“Do you have any Blues?” I heard the words as they tumbled out of my mouth. I had come to Walmart to buy cleaning supplies for my lovely new apartment, not drugs.
I had never intentionally used illicit fentanyl and hadn’t been addicted to drugs in many years. Without an iota of forethought, I saw a woman nodding out by the shopping carts and asked her for Blues, the fentanyl pills that dominate Portland’s opioid market.
She looked me up and down, sized up the likelihood I was a snitch, and answered my question. “No, but the guy by the bottle return does.” I thanked her, but proceeded to walk inside the store, not towards the Blues.
I grabbed the items I’d braved that hellhole for, paid, and walked straight to my car. On the way, I glanced over my shoulder at the bottle return, knowing relief was just a few steps away. I wanted to stop existing. Temporarily, permanently, whichever was most convenient.
Opioids have always been the kinder, gentler alternative to suicide for me. In the days after my mom’s sudden death, and again after my arrest for my friend’s sudden death, languishing in jail facing 20 years in prison, access to heroin saved my life. The alternative would’ve been suicide.
I drove home and thought about what I’d just done. What if she would’ve said yes, and sold them to me right there by the shopping carts? Would I be on my way to smoke fentanyl in my living room?
If I died alone in my apartment, it would take a while for anyone to find me. I couldn’t stomach the thought of inflicting that trauma on them. I’m the one who found my mom. Trauma it is.
Did I want to die, or just get high? I hoped it was the latter. That’s simpler, more rational. Getting high feels good. But what if it was more sinister, that I wanted to die? I live a life most people could only dream of, including me. I should feel grateful. Instead, I felt like using fentanyl. Knowing how high the risk of overdose is, I worried about using alone and the potential to die and not be found for days.
But there is no alternative to using alone for me. My entire professional career is built upon having used drugs, previously, past tense. I inject distance between me and the more unsavory elements. In distance, there is safety. Even if that distance is artificial.
We spend our lives fighting against stigma and then reproduce it in our personal lives, project it upon our own selves. When I first tweeted about this back in February, I was imagining a scenario in which I’d returned to compulsive use.
But the Blues incident reminds me there’s an even simpler (and more likely) scenario: a single, one-off use.
I disallowed myself from considering the temporary repreive of opioids. I thought of my landlords, and my coworkers, and how they wouldn’t hear it about it for days and probably only then via Twitter. (Why those folks rested heaviest on my mind, I cannot say.) It’s not that I stopped obsessing over finding a reprieve, though.
I’ve struggled with passive suicidal ideation since I was in middle school. If suicidal ideation is a scale from 1 to 10, I never get below a 4.
Six weeks after the Walmart incident, it wasn’t Blues that I wanted impulsively. It was the splaying of my veins or jumping out of the 45th floor window of the Marriott.
One month ago, I nearly took my own life. It would have been easier to kill myself than to admit to anyone that I was going to use street opioids.
That level of suicdiality was unlike anything I’ve ever experienced before. The internal screams of “kill yourself” receded to a less terrifying volume after I stopped taking the medication, per my psychiatrist’s advice. Not wanting to be put on a pysch hold, I greatly downplayed what I reported to my doctors until after it had improved.
I’ve built an entire career around being in recovery or having been to prison but now being on the straight-and-narrow, and I’ve made it nearly impossible to ask for help. Even though I’m surrounded by zero-judgment harm reductionists and supportive people, something inside of me —and the knowledge that it truly would decimate my career should it become public knowledge that I’d returned to use—makes it impossible to admit my struggles while they’re ongoing. (Is this internalized stigma I now project on myself? Yes! But this is also society.)
I came closer to committing suicide than seeking temporary oblivion. When prominent harm reductionists and drug policy experts die of drug overdose, even though they knew better and we spend our lives telling people not to use alone, I get it. I feel it in my bones, knowing that could be me. Knowing better doesn’t translate to doing better when so much is riding on my struggles being a thing of the past. When my very successful career depends on the fact that I did drugs a long time ago.
I don’t tweet or otherwise share problems as they happen, I’ve realized. I need everything to have a beginning, middle, and an end. Things must be more or less cleanly resolved before I dare commit them to writing. Twitter would never know when I was at my most depressed, until a month later when I can talk about it with that distance of time that brings safety.
In early October, I considered checking myself in as a psych patient at the VA. But I know many of the doctors there and have professional engagements; is that a pro or a con when in mental health crisis? Later, in talking to a dear friend who has worked at the VA, I realized that I should’ve gone in. If it happens again to that degree, I will. Probably.
Since the peak of the bleakness, my depression has waxed and waned. Ceasing to take the SSRIs (and later SNRIs) seems to have helped restore my suicidal ideation to a familiar place. I can deal with familiar, I’ve spent two decades forming defenses to it.
I sought treatment and have been approved for esketamine therapy. It would’ve taken several more medication failures to get the VA to pay for it, so I’m using my employer-based health insurance. Overcoming my initial disgust at the American medical system after a lifetime of military healthcare, I’m warming to it. It would have taken more failed medication trials—that I am unsure I would survive—to get the VA to offer ketamine to me. With my private health insurance, it was fairly easy.
I don’t actually want to kill myself. Well, sometimes I do. But I don’t want to want to. I want to be grateful to be alive! Hell, I’d take ambivalent. I wonder how much more productive or successful I could be if I didn’t spend so much of my mental energy on not killing myself. Why do the slightest of tasks take such effort?
I’ll be documenting my esketamine treatment and its effects to share with others, and to understand it myself. I don’t expect a magic cure. I would be happy with marginal, temporary improvement. I very much do not want to be alive most days, despite how much I love the people I share my life and the work I do. It doesn’t even make sense to me, so any confusion upon reading this is warranted. More than anything, I don’t want to leave a void in this world with my absence.
I’ve felt the gravitational of pull of those voids too many times. I do not want to inflict that on others, and am committed to not doing so. It doesn’t mean I don’t have a nagging suspicion my destiny is to become one nontheless.
Maybe ketamine will help. Maybe my new therapists (plural) will help. Or maybe they won’t. But maybe it’ll get easier to live with. Or maybe it won’t. And then what?
This story has no ending. For once, I’m sharing struggles as they are ongoing.
To those I reached out during that time: thank you. I couldn’t bring myself to march into the ED at the VA, but I did confess how close I was getting to ending my life to at least two people who helped me enormously. I’m still alive and want to thank them.
A note to everyone else: you didn’t “miss the signs.” In social situations, I can reciprocate the happiness of others. A lot of my positive emotions are confined to being reciprocal, actually. I struggle to generate them spontaneously. Outwardly, I can look like I’m doing great! Back in my hotel room, alone in my car, it’s a different story.