Editor’s Letter

Medication Nation

I recently suffered from — in medical terms — a psychotic episode that was the direct result of venlafaxine discontinuation syndrome. In street-speak, I “went off my meds” and went through a hell of a withdrawal. When I entered recovery over 13 years ago, I learned something that really stuck with me. One of the lectures by the staff physician focused on the long-term impacts of the use of stimulants like meth, crack, and my favorite, cocaine. The doctor made it crystal clear: regular users of any of these should expect physiological recovery to take 1-3 years. Minimum. He went on to describe the symptoms one might experience during the healing process: mood swings; the absence of a “sense of well-being;” and “the blues.” Early recovery is already a minefield, and now this? I steeled myself for what I imagined was inevitable. Within the first year of leaving treatment I was living in Jackson, Mississippi. During a visit to the clinic for an unrelated medical need, the doctor, a primary care physician, and I were shooting the shit and came to realize we’d both been through drug & alcohol treatment at about the same time. As it turned out, his experience with the blues and such had been similar to mine, and he mentioned he’d been taking an anti-depressant called Effexor (the brand name for venlafaxine) that was very effective at relieving these symptoms. “Would you like to try it?” He asked. “Sure!” I replied. I doubt he even knew much about the effects of long-term use, much less what it would take to get off of it. I didn’t ask, either, because he said it worked and was “non-addictive.” That was over 12 years ago. The good doctor was right. Effexor worked, for a little while. But slowly, incrementally, its side effects began to materialize. So slowly that I didn’t begin to connect the dots until years after it began having a seriously detrimental impact on my quality of life; it wasn’t until clearing my system of it that I’ve been able to draw a straight line between cause and effect. Eleven years ago, I found my (now former) primary care physician in Nashville during what was, ironically, the first shot across the bow that all was not well in Effexor land. I’d run out of pills and had no refills left on my prescription one Friday. I really thought nothing of it until I recently suffered from — in medical terms — a psychotic episode that was the direct result of venlafaxine discontinuation syndrome. In street-speak, I “went off my meds” and went through a hell of a withdrawal.
      When I entered recovery over 13 years ago, I learned something that really stuck with me. One of the lectures by the staff physician focused on the long-term impacts of the use of stimulants like meth, crack, and my favorite, cocaine. The doctor made it crystal clear: regular users of any of these should expect physiological recovery to take 1-3 years. Minimum.
      He went on to describe the symptoms one might experience during the healing process: mood swings; the absence of a “sense of well-being;” and “the blues.” Early recovery is already a minefield, and now this? I steeled myself for what I imagined was inevitable.
      Within the first year of leaving treatment I was living in Jackson, Mississippi. During a visit to the clinic for an unrelated medical need, the doctor, a primary care physician, and I were shooting the shit and came to realize we’d both been through drug & alcohol treatment at about the same time. As it turned out, his experience with the blues and such had been similar to mine, and he mentioned he’d been taking an anti-depressant called Effexor (the brand name for venlafaxine) that was very effective at relieving these symptoms.
      “Would you like to try it?” He asked. “Sure!” I replied. I doubt he even knew much about the effects of long-term use, much less what it would take to get off of it. I didn’t ask, either, because he said it worked and was “non-addictive.”
      That was over 12 years ago.
      The good doctor was right. Effexor worked, for a little while. But slowly, incrementally, its side effects began to materialize. So slowly that I didn’t begin to connect the dots until years after it began having a seriously detrimental impact on my quality of life; it wasn’t until clearing my system of it that I’ve been able to draw a straight line between cause and effect.
      Eleven years ago, I found my (now former) primary care physician in Nashville during what was, ironically, the first shot across the bow that all was not well in Effexor land. I’d run out of pills and had no refills left on my prescription one Friday. I really thought nothing of it until the following Sunday when I began experiencing bizarre symptoms — what are known amongst those who’ve had them as “brain zaps,” which can only be described as inter-cranial lightning bolts. This was my first experience with them, and it freaked me out. I ended up going to a 24/7 walk-in clinic where I was prescribed a month’s supply and referred to a local family practice. At no point during my entire 12-year ordeal was I ever referred to a psychiatrist.
      I now believe this is by design. The manufacturers of this drug are in business to make money. Period. They tell the general practitioners the drug is “safe and non-addictive,” and as long as the patient isn’t suicidal, then more’s the merrier.
      Never mind that I repeatedly complained to my doctor about sleeplessness, restless leg syndrome (RLS), the need for naps almost every day, anger issues, etc. “Maybe we need to adjust your dose,” would be his response. “This a good drug. People can stay on this for their entire lives if needed.” Right. “Well, what if I want to get off of it?” I would ask. “The recommended method is tapering off,” was always his answer. I should also note my doctor never, ever connected the taking of Effexor to the RLS or my inability to sleep.
      The same week as the 13th anniversary of my sobriety, I found myself out of Effexor. I’d been on the six-month re-up plan for years at that point: schedule appointment; go to appointment; answer “no” when asked if I’m suicidal; receive prescription for another six-months’ worth of dope (yes, as far as I’m concerned, it’s dope). I’d missed one appointment already and had to have a prescription called in for enough dope to make, to my rescheduled appointment, which I then proceeded to miss.
      With no dope left and knowing the brain zaps were forthcoming, I was faced with a choice: Reschedule again and re-up, knowing that I’d be back on the horse for another six months or; Fuck it! — the underlying thought being, “There’s never going to be a good time to do this. Might as well get it over with.”
      In a move I would never recommend to anyone, I chose option two. Obviously, I made it through. I’m not sure what the outcome would’ve been without the loving care of my partner during the ordeal, which lasted every bit of three weeks. A subsequent trip to a psychiatrist revealed I never should have been on Effexor to begin with, and he was quite appalled when I told him a primary care physician had been prescribing it for a decade.
      The results are in: The USA is the most medicated nation on the planet. How’s that for American Exceptionalism? One might argue our prosperity is making us very unhappy and killing us. According to a Centers for Disease Control survey for the years 2005-2008, 11 percent of Americans aged 12 years and over take antidepressant medication. The CDC also reports 70,237 drug overdose deaths occurred in the United States in 2017.In both rural towns and affluent suburbs; from rock stars to the poor and disenfranchised; white, black, or brown, no one is immune. No part of our society is untouched. The scars are everywhere. We are all culpable. We’ve allowed this. The question is: What are we going to do about it?