Addictive Ritalin - More, Now, Again

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http://books.guardian.co.uk/extracts/story/0,6761,647315,00.html

More, Now, Again

Ritalin - it was a drug they gave hyperactive children. How could it be

addictive? Wurtzel - who famously has known depression, Prozac,

heroin and cocaine - found a way when she secluded herself in Florida to

write a book. She describes the long, tortuous journey back to recovery

Saturday February 9, 2002

I don't remember the beginning at all. I mean: the beginning of addiction.

It's hard to say when it becomes a problem; it sneaks up on you like a sun

shower. Even if you keep a record in your Filofax and you know the first

time you did this or that, and then the second and the third and the ninth

and the 90th, it is still difficult - no, impossible - to say when it went

from casual use to a bad habit to a problem to abuse to addiction.

All I ever wanted was to be good. And it's all turned out so bad.

I arrive in Florida on Halloween, in 1996, and it is so sunny that the

world feels like a blank of light, nothing but whiteness. My mother's

apartment is completely white - the tiles on the floor, the walls, the

faux-marble bathroom, everything is just stark - and life feels simple and

shiny. My whole life has been erased by the sun. Whatever is going on in

New York is gone, bleached out. All that's left is me.

I don't need drugs, I don't need friends - for all I care the phone can be

disconnected. I'm through with everything. Bye-bye life.

It used to be easier to manage life. I lived in a huge apartment in the

Flatiron district and everyone came by and hung out there, all my friends,

a bunch of listless bohemians lounging about and drinking tea and beer and

carrot juice, and sometimes smoking pot. I didn't have to go anywhere to

see anybody, because everyone came to me, I was the barmaid at the

neighbourhood pub, I was the happy hostess. But it's not like that any

more. I'm 29, everyone I know is hovering around 30, no one's life is

settled in any conventional sense, but the feeling seems to be that it's

time to try.

Among my pals, I am the only drug addict. They may not be married, their

apartments may look like Nagasaki in a walk-in closet, but I alone am a

junkie. Everyone I know has withdrawn in one fashion or another, and so

have I. Here in Florida, I will stay clean, because instead of using drugs

to hide, I will just plain old hide.

I love it. I am not making this up. This is my idea of heaven. I've got a

TV and a VCR, I've got 51 channels of cable, I've got a view of the

Intracoastal, I can laugh at the pathos of human existence all day long

because it does not matter any more. I owe my publisher a book, I will be

honourable about completing it, but beyond that, it's over between me and

the world.

I have been seeing Dr Singer in New York for about a year now. She is an

addiction specialist, and she used to run a substance abuse programme at a

teaching hospital. I started seeing her three times a week, because I

thought, given her area of expertise, she could help me stop using heroin

and cocaine. And it worked for a while. Under her tutelage I went to AA and

cleaned up.

That lasted about four months, all through the summer of 1996. It lasts

until my friend Oona, who is my sobriety buddy at AA, calls me to say she

has a bundle of dope, and what should we do about this. I'll be right over,

I say.

So eventually I walk into Dr Singer's office with a heroin hangover, a

headache like hell, vomiting, shaking, jonesing. I cannot bear to admit to

her that it's come to this. I've been doing so well.

" What do you want to do? " Dr Singer asks.

" What do you mean? "

" Are you ready to stop using or is this binge going to go on for a while? "

She is so calm.

" No, I've had enough, " I say, because I have.

Dr Singer tries to rearrange my antidepressant combination so that the

medication will be more effective, and finally she throws some Ritalin into

the mix. My psychiatrist thought that taking four Ritalin a day would curb

my interest in doing other drugs, and she certainly got that right. This

form of safe speed would be a good way to give me the stimulation I needed

without putting my health and life at risk.

And it worked. It definitely worked.

After a month on Ritalin, after feeling much better, I decide to go to

Florida to work on my second book [bitch], and ignore how unbearable and

confusing life is when I'm not getting high. I loll about. I read a lot, in

the guise of doing research, but in truth, I really do need to read these

books. Maybe not all of them, maybe not from cover to cover, but it is a

time-honoured tradition for writers to procrastinate by doing more

background work than they need. I take taxis to the mall, and I go to the

Borders and drink coffee on the deck and watch the water taxis float by. I

special-order books I need and I befriend the clerks.

I have relatives in Florida - I mean, who doesn't? My aunt Zena and uncle

Bill live in Inverrary, due west of here, and play a lot of golf. My mom

and I were always the poor city relations, living in state-subsidised

housing in Manhattan. I went to private school on scholarship, and you'd

think that all my Long Island cousins and aunts and uncles would have

thought we were worldly and sophisticated, but all they ever noticed is

that my mother never remarried and, now, that I am closing in on 30 and

have still not managed to get to the altar myself. They can't understand

why a pretty, educated girl like me can't nab a man, like my only value is

in my marriageability, and since I appear to be perfectly desirable, they

just figure I'm an artist and I'm strange.

One day I am talking to Dr Singer on the phone, and I tell her that I wish

the Ritalin didn't hit so hard, that I could take it more gradually. Or

maybe I complain that it does not last long enough, that I can actually

feel it wearing off. Dr Singer suggests that I try cutting the pills in

half with a sharp knife. So I get out a steak knife and cut a Ritalin pill

in half. This is harder to do than I might have guessed, and it just splits

into little pieces, crumbles like a biscuit, with powdery flakes all over

the place.

Eureka!

Why had I not thought of this sooner? I swallow a couple of the chunks with

water like I normally would, and the rest I chop up into even finer bits. I

press on them with the knife and break them down until they're a white

powder. I snort up the Ritalin. It scratches and burns my nostrils a little

bit, but it's not too bad. And then I feel a tiny rush in my brain. It's

nothing too intense, just a little burst, but it feels so nice. So nice to

be putting stuff into my nose again. I can't imagine there is anything

wrong with it. It's the same thing, after all, the same amount of

medication, just an alternate method of absorption.

The only problem is that it hits very hard when I sniff it up, it goes

right to my brain, so there's no chance for it to absorb into my

bloodstream gradually. The exact problem I was complaining about in the

first place. So I try to snort half a pill at a time; I try to maintain at

least two hours between lines.

I try.

And then after a few days, I give up on trying. I take a whole pill every

couple of hours. I figure that means I am taking eight a day instead of

four, which isn't great, but how bad could it be? Plenty of people are on

much more than 40 milligrams of Ritalin a day. There are six-year-olds who

are given Ritalin for attention deficit hyperactivity disorder (ADHD), and

some of them take more than a hundred milligrams a day. According to all

the literature, Ritalin is not addictive. If it were, they would not be

giving it out to patients who are still in elementary school, still in

their cavity-prone years. I have finally found a way to stay happily clean.

Amazing. Just amazing.

I am suddenly happy and upbeat all the time. I have a new energy that is

delirious, vertiginous. I work out in the little gym downstairs in my

mother's building at two in the morning. Once I'm done with my physical

fitness routine, I go back upstairs and watch TV, or sometimes I write. Did

I mention that I have started writing? It has been completely splendid.

Instead of just sitting around and reading I am now actually taking my

research and getting started on my book. I almost can't help myself.

Sometimes I don't mean to be writing, it's the last thing I feel like

doing, Imitation Of Life is on and I really want to watch it, but I find

myself writing anyway. This has never happened to me before. My editor is

extremely pleased.

I realise I have run out of Ritalin about two weeks sooner than I am

supposed to. I can't figure out how this has happened because, even though

I know it's not true, I still believe that I am only taking four pills a

day. I assume that perhaps the pharmacist miscounted, maybe he did not give

me quite as many pills as he was supposed to. So I call the pharmacy and

tell them they must have sent me fewer pills than they were supposed to. He

apologises and sends me 60 more. Since it is his mistake, I don't even have

to pay for them.

One day I am in a tiny drugstore. Hidden in a corner, on a shelf of herbs

and vitamins, I find a combination pill slicer and crusher. This is a

wonderful apparatus for me, since it means I can put a whole bunch of

Ritalin in it, crush it into powder all at once, and just spill it out

throughout the day and cut it into lines. I love this little thing, I can

carry it in my bag anywhere I go, I no longer need to find appropriately

smooth and shiny and dark surfaces for cutting up lines.

After a few days, I start snorting the Ritalin right out of the cup in the

crusher, not even bothering to mete it out into smaller segments. I have

only been in Florida for a few weeks, but Ritalin has already become my

life. The consensus among my relatives is that I am thriving. Ritalin has

made me popular. Life is easy.

By the end of December, I am short on Ritalin again. I still can't quite

make sense of this because I still do not think I am taking all that much

of it. I tell Dr Singer that I am running low. I tell her that I think the

friend who has been dropping off my Ritalin prescriptions for me might be

stealing some of my pills. And Dr Singer says something about Ritalin being

legal, that many people who are uncomfortable with street drugs would have

no problem abusing prescribed pills. I laugh as she tells me this - how

ridiculous can people be ? How lucky I am that my problems are with cocaine

and heroin, and not Ritalin.

We laugh, and Dr Singer agrees to write me a new prescription a couple of

weeks early.

I am reading Vanity Fair; it is the Hollywood issue. This actually passes

for research, because there is an article in it by a woman who, when she

was a teenager, knew the 13-year-old girl who slept with Roman Polanski.

Since I am writing about troubled teenage girls and Polanski's affairs,

this magazine memoir is germane to my work. In the first paragraph, the

author establishes she fell in with a fast crowd in Hollywood, that she had

been up to no good long before she met this girl, long before she'd

encountered Roman in some decadent hot tub. " I'd already been sent away for

treatment for Ritalin addiction, " she writes.

Ritalin addiction ? Excuse me?

Ah, so. Maybe this happens to people. Here I am, thinking that everything

is fine - well, not fine, but you know what I mean - because I am abusing a

drug that's basically for six-year-olds. The idea that this could happen to

other people, the possibility that I am not the first person to come up

with this activity, has never occurred to me. Never. Ritalin is too tender

and childish to rate as an addictive substance.

But I guess it is. I guess it must be. I am a Ritalin addict.

My friends start to wonder where I am, why they don't hear from me. On the

rare occasions that I pick up the phone I just say it's nothing, I am

working hard, I'm fine.

Kathlyn stops in Florida to see me on her way home from a trip to Brazil.

She has to switch planes in Miami, or so she says, so she figures she

should check up on me. Kathlyn is my best friend. We sit at my kitchen

table and talk. I tell her it is time for my medication, that I hope she

does not mind if I snort it. She can hardly object in my own home, so I cut

up lines and inhale them with a $20 bill that has been rolled up, coated

with snot and sticky white powder, for quite some time.

She looks horrified, but I tell her this is just an alternative method of

transmission, it's a prescription, it's fine. " Well, whatever you say, " she

says.

Kathlyn is probably my favourite person in the world. She is a venture

capitalist and what most people mean when they talk about a fiery redhead:

she is half Irish and half Ecuadorean, with serious tits and ass, and you

definitely do not want to have a disagreement with her. She does not - she

cannot - suffer fools. I think she is fast becoming disgusted and sad.

" Look, I know I have a problem. " I pause. " After my book is finished, I'm

going to get serious help with the drugs. I'll check in somewhere or

something. I know I need help. I'm not kidding myself. "

" When is this going to happen? "

" Soon. " I'm not lying. I really believe it will be soon. Soon doesn't mean

the same thing to me that it does to most people, of course, because I'm on

speed and I'm in a place without seasons. I don't even know what month it is.

" Okay, " Kathlyn says. " Promise? "

" Promise. "

I move back into my mother's apartment. , who's a relative, is doing

renovations. There is dust and sawdust everywhere, from uprooted tiles and

cement and plaster. Wherever I cut lines, they are adulterated with all

this household debris. And I really cannot stand . I never know when

he'll turn up, so I cannot leave my lines cut up just anywhere.

is supposed to call and say he is on his way, but he is family,

he's got the key. He comes in at eight one morning unannounced. I've been

up all night, maybe writing, maybe not, and his arrival jars on me. I just

want to be alone with my drugs . That's all I want. Just leave us alone,

let us be happy together. We are in love, we are a young misunderstood

couple, everyone wants to tear us apart. They just don't understand. We are

Romeo and t! We are star-crossed lovers. No one will let us be.

My mom walks into the house one day in October at eight-thirty in the

morning, which is reasonable enough, since this is her apartment. " We need

to talk, " she says. " , I don't know how to say this nicely, but...

" Long pause. " You will never be done with this book. It never ends. Maybe

you can't write right now. I don't know what's happening, but you don't

seem to be getting anywhere. I can't watch this. Go home. Go see Dr Singer.

Go be with your friends. Something's wrong. "

She's right, of course.

Two weeks later, I'm back in New York and it is pouring, the beginning of

the November rains. I miss Florida already. I go straight to my apartment.

It shouldn't be too much of a shock - it's only been three months. I'll

make myself a cup of tea, because I always do. I'll snort up some Ritalin,

because I must. And then I'm going to get a hold of José, the coke man.

It's too tiring keeping myself supplied with prescriptions.

But that's okay. Cocaine is fine. Just fine...

It is December 1997, and I am finally checking into a drug rehabilitation

programme at Silver Hill Hospital, a country-clubbish sprawl in

Connecticut, that famously treats deranged dowagers and literary drunks,

but is in fact a psychiatric institution full of people in big trouble.

My mom and I get lost driving around the hospital grounds, and we both

can't stop crying. I walk into the intake room late at night - everything

is always late - and I don't want to stay. I am leaving. I ask to call a

taxi. But the doctor on duty says she can hold me against my will for up to

72 hours because I am a danger to myself and others. I am in acute cocaine

psychosis.

I cry and cry on the phone. I cry when the nurses pull me away from the

phone and say that it is time to go to sleep. My fear of being here is

stronger than the Thorazine they gave me. I should be paralysed, but

instead I am crying and crawling toward the phone. I barely remember where

I am, what day it is, but I remember my calling card number perfectly,

remember everyone's phone number. I will call anyone whom I have met or had

coffee with in the last five years. Anyone I've sat next to on the subway

may hear from me right now. I will call them and beg for rescue.

I will do all these things, but not before morning, the nurses insist. They

know that by then I will be so comfortable, so at ease in my sleepy

solitude, so happy to not be hitting the streets and paging people and

searching for coke, so relieved to not be lying to doctors to get

prescriptions, so thrilled to not be living in a hotel and watching

pornography and fucking a married man, so ready to just have the whole

miserable business of being an addict over with - at least for a little

while - that I will never want to leave this place.

Activity is kept to a minimum. Mostly they leave me alone to read my

Berryman poems and my thousand-page Don DeLillo novel and to listen to Bob

Dylan in my room - that voice, it is all that penetrates my dull delirium.

They only force me out of bed for group sessions and our nightly Twelve

Step meetings, or to go to art therapy. You can't close the door to your

room during waking hours unless you're changing clothes, which I do several

times a day because the weather goes from cold to colder as we progress

toward evening, and I go from heavy wool-blend sweaters to weighty

cable-knit angoras. Or I wear cardigans with T-shirts and wife-beaters that

leave my lower abdomen and navel ring exposed, and the counsellors often

insist that I put more clothes on and cover up better. Also, they want me

to wear a bra, which I don't like.

You're not supposed to be sexy here in rehab, and I can't stand it. I

always want male attention, and I keep my toenails painted even though I

never wear anything but thick socks and cowboy boots. I flirt with the male

counsellors; I flirt with the male patients; I flirt with the male doctors;

I flirt with the male volunteers who come in to lead in-house Twelve Step

meetings. I finally get a citation for " excessively flirtatious behaviour "

and " stomach-baring attire. "

Ah, but don't they understand? The whole world is my pick-up joint. Take

away my drugs, and all that's left for me is men. I know this isn't good,

that part of the point of being here is to get over all these addictive,

destructive tendencies, but I don't know what to do if I am not inspiring

some sort of false fascination. When we go to meetings in the auditorium, I

check out the guys, see who is cute, plot assignations with no one in

particular.

Aidan checks in over the weekend. At long last, someone who is my

handsomely dishevelled type. This is his ninth stay at Silver Hill. He

almost looks like a teen runaway in a cartoon. I half expect him to have a

bandanna full of necessities tied to the end of a stick slung over his

shoulder, but he's just a junkie seeking refuge. Aidan's fright and anxiety

are sexy, because that's the sick orientation I've got when it comes to

men. He spends most of the first day throwing up. He's given methadone and

clonidine, and still he paces around, nauseated and exhausted and sleepless.

Given the situation, the last thing he wants is me coming on to him. But

who says he has a choice? I think he's hot, and that's all.

We have some kind of group therapy the evening Aidan arrives, and we all

sit around filling out worksheets about what our triggers are, what are the

worst things we ever did for drugs, what our reasons are for wanting to

quit. I know all the answers to these items only too well. I stare at Aidan

and make goo-goo eyes at him the whole time. Afterward, I wait to hear him

in the kitchen so I can corner him and converse. What a pleasure it is to

have a crush on someone! How I've missed the pursuit! I keep trying to

remind myself that this is not a party, but that's what I want it to be. A

dope-free, coke-free, booze-free bash. I'm here to relax and socialise.

Anyone else up for a good time?

Niccolo checks in on December 23, and is immediately a pain in the ass. He

hits on me in the dining hall, when he is not busy nodding off and

drooling. He's got withdrawal going bad, but he can't quite succumb to it.

He's still trying to flirt with me, telling me that his family owns the

largest bagel bakery on earth, that if I marry him I will be neck deep in

Sunday brunch for the rest of my life.

Quite an offer, I think. Quite a romantic proposal. But he mostly just bugs

me. This is so inappropriate! We're in rehab! This is not a pick-up joint!

It is not fair for him to be pushing at me this way.

Now I know how Aidan feels.

I have to act as if . That's a big recovery term: act as if. Act as if you

believe you will stay sober. Act as if you like meetings. Act as if you

believe in God. Act as if you like getting on your knees and praying. Act

as if there is a lot of wisdom in the Big Book and the Twelve Steps. Act as

if there is a point to making your bed each day, even if you are just going

to get back into it that night. Act as if everyone around you is not an

idiot. The idea is that if you do what you are supposed to, your mind might

catch up with your body.

If I stop acting as if therapy is one big useless joke that I have been in

for 20 years only to land in a mental institution at long last, if I act as

if this time it's for real and this time it will work, it just might. It

just might.

By my last week at Silver Hill, it is definitely time to go. I've been here

for four months, and most people don't make it through four weeks. Hank, my

best friend at Silver Hill, my boyfriend, drives me home in his rented

pick-up truck, and we are happy. We are happy and chatty unloading boxes

into my attic apartment in the tilting old house on Carmine Street. We

listen to Big Star and Serge Gainsbourg and Bob Dylan on my stereo, and

music never sounded so good.

Then the phone rings, the first call since I've walked in, and it's my

friend . I have not spoken to him since before I went to Silver Hill.

I'd almost forgotten him. But here he is on the phone, after all these

months.

And I can't help myself. I ask, Are you holding?

A few hours later, we are cutting lines on the little green steamer trunk

that passes for a coffee table. I am snorting a few here and there, shyly,

as if I've been caught naked. It's okay, I keep telling Hank. This is all

just to prove that I still can do this. After all, I'm cured, four months

in rehab, clean as Ivory Snow, sitting with white powder that can't hurt me

any more. It's not like I had a plan, not like I said, As soon as I get

back to my apartment, I am going to use again. I was not even particularly

craving it, or thinking about it at all. But as soon as I heard 's

voice, I knew I had to. It made sense. There was no moment of doubt or

crisis because I knew it was meant to be. 's call was written on the

wind. I can't fight with that.

My book tour is, I guess it's fair to say, a mess. I do coke and do

interviews about how great it is to be clean. I get coke FedExed to me here

and there. I fall asleep during an interview with a woman from LA Weekly,

which is a shame because I like her and she is a fan of my work. Things get

better in Seattle and Portland, but it's all I can do to stay awake and cope.

I spend the whole of the next summer doing drugs and waiting for Hank to

call. Probably I do some other things, but they don't matter. And I can't

tell anyone. I've been in rehab four months and I'm using again. No one

will ever understand.

I got the crucial lessons from Silver Hill. I learned about going to

meetings. I learned to love many people who were quite different from me. I

learned that it feels better to be clean than dirty. I learned what life is

for. But what I did not learn is that as an addict, I really am as goofy

and grotesque as the next person.

There is nothing left for me to do but go through recovery. I get some

late-night drunk phone calls from Hank, but it's obvious that this

relationship is over. It has been for a while; he's just forgotten to tell

me. So now he's gone, there's just me, and I can't hide any more.

I go to meetings all the time. I'm not sure I do anything besides sleep and

go to meetings. No matter how early I go to bed, I can't seem to get up and

out before sunset. Even after lying there for 16 hours, I do not feel

refreshed - I feel more tired, ill. I realise that I am plain old

depressed. Take away the drugs, take away the non-working relationship to

obsess about, and I am left with my depression. Does nothing ever change?

But I am going to deal with it. Dr Singer puts me on a new antidepressant,

an old-fashioned tricyclic called nortriptyline, which does not make me

tired the way Prozac and the other drugs in its family do. I pray all the

time. I get on my knees and beg God to just get me through this. I am

inarticulate, without poetry, without words even: mostly I just kneel on

the floor in front of my bed, my palms open on top of it, and no matter

what I am trying to say, I usually just end up crying with my face in my

hands until I can't cry any more.

I listen to everything everybody says. I no longer differentiate between

good meetings and bad ones - they are all just meetings, and they are all

somehow helping me to stay clean. And in some strange way, they are also

helping me, very slowly, to feel less depressed. I don't know why it works,

no one really knows why it works - if it were just about being with fellow

sufferers, group therapy would have the same effect - but somehow, I feel

better. At any rate, I stick with it.

I find a sponsor. I meet her at a meeting at Midnite, a place on Houston

Street where, in typical AA fashion, there isn't actually a meeting at

midnight. But there's one at 12.15 and another at 2am, which is later than

they are anywhere else. Midnite after midnight is a hard-luck, hard-case

hangout, full of pre-operation transsexuals and bikers and factory workers

on their way to the graveyard shift across the tunnel, in New Jersey. No

one here is even sort of like me. We are, all of us, so different, but we

all need help, we're all trying. At this point, trying is more important

than succeeding. But the two do seem to go together: at any meetings I

attend, when the chairman asks if anyone who is counting days wants to give

their number, I always do - and the days are accumulating, they are well

into double digits. I am staying clean.

, my counsellor recommends that I go on to a day programme, five days a

week, four hours a day.

" I already spent four months at Silver Hill, " I say. " Why should I go

through a full-time programme again? I'm staying clean. I'm going to

meetings. What am I doing wrong? "

" Instead of seeing this as a punishment, why don't you think of it as an

opportunity? " suggests. So I do. I give it a try.

The day programme starts at 9am. Every morning I feel like I'm going to a

wake - and not the kind you have for a grandmother who's died peacefully in

her sleep. It's more like one for a five-year-old victim of leukaemia,

where everyone can't stop crying. This place is not cushy and relaxing like

Silver Hill. If you're here, you have to do the work, or you are asked to

leave. It is exhausting. Four hours a day of emotional boot camp.

And so it is that my whole life is devoted to recovery. When I don't go

home and pass out, I go to a meeting at Street at 8:30 and then

coffee or dinner afterward with other AA people. On Saturday nights I watch

boxing or go to the movies with others. This is all there is for me now.

For the first time in my life, I am taking something seriously. And for the

first time ever, I am good at something besides writing.

I am committed. Dare I say that I am gung ho? I have never been gung ho

about anything in my life. What is happening to me?

© Wurtzel, 2002. This is an edited extract from More, Now, Again,

by Wurtzel, published by Virago on February 18 at £12.99.

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Sheri Nakken, R.N., MA, Classical Homeopath

http://www.nccn.net/~wwithin/vaccine.htm