Opioid Dependence is Part of Our Relationship, But Doesn’t Define It


Opioid dependence can take over your life. Ben — who has suffered an overdose and experienced withdrawals — knows this all too well. But when Kristen came into the picture, that all changed.

My upbringing was like that of any other typical, small town, middle-class family. My father was a teacher and basketball coach. My mother owned a flower shop. We were very involved in sports and the local community.

After I left home to play college basketball, though, a whirlwind of problems began.

On the first day of practice my junior year, I got a really bad high ankle sprain and my doctors prescribed opioids to help me with the pain. It didn’t take long before I became dependent on them.

Not long after, during a vacation in San Diego, I ran out of pills and started experiencing opioid withdrawal symptoms for the first time. This included symptoms such as: cold sweats, nausea, vomiting and diarrhea. My body felt fired up; I had no appetite and I couldn’t sleep no matter how hard I tried.

That was the first time I really understood choice was not part of the picture. I was addicted.

Ben and Kristen

Soon after I graduated college, I lost my job, and with it, my insurance. I could no longer afford to see my doctors or get prescriptions to fuel my opioid dependence, so I started forging prescriptions. Then, once I realized how expensive the pills were without insurance, I resorted to selling them to afford my next refill.

I started seriously abusing opioids at that point — a month-long prescription would only last me three to four days. Eventually, the constant cycle of forging prescriptions and getting refills caught up to me.

I was busted by the police and sentenced to 10 years in prison; I ended up serving 44 months. During my sentence, I went through a full withdrawal experience and instead of being able to ease the withdrawal symptoms with medications and fluids, all I could do was wallow through the pain and suffer while on a cot.

When it was over, I thought I had finally defeated my dependence. But once I returned to real life post-prison, I went back to my old ways.

This time it wasn’t pain pills, though. Those had gotten too expensive and scarce since I’d been in prison. Heroin was cheaper, lasted longer, and I could get more of it at a time, so I made the switch.

Meanwhile, I had just started dating Kristen. I didn’t tell her about my past with opioid dependence until we’d been together for a few months and — to my surprise — she was amazingly understanding about it. She knew I was dealing with a disease that I wanted to “get better” from.

Then I accidentally overdosed. As usual, I was using in my truck at a gas station, although unbeknownst to me, it wasn’t heroin in the syringe this time: it was a drug that’s a thousand times stronger than heroin. It hit me so fast I didn’t even have time to pull the needle out of my arm. I woke up two hours later with no memory of anything that had happened. Standing over me were EMS workers, Kristen and a member of my family.

What I love most about Ben is how charismatic and charming he is. We went to neighboring colleges and met through social media. Our connection was instant.

So when he told me about his dependence, I felt like I was at a crossroads. I thought, We’re still fairly early in our relationship. I can totally walk away from this and be fine. But I was very drawn to him.

I didn’t feel like his opioid dependence was a good enough reason for me to abandon our relationship because I knew that people who dealt with addiction weren’t inherently awful, or evil, or damaged. I think the fact that he wanted to recover, get stronger, and help other people was also part of my attraction to him. So I chose to stay and support him.

At the time of Ben’s overdose, I had no idea he was using again. He was very good at manipulating situations, hiding truths, and changing the conversation. Our communication had been kind of spotty until one day I received a call from his sister.

She told me Ben had overdosed and needed someone to take him to the hospital or else “he’s probably going to go to jail, or they’ll release him, and he’ll go shoot up again.” Without hesitation, I threw on my jacket, grabbed my keys, and told her, “I’ll be there in 20 minutes.”

He went through three days of detoxification at my house. You see the detox experience in movies, but to actually witness it firsthand was completely different.

I didn’t feel bad for him, though, even if I wanted to. I thought he needed to go through all the pain, vomiting, diarrhea, screaming, and psychosis to get to the other side. And I wanted to know what he was going to do afterwards. Was he going to seek out rehab, or was he going to say he was fine? Luckily for him — and for us — he chose rehab.

I knew I needed a treatment plan that would really work this time. I had tried another medication-assisted treatment (MAT) plan before, but it wasn’t the right fit for me.

My choices at this point were basically jail or death. Then a friend who’d started recovery at the rehab facility I was headed to told me about VIVITROL® (naltrexone for extended-release injectable suspension). When I asked my doctor about VIVITROL, he explained that it is a non-addictive, once-monthly injection that blocks opioid receptors in the brain and prevents relapse to opioid dependence when accompanied by counseling, and following opioid detoxification. He mentioned that there are significant risks from VIVITROL treatment, including risk of opioid overdose, severe reaction at the injection site and sudden opioid withdrawal, and that VIVITROL is not right for everyone.

I decided to give it a try. I was prescribed and administered VIVITROL by my healthcare provider after detoxing from opioids and it has helped me stay opioid-free, while counseling taught me new coping skills. I also joined recovery groups that allowed me to finally address the reasons behind why I was using in the first place.

When I was younger, I thought people who used heroin and opioids were weak. But having gone through opioid dependence myself, I know we’re good people under unfortunate circumstances.

I’ve made mistakes in my life and have done things I’m not proud of, and while those things are part of me, they don’t define me, Kristen, or our relationship.

The recovery journey can be an intense process, but we have been able to find great moments and fun experiences along the way.

The truth is, this hasn’t been an easy journey for me. I don’t know that everyone is cut out to be in this kind of relationship, or to be supportive through these kinds of challenges. And that’s OK.

There was a lot of work that Ben had to do on his own before we could really start working on our relationship. Being on medication, going to counseling, and attending recovery group meetings seemed to help him to get to where he needed to be, which allowed us to move forward.

There was something different about him this time, like he really felt he could do it. Knowing he feels that way gives me a sense of comfort and security, too.

I’m coming up on two years of going to a recovery program for friends and family of people with addictions. It’s taught me that I didn’t cause his opioid dependence, I can’t cure it, and I can’t control it.

It’s so important to look at this for what it is: a disease. Once I realized all that, my support for him became just about love. My love for him helped me feel strong enough to take this journey with him.

Ben and Kristen received compensation from Alkermes for time spent sharing their stories.

Please read the Brief Summary of Important Facts about VIVITROL below. Discuss all benefits and risks with a healthcare provider. See Prescribing Information and Medication Guide.


VIVITROL® (naltrexone for extended-release injectable suspension)

BRIEF SUMMARY OF IMPORTANT FACTS ABOUT VIVITROL

What is the most important information I should know about VIVITROL?

VIVITROL can cause serious side effects, including:

1. Risk of opioid overdose. You can accidentally overdose in two ways.

  • VIVITROL blocks the effects of opioids, such as heroin or opioid pain medicines. Do not try to overcome this blocking effect by taking large amounts of opioids—this can lead to serious injury, coma, or death.
    • After you receive a dose of VIVITROL, its blocking effect slowly decreases and completely goes away over time. If you have used opioid street drugs or opioid-containing medicines in the past, using opioids in amounts that you used before treatment with VIVITROL can lead to overdose and death. You may also be more sensitive to the effects of lower amounts of opioids:

      — after you have gone through detoxification

      — when your next VIVITROL dose is due

      — if you miss a dose of VIVITROL

      — after you stop VIVITROL treatment

      Tell your family and the people closest to you of this increased sensitivity to opioids and the risk of overdose.

        2. Severe reactions at the site of injection. Some people on VIVITROL have had severe injection site reactions, including tissue death. Some of these reactions have required surgery. VIVITROL must be injected by a healthcare provider. Call your healthcare provider right away if you notice any of the following at any of your injection sites:

        • intense pain
        • the area feels hard
        • large area of swelling
        • lumps
        • blisters
        • an open wound
        • a dark scab

          Tell your healthcare provider about any reaction at an injection site that concerns you, gets worse over time, or does not get better within two weeks.

          3. Sudden opioid withdrawal. To avoid sudden opioid withdrawal, you must stop taking any type of opioid, including street drugs; prescription pain medicines; cough, cold, or diarrhea medicines that contain opioids; or opioid-dependence treatments, including buprenorphine or methadone, for at least 7 to 14 days before starting VIVITROL. If your doctor decides that you don’t need to complete detox first, he or she may give you VIVITROL in a medical facility that can treat sudden opioid withdrawal. Sudden opioid withdrawal can be severe and may require hospitalization.

          4. Liver damage or hepatitis. Naltrexone, the active ingredient in VIVITROL, can cause liver damage or hepatitis. Tell your healthcare provider if you have any of these symptoms during treatment with VIVITROL:

          • stomach area pain lasting more than a few days
          • dark urine
          • yellowing of the whites of your eyes
          • tiredness

            Your healthcare provider may need to stop treating you with VIVITROL if you get signs or symptoms of a serious liver problem.

            What is VIVITROL?

            VIVITROL is a prescription injectable medicine used to:

            • treat alcohol dependence. You should stop drinking before starting VIVITROL.
            • prevent relapse to opioid dependence, after opioid detoxification.

              You must stop taking opioids before you start receiving VIVITROL. To be effective, VIVITROL must be used with other alcohol or drug recovery programs such as counseling. VIVITROL may not work for everyone. It is not known if VIVITROL is safe and effective in children.

              Who should not receive VIVITROL?

              Do not receive VIVITROL if you:

              • are using or have a physical dependence on opioid-containing medicines or opioid street drugs, such as heroin. To test for a physical dependence on opioid-containing medicines or street drugs, your healthcare provider may give you a small injection of a medicine called naloxone. This is called a naloxone challenge test. If you get symptoms of opioid withdrawal after the naloxone challenge test, do not start treatment with VIVITROL at that time. Your healthcare provider may repeat the test after you have stopped using opioids to see whether it is safe to start VIVITROL.
              • are having opioid withdrawal symptoms. Opioid withdrawal symptoms may happen when you have been taking opioid containing medicines or opioid street drugs regularly and then stop. Symptoms of opioid withdrawal may include: anxiety, sleeplessness, yawning, fever, sweating, teary eyes, runny nose, goose bumps, shakiness, hot or cold flushes, muscle aches, muscle twitches, restlessness, nausea and vomiting, diarrhea, or stomach cramps.
              • are allergic to naltrexone or any of the ingredients in VIVITROL or the liquid used to mix VIVITROL (diluent). See the medication guide for the full list of ingredients.

                What should I tell my healthcare provider before receiving VIVITROL?

                Before you receive VIVITROL, tell your healthcare provider if you:

                • have liver problems, use or abuse street (illegal) drugs, have hemophilia or other bleeding problems, have kidney problems, or have any other medical conditions.
                • are pregnant or plan to become pregnant. It is not known if VIVITROL will harm your unborn baby.
                • are breastfeeding. It is not known if VIVITROL passes into your milk, and if it can harm your baby. Naltrexone, the active ingredient in VIVITROL, is the same active ingredient in tablets taken by mouth that contain naltrexone. Naltrexone from tablets passes into breast milk. Talk to your healthcare provider about whether you will breastfeed or take VIVITROL. You should not do both.

                  Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your healthcare provider if you take any opioid-containing medicines for pain, cough or colds, or diarrhea.

                  If you are being treated for alcohol dependence but also use or are addicted to opioid-containing medicines or opioid street drugs, it is important that you tell your healthcare provider before starting VIVITROL to avoid having sudden opioid withdrawal symptoms when you start VIVITROL treatment.

                  What are other possible serious side effects of VIVITROL?

                  VIVITROL can cause serious side effects, including:

                  Depressed mood. Sometimes this leads to suicide, or suicidal thoughts, and suicidal behavior. Tell your family members and people closest to you that you are taking VIVITROL.

                  Pneumonia. Some people receiving VIVITROL treatment have had a type of pneumonia that is caused by an allergic reaction. If this happens to you, you may need to be treated in the hospital.

                  Serious allergic reactions. Serious allergic reactions can happen during or soon after an injection of VIVITROL. Tell your healthcare provider or get medical help right away if you have any of these symptoms:

                  • skin rash
                  • swelling of your face, eyes, mouth, or tongue
                  • trouble breathing or wheezing
                  • chest pain
                  • feeling dizzy or faint

                    Common side effects of VIVITROL may include:

                    • nausea
                    • sleepiness
                    • headache
                    • dizziness
                    • vomiting
                    • decreased appetite
                    • painful joints
                    • muscle cramps
                    • cold symptoms
                    • trouble sleeping
                    • toothache

                      These are not all the side effects of VIVITROL. Tell your healthcare provider if you have any side effect that bothers you or that does not go away. You are encouraged to report all side effects to the FDA.

                      Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

                      This is only a summary of the most important information about VIVITROL.

                      Need more information?

                      • Ask your healthcare provider or pharmacist.

                        Read the Medication Guide, which is available at vivitrol.com and by calling 1-800-848-4876, option #1.

                        This Brief Summary is based on the VIVITROL Medication Guide

                        (Rev. July 2019).

                        ALKERMES®

                        ALKERMES and VIVITROL are registered trademarks of Alkermes, Inc.

                        ©2020 Alkermes, Inc. All rights reserved.

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                        vivitrol.com

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