"Dope Sick: A Special Kind of Hell"

[How, Why I sold my soul for needles full of Fentanyl and Heroin]

Smack, Hair-on, Brown, Junk, China White- these are common street names that make any seasoned junkie's ears, sober or not, perk up like Jesus just called your name asking you to come play checkers with him(aww thanks Jesus). To put it lightly, its pretty effing awesome. If you've never had the pleasure of shooting heroin, or any opiate for that matter, deep into your virgin veins, imagine being in a snowstorm freezing your ass off. Aimlessly wandering, you come across a shady looking guy who says, "hey bro you need a blanket?" Being the cynical smart-ass that most would be in this piss-poor situation, you might reply, "nah bro I'm good thanks though buddy!" Smiling that devilish smile that all well-trained dope dealers have, he offers you a "blanket", free of charge, because he's "so concerned about your well-being." "Get me back later," he replies, like a credit agency minion, suggesting that he's actually doing you a favor because he knows your good for it. So, Snowstorm. No clothes. Cold as fuck. Free blanket. No charge. Unless you're just a difficult asshole, most people are gonna utilize that blanket like a disgraced DOJ official utilizes the 5th amendment during a congressional shakedown. Again, unless your a fuckin asshole, the blanket represents Heroin. Stay with me Sling-blade. Now, imagine you bang that "blanket" into your most accessible blood-highway(vein bro) and the next thing you know- its a warm, twilight, sun-setting day in May. Birds are winding down for the night, dusk is ever so softly basking the landscape in a golden array of warmth, while you- oh you- are filled with an angelic, euphoric, river of grace washing from your brain stem, dopamine receptors, stomach, down to your toes, as if a direct line of communication has been established between you and almighty God. You have an uncanny, holy, reverent connection with the world. Sounds ring like church bells. Smells dazzle your palates as if this moment were created just for you, just for your pleasure. In your peripheral vision a young Cindy Crawford appears, ripping off her clothes seductively screaming, "come get it you sexy-", ok I digress, its just really really intense is what I'm trying to say. Its a beautiful, scared experience. Then you wake up. Shit. "When did it starting snowing again!?" Boom, goes the dynamite(napoleon dynamite).

[Bayer Co. Heroin] was freely marketed, and unregulated, as a cough suppressant/pain reliever from 1898-1917, sold completely over-the-counter.

Heroin in-itself, is not evil. It might surprise you to know that you've probably ingested Heroin(or close to it) at some point in your life, if you've ever been to an emergency room and been given IV pain meds. You see(class is in session), heroin is not the actual name of the chemical compound we all know as "heroin". The correct medically accepted term is, Diacetyl-Morphine. Diacetyl-Morphine is a morphinan based substance derived from the dried latex of the Papaver Somniefurm plant, otherwise knows as the "Opium Poppy". In lay-mans terms, once opium poppies are fully cultivated, their pods are then scored(cut), at which point crude opium leaks out of said pods. This crude opium is then put through some Bill Nye the Science guy shit, whether refined into actual medical grade opium which we derive naturally occurring opiates such as codeine and thebaine from, acetylated(washed with an agent such as vinegar) into diacetyl-morphine(heroin), or synthetically manipulated into Opioids(hydrocodone, oxycodone, fentanyl). To simplify this- Opiates(natural)=diacetylmorphine, morphine, codeine, thebaine, Opioids(lab made)=hydrocodone, oxycodone, fentanyl). Names such as Heroin, Oxycontin, Vicodin and Fentanyl are brand names which pharmaceutical companies use, they are not the actual chemical compound. Funny enough, "Heroin" was coined by Bayer in 1898, and marketed as a cough suppressant, and pain-reliever, freely available over-the-counter, unregulated(hell yeah bro). In 1914, the Feds introduced the "Harrison Narcotics Act" which made Heroin a prescription only drug(still hell yeah bro). Then, in 1924 someone in the Feds pulled their head out of their ass, completely outlawing heroin all-together(damnit bro wtf). What a bunch of assholes. One commonality amongst all the substances listed above is that they all deliver versions of the same effects, varying based on strength of substance. Opioids, Opiates, Non-Narcotic pain relievers(tramadol), all hit the same Mu/Kappa-opiate receptors in the brain, for the most part. Imagine a food-chain. Codeine, thebaine, tramdol are on the bottom(relatively weak), all the way up to morphine, diacetyl-morphine, oxycodone and fentanyl(strong AF). When you hear Mu-Kappa receptors, think analgesia. These receptors are responsible for the warm, fuzzy, euphoric feeling one experiences when ingesting said substances. In the beginning, a virgin opiate/opioid dug user with no tolerance can ingest codeine and feel quite literally the most euphoric they have ever felt in their life. But, tolerance will inevitably set in, at which point they will move all the way up the chain-of-command, chasing that high, until they are shooting enough fentanyl into their arm to kill all of Pyongyang. Trust me, I lived in Pyongyang for years.

Remember that bitch-ass snowstorm I spoke of earlier? The more proper, professional term is withdrawal, or dependence. The problem with opiates and opioids is that not only are they psychologically addicting, they are physically addicting as well. Allow me to explain(class is in session pt.2).

[Endorphins] are the brain's natural pain killers and act as our front-line defense to depression, sadness, and injury.

Our brains have naturally occurring opiates called endorphins which are released when positive experiences take place, I.E.- laughing, sex, singing. This is the brains way of incentivizing us to continue said experiences, which are necessary for our survival. Our brains are wired to survive, at all-costs. Sex, food, relationships- these are essential for our survival as a human race, so naturally, our brains want us to continue partaking in these positive experiences. Think happy chemical. You most likely experienced an endorphin rush in the form of vivacious laughter when you saw that President Biden is running for a 2nd term(come on bro). In all seriousness, endorphins help us cope, they block pain, and are absolutely balls-to-the-wall crucial for our existence. When we lack endorphins in our brain(due to many different circumstances), we experience depression, sadness, and become a hollow shell of who we once were. So, next time you have a season of utter grief, inner turmoil, and cant seem to shake that dark cloud hovering over you- you're not crazy, you're just lacking necessary chemicals in your brain. So, what happens when we ingest opiates/opioids? Once again- lets hit the classroom.

[Nerve Opiate Receptors] can't tell the difference between actual naturally produced endorphins or artificial opiates. Although structurally different, they attach to the same areas of the brain as endorphins.

When someone pops an oxycodone, or shoots heroin, that chemical binds to opiate receptors in the brain- the same receptors that endorphins bind to- hence why endorphins are the brains natural opiates. The two, although structurally different, are incredibly similar and the brain can't distinguish the difference from them(imagine a near Identical twin). When a synthetic version of endorphins or anything for that matter is introduced to the brain, the brain quits producing its natural supply of said chemical because all it knows is that said chemical is already "doing its job", so no need for anymore. In essence, the brain is being tricked, which leads to some dangerous and painful repercussions- enter physical dependence.

If I put 10 people in a room, shot each of you up with heroin every day for 30 days, then at the end of the 30 days, removed the heroin, telling you to go home and let me know how you feel the next day- 10 of you would report feeling like complete dog-shit, and a few of you would probably already be banging down my door threating to kill my family if I didn't shoot you up with more(ok that's probably a little dramatic, but you catch my drift). Point being, once our body halts its natural production of endorphins, once that synthetic version is also halted, now our body has NO endorphins(real or artificial), which leads to the painful symptoms otherwise known as withdrawal. Remember I said our body craves and needs endorphins in order to survive? That's still a very real thing, so on top of feeling like a mannikin crash dummy for Ford Motors, we also feel like we're going insane, completely freaking the fuck out. This is our body's physiological version of, "Oh shit bro, we're in trouble!". Now, imagine if you shot heroin for decades, or popped pills for years, you can start to see how one might have a hard time getting through that detox phase not to mention staying clean all-together. When we train our brains to live a synthetic way of life, our brain's adapt, and forget our past natural way of living. This is where you see people pawning their vacuum cleaners, robbing pharmacies, selling their bodies, etc. Its actually quite horrific to experience.

[Opiate/Opioid Withdrawal] symptoms emerge 6-8 hours after last use, peaking at hour 72, then slowly subsiding over the coming weeks. Depending on which opiate/opioid used, some symptoms last well into the following months(Buprenorphine, Methadone), while some subside rather quickly(Fentanyl) due to their shorter chemical half-life.

I'm sure their is a nay-sayer or two out there who are currently shaking their head right now saying, "Bull-shit, those junkies are just weak." Well, check me out Gomer: lets hook you up with heroin straight to your veins everyday for 30 days, then after a day or two of abstinence, if you still hold that belief, I will get a tattoo of a big penis on my forehead(that's fair bro). I'm quite confident I will emerge victorious. Not to be mean or condescending, even though sometimes I love to be, if you have never been there, just shut the fuck up already(with love). That's like me calling my pregnant sister today and schooling her on what to expect during the 3rd trimester of her pregnancy. No amount of reading, listening, podcasts or even observing, can come close to understanding what it feels like. Let me ask you this, when was the last time you robbed your family members or a complete stranger because you were out of Lucky Charms Cereal? What about the last time you walked 15 miles in the pouring rain to buy some Pepsi? These are crude examples, but they do have some value nonetheless.

[Nancy Reagan] coined the famous phrase "Just Say No" to drugs, during her and her husband's, President Ronald Reagan, War on Drugs.

Physical dependence to opiates/opioids

is no joke. Imagine having the worst flu you have ever had, accompanied with crippling depression, shame, guilt, along with bizarre emotional and mental reactions teetering on manic insanity. Hands down, withdrawal is one of the worst feelings one can experience, at least in my experience. Detox is an actual medical condition and if one has the resources, should be conducted in an in-patient or hospital setting. Unfortunately, most people don't have those luxuries. Opiate withdrawal by it-self isn't lethal, however one will have moments where the feel like they are going to die, especially newcomers. After you have been through it a few times, or thousand in my case, it becomes an ever impending doom waiting around the corner of every waking moment one is not using, in my experience.

Thankfully, modern medicine has found ways to combat withdrawal symptoms, some removing them nearly all-together, if done "right", incredibly limiting one's discomfort during detox. If you are someone who stands up and advocates for cold-turkey, quit bitching, sit-back and enjoy the madness in efforts of proving to yourself that you never want to go through this again rhetoric- please sit your ass down, just sit down Cletus. What those people don't understand, is someone is incredibly vulnerable at this point and half-way through detox the inevitable, "Fuck this shit" voice will emerge, at which point most addicts are going to do anything they can to score some dope in order to gain some semblance of relief. Unfortunately, this is where people forget they have a drastically lowered tolerance and die from ingesting the same amount they used to when they were full fledged using. Trust me bro, detox IS NOT the time to get all John Wayne gung-ho about this shit. Save that for when you are completely sober.

Four remedies exist for opiate/opioid withdrawal, two of which are approved by the FDA:

[Suboxone] brand name of Buprenorphine/Naloxone which is used mainly in detox settings as well as maintenance programs for opiate detox.

1. Buprenorphine(Suboxone)- Buprenorphine is a partial mu-kappa receptor agonist. Pound for pound, it is 37X stronger than morphine, HOWEVER, due to it being a PARTIAL agonist(slightly stimulates the receptors)- someone with a severe opiate/opioid dependence will only gain relief from withdrawal symptoms, it will not get them high. A non-addicted person will get sick AF and might die from it. Bupe is available as a detox as well as a maintenance tool. When taken for detox, it's usually administered when initial withdrawal symptoms emerge, then is taken in a tapered dosage for anywhere up to a week. This does not mean said person gets off "scot-free" however. There is a rebound effect in which the detoxer will experience mild withdrawals, but in my experience it is damn worth-it. Used in detox, Bupe is a god-send. It is also available as a maintenance tool, meaning a replacement for your addiction, taken daily for a year then slowly tapered down, in order to give someone a "respite" from hard-drugs, without completely freaking out the physiology of their brain. Also, in my experience, this is a horrible decision. I would never advise someone to get on long term Bupe outside of detox. Due to the drug's incredibly long half-life(37 hours), the withdrawals one will certainly experience after quitting Bupe will end up being worse than the original symptoms they are treating. Do yourself a favor, don't go the maintenance route.

[Methadone] syrup which is strictly dispensed at local clinics daily to addicts who are trying to kick their serious Heroin habits.

2. Methadone- Oh methadone. Methadone was initially the only tool we had to treat opiate/opioid dependence. It is a full mu-kappa agonist(just like heroin) and is used exclusively for maintenance. Essentially, insert opiate/opioid of choice is replaced with daily doses of methadone, the idea being that having some stability away from hard-drugs, while keeping your brain's nagging craving for dope at bay, will result in a better quality of life. What most don't understand is that, methadone is no different from any other opiate. Its just a cleaner, regulated version. It is doing nothing to further your sobriety, its only keeping it at bay, for the moment. Inevitably, someone will have to increase the dosage, which will lead to further dependence which will lead to the same conclusion that any other opiate/opioid will. If you ever want to get off of Methadone, take Heroin withdrawal and times it by 10X over 3-6 months. Its mind-boggling how this is even an option. Unless you have an unlimited supply/resources to acquire methadone, and plan on staying on it the rest of your life- stay away, run for the fuckin' hills.

[Kratom] also knows as Mitragyna Speciosa, is a plant native to Southeast Asia, which has been used for thousands of years as an herbal replacement for other opiates.

3. Kratom- Kratom, Mitragyna speciosa, is an herbal leaf from a tree of the Rubiaceae family, a tropical evergreen tree in the coffee family native to Southeast Asia. It is a naturally occurring leaf which has been used for thousands of years(outside the USA). Kratom has opiate qualities, in that it does stimulate some of the same receptors as other opiates, although rather lightly. Kratom gets a bad rap because most people are uninformed, and have never tried it themselves. As one can imagine, pharmaceutical companies make billions a year off of Suboxone & Methadone. Without insurance, a prescription of each will cost you $1000 a month for 30 doses. In return, you get everything negative symptom we have spoken about above. Kratom on the other hand, costs $10 an ounce, is readily and widely available in retail form(unregulated by the FDA), and would run you roughly $80-150 a month depending on your tolerance. Kratom is naturally produced, poses dramatically less negative symptoms as Bupe/Methadone, is way more sustainable, and is 1000X easier to come off of in the future. I have experienced this as well. But, the last thing Perdue Pharma(assholes) wants is a healthier, less addictive substitute for their cash cows Bupe/Methadone. See what I mean? In my well-versed opinion, Kratom is the way to go- hands down, any day of the week.

[Loperamide] brand name, Immodium, is an anti-diarrheal medication that if taken in large enough quantities, can provide addicts in withdrawal some relief. However, it is incredibly dangerous and should be a complete last-resort.

4. Immodium- Yes, diarrhea pills. Immodium, chemical name Loperamide, at its core is actually a strong opioid-like chemical, believe it or not. The problem is that this chemical has an incredibly difficult time crossing the Blood-Brain-Barrier, something that is needed for psychoactive effects, so in normal doses, no analgesic effects are felt. There is research to suggest that if one could manage to coat loperamide in some type of polycarbonate-80 substance, this would unlock the blood-brain-barrier issue but lets be honest- who the fuck has time for that. However, all my hardcore junkies out there know that when taken in mass doses, I'm talking upwards of 100 pills(totally safe bro), enough of the active ingredient is essentially forced through the blood-brain-barrier, giving someone a little bit of detox relief. I can say with certainty I have tried this and it does work. It is nowhere near as effective as Bupe, Methadone, or Kratom, but sometimes we are stuck with having to improvise, at least I was. However, DO NOT DO THIS. Its fuckin stupid. Its easy to overdose on, it can send you into immediate cardiac arrest, and the best part, you won't shit for a week. Just go buy some kratom, please. Don't do it.

In closing, opiate/opioid withdrawal is a bitch any way you cut it. If you play the game long enough, you will experience it, likely more than once. Whether you are detoxing from heroin, morphine, methadone, oxycodone, or fentanyl, just know- it will eventually end. You don't have to go through that ever again. Give yourself every chance to succeed, whether that means in-patient treatment, hospitalized detox, or if those are not an option, find someone who can take-care of you while you go through it. If you are able, don't go through it alone. Your body will be screaming for a dopamine release, so go buy massive amounts of sugar, eat high carb sugary foods, find a place on your couch and watch netflix. Don't burden yourself with jumping into recovery just yet. Allow yourself the chance to get physically well first, then, once you attain that, jump full-force into recovery. Or, go out and do some more market-research. Dope ain't going nowhere.

[Spencer Brooks Otto] 2023

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