An Essay on Sobriety, Recovery, and Medically Necessary Opioid Use

Mother Superior and Leaving the Crossfade Behind

In the past year, we’ve heard discussion in popular culture about what “sobriety” means. “Sober” sober (abstaining from everything) versus “California sober” (not doing harder drugs but still getting high). 

I’ve had philosophical discussions with clients regarding what “sobriety” means to them, and to me. Should I still refer to myself as “in recovery” when I’ve not had my drugs of choice for over 11 years? Does the word “recovery” define me? I’ve seen people call themselves “sober” even though they were clearly using a LOT of drugs that were prescribed by a doctor (and using said drugs inappropriately, at that). And I’ve seen people refer to themselves as “in recovery” when they’ve had 20 plus years sober. It’s all a matter of perspective, I suppose. 

I don’t call myself sober. I don’t define myself as a person in recovery. I do not call myself a drug addict. Is that arrogant of me? I fly against the dogma of AA and NA. Why should I continue to refer to myself as something that I used to do? That is a part of my past, not my present, and there are greater things that define my life right now.

My drugs of choice were benzos and opiates, preferably together. Nothing else ever hit that sweet spot of addiction for me – wine washed down my pills but I don’t particularly like alcohol, weed hasn’t been my “thing” since I was about 16 years old, uppers never agreed with my high-strung self… you get the picture.  Benzos and opiates numbed my anger and my shame, they made my self-hate, self-doubt, my low self opinion* all go away. 

With all of this in mind, as I mentally prepared myself for surgery this month, I knew that I would be on painkillers through the healing process. I also know that I am in a different headspace than I was when I was using. All my demons have been set free. All my shame has become public and can, therefore, no longer drive my self hate. I like being fully present and clear headed because I like who I am now-a-days (that is not something that was always true). 

What does that mean for someone who used to abuse pain killers? What would healing look like, as I navigate recovery from my surgery as well as maintaining appropriate use of narcotics? 

Woman. Mother. Wife. Therapist. Artist. Friend.

My drugs of choice were benzos and opiates, preferably together. Nothing else ever hit that sweet spot of addiction for me – wine washed down my pills but I don’t particularly like alcohol, weed hasn’t been my “thing” since I was about 16 years old, uppers never agreed with my high-strung self… you get the picture.  Benzos and opiates numbed my anger and my shame, they made my self-hate, self-doubt, my low self opinion* all go away.  With all of this in mind, as I mentally prepared myself for surgery this month, I knew that I would be on painkillers through the healing process. I also know that I am in a different headspace than I was when I was using. All my demons have been set free. All my shame has become public and can, therefore, no longer drive my self hate. I like being fully present and clear headed because I like who I am now-a-days (that is not something that was always true).  What does that mean for someone who used to abuse pain killers? What would healing look like, as I navigate recovery from my surgery as well as maintaining appropriate use of narcotics? 

The Appropriate Tool for the Job at Hand. 

A tool is meant to be used. One should use the appropriate tool for the job. You don’t use a hammer to screw in a screw, right? 

In my pre-surgery medical visit, the doctor informed me that I would be on narcotics for at least a week. This would be necessary for pain management in the post operative period of what is considered one of the more painful surgeries to have (grade IV external hemorrhoidectomy – I was going to have stitches in my bum). 

I have a pretty high pain tolerance. I had two large (8 pounds plus) babies with completely unmedicated births. I’ve tattooed myself. I got this, right? 

The purpose of narcotic medication is to help the body not spasm in pain. Not feeling the pain as acutely allows the body to relax and can facilitate the recovery process. Being tense and tight with pain increases the cortisol and other stress hormones to flood the system, which impedes healing. And while not using a body part that is healing may be necessary for some post-op care, you can’t not poop. And pooping was going to hurt. Also, narcotics can be constipating, so the healing period would be a delicate balance of high fiber foods, fiber supplements, stool softeners, and pain management. I would be lying if I said I wasn’t worried – balance isn’t always my strong suit.

A Different Time, A Different Mind, A Different Reaction. 

When I had to get a colonoscopy prior to this surgery, they gave me some benzos in the surgery center to calm me down (I’ve got some serious white coat syndrome). It helped to calm me, but I didn’t “enjoy” them the way I used to enjoy Xanax. I found that to be interesting. The tool did the job but didn’t bring me a “high”. In my active addiction, I never used anything as prescribed, I’d use to get effed up, so doing something as a doctor ordered is… interesting. 

I kept that in mind, as I mentally processed what being on narcotics would mean to my relative sobriety. Would I want more than I should be taking? Would I enjoy being “high”? Would I have a hard time controlling my use? How would I approach this? Should I give the pain pills to my husband and let him dole them out to me? How cautious did I need to be? 

Day of surgery: The doctor’s orders state to take the first pain pill within one hour of being released from the hospital, as you need to stay on top of the pain versus trying to catch up to the pain. Done – because even with the IV pain meds my undercarriage was not a happy place.  

The script reads 1-2 pills every 4 hours (Vicodin 325s). Should I take only one? Should I take 2? How do I approach this? 

This sentence is being written on the Monday after surgery (on Friday). There was one point on Saturday where I took one pill about 3.5 hours after the previous one – other than that, I’ve been doing one pill every 4-5 hours and going 10 hours overnight (taking one at 10 pm and the next one around 8am).
I’m trying to navigate my pain appropriately. This hurts worse than post-childbirth, and I didn’t have drugs after having babies, so that should give you perspective.
I don’t want to be high. Vicodin makes me feel cold, which is annoying. Opiates are not nearly as much fun when they aren’t being mixed with Xanax or Valium or chased with bottles of wine. I don’t want the sleepy, goofy, stoned feeling. I know the pain pills will not make the pain go completely away – they are to take the edge off and keep me from being in really bad spasms of pain. I need to be present and functional. I can’t be high in front of my kids or my clients or even my husband. 

Using a substance as prescribed is a new experience for me.

Philosophically Speaking, Is This a Relapse? 

I feel silly calling this a relapse, yet I question myself repeatedly. I’m using, isn’t it a relapse? When I was in the throws of active addiction, I constantly lied to myself and everyone who would listen that my drugs were for pain management – I NEEDED them. Here and now, I get caught wondering if I’m gaslighting myself. Do I need them? Am I using these pills appropriately? What would it look like if I was not using them appropriately? I am questioning myself, my use, and if I’m “going down that road”. 

I can remember having conversations in my substance abuse group when I interned in the Naples Jail – what if I got into a car accident? What if I had to have surgery? What if I needed pain pills for real reasons? Would I be like Sandra Bullock in 28 Days and take OTC pain meds for a broken leg? Am I that brave or stupid? Would I suck it up and deal with the pain? Would I relapse? Would I lose myself in the bottle, sucked back into that sour romance of warm fuzzy opiate hugs? 

I don’t know what to call this. It doesn’t feel like a relapse. Is this what it means to be normal?

I do not recommend to anyone that they go out and test themselves by taking some of their preferred poison. I do not think that anyone is ever “cured” of an addiction. It would be very easy to get sucked into the vortex of altered reality. I am very lucky that I’ve had years of non-use behind me, years of therapy, and a strong desire not to go down that road again. We like what we like – and the brain fires off those reward chemicals when we do the things we like. But these days, the dragon has lost her glimmer. It’s just not that appealing anymore. My life is different. I am different. Mother Superior has shed her habit. 

I would be lying if I said this experience was not frightening to me. It is super triggering and super scary to hold that pill bottle in my hand. I am now (finishing this blog post several days after the above paragraphs were written) multiple days since my last pill, and unless something dramatic happens (like needing another surgery), I’m done. Every single pill I took was taken with fear. 

You know what? I didn’t even finish the bottle.

*Low S O – song by Henry Rollins. Very powerful for me while getting clean if you care to check it out. 

Jennifer Albert, LMHC

Hello! My name is Jennifer Albert and I am a licensed mental health counselor. I work with teenagers and adults, those with addictions, first responders, and those with depression, anxiety, impulsivity, and other mental health disorders in order to help them process historical trauma and lead them on the road to self discovery and peaceful living.