Rapid Detox
By Jessica Robyn

I might be a little on the naïve side. My dad didn't really marry that bitch; my ex-boyfriend doesn't ever like other girls; Pop-Up Videos will be back someday. And detox? Rehab? Withdrawal? It's all in a Saturday morning spent on my futon, Gatorade and aspirin at my side, curtains drawn, watching On-Demand and cursing Molson triple-X. Every once in awhile, however, I get a stabbing reminder ignorance doesn't guarantee bliss. I've seen the wedding pictures; I've heard about the thing he had with the bartender; I've watched Best Week Ever. And, upon being asked to check out the local methadone clinics for the magazine to see just what rapid detox was all about, I had the unwelcome feeling that I was again about to swallow another unpleasant spoonful of reality - something I generally have little patience for. I reached for my box of crayon-colored Nat Sherman's. I'm not a smoker; the first half-pack of cigarettes had lasted me nearly a week. I wondered whether the second would last me through the day.

I called the Health Department and asked for the numbers of relevant local clinics, as well as any information about heroin withdrawal or rapid detox that they could give me. I was given neither, only a number for someone who supposedly had what I was looking for. Dialed it; same response. (And this one was rather rude. Bitch.) Dialed that number, got the numbers for five local centers, but no direct information. So far, I was half-way through a jade-colored cigarette, smoked more out of frustration than nervousness. Maybe this wouldn't be so bad. I picked up the phone again.

Two of the five centers were closed for the day (one of them closed at 1:45 each afternoon, or so said the recording; who does that?). The remaining three refused to talk, regardless of my shameless attempts at charm, wit, and proverbial dick-sucking. Not much for media coverage, eh? Undaunted, I flicked around on the internet to see what info I could find - more clinics, national hotlines, articles. Finished the green, finished a pink, and started working on a blue when I tried calling the clinics again. Got the same reaction from two of them - one asked me not to call again. Why wouldn't they talk? What did they think I was going to expose, unearth? I've got dirty little secrets too, but I at least converse with the people who fucking call me. Discouragement was setting in; if I couldn't get anything out of the receptionists, I was never going to learn anything from the people administering the actual treatment, much less the people being treated. I was pissed; I was on a mission, and these people were making me fail. I had one center left to redial. I never called.

___

The Narcotics Anonymous meeting was held in the basement of a Baptist Church in Western Maryland . Pittsburgh has its own local chapters, but after the trouble I'd already had, I wanted to see what was available in some other neck of the Allegheny woods. Plus, I had a friend at my old university who volunteered at these things. At the very least, I was hoping she'd up my comfort level; I was still apprehensive, and I was running out of cigarettes.

I got lost on my way to the red brick building, and got lost on the inside (ironic when you realize that the people coming are looking for guidance and direction ) but finally wandered into the room where the meetings were held. It was painted a pallid and sickly green, the same moldy color that will forever remind me of an elementary school gymnasium. I read once that they use the color in public buildings because it induces a sort of calm. Upon entering the room I decided that was bullshit. What was I so uneasy about? Fortunately, the only other person there so far was my friend Becca, an undergraduate social work student doing her senior thesis on drug intervention. We had some time to kill, so I told her about the trouble I'd had back in Pittsburgh - no one wanted to give me any information. On anything.

"I'm not too surprised," she said, taking a red cigarette out my box and lighting it. I followed suit. (When in NA, do as the...) "Rapid detox has only been around for about 15 years, and has only been in its present form for less than half of that. It's still a young treatment. And as is the case with most medical procedures still in their adolescence, it's surrounded by a lot of controversy. A lot of places shy away from interviews and media attention because they don't think any good will come of it. Either their center participates in rapid detox programs, and they don't want any criticism for doing so, or they don't offer it, and they don't want any criticism for doing so. These are people who do what they do because they believe in it and want to help; they don't want their names or faces attached to any sort of stigma. They practice a different kind of medicine; it's not about money and attention and trying to attract more patients."

And I can understand that. Except for her comment about the money - at about $15 grand a pop, someone's certainly raking it in, and I doubt it's the receptionists - most of what she had to say fell in line with what I had read. Rapid detox is essentially just what it sounds like: Literally, a quick fix. A heroin addict attempting detoxification opts for an intravenous blue chemical cocktail of naloxone (an opiate blocker) and anesthesia to inhibit the body's ability to be further affected by the drug (a permanent result, if the patient follows up with a daily dose of naloxone, in pill form, for a year). Simple enough, yes? The procedure itself takes less than half an hour; recovery, no more than a weekend. This, in contrast to classic cold-turkey, wherein an addict suffers pain, depression and some GI turbulence - sometimes for a matter of weeks. I worked things out in my head - a little pain (and excuse me if it sounds like I am belittling anything here) for a couple of days, versus veritable hell for the better part of a month. And the problem was.?

"Eh, you know. some law suits back in the early days, ethical questions about whether it's right to speed up a natural withdrawal process so quickly, the matter of the cost." Becca didn't seem to have much more to say about it, and I didn't have time to ask. Becca's weeknight crew had arrived. It was meeting time, and what was more, it was cigarette time. I lit a gold one. Seeing their faces made everything very, very real. We weren't talking about addicts, anymore; we were talking about people.

Eh-hem. Sorry.

Aside from Becca and I, there were only four others in the room. Two non-descript, blue-collar, blonde-haired, twenty-something guys in work boots, ripped and paint-adorned jeans, and t-shirts who we'll call Keys (because he couldn't let go of his all meeting) and Boner (because he couldn't let go of his all meeting). There was Mama, a pregnant woman of indeterminable age whose stringy grey hair made her look much older than I suspected she really was. She was soft-spoken around the bubbly sorority girl who I recognized from a class I had taken when I attended the local university. I sat hoping she wouldn't recognize me, although it didn't matter; Becca introduced me, and told her four faithful attendants why I was there, and that the first half of the meeting would be devoted to my questions, should they feel comfortable enough to answer them. I thought they'd be disgusted, nervous, angry. I expected the blonde to leave; old friends aren't people you hope to see in rehab. Surprisingly, it was the sorority sister (I'll call her Delta) who had the most to say to me - for better or for worse.

Of the four there, only the two women had gone the rapid detox route; Delta, twice. The boys had each quit cold-turkey - Keys had been clean for two months, and Boner for four, but had quit a total of three times in as many years. All of them had been addicted to OxyContin.

Since rapid detox was of the most interest to me, I dove right into the subject; however, before either of the girls could speak up about their experiences, Keys caught me off guard. I hadn't expected him to have much to say, so I only gave him half of my attention - at first.

"I wish it wasn't so fuckin' expensive," he lamented. For such a primitive sentence, my attention has never been so commanded. The guy had presence, and passion, and pain. I liked it. "I quit, just quit, all at once, on my own, because I couldn't afford that detox thing. It was hell. Nothin' has ever hurt so bad. If I could go back and do it the easy way, I would, but hell - $14 grand? Something like that. shit I'm lucky if I make that in a year."

"Sure, it's a lot," Mama said quietly, looking down. "But it was just so, so worth it. I feel like I can do anything now. I feel brand-new. I feel almost scared, because I don't know what life is gonna be like without the drugs. I'm wandering into some real unfamiliar territory." I could certainly relate; my nerves had yet to subside. "But when you think about it, it's $14 or $15 thousand dollars for the rest of your life."

"Exactly." Delta was joining in. "It's not about money; it's about freedom from the Oxy. Whatever it takes, you find the money. It's just something you gotta do." I ask her where she managed to scrape up $30,000 - remember, she'd done this twice. "Oh. My parents. But I mean, still; to them, it was just something that had to be done. If I ever needed it again, I'm sure they'd do the same thing for me. You can't put a price on your life, you know?" Keys and Boner make some barely-audible noises of disgust; a part of me can't blame them. Boner sulks down into his seat and quickly slips his hand over his erection; I pretend not to notice. I ask what the rapid detox itself was actually like. I didn't want to hear about Daddy's money any more, and I didn't think that the guys who couldn't afford a rapid detox session of their own had much interest in the story, either. Mama interrupts Delta's attempt at answering my question; I'm amused. Thatagirl.

"They put you under, so you don't remember a whole lot. When I woke up, though, it was the first time in forever when I wasn't dying for a pill. I kept waiting and waiting for the urge to come back and I kind of still am. I know it won't come back, as long as I keep taking my [prescribed] pills, and I've still got two months left. it's still strange to me." I want to ask whether the naloxone pills have any projected effect on her unborn baby, but I'm not comfortable enough to. I shouldn't have hesitated; Delta jumps at the pause in conversation to speak. I almost interrupt her but change my mind - why am I being such a bitch? This is her story too, and without hers, I wouldn't have mine. I try to tolerate, try to listen.

"The first time for me was like that, too. I kept wanting to want one [an OxyContin] because it was just what I was used to. I mentioned that to my nurse or my caretaker or whatever the hell those people at the clinic are, and she just laughed. She said I should be thankful. The second time, though, was a lot different. I was in a lot of pain. And I kept wanting an Oxy, but I don't think it was because I was still addicted; I think it was just because I knew it always made everything feel so freaking good." I wonder if the pain is common in repeat-rapid detoxers. No one has an answer for me. Boner mentions that a friend of his reported a dull ache after his treatment, but he'd only done the rapid detox once. "No," Delta interrupts. "This was no dull ache. This was like all of your bones were swelling or on fire or something. It fucking hurt ." It was the only time in the entire meeting when she made a comment without a smile on her face. Keys mutters, "Now you know how we felt," glancing at Boner before looking back at her. "A little."

And what about NA? Did it help? What was the first time like? And how could they be so open?

"I wouldn't have been able to stay clean if it weren't for the NA," says Keys. "I don't have any of those follow-up pills the rapid-D people've got, so I need something. And it's this, or the OxyContin."

Boner agrees. "The first time I tried to quit, I didn't go to any meetings or anything. I think that's the reason I went back to the pills in the first place. But now, with the meetings and [Becca] and the rest of the group, I'm doin' better. Hopefully I'll stay better."

"It definitely helps, even with the naloxone, the meetings help. But it was tough to come in here for the first time." Delta's saccharine smile is back. "I'm so young, and I'm not local either - I felt like I would feel so alone. But then you realize that everyone's got the same problems as you, and age or hometown don't matter anymore. It's a matter of support, and there's a lot of it here." She's like a poster child for this. Her gushy praise for the meeting makes everyone noticeably uncomfortable; fortunately, Mama speaks up in the squirmy silence.

"Of course it helps. And of course it was scary coming for the first time. But new things always are, and they don't usually turn out to be that bad. Just like going in for the detox made me nervous, coming here on the first day did too. But hey, 'no pain, no gain,' right?"

Becca calls for a break; the first hour is over. Most of us head outside to smoke. (Why we chose to stand in the rain when smoking was allowed in the building is unclear, but I blame that fucking green paint). The first hour had raced by - surprisingly - and I felt like I had so much more to say (or really, to hear). I know they've got business to get down to, though, and I don't want to take up any more of their meeting time. I fish out my keys and my box of cigarettes. Only one left - a pink one. I ask to borrow Delta's lighter.

"Oh I love those cigarettes. I smoked, seriously, like half a box before I came here for the first time, I was so shaky and nervous. Scared of that , can you imagine?"

For the first time all night, I don't hate her. Another choking dose of reality - this girl and I aren't so different. Both a little green on the vine, but sometimes more scared of it than we should be. I remember the empty box of designer cigarettes in my hand and laugh. "Yeah. I can imagine."