My Oxycontin Years

by Lambert Dolphin

In my later career years I enjoyed hunting for lost treasure! Not exactly hunting for my own possible gain. Having acquired some basic skills in geophysics I made myself available for hire by clients who could afford to pay for my services. This season of my life proved to be more meaningful than my professional career because of the amazing people I met and worked with for some years.

In 2008 I injured my left knee crawling around in a lava field in Southern New Mexico. We were using ground-penetrating radar to look for lava caves where a Wells Fargo stage coach strong box had allegedly been hidden a hundred years earlier.

Limping home with a painful knee several days later, I visited my doctor who prescribed a small dose of the opioid Oxycontin. Pain went away but I found myself returning to the same young surgeon a few months later as the pain returned and arthritis in my legs and feet developed. Dr. W accommodated me for the next ten years possibly assuming he would eventually be my knee replacement surgeon.

Eighty milligrams twice a day was the maximum dose I ended up with. The entire ten years I had no idea that my Oxycontin addiction was as serous as heroin. Life seemed to go on as usual until June 2017. I was teaching the Bible at church, taking friends to dinner and leading a men’s group until...I thought I had my act together but discerning friends knew otherwise.

Then I crashed! My friend Tom MacGowan found me unconscious in my room one day, He cleaned up a huge mess and drove me to the ER. I remember nothing about the next two weeks! I was deletions. I am told I nearly died from aspirating food and the pneumonia that followed. My primary care physician, Dr. John Madej told my friends I was not going to make it.

My loyal friend Lawrence did not retreat but rounded up all my known friends and asked them for prayer on my behalf. I have since learned that several special friends came to see me at my bedside but so far I remember nothing of these weeks of delirium.

As my meds were adjusted, I stopped taking Oxycontin cold turkey. Ten years of opiate addiction was over by the grace of God.

In the hospital from July 4 through mid-August I gradually came back to reality after those weeks of delirium. I remember vaguely the ambulance ride across the street from ECH to my new recovery hospital.

In the ensuing days I knew I was in a hospital though I had no idea why. I knew I had a relationship with God. Why then was He so remote? I was evidently confined to the hospital unable to leave until someone came and got me out. Nothing else was in my awareness data base at the time.

The total care I was receiving by the staff was amazing! I was in a far better “prison” than the Mamartine in Rome. I started talking to God asking why I did not feel close to Him. I knew the answer was “Who Moved?” But what a great place to be confined —with freedom to talk to God night or day! (The Room was equipped with TV but I soon saw that 99% of the fare on TV was trash).

Lawrence brought me, upon request, an iPad and player with 67 audio files by Ray Stedman (“Through the Bible Book by Book”). Ray’s voice was immediately familiar so I listened to all of the messages two and a half times. Lawrence also gave me a full set of gospel folk songs.

I had no idea who Lawrence Hoppis was but he was evidently trustworthy and in charge. I rested easy. Memory largely eclipsed but slowly coming back! I had actually known Lawrence well for twenty years!

Fully Addicted to Oxycontin! 80th Birthday 2012.
Left to Right: Brad Cantrell, Lambert, Matt London, Lawrence Hoppis

I soon ate three full meals a day, with gusto, wondering why I still had a feeding tube gadget in my stomach. I was incontinent and not able to get out of bed, but the staff did not seem to mind changing me. I swallowed all my meds dutifully. I saw that my demeanor mattered to the staff; they were all very interesting men and women.

In a week or so, a polite young girl from the on-site gym informed me she was scheduling some PT for me starting now. I politely declined, but she was so gracious I had to go along with the program. A great friend from church came by one day and she informed me in no uncertain terms that PT was not optional unless I wanted to waste away and die like some old timers I had seen down the hall. I gritted my teeth and accepted her admonition to the call of destiny (I never was athletically inclined). I wanted to please the young staff from the gym so I humored them—and they pushed me further one day at a time. "First, Lambert, learn how to get out of bed, how to maneuver a deluxe wheel chair to the gym. How to use the toilet.”

Could I walk to the gym while my “trainer” stood by? Could I throw the beach ball and endure five minutes more on the exercise machine? Could I walk from the gym back to my room. I took the opportunity of learning who my keepers were. None were Christians so I prayed for them and for my wonderful nurses. It was actually fun seeing my body regain both form and function!

When Nurse Ann took me down the hall for a shower the first time I was scared, but she was nonplused and business like. I learned she was a single mom raising three boys in their twenties. Ann said she worried too much, so naturally I prayed for her, I was always glad to see her when her shift came around

On August 15, Lawrence and son Elliott came and picked me up at the hospital. Abandoning my wheel chair at the front door I was ready to go “home.” Where I lived was a mystery but a trusted Lawrence. I remember feeling sorry for Elliott as he was obviously very very tired that day.

I had been the recipient of the lavish mercy of Jesus and friends which I soon would realize more clearly. I am amazed at the total care God was providing me 24/7. It felt like something new I had not ever known before!

Every day since, writing this sixteen months later, a huge flood of memories has come flooding back one day at a time! This memory recovery in the brain seems to be like the opening and excavation of an old closed gold mine! Every day has been a new, orchestrated, integrated exciting adventure. No more arthritis nor joint pain and weight normal and stable.

My relation with Jesus since has been so new and different I feel as if i have been “born-again, again.” I have learned that my story is one of many true NDE stories of the saving life of Jesus at work in file recovery and restoration now underway in many lives.

When I came home from the hospital (August 15, 2017) I remembered very little. I assumed I had a short season of life remaining but I thought I had to start all over again, everything from my previous life had presumably been erased. But I was being given a choice of going home and starting over from scratch. Or, if if I refused God’s mercy, I could possibly be catapulted alive into the lava lake of Mt. Nyriagonga in central Africa. (True story of a vision I had about July 5 or so).

A temporary reprieve was obviously what I wished for!

The Lord first gave me early on an instant replay of my entire life from the first grade on till now, with vivid detail. I saw that the forgiveness of one’s sins extends into the past and the future both—from the time we received Jesus. I saw also that I had could drop, as superfluous, a ton of baggage surrounding my self-image from boyhood to the present. Having not bonded with either of my parents very well in childhood I had unvented and reinvented an identify to suit the changing scene of my life. Somehow I had always managed to fit in and survive, sorta. But, I had faked life, taken a chameleon’s approach to life—which I now saw never fooled God.

Jesus is an utterly realist and has an inexorable memory for details. He wanted an intimate relationship with me and my current experience of God seemed too good to be true. But my conversion experience in 1962 was valid and God had dealt with me accordingly ever since.

“(God) life to the dead and calls into existence those things which do not exist as though they did.” (Romans 4:17)

In other words, God does not keep score the way we do! He is concerned about our long term wholeness and does not violate our freedom of choice. True, the “consequence engine” is at work—God can not violate His own rules.

My newsletters old and new are archived on my web site, for anyone interested. I am glad to answer email from anyone interested in journey. Lawrence Hoppis and Bryce Self promise to document my initial hospital stay about which I still remember nothing. The "healing of memory" process by our God continues to this day.

December 8, 2018. March 9, 2019.

Important Resources

TEDx Talk by Rachel Kurtzman

Tedx Talk on Oxy Withdrawal by Travis Reider

A Lettter to Friends

December 22, 2018

Dear _____,

In my later years after SRI, I enjoyed hunting for lost treasure! Not exactly hunting for profit. Having acquired some basic skills in geophysics I made myself available for hire by any and all clients who could afford to pay for my services. This season of my life proved to be more meaningful than my professional career because of the amazing people I met and worked with for some years.

In 2008 I injured my left knee crawling around in a lava field in Southern New Mexico. We were using ground penetrating radar to look for lava caves where a Wells Fargo stage coach strong box had allegedly been hidden a hundred years earlier.

I fell on the sharp basalt and tore a ligament in my knee. Limping home several days later, I visited my doctor who prescribed a small dose of the opioid Oxycontin. Pain went away but I next found I was returning to the same young surgeon within a few months as the pain returned and arthritis in my legs and feet developed. Dr. Wong accommodated me for the next ten years reluctantly assuming, I suppose, he would eventually be my knee replacement surgeon.

Eighty milligrams twice a day was the maximum dose I ended up with. The entire ten years I had no idea that my Oxycontin addiction was as serous as heroin. Life seemed to go on as usual until June 2017. I was teaching the Bible at church, taking friends to dinner, and leading a men’s group until...

I crashed! My friend Tom MacGowan found me unconscious in my room. He cleaned up a huge mess and drove me to the ER. I remember nothing at all about the next two weeks! I was deleterious. I nearly suffocated from aspirating food and the pneumonia that followed. My primary care physician John Madej told my friends I was not going to make it.

But my loyal friend Lawrence Hoppis did not retreat. He rounded up all my known friends and asked for prayer on my behalf. Several special friends came to see me at my bedside but so far I remember nothing of these weeks of delirium. I should have died! As my meds were adjusted, Lawrence persuaded my doctors to stop the Oxycontin cold turkey. Ten years of opiate addiction was over by the grace of God.

Ten years on opiates! Little did I know that my awareness of people and of Jesus had been compromised little by little. A nightmare!

In mercy our Lord brought me back to this life in mid 2017 (as you know). I came home from the hospital with 23 prescriptions and gradually weaned myself down to 7. Arthritis now gone. Joint pain gone. Hearing in right ear restored after a decade of 60 db hearing loss.

Best of all, a daily flooding of recovered memories from childhood till now is still happening. I am now very careful about what I eat and the new diet regimen is a big part of my healing. I am driving, walking with no joint pain, active and social. Drove to Parumph, NV and back last week.

But B's porphyria handicap is awful! He certainly should not stop meds cold turkey! I am praying for the resurrection life of Jesus to pour in on both of you at this time.

What I seem to be experiencing is pre-Rapture grace. I do think the Rapture will happen soon. Surely you two are due for a new supply of Holy Spirit power from Yahweh Rophe?

I love you both very much! I am 86, so it is hard for me to identify with you mere 70 year olds!

The free gift of God is eternal life—which is our present possession! “The outer man perishes, but the inner man is renewed day by day.”

Thank you for your terrific newsletter!



Dear Lambert,

Your account makes it sound like there were no real problems for almost 10 years from 2008 to 2017, "life [went] on as usual ... I thought I had my act together":

But you were telling about your oxycontin troubles for YEARS before that July 4 (?) 2017 crash.

In June 2010, over 8 years ago, you had a horrible life-threatening crash, which you reported in your June 22, 2010, email (find and read the whole thing if you want to get a complete "feel" for what's going on, I'm selecting some less disturbing portions)...

A few months later you gave me a progress report, on Sept 23, 2010, when you emailed me...So this did not suddenly appear without warning in 2017.

I don't know if this helps any but after my accident getting hit by a car last year, I had spinal surgeries which prevented spinal cord injury (a real miracle), but needed heavy-duty painkillers, mainly dilaudid. After 3 weeks, and after noticing virtual intestinal paralysis side-effects, I was able to quit dialudid and went on a non-opioid nerve pain med gabapentin neurontin, usually used for shingles but now being found very helpful as a general analgesic for moderate to moderately-severe pain (but not severe pain). Only one of my doctors knew this and took action, and none of them (including the one doctor) had noticed or said anything about how I had been having opioid side-effects with severe constipation and that this gabapentin would avoid them. After another month hospitalization and 4 months home while gradually reducing gabapentin I went off it entirely.

God's Blessings to you in the New Year!


My response

Dear B,

You quite right my friend! The recovery of my memory from about 2008 till 2017 has so far been poor! The clarity I am experiencing now seems to begin about 2007 and extends back in tIme to childhood.

I have a written diary of notes (one page per year) from 1936-2018. So I have written reminders of major events in my life but my memory is vivid or recoverable (so far) only for early events. In rereading my newsletters from 2008 to 2018 I am unable to remember what really happened! So what I read in my newsletters comes as a shock.

I can recall many details of my life prior to 2008 given a trigger from someone. I do not know how the brain heals itself but obviously there are gaps in what I think happened versus objective records. It is frightening to realize that I was doing so poorly for years when friends like you clearly saw my declination. I was highly self-deceived!

I have no idea how to comment on opiate influence in other people. Obviously pain relief after an accident or surgery is important and surely most people rebound with no ill effects or memory loss?

What I remember about you since we met is your incredible memory for detail in facts and dates and accuracy! You have always amazed me for this and for your tenacity in the arena with lions.


Note Added

None of us knows himself/herself very well! A spouse or best friends often see us much clearly than the self-image we create for ourselves! Scottich poet Robert Burns wrote:

O would some power the giftie gie us to see ourselves as others see us.

(O would some power the gift to give us to see ourselves as others see us.)

December 30, 2018

Previous Drug Addictions!


Ten days ago an acquaintance, obviously frustrated with what he had been taught in his church, wrote to ask me if I had ever seen a real miracle. I replied that I hadn't. Most of the miraculous events I have ever seen have been gradual, over time. No, I could not recall ever seeing a sudden, on the spot miracle up close.

Ever Seen a Miiracle? I ARE one!

Twenty odd years ago while doing some ground penetrating radar searches in Southern New Mexico, I fell on my left knee while leaping and bounding over a field of jagged lava. The pain was quite intense at the time but I ignored it. Bad idea. Arthritis gradually set in and slowly worsened over time.

Several years later while hiking in the hills above Silicon Valley, I felt (and heard) a tendon in my ankle snap. No pain, just a weird sensation. Gradually my left ankle lost rotational support and then more arthritis set in. The opposite leg compensated and sympathized. By about 5 years ago I had lot of bad arthritis, and my body was a bit lopsided.

A very fine NSAID pain pill from my doctor kept me quite comfortable -- until two years ago this month. In June 2008 I found myself in the hospital from a blood clot in my right leg (DVT). I'd had a pulmonary embolism. (This sort of event is fairly common and often kills a person right on the spot). Now I had to switch arthritis pain meds. For safety I was now on blood thinner and the only real option was the opiate oxycontin. As a supplement (since I don't like pain), the doctor gave me ultram (aka tramadol) to be used as needed.

Two years elapsed. I had vague symptoms such as running out of energy fast, but I assumed this was just part of the normal aging process. My doctor said he thought I had ten more good years ahead, but I did not believe him.

Then a fortnight or so ago, out of the blue, everything went wrong fast. I began to get truly horrific withdrawal symptoms, apparently from tramadol. I woke up sweating, experiencing leg cramps, feeling apathetic, sleeping a lot but not getting rested, all for no apparent reason. I was constantly fatigued and lacking in energy even for the simplest tasks. My mind was really dull. I was getting only crumbs and scraps of new insights and life out of the Bible.

Long story short, these worrisome symptoms then escalated about a week ago. Insomnia--four straight nights with zero sleep, and anxiety screaming in my brain without a break. I started praying constantly without stopping, and I asked everyone around me to pray for me. How could any of them know the urgency I felt? The heavens above me seemed like solid brass (Deut. 28:23). A trip to the ER failed to get me any real help. They could not help and just sent me home! I called the recommended best drug detox doctors in Silicon Valley only to find that they were booked solid until mid-July. From all I had read, a person should never go cold turkey from either of these very dangerous drugs, and then only come down under a doctor’s supervision. The detox process was said to take months. I knew I could not bear another day of such intense anxiety, especially with no sleep at all.

Now my prayers really became desperate and urgent. Time was out of joint, what seemed hours was actually only a few minutes. I begged God to take me home to heaven. Yet apparently I had appealed to the highest power above all powers. and He was silent. This was like being in hell without being in hell. The door to heaven was apparently locked, nor could I go back to my normal life on earth. (Evidently one can't go in until the appointed time. "It is APPOINTED for man but once to die, and after that the judgment).

I begged the Lord to be gentle. I believe He replied, "I am being as gentle as I can." Searching for an analogy to what was happening I was drawn to Hebrews 12:

You have not yet resisted to bloodshed, striving against sin. And you have forgotten the exhortation which speaks to you as to sons: “My son, do not despise the chastening of the LORD, Nor be discouraged when you are rebuked by Him; For whom the LORD loves He chastens, And scourges every son whom He receives. If you endure chastening, God deals with you as with sons; for what son is there whom a father does not chasten? But if you are without chastening, of which all have become partakers, then you are illegitimate and not sons. Furthermore, we have had human fathers who corrected us, and we paid them respect. Shall we not much more readily be in subjection to the Father of spirits and live? For they indeed for a few days chastened us as seemed best to them, but He for our profit, that we may be partakers of His holiness. Now no chastening seems to be joyful for the present, but painful; nevertheless, afterward it yields the peaceable fruit of righteousness to those who have been trained by it. Therefore strengthen the hands which hang down, and the feeble knees, and make straight paths for your feet, so that what is lame may not be dislocated, but rather be healed. Pursue peace with all people, and holiness, without which no one will see the Lord: looking carefully lest anyone fall short of the grace of God; lest any root of bitterness springing up cause trouble, and by this many become defiled...” (Hebrews 12:4-15)

I don't mean to imply for a moment that all Christians ever go through hellish experiences like mine. What I was going through was apparently not punishment for sin, but just more old fashioned sanctification. None of us gets into heaven "unsanctified!" I believe holiness can be equated with wholeness -- and holiness is not optional for living in heaven.

"Therefore gird up the loins of your mind, be sober, and rest your hope fully upon the grace that is to be brought to you at the revelation of Jesus Christ; as obedient children, not conforming yourselves to the former lusts, as in your ignorance; but as He who called you is holy, you also be holy in all your conduct, because it is written, “Be holy, for I am holy.” (1 Peter 1:13-16)

I'll add more later but suffice it to say I reached a point of total despair last Saturday evening. I felt as near as was possible to what it must be like being in hell. I had found no way to sleep in four days. If I lived I'd detox one small step at a time, for months. In complete despair, I took a sleeping pill and pulled up a pillow.

Instantly I fell asleep. Everything went blank.

Next morning, perhaps 8 hours later, I was wide awake, refreshed, alert, feeling like a new man. No symptoms remaining! Three full days now back to normal. But what I am experiencing now is not the normal I have been living with for two years. The fog in my brain was gone! I was an absolute miracle. Only Jesus Christ could have pulled this off. There was no other explanation.

"Streams of mercy, never ceasing. Call for songs of loudest praise."

My dear friend David Alexander, a Christian brother I've known for 20 years, is a former ER nurse who was with me a good part of the time last week. David wrote the following yesterday to mutual friends of ours:

The last time we met for [Bible study] via skype, Lambert was beginning what was to be perhaps one of the most painfully difficult and tedious times of his life. I've known Lambert for over 20 years. For him to miss a bible study we all know something is very, very serious. After that study I went to his home and visited with him for a few hours and he seemed anxious. Because of the type of work I now do I was afforded, via Jesus' providence, several occasions to check in on him that next week. He seemed to be getting worse throughout the week. Things got even worse despite his visit to the ER on Wednesday evening. I was most concerned for him. One of Lambert's roommates, Chris Gonzales (Gonzo) and I went to an air show on Saturday but before we left Lambert asked us all to pray over him -- which we did. All I could think of praying for was his strength and some rest and patience to endure the long, tedious, arduous withdrawal period (I've gone thru it myself and it's perhaps as close to hell as one can ever get without actually going there).

More symptoms cropped up in Lambert's life while Chris and I were at the show. I feared that Lambert might be approaching something so serious that he'd need hospitalization. But he continued to pray. I was most concerned for him all Saturday night. From my own personal experiences with narcotic addiction/withdrawal, and from my own professional experience, my friend might well die that night.

Yet when I got home from church Sunday early afternoon to read his emails I was utterly shocked! I was immediately full of surprise (almost to disbelief) as if I was in a dream and would soon awaken only to find the dream shattered and me being forced to return to the stark reality of how ill my dear friend still was. But no....he was completely healed! I had to go to his home that afternoon to see for myself and sure enough he was his old self ...the brother I've known him to be, before his mind and body was hijacked by disease and infirmity and the cloudy thinking that always accompanies long term narcotic use. (Although he was not addicted his body had become very, very dependent on those powerful drugs). At his home on Sunday I found a man not in pain, not sick but utterly set free from all the anxieties and symptoms he'd been wrestling with over the past 4 days or so. I couldn't believe it! It took me about 3 weeks to withdraw from narcotics. Lambert's recovery is indeed a true, honest miracle!

Friends, in addition to just these surface details, I was fully conscious during my entire experience with our Lord, outside of time. I have volumes of fresh new insights to write down, analyze and integrate -- a wealth of "wondrous" things I learned from our Lord Jesus. One might put them in the category, "the fellowship of Christ's sufferings." God willing, I'll edit and add to this short interim report as our Lord permits.

In a few weeks, God willing, I plan to give a more complete report at my church. I'll record that meeting and post it on my web site because, paradoxically I saw much good news in what I experienced about our God on my trip to the outskirts of Hades last week.

Many older folks are in trouble with dangerous, powerful prescription drugs these days, as I was. Illicit drug use is rampant everywhere now--I believe I now know a bit about what that must feel like.

Anyone, anywhere, can call out to the Lord Jesus Christ, no matter their circumstances. "Jesus saves" is still a major plank in the platform of King Jesus who will soon be back to take charge right here on earth. Our enemy Satan, the usurper, the present god of the age, lies, deceives, blinds, warps and destroys. We are no match when taking on the "god of this world," but Jesus is.

No one gets away with anything in this universe. God is Just as well as Holy. Only the "works" of Christ through His people have any lasting value. All the rest will be burned up.

"And whatever you do in word or deed, do all in the name of the Lord Jesus, giving thanks to God the Father through Him." (Colossians 3:17)

Repentance must go hand and hand with knowing Jesus. This is an individual task, no one can do it for you. Cherubim with flaming swords bar the gates back into Paradise. That gate is the cross. There is no reason for you to be left behind, but there is no escape from the world until God opens the gates and calls us home, either one at a time or all together at the rapture. Those who belong to Jesus are a small remnant. Don't be misled by large numbers of merely "religious" persons who think they are God's kids --they may not be. (Note how the Sermon on the Mount closes). I can see that we may think we need no repentance but we can be self-deceived. Start confessing to the Lord any minor peccadilloes you see on the surface of your life and let God peel them back one way one. You'll probably soon see, as I have, that layers of more serious issues lie half buried, clogging the channels the Spirit would like to flowing through, as in "streams of living water."

We Christians are, I feel certain, right on the verge of the scheduled time of the departure of the true church. Any moment now, the Bride of Christ will leave to be with her Lord and Groom. The symbol of the "bride" speaks of inner intimacy and purity, it's not about outward appearance, and not about "performance." I believe the church in America is far far from being ready for the wedding day.

Further, we are most likely living in the age of the last of the seven churches described in the Book of the Revelation. Jesus has no commendation for Laodicea but he offers hope to the small believing remnant in that assembly. (Check my web site for more about this later. I believe the long overdue judgment of America is now beginning to unfold. This is a time or all of us to start praying, then repenting, then praying again, then fixing relationships that are broken and settling old accounts. "Pray without ceasing." We American Christians are fake and phony for the most part. We can't hide form God. No one can! He will take us safely into His sheepfold if we call on him from our hearts and repent down to bedrock. You'll know it when you've done your homework.

Isaiah said,

“Come now, and let us reason together,@ Says the LORD, “Though your sins are like scarlet, They shall be as white as snow; Though they are red like crimson, They shall be as wool. If you are willing and obedient, You shall eat the good of the land; But if you refuse and rebel, You shall be devoured by the sword”; For the mouth of the LORD has spoken." (Isaiah 1:18-20)


1. I found I could identity with much of what T. Austin-Sparks said in The Fellowship of His Sufferings, (2 Corinthians 1:3-5; 2 Corinthians 6:8-13; 2 Corinthians 2:4; 2 Corinthians 11:23-28; 1 Corinthians 4:9-13; 2 Corinthians 1:8-10)

Comments: Ted Wise has been a very special friend of mine for more than 40 years. He has "suffered many things from many physicians" for years. Ted wrote me today saying,

"You wrote, 'Next morning, perhaps 8 hours later, I was wide awake, refreshed, alert, feeling like a new man. No symptoms remaining! Three full days now back to normal. But what I am experiencing now is not the normal I have been living with for two years. The fog in my brain was gone! I was an absolute miracle. Only Jesus Christ could have pulled this off. There was no other explanation.'

Are you saying no symptoms of withdrawal or no symptoms of withdrawal and your various inflamed joints, muscles, tendons, etc.? I hope you mean your chronic pain is healed too. Over the years my doctors have occasionally prescribed treatment that ended with me on a trip to the ER. May God give you the wisdom and grace to respond to the email you and the Paracleteforum will surely receive.

--"For to me, to live is Christ and to die is gain." (Philippians 1:21)


I replied to Ted, "As usual you have sent excellent advice for me and anyone who happens to read my remarks, to keep communication in reasonable balance! You have always played this role in my life ever since we went to India and Germany and worked together at PBC.

The real 'miracle' one week ago involved total withdrawal from tramadol (ultram). The doctors all claim this takes months and should be undertaken only in small steps under medical supervision, never cold turkey.

I am still on oxycontin which holds the arthritis pain down to a reasonable level. The use of tramadol over two years' time had dulled my mind greatly and sapped my energy. I had not expected such a fine big bonus reward for stopping tramadol. My friend David (the former ER nurse) says these narcotics often dull the brain and cause lethargy and apathy.

I still have to eat right and sleep and not take on too much. My daily arthritis pain is not pleasant, but it is bearable. My primary care physician is tracking down a pain specialist to help me stay on track with the best possible meds, starting right away. I would love to stop Oxy, too, but for the moment that does not seem possible.

Your email reminds me to pray for you with more regularity and diligence. I can't begin to imagine the pain you live with day after day and year after year. More than likely your experience, with all manner of meds, and every kind of doctor over years now means you know far more than I do about all this pharmakeia.

Just a week ago I felt like I was hanging over what seemed like the pit of hell, in horrific mental pain that would not go away. Neither could I sleep. Time slowed down. I was in complete despair seeing no way out. The overnight change brought about by Jesus Himself was so amazing I am still reeling with thanks to God and experiencing much joy." --Lambert

Lambert Dolphin
June 23, 2010

Alcohol Addiction

In 1977 I spent two week-long sessions at Raleigh Hills Hospital in Redwood City. The second week persuaded me to stop drinking alcohol for the rest of my life. Sober ever since thank God.

How Opioids Kill

What happens in the body during a fatal overdose? And why is fentanyl responsible for more deaths than ever?

Dina Fine Maron

January 8, 2018

One evening this past fall a patient stumbled into the emergency room at Brigham and Women’s Hospital in Boston. “I don’t feel so…” she muttered, before losing consciousness. Her breathing was shallow and her pupils were pinpoints, typical symptoms of an opioid overdose.

Her care team sprang into action. They injected her with 0.4 milligram of naloxone, an overdose antidote—but she remained unresponsive. They next tried one milligram, then two, then four. In total they used 12 milligrams in just five minutes, says Edward Boyer, the physician overseeing her care that night. Yet the patient still had trouble breathing. They put a tube down her throat and hooked her to a ventilator. Twenty minutes later she woke up—angry and in drug withdrawal, but alive.

The patient, whose identifying details may have been altered to protect patient confidentiality, had apparently injected herself with a synthetic opioid such as fentanyl right outside of the hospital building. That gave her just enough time to seek help. But many users of synthetic opioids are not so lucky. These drugs, which bear little chemical resemblance to any opioid derived from the opium poppy, are much more powerful than poppy-based heroin and semisynthetic opioids such as oxycodone or hydrocodone. Thus, the standard dose of naloxone employed by first responders (and sold in bystander overdose kits) is often not potent enough to save a synthetic opioid user’s life.

Recent data indicate the rise of these synthetics is proving particularly deadly. Between 2015 and 2016 the rate of reported overdose deaths involving synthetic opioids—meaning fentanyl and similar drugs, as well as the painkiller tramadol—doubled, accounting for about 6 deaths per 100,000 people in 2016, and contributing to the more than 63,000 deaths from drug overdoses that year.

But how do these drugs actually kill people? When a person smokes, snorts or injects an opioid, the substance enters the bloodstream, then the brain. There it can act on mu-opioid receptors, says Eric Strain, director of the Center for Substance Abuse Treatment and Research at Johns Hopkins University. “Once the drug binds to those opioid receptors and activates them, it sets off a cascade of psychological and physical actions; it produces euphoric effects, but it also produces respiratory-depressing effects,” Strain says.

As a result, victims of a fatal overdose usually die from respiratory depression—literally choking to death because they cannot get enough oxygen to feed the demands of the brain and other organ systems. This happens for several reasons, says Bertha Madras, a professor of psychobiology at McLean Hospital and Harvard Medical School. When the drug binds to the mu-opioid receptors it can have a sedating effect, which suppresses brain activity that controls breathing rate. It also hampers signals to the diaphragm, which otherwise moves to expand or contract the lungs. Opioids additionally depress the brain’s ability to monitor and respond to carbon dioxide when it builds up to dangerous levels in the blood. “It’s just the most diabolical way to die, because all the reflexes you have to rescue yourself have been suppressed by the opioid,” Madras says.

Saving Lives with an Opioid Antidote

Naloxone can short-circuit that deadly spiral. It races to those same receptors and lies in wait. Then, as soon as an opioid molecule falls off the receptor (as it normally would every few seconds or minutes), naloxone immediately latches on and takes its place before the drug can bind once again. This halts the respiratory-depressing actions—and often sends a user into an agonizing drug withdrawal.

But synthetic opioids present two problems that can interfere with Naloxone’s lifesaving process. One is a matter of timing: These substances are so powerful they may act extremely quickly, suppressing a person’s breathing before naloxone has a chance to reach its target. The second issue is potency: The synthetic drugs bind to receptors much more tightly than an opium-derived substance such as heroin or a semisynthetic opioid like oxycodone, so the antidote has difficulty reaching its destination.

So what can be done? To get around these hurdles, doctors may give a patient multiple injections of naloxone—hopefully overwhelming the drugs that are competing for a place at key targets in the brain. The situation at the mu-opioid receptors is akin to a crowd waiting to buy tickets for baseball game, Madras explains. “If 20 Bostonians all want to see a Red Sox game and there are 300 Yankees fans around, the 300 Yankees fans are going to have a 15 times higher probability of getting the tickets to the game because there are so many more of them. It’s not that the Yankees fans are pushing the Red Sox fans out of the way—it’s just that there are much more of them, and so it’s a probability issue.”

That numbers issue, combined with the recent spike in synthetic opioid overdoses, has rekindled the debate about adjusting the default amount of naloxone used for overdose. The main question is: To boost the odds this antidote will have a shot at saving someone’s life, should naloxone doses be increased for everyone—basically betting that an apparently overdosed patient has consumed a drug laced with a synthetic opioid such as fentanyl? Some doctors and researchers say yes, and suggest starting patients on two milligrams of the antidote instead of 0.4 milligram. “But now you get into that whole issue of the cost of naloxone and its availability,” Strain notes. (Naloxone is a pricey drug. In Baltimore, for example, it now costs $37.50 per dose, according to the city’s health department.)

And there’s another catch: A large dose of naloxone can worsen drug withdrawal. “That’s a danger in of itself, because people who go into withdrawal can vomit and breathe that in, and aspirate on their vomit—choking on it,” Madras says. Moreover, some individuals experiencing withdrawal may get violent, endangering others. A patient suffering from intense withdrawal may also become so ill, it discourages that person from trying to quit and enter into a treatment center, she adds.

Some opioid researchers have floated the idea of developing respiratory stimulants a first responder could easily deploy to jump-start a person’s breathing without having to target the mu-opioid receptors. But so far there has been scant research in this direction.

For now, Strain says he would first advocate deploying higher doses of naloxone, because that substance is available and addresses the problem at its source. Meanwhile Madras thinks there may be another option. She suggests both emergency response workers and families of opioid users should have extra doses of standard-dose naloxone on hand. Then, to combat extreme withdrawal, professional first responders should be allowed to administer medication such as buprenorphine. This prescription medication, often used to manage opioid dependency, targets the same brain receptors as other opioids and can relieve drug cravings without giving a user the same high.

At the same time, Madras says, more data should be gathered about overdoses, including: how often people are saved by naloxone, what levels of the substance were required and who administered it—a recommendation Madras and other members of President Donald Trump’s Commission on Combating Drug Addiction and the Opioid Crisis included in its final report this past fall. “What we see in the literature are not systematic, national data at all,” she says, because health care workers are not required to report details about opioid overdose incidents. As a result of this and other data gaps, it remains difficult to combat aspects of this crisis, Madras notes. For example, one recent study found about 90 percent of patients who have overdosed continues to get opioid prescriptions from their physicians. The reason that keeps happening, she says, is “there are no reporting requirements that say a physician should be informed that a patient has overdosed.”

New Yorker Article 8/28/19

An addiction specialist said that the Sacklers’ firm, Purdue Pharma, bears the “lion’s share” of the blame for the opioid crisis.Illustration
by Ben Wiseman

Full article:

On October 30, 2017, The New Yorker published a multi-page exposé on Mortimer Sackler, Purdue Pharma, and the entire Sackler family. [8] The article links Raymond and Arthur Sackler's business acumen with the rise of direct pharmaceutical marketing and eventually to the rise of addiction to OxyContin in the United States. The article implies that Sackler bears some moral responsibility for the opioid epidemic in the United States. [8] In 2019 The New York Times ran a piece [24] confirming that Sackler told company officials in 2008 to "measure our performance by Rx's by strength, giving higher measures to higher strengths". This was verified again with legally obtained documents tied to a new lawsuit, which was filed in June by the Massachusetts attorney general, Maura Healey. The Times reported that the lawsuit claims Purdue Pharma and members of the Sackler family "knew that putting patients on high dosages of OxyContin for long periods increased the risks of serious side effects, including addiction. Nonetheless, they promoted higher dosages because stronger pain pills brought the company and the Sacklers the most profit". [24] (Wikipedia:

Last update August 29, 2019. June 12, 2020.