In a recent podcast, “A first-hand account of kicking Fentanyl addiction: reversing Hebb’s law” (May 12, 2022), Walter Bradley Center director Robert J. Marks interviewed a man who got addicted to Fentanyl as a medical drug. Some opioid addictions begin in the hospital. In the previous portion of this episode, “Stretch” told Robert J. Marks how he became addicted while seeking relief from pain stemming from operations — because “neurons that fire together wire together ( Hebb’s Law )”. Then, when he sensed that drugs were ruling his life without really dealing with the pain, he set out on the road to recovery — and was surprised to find anesthetists and nurses in the recovery group with him. Now, in the final portion of the episode, he tells Dr. Marks how he finally got away from medical opioids.

Before we get started: Robert J. Marks, a Distinguished Professor of Computer and Electrical Engineering, Engineering at Baylor University, has a new book, coming out Non-Computable You (June, 2022), on the need for realism in another area as well — the capabilities of artificial intelligence. Stay tuned.

This portion begins at roughly 34:00 min. A partial transcript and notes, Show Notes, and Additional Resources follow.

Stretch: I kicked it by going to two different rehab programs, one in Columbus. But it was premature. I still needed it from medical standpoint. So I ended up, months later, starting it again.

Robert J. Marks: That’s what I was going to ask you. If you go through detox and you still have the pain, I don’t know. Is it better to live with the addiction or live with the pain? It’s a rough choice.

Stretch: You can’t do the pain; it’ll just destroy you. Actually, there was another solution we tried, and this was through the pain management clinic at the Cleveland Clinic. The doctor had been involved in the early days of the neurostimulator development. He thought he could place a lead along my spine that would electrically scramble the pain signals coming from that area.

I had two or three trials with that system that were temporary, where the wires came out of my back.

Robert J. Marks: Oh my goodness. That’s terrible.

Stretch: And it was amazing how it worked.

Robert J. Marks: It worked?

Stretch: It really was. It would work, but the problem was it had to be located just right along your spine. And I would have the trial and be in the car, and by the time I would get home bouncing in the car, it would’ve shifted enough where it had stopped becoming effective.

And it may start working somewhere else, that you didn’t want the electric stuff going to.

Robert J. Marks: And what happens when it works somewhere else? Do you go numb?

Stretch: Well, if you don’t like the feeling of electricity boiling through your “lower member,” it’s not comfortable. And actually that happened during one of the surgeries. He was trying to place it and it electrifies my genital area essentially. And I start hollering in the operating room that that’s what’s happening. He and the other people that were in there are laughing out loud at me. But it is kind of a shock.

Robert J. Marks: Well, you want a doctor with a good sense of humor, I suppose. That’s very interesting…

Stretch: And then there’s a remote you use to control it.

Robert J. Marks: Oh really? So you have a little wireless remote? Or is it plugged in?

Stretch: No, there was no wire when it was done, however they did that…

[Unfortunately, the neurostimulator treatment did not work, possibly due to internal scar tissue from previous problems and surgeries. But even if it had, Stretch still faced withdrawal from opioids, which he then undertook.]

Robert J. Marks: So how long have you been free of opioids?

Stretch: Seven years.

Robert J. Marks: Will you ever take pain medication again, opioids?

Stretch: I have. I’ve had to be in the hospital for bowel obstructions and I used what they gave me in the hospital. And I came home with a very small amount and used it, didn’t have a problem.

Robert J. Marks: So what was the problem the first time [when you became addicted]. You overdid it?

Stretch: Yeah, I think there was just way too much in my system. My body truly became dependent. It needed the drug to function properly. And the way they describe what the drug does to you, it changes your brain chemistry. Your brain chemistry takes a very long time to readjust.

Robert J. Marks: That’s what I talked about in the introduction, this idea that neurons that fire together, wire together. So it takes a long time for that path to diminish and go away.

Stretch: Absolutely. I had another factor that was important. I did the Alcoholics Anonymous thing through the Suboxone program, which is required. Suboxone was the medication they used to wean me off of opiates and that took five years. I gradually tapered down on that stuff.

So it was a very long and deliberate process to get off of it. Basically, after twice in rehab, I was still addicted, dependent. I had got to the point while I was in rehab the second time at the Cleveland Clinic that I could go a day and not be miserable. But as soon as I went home, it was starting all over again.

I think that’s a testament to the people, places and things. You hear them say: You got to change your people, places and things.

And that’s easy to do when you go to a hospital. But then they release you from the hospital and you’re back to your same old people, places and things, which may be a daily routine of dealing with medical problems, which you don’t get away from.

The thing that saved me, I believe, was I did have that J-pouch removed. They gave me another solution, another pouch, that works a different way. It actually is now problematic it but isn’t causing the pain that the other pouch caused. So I didn’t feel it necessary to continue with the Alcoholics Anonymous system because my addiction was rooted in the medical aspect.

I didn’t have the same triggers as the people that were there taking, say, heroin and cocaine and other stuff. If I didn’t have the medical problem, there was no pressing need for me to take that medication. Now, if it was lying around in front of my face, if it was down at the corner store like alcohol, I may have not been able to kick it. But it was too hard to get, too risky to try to get. And I never wanted to take that step outside the relative legality of… I say “relative” because there was more prescriptions than I was supposed to have, just on account of being in and out of the hospital so frequently.

And they would write me “scripts” every time I left the hospital. So I ended up with an abundance of scripts that offered me more medication than I really should have been taking. It wasn’t done legitimately but it wasn’t done on the street.

Robert J. Marks: Well, let me ask you one final question: What advice would you give to people who are undergoing operations, who will need pain medication such as Fentanyl, the lollipop, the patches? Did you use the patches, the Fentanyl patches?

Stretch: I did patches, pills and lollipops at the same time.

Robert J. Marks: Really? Oh gosh. What advice would you give, maybe, some youngster who’s considering going out and getting some Fentanyl on the street?

Stretch: Maybe you would be better off playing chicken with your friends in your fast cars or something than playing around with Fentanyl. Maybe you’d want to try some skydiving without a parachute or cliff climbing without any ropes. It’s kind of the same thing. You’re likely going to die if you don’t have a real good understanding of the risk that you’re taking. And nobody does because nobody looks at it from the addiction point of view.

Robert J. Marks: They’re looking for that high. So what would you say to people that are undergoing an operation, that know that they have to use this pain relieving medication after they’re done? You basically didn’t have a choice.

Stretch: Well, I did, just because of the circumstances. The first surgery, the doctor says, “Don’t use it if you don’t have to.” And then I did use it a couple nights that were bad, but I don’t even like taking it. So I stopped, I had no interest in using it. I had an alternative, I had ibuprofen, which interestingly down the road, becomes a problem for people with bowel problems because you can’t take lots of ibuprofen; it causes bleeding in your bowels. So as a bowel patient, you have no pain option choices other than acetaminophen which doesn’t work, Tylenol, or opiates. That’s your choice.

Robert J. Marks: Yeah. Well this has been great. Thank you. We’ve been talking to somebody anonymous we’re calling “Stretch.” Thank you, Stretch.

Stretch: I hope I scared those kids enough to stay away from that stuff. It’ll kill you, it really will. And you don’t understand how it will kill you until it’s too late — and then you will be on your way to the grave.

Here are the all three parts of the episode:

Some opioid addictions begin in the hospital “Stretch” tells Robert J. Marks how he became addicted to medical doses of opioids while seeking relief from pain stemming from operations. Stretch discovered Hebbs’ Law, “Neurons that fire together wire together” the hard way when he became addicted. Later he found that it can be reversed.

Medical opioids: The war between chronic pain and addiction “Stretch” tells Robert J. Marks, the surgeries did not really work and he became addicted to the painkillers while trying to live a normal, working life. When Stretch started in recovery, he met dentists, anesthesiologists, and nurses who were addicted to medical opioids too — as well as former Death Row inmates.

and

How “Stretch” finally kicked the medical opioid habit. It wasn’t easy but it was the high cost of staying alive while managing his chronic medical disorder. Stretch’s advice to kids who’d like to try opioids: “Maybe you’d want to try some skydiving without a parachute or cliff climbing without any ropes…”

You may also wish to read:

Opioids: The high is brief, the death toll is ghastly. Fentanyl has medical uses in, say, open heart operations where the patient is on life support; otherwise, it is a one-way ticket off the planet. Anesthesiologist Richard Hurley tells Robert J. Marks how Fentanyl affects the brain and why the street version is so deadly.

and

What anti-opioid strategies could really lower the death toll? Anesthetist Dr. Richard Hurley discussed with Robert J. Marks the value of cognitive behavior therapy — reframing the problem. Life expectancy in the United States is decreasing due to opioid deaths, though the problem is now primarily street drugs, not medically prescribed ones.

Show Notes

• 03:19 | Introducing Stretch
• 03:54 | Failed Surgeries and the Beginning of an Addiction
• 26:28 | Fentanyl Lollipops
• 29:45 | Withdrawal Becomes the Motivator
• 34:39 | The Difficulties of Detoxing
• 44:45 | Advice for those Undergoing Surgery

Additional Resources

• More information about Dr. Robert J. Marks
• Podcast with Dr. Richard Hurley on opioid addiction: Exercising Free Won’t In Fentanyl Addiction: Unless You Die First
• More information about Oxycodone (OxyContin, Percodan)
• More information on fentanyl

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