Advanced Psychopharmacology

Opioid Use Disorders Video Transcript

Joe: I promise you, I have more problems than you’re going to want to deal with.

Off Camera: What sort of problems?

Joe: I’d say chronic pain, but that can also describe my wife.

Off Camera: So you have physical pain problems and you have problems with your wife?

Joe: [Laughter] No, you can’t take a joke, Doc. You know, I guess that just goes against your training, huh?

Off Camera: Oh, OK. I get the joke now. No, you don’t. That’s alright, that’s alright. My wife’s fine, sex is great, no risk of pregnancy, it’s heaven. So you do have physical pain.

Joe: Oh, yes. Everywhere. All over my body. And I won’t even get into the blood pressure and all that crap. I’ve had three stents, and you know I could probably do a Wilford Brimley commercial on diabetes.

Off Camera: OK. So you have many health issues.

Joe: Many! They could use me to teach an entire encyclopedia of medical problems.

Off Camera: So, why is it you’re here? Why are you seeing me today?

Joe: I have sleep problems, a non-sexual kind, and lately, lately I’ve been having these friggin attacks.

Off Camera: Uh-huh.

Joe: I can tell you exactly what I need.

Off Camera: OK.

Joe: I need something like Percocet or Oxycontin.

Off Camera: OK, well first let’s talk more about these attacks you’re having.

Joe: No, let’s talk more about Percocet.

Off Camera: So you want to talk about the medications, first.

Joe: Doc, when it comes to my health. I don’t like being jerked around.

Off Camera: Do you feel like you’re being jerked around?

Joe: No offense, but I’m old.

Off Camera: OK.

Joe: I’m broken and I need to be fixed. And I don’t want to waste any time talking about where my hurt came from. My body tells me enough of that.

Off Camera: OK, OK. But, so I can understand better to help you, I need to know what’s going on with these attacks that you said you’re having.

Joe: Ah hell. Alright [sigh]. I get tightness in the chest. I’m out of breath and I start sweating.

Off Camera: OK.

Joe: Hell, they’re panic attacks. And if you had any decent training, you already knew that.

Off Camera: When was your first panic attack?

Joe: About two weeks ago. Yeah. The wife and I took a road trip. We have an RV and Harleys and so forth. And we found a campsite at Joshua Tree.

Off Camera: Nice.

Joe: Actually, the trip was a little more stressful than normal. Susie, my wife, she left medication back at the house; actually it was her extras that she includes in some of her dosage. And it was too late to turn back.

Off Camera: OK.

Joe: So, I’m setting the RV up. Actually putting the awning up and Susie thought I was having a heart attack. She called the rangers and there they were and they even brought an ambulance all the way up there. You know, can you imagine what that must have cost the government?

Off Camera: Wow, yeah.

Joe: Had to be a shitload.

Off Camera: And then what happened after that?

Joe: Well, they released me. Next day, we went home like nothing had happened.

Off Camera: Hm. So, I do treat people for panic attacks. How much Oxycontin do you take?

Joe: Just what the doctor prescribes.

Off Camera: Uh-huh. How many pills a day is that.

Joe: The dosage? I don’t know. I just pop the pills they give me.

Off Camera: Do you think it’s two, three, or more pills a day?

Joe: No.

Off Camera: Did you recently stop taking the Oxycontin?

Joe: Mark cut my dosage about three weeks ago.

Off Camera: Uh-huh.

Joe: Which left me with nothing but my Ambien and a little Klonopin.

Off Camera: OK. So your doctor has you on both Ambien and Klonopin.

Joe: Ambien, yes. It helps me sleep. But my wife takes the Klonopin. And during the day I take a little of her Klonopin too.

Off Camera: So you mix the medications.

Joe: When that’s what my doctor prescribes, yeah. It seems to work well.

Off Camera: Are you and your doctor pretty good friends?

Joe: Oh! Mark and I? [Laughter] hell, yes! We ride together, on the weekends we’ve got a big group of us. I’ve even been to Sturgis with him.

Off Camera: Sturgis.

Joe: Big bike rally. Harleys. South Dakota in the Black Hills. Everybody should have a doctor that they can kick back with and down a beer or two.

Off Camera: You and your doctor drink beer together?

Joe: [Laughter] Beer? A lot more than beer, Doc. Mark’s a champ.

Off Camera: What do you mean?

Joe: Well, one of the craziest things, if not the craziest things we’ve done, it was one of these loco Indian ceremonies.

Off Camera: Right.

Joe: And, well, fuck me with a hot poker. You take this hallucinogenic drug. It’s ah, whatchamacallit. You stay up all night, the drums are beating all night long and you’re in a sweat lodge hallucinating with other people.

Off Camera: And are there any other drugs?

Joe: Oh no. No, I did all that when I was young. I guess the only time I really get carried away is the annual trip to Sturgis. Then I let ‘er rip.

Off Camera: So, the rest of the year, do you feel like you have your drug use and your alcohol use pretty much under control?

Joe: No, damn straight, yeah. I’m too old. I don’t bounce back like I used to. And I just said it; I am getting old, Doc.