I grew up in a family that was both very intellectual and very drug permissive. Part of that was due to having a brother with leukemia who, at that time, was helped by cannabis during his chemotherapy. The take-home message for me was that drugs aren't really bad, and they aren't really illegal.
I started using cannabis regularly in junior high school. There weren't any obvious negative consequences of doing this; my grades were good, I was in a band, and I was happy socially. I continued using through high school and got into a top small liberal arts college, where the academic standards were high and drugs were not only prevalent, but also seemed to be encouraged by the student body. I started supplementing my cannabis use with hallucinogens. Again, I experienced no obvious downside to my behavior.
After college, I worked for a nonprofit environmental organization in Washington, D.C. This was very fulfilling work, but again, using drugs was the norm, not the exception. It was part of a hip counterculture that was inextricably linked to the work we were doing to clean up the earth. The partying occurred almost nightly, with hashish and cannabis, cocaine and ecstasy, as well as the Valium my psychiatrist was prescribing for my anxiety and insomnia, which I generously shared with my friends.
Upon acceptance to medical school, I had two deeply ingrained habits: studying hard, and using intoxicants when I was not studying. I looked down upon the straight, narrow-minded, boring nerds who didn't get high. I was much cooler than them because I was still connected to this hip counterculture, which, in the absence of other people, came down to me smoking pot by myself. I also started experimenting with pills that I would pick up in the hospital on my third- and fourth-year rotations.
During residency, my access to prescription drugs vastly increased, because I could pilfer medications in the hospital from supply closets and patients, and by then I had the ability to prescribe them myself. It was the perfect storm: the inhuman demands of residency, which provided rationalization for any pleasurable behavior, mixed with an almost limitless supply of intoxicants. Drugs would be my reward for a 36-hour shift or a particularly challenging day of dealing with unreasonable patients. I deserved it, and, after all, I wasn't really harming anyone, was I?
It got even worse when I graduated to private practice, because then I had a professionally stocked supply closet and my own panel of patients from whom I could pilfer medications. As a busy and successful physician, it was easy to rationalize the drugs. I didn't drink alcohol, so I equated Percocet or Vicodin to the glass of wine other doctors had with dinner. I was such a high-functioning addict that no one at my job ever suspected anything, and I was able to stay clearheaded during work hours. It didn't occur to me that returning to my office at night to chop up and snort Oxycontin was in a league of its own.
I was asking physician friends and colleagues for prescriptions for migraines, preying on their good intentions, their trust, and their professional courtesy. I was milking my psychiatrist for Klonopin. I got into the habit of sharing prescriptions with patients, writing them for more than they needed and then taking some for myself. I also started writing prescriptions for people (who didn't know I was doing this) and then picking up and using the prescriptions myself. This pattern went on for about five years after residency.
One day I came to my office only to be greeted by the state police and the DEA. I was charged with three felony counts of prescription fraud. The charges stemmed from a prescription I had written for our nanny (who was no longer in the country), picked up, and taken myself. Suspecting I was masquerading as someone else, an astute pharmacist at CVS called me and asked me "my" birthday, which, of course, not being the nanny, I didn't know.
Under the duress of criminal charges and pressure from the medical board, kicking and screaming, I signed a contract with PHS, and, as such, was still able to practice medicine. My PHS associate director said, "If you just stop using drugs, everything will work out fine." But, I STILL continued to use, cheat, and try to outsmart the drug tests. Luckily for me, PHS was even smarter, and fairly quickly picked up on what I was doing, with me testing positive for several substances I had not been prescribed.
Now that I had flunked a sequence of tests, my medical license was suspended. My marriage was rapidly dissolving. I had criminal charges hanging over my head, and I was fired from my job. My certification in internal medicine was suspended. I had expensive legal fees. I was living with my parents. I was hardly seeing my kids. It's fair to say that I had hit rock bottom.
I felt railroaded into rehab by PHS and by my attorney under the threat of not regaining my license, which I can now say was the best thing that happened to me, though at the time I was very upset about it. At the time I thought that PHS was some fascist, coercive organization created to torture innocent victims such as myself.
It was during my 90 days in rehab that recovery took hold. But, after that 90 days were up, I still had to deal with a suspended license, an impending divorce, criminal charges, a lost job, lawyers' fees, terminated health insurance and HMO contracts, and an endless list of family, friends, and relatives who had in some way or another been affected by my years of deceit - not to mention my own guilt, shame, and feelings of failure.
PHS was the one bright spot and common thread through all of this. It is only through the PHS testing regimen, which is airtight, that I could prove my sobriety to the medical board, the different HMOs and insurance companies, and the American Board of Internal Medicine. The PHS testing regimen is the only thing that satisfied my well-intentioned but distrustful probation officer. Without PHS, I would probably still be on probation, because, with addiction, you are pretty much guilty until proven innocent. But, thanks to PHS, I was able to document my innocence - something most addicts can't do.
PHS was also integral to my custody battles, as my ex-spouse tried to exploit my addiction to seek a draconian custody arrangement that would have been ruinous to my children. The judge trusted PHS and, upon receiving a compliance letter from them, was sufficiently reassured to allow me to obtain a fairly typical custody arrangement; as a result, my kids are flourishing.
I am currently back at work at a prestigious Boston hospital, helping low-income patients deal with their primary care needs. Convincing the medical board that you are safe to work again after an addictive illness can be like climbing Mount Everest, but again, thanks to PHS, after a hiatus of three-and-a-half years, I was able to return to work. PHS helped me regain my prescribing privileges from the DEA, and PHS helped me, one by one, remove the restrictions on my license.
Early recovery is a very dark period. One's professional and personal lives are in shambles as he or she starts trying to deal with the consequences of years of drug abuse. The associate directors of PHS, some of whom have been through this themselves, were profoundly supportive and inspirational to me, giving me reason to hope and believe that if I just stopped doing drugs, everything would work out. It has.
How to make a referral to PHS
