NASHVILLE, Tenn. (AP) — For straight-talking ex-trucker Jeff McCoy, it was when he grabbed a gun and threatened to blow his brains out if his mother didn’t hand over his fentanyl patches.
Addiction to powerful painkillers snuck up on McCoy, an ordinary American who began taking the drugs legitimately for pain, but like millions of others, got caught up in the worst opioid epidemic in U.S. history.
But McCoy credits a Nashville doctor too, an addiction specialist who also works as a Vanderbilt University pain medicine physician — sometimes recommending the same drugs to pain patients that brought the others to the brink.
The ironies and tragedies of the crisis are not lost on Dr. Dan Lonergan, who faced his own dark abyss years ago in medical school, when his older brother died suddenly of a possible opioid overdose.
He’s heard criticism about doctors “who get ’em hooked on drugs and then turn around and treat ’em for addiction.” And he’s seen the finger-pointing from those who think faith and willpower are the answer, who say prescribing opioid drugs to treat addiction is trading one vice for another.
“Doctors have contributed to this problem. In the past three decades we have gotten a lot of patients on medications that can be very dangerous,” he said. “The pharmaceutical industry has contributed significantly to this problem. This is a problem that we all need to own.”
But to stigmatize addiction as a moral failing rather than a brain disease is wrong, Lonergan says. Research has shown that opioid drugs can cause brain changes leading to uncontrollable cravings for drug use even when it leads to dangerous and unhealthy behavior. To not offer medicine as a treatment, he says, would be like withholding insulin from a diabetic.
More than 2 million people are hooked on opioids. Overdoses from these drugs have killed more than 300,000 Americans since 2000, and they are killing an average of 120 people every day. Even for survivors, success never quite seems certain.
On a country lane 40 miles outside of Nashville, a lanky tattooed man wearing overalls and a do-rag gingerly leans over to tend sunflower seedlings in his spartan front yard.
Jeff McCoy, 56, is a straight-talking study in contrasts. He’s been a meth-using country band drummer, Harley rider and long-haul trucker, but these days McCoy calls himself a house husband — gardening, baking cookies for family and friends, doing crochet and doting on his wife, Joanne. Recovery from opioid painkillers prompted the turnaround.
It started nearly 17 years ago, after surgery for a progressive back injury — could be from baling hay as a boy, or too much time on the road, he’s not really sure, but it forced him to retire from trucking. His doctor prescribed Vicodin — painkillers that contain hydrocodone. After a year he was hooked.
“I just went full bore,” McCoy says. “I was popping pills like crazy.”
When those stopped working, he was prescribed fentanyl patches, powerful opioid medicine often used for intractable cancer pain. Placed on the skin, they deliver medicine gradually. McCoy figured out that yanking them off and chewing them worked faster. He didn’t know it can be fatal.
“Phew — what a rush. I’m not gonna lie — awesome. It makes you feel invincible,” he said.
Medicated, McCoy says, he felt normal. But then the pain returned and when he ran out of medication, withdrawal symptoms kicked in. “That’s when my body was just aching for that opiate,” he said.
“I didn’t wake up one day and say, ‘Oh my God, I’m addicted.’ It just happened,” he said.
He knew he was in trouble when his wife started locking up the patches in a safe. When he found the key, his mother — who lives nearby — took over doling out the drugs.
“Got to the point where I got on the phone with mom, ‘You better bring me that patch right now else I’m splattering my brains all over this living room.’ I wouldn’t have done it. I don’t think I woulda,” McCoy said. “Who knows?”
When his wife threatened to leave, he finally got help.
“I came close to losing her, and I love her more than anything in the world,” he said. “I’d honestly die for her.”
He checked himself in to a detox center, and began a new year, 2009, with two hellish weeks of withdrawal.
“It was rough. It was scary. They locked the door,” McCoy said. “It was the best thing that ever happened to me.”
He figures he’ll be on anti-craving medication for life even though sometimes now he takes just half a pill and still has some left when it’s time for a refill. That didn’t happen when he was taking pain medication.
“I’d have to suffer until I had my doctor appointment,” he said. “That’s the worst part about it. You’re all high when you got that big ol’ bottle of pills, you’re all happy party time. Then as it slowly goes down and slowly gets emptier and emptier, that’s when the anxiety (hits), ‘What am I gonna do, where am I gonna get some more?’”
Now, he says his wife is his addiction. “She’s my everything, she’s my drug. All she has to do is walk by me and pat me on the head and I’m like a dog in heaven.”
She taught him to crochet, a hobby for summer months when it’s too hot to bake. Cooking, cleaning and grocery shopping are also therapeutic for a man who hates to sit still.
Back pain still bothers him; he spends a chunk of each day flat on his back to rest it. His addiction medication helps a little, and he worries about not being able to find a doctor to prescribe it, if he or Lonergan were to move away.
Special training is required to prescribe that medicine in an office-setting instead of the kind of treatment clinics where methadone, another opioid recovery medicine, is prescribed.
Still, McCoy says he doesn’t worry about relapsing.
“I can honestly say I don’t even think about pain medication,” he said. “I’m not tempted one iota.”
He jokes that his life now is “boring as hell, but I’m happy.”
“The only thing that makes me different” from other addicts “is I finally wanted to stop,” McCoy said. “If I can survive with no life, come on, it’s worth it, but you gotta want to.”