“I’m pregnant and a heroin addict,” is what she said first, followed by, “I know you’re the only one who can help my baby.”  My initial response was silence.  This is the story.

I first met Pam at an Italian restaurant where she waited tables.  The owners knew me and allowed me to sit in the back where I could be alone, uninterrupted, to eat and do my research with multiple books and studies spread over the table. 

When I work, I like a little white noise from people.  With my brain chemistry, it has always helped me focus and write in stream-of-consciousness mode.  I tipped generously because I loved the ability to do my research there. 

Pam would ask about what I did for a living, which she found interesting.  She inquired about the books I was reading and asked thought-provoking questions.  She was a runner, thin, tall, five-eight with red hair and porcelain skin and dressed like a hippie in the 60s.  I liked her balls when she spoke about a topic she was fascinated by and her eyes lit up with enthusiasm.  

After months of waiting on me, Pam and I became friends, so I also learned Pam’s story.  She was a victim of child abuse, a loner and extremely intelligent on a wide variety of topics.  When a person is abused as a child, the flight or fight response is amplified as an adult.  She was in a constant state of hyper-alertness with adrenaline coursing through her veins 24/7. 

Pam wanted to die.  In a year, she made two suicide attempts, cutting both her wrists one time and overdosing on sleeping pills the other.  Pam believed the only way to survive was to be tough, invisible or absent altogether.  Traumatic memories are like having an infection-causing splinter in the brain; in order to get well, it has to be removed. 

Pam’s downward spiral started after knee surgery.  She was prescribed opiates for four weeks, which tipped the scale right into addiction.  When she exhausted her prescriptions from her physician, she hit the streets for heroin. 

Compassion for Victims of Addiction

When you know the backstory of a person who becomes an addict, it makes perfect sense.  People don’t wake up one day and say, “Today I’m going to do heroin.”  It’s an evolution of traumatic events over time.  These people can experience extreme loneliness even while with their family.  The way they deal with their pain is the mind-numbing effects of a dopamine burst.  Even if it’s every three hours, their pain vanishes and is replaced by a warm feeling, like a security blanket.  In this state, bliss drips slowly, like warm honey. This is why addicts chase the dragon.  The more highly functioning a person is, the more he doesn’t fit in and drugs help him open up and out of his isolation, allowing him to enjoy more tribal behavior.  However, if your tribe is a handful of drug addicts, you have to find a new one to get well.

People who have been traumatized tend to lean on tranquilizers: benzos like Klonopin, Valium, Xanax and Ativan.  In many ways, these prescription drugs work like alcohol and make people feel calm and keep them from worrying about anything—just a peaceful state of mind.  Casino owners love customers on benzos; they don’t get upset when they lose and keep gambling.  Slamming drugs into your veins is a “safe space,” in that it never lets you down like people do—it’s always there—and like an abusive lover, you deal with the pain just for sixty minutes of peace. 

Pam knew me and knew I gave a shit.  She said, “Russ, I could die tomorrow and never be missed by anyone.  That’s fucking sad.  I want to have this baby.  It will be all mine to love and take care of.”

I couldn’t help but explode.  “You’re a fucking drug addict!  I know that’s tough to hear.  I will help you.  You know that.  But you need to step the fuck up and stop meeting with your drug dealers.  Say bye-bye to that bling-bling fuckstick.  You don’t have a job.  Heroin is pumping through your veins and you want a baby to keep you company?  Christ, Pam, this isn’t a video game!  This is as real as shits gets! Come on, be rational.  Think.  You’re wicked smart.  You know what you have to do if we go down this road.”

Pam burst into tears.  “I want to have this baby!  I want you to help me!  You’re the smartest man I know!  I know you can help!  Don’t push me away, please, don’t push me away!” 

Fuck me! 

I went too far in my drill sergeant approach to make a point.  I grabbed her up and hugged her tight as she cried.  She held me and didn’t want to let go, and neither did I.  I felt her breathing against my chest and it was calming to both of us.  I was hoping my knowledge and her strength could see this dangerous situation through to the other side.

The Job of Recovery

This job can kill you.  You get so personally invested in your clients’ lives, if they die, so does a part of you.  It’s not like when people died on me while I was a paramedic.  I may have had seven to ten minutes invested in life-saving efforts; with that, I was able to compartmentalize.  Now as an interventionist I have months of face-to-face time with clients.  This is what people don’t understand.  To heal someone, you have to love them as much as family and then be able to extricate yourself. 

You think about them, wonder how they’re doing and hope to see progress.  I’ve spent 48 hours detoxing addicts and it’s exhausting.  It takes me weeks to recover from each high-level intervention.  As I’ve gotten older, my ability to compartmentalize has weakened; but I can admit that I don’t have the juice anymore, which allows me to exhale and move on.  I remember my father taking care of alcoholics in the 1950s.  He always gave a shit at the end of the day.  Maybe I model his behavior because I never give up. 

Working with addicts is like walking a tightrope:  they must believe in your total commitment to helping them get better, then you can slow it up as their lab work starts looking good.  With more normal neurotransmitter levels, their behavior improves, their depression lifts, they start to smile and they find a new healthy tribe of friends and a strong social network.  Then I can start to fade to black.  Pam’s case was like a seesaw—a fine balance of stability and progress, letting her know I was a phone call away. 

I understood everyone one in Pam’s life had given up.  No one knew how to care for an addict.  They all thought Pam was just a bad person and that wasn’t the case.  Addicts don’t just struggle every day; they struggle every hour trying to avoid the pain of withdrawals.

Pam had a strong mind and a stubbornness locked into her DNA from her father, an abusive retired police officer.  Even though Pam leaned on me for the best treatment options, she rained down verbal and mental abuse on me like a prick with a badge.  By using therapeutic listening techniques with Pam, I could avoid the triggers and land mines that would cause her to lose trust in me, shut down and use heroin.  I could not reason with Pam when she was high; but she was scared shitless about the drugs damaging her developing baby and I was, too.  I had no idea how to save the baby at first, but weeks later I uncovered a plan of action.

The Physiology of Addiction Recovery

An addict’s main goal is to avoid getting “dope sick.”  They usually require a bump every four hours to avoid withdrawals.  This becomes costly very fast and why using also leads to prostitution and crime.  Most of their symptoms are classified as psychiatric problems.  Viewing these symptoms as a permanent disability limits the focus of recovery efforts and dictates more drugs as treatment.  We use balanced, personalized, gender-specific science.  We develop therapies based on lab work, which indicates where the patient stands metabolically at that moment.  Our approach is multifactorial, affecting many systems at the same time.  The human metabolism is interconnected; using one drug (monotherapy) will never work.  Brain chemistry and the microbiome are never tested in conventional addiction centers.  Just our understanding of the gut-brain connection is light years ahead of any addiction center in the US. 

While developing advanced testing on multiple metabolic pathways, I observed something interesting about alcohol and opiate addicts.  Not eating (which addicts do sometimes for days) can be looked at as fasting, which flips a cellular switch and a process called autophagy kicks into overdrive.  This is the cellular cleaning of the toxins from the metabolism.  By not eating for 15 to 24 hours, addicts are inadvertently speeding the detoxification process, which is the first step in rehabilitation and recovery.  This can also speed withdrawal symptoms and the requirement for more of their favorite drugs. 

The liver has two detoxification pathways.  With a urine sample, we test whether addicts are fast or slow metabolizers, i.e., some addicts clear drugs from their system quickly—fast metabolizers—and need more of a drug to get the desired effect.  Slow metabolizers need less of a drug because it stays in their system longer.  Pam was a slow metabolizer, so we had a running start to help with her rehab process. 

Addiction treatment is like walking up a flight of stairs with a yo-yo.  The addict takes positive steps up every day.  The yo-yo is a metaphor for sleep, mood, diet and cravings, which can change hourly.  If Pam had gone through tradition treatment, she would have been labeled with a mental illness as well because of low neurotransmitter levels.  Pam could swing from happiness to despair to rage all in minutes of each other.  When I developed a detox program for Pam, I had to be careful not to sweep the heroin out too fast or the withdrawals would hit her like a storm.

Pam’s Recovery

Pam met me at our office, which is inside an addiction center.  Our physician did the evaluation and lab work, which revealed her body was already mining vitamins, minerals and amino acids from her own tissue because of a condition called opiate bowel.  Heroin causes an imbalance in the microbiome, the beneficial gut bacteria which converts food to energy.  “You are what you eat” is a misnomer.  You actually are what you absorb.  If Pam already had severe nutrient deficiencies from her heroin use, the developing baby had deficiencies as well.  

This was the perfect storm for failure, and she was suicidal from taking antidepressants.  This was a shit show, but I didn’t want to let her go.  I wanted to learn from her and prayed we could shift her behavior.  

I felt gut-punched.  I had to be the parent, the realist, the interventionist and a motherfucker when driving home the point to stay away from her drug dealer.  I had to create friction in Pam’s brain and show her how to hold two opposing thoughts at the same time, to think geometrically, not linearly.  For example, a lost mountain climber about to freeze to death might be sad, angry and depressed.  He has to accept that he might die, but with a stroke of luck he might be able to start a fire.  He then has new hope and motivation to power through his dreadful situation.  I had to find that fire to save Pam and her baby.  

She was about a hundred pounds and anorexic which could be a benefit, as I explained, because that causes the cellular cleansing process of autophagy.  I thought if we could ramp up her natural internal antioxidants—catalase superoxide dismutase and glutathione—with oral or intravenous antioxidants, the baby could have a shot at a normal life.  Throughout her pregnancy, Pam followed her diet and took the supplements she was deficient in.  The human metabolism, when given the right balance of nutritional and hormonal support, can make miracles happen.

* * *

Fast forward four months, I met with Pam and she showed me video of a healthy baby boy.  I saw the love in Pam’s eyes.  All the abuse and drug use disappeared now that Pam had someone who truly needed her to keep them both healthy. 

It was a situation I’ll never forget, meeting a person who went from suicidal to a loving mother.  We are now using our research on the opiate bowel along with mitochondria function to help addicts across the US.