September/October 2019 – He pulled up his sleeve to reveal a red, swollen arm marked with scars, scabs, and infected puncture wounds. The damage was so alarming that I gasped. Another client, Sarah, drank alcohol and smoked marijuana every night to the point of blacking out. With no memory of how she’d gotten herself to bed, she’d wake up groggy with a splitting headache, take aspirin, drink a cup of coffee, and drive to a job that she hated. In her view, she drank and smoked to relax, but occasionally her hangovers caused grand mal seizures that hadn’t killed her yet but probably would. Her doctor had been trying to persuade her to stop using substances for seven years with no success. She didn’t want to stop, but she didn’t want to die, which is why she was working with me.
Drew was a 20-year-old man who’d taken a year off from college to recover from a life-threatening staph infection. During that time, his drug use had gone from an occasional beer or joint to near daily use of some combination of marijuana, alcohol, Xanax, heroin, pharmaceutical opiates, and cocaine. He prided himself on being well-educated about the risks of drug interactions and knowing how to stay safe. He loved getting high but wanted to “fine-tune” his drug use, now that he was back in school. During a phone session, I became alarmed at how intoxicated he was. He reassured me that he’d only used “a little” heroin and drunk one beer. Opioids and alcohol can be a lethal combination. I told him I’d call back in 15 minutes and if he didn’t answer the phone, I’d alert school security and his parents. When I called back, he didn’t answer.