The following essay appears in The Heavy Feather Review.
1.
I tell my mother that I’ve started taking opiates again. “Not the way I took them last time,” I say. When I say last time, I mean the time she knows about. The time when I wasn’t 18 and 19; the time when I wasn’t taking them for fun. When I say last time, I mean the five years during which I buried my headaches under fistfuls of round blue oxycodone pills. “It won’t be like last time,” I promise when she starts crying and I start crying and for a minute I think she really means it when she says, “You can do what you want, but you’re on your own; I can’t go through that again.” When she says that again, she means the way I scurried around New York scavenging pharmacies for the kind and number of pills I needed; she’s talking about the death rattle in my voice when I couldn’t find them. When she says that again, she means the eight months I spent on Suboxone and the four weeks I spent detoxing in the bed where she doesn’t sleep anymore, in the house where she no longer lives.
2.
When her mother died, my mother stayed in that bed for nine years. She lay on top of the covers and stared at the TV without really watching it. She wore loose-fitting house dresses designed for tourists, printed with white fish that swam in straight lines down to her knees. Sometimes she ran errands in them. She rallied to make dinner around sunset but then sat down at the kitchen table and watched my sisters and me eat the pot roast and lemon chicken she rarely touched. When our dad took his plate to the computer and ate in front of his online cribbage match, she moved to the couch and watched CNN until she fell asleep. In the mornings, she hovered by the front door as my sisters and I pulled on our backpacks and headed out to the Jeep we shared. We were 16. “Cher says I’ve been depressed for a long time,” my mom told me after she divorced our father. She’d started seeing a therapist. “I thought you’d been depressed since Memaw died,” I said. She paused. “You knew that?”
3.
My sisters and I are triplets. Bev is finishing an OB/GYN residency at UC-Irvine. Cassie practices real estate law in our hometown; her office is in the same complex as our dad’s insurance agency and a few miles from our mom’s new house. I feel weird calling our parents my mother or our dad. My sisters and I call our parents “the mom” and “the dad.” Cassie eats lunch with the dad every day, but I can’t tell whether she or Bev is his favorite. I only know that I am not. When I visit Destin, we’ll go out to eat and run into one of the dad’s friends. “Is this the doctor or the lawyer?” the friend will ask. “I’m the other one,” I say, and the dad grimaces like he knows I’m right while I explain that I’m working on a graduate degree in creative writing. After I finished my first Master’s, I got a job with the ACLU in California. The dad worked himself into a rage that could have launched his career as a Fox News host. He said I was a communist and he was a capitalist and that my working for the ACLU was like taking his head and rubbing it in the sand. The dad loves me, but he doesn’t like me. He likes Bev and Cassie. The mom used to tell me that wasn’t true. “Of course your father likes you,” she’d say. Now she tells me not to worry about it. “He doesn’t understand people who aren’t like him.”
4.
I’d called the mom earlier that day, but I hadn’t mentioned opiates. Because I’m taking them again, I don’t call her as much as I usually do; it feels like lying, talking to her on opiates I haven’t told her about. If she doesn’t know I’m taking opiates, she won’t understand why I need them. She won’t know when I tell her I wrote for six hours today that without the opiates I might have gotten in an hour of chain smoking and deleting sentences. She’ll think I’m able to work through my headaches or that they’ve gotten better even though I can’t and they haven’t. If I call her on one of the days when I won’t let myself take opiates, I’ll have to explain that I don’t really feel like talking, and she’ll wonder why I did feel like talking the day before. She asks me whether the lidocaine that my pain doctor’s wife injects into myofascial trigger points helps me. I can’t say that it is, but neither can I say, “The Opana he prescribed sure does, though.”
5.
The mom came with me to my first appointment at the Blacksburg Center for Pain Management. She thought the lidocaine treatments sounded promising. I thought the Christian paraphernalia around the office made her comfortable, convinced her I’d found a good doctor who wouldn’t write me opiates. The second time, I went alone. I knew I would leave with a painkiller prescription. I’d planned it all out. I just had to cry a little after Leah injected me and wonder aloud whether I could endure this pain while I waited for the lidocaine to work, if it did at all. She said her husband had a cancellation and would talk to me if I could wait. I waited. Dr. Bivens offered me oxycodone, Dilaudid, or Opana. I pretended I’d never heard of Opana and let him explain oxymorphone to me. “Whatever you think is best,” I said and walked out with a prescription for a drug that my junkie ex-boyfriend once described as better than heroin. But when I got home and took one, I only felt the high in my body. I had to crush the pills and snort them to get any headache relief at all.
6.
The mom remembers that I used to crawl into her lap and say, “My head hurts,” before I knew the word for what I felt. Our pediatrician told her I was too young for headaches. When I was nine, he blamed the pain on my personality; I was high strung with tinfoil nerves. In college, I took downers and smoked pot, and the headaches receded into some hidden fold in my brain. They reemerged the October after I moved to Santa Cruz; I was taking meeting minutes when a tingling pain calcified behind my eyes. “Does anyone have some Tylenol or morphine or something?” I said as we trickled out of the conference room. Ofelia gave me an Excedrin Migraine; the pain broke through it within 30 minutes. Brenda suggested I go to the ER. The doctor there gave me eleven 7.5-milligram Vicodin. I took two and called the office. “I can come back,” I told Brenda. She called me crazy. “Go home,” she said. “You need rest.” I drove to my apartment in the mountains, curled up on the floor, and took more Vicodin. I thought I’d save the rest, keep them around and get high a few times. But the migraine lasted seven days. I took all the pills and had the ER doctor call me in a refill. A month later it happened again. By the time I left California for D.C., I’d developed daily headaches, biweekly migraines, and a dependence on butalbital mixed with codeine.
7.
When I tell people I’m taking opiates again, I say, “I thought about it a lot. It wasn’t an easy decision.” But I had already decided what I wanted to do before I walked into Bivens’ office, and I didn’t think so much as I worried about it. I still worry about it. I worry that when I leave Blacksburg I won’t find a doctor to replace the one who writes my opiates now. I’ve yoked myself to a class of drugs so heavily scrutinized that some physicians refuse to dispense them at all, let alone to neurotic 30-year-old women who complain of invisible pain in their heads. I worry about whether I can make my prescription last the month that it’s supposed to. I worry about my tolerance. I worry that some day I’ll require such a high dose just to make it through a regular day that I won’t have the extra pills I need in order to write. I make contingency plans in my head: if I can’t find another doctor, I tell myself, I’ll find a methadone clinic. I’ll do heroin. I’ll buy pills from dealers. I’ll be okay. But I don’t know that. I’ll only know that when something goes wrong, and I worry that it will.
8.
In D.C., I swallowed butalbital with codeine like it was water. I probably ingested more pills than calories. I was the sole employee of a drug policy reform group that was really just an ugly website. My boss wanted me to update the news section by 8 am EST even though most of the news then came out of California and Oregon. I woke up so early that I couldn’t eat breakfast; I’d nibble on melon slices and gag over my toilet. I drank coffee until two in the afternoon, when I could hold down a Potbelly sub, the only thing in DuPont Circle that wasn’t meat or pizza or 14 dollars. I ate popcorn for dinner and smoked weed on my porch or in a beach chair in front of the TV. I talked to the mom at night. By then, I’d taken so many pills that she could hear them in my slurred words. “The work you do… are you?” she asked me once, and I said, “Yes, I’m stoned,” because I preferred admitting to illegal drug use over telling the mom that I was high as fuck on prescription painkillers.
9.
I don’t tell the mom about the Opana. I tell her I’ve been taking oxycodone for about two weeks. Really, I spent three weeks snorting oxymorphone and then asked Bivens to switch me down to oxycodone. I’ve been taking opiates for a month when I tell the mom about them. I want to tell her while the pharmacist at Kroger refills my anti-anxiety pills, but I’m in public, and I know I’ll cry when I do. I only called because it had been so long; I just wanted to say hi, check in. I don’t need to call her again except that by the time the bus drops me off a block from my house I’m crying in that silent way that’s more like choking because I’ve deceived the mom and I know how much I’m about to disappoint her. I try to explain why it’s different now. “I’m taking less in a day than I used to take in one pill,” I say. She’s not soothed. I get off the phone and feel worse. The mom is upset—maybe with me, maybe for me, maybe both and probably more—and I can’t do anything about it. She calls me back a few minutes later and tells me she’s sorry for getting mad. She says she trusts me and that she’s just worried. I say I know; I’m scared, too. The mom says she isn’t disappointed in me. She understands. I tell her I’m sorry anyway.
10.
I’m the mom’s favorite. She loves Bev and Cassie; she likes them. But she likes me best. We’re the most similar. We both worry too much. We’re depressive and intense, and we need to talk about those feelings. We like mid-century junk and can’t throw anything away. The mom keeps all our baby clothes and 80s toys in a storage unit with her American-flag fringe vest and her sister’s 1940s Brownie uniform. I keep her college notebooks on my writing desk, which was my great-grandmother’s kitchen table. Every time I move the dad says, “It would be cheaper just to buy new stuff.” He doesn’t understand the sentimental value I attach to hand-me-down chairs and vintage lamps the way the mom does. Stories—and props—matter to us. The mom tells me stories she doesn’t tell my sisters, like the way she smokes or how she miscarried a few years after she had us. Last Christmas, she showed me a box full of old photos that the dad had told her to throw away. “I didn’t,” she said with a prim, proud smile. The pictures are of her old boyfriends. One is her first husband, a geeky-looking Alabaman she married when she was 19 and divorced before she turned 21. One is bearded, holding a Miller Lite and a fishing pole. He’s not wearing a shirt. I joked that she should have married him instead. “He wasn’t that kind of guy,” she said. The mom looks so pretty in these pictures. She’s blonde and thin as I am but with ample breasts and a big, candid smile. I can see why the dad didn’t want her to keep 40-year-old snapshots of men who made her smile like that. But I can see, too, that she wants me to have pictures like these when I’m her age. She hopes I’ll have stories as good as hers to tell and the love of men with beards and fishing poles. She wants me to live the full life she has, and on opiates she isn’t sure I can.
11.
My mom texts me reassurance: I know you’ll be okay. Make sure to eat well and take care of yourself. I love you. I can’t compose a proper response. Every sentence I click out with my thumbs demands another. I’m still deleting and editing when she sends me a picture of Benny, our family’s only surviving cat, sprawled across her bed. I slept there when I was working in Florida over the summer. Benny acted like the mom’s new bedroom was haunted. He’d stand at the threshold and meow when he wanted food in the middle of the night. We lifted him from his favorite chair, set him between us, and pet him until he slunk back into the living room as though he’d needed every muscle in his 18-year-old body to stay on the bed for six minutes. Benny now comes to the bed all the time, the text says. His new favorite place. I abort my reply and write a new one about how nice it is that Benny’s come around to the bedroom. I add Thanks and I love you, too before I hit send.
12.
The mom got a new bed when she moved out of her old house, so the bed I slept in when I last saw my mom was not the bed where she lay depressed for a decade. It was not the bed in which I lay two years ago, sweating and chattering my teeth and moaning about the pain in my stomach and my bones. It was not the bed to which the mom brought me soup and ice cream because they were the only things I could eat in opiate withdrawal. When I wanted real food, she ordered me thin-crust pizzas without cheese and let me eat them on sheets she didn’t wash for two weeks because she knew that standing up made me want to vomit. I hit week three and moved upstairs to Cassie’s bed; I read Joyce Carol Oates and Barry Hannah and Amy Hempel’s Collected Stories and all of Infinite Jest in the same rapacious, irritated way I’d binge-watched six seasons of True Blood and two of Grey’s Anatomy and the entire run of Weeds in the mom’s bed. When I held a book, my arm muscles twitched and quivered, and I’d wake up sore from wrist to wrist. I tried to write, but I couldn’t sit up to type without feeling nauseated and feverish. I would leave for Virginia in a week, and I still wasn’t strong enough to do anything but shuffle around the mom’s house, in and out of beds in which no one sleeps anymore.
13.
I used to call the mom’s old house “our” house, but the dad abandoned his claim on it when he left with nothing but his clothes. He moved into a furnished condo on the harbor, the opposite of the big house on the bay that the mom dictated to an architect when my sisters and I were in third grade. She filled it with junk shop antiques and the furniture we inherited from the dad’s grandmother. He didn’t want any of that, nothing from his old life. The only thing he’s asked for since he moved out is the Kinks box-set that Bev, Cassie, and I gave him the last Christmas the parents spent together. I saw it sitting beside the mom’s new front door when I rolled my suitcase in from the airport last summer. “He didn’t even want his Kinks box-set?” I asked. Usually, when the dad opens a gift, he says, “It’s a nice… a nice… tie” or “a nice… a nice… book.” But I took a video with the Blackberry I no longer own of the dad tracing the Picture Book track list with his index finger and singing the first few lines of 138 Kinks songs. The mom said he’d called to ask if I could bring it to him when we met for dinner on Thursday. “I’m hauling around 20 years of a life, and he walks away with some suits and CDs,” she said. I didn’t tell her it hurt my feelings that he hadn’t missed the box-set sooner.
14.
The first time a guy broke up with me, the mom took me into the closet under the stairs where she kept her records. We sat cross-legged on the carpet and flipped through Harry Chapin and Bob Dylan, Graham Parsons and Hank Williams. The Doors, the Beatles, the Rolling Stones. “All the cheesy ones are your dad’s,” the mom said as she passed over Rod Stewart and pulled out a stack of Emmylou Harris albums. “I always listened to her when I was sad,” she told me. I took the records to my room and listened to Luxury Liner first; the mom said it was her favorite. I put on Quarter Moon in a Ten Cent Town because I liked the title and then Elite Hotel because Emmylou looked so cool on the cover. I listened for echoes of the mom’s sadness and of my own. I imagined her at 16, horizontal beside a record player in the suede miniskirt that’s in my closet now and the lace-up boots whose soles I broke when I tried to move them to New York. I understood that my mom had invited me to know her in a way she’d never done before. I’m sure she also gave me advice and told me I’d feel better with time, but I only remember the way she handed me those records and inducted me into a fellowship of heartbroken women. When we talk about opiates, we talk about a heartbreak more cutting than any a lover could inflict. The words we use with men are bloodless compared to the empathy and fury the mom and I express to one another. We have our own language for it, but we can’t teach it to you. Our fellowship is too exclusive, the cost of entry too high. The evidence of our initiation is engraved upon our ribs in an alphabet only we know how to read.
15.
The dad and I don’t talk about my headaches—when I lived in New York and had little else to talk about, he’d tell me he wasn’t interested if our phone conversations veered into headache territory—but we must have talked about them at dinner the night before I moved to Virginia. I don’t remember what I said, but I remember his reply: “Well, I wouldn’t have taken the pills in the first place,” he said. He’d just paid the check. I said, “Yes, you would have.” To hear him tell it, the dad’s pain tops the charts, and when it strikes, he’s the first to reach for a bottle of NSAIDs, a tube of Gold Bond cream, a carton of Epsom salt. The dad takes pride in his self-sufficiency. He doesn’t want to admit his mortality, to consider that one day his own body will hurt in ways he can’t endure. That he might bow to an addictive drug scares him too much to contemplate. So, the dad’s story about my headaches has something to do with a weakness in me: I was in pain, and I took the easy way out.
16.
The mom doesn’t like me taking opiates again because she knows it isn’t easy. She’s heard me complain about stingy doctors and out-of-stock pharmacies and side effects that render most prophylactics untenable; she knows how many things I’ve tried and that none have worked. The dad thinks, if he thinks about it at all, that getting on and then off opiates was easy for me because I made it look easy. He has the luxury of thinking that way because he didn’t have to see it. But the mom knows how hard it was. She watched me lose the ten pounds I haven’t gained back; she can see that I don’t have more weight to lose. She understands that opiate withdrawal increased my anxiety to the point that I still take what psychiatrists consider the “ceiling dose” for Klonopin. She knows because she paid for it when I didn’t have any money left that I can’t afford another Suboxone detox. That I might never get off opiates again upsets the mom in part because she thinks it means I’ve given up. “Just don’t give up,” she always says each time I see a new doctor or try a new treatment. “I won’t,” I say, but I have. Last month, a pain specialist called Dawn, my primary care physician, to warn her that I’m not really a pain patient because I wouldn’t let him inject lidocaine and cortisol into my occipital nerve. “The idea is,” Dawn explained the next time I saw her, “that if you were really in pain, you’d try absolutely anything to make it stop.” Since I’d said no to the injections, the pain doctor decided that I just wanted drugs. I sat next to Dawn and cried. I told her that the other doctor was right; I do just want drugs. I know drugs work, and I’m tired of getting my hopes up over miracle cures that never materialize.
17.
The dad actually left the mom twice. I can’t know for sure, but I think he went back to her because he talked to a lawyer and realized how much money a divorce would cost him. He went back to his marriage the way I’ve gone back to opiates: in stages, tentative and brazen. He tested his resolve one last time, but his effort lacked conviction. And when he decided he’d had enough of trying, he told the mom he didn’t want a divorce this time. He didn’t want to involve lawyers. He would give her a monthly allowance, let her remain on his health insurance plan; she could keep the house. On paper they’d be married but would live separate lives in different places. He got the idea from his girlfriend, who has the same arrangement with her husband. The mom insisted on a real divorce. “I have to look out for myself,” she told me. I told her I was proud of her. I said she was right. I pictured her old and infirm, the dad unable or unwilling to take care of her the way she took care of him and his house and his children for three decades. “You shouldn’t have to depend on him,” I said. I know that when the mom expresses her apprehension about opiates, she’s telling me the same thing; she doesn’t want my life to revolve around doctors and pills again. “I won’t let it get that bad,” I promise. But I might.
18.
When I stopped taking oxys and got off Suboxone for good, my mom and my sisters and my friends and my doctor in New York all said they were so proud of me. I hated hearing people declare themselves proud of me. I didn’t achieve anything. I did what I had to do, what I was supposed to do, what I thought I should do. It was hard, but not because I craved opiates; I craved pain relief. Suboxone is mostly buprenorphine, a partial opiate agonist. Partial agonists don’t activate as many of the brain’s natural opioid receptors as do full agonists (codeine, oxycodone, morphine, heroin), but they offer some analgesic effects. Doctors drew me pictures and used analogies, but I’ve never understood how Suboxone works. I didn’t expect it to provide any pain relief at all. When I habituated to it and found my headaches bearable, I thought the full agonists I’d been taking had actually caused the pain, and I blamed it on myself. I didn’t feel proud, and it embarrassed me when people said I ought to. When I tell the mom I’m taking opiates again, I want her to be proud of me for trying to stay off of them and proud of me for recognizing that I can’t. I want her to be proud of me for being honest with her, and I want her to be proud of me the way I’m proud of myself: I made the decision I needed to make for myself even though I knew it would disappoint everyone else.
19.
The mom says I was a different person when I downed 300 milligrams of oxycodone every day, and she doesn’t want me to be that person again. I wish I could see what she saw. I never told her about the way I used to cross Flatbush at rush hour, muttering “Go ahead” to cars I nearly let hit me, so I don’t know if when she calls me different she’s referring to the way the pain and the energy I exerted trying to alleviate it left me sunken and scraped up like my knees the summer I broke my only flat sandals and tripped so often in five-inch wedges that I still have scars where then I had scabs. The mom tells me that opiates make me negative and angry and single-minded. Mostly, I think that’s what she means by different. But she might mean something else. I’m afraid to ask. Sometimes I think my mom loves me in spite of the drugs I take, and that’s what really scares me. She accepts that I need opiates. She’s okay with it. The way the mom feels about opiates parallels the rhetoric of tolerance: we don’t like what you do, but we’ll live with it; hate the sin, love the sinner. I tried to explain last night how I’ve thrived during this year I’ve spent taking opiates again. But for the mom, oxycodone remains the unfortunate drug I have to use because no one knows why I have headaches or how to stop them. She knows how much of my life pain obliterates, but I can’t make her see how much more I lose if I don’t have the pills that relieve it.
20.
Every time I see my psychiatrist at the student health center, I fill out a form that asks me whether I have “thoughts of ending my life.” I always click the “0” that means “not at all like me.” But I’m at least kind of lying. I’m thirty years old, and every morning I take a blood pressure pill, an anti-anxiety drug, and an opiate. Of course I’ve thought about it. I answer “0” because I don’t think about ending my life in the way the question means. I think about my future and wonder what it will look like. I wonder if my life is worth all this. But I don’t think about how I’ll die (I know how: I smoke, and I’ve been killing my liver since I could open a child-proof Tylenol bottle); I think about how I’ll live. When I tell my mom I’m taking opiates again, I’m telling her how I will.
