Jonesin’

Itching, sticking, sweating, sniffling, tearing–
Crying.
Cramping, fetal position, dry heaving, pounding–
Stigmatizing.
“Feening,” scheming, planning, trying, feels like–
Dying.

Dilated pupils, hairs on end, goose bumps, close to–
Collapsing.
Anger, fear, sadness, can’t stop moving, although it’s–
Transient.
Screaming, cursing, fighting, interactions–
Short lasting.

[[{"type":"media","view_mode":"media_crop","fid":"27110","attributes":{"alt":"drug withdrawal","class":"media-image","id":"media_crop_8070927406797","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"2605","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","title":" ","typeof":"foaf:Image"}}]]Pain, discomfort, “crawling out of my body”
“Leave me alone!” [but stand beside me].
Methadone, suboxone, “You have to help me!”
Heroin, oxycontin-“pain is gone”
but still so lively.

Cycle, revolving door, if I fall
“Who will catch me?”
Uncertainty, loss of confidence, locus of control
Outside of scope, not “inside [me].”

Biographical statement:

[[{"type":"media","view_mode":"media_crop","fid":"24455","attributes":{"alt":"Claudia Rodriguez, MD","class":"media-image","id":"media_crop_3008570854075","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"2114","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","title":" ","typeof":"foaf:Image"}}]]In a world in which substance use disorders are no longer suffered in isolation, treating addiction is a challenging journey with obstacles, intermittent failures, and life-altering successes. As relapse is part of the illness, acceptance on the part of the physician becomes an integral part of the interaction that allows for reflection, change, and ongoing commitment to treatment.

One role of the addiction specialist is to recognize symptoms of withdrawal, clearly identified in psychiatric scales used to manage its treatment. These scales are clinically helpful, but witnessing the despair, helplessness, and loss of identity suffered by some of these individuals leads to a greater understanding of the underpinnings of addiction and the loss of control that identifies the illness.

The neurobiological changes that occur with the use of drugs become most evident in the stages of intoxication and withdrawal. The drug, or lack thereof, as if possessing the soul, reveals an individual different from the patient’s true self.

I wrote this poem to reflect on the experiences that I have witnessed in many patients, who-after treatment-transform into entirely different human beings.

Dr Rodriquez is a Fellow in Addiction Psychiatry at Boston University Medical Center.