Because the medications helped her to excel at her job and to work extended hours, Lara didn’t admit to herself that what she was doing was dangerous.
One afternoon, she realized that she hadn’t wasted a single narcotic in five consecutive workdays. Somehow, over the past several months, her maneuvers had shifted from secretive to sloppy. Surely, she worried, someone would catch on to her. She took a swig of Pepto-Bismol to calm her stomach, which was shaky as usual. She blamed her nerves, because she was applying for a position as a flight nurse on a medical trauma helicopter, her ultimate career goal since nursing school. Ugh, if I could just get another vial, then I won’t feel sick. Then it hit her. Oh my God, it’s not because I’m nervous. It had taken her that long to see, or accept, the link between her stomachaches and her addiction.
Many addicts say that there is often no single defining event that leads them to want to stop using. For some, there simply comes a point when they are ready to admit to themselves that they have a problem and they don’t want to have that problem anymore. That’s how it was for Lara. That day was no different from the day before, except that a layer of her denial suddenly lifted. Later, she would be amazed that she had ignored the signs of addiction for so long.
Once it clicked, she was petrified. She was ashamed of herself and afraid of what people would think; she didn’t know which was worse. She vowed to do everything she could to quit her addiction. Lara tried calling in sick to force herself into withdrawal. Okay, I kicked this. It’s cool, she would say to herself after a few days. But then she would return to the hospital to find that her desire for the drug was stronger than she was. After hours of trying to tough it out, she would grab a vial and a needle, so easy, so irresistible, and run to the bathroom.
She attempted to discourage herself by calling her brother, whom she didn’t want to disappoint. She wrote herself letters: “This isn’t how you want to live your life.” She tried stipulating that she could shoot up only at night to help her sleep, or she could use only morphine so she wouldn’t get as sick. She told her roommate, Angie, a fellow ER nurse she loved, so that someone else could hold her accountable. Lara and Angie had been ER nurses together for six years. Angie was the type of strong nurse that other nurses wanted in the room with them. When they started out as new nurses together, they had leaned on each other to endure the ER sink-or-swim craziness the way many nurses did if they were lucky enough to find a competent, likeable partner. Lara and Angie had combined their strengths and pulled each other through stints at two hospitals.
Angie could not believe it. She was sympathetic but appalled. She wouldn’t turn Lara in, yet couldn’t persuade her to stop using for long. Each time Lara tried to stop, within twenty-four hours she slid from being able to glide through her shift and an invigorating workout at the gym to feeling too sick and depressed to function. She felt like she had the worst flu possible, a debilitating illness that could vanish in moments after an injection. So she kept injecting. She didn’t know that there were narcotics addiction treatment programs specifically for medical professionals. She didn’t know what else to do. I need to stop feeling so sick, she told herself. I’ll take something today and then I’ll stop tomorrow. She said this for four more months.
Eighteen months after her first Percocet, Lara was offered the dream job that she had applied for: a flight nurse for a hospital system. Flight nurse opportunities, prestigious within the field, were rare. When Lara saw the helicopter she would be working on, she couldn’t contain her exhilaration. She ran her hand along the airframe, climbed inside, and sat in the nurse’s seat, incredulous that she was exactly where she wanted to be.
The next day was a Thursday. Determined to get clean, Lara checked into the drug treatment program at her hospital. She thought she simply needed to get over a few days of drug withdrawal. She’d let the professionals get her clean over the weekend, and she’d leave on Monday, the drugs gone from her system, her body free from their grasp. Lara assumed her hospital was so large that no one would see her. She didn’t turn herself in to her ER bosses because she figured she would quickly get this sorted out. Still in some measure of denial, Lara thought that she could conquer any treatment plan they gave her. After all, she was strong. She was determined. She still didn’t realize she was that sick.
That weekend, when Lara was feverish from narcotics withdrawal, Angie called from the ER. The director told Angie that the department had been aware of Lara’s problem for months. “The ER knows what’s going on,” Angie said. “They know you’re stealing drugs and I think you should turn yourself in.”
I’m an idiot, Lara thought. Who goes in for drug treatment at the same hospital where they work? She raced to turn herself in, hoping the consequences would be lighter if she admitted she had a problem and was desperate for help. She dashed out of the building and down the sidewalk in the sweatpants she’d worn for two days straight and a long-sleeved shirt covering the marks on her arms that she didn’t want anyone to see. She sprinted the block between the treatment center and the ER and barreled into the director’s office.
Before the ER director had a chance to speak, Lara unloaded. “I have a problem and I can’t stop and I’m trying to get help and I’m in treatment now,” she blurted through tears. “I don’t want to live like this anymore.”
The director had been one of Lara’s favorite people to work with. A former nurse, she came into the unit and helped when the staff was overburdened. Unlike Lara’s previous administrators, who would either sit comfortably in their back offices while their nurses drowned in work or stand imperiously on the floor telling staff what not to do, this director rolled up her sleeves, pushed stretchers, and ordered food for her employees.
The director reluctantly pushed a large stack of papers across her desk. The file documented instances when Lara had taken narcotics under a patient’s name. Lara had never taken medications from a patient, but she had taken larger vials than patients needed in order to increase the leftovers. The administration had tracked her for approximately eight months.
“You’re under investigation,” the director told her sadly. “We’re going to have to fire you. For a long time, I didn’t do anything because I just couldn’t believe it.”
Lara was scared. She didn’t know what would happen next. Would she go to jail? At the same time, she felt a tremendous sense of relief. This is over now and I can move on, she thought. Whatever happens is going to be better than where I’ve been. Now that it’s in the open, I don’t have to fight this battle by myself anymore.
Lara never found out why administrators didn’t report her to law enforcement. Perhaps it was because she had voluntarily turned herself in and had entered a drug treatment program. Or perhaps they didn’t want to derail the career of an exceptional nurse. Lara reported herself to state nursing board officials, who said that to keep her license, she would have to enroll in the Medical Drug Intervention program.
MDI (a pseudonym—most states have their own program) was an intense multiyear program designed to help nurses and other health professionals. Even after the initial thirty-day rehabilitation, patients were not allowed to work in any medical field, so they could focus exclusively on getting clean. MDI administrators decided when to allow a nurse to take a job. Lara met nurses who had been kept out of work for a year.
The thirty-day rehab program was a beast. Lara was the sickest she’d ever been. She had flu symptoms, sweats, chills, extreme fatigue, aches, and unimaginable joint pain. She couldn’t brush her teeth because it hurt too much to close her fist around her toothbrush. For weeks, the agony was unrelenting, but Lara was determined to take no medications to ease her through it. She attended her assigned meetings and classes, where program leaders introduced her to Narcotics Anonymous and forced her to examine her demons.