DEA/PDMP

I’m going to post this as an appendum to my last offering. Two states in the U.S. (Washington and Colorado) have legalized marijuana, and it’s on the ballot here in Oregon. Federal law prohibits the sale of marijuana, so even in states where it’s legal, the DEA (Drug Enforcement Administration) could raid suppliers. I loathe, detest, and despise the DEA because, for one thing, based upon my experience—and the experiences of voters in Washington and Colorado—they spend millions and millions of dollars persecuting marijuana users for no reason other than that they receive millions and millions of dollars for persecuting marijuana users. Since they’re losing their grip on pot, they’ve now turned to narcotics as public enemy number one, and to this end, they’ve upgraded hydrocodone (the narcotic in Vicodin) to the same level as the stronger drug oxycodone (the narcotic in Percocet), and they’ve made it harder for people who use the drugs legally to obtain them.

Here’s what I—and everyone else who uses long-term narcotics legally—have to go through to get them. Every month, I have to go to my doctor’s office and put the date, time, my driver’s license number, and my signature, on a form in order get a new prescription for a thirty-day supply of oxycodone. Before I started using a mail order pharmacy, I would then have to take the prescription to a walk-in pharmacy, show the clerk my driver’s license and sign for the drug. Now that I’m on Medicare, I use a mail order pharmacy, so I have to mail the prescription (I, as in me, because my doctor can’t do it, and no one can fax it) to a special address in Pennsylvania. For some reason, it takes them two to three weeks longer to ship oxycodone than other prescriptions.

They send it by UPS (United Parcel Service), and I have to receive it at my house and sign for it. It can’t be left with a neighbor, and I can’t pick it up at a UPS facility. It has to come here, and it has to be signed for here, only I never know what time of day it’s coming, and I have literally stayed home all day trying not to make noise so I wouldn’t miss the delivery. One day, I waited ten hours, finally had to go somewhere, and, of course, that’s when the truck came, and I had to start the wait all over again the next day—three misses, and they ship it back. I have to do this every month, which means everything else has to be scheduled around the delivery, only I never know more than three days in advance when it’s coming, which makes it hard to plan my frequent doctor visits, not to mention little holidays with Peggy.

All of this bullshit is the work of the DEA, but they don’t stop there. They also require that I sign a yearly contract with my doctor promising that I won’t get narcotics from any other doctor—as I might do if I were if I were an addict, or having surgery. I also have to promise to always get my narcotics from the same pharmacy. A record of all this—along with every narcotic prescription I have filled—is put into a database so the DEA can be sure I’m being a good boy. Of course, they don’t say that this is the purpose of the database:

“The Oregon Prescription Drug Monitoring Program (PDMP) is a tool to help healthcare providers and pharmacists provide patients better care in managing their prescriptions.”

Bullshit! Bullshit! Bullshit! The sons of bitches! How dare they claim that they’re forcing every doctor and pharmacist in Oregon to spy on people for their own good! As might be expected, the news media is only too happy to handle PR for the narcs by running story after story about the evils of narcotics—how they are over-prescribed, how many people die of them (it’s an “epidemic!”), and how we need to use “other methods of pain control,” all this without a single, solitary mention of the fact that narcotics have a legitimate place in medicine, or that other “methods of pain control” might be inadequate, either in whole or in part. Heavens no! At the behest of the DEA, narcotics in and of themselves are coming to be regarded as the enemy, and let the patient tremble who, for whatever reason, gets them from two doctors or two pharmacies, even once, and woe be to the doctor who prescribes more of them than the DEA thinks appropriate because he or she will be raided (we might not have money for road repair and social services, but the military and the narcs need never go begging). Bear in mind that such raids never happen before patients arrive or after they have left, but always when the clinic is filled with patients, the goal of the DEA being the same as Bush’s goal when he bombed Baghdad—SHOCK AND AWE. It’s their way of saying to doctors, Put the image of being led away in handcuffs in front of a waiting room full of patients into your pipe and smoke it every time you write a prescription for Vicodin.

On the bright side, I only have one thing to report: the ACLU (American Civil Liberties Union) is suing to put an end to the narcotic monitoring program because they are so radical as to think that what transpires between a doctor and his patient—or a pharmacist and his customer—should be private, but, of course, as every real American knows, the ACLU is nothing more than a left-wing nut group.

When logic and proportion have fallen sloppy dead

I take little pleasure in hearing about people’s vacations to exotic destinations because I can’t relate them to my experience, and because I feel vaguely disapproving that anyone would even want to go. The same applies when a drug user talks to a non-drug user about his latest high.

People travel for all sorts of reasons just as people use drugs for all sorts of reasons. I started my own drug use in the ‘60s partly out of curiosity, but moreso in the belief that they would lead me to enlightenment, it being the era of Timothy Leary and Richard Alpert. When I would meet a person who said, “I don’t need drugs to get me high, or, “I prefer reality to staring at the wall like an idiot,” or, “I don’t use drugs because I like who I am,” I would regard them as ignorant if not cowardly. It later occurred to me that similar arguments could be applied to travel. For instance, “I don’t need to go to the other side of the world to experience happiness,” or, “When you’re a person of depth, your own backyard is no less exotic than Rampur.”

Other than coffee and an occasional drink or two (never more than three), I hadn’t been high on anything for years until I started living with chronic pain. Then came narcotics, marijuana, sleeping pills, Neurontin, and Cymbalta. Now, never a day passes but what I don’t take three or more of these, marijuana being the only one that I don’t use regularly because I can no longer tolerate it. I’m not addicted to any given drug, but if it’s possible to be addicted to the desire to get high, then I’m addict because I love getting high. I always loved getting high but until I started living with pain, I just didn’t do it everyday.

When I was in my upper twenties, I only had regular access to two drugs—marijuana and alcohol—so I bought books about legal substances that could get a person high, things like lobelia, kava, jimson weed, and fly agaric. Some sounded so scary that I didn’t even dare try them, and of the rest, I had to order some, and none of them took me to where I wanted to go. Then LSD came into my life by way of one friend and psilocybin through another. My sister was by then a coke addict, so I snorted that a few times, and then someone gave me angel dust. I also took speed on a few occasions, but, except for marijuana—which gave me insights and hallucinations—I never got what I wanted from any of these drugs until I tried ecstasy, and it took me as high as I could even imagine going. When I shared some with a friend and she went into convulsions, I felt disillusioned that a drug which had been, for me, a source of overwhelming love and happiness could turn right around and make her seriously ill and panicky.

Like a lot of people, I didn’t care for narcotics at first, and they weren’t even that good at controlling shoulder pain, but they were what I had, and they were better than nothing, so I took them, and I’ve continued to take them for six years now, more recently for back pain and knee pain as well as shoulder pain. The enjoyment of a lot of drugs is like the enjoyment of riding a bicycle in that it’s no fun until you learn to do it well. Take Neurontin. I mentioned it a few posts back, and at least two people wrote about how unpleasant they found it, what with it making them dizzy and causing them to walk into walls. I initially liked the drug because it would enable to sleep through the pain when nothing else would, but then I learned that if I went from a low dose to 900 mgs all at once, I too would walk into walls, but the pain would disappear, and I would lie in bed for hours on end having amazingly vivid and happy dreams, one after another after another. Like touring Borneo, the effect of a drug is partly what it is and partly what you are able to make it.

Back in the ‘60s, young people were divided into two camps, those who were open to experimenting with drugs, and those who were not, and neither camp thought much of the other. I was never ashamed of my drug use, but was instead proud that I had the courage and the desire for growth that was necessary for me to take substances that scared the daylights out of me and had a reputation for putting people into mental institutions or worse. When I finally got an inkling of just how bad a bad trip could be, and determined that I was more prone to them than less sensitive people, I became more cautious. That was why, of the three times that I took acid, I only took a full hit once. It was also why I stopped taking hallucinogens at night, in unfamiliar places, when unwell, or among people I didn’t trust and couldn’t easily escape.

As the hippie era wound down, people came to regard drugs as less a vehicle for growth than a means for entertainment. Again, there’s a parallel with travel because a lot—probably most—people travel for stupid reasons. Maybe they’re simply bored at home, or maybe they want to travel for the bragging rights, or maybe they expect foreign countries to effortlessly enrich their minds. When you think about it, is there really that much difference between stories that start out, “I saw twenty countries in two weeks…” and those that begin, “I was so fucking wasted…”? Nothing, in itself, can make you a better person, and anything can be done for unworthy reasons, but the boundary isn’t always clear.

Like with narcotics. They can be used to relieve pain, but they’re also good for the emotional distress caused by pain. The common belief is that you’re only justified in taking them for the former, which means that you’re better off seeing a shrink or taking anti-depressants for the latter. My guess is that most people who use them for very long use them partly for psychological relief even if they take other measures, because when you’re sinking like the Titanic, there’s nothing like the profound relief of a drug that can give you instant peace and happiness.

I was stricken when I learned that, within blocks of where I live, people rob pharmacies at gunpoint for the very drug that I take almost everyday. I know that these people will be locked away in prison, and that strikes me as throwing tragedy after tragedy. Peggy has another view because she’s seen how manipulative druggies are when they come into the hospital, not because they’re sick but because they want to make people think they’re sick in order to get drugs. In Peggy’s view—and the view of a lot of healthcare provides—addicts are lying, thieving sacks of shit who deserve prison. Because I know that the only thing separating me from them is lucky genes, I feel a mixture of outrage that some addicts let themselves sink so low and compassion because I don’t think they can help it.

I don’t know what the answer is, although I doubt that legalizing narcotics could be any worse than locking people up, because if they were legalized, fewer people would progress to heroin (most people turn to heroin because it’s cheaper and more available than legal narcotics), and no one would rob pharmacies at gunpoint or go to a doctor pretending they were in pain. Narcotics, bought legally, are far cheaper than liquor, and, having taken them for years, the downsides are not terribly obvious to me. I know they’re bad for my health, but I also know that I can function so normally when taking them that my mental state isn’t apparent to others, and this makes me wonder if addicts couldn’t hold at least some jobs if their drug supply was assured. If any drug that I’m taking has caused an obvious change in my behavior, it’s not narcotics but Cymbalta because Cymbalta has caused my extremities to twitch, but it has also alleviated my depression. The last time I was on an anti-depressant, Peggy begged me not to go off it, and I’m sure she would beg me now if I said I was going to quit taking Cymbalta. That’s how pronounced a difference such drugs can make.

I simply don’t believe that addiction in itself is the worst thing in the world as long as a person can afford whatever substance he or she is addicted to, and as long as the drug in itself doesn’t cause disruptive or criminal behavior, as with meth. My thought is that we would be better off legislating against bad behavior while on drugs rather than legislating against the drugs themselves. Alongside the futility of attempts to put an end to drug use, I think people have the right to use mind-altering drugs. I’m probably more intolerant than most of antisocial behavior while on drugs (for example, if you kill someone by driving while blind drunk, I think you too should be killed), but drugs don’t make a person drive while loaded or otherwise act like an ass.

I have a friend who smokes pot, another who drinks to excess on occasion, and a third who doesn’t use any drug, even caffeine. Of these three, the least interesting is the one who smokes pot, so I’m far from claiming that drugs are every case desirable, yet I’m incredulous in the presence of people who won’t at least try marijuana, especially when it’s free and offered by a friend. Hell, I might not be keen on travel, but if I won a trip to Uzbekestan, I would surely go because, well, why not? I would learn as much as I could in advance, put as much energy as I could into being enriched by the experience, and see how I liked it. Why not approach marijuana the same way? The usual answer is, “I like myself as I am,” which misses the point when said about drugs just as it misses the point when said about travel. To be anti-drug is to risk missing a trip down the rabbit-hole with Alice, and that’s a terrible thing to miss. There’s so much in our heads that we’re unaware of, and drugs can open the door to them. That’s a precious gift in my estimation.

Now, I’m going to tell you as good a drug story as I know. Three months ago, overwhelmed by pain and consumed by depression and thoughts of death, I started taking Cymbalta. Now, I rarely think of death, my pain is still appreciable, but greatly reduced, and I only feel depressed for moments at a time. All of this I attribute to Cymbalta. If a person can have a stroke and immediately assume a radically different personality, or, as in my case, take a drug, and undergo a dramatic change both in mood and in the content of his thoughts, how can we regard anything about ourselves as constant? But if we are not a constant, then what are we but sacks of chemicals that are waiting to be acted upon by other chemicals? So much for innate human dignity.