At Bully Hills Ch2

1 DeLuca/At Bully Hills Chapter Two-Suboxone

It was time for my physical, so the nurse with the long corkscrew blonde hair ushered me to the medical area behind the credenza, the wall between patients and staff. I entered an examination room and was greeted by a large woman in a white lab coat. She was a pleasant woman, a Physician’s Assistant—an ersatz Doctor. She explained, with a reassuring smile, that I would receive a cursory physical before being given something to ease my withdrawal. Hell, at this point 20mgs of Valium would have helped, but I had no idea how wrong I was—what dreadful medicine was headed my way. I was asked to stand on a double beam scale so that my height and weight could be recorded, then the PA asked me to hop-up on the exam table and have a seat. As I rested on the naugahide examination table my blood pressure was taken, after I slipped-off my shirt she listened to my heart and checked my motor reflexes. I hadn’t had a Patella Reflex in my right knee in over 7years, and this afternoon would be no different. “No Patella Reflex…odd,” she queried. “Told you it wasn’t there, hasn’t been there for quite some time,” I answered. “Let’s move on,” she guided the conversation. “I’ll need a urine sample,” the PA told me, as she handed me a sealed plastic urine cup. I went into a small bathroom and she asked me to leave the door open a crack while I filled it, so she could hear what was going on. I put the urine screen on a metal tray when I finished and she checked the temperature on a little numbered strip-gauge. After my piss-test, I filled-out a long questionnaire about my Drug History; I checked off a laundry list of college experimentation, from Locker Room inhalant to Whippets (N2-O). I answered “Yes” to having tried just about every drug except Ecstasy and PCP. I was given a brief

social history that surveyed my proclivity towards any genetic predisposition toward alcoholism or Drug addiction. I told her that my paternal grandfather—Johnny Bones—was a jazz musician, who died at age 65 from a lifetime of alcoholism and hard living. He was primarily an alto saxophone player, but could just as easily play piano, vibraphone, and clarinet—all by ear. I went on further to tell her that alcoholism galloped on my mother’s side of the family as well. My maternal grandmother’s maiden name was Limbaugh. The Limbaughs came from a long line of Hell raisers with desperate reputations, not so much the sisters, but Marvin, Rush and Denver all had their own stories to tell. Uncle Rush was a former Marine who used to ride with the Hell’s Angels motorcycle gang; he had calmed down considerably by the time I got to know him. I told the PA that it was actually through my maternal grandfather that I was a blood relation to the Conservative Radio Talk Show host Rush Limbaugh, from the Cape Girardeau area of Missouri. She just grinned and made a notation on her clipboard. Then she asked me to summarize how I thought other people viewed me. “That’s an easy one,” I responded, “doesn’t give a shit!” “Hmmm,” she hummed as she wrote on her clipboard, “doesn’t-give-a-shit.” The PA spoke the words as she printed them in ink on paper, and with a stroke of her pen she underlined the statement for emphasis. “Do you have any heroes?” She asked me. “What do you mean heroes?” I responded. “You know, people you look up to or admire,” she shot me a quizzical look in disbelief. “Uh, yeah…Jaco Pastorius, a jazz bassist,” I spoke, “revolutionized the electric bass…a real virtuoso…played it like an alto saxophone.” “Never heard of him,” she never looked up from her clipboard, “should I have?”

3 DeLuca/At Bully Hills “Uh, yeah-uh…he played with Wayne Cochran and the CC Riders, Al Di Meola, Pat Metheney, Joni Mitchell, and Weather Report…put out a debut solo album the year I graduated high school that put him on the map, a real Monster,” I continued. “I had just begun playing electric bass in my high school’s Big-Band,” I explained, “he had a huge influence on my playing, tragic life though… spent the last few years of his life in and out of Bellevue Hospital’s mental ward…Drug and alcohol problems…got beat to death by some bouncers at a sleazy club outside of Ft.Lauderdale…fucking tragedy, a real tragedy, he was only 35 years old when he died.” “How do you spell that?” She asked me. “Pastorius, P-A-S-T-O-R-I-U-S.” I spelled it for her, “half Greek, half Cuban.” “And he’s your hero how?” She quizzed me. “Well, he was a genius for sure…but, it was like a double edged sword,” I continued, “he was given so much…musically…but all his success kind of blew his mind out…he took it too far…I looked up to him as a bassist, yet his death was a warning of what could very well happen to me if I don’t kick this narcotics habit…it’s ‘gonna kill me if I don’t do something about it. Same thing happened to my paternal grandfather, the booze got him…a really talented guy, but he pissed it all away…I never even got to know him really, he just drank himself to death while I watched as a child.” “That’s why you’re here now isn’t it?” the PA spoke, “to save your own life…and to get all these Prescription Drugs out of your system…so you can begin to work on your lifetime of Drug and alcohol addictions, the past 30 years it shows here on your chart…and that’s a mighty long time...I’ve got to give you credit for at least trying to do something about your problems, you’re a very brave man to face up to the sizable narcotics addiction you’ve acquired.”

“Yeah, been partying since I was 14, never thought I’d wind up in a place like this,” I sat there for a moment in quiet reflection, “been high most of my life…on one thing or another… guess it’s time I giddyuped and got going on this clean-up-my-act-thing, I’ve hit the break point…gotta’ do something…do something or it’s going to kill me.” “It’s actually a good place to start…to work on your problems, it’s really kind of nice here” the PA said as she began an examination of my upper body. So as I sat there on the examination table with my shirt off, I suddenly felt cold. “Not much muscle tone here,” she spoke as she prodded my flesh with her right index finger. Apparently, the last 10 years of narcotics use had put my gonads to sleep along with my mind and body. “Not much testosterone left in the Old Boy,” I thought. Loose flesh and muscle hung off my frame and a large pot-belly emerged from my waist line. “Atrophy,” she murmured as she wrote on her clipboard. The last six years of heavy Drug abuse had taken its toll. “How much did you say you were taking? The OxyContins I mean…the last three years?” she asked. “Oh, at least 10 or 12, 80mg. ER’s a day and whatever else I could muster,” was my reply. “Hmmm,” she hummed. “And how many have you taken today?” she asked. “Just two this morning,” I replied weakly, “I really need something right now, I’m feeling kind of sick.” “I’ll bet you are, I’ll bet you are,” the Little-Voice-in-my-Head answered. “Uh, we’ll get to that in a little bit,” she reassured me. As the physical ended she asked me

5 DeLuca/At Bully Hills about my panic disorder, “So what happens when you get these panic attacks?” “Well, let’s see…first my heart starts racing, my palms get sweaty, my skin starts getting very hot and then my world starts crashing in all around me…and there is an incredible terror that grips me as I am being suffocated by a sense of Impending Doom.” “Then the Heebie-Jeebies creep up my back,” I explained as best I could. “The Heebie-Jeebies? And then…?” she asked. “And then I do my best not to freak out, I try to relax and ride it out as I wait for the Xanax, I have just taken, to kick-in,” I managed to blurt out. “Well that doesn’t sound like much fun,” she answered. “No shit, lady…it ain’t a party,” I said to myself as I wondered, “she doesn’t have the slightest idea of what a panic attack is all about, does she? She doesn’t have a clue.” Evidently, this clinician lived in a safe, sterile, clean, environment, devoid of panic and despair. Then we discussed the sessions with my shrink and how long I had been on Xanax (14 years) Blah, Blah, Blah, and then we moved on. “What’s this?” As she poked my right arm near the inside bend of my elbow. “That…that? What do you think it is Lady?” I snarled, as we both looked at the scar on my right arm. The “Pipe-Line” I used to call it. A slightly raised scar on my right arm with a halfpipe depression dug into it, where a B&D micro fine diabetic needle loaded with 15cc’s of liquefied Cocaine could be inserted and flag-a-Hit; whereupon a small red ribbon of blood backs-up into the syringe, a telling lick of blood that says, “You’re in, push the plunger.” No muss, no fuss, no tourniquet needed, just a self-registered clean Hit—no problemo. There were multiple scars on both of my arms, badges of honor from the Drug Wars, after years and years of mainlining Cocaine. But to notice them you had to know where to look and what to look for.

“Just what do you think it is Lady?” I exploded. “I don’t know, whatever you tell me I’ll believe it,” she blurted out . “What a rube, what kind of novice did they hire?” I thought. “What kind of rehab is this?” Surely Dr.Dungaree would have spotted this in a moment. “Where was that Old Teddy Bear of a doctor, anyway?” I wondered, “Why wasn’t he giving me this physical?” “Well, I just believe what people tell me,” she recovered, “call me naïve, but I just believe people.” What a sap, what a maroon, what a moax she was; believed people? What kind of joke was this place? They couldn’t even spot track marks on a Junkie? What kind of place have I checked into?” “It’s called the Pipe-Line,” I told her, “ya’ know a track mark…from mainlining Cocaine…it’s where I know I can flag a clean Hit!” “Thank you for your honesty, we don’t get a lot of that around here…you’re very forthright…I appreciate that, now let’s get down to business, it’s time for your medication.” As the PA grabbed a blister pack from a nearby drawer, I noticed the label—Suboxone— Buprenorphine/Naloxone.1 “Uh-Oh–Naloxone—I knew that was the same stuff that’s in Narcan,” I thought to myself, “that’s the stuff they give to Junkies who have overdosed…brings ‘em straight out of a righteous Nodd after a couple of ampules are pumped into their system.” It throws a narcotics 1 Suboxone; Buprenorphine/Naloxone combination in a 2:1 ratio, Buprenorphine is an opiod ligend taken from the morphine molecule, first patented by British firm Rickett & Coleman (now Rickett & Beckinser) in the 1980’s, FDA approval as schedule III drug in 2002—Buprenophine is a mµ-opiate receptor agonist, and partial antagonist, a delta-opiate recptor partial antagonist, and a k-opiate receptor antagonist administered intravenously or sublingually See also: Naloxone is a mµ-opiate agoinist sold under the trade name Narcan®, injected intravenously, intramuscularly or subcutaneously to counter the effects of opiod overdose (e.g.Heroin, Morphine, OxyContin,etc.) See also:Buprenorphine and Naloxone are both synthesized from Thebaine, a naturally occurring substance found in the Opium Poppy (Papaver somniferum )and the Great Scarlet Poppy (Papaver bracteatum)

7 DeLuca/At Bully Hills addict into immediate withdrawal. I had first found-out about Naloxone and Naltrexone way back in 1990 by Nina, and a friend of mine named Dr.Mobius who read about them in a magazine article. Dr. Mobius or “Moped” as we used to call him first alerted me to the medical benefits of Naltrexone from an article he had read in Scientific American, way back in 1990. It held promise for the experimental use of Naltrexone as a treatment for alcohol addiction. Naltrexone appeared to block the narcotic high alcoholics enjoyed after bouts of heavy drinking. Dr.Mobius graduated with a Ph.D. in Chemistry from Syracuse University back in 1989, the same year I graduated with my Master’s of Music. I used to walk over the quad and visit Dr. Mobius in his lab between classes; we were both graduate students at Syracuse University. I was first prescribed Naltrexone by Dr. Dungaree back in 1990, when I first met him at Personal Counseling Services while he was pinch hitting for Dr.Bailey. It just so happened that my first addiction doctor—Dr. Bailey—had gone bad on T’s & B’s (Talwin and Benadryl) while he was acting Medical Director at Personal Counseling Services. Dr.Dungaree was filling-in for Dr. Bailey while he made an unscheduled trip to a rehab in Atlanta for doctors called Seafield. So Dr. Dungaree prescribed Trexan2 for me while I was enrolled in my first out-patient Drug Treatment facility. I was seeing a drug councilor named —Phil Zeppetello—while at Personal Counseling Services. That was my first time around for out-patient treatment for Drug and

2 Trexan; Dupont’s version of Naltrexone (an opiate receptor antagonist), patented by Endo Laboratories, Endo 1639A—1967 See also: FDA approved 50 mg tablets of Naltrexone for Heroin treatment in 1984 under brand name Trexan® See also: Naltrexone was designated an orphan drug by FDA on March 11th, 1985 which provided seven years of exclusivity research for DuPont See also: Dr.Joseph Volpicelli & Dr.Charles O’Brien (Chief of Psychiatry at Penn Univ.) conducted an unfunded study of alcoholism treatment using Naltrexone on volunteers at VA CenterHospital in Philidelphia—1985 See also: ReVia; by DuPont, Brand name ReVia ®(Naltrexone) approved by FDA as treatment for alcoholism in January of 1995 See also: Naltrexone is also synthesized from Thebaine (information courtesy of Gazorpa.com)

alcohol abuse. I remembered getting my prescription filled at Ryan’s Pharmacy in Syracuse, because that was the only place in the area that carried Trexan. The pharmacist at Ryan’s warned me about the side-effects before he filled my script. “You know what this will do to you if you’re on narcotics, don’t you?” he asked me. “It will throw you into complete withdrawal,” he asserted, “in a very short time when this stuff hits your system…you will be thrown into complete narcotics withdrawal…with no turning back.” I listened intently. “Do you understand?” he asked me. “Yes, I understand but I’m not on narcotics, it’s for alcohol abuse,” I answered. Those words were burned into my Memory Banks. I was prescribed Trexan to block the narcotic effects of—THIQ-tetra-hydra-iso-quinnaline—that is a byproduct of how alcoholics metabolize alcohol. After drinking alcohol most people metabolize it into acetaldehyde and carbon dioxide, however it has been shown that alcoholics process alcohol into THIQ. Naltrexone closes the window of opportunity for the narcotic high alcoholics enjoy when they get drunk. The PA handed me a couple of hexagonal orange tablets and I placed them under my tongue. “Sub-Lingual,” she said, “let these dissolve under your tongue.” I don’t know why I did it, but I did. I put the Suboxone under my tongue and let it dissolve while the PA timed me with her watch. Within 2 minutes there was a roaring in my ears, as blood whooshed by my eardrums. My heart started to Rush and my ears were ringing. “An ear-ringer,” I thought, just like a righteous shot of Cocaine. Now there was a surprise, an ear-ringer in a rehab.

9 DeLuca/At Bully Hills “Try and relax…let the Suboxone work,” the PA said to me. After 10 minutes or so the PA looked at her watch and said, “Almost 6:00 O’clock, almost time to go home.” Have to Go? Every goddamn person in this place was watching the fucking clock. Didn’t anyone in this place give a shit about me? That little bitch Melanie had been watching the clock too; she was supposed to leave at 4:00 O’clock. Now this PA was packing up to bolt by 6:00 O’clock. Mother-Fucker! “What if I have some kind of anaphylaxis or bad reaction to this shit?” I asked. “Oh, don’t worry…someone will be on staff this evening,” the PA said. “Gotta Go!” She put her coat on and left. Jesus H. Christ, I’m on my fucking own from here on in—just me and that Little-Voice-inmy-Head. I was beginning to get tired and decided go back to my room and to lie down and take a quick nap. I was shown back to my room by the nurse with the long corkscrew blonde hair; I lied down on my bed and my head hit the pillow. “Relax,” the Little-Voice-in-my-Head spoke to me, “lie down and just go with the flow.” Little did I realize it, but this would be the last rational thought I would have for the next 6 or 7 days.