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Not long afterwards, I suffered a life-threatening injury on The Farm and was bedridden for weeks. I was given Vicodin—7.5/500s, the mid-level strength—to take as needed for pain. This relatively low dosage, this medication, was completely inappropriate for the serious nature of my injury and no matter how much I took, the pain was constant and only mildly dulled by the pills. After going through several large bottles of Vicodin, I found myself mildly sick one evening in the middle of the night. I explained my symptoms to Karen’s older brother Tommy, the sweating followed by sudden cold shivers, my muscles aching, as though they were trying to push out past my flesh, my bones hurting. Tommy laughed and shook his head.

“You still feel it?” he asked.

“No, it just lasted for maybe . . . a couple of hours last night.”

“You were getting hooked, man.”

“No way,” I said. “I only took these things for a few months.”

“How many were you taking a day?”

I told him it was well up over a dozen or so and he said that was enough to do it maybe but that I wasn’t really “hooked” yet since the withdrawal was so short.

He was right. It takes some time to get a real habit, not just on heroin but pills such as Oxycontin, Vicodin, and other synthesized opiates as well. After leaving Karen and moving to San Antonio, I took small handfuls of over-the-counter pain pills like ibuprofen and Advil or extra strength Tylenol, which was really only 500 mg of acetaminophen. This 500 mg was the same amount of acetaminophen I had gotten from one Vicodin, Lortab, or generic hydrocodone before. Much as I had done in high school, I even began to look in friends’ medicine cabinets for stronger drugs while using their bathrooms. These were small, easy steals, some non-user’s long expired script above or below the bathroom sink. I wasn’t going to be an idiot or an asshole and lift a pill or two from any friend of mine who actually had some current script or injury, who still needed their pills every day for either pleasure or pain, and who would notice their absence. Regardless, even though I did feel legitimate pain, I was also still seeking the tangible, long-lasting high that the opiates gave me as well.

When I first began dating my new girlfriend Patricia in San Antonio, she gave me access to some old Percodan she had left over from having her own wisdom teeth pulled years before. She was under a lot of stress then and used to occasionally come home from work with a bad migraine. She’d take half of one of these opiates to help her sleep and get some relief. She’d had the same small bottle for four years. Before she knew it, I had taken almost all of her pills. She discreetly hid the rest from me and we said nothing.

I wasn’t then, or ever, a full blown, out of control “addict,” one of the people who uses so much that they lose their jobs or ruin their own lives by stealing merchandise, taking from the till, turning nasty tricks, cheating their family and friends on investments, stealing their spouse’s or children’s savings, all primarily to then get more money to buy more of whichever drug they think they need. These after the fact actions are in fact called “crimes” and the drug is often used as an excuse to do them.

I had yet to become “dependent” on these powerful drugs, that is, physically dependent, so that one becomes ill with withdrawal symptoms when the drug is removed. I went on this way for months, in pain, until I finally just went to a doctor and told her of my injuries. She was a low-rent doc on San Pedro in San Antonio, a long ugly street of blatant commerce that cut a straight line between the more wealthy center of the city and the beginnings of the mostly more impoverished West Side. San Pedro is lined with pawn shops, used car dealers, old dying restaurants still hanging on with marquees from the 1950s and ’60s, new fast-food joints, window tinting and car alarm businesses, abandoned strip joints, grocery stores, dentists, doctors, nail and toe salons, tanning shops, and beauty supply stores, as well as anything else you could cram into a decrepit strip mall.

Her name was Dr. Christianson, and her sign said she was a family clinic MD. I could tell she thought I was maybe conning her, as I refused to have an MRI done with her partner in the clinic, a quacky-looking guy from Africa, Dr. Kungwale, who was mainly in charge of physical therapy for her. I didn’t want or have time for physical therapy; I just wanted some hydrocodone, half for the back pain, and half for the high the drug still gave me. I didn’t mind getting an MRI, in fact I wanted one to see what was wrong. But I had no insurance yet and couldn’t afford the expensive procedure. I didn’t fit the profile of her usual con artist, at least not yet, as Vicodin was just beginning to become one of the most prescribed and popular middle- and upper-class drugs in America, and one that millions would be soon taking.

Hydrocodone, in all its forms, is a legal prescribed high that is ten times as strong as marijuana, and, if taken for long enough, it will lead to physical dependence due to the body’s growing tolerance to its effects. I was a well-educated forty-year-old professional with a respectable job and position in society. My girlfriend Patricia was also a professional, both of us living in one of the most expensive neighborhoods in the city. Dr. Christianson had pulled all of this info out of me before prescribing 60 7.5/500’s a month. I was to take two a day and then call her for any refills. At that time, I would take three of them a day, which was about 22 mg of the opiate and 1500 mg of acetaminophen, that is, not much at all. I got a nice buzz out of this amount, and because it mostly masked my back pain, at least throughout the day, I was able to live like I had before my injury, going on bike rides with Patricia or swimming with her, walking our dogs, working in our yard. Patricia and I even joined the nicest health club in San Antonio where she talked me into doing mild Hatha yoga. I would take one Vicodin before one of our long Sunday morning yoga sessions and between the calming, meditative workout, swimming laps in the pool, a steam in the sauna, the whirlpool for my back and a final cold shower, I felt better than I had in years. The Vicodin only added to this good feeling of health and exuberance. I’d take another pill in the afternoon and another in the evening before the soreness could set in.

Eventually, Dr. Christianson insisted I go to Dr. Kungwale for physical therapy. I had insurance now for the first time in decades due to my new job, and I was able to get the MRI that he insisted on before any further treatment. Dr. Kungwale did refill my existing script one more time on that first visit. After I got the MRI on my back, he and Christianson both seemed relieved. They pointed out I had two broken vertebrae, compression fractures that had healed improperly and fused together at an offset angle in the middle of my back. This was the reason for the lumps, scar tissue, and pain in the middle of my back, they said. As for my even more constant lower back pain, they chalked that up to sore muscles from years of hard physical labor. Dr. Kungwale prescribed a muscle relaxant for me, 10 mg of Flexeril once a day along with two of the mid-strength Vicodin which I bought as the generic hydrocodone at 7.5/500 mg.

I was teaching at community colleges during the day and at night, six classes to try to make a living. I hated my three-hour evening classes. I tried as hard as I could to keep the class interesting, but it took it out of me, giving out all of this energy to just have it sucked up by the black hole that was my tired, unenthusiastic audience. I began to take an extra Lortab as well as bring a tall closed mug full of two shots of vodka and a little cranberry juice and soda that I would sip on throughout the night. Planned properly, the one Vicodin kicked in at mid class and the euphoric high, enhanced by the alcohol and the muscle relaxant I’d also taken, sharpened my focus and made me more energetic. My body, mind, and mouth were fueled by the drug combo. I ended up putting on a good routine for these guys, who came to enjoy my class year in and year out.

I figured what worked for me in the evenings would work for me during the day as well when I began to take on more day classes than nights. I started taking one 7.5/500 in the mornings before my first class and it made the next two or three hours of lectures bearable. I also started taking more in the afternoon and evening, as the drug made me more personable through the night. I could visit easily and gab for hours with people I’d normally clam up around, nodding my head and pretending to listen to their conversation. Soon, I was almost running out of Dr. Kungwale’s script within two weeks. I would then have to cut pills in half to spread them out, drink more, take more of the muscle relaxants, anything to give me some sort of energy to get through my three-hour lectures at night. I felt little if any withdrawals at that time since I was taking such small amounts.

At first, I asked Kungwale for more, and he upped my dosage to two 10/500s a day, the strongest HC I could get from most doctors beyond Oxycontin, morphine, Demerol, or special patches and pumps, massive hardcore doses for the terminally ill or severely injured. I also asked him to up the number of pills per day, but he gave me some extra Ultram instead, a non-narcotic that only made me drowsy and did nothing for the pain, nor did it get me high. I started going to other doctors then to get more Vicodin. I hit up one guy who was obviously some very anti-drug asshole who looked at me with great suspicion and would only give me Soma, which despite its promising name turned out to be another mild, non-opiate, pain-killer/muscle relaxant that did little for me compared to HC. I went to another suspicious doctor who didn’t seem to like it at all that I knew what I wanted. He gave me Darvocet, a nominal narcotic that did absolutely nothing to mask my pain or give me a high.

I found another general practice guy at random in the phonebook, a Dr. Garza, who had an office next to a run-down inner city hospital. Dr. Garza was a younger man than Kungwale, probably in his late thirties, near my age. He had a mostly lower working-class client base at the time, his waiting room full of sick crying children and their tired out mothers, sick old men and women with walkers and canes. I had just had some sort of strange, new, extremely painful episode with my back, something that occasionally happens to me that is frightening and debilitating. I still don’t know what it is exactly, maybe a muscle spasm, but it feels like something has slipped, or a nerve is pinched, a knife in my spine that then has a vise clamped around it to ensure that the pain stays. These episodes or spasms, whatever they are, happen with no notice, always in the morning, and can come from something as simple as reaching for a pen on the floorboard of my car, or picking up the cat’s litter box, or bending over to feed the dog. There was no reason or desire to fake these debilitating spasms; when they happened, they scared the crap out of me. I was partially bent over, could not straighten up my spine, and could barely walk. It took about three days to get back to normal when it happened. I would also take more Vicodin when one of these rare back seizures came on but it didn’t help much.

The seizures only happened a couple times a year, but one had just hit me when I went to see Garza. He interviewed me briefly about my job, where I lived, past medical history, the usual. I could tell I was going to score easily with this guy, that he needed me as a good paying patient. He prescribed me two 10/500s then a day, sixty a month, with one refill. I also told him I had to take a plane flight and needed some alprazolam, one of the benzodiazepines, for anxiety. Patricia had turned me onto this drug, also known as Xanax. She got it from her grandmother who in turn bought it in Mexico where it was sold over the counter. Her grandmother, along with many others, crossed the border from Texas to Mexico regularly along with thousands of other older Americans to buy the exact same pills from the exact same manufacturers for a fraction of the price that they were sold to the suckers of United States. The senators and congressmen of America at this time were still completely in the pocket of the large HMOs and drug companies who partially financed their campaigns and perpetuated this gigantic con on the citizens of the country, milking out every last extra cent with some bullshit song and dance routine that they needed to fleece us out of this extra cash in order to find even better drugs for hard-ons and allergies, never mind curing cancer or Alzheimer’s, something useful.

I’d taken a blue 1 mg Xanax of Patricia’s one night after dinner when we were first dating. She had advised me to take less, as she only took them by the quarter or half, one prescription lasting her well over a year. She used it wisely, and only when she really needed it for mild anxiety or to get some sleep. An hour after taking the pill and two glasses of wine, I was standing up and talking to Patricia when suddenly it seemed as though I had lost a segment of time, or my train of thought. I couldn’t remember what I’d been saying. I was still standing, swaying. I opened my eyes and found myself staring at the floor. I looked up and saw Patricia’s worried face.

“Jake? Jake, you need to get into bed.”

“What happened?”

“I don’t know. You just passed out but you were standing up. I don’t know why you didn’t fall down.”

“It’s that Xanax. That shit really works.”

“You’re not supposed to drink with it,” she said and helped me to her bed. I wasn’t supposed to mix four hydrocodone with it either but I didn’t mention this as she didn’t know how much I took and respected my privacy with most all drugs anyway.

So I took a chance with Dr. Garza, and he gave me a thirty pill once a day half a milligram script of Xanax in addition to the two 10/500s of Vicodin a day. Just before I left though, I found out he was no sucker as he told me first to be careful with the Xanax, that they snuck up on people, and second, that I would have to come in to see him every two months for my refills. This gave him a thirty dollar co-pay each time from me and another hundred bucks or so from the insurance companies, or whatever he could wrangle out of them. My insurance plan’s co-pay had me spending another ten bucks to fill the script, so I was looking at, coupled with Dr. Kungwale, about twenty bucks a month at the pharmacy for one hundred and twenty of the strongest Vicodin, which sold for maybe four bucks a pop on the street if you were stupid enough to sell them. I was feeling good, doing these calculations in my head, when Dr. Garza put a form in front of me to sign.

“What’s this?” I asked.

“All of my regular patients who take narcotics have to sign that release,” Dr. Garza said, making light of it.

I hesitated, reading it. The form said I would not go to any other doctor besides him for this medication, that I would not take more than prescribed, that I would submit to a random drug test, as well as more restrictions that, if I broke any of them, would force me to go into a rehabilitation program. If I broke one of the rules after that, I could face charges.

“Don’t worry,” he said. “I’m not accusing you of anything. This is mainly just to cover my ass as a doctor. They’ve got some physicians on San Pedro, these little clinics over there where people end up lining up around the block to get narcotics. They busted a doctor over there last year with 50 drug addicts filling up his tiny little waiting room. The cops finally figured something was up, you know? This little old doctor and he’s got lines of people around the block?” He laughed.

The guy was good. He’d sprung this on me at the last minute after writing me both scripts that were in my hands already. He knew I probably had some real pain from examining me and the story I’d given of my injury, but I had yet to show him my MRI for some reason so he was letting me know I could easily just be another drug addict liar looking for a legal high. To split now would be a dead giveaway so I signed the form and figured I’d take my chances.