115: David Poses – The Weight of Air (Sort Of)

We sit down with David Poses, author of The Weight of Air, to talk about his book and the world of science as it applies to opioid addiction. David’s, through the story of David’s life and trying to find recovery from heroin and pill abuse, tackles many of the tough topics around medication assisted treatment and the many misperceptions our society has. We talk about harm reduction and how our practices have not caught up with the science. David tells us how alcohol is not legal because it’s safer, it’s safer because it’s legal and regulated. We investigate the science that is showing how much safer it is to use assistance in recovery as opposed to the old ideals of complete abstinence which are based entirely on a moral belief. We debate the old belief systems versus the new scientific evidence. Listen in and then go check out David’s book, The Weight of Air. When you use our link to sign up for a free 30-day Audible trial, we earn a small commission! Join the conversation by leaving a message, emailing us at RecoverySortOf@gmail.com,  or find us on TwitterFacebook or Instagram, or find us on our website at www.recoverysortof.com.

The Weight of Air

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recovery sort of is a podcast where we discuss recovery topics from the perspective of people living in long-term recovery this podcast does not intend to represent the views of any particular group organization or fellowship the attitudes expressed are solely the opinion of its contributors be advised there may be strong language or topics of an adult nature

welcome back it’s recovery sort of i’m jason a guy that has read a book and i’m billy i’m a person in long-term recovery and today we’re here with david poses author of the weight of air uh david why don’t you tell us a little bit about yourself and and why you’re here sure um hi uh so i wrote this book the weight of air um it’s a chronicle of my uh basically the depression that led to uh heroin when i was 16 and then the decades following of trying to stop using heroin um my uh my mom started taking me to therapy when i was four um i was a very sad kid before i knew the word depression um i i wanted to die and and and you know i was the most depressed person in the world um and this cop came to my school in fifth grade for a dare assembly and he said um uh he he basically explained that heroin was the worst drug because it makes you not have any feelings and i thought like that’s exactly what i need um so uh that that kind of got me on the on the course and we’re here to talk about that yeah absolutely um so the weight of air is an interesting title can you talk about what that means to you without giving away too much of the book is that possible sure yeah absolutely i mean you know it’s funny you should ask um the title i sat down to write this book um and i called it the kick when i started because you know for me it was like just this is a very long saga of kicking um you know heroin and when i sold the book uh and i hadn’t thought like i just i called it the kick i wasn’t thinking that was necessarily the name but like you know that was that um so when i sold the book and the publisher was talking about like you know the kick people might see that in a bookstore and that could mean soccer for some people um and if it means heroin like you’re leaving out all the depression and it’s really not a book about heroin addiction so maybe we want to come up with something else um and i didn’t have any ideas and uh and so you know we had a ton of conversations and like i can’t take that stuff seriously so i’m going like what about like 50 recipes for your next you know afternoon tea party or something um and uh and and so she came up with the weight of air because uh from a lot of the things that i say in the book and there’s a there’s this kind of theme of um not being able to breathe and suffocating and drowning and you know that kind of thing and and the difference that um you know that that heroin made uh when i started using it that i i was able to breathe so that the weight of air was just kind of the how heavy um life always uh you know felt right and so uh david had you know we got linked up on social media somehow and we talked and you know he he sends me this book and i’m like is there an audio book right like i i’m not now there is no there is now right right at the time there was not um and and i was like man i i generally don’t find time to read right and it just so happened we took a vacation it was to a beach and there was an entire like flooded out day and we all just sat around the house and i was like oh what the hell i’m going to read this book and i literally read the entire book that day and um you know my thought at the time was i’ll just start it but it it it got a hold of me a little bit right i think the storytelling in it is um at least from somebody who has been through the detox process it was very relatable right i could remember and picture myself in in some of the scenes you were talking about and then as it kept going on i really i started to want to know what happened i’m like well where does this go right what happens to this guy um and then you know getting getting towards the end and maybe like the the three-quarter mark and towards the end there starts to become a lot of really good points and it’s no longer just a book and a story that i’m reading about some you know random guy it became a book about you know harm reduction methods and and maybe i i don’t even know that i want to call them harm reduction methods but just like

are we living miserably still even though we’ve found abstinence or or is there still an underlying problem and uh you know i don’t even know where to begin with some of the quotes that really gripped me but but one for sure this idea that alcohol is not legal because it’s safer alcohol is safer because it’s legal and you know the implication behind that do you want to talk more about that yeah i mean you know it’s it’s true um i think you know most of most people i mean i i you know you’d have to be pretty old to be you know young in in the uh prohibition era when alcohol was illegal but um you know so we don’t really have a memory of that but everything that i’ve read and i’m aware of um people were dying left and right during prohibition because for the same reason that people are dying now you don’t know what you’re put you’re putting in your body right so like legal regulated i mean look it’s like 93 or 97 some like ridiculous uh percent of overdose fatalities um happen with illicit drugs because you have no idea what you’re putting in your body so like you know if you come over to my house i mean i don’t drink but like i i’ve got two pint glasses of alcohol here and you know one of them is methanol and one of them um is hard seltzer and you don’t know which one is which you’re gonna die if you drink the wrong one like that’s just a fact so when something is legal and regulated that’s never gonna happen but when it’s not that’s gonna happen all day every day and that’s precisely what’s going on so alcohol the po you know if overdose not if overdose is an overly potent dose i mean that’s what it is right so you can’t prevent an overly potent dose when you don’t know the potency of what you’re dosing um and and so you know the consistent potency of of alcohol i mean there’s alcohol laws now the harm of alcohol is is you know reduced because of the loss and you know the other thing that i think people forget like you know we have this kind of baked into our collective consciousness that like drugs are so terrible and they’re you know they’re illegal because they’re dangerous they’re so bad um you know the entire opioid category they um they slow down your essential nervousness that’s how they kill you right you stop breathing because you know it’s it’s a cns depression alco so that’s that’s the danger of opioids and constipation um alcohol will shut down every organ in your body right so you’ve got central nervous system and then you’ve got every organ like all other drugs in the [ _ ] world can’t cause that much harm um but alcohol can and alcohol you know i mean heroin withdrawal was brutal and i think everybody uh who’s experienced it agrees um and you wish that for death a lot but um but you know it’s not gonna kill you whereas alcohol is so addictive that um you can die in withdrawal so you know alcohol is the most dangerous substance on the planet i mean it’s more addictive than anything else it’ll kill you in more ways like it’s horrifying how how stupid bad for you alcohol is but you know it’s everywhere it’s it’s ubiquitous and it’s fine and like you know people like my mom is kind of this yardstick for america because i you know i want to believe that she’s more educated than most just by virtue of being you know my mom but but she slipped back into that you know i mean i’ve only been like this was all i didn’t talk about this until two years ago so you know it’s easy for her to slip back to the thing and so um i had this friend who who died from overdose last christmas and he was you know i mean the last of my friends that died um and so and she said you know it’s really sad but he obviously i mean look he didn’t care about himself it’s accidental overdose he you [ _ ] up he wasn’t careful and i was like okay so when when you’re drinking a glass of wine um if if you poured a glass of wine and it turned out that it was you know could you drink the equivalent of like 33 glasses of wine in one glass of wine or would you die and she was like i would totally die so what if that happens to you and she’s like that’s not going to happen so she like basically goes through the argument for me you know it’s not going to happen because i buy it at the liquor store and it’s sealed and i take the cork out and it’s you know regulated and all this stuff and it’s like that doesn’t mean that alcohol is safer that means there are safeguards that prevent you from dying from [ _ ] alcohol poisoning because of alcohol loss um nobody can argue that something is going to be safer if it’s if it’s illegal i mean you know there are cheeses that are illegal in the united states because they contain you know like maggot particles and they’re going to like perforate your organs or something like um you know or or you know a few years ago with the listeria outbreak um with cantaloupe or a few years ago with uh you know in mozambique when people were dying from toxic beer like legalization and regulation is people are dying from illicit drugs there’s no amount of like regulations and prayer in prison and all of this [ _ ] like that’s not going to stop you people have been using drugs before written language so the idea that like we’re going to stop people from using drugs like why don’t we just make drugs safer like why is that so [ _ ] terrible um so sorry um yeah yeah that’s what you’re here for it’s unconscionable to me that these you know there are the opioids that are in um uh you know pharmacies right now you’ve got you know diluted morphine all of these opiates the dea put out this thing a few weeks ago it’s this one pill can kill campaign did you see this these [ _ ] are they’re they’re saying the only safe pills are dispensed in the pharmacies right so if you’re gonna use opioids it’s gotta come from a pharmacy that’s the only safe bills everybody knows that um these counterfeit pills have never been a bigger problem they’re everywhere over the past two years has exploded we can’t keep them you know we can’t contain them and they’re killing people left and right blah blah blah right so the counterfeit pill problem started when the dea started uh tightening restrictions on um on prescription opioids like is it really a surprise that you can’t get these so people are getting these i mean like they created this monster and now they’re blaming the cartels it’s like it seems to me that if you want people to not die from toxic illicit drugs why don’t you make the safe drugs available like i mean i i just i don’t get it like we we have this myth of um legalization leads to widespread use which is not true and has been disproven all over the place and if anybody doesn’t believe that like it’s easy to debunk it yourself like nobody loads up on beer every time they’re at the gas station and nobody seems to know anybody who’s going to start using meth or heroin if it was legal so all these people that are going to start using like nobody can name one um but uh you know it it’s like we’re so afraid of we’re more horrified by the idea of people using legal regulated drugs then we’re horrified by the people dying from from the illicit drugs and and that’s i just don’t get it well not only that but now they’re making it harder to get pain medications when you are in like legitimate pain for legitimate medical reasons it’s harder now to get pain pills than ever like yes people there there are there are many many documented um uh cases of suicide where people are are killing themselves because there’s people in hospice that aren’t allowed to get um opioids i mean you know it’s been i mean look i don’t want to get into like the whole purdue pharma um you know [ _ ] but like it’s been proven a million times over that this crisis is not a result of somebody was prescribed oxycontin and five minutes later their own hair like that that’s not what’s going on here um it’s poison drugs people are dying because our drug supply our illicit drug supply is poison until we replace those drugs with safer drugs people are going to keep dying like there’s just no way around it and if you have this conversation with with somebody who you know like my mom can’t have a rational conversation look fear isn’t rational so nobody can have a rational conversation if they’re afraid of drugs but like if you if you use any analogy like um you know if caffeine was illegal and 300 people were dying every day from coffee and we could either go after cartels and blame you know people in foreign countries and and all of that kind of crap or we could make the caffeinated beverages that we’ve restricted just make that [ _ ] available to people like i i can’t think of any lawmaker that would be like no no we’re much better off spending 48 billion a year going after uh you know the people in mexico and and all that crap i mean we’re on drugs right now we’re spending 48 billion dollars a year on interdiction alone so forget about treatment and all that kind of stuff right so 48 billion dollars if we were to stop that um right now shut the dd dea down legalize and regulate drugs so it’s clean drugs going out right and tax and sell them like alcohol it will be 108 billion net swing every year so like you have to hate people and money in order to want to do that and all the people that are like i’m sick of paying for all these you know drug programs like blah blah blah it’s like those guys should be the first people on board um for legalization and regulation but you know it’s it’s like we’re all kind of um you know i mean i think just most people don’t it’s so baked into our collective conscience that they most people find it you know i say these things to people and they’re like that can’t possibly be true and then they look them up and they’re like oh my god that’s true yeah yeah and uh you know i recently read another book called sapiens uh brief history of humanity or something like that and it talks a lot about how all these things we take for granted are myths and most of them are based on a christian religion so to speak right i mean money’s a myth uh the idea of equality honestly is a myth fairness justice they’re all myths that we’ve created like they don’t exist in science and in the animal kingdom um and i do i think we have harped onto this idea and latched on to drugs are bad okay right and we’re just stuck there i mean look if we didn’t moralize drugs we would see that the moral failure is the way that we’re treating drug users i mean you know i’m morally object to uh to harm reduction like really uh you don’t like seat belts either i mean come on you know right right um so one of the quotes that i i found interesting and maybe this will lead into a question for me is addiction isn’t an automatic result of exposure to opioids compulsive use is driven by the relief they provide that’s the draw painkillers kill pain opioids don’t know or care if you have a prescription or whether your pain is physical or emotional they flood your brain with dopamine and serotonin and bind to your opiate receptors so if addiction isn’t the automatic result of exposure to opioids where does it come from what is it um that’s a great question you know i i’ve noticed lately um that addiction is such a kind of word that people assume that everybody means the same thing and i find that in a lot of conversations that i’m having with people i’ll like kind of stop in the middle and say like i mean look everybody can look up addiction in the dictionary and it says compulsive use despite negative consequences right but um if you say to somebody like what do you think addiction means everybody’s definition is very very different um i’m finding and so the idea that like addiction as we are you know as it’s predominantly treated um in america right now we treat it with sobriety with abstinence right um so so when i’m saying uh you know addiction isn’t as a result of uh these these drugs don’t you know they don’t hook you i mean like you know my mom had cancer twice she had all kinds of surgery she was prescribed by all kinds of opioids um the pain went away and she stopped taking them right so if you’ve got hip replacement surgery and you get two weeks of you know percocet or two minutes you know these days and then you’re still taking it after after the pain is gone you’re taking it to kill some other kind of pain right so opiate receptors regulate your physical pain and emotionally i mean they do the same thing whether whether you’re depressed and it’s emotional pain or whether you know your foot got chopped off so this idea that sobriety is the answer it’s [ _ ] i mean i’m not saying go out and use drugs and everybody should be on drugs um not at all but if you think about it like addiction the medical condition right so like let’s say you drink a bunch of alcohol for you know however many years and you’re addicted to alcohol um you stop drinking alcohol you go through the detox i don’t know how long that takes but whatever it is like the booze is out of your system your alcohol addiction is over you’re no longer addicted right physically addicted um you are sober you’re abstaining you know that’s that so that’s the cure right compulsive drug use compulsive behavior is a mental health disorder so um if i’m compulsively taking painkillers to kill pain um it’s no different than you know the ocd guy who who you know turns to the doorknob 87 times or else you know my grandmother’s going to die of uh you know an anvil’s going to fall out of the sky and hit my grandmother if i don’t you know do this so he can stop turning the doorknob he’s sober he’s abstaining but he still wants to turn the doorknob and he still thinks his grandmother’s going to die like i can stop taking if my foot got chopped off and i stopped taking painkillers like nobody in their right mind is gonna be like your foot got chopped off because you’re on morphine um the pain is only gonna stop when you stop taking the painkillers like we have these ideas that like are completely like biologically [ _ ] insane um but for whatever reason we we think that they’re true so like you know sobriety is hard um because pain doesn’t stop when you stop taking uh painkillers it gets worse and we know that and we’re making this false promise to people in rehab um you know your sobriety is gonna be better you’re gonna love it you know everything’s gonna be great it’s gonna solve your problems and it doesn’t and and you know people are relapsing all over the place and it’s really you know very tragic because we’re we’re leading people to believe that you know sobriety so it’s like we’re treating addiction the the physical the cure to the med to the physical medical condition um sobriety does not is in no way the cure to the compulsive disorder but we’re treating it as such and that i think is is kind of the fundamental flaw in what we’ve got going on right now you want to argue i know you do well i don’t want to argue it i guess

sure sobriety doesn’t get easier with time um with opi doesn’t necessarily get easier with opioids because it’s the only type of substance um that has a natural target in your brain and takes hold with that kind of ferocity so you know there are all these studies that show uh you know you quit playing blackjack you quit drinking anything else any vice any substance um your neurotransmitters rewire over time there’s studies that are you know 50 years out that they don’t rewire over time so you know for me like i spent so much of my life being miserable and feeling bad that i was miserable because i had it so good and all that kind of crap like if i can choose between suffering and not suffering i’m going to take not suffering 10 times out of 10 and like when my you know my mom doesn’t want me to be on buprenorphine it’s like do you want me to be productive and happy or do you want me to be pure in my body and miserable and jumping off a roof every five seconds i mean like what’s the objective here so anyway sorry please refute that’s okay no and it’s not a refute i think this is where jason and i sometimes have a uh i don’t know difference of opinion but for me like my experience is i don’t other than being an addict i was an addict on heroin for years i’ve spent time in jail all those sorts of things and i got off through an abstinence-based 12-step program and that’s been where my recovery is and it’s worked for me but when i went to the 12-step fellowship i guess one of the i guess core tenets of what was explained to me or what’s the foundation of my recovery is just that what you just talked about is that just stopping the drugs isn’t the problem like drugs are just a symptom of my underlying condition and that i need to address some of those other things and like for myself like i’ve never been diagnosed with like a clinical depression or that sort of mental illness i was sexually abused as a kid so i had some trauma there and as i got into recovery i was able to address some of those things and deal with some of those issues so like for me i don’t even solve that problem though i’m sorry sobriety wasn’t the cure for all of your trauma uh abstinence wasn’t yeah i mean it didn’t it didn’t just fix when i was in abstinence it took the work through a 12-step fellowship but i don’t think that works for everyone because people’s level of trauma is different and some people suffer from like depression or things that are going to be lifelong versus things that can be treated through maybe therapy or counseling or in my case i just got lucky with i mean because i realize 12 step is really dependent on the quality of the people you have in your life um what you’re willing to kind of work you’re willing to do on yourself you know and those sorts of things i mean right i mean you know i i i would never discourage somebody from doing anything that works for them um i know people who who love aa i’m truly happy that it works for you like that’s great um i think my problem with it is it’s not uh you know this is a this is a medical condition and so there’s really no other medical condition that says cozy up to god don’t take any medicine um forget about the science and you’ll be fine like um you know god we’ve known that that god hasn’t cured you know diseases since like bubonic plague um so it just seems kind of you know preposterous that that that that would be a responsible way to like i guess what i’m saying is if it works great if it doesn’t we shouldn’t be telling people like you’re a [ _ ] [ _ ] because this isn’t working for you like it’s your problem you know and and that was what happened with me it was like you know i’m i’m a crazy person um in denial and uh you know all of this kind of stuff and it’s like i mean you know look i’m not gonna blame anybody for my decisions and my actions um but i’m pretty sure that things would have been very different had i gone to rehab and instead of saying depression’s an excuse uh you know your full [ _ ] and static mentality if my counselor would have said oh my god you’re depressed we should really deal with that because in the absence i mean look without medical credentials which is what is going on here with these you know in 46 states you can you can be a an expert um you know treatment counselor and you don’t even have to have graduated from high school so the idea that like you’ve got medical experts without medical credentials pushing a cure that involves you know basically prayer and a you know anonymous support group um that for any other medical condition like that’s literally the definition of quack medicine so these guys are actually if if addiction is a medical condition and these guys don’t have any medical credentials then they’re actually not qualified to diagnose treat or um you know even uh manage um any any medical conditions which or mental health which includes addiction depression um and so forth so if it works for you that’s great like and and and we should be happy and and um but that that is more of a fluke i mean like if you know somebody who who has cancer and goes to one of those witch doctors and um you know some foreign land and it cures their cancer it’s not proof that that works it’s it worked for this guy and that’s great you know um and we should celebrate that well and i i know like you’ve used the example of like diabetes and i just to kind of go that route like we know diabetes can be treated with medications and stuff if you’re a diabetic but you can also change diet exercise and do some other healthy things that will work as well um and i kind of look at addiction is the same like you can if you look and find a path that works for you like recovery from my understanding should be like you’re the author of your own life and you should have some input and say into your recovery path and what you want to do and i do agree like treatment centers shouldn’t just tell everyone like hey abstinence is what you need to do and you need to come in and get abstinent and go to 12-step meetings like that’ll work for me personally i think that actually doesn’t help me as a member of 12-step fellowships having all these people pushed into a program that they don’t really want to be in any way i think that contributes to the failure rate is that there’s a lot of people there that don’t want to be there they’ve just been told this is what you have to do or this is what you’re supposed to do and they don’t want to do it so it doesn’t work for them no and and the stakes are very high at this point because you know the highest risk of overdose obviously is when um you’re completely clean because you have no tolerance and the highest the other highest risk of overdoses when you’re using illicit drugs because you have no idea what you’re putting in your body so you know if i go to aa because that’s what i’m supposed to do and i’m sober and abstinent and then a week later i’m like [ _ ] this is a bad idea um and now i can’t get on buprenorphine because i or methadone because i don’t have to open my system and i’m kind of freaking out and i just need to clear my head and i go out and score like i’m dead and that happens all the time i mean there was this gemma study i mean there had been a bunch but there was one in particular last um either january or april um by uh dr sarah wakeman um was the lead on it and and it basically said that like if you so medically assisted treatment in either form um reduces the risk of overdose relapse and death by like 79 um faith and abstinence-based inpatient rehab increases those risks in almost as close a percent um if you find out your kid is on drugs and you say look we don’t want you to use drugs um we really wish you wouldn’t but we got you a bunch of narcan please don’t use a loan you know whatever um they have a better chance of being alive in six months than if you send them to rehab and you know parents like contact me all the time for advice and you know i tell them i’m not a doctor and all of that and i and i’ll you know kind of quote this this study um you know and it’s an empirical study like it’s not like uh you know i mean it’s science um so you know most parents will say to me like are you out of your [ _ ] mind like i don’t want my kids using drugs like what are you telling me do you want me to tell my kids to use drugs like why am i gonna do that and it’s like i’m not asking if you want your kid to use drugs i’m asking if you want your kid to be alive because here are your options you know um like that that’s the likelihood so um you know i i don’t know i i think as you said like we have to recognize that every i mean look everybody is different like it’s it’s crazy to think that there would be a universal treatment modality when we know that everybody’s different we know that each type of substance affects our neural pathways differently like there’s so many variables involved the idea that like one thing would work for everybody and it’s it’s not even a scientific thing um you know it’s kind of is kind of crazy so um you know we we we should make all these options available and especially now like when people are dying like this i mean look the fact that i call methadone clinics every couple of months um all over the country i’m on a bunch of waiting lists i’ve been on some waiting lists for like 16 18 months at this point it’s [ _ ] crazy you know um you can’t get buprenorphine like it it’s you know we’ve got it we’ve got to make treatment more available and we’re spending uh you know 40 whatever billion dollars on an interdiction which is going after the bad dr so like it’s easy you know you can like you can get anything delivered to your house uh you know like that you can’t get you can’t get treatment that best i mean like what are we doing here yeah we are in a small rural community and finding doctors that will actually prescribe buprenorphine is very difficult like it’s it’s really difficult to get you know doctors one of our sponsors voices of hope is a community organization in this area and they have tried to like partner up with different doctors and and methadone clinics to help people like say it at the biggest the highest at risk are the people coming out of treatment people you know that coming out of jails and institutions that could use those substances you know what i mean to use the medications to help them through those difficult times and it’s you can’t find doctors that want to prescribe it because it’s a i guess stigma or the fear it is i mean you know and if you where are you where are you what’s your rule county maryland so we’re sort of right off the 95 corridor between like baltimore and philadelphia have you um you know ophelia might uh have people in your area it’s a telehealth company um i’ll i i can check it out uh after they have one local doctor they’ve been working with now and the telehealth they were hoping to open you know when covett came and actually opened up some of that a little more to make it a little easier so well it it did i mean i you know i think the the challenge with i mean when when the laws change when they open it up a few months ago of um you know any dea licensed doctor can can prescribe buprenorphine to 10 patients the problem with that you know it sounds great but the problem with it is um you know doctor just because you’re a doctor doesn’t mean that you’re an expert on you know every toenail fungus and you can you know remove pancreatic cancer and uh and treat buprenorphine um so you know like if you became a doctor because you want to do you know doctors without borders or or you’re um you know interested in uh being a plastic surgeon or whatever it is like that doesn’t mean that you want um you know uh people who are addicted to heroin knocking on your door saying like hey you can prescribe morphine you know give it to me right now and there there is a lot of stigma like there you know i mean i know actual doctors who believe things about addiction that are like so [ _ ] insane but they go to medical school i mean look addiction has been siloed off from science and medicine for so long because aaa has been the brand you know and it’s been around since the 30s and so you know that was what you do and they had the monopoly i mean you know that’s why rehab is you know uh not a hospital um so like a lot of assumptions are made that just aren’t true they i mean you know i know an emergency room doctor who went to a very good medical school um and spent a lot of time there after and he said they learned about addiction for about 30 minutes right in in all of medical school um and i mean you know it’s just it’s like uh there’s a million and a half licensed physicians in america right now of that million and a half 1183 are certified in addiction medicine so if there’s you know 20 or 40 million people that are struggling with opioid addiction right now on top of the underlying conditions of you know whatever mental health disorder trauma you know depression and so forth that they have um you know it’s it’s the ratio is like um one uh doctor for every like 36 000 people who are struggling with addiction like are we really going to solve this problem that way i mean you know in your rural maryland town i’m sure that you could find you know five specialists for some a very obscure form of toenail fungus you know no problem um but you can’t find a buprenorphine doctor and it’s the leading cause of death right now great you know uh something that came up for me when you guys were having that little the discussion about that like just imagine and i get that we’re a little biased from our own anecdotal evidence right that like this worked for us so yeah there’s got to be some credence to it right right right if my kid got cancer right and there was an fda approved cure that worked for five to ten percent of people and an fda cure that worked for 79 percent of people yeah what are you gonna go with which one do you think i’m gonna give them right and and i feel like that’s my thing it’s not so much that uh that that i don’t think 12 steps can work or an abstinence-based program can work yeah i think it can but if i’m going to send people somewhere like i want to give them the coveted vaccine that works 80 of the time not the one that works five to ten percent of the time and i’m not going to take my chances on suggesting the five to ten percent of the time one to people and and i get it like it doesn’t feel good because that’s what worked for us you’re acting like that being on a medication doesn’t come with any kind of side effects and i think any medication comes with a certain side effects i mean they’re always side like i just for myself this is just me like i’m i guess you would call it like a naturalist person like i went to the doctor about two years ago they told me i had high cholesterol and that i could get on cholesterol medication or i could change my diet and exercise right so i said i’m going to diet and exercise i’m going to go that route because not that that medication can’t fix it and i don’t think there’s anything wrong with people that do it great if that’s what you need and you don’t want to change but no judgment on that i’m just picking what i think is right for me based on i don’t want those side effects and i mean you know like for for me i mean you know i i i say this a lot and and like it kind of freaks people out but like i don’t want to be taking anything like ever i didn’t want to be taking heroin like i don’t want to have to take something in order to function like i want to wake up in the morning and just go i i don’t i don’t have to remember [ _ ] i don’t want to go to the doctor once a month i don’t want to go to the drugstore like i i don’t want it um i know for myself that i’m going to completely [ _ ] fall apart if i stop taking deeper i haven’t you know tried to uh whittle it down lately i did a few years ago it was it was it was miserable i mean i you know and so maybe i’ll do it again maybe i won’t um as far as the side effects go like you know there are people who have whatever issues that they have i haven’t heard of anything that’s um that would that would make anybody stop using other than somebody who was on a very high dose um and got headaches but like opioids all by themselves in the long term constipation is the only problem like they shut you know the cns depression problem is obviously a problem but a person could be on pure heroin or you know synthetic buprenorphine or whatever it is for the rest of their lives and theoretically not have any kind of um you know other side effects so and everybody’s different and that’s fine i know for me the side effect of not being on buprenorphine is that my opiate receptors are not um you know saturated with what they need and so because depression is you know it’s it’s a degenerative biological condition right my opiate receptors multiplied like everybody else’s with every dose whether you have a prescription or not that’s just what they do so i’ve got a badrillion more receptors than i had when i was 16 when i started using heroin and i know that like i can’t function unless i’m opiated and and i get that like we don’t like that and society wants you to be abstinent my mom wants me to be absolutely you know my wife wanted me to be abstinent for a while and all that crap but like what it really comes down and you know i mean i was very ashamed i mean i didn’t tell anybody i was on beaver morphing for ten years it was it was really um shameful for me but at this point it’s like what it comes down to for me is there are no side effects that i’m experiencing i get that that might not be the case for other people um i’m miserable without it and i don’t want to be miserable so you know and and and i mean any of the like you know it’s just bad heroin and all that kind of crap like i don’t think i look like i’m nodding off and drooling and i’m you know not like going around stealing your vcr and [ _ ] like so you know and i mean anybody who thinks it’s just as bad as heroin like ask for it after your next uh you know knee surgery and let me know how that works out this episode has been brought to you in part by voices of hope inc a non-profit recovery organization made up of people in recovery family members and allies together members strive to protect the dignity of those that use drugs and those in recovery by advocating for treatment harm reduction and support resources and mentoring please visit us at www dot

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to uh to speak to the constipation for anybody who has never used heroin and is listening i came off a short uh heroin use run that was what we call it uh back then at least and uh i had a bowel movement you know from not having a bowel movement for quite some time and and it was so impressive that i literally had to go get my father this was before camera phones i literally had to make him come up and look at it i was like dude this is not human it was it was crazy so did you hear what you’re saying did he know you were on you were on dope at the time no i don’t think he did i don’t think he did uh he he might have did after that yeah he might have known after that uh i mean it looked like something a horse would do it was it was crazy um how long had it been before you uh like what was that i don’t have anything that long i think it’d only been like a week or two like a week but it was yeah a week or two and i just uh you’ve gone two weeks without pooping before oh i went 30 days but that was a whole different reason i was uh i was smoking crack and i wasn’t eating all day every day except at the end of the night i would eat a mustard sandwich because that was the only thing i could get down and then after 30 days it was still like gerbil pellets it was ridiculous it was like nothing what did you do about that nothing i mean i i assume you’re not still on crack no no i’m not uh no i went i went to twelve-step route two i just uh uh well let me let me say billy uh so yeah you you talk about the cholesterol and and yes you know there are other methods but if you were if you got cancer and they said hey if you do nothing there’s a five to ten percent chance of that being a survival right if you do nothing or just do these healthy practices and there’s no side effects or there’s this eighty percent effective treatment that might have a side effect or two which one are you going with like i i just i get it we have our hearts tied into this 12-step thing but i really think can we step back i mean this is the leading cause right right you’re gonna [ _ ] die yeah but i don’t i mean at least for me personally like i don’t feel like my choice of abstinence is any like i don’t have any side effects other than i can’t get high which i really miss like that’s about it yeah no but i mean i think you know i think that’s the thing with with um with anything that anybody does i mean look i’m obviously biased toward this i i started on buprenorphine i mean you know when when i wrote this book and got an agent one of the first conversations we had was um about my unconventional path to recovery because buprenorphine was not the gold standard a.a was and i was some crazy [ _ ] kooka-do talking crazy [ _ ] and she was saying like you know science has to catch up with this at some point like there’s got to be a day where like people are going to be like oh my god this [ _ ] actually works because clearly it does um you know so it’s nice for me to be able to have this conversation from the perspective of 79 and all that like you know that’s great this works for me oh and here are the statistics um you know whereas you’re in a different spot but it worked for you so your convictions are um just as strong as mine and if it’s the two of us like i’m not going to convince you to do this you’re not going to convince me to do that because it worked for both of us so if it’s another person off to the side um you know i mean as far as this conversation of like you know if i mean look if my kid had cancer like i don’t give a [ _ ] what i’m doing i’m going to the you know the thing um to the one that works um but you know but that that’s just me if i had done the witch doctor approach and it worked i would try the witch doctor approach you know no question um but for for most people i think it’s reasonable to say you know look this is what i did this is what he did it worked for him it worked for me for different people it worked for different reasons this might work for you you might like this you might not like that if you don’t want to take any medicine and you want your body to be um you know clean and you want to try this round whatever and and it works for you like great do it if it doesn’t try this if you think you want to try that then that doesn’t work like you know do this but um but the idea that like we’re i mean you know there wasn’t there was an aaa um group in syracuse new york that um i mean you know everything that i read about it like they were calling them militant which i’m not really sure what that means but the members were shaming people um you know you can’t take antidepressants like there’s a whole you know litany of things that you’re not allowed to take so somebody was on wellbutrin and they were like you’re not uh sober blah blah blah um so he was like [ _ ] i’ll stop taking it stop taking it and the guy killed himself um and this has happened a few times in this in this aaa um you know faction and so i think the bottom line is um that’s not okay and that’s just as not okay as somebody like me saying you got to try this stuff it’s the only [ _ ] that works look 79 it’s the you know gold standard blah blah don’t even listen to these bastards because they don’t know what they’re talking about and look at these numbers and you know whatever like you know if i’m shaming somebody out of trying that it’s just as bad as as um you know what what’s going on i mean i guess it’s there is a difference in the sense that like you know with the non you know medical part or whatever but um i mean either way it’s like you know everybody’s different um well and i guess my hope is that like so this community organization my wife actually started it it’s called voices of hope and the idea with that and she’s abstinence-based recovery that’s what her recovery was in but the organization itself is like all pathways of recovery and the idea is that people can come there and they focus more on person-centered care like when people come there they say hey what do you what do you need you know do you want to get on a maintenance program we can do that they actually just partnered up with a methadone program that they started in their facility for people that want to go that way but like abstinence is also a path that some people want they have people that come there that say hey i’ve been on methadone for 10 years i’ve been on you know suboxone for several years i’d like to get off and they’re having difficulties in some of these clinics because the clinics are set up in a way that says well if you can’t pay we can get you off in seven days or ten days but if you want to get off medically we can only reduce you like five milligrams a week for so and so many weeks and it just seems they feel like they’re trapped and so you know they want to offer people different pathways of recovery different options because ultimately recovery is up to the individual a person isn’t going to do what they don’t want to do they’ll try it but me personally like i think the medical field like we sort of look at 12 step and want to blame them for where they’re at but i think they only got such a powerful position because the medical community dropped the ball medical community didn’t want to address people with addiction they didn’t want to deal with it they just wanted to shame people and push them away so they found these rooms in these basements where they could go and they started helping each other and now i think where we’re at i i i don’t trust the medical community at all i haven’t i’ve had shitty experiences with most of the doctors that i’ve seen um the minute it turns out that i’ve stuck needles of dope in my arm uh you know i’m some kind of scumbag and i don’t like that and i think that there’s all kinds of you know [ _ ] medicine go like i don’t trust a lot of things about medicine um what happened in in america that you know gave rise to all these programs like the 1914 harrison act when opioids were um available by prescription for physical pain only there were a lot of people that were i mean you know look uh one in 200 americans were addicted to opioids at the turn of the 20th century um so we had a i mean this exact problem that we have right now was going on 100 years ago minus the overdoses um and so how they handled that was uh addiction was believed to be an incurable moral defect right so um there were doctors who felt bad for the you know these incurable moral you know failures um and they and and also wanted to make money so they set up these uh basically clinics that were their idea was we’re going to give um opioid i mean it was heroin at the time or morphine so we’re going to give these guys morphine and heroin um and that will keep them off the streets and they won’t be you know stealing your [ _ ] and blah blah and it worked but the government didn’t like that um so they started shutting them down and those like farms that sprung up so doctors weren’t allowed to like doctors were getting busted and going to jail for treating the junkies i mean i you know i don’t know what was going on with with alcoholism um back then i mean obviously aaa was uh you know built on alcoholics anonymous um but uh you know it it seemed like any doctors that wanted to help were um gotten a ton of trouble for it so it was more government intervention that yeah i mean like yeah they they were throwing them in jail and you know i i don’t i don’t know you know whether it’s whether it’s the government didn’t like the junkies or you know it doesn’t really matter the bottom line is that i would think that most doctors didn’t care about junkies because you know at the time we were incurable moral defects so why would they right i mean no really so um so this small handful of of doctors who cared enough to do something the message they were given was like you’re a [ _ ] [ _ ] and we’re gonna take your life away from you so that’s a very easy way to kind of level the playing field and make sure that there’s not a doctor in america that cares about people who are on drugs right if you ask me so you mentioned another thing david about how difficult it was to get prescribed suboxone or buprenorphine i should say um can you talk a little bit about how the government restrictions i mean you know for me it was especially hard because i um i was coming off of a like so i had relapsed um and i knew that i had to do something like i i couldn’t um you know i couldn’t stand drugs but it was very very short like i had you know days worth of of um you know percocet and then i stopped you know um i don’t want to give away anything in the book but the moral of the story is i didn’t end up um thinking about buprenorphine it’s like two weeks later and i my system was totally clean i had i had no drugs in my body um and so there were six buprenorphine doctors within like 200 miles of my house i mean this is 2008 so there’s no opioid crisis yet and um and i called them you know i went down the list and one by one they were like well you need to have drugs in your system for us to treat you that’s the law uh and i explained the obvious paradox to all of them you know being that if i have to go out and score i’m not coming to see you um so please help me uh and one by one they all said no and when i got to the last guy i was just like look man i mean i have a two-year-old daughter and do you really want my blood on your hands um and he agreed and uh you know since then or not really since then i mean i didn’t talk about it until a couple of years ago but i have since tried to get to the bottom of do you need to have drugs in your system in order to be prescribed methadone and bureaucracy because the answer is very hard to find um and you know if you ask me i mean look my induction was um very simple obviously and in the fence and all era where it’s very hard to get on buprenorphine because fentanyl is lithopholic so it stays it’s stored in your fat cells and people are going into precipitated withdrawal left and right like it’s it’s practically impossible to have a smooth induction um you know so if methadone and buprenorphine reduce the risk of relapse and overdose and death i mean i don’t know about you guys but like i saw every relapse coming from a mile away um so the idea that if i if i’m a person who knows that i’m going to relapse and i can call a buprenorphine methadone doctor that’s better than offensive i mean i don’t care what kind of program you’re with or who you are or what you think like there’s something a lot safer about methadone and buprenorphine than illicit fentanyl so the idea that you can’t get it um if your system is clean is just kind of downright insane and i actually came up on twitter like this morning um i brought it up and somebody who i um now i’m kind of regretting even bringing it up uh anyway the the conversation of um you know you should have drugs in your system because it will show that you can tolerate methadone and buprenorphine it was the argument from this person and it’s like that’s crazy like you’re going to these doctors because you know you can tolerate the drugs that’s why you’re thinking about relapsing right right and this is a legal regulated substance that saves lives so the idea that like i should go out and shoot a bunch of fentanyl so that i can prove that i can handle the butte like are you out of your [ _ ] mind i mean like that person is going to die yeah there’s a i’m going to say similarly strange law at least in maryland so um as i mentioned my wife’s organization is working with this methadone clinic well they also wanted to have their doctors be able to prescribe buprenorphine or you know the other uh medications and they can’t do both if you have a license to dispense methadone that’s all you can do you’re not allowed your doctor is not also allowed to prescribe an orphan like it’s it’s some crazy stupid like they just make it harder for people they do and you know the thing about methadone that um i mean i i’ve been on a big campaign to change this lately because you know methadone if my doctor prescribes methadone for my knee surgery which obviously is not doing that for me um and your doctor prescribes methadone for your drug addiction you have to go to the methodology

i can get the method own at the pharmacy and get it in monthly prescriptions it’s the same methodology like it’s literally the exact same method so the idea that like we want to get you back to normal we want you to lead a normal life we want everything to be great for you we want to save your life we’re going to make you come to this [ __ ] clinic every morning at six o’clock in the morning um make you pee in a cup and disrupt your life and make it impossible for you to get a job and be a parent and all that kind of business so when i call the methadone clinics um you know on my semi-regular campaign it’s like you guys like you know they’re allowed to give take-home doses and they’re choosing not to and like i will say to all of them you know look i’m i’m a parent i cannot leave my house until 10 o’clock like it’s just not possible so my options are i get fenced and i’ll deliver to my house i’m not having fun um to be clear this is uh hypothetically um so either i’m gonna order a bunch of drugs in my house it’s gonna kill me um but i’d like really like scout methadone to save my life so you’re telling me that instead of saving my life you’re gonna tell me to get defense at all like that’s what you’re telling me and they’re like i’m not telling you that it’s like well but if you’re not going to give me the methadone what are my options uh right yeah it’s a tragedy when it’s easier to get illicit drugs than it is to get legal

it’s like the [ _ ] antidote is harder to get than the voices like what do you think is going to happen yeah absolutely so so david i don’t want to hold you up uh much longer i know you got some stuff going on but i do want to say so read in your book for me really re-solidified and brought home this idea of uh i i want to spend every day i have on this earth to the best of its ability for me right um i’m a guy who has struggled with depression who who has been on and off different antidepressants who it seems like no matter what i do there’s always some gnawing or or you know i don’t know that pain as you refer to it is the exact right word i don’t know if we even have a word to describe what this this thing is right whether it’s like an underlying misery of our experience or or something i i don’t i don’t know what it is but i you know i’m just looking at my life i’m looking at my father i’m looking at his father you know they died around 60. that might give me 20 more years and yeah maybe i can sit still in this misery and and through some like buddhist process become okay with it in 10 years but i don’t want to spend half of what i got left with this dis ease right i’m with you yeah i i just and i don’t and i’m not saying that you know i think buprenorphine is the answer for me at this point in my life but maybe it is right maybe that is maybe it’s maybe it’s some of these experiments that they’re doing with psychedelics maybe it’s you know maybe i do get back on cannabis or something i don’t [ _ ] know but i i don’t want to be miserable and i’m willing to bend on the abstinence i i mean look buprenorphine works i mean i took it because it it works for my depression like any kind of opioid is going to work for depression because it regulates emotional pain and buprenorphine is especially effective for depression because um it sits in particular on the kappa receptor which is the receptor that’s most responsible for emotional pain so i mean look i don’t want to sell you on buprenorphine i will tell you that i think there’s absolutely no shame in uh you know in it obviously but um you know i have found that that’s what it does and i think most people don’t necessarily realize i’m taking um heroin for depress like i don’t think most people are you know kind of consciously i’ve got a separate text and [ __ ] um i don’t think most people are consciously aware that like i’m taking a painkiller to kill emotional pain i think people are just like i’m my life sucks so i’m on heroin um you know but buprenorphine i mean look if if an end um 49 of depressed adults are unresponsive to another questions there’s two kinds of antidepressants um so here sorry um there’s two kinds of antidepressants and and they don’t work for most people so the idea that you know buprenorphine is gonna work like there have been lots of studies about small dose buprenorphine for um uh uh what do you call it for depression i think in today’s environment nobody in their right mind is going to suggest an opioid for anything um you know right when we’re living in you know this kind of age but um there’s lots of studies that show that work and like why wouldn’t it work it’s you know i mean notwithstanding whatever the word is that you’re we’re looking for to apply to whatever this is like emotional well-being if you’re not unwell emotionally it’s unwell emotional well-being like you know so so um you know it saturates your receptors it does the same thing um that dope does and uh you know i mean look if you want to talk about it some other time i’m happy to do that i always have a massive stockpile of it because people can’t get it i’m happy to give it to you i’m not a drug dealer um and it’s illegal to give it to you so i’m not actually going to give it to you um but you know you know what i mean yeah so so david to speak to your point yeah exactly the fact that you mentioning that buprenorphine might be good for my depression and and the fact that i got to worry about oh well what does my peer group think about that or this that or the other that’s the exact problem there’s too much shame and i really appreciate your book because i think the weight of air is a good read to really rethink some of these ideas that we’ve just had drilled into our heads and and thank you so much for coming on yeah thank you very much for coming on and it was very fun talking to you um i guess my biggest hope is that we respect each other as recovery people and we come together to sort of fight against like the stigma and the shame and all those things that we can help and support each other in our different paths and more people can get the help that they need so thank you very much the leading cause of death um so thank you thank you for having me and uh give me a call anytime i’m happy to pick up the conversation all right sounds great david good talking to you cool youtube all right bye did you like this episode share it with people you think might get 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