THE FACES OF OPIOID USE DISORDER
MY NAME IS SUSAN…..
Recently, I attended a conference with a number of my attorney colleagues, regarding mass tort opioid litigation. I left that conference with a lot of knowledge, new friends and an overwhelming sense that I needed to talk about my own experience concerning substance use disorder.
My name is Susan, and I am in sustained remission from opioid use disorder- in other words, as my peers put it. I AM A DRUG ADDICT. With that term comes lots of preconceived notions, prejudices, hateful language and gross misunderstanding. I am neither embarrassed nor ashamed; it is a fact of my life. I am one of 20.2 million of Americans who suffer a similar ailment*. This disorder has many challenges and stigmas attached to it. Some of the other facts of my life; I have also been diagnosed with several other chronic conditions, adult-onset diabetes, depression, hypothyroidism, and hypocholesteremia. I’m five feet tall (with a much larger attitude) I’m a registered nurse, sexual assault counselor and survivor, attorney, licensed health care risk manager, volunteer, mother and grandmother.
In the early 2000’s, I spent many mornings walking on the beach with my dogs. One beautiful morning as I walked along the edge of the ocean, I was literally rear-ended by a pack speeding happy dogs. My feet went up and I landed so hard on my back that I felt like I stopped breathing for five minutes. I initially brushed it off, but by later in the evening, I was in pretty significant pain. I spent some time trying to use home therapies, being a nurse and all; I thought I could manage this. At the same time I was a practicing attorney and the single mother of three young teenage girls. As the sole support of my children, taking a lot of time off from work was simply not an option. I finally went to an orthopedic surgeon, got an MRI which revealed fairly significant herniations at L3-4, L4-5 and L5- S1. My doctor and I reviewed my options; he recommended physical therapy and pain medication for me. We specifically discussed the OxyContin he was recommending, as I did have some concerns taking any narcotic pain medication. Truth be told, I had problems with alcohol during the time of my divorce, but felt that those issues were behind me. My doctor told me of studies that supported that OxyContin was extremely effective for pain and there was a very low chance of severe dependence (addiction.) Perhaps I was hearing what I wanted to hear, but I knew that I was in significant pain and I needed to get back to work. So my journey into the abyss began.
Initially, OxyContin was the wonder drug! It relieved my pain, did not interfere with any of my activities of daily living, including my ability to work. After a time, the OxyContin became less effective. It took more and more medication to do less and less in terms of pain relief. I had developed a tolerance for the OxyContin. I was reporting more severe pain symptoms and the dose was slowly increasing, but it still wasn’t enough. I was becoming more and more anxious and not able to sleep. I was exhausted all the time. While somewhere in the back of my mind, I knew this was a bad idea, I started with a glass of wine or two to help me sleep.
Slowly, but surely, I started falling into the deepest chasm of fear, bewilderment and despair. While I did not want to die, I started to have glimpses of catastrophes’ on the horizon. I could not stand my life with the little pills and Vodka, but I also couldn’t imagine my life without them. They were taking me to places I never wanted to go but found myself there – shaming myself each time - how could I? The truth was that everything that was happening in my life and every decision was directly tied to my substance abuse. I tried and failed to moderate the dosage, drink less but moderation was not going to change the fact that I was “addicted”. No amount of willpower could keep me or my children safe! I wasn’t a “bad” person trying to get “good”- I was a sick person trying to get well.
At the conference, during a discussion of representing babies afflicted with Neonatal Abstinence Syndrome, a question was raised about whether the presenter was planning on including the Mothers as Plaintiffs, the presenter responded by saying he hadn’t decided whether to make the Moms defendants or plaintiffs - laughter ensued. As a 30 plus year practicing Plaintiffs attorney, I understand the pitfalls of representing certain individuals and I am not advocating for or against this – it’s a strategic legal decision left best to the specific attorney of whether an individual Mom has a claim to pursue. HOWEVER, could I relate to that Mother who took prescribed and/or street drugs while she was pregnant...? Absolutely, there but for grace – go I. My children suffered as a result of my Opioid Use Disorder. I did not wake up every day thinking everything I was doing was ok – quite the opposite, yet for a significant amount of time, I was powerless to stop. If we, as advocates, don’t believe that these Moms are more likely the victims and are suffering from this well documented series of chemically induced illnesses, who will?
My recovery journey started as many others have and I am grateful it is been more than a decade since I have felt it necessary to drink or drug. I am privileged to have survived my Opioid Use/Substance Use Disorder as there are many others not so fortunate. There is absolutely no difference between me and the so called Junkie, Crackhead, Drunk, Dope fiend, Stoner, Tweeker- well you get the idea.
WORDS matters! As I sat through this conference, I was struck by how even my colleagues who represent folks like me - describe folks like me. I would suggest that if my colleagues want to do a service to those suffering from this chronic, devastating and frequently, deadly disorder they speak the language. Perhaps attend a few open 12 step meetings and see what it’s really like in real time. While I have called myself a drug addict and alcoholic and even written a paper using the term – I have come to understand that I do no service to my fellow survivors by doing that in communicating with those who are fortunate enough to not be so afflicted.
So instead of calling us addicts- which we absolutely know is the more flattering of terms the defense is going to call us. Use the medical terminology, I have been diagnosed with opioid use disorder, substance use disorder and am in long-term remission. Please review the DSM-V- it explains and describes Opioid Use Disorder and related disorders. Look at the ICD 9 and 10 (international classification of diseases) you will find opioid use disorder in there along with the many co-occurring disorders. It’s not THEM vs. US. IT is US. Two million Americans had a substance use disorder involving prescription pain medication in 2015 and 174 Americans die every single day of a drug overdose.
My name is Susan and I am a survivor of Opioid Use Disorder. Call me an Opioid Victim, Opioid Survivor, A person with Substance Use disorder, a non- fatal causality of drug manufacturers planned campaign to sell more and more drugs! We are bright people – let’s reframe the conversation. Please join me and be the messengers of change!
*According to SAMHSA’s 2014 National Survey on Drug Use and Health (NSDUH) an estimated 43.6 million (18.1%) Americans ages 18 and up experienced some form of mental illness. In the past year, 20.2 million adults (8.4%) had a substance use disorder. Of these, 7.9 million people had both a mental disorder and substance use disorder, also known as co-occurring mental and substance use disorders
Ms. Ramsey’s professional experience began as a Registered Nurse at Yale New Haven Hospital. While pursuing her Bachelor’s Degree, she was a counselor with the New Haven Rape Crisis Program. Ms. Ramsey graduated from CUNY Law School, and is admitted in several different bars and has actively advocated for victims of health care negligence and defective medical devices. She continues to speak and present publications for a number of organizations, including nursing and legal institutions. She received the Arnold Markle award by the Judicial District in New Haven, Connecticut, for her work with survivors of sexual assault. She is a member of the Palm Beach County Sober Home Task Force, a Compliance Committee Member of the Florida Association of Recovery Residences and advocates for victims and survivors of substance use disorders. Ms. Ramsey actively litigates cases involving catastrophic injuries and wrongful death on behalf of victims.
By Susan Ramsey