractions, but it seems they were often overlooked—possibly to prevent junkies from permanently returning to the street’s version of the same drug they were distributing. Consequently, most patients who successfully avoided relapse remained indefinitely addicted to the same levels of meth that were first prescribed, while some bad apples simultaneously maintained two habits.

At best, meth maintenance served only to further marginalize junkies by keeping them permanently sedated and off the streets, while robbing them of any chance they might have at recovery or a normal existence. Once again, complete indifference or at least a failure to understand addiction at its most basic level was demonstrated by yet another city-funded agency, as the band-aid solution was to simply replace one tainted brain chemistry with another.

Of course, it wasn’t as if I didn’t know any of this. Throughout the course of my junky odyssey I’d gotten to know many addicts who had been on methadone maintenance and there was no shortage of horror
stories. But just as the thrill of getting high enabled me to turn away from the reality of heroin addiction, the fear of being dopesick now enabled me to turn away from the reality of methadone maintenance. Obviously, I knew I could report for just the first few days of treatment to eliminate withdrawals and buy some time without risking an addiction to methadone, but in my fear-induced state of reasoning I considered that a maintenance program might have been precisely what I needed. Quite frankly, I could never imagine myself completely abandoning opiates and thought that by giving-in to the stupid substitute I might at least stay out of jail.

Regardless of how thoroughly I would commit myself to the program, I decided that for the moment I simply had no choice. It had been only 22 hours since my last fix and I was already beginning to feel a syrupy sweat collecting on the back of my neck—a sure sign that more serious withdrawals were on the way.

I quietly left the room being careful not to wake Perry, who would have talked me out of the idea as he was entirely opposed to methadone. His objections probably stemmed from the fact that he, unlike I, was largely hooked on the orgasmic rush and the actual process associated with mainlining heroin, which is also known as being “addicted to the needle.” It’s an element of the addiction that meth does little to mitigate, and another reason why the program has such limited success.

At about 7 a.m., as I left the hotel and headed to the nearest bodega for my daily bacon, egg, and cheese bagel, I passed a crackhead hooker who was hobbling toward me and in very bad shape. She was visibly filthy, her hair was matted together, and the edges of her mouth were lined with bulging red sores. Her “dress” was torn from her shoulder, and as she limped closer compensating for a broken heal that desperately hung on to what was left of her right shoe, I could see she also had a black eye.

“Hey, have you seen Jacky, have you seen Jacky yet?!?” she croaked with desperation in her raspy voice to a man who was just a few paces in front of me.

“Lookin’ great, babe, lookin’ great,” he replied, at first ignoring her question. “No, I haven’t seen him.”

I continued on, trying to wipe that bit of human degradation away from my brain as I now tried to come to terms with my own.

After eating breakfast, I jumped on a downtown train and headed for the clinic on Delancey Street. As I began the journey toward
Methadonia, a tiny part of me was fiercely protesting against any long term commitment to the program; however, my reservations were more than counterbalanced by the harbinger of dopesick sweat now soaking through my shirt.

Within ten minutes the train reached the Delancey Street subway station, which was three blocks away from the clinic and quite ironically—only two blocks from Angelina’s. The clinic’s proximity to the boutique made me again momentarily question whether or not methadone maintenance was the right decision, but once more I was able to look past my doubts and continue in the direction of the clinic.

When I entered the building I made my way to the appropriate suite of offices and after signing in, sat in a waiting area which remained empty except for the occasional junky wandering from room to room. As I filled out the questionnaire a loud, ripping, gurgle echoed from my stomach and I knew the game was on. I informed the clinic’s receptionist that if need be she could find me in the bathroom making my case for admission into the program. I then headed directly to the lavatory and thought that for once, perhaps, I might have been exactly where I needed to be.

I took care of business and returned to the waiting area. Within a few minutes the intestinal grumbling resumed, and as I rose to return to the bathroom I was re-directed to an office that was only a few feet from where I was sitting.

“The counselor will see you now,” the receptionist said.

I ignored my boisterous bowels and entered the office where a middle-aged woman sat behind a desk awaiting my arrival. From the very beginning, I could tell she’d long had her fill of junkies. Without introducing herself, she immediately commenced with a quick review of the program’s details that were first and foremost on my mind.