In his late 20s, Christopher Milford of East Boston, Mass., got high on some OxyContin his friend gave him. By the time he was in his early 30s, he was shooting heroin and Suboxone.
Milford is part of a group of opioid addicts whom doctors describe as the sickest of the sick: intravenous drug users, mostly people who use heroin, who get endocarditis. Some aspects of their treatment present an ethical dilemma for doctors. Cardiologists, surgeons and infectious disease doctors can fix the infection, but not the underlying problem of addiction.
I was on the bus earlier today and sat behind this guy who had a can of alcohol that he was sipping from. I didn’t think much of it except how much cheaper alcohol is than dope and that I wouldn’t mind a nice, fat shot of some afghan brown or china white. The guy then gets up to stand in front of the doors so he can get off at the stop we’re approaching when all of a sudden he turns around and lunges towards the window and spews projectile vomit at the cars passing us. Everybody’s staring and I’m so happy I moved down to the seat on the other end of the bus before he sprayed alcohol and stomach juices at everything in front of him. When he’s done, he slams the window closed in frustration and maybe even despair and the second he turns around to walk off the bus and light a cigarette, I realize I know him.
He was this guy I spoke to at my last detox about a year ago. He had scars on his arm from the years he spent self harming and was trying to cleanse himself of alcohol and heroin before it was too late. He acted tough and like he didn’t give a fuck about anything but chilling and having fun with some bottles and blunts. But that was a lie or else he wouldn’t have been in there with me. We never spoke or saw each other again after those few grueling days, but I thought about him every now and again. Not because he was cute or charming or anything like that, but just because he stuck out in my memories. He was different but pretended to be the same.
And when I saw him on that bus, I felt this deep sadness in my chest. Like how awful it must be to be him, to be broken and alone and still so addicted. I remember those feelings and how awful they were. The days and nights I spent dope sick, either rejected from detox or just went AMA, throwing up on trains and buses - just like him, homeless and hurting. It’s been a year and he’s still in the same spot, most likely worse than before.
And me? I’ve been clean for almost a year and I am so grateful for that because living that kind of life isn’t really living at all, it’s just existing with this constant pain and despair. I didn’t want that big shot of dope anymore because nostalgia is a liar. There’s not much good with using dope, it’s mostly just fucked up experiences and vicious cycles that get you nowhere but dead.
Heroin Epidemic Is Yielding to a Deadlier Cousin: Fentanyl
Fentanyl, which looks like heroin, is a powerful synthetic painkiller
that has been laced into heroin but is increasingly being sold by itself
— often without the user’s knowledge. It is up to 50 times more
powerful than heroin and up to 100 times more potent than morphine. A
tiny bit can be fatal.
In some areas in New England, fentanyl is now killing more people than
heroin. In New Hampshire, fentanyl alone killed 158 people last year;
heroin killed 32. (Fentanyl was a factor in an additional 120 deaths;
heroin contributed to an additional 56.)
Syringes scattered along the ground at a homeless encampment in Lawrence, Mass. Credit: Katherine Taylor for The New York Times