I’ve been clean for over twenty years. Let me give you an example of the kind of problem addiction is, the scale of the thing. In April 2019 I went to the dentist. I had a mild ache in a molar. He said the whole tooth was totally rotted all the way through, that they couldn’t do anything more with it. It was hopeless. The tooth was a total piece of shit and would have to be extracted. He gave me the number of a dental surgeon and I called and made an appointment. I talked to my dad, who’d had many teeth extracted, and he told me it was no big deal. When I got to the dental surgeon’s office I told him that I’m a recovering addict, and that I wanted to avoid opiate painkillers. He looked in my mouth and when he got out he said, “You’re going to need opiate painkillers.”
Then he shot me up with Novocain and he went in there with a wrench, and I realized that dentists have soft, delicate hands and seem like doctors, like intellectuals, but when you really need dental care, you go to a dental surgeon and their main qualification is brute physical strength.
This guy had white hair and arms the size of my legs, and he put the pliers on me and wrenched and wrenched and wrenched, and despite the Novocain, the pain was like a hundred Hitlers gnawing on my nerves, gnawing them right down to the roots and then just sinking Nazi teeth up to the hilt in my brain. There was blood everywhere. I was making horrible sounds out of my throat, and the dental surgeon was saying just hold on for one more second, saying it through gritted teeth, and I was writhing in my chair with tears pouring out of my eyes.
Then it was over and he was wiping the pliers on his white coat and I thought, I never knew something like this could happen in America, and he said, “I’m going to write you a prescription for Percocet.”
There was a nurse there who said, “Maybe that’s not such a good idea, this patient is a recovering addict,” but the dental surgeon just ignored her and wrote the prescription and gave it to me.
I drove off. The Novocain was still strong, and once the actual brutal wrenching had stopped, I didn’t feel too bad. They’d given me a pamphlet about the dangers of dry socket. It said not to eat solid food. I thought, Well maybe I’ll get the prescription filled but I won’t use it.
It was surreal standing there at the CVS waiting for Percocet. I’d been clean for seventeen years, three months, and twenty-two days. No alcohol, no marijuana, no cocaine, no heroin, no Percocet, no Oxy, no Vicodin, no Ecstasy, no amphetamines. Nothing.
I took the bottle directly home and gave it to my wife. The amber bottle glowed in the sun. I put the Protocol into action.
The Protocol is what recovering addicts are supposed to do in a situation like this.
Give the medication to a friend or family member. Tell them to hide it and not to tell you where.
Even if you ask.
Take the medication only if you really, really need it.
You will probably lie to yourself about how much you need it.
Do you really need it? No.
Take the medication exactly as prescribed.
Stop taking it while you are still uncomfortable.
Then tell the family member to flush it down the toilet.
I was in my office on the second floor of my house writing an email when the Novocain started to wear off. It wouldn’t be crazy to refer to my house as a mansion, I reflected just before the Novocain wore off. Things have gone pretty well for me since I got clean, I reflected before the Novocain wore off, looking around my spacious office. This place sure is a long way from the bare, metal shelf beds at the Cook County Jail on Twenty-Sixth and California. Or even from the relatively plush jails in the suburbs. To say nothing of the jails in Baltimore. At least the Cook County Jail didn’t smell like piss.
Then the Novocain wore off. I called my dad and said, “What the hell?” He chuckled. “I didn’t want to scare you,” he said. “You mean you knew it was going to be like this?” I was holding my face when I said it. My voice was a little muffled. I was maybe crying a little. “Yeah,” he said. I went down and told Lauren and she left the room and went to wherever she’d hidden the bottle and came back and gave me a pill.
I went and sat in front of my computer and played Slay the Spire. I felt the Percocet come on. I remember my dentist, the regular one, the one with the soft hands, saying once when I had a root canal that he didn’t prescribe opiates because he’d read somewhere that they didn’t remove the pain. They just made it so the pain didn’t matter.
That dentist understood nothing. It’s like saying there’s no point in flying to Florida to escape the winter, because it’s still winter in the place you left. It’s like saying there’s no point in cutting off this gangrenous limb, because the limb will still have gangrene after you cut it off.
When the Percocet wore off, I thought, Okay, I just needed a breather, I can deal with the pain by myself now. It’s not like it’s going to kill me. So I didn’t take any more Percocet the rest of that day, or that night when I couldn’t sleep because of the pain, or the day after. I ate my meals through a straw. I picked pieces of bone out of my gum.
“Is that normal?” Lauren asked, watching me hold up a sliver of bone from my gum.
I developed a kind of stoop. The pain wasn’t in my back. It wasn’t in my limbs, but I walked around stooped over. Unceasing pain makes you stoop. It makes you tired. You can feel yourself getting older. Those seconds and minutes you used to skip over, now you have to go all the way through them.
It’s a scientific fact that there’s no way to know exactly how long a single second is. It’s not like an inch. You can’t lay a second next to another second and see if it’s the same size. The truth is that seconds might be all kinds of different sizes. Ordinarily this is an abstract, philosophical kind of truth about the difference between time and space, but when you experience extended chronic pain, this truth loses its abstract quality and you understand that all seconds are not the same size and that there are long seconds, and there are longer seconds, and there are Very Long Seconds.
The next morning I asked Lauren for another pill. The bottle said to take one every four to six hours. I waited the full six hours before asking her for the next one. It wasn’t like I looked idly at the clock and thought, Wow, it’s been six hours already, time for my next dose. No. I was getting up from my chair at five hours and fifty-eight minutes. I was asking her at five hours and fifty-nine minutes. I had calculated that it took her approximately forty-five seconds to leave the room and come back with the pill. I gave her fifteen seconds extra. If she took sixteen seconds extra, it wouldn’t have been okay. I would have said something.
And it was as if all this time, inside my skull, a calloused old scabbed-over eyelid was slowly rising. There’s an eyeball inside my skull, and when it opens, my other eyes, my outside eyes, the eyes on my face, grow dim. This eyeball in my skull is made to see just one thing. It has only ever seen one thing, and now the ancient long-closed lid was slowly rising, and then it was up, and the eyeball was looking at the thing it was made to look at, and the thing was still there inside me, and the thing was the first time I ever did heroin.
That night, sitting next to Lauren watching a TV show while on Percocet, I felt no connection to her. It was as if all the nearly invisible connections, all the little threads that connect our nerves and memories and feelings to the people around us, all those fine filaments of perception that had slowly grown back over years of recovery—it was as if they’d all snapped, and I was floating in outer space. Sitting there next to her on the couch floating in space. In high orbit. Orbiting the eyeball inside my skull.
The next day, I stopped taking the Percocet. I was still uncomfortable. I was still in pain. It was no longer quite as bad, though, and as I was sitting there around four hours after the last dose, I thought, I have to stop this now.
I called my wife and I watched as she dumped the rest of the pills into the toilet and flushed it.
Okay. Breathe. I’d followed the Protocol; I was still clean.
But the whiteness, the whiteness of the first time I did heroin, the whiteness of the memory disease, that whiteness, after so many years, when it filled the eyeball in the center of my skull … there was a second when my vision dimmed.
And it was like when all the sound goes out of a crowded room. And you can hear yourself breathing. And you think, Things aren’t what they seem. Houses, marriages, children, careers, can vanish.
The whiteness is real. It’s under those other things. Those other things are made of it—and look! Their outlines are starting to blur. They’re starting to turn white …
For the next couple of months, I went to more NA meetings than usual. The eyelid in my skull closed up again. It had only been open for a couple dozen hours, after all.
Call it the Pain Medication Paradox. That’s one aspect of the problem of addiction, a problem that has nothing to do with a stigma, nothing to do with anyone’s attitude. And maybe you’ll say, Well then, if it’s such a problem then just don’t take pain medication. Paradox solved.
Sure. How about you get a molar extracted, an extraction with “complications,” as the surgeon later described it when I went back, an “unusually difficult” extraction, how about you go through one of those and then you don’t get pain medication?
Pain is horrible. It’s inhumane. Literally dehumanizing. I was walking around like an ape on the second day. And opiates are still the only thing that works. We haven’t invented anything else that works. Should addicts be denied pain medication? Forced to writhe on the floor in pain for the crime of being born an addict? Is that progressive? Is that modern? Is that humane?
Okay, you say, so give the addicts pain medication if and when they really need it. Follow the Protocol, just like you did. You’re okay now, right? You just celebrated your twentieth year in recovery.
Yes, but what if things had been a little bit different for me? What if—on one of the innumerable occasions when someone offered me a drink—at a wedding reception, a Christmas party, an airplane ride, a dinner, a literary reading, a basketball game—what if on just one of those occasions, I’d reflected, Hey, I never really had a problem with alcohol. My problem was heroin, not alcohol, and I’ve had a long day, a hard day, a stressful day. Surely I can control my use of alcohol after twenty years, come on! Just one drink, just one little drink …
Or what if after being clean ten or fifteen years, I just decided to stop going to NA meetings? My wife has never seen me on dope. My daughter. My colleagues, my friends—none of them have ever seen me on dope. Why not stop going to meetings so much? There’s so much to do, life’s busy. It would be so easy to stop …
Or what if I got depressed? What if I just got depressed—depressed about the political situation, the climate, the state of literature, the state of the arts, the fact of death, the distance of my youth, hurtling away from me at lightning speed? I can barely see it anymore, a green blur in the distance. What if I finally just got really bummed out about the nature of time? And, like normal people when they get depressed, I stopped doing some things for a while. Took a little break. Stopped meditating, stopped exercising, stopped keeping my daily recovery journal, stopped reading recovery literature, stopped talking to recovering addicts …
What if I’d fallen prey to any of the innumerable things that cause recovering addicts to drift away from recovery? What if I hadn’t gone to a meeting in one or two or six or twenty months before walking into that dental surgeon’s office? What would have happened?
I can tell you what would have happened. It happened to a friend of mine. Call him George. He’d been clean for over ten years, stopped going to meetings. Things were going good for him. He didn’t need to go to meetings anymore. A year or two later he had some kind of medical procedure and took Percocet, and when the Percocet ran out, he found some dope and now he’s dead. Like the five addicts who will die as you read this, if you’re reading fast.
Let’s go further and imagine that I’d never really gotten into going to meetings at all. If that mysterious thing that I write about in my memoir, White Out, had never happened to me, and I’d never really given up trying to get high. Like millions of other addicts who are exposed to recovery but for whom, for whatever reason, that mysterious, maybe even mystical thing, never happens, and they never grasp that the only way out of addiction is also out of yourself.
A thousand little things, a thousand considerations of the most rational, the most progressive, the most reasonable kind can prevent a person from taking that step out of themselves, out of everything they know and are, out of the skull with the single interior eyeball, out of their mind. And if you don’t go out of that mind, you die.
As long as there’s a really effective way to stop pain, there will be addicts, and as long as there are addicts, many of them will die. That’s the kind of problem addiction is. And the Pain Medication Paradox is only one aspect of it. There are many others.
Don’t get me wrong. I’m not against the “Beat the Stigma” campaign. I wouldn’t be opposed to a new “Just Say No” campaign either. I’m for Suboxone treatment centers, halfway houses, twelve-step meetings, decriminalization, recriminalization, all of it. I’m not against doing anything or everything that helps. But don’t fool yourself. Addiction is a public problem. But it doesn’t have a public solution.
It has only private solutions. Unobjective solutions, nonscientific solutions. Solutions that speak in the first person.
From the foreword to White Out, to be republished by McNally Editions this month.
Michael Clune is the Samuel B. and Virginia C. Knight Professor of Humanities at Case Western Reserve University. He is the author of Gamelife, Writing Against Time, American Literature and the Free Market, and A Defense of Judgment.