Up until one night in March of 2004, Randy, 37, considered himself a pretty normal person. He grew up in Philadelphia. He studied Computer Science with a business emphasis at Temple University. He partied in college but nothing too out of the ordinary. After graduation he settled into the routine of many urban twenty-somethings: he had a good job, he was dating someone, he partied with his friends a couple times a month.
On that night in March of 2004, when a friend offered him heroin, his first response was, “you’re out of your mind, you’re crazy,” Randy told me. But hours later, after some drinks, he reconsidered and made a mistake that changed his life. “That night led to basically this whole debacle…seven years of on and off opioid use.”
For many people, opioid dependence can creep up like a slow-rising tide. It can begin with a prescription, and then finding yourself in withdrawal when it runs out. Or maybe it’s a few pills when partying, then a few during the day for energy, and then it becomes every day to stave off withdrawal. A 2012 study found that 86 percent of the young heroin users they surveyed began with prescription opioids. But for some, like Randy, it happens overnight.
For the next seven years after becoming addicted to opioids, his life steadily became unrecognizable to him. “Looking back on that, like, you are not who you’re supposed to be. Like at that time I was a different person.”
He eventually lost his job, then he was arrested and went to prison. He stopped using while he was in prison but a few months after he got out, he relapsed. Then he tried going to rehab, two different times, but both times he relapsed within a few months. The relapse rate after inpatient treatment for opioid use (without medication-assisted treatment) is higher than with any other drug, with studies showing 80 to 91 percent of people relapsing, most within the first week.
Each time he left treatment, Randy said, he was committed to kicking heroin for good. And each time, he found the cravings overwhelming. “Getting clean is easy,” he told me, “it’s staying clean that’s not easy.”
Finally in December of 2011, he reached a breaking point and started looking for something beyond traditional rehab. “I just decided I can’t do this anymore,” he said. “That’s when I started looking at different options, I started looking into medication-assisted treatment.”
After years of trying to quit only to end up back in the same position, at first he was skeptical of Suboxone. “When I started, I didn’t think it was going to work. I thought it was going to be the same thing,” he said. But within the first week he noticed the difference. “Suboxone was a lifesaver. It stops your withdrawals, it stops your cravings, and allows you to live your life without having to chase a drug.”
He began to rebuild his life as the one he’d envisioned for himself before that decisive night in March of 2004. “All and all, it just started the process of me being able to change my life. Suboxone gave me that start, like a safety net.”
Three years ago Randy tapered off of Suboxone successfully, after six years of medication-assisted treatment. “I still have bad days, like everybody,” he said, “but my bad days now are nowhere near as bad as they were then.” His advice to anyone struggling with opioids: “I think the most successful way is medication-assisted treatment, without a doubt, and I tried it all.”