I will not do this
It's just another day at work—a beautiful day, in fact—the kind where you find yourself looking longingly out the window every few moments wishing you could enjoy just a bit of the clear, crisp fall weather before it fades to the inevitable bone-chilling damp cold of winter. The bright, spacious sun room I am perched in offers a glimpse of what I am missing outside: sun-dappled orange and yellow leaves, just a hint of a fair breeze, a pure blue sky with only the faintest wisps of clouds overhead.
I am fortunate to have a job as wonderful as this one. The cozy group home where I work is meticulously geared toward making this environment a happy, safe, and comfortable one for the people in its service. It is a quiet day here--though of course one knows better to say such a thing out loud--and I have the time to pore through a large drawer of medications waiting to be wasted.
I am fortunate to have this job for another reason. Nearly four years ago I reported myself to my employer at the time, and to the board of nursing soon afterward, for a devastating struggle with prescription medications. It crept upon me insidiously, worsening when I made the decision to quit drinking. Alcohol abuse was present in my family and I had recognized in myself a difficulty controlling my drinking, which was becoming more frequent. I unsuccessfully tried my hand at "social drinking." The phrase, and indeed, the concept entirely, is a bit humorous to me. Like many alcohol abusers, I don't really understand why anyone would choose to go out to a restaurant with friends and just have a drink or two. For the taste? Soda tastes good and doesn't cost $5 per serving. As a social lubricant? I certainly found myself completely unable to hit that sweet spot between relaxed/charming and completely embarrassing myself. My kids were getting older, and I didn't want them to be tormented of memories like the ones I had of my mother while binge drinking: wetting her pants, falling down the stairs, begging for her car keys so she could drive home, all the while barely able to stand. I was done. No more drinking for me.
The best thing about giving up drinking was that it was incredibly easy. I never really liked the taste, and I certainly was glad to know I would not be suffering anymore hangovers. The problem that I didn't recognize at the time was that I had grown accustomed to treating myself to a slew of alcoholic beverages for the most mundane reasons: I had a hard day at work, I was stressed at taking care of the kids, I was bored and doing dishes was more fun with a buzz. I wasn't really ready, or even equipped, to deal with the stress or boredom. It was far too easy to fall into using medications to create that false sense of comfort and ease. A lack of secure med management at my place of employment meant an easy and guilt-free pipeline to a bevy of discontinued meds, untracked until they were discarded. It was far too easy to talk myself into just taking this or that here or there rather than just throw it away. What a terrible waste, after all.
Ultimately I knew that my problem would catch up with me. I pondered reporting myself to my supervisor or seeing a therapist for advice. I wanted to tell my significant other so badly, but did not want to feel the judgment and shame that I would certainly be subjecting myself to. It was far easier to just keep sneaking, and keep hoping. I had not nearly reached the depths of how bad I could envision my problem becoming when I made the decision to report a diversion to my boss. It was the hardest thing I had ever done, and I was rewarded for stepping forward by being fired less than a day later. Suddenly it seemed I had lost everything.
It is agonizingly difficult for nurses in recovery to find jobs. The stigma from those both in and out of our field is unmistakable. Nurses are often the ones on the front lines who deal with addicts, yet the judgment cast on us is incredibly harsh. We are the caregivers, we are the gatekeepers to wellness, we are the ones tasked with pulling someone from the depths of unbearable pain and loss into the hope of a new beginning. How can we be expected to do so when we are sick--when this flaw, this failing, is marbled through us?
I am fortunate to have found this job. I am fortunate to be given the opportunity to rebuild myself and begin anew in sobriety. Every day I am thankful that I am still an RN. I am fortunate enough to have been hired by a woman who, when I looked her in the eye and told her I took medications, said, "It can happen to anyone."
Today none of these things are on my mind as I gather up medications waiting to be wasted and sit down on the mat table in that bright sun room. A bottle of Tylenol that was never used. A prevacid that fell on the floor. A whole bevy of compazine suppositories that have sat in the med fridge for months. My mind wanders as I pop the medications into the coffee container filled with cat litter, thankful that my day will end early enough that I can spend the afternoon out playing in the leaves with my kids when my shift is finished.
Suddenly it all changes.
The next medication in my pile is a card of tramadol.
Tramadol. I freeze.
Tramadol is a medication that I remember very clearly. The soft, sweet euphoria of this pill is burned into my mind forever. Whatever flaw it is in me which makes me brain think that it NEEDS these things, it is still there. It was hidden until this moment. Suddenly all I can think about is the high. All I can think about is how long this blister pack of medications would last me. 58 pills. 58 whole pills. No one else cares about this blister pack. Whether it goes in the trash or slips surreptitiously beneath the jacket lying next to me on the mat table, no one will know or care. But I am being monitored by the state to prove my safety and sobriety. I can't take these pills. Not today. Not yet. My contract is up very, very soon. In just a few weeks I won't have to worry about random UAs, about whether the state will be aware that these pills are floating in my system. I can take these with me and no one will know.
I can't say how long I hold this blister pack in my hand. It feels like an eternity. I am acutely aware of every sensation in my body at this moment. My heart rate has quickened, thinking about the euphoria at my fingertips. Thinking about the risk I am willing to take to have this feeling. Thinking about how I can get away with it. I can, I know I can.
But I will not.
I tell myself this. I will not do this. I can't start all over. I can't give up everything I've worked so hard to prove these last few years.
No one will know.
It isn't a voice. It doesn't say this to me. It imbues its influence in me. I suddenly and intensely feel it in every fiber of my being.
No one will know. It feels so good. You want this. You need this.
My hands begin to shake. I feel suddenly as if a bucket of ice water has been poured on me. The happy, chipper sounds around me of staff making small talk with one another in the rooms around me have drained away in a whirlpool of oblivion. It is just me and these pills. These pills, to which almost every part of me is screaming out...you must have these.
I will not.
I punch the medications into the waste container as fast as I can. Normally I would take a collection of pills such as this and pulverize them first, making sure that the powder and litter granules are interspersed sufficiently that no one, in their right mind or not, would be able to pick through for the remnants of medications. But I want these out of my hands, now.
One pill, POP.
You can still stop.
Two pills, pop.
There are still plenty left.
Three, four, five...pop, pop, pop.
What are you doing? You're wasting them. What if you need them? What if you really need them? You can still stop. Stop. STOP.
I pop them as fast as I can into a pile in the old coffee grounds container. They lay in a neat little pyramid in a putrid mess of leftover cough syrup, cat litter granules, suppositories, and split-opened capsules.
They're all sitting on top. You can still get most of them. Only a few were really wasted. You can still get them.
I pause for just a moment before I pick up the container, seal it, and shake it. I can hear the granules and syrup coating the pills, making it into a sloppy, disgusting mess. I know I will not open the container again. It's over. I won.
I don't feel victorious, or triumphant, or anything but sick and scared and small and vulnerable.Last edit by Joe V on Nov 14, '13
Nov 14, '13 by sunshyne17Wow...That was so emotional and beautiful and heartfelt. Tysm for sharing.Nov 14, '13 by mortewhat do you take for an AD? I suspect that is the effect of the tramadol that you are missing.Nov 14, '13 by BCgradnurse, MSN, RN, NP GuideI admire your honesty and your courage. I wish you the very best.Nov 14, '13 by Conqueror+, BSN, RNWow. I would have to get a desk job if I went through that level of struggle in my daily work. Kudos to you.Nov 14, '13 by jwheeler7791, ADNWow. That was very powerful and moving! Thank you for sharing your struggles.Nov 14, '13 by NurseDirtyBirdThe stigma of drug addiction is probably worse than that of other mental illnesses. While mood disorders and others can be treated with medications and the sufferer can lead a fairly normal life, once someone is stamped with the word "ADDICT" on their forehead, they are seen as hopeless and often dangerous cases. I applaud your strength, your willingness to do the right thing (self-reporting and resisting temptation), and your honesty in the face of all that. I'm very happy to hear you found a sympathetic employer as well. Good luck to you!Nov 14, '13 by VivaLasViejas, ASN, RN GuideWhat a powerful article! Thank you for telling your story of honesty and integrity at a time when there is precious little of either in public life. But I respectfully disagree with your last sentence, because you are much stronger than you realize and this IS a victory!Nov 14, '13 by RNfasterI'm glad for you... Compelling story. --I am a little confused, though. Wouldn't narcotics wasting/destruction require a witness? If for some reason it doesn't, given your history, I would use a witness. --I'd even use a witness without any abuse history...it just seems prudent given the stakes.Nov 14, '13 by VivaLasViejas, ASN, RN GuideTramadol is not a controlled substance, though it has CNS depressant qualities.Nov 14, '13 by nurseprnRNQuote from VivaLasViejasTramadol is not a controlled substance, though it has CNS depressant qualities.
And is habituating and addicting.
It is a controlled substance in several states.
"Tramadol is not a federally controlled substance in the United States; however, Arkansas, Kentucky, Illinois, Mississippi, New York, North Dakota, Oklahoma, Tennessee, West Virginia, Wyoming and the U.S. military have classified Tramadol as a schedule IV controlled substance under state law. Other states have legislation pending concerning scheduling tramadol." Tramadol - Wikipedia, the free encyclopedia
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