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Opioids in America, Part 2: Faces of addiction

Greeley Tribune - 10/25/2020

Oct. 25--Editor's Note: This is Part 2 of a three-part series looking into the opioid epidemic across the U.S., rehabilitation options in Weld County and stories from people who have overcome or are currently fighting addiction to opioids.

Hopping out of his van in front of the Greeley Tribune office, Nathan Pierot greets me with a big smile on his face and carrying a small black plastic toolbox in his hand.

The toolbox, secured with a lock, holds Pierot's methadone.

Methadone is a synthetic analgesic drug that is similar to morphine that reduces the cravings for opioids and withdrawl and blocks the effects of opioids, according to the Substance Abuse and Mental Health Services Administration. Methadone is approved by the Food and Drug Administration and has been deemed as safe when taken as prescribed.

Setting the box on a table, Pierot digs in his pocket for the key. Pierot flips the lid open to expose several small bottles --some empty, some not --containing the liquid that is helping him overcome his addiction to opioids.

Pain equals pills

Like many people addicted to the pain medications, Pierot, 43, got hooked on the drugs after being prescribed the medication for a foot injury he sustained. Pierot also experienced chronic pain from back and knee injuries he got when in the Air Force.

During the time he was prescribed opioids for pain, Pierot was coming off an addiction to methamphetamine.

"I had a set prescription, and it was a fairly low amount," he explained. "My therapist knew about it, my doctor knew about my meth addiction and we all worked together to keep a watch on things."

His prescription began to increase after a couple of months.

In addition to the chronic pain he had in his back, foot and knee, Pierot had PTSD, depression and anxiety, which once the rules for prescribing opioids changed, labeled him as a high risk for addiction to the drugs.

"I was taken off of those opioids immediately. I walked in to refill the prescription and was told 'this is your last prescription; we can't fill you anymore,'" he explained. "And then that was it. The best thing they could offer me was a referral to a pain management clinic which had a three- to six-month waiting list."

While the laws surrounding how opioids could be prescribed were changing, the government and Centers for Disease Control and Prevention (CDC) did little to nothing to educate doctors about the addictive dangers or how to get their patients off of the drugs.

"I was given no information that it could be addictive within two or three doses. You can be addicted to opioids after taking two pills," Pierot said. "The way that the drugs react with the endorphins in your brain is almost immediate. After taking them for weeks or months, if you stop taking them, you get physically sick."

Sweats, chills, muscle aches, cramps and vomiting are some of the effects of opioid withdrawals. Pierot compares it to being sick with the flu, but at a severe level of the flu.

In addition to physical withdrawals, the brain also goes through withdrawal from the drug through emotional upswings and drops.

"Linear thought is really hard. There's no doing algebra when you are withdrawing from opioids; there's no solving for x. You can't even make a shopping list because you can't think," Pierot said. "So you need to take your pill in order to get your body and mind in a position where you can live your life."

Not wanting to experience withdrawals, Pierot started buying pills on the street from people who had prescriptions, with the hopes of being able to wean himself off of the drugs.

"I did meth for five years and walked away cold turkey, but withdrawals from opioids were so much worse," he said. "Opioids, after a year and a couple of months taking the prescription, I needed a doctor's help to quit."

That help came in the form of methadone.

On the road to recovery

In the beginning of his recovery process, Pierot had to go to the clinic every day to get his medicine. The process, combined with therapy, phases patients up to where they eventually get to take a bottle home, then two bottles, then three, etc.

"Everybody is there for the same thing and the staff is upbeat and supportive," Pierot said. "You get better and they help you get a life back."

Pierot has been going to the clinic for nearly two years now and goes in every two weeks for his medication.

"They give me all my little bottles and I have to keep them in this little box with a padlock on it," he said. "Anytime they can come and check me and I have to turn in my empty bottles every two weeks."

The father of five kids, ranging in age from 13 to 21 years old, Pierot celebrated his 17th wedding anniversary this year.

"Because of those treatments, I'm not chasing drugs anymore," he said. "I am very lucky to have the support of my wife, my pastor and friends. My mind is much clearer now and my body is getting healthier all of the time."

While some people are able to get off of methadone, Pierot said he will probably have to take the medication for the rest of his life.

I have a pretty addictive personality," he said. "I'm pretty sensitive, and that's why I am on such a low dose. I take 48 milligrams, but I've talked to people who take 200 or 250 milligrams. So I am on a really low dose."

Lift the Label working to end the stigma of opioid addiction

Pierot is part of Lift the Label, a Colorado organization that works to change the views and stigma around opioid addiction. The organization's website features dozens of stories and videos from people addicted to the drug as well as the stories from their loved ones.

Jefferson County District 22 Senator Brittany Pettersen is featured alongside her mother, Stacy Pettersen in one of the videos. Brittany Pettersen talks openly about her mother's addiction to opioids and how it affected her and her siblings growing up.

"I was six years old when my mom had her back surgery and was prescribed opioids," Brittany Pettersen explains in the video. "My brothers and I have so much pain around thinking that our mom was choosing to do these things."

"I did whatever it took to keep my prescription going," added Stacy Pettersen.

Alongside Pierot, Magda from Denver, Taylor from Arvada, Leon from Broomfield and Ozzie from Commerce City are others opening themselves up to share their stories of opioid addiction and recovery.

North Range Behavioral Health helps addicts seek sobriety

Alex B. Murphy is a Behavioral Health Consultant/Mental Health and Medication Assisted Treatment Therapist (MAT) with North Range Behavioral Health who works with people recovering from opioid addiction.

The MAT program pairs medication with counseling as part of a client's recovery process. The program uses Suboxone, which is similar to methadone, and Naltrexone, which is used to treat alcohol as well as opioid addiction.

One of the first things to consider when talking about opioids is the difference between dependency, tolerance and addiction.

"Dependence is something that can develop very quickly," Murphy explained. "If you or I take opioids for a week, we are going to have a certain level of dependence on that medication. You also have a dependence on other medications."

Antidepressants and insulin are medications that someone's body can become dependent on, making it difficult to get off of the drugs.

Quitting medication that your body is dependent on can take anywhere from a few days to a couple of weeks, Murphy said.

Tolerance is when your body adapts to a certain amount of medication that has to be increased in order to have the same effect.

"Cancer patients that are on opioids have this all of the time. The doctors are less worried about them abusing the drugs," Murphy explained. "It's increased to improve the quality of life, especially if they are in palliative care or hospice."

People can experience dependence and tolerance apart from addiction.

"Having dependence or tolerance does not mean you have addiction," Murphy stressed. "They are not one and the same."

Murphy explains addiction as developing more slowly, often months, and it does not resolve when you discontinue the substance.

"Sobriety does not equal recovery," he said.

The medical community knows that there are certain characteristics people possess when it comes to having addictive tendencies, Murphy said. Addiction is not a predictable outcome for opioid prescriptions.

"It's more complicated than that. We know that there is a genetic issue," he said. "We know that much."

Some of the main features of addiction include a pronounced craving, obsessive thinking about the drug, the willingness to do anything to get the drug and the erosion of the inhibitory control of your prefrontal cortex.

"In addiction, this part of your brain is hindered and your hippocampus also shrinks, which is where your learning center is," Murphy said. "Your hippocampus doesn't begin to grow again until about three months into recovery."

These things don't happen with dependence, he continued. There associated structural and functional changes that occur within the brain with addiction.

Withdrawal from opioids an uphill battle

Like with any drug, kicking an addiction to opioids isn't easy.

"I have seen people withdrawing and they are doubled over and can't talk," Murphy said. "And it's three or four days of them being doubled over like that. They don't care about anything but getting rid of the pain."

That desire to get rid of the pain is one of the reasons it can be so hard for someone to get off of the drugs.

"They are deathly afraid of that withdrawal. They just don't want to get sick," Murphy said. "They may not even betting getting the euphoria from opioids anymore, but they don't want to get sick, so they hunt down their dose."

The process of achieving recovery begins with detoxing. Once the person has detoxed from opioids they are put on Naltrexone, Suboxone, or methadone and begin working with a counselor.

"It's important to get their support system, like their family or friends, involved," Murphy said. "Also, we treat any other psychiatric disorders and trauma. Making sure we are hitting those underlying mental health concerns."

Connecting clients with mutual self-help groups is also an important part of the recovery process.

"They need to expand their social connections and health connections because they are going to be their cheerleaders," Murphy added.

Greeley native fighting addiction to opioids

Greeley rapper and music producer Chris "Boo-G" Mesa is another victim of opioid addiction. However, unlike Pierot, Mesa is still taking the medication.

At 32-years-old, Mesa walks like someone over twice his age with a cane due to a chronic back condition, for which he was prescribed opioids.

"I've always had back problems growing up, but it wasn't until 2015 that it got really bad," Mesa explained. "I had a bulging disc that was pushing on my nerve."

Mesa uses his music to channel his frustrations about his opioid addiction. He recently wrote and produced three songs --"Euphoria," "Solo" and "So Far Gone" --about his addiction issues and struggles.

"People have told me they can relate to my music and they are going through the same thing," the musician said. "It makes me happy to hear people are being helped by it and are responding to it, but it also makes me sad knowing there's more people going through this same thing."

Four back surgeries later, Mesa was consistently given prescriptions of Percocet and Oxycodone to help manage his pain.

"I've been on and off these opioids. I'd get off of them and then get back on. The doctors never told me anything about them being addictive," he said. "I didn't know anything about withdrawals until I was wondering why I was so sick."

Similar to Pierot, Mesa experienced severe shaking, vomiting, nausea and other symptoms of opioid withdrawals.

"I really want to get off of them, that's my goal," he said. "I see a lot of people overdosing on them and that scares me. I have kids and I don't want to be a victim to these pills."

When asked if he thought he was addicted to opioids, Mesa responded with a resounding "yes."

"I know I am addicted. I have that craving and obsess over when I can take my next pill," Mesa explained. "I tried to get off of them, but I keep fighting the urge. The doctors give them to me, and it's not their fault, they are just trying to help me."

Addiction a genetic trait in Mesa's family

Addiction runs in Mesa's family. His father was an alcoholic, his mother was into various drugs and his brother is addicted to meth.

"I was raised by drug dealers and raised in drugs," he said. "I am the only one in my family to graduate high school, and once I graduated, I got out away from that."

At one point, Mesa's pain was so extreme that his doctor put him on 30 milligrams of morphine, 20 milligrams of OxyContin and 20 milligrams of Oxycodone all at once.

Despite tampering down his pain, the medication has affected Mesa's mental health to the point where he started to experience severe depression and anxiety, forcing him to go see a psychologist.

"I had problems being places or leaving my house," he said. "I've had anxiety growing up, but not like this. It messed with my family and my marriage."

With several more months of recovery from his back surgery and a possible hip reconstruction in the future, Mesa won't be able to get off the painkillers anytime soon.

"I hate that I am in this addiction category," Mesa said. "The only thing that helps the pain is Percocet. I'm on tens right now. I was on 20s and then 15s and now I'm down to tens. I'm trying to take it easy; I don't want to take a large amount to where it's going to mess me up.

"But my goal is to get off of these," he reiterated.

For more information on North Range Behavioral Health and the MAT Program, go to www.northrange.org.

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