Health Abroad Part I : How to Detox Your body and help Yourself without institutions (private detox) ?
Life has a cost ?
Strange headline for an Hub, huh? Well, it is about time to speak out LOUD and say some things that are "public secret"! Did you know, that there are over 1/3 WORLD POPULATION that has no right treatment for them, in their domestic country, and they need to go abroad to get the right one? So, to make things simplified: there are millions of people, some of them even starving their whole family, just to get the proper treatment for their relatives, children, or someone close. I know several cases, where people were so desperate - when they found out the amount of money needed for surgery in some foreign country for their closest. This is a story about them, about us, about me - that needs a therapy to stay alive.
DO NOT THINK ABOUT IT, DO NOT TRY IT - EVER!
Where is our soul, when we don't have heart?
Taking someones life - has a cost, prison or death penalty! Making someone cripple has a price - prison, money penalty, or death penalty! Trading someones life(lives) has a price - prison, or penalty fee. But, do we ever question our-selfs or our health institutions, how come that someone that's life is in danger if the right therapy/treatment is not applied ; or if someone is in situation that there is one crucial surgery that can't be done in mother-country ; what price do we pay then? Should the government, health institutions, even World Health Organization pay the price of not offering the right treatments, in domestic countries, for those who are the most "vulnerable group" , or "the group of highest risk".
Few months ago, I was participating in action called "New heart for Sladjana" - that have had a goal to gather the amount of money - NEEDED FOR NEW HEART, AND HEART SURGERY!
How can it be, that in 21st century, modern European country like Serbia, doesn't have the right instruments and "machinery" for doing the surgery - or the right heart to donate for sicks mother of 2 kids? Serbia has got, from E.U fonds, in past two years about 325.000.000e for all kinds of improvements. I am talking about amount of money that is "one-way", so it isn't the one that people have to pay off in coming years! There are BILLIONS of euros, entered in this country, for modernizing infrastructure, stabilizing fiscal economy, and IMPROVING HEALTH SERVICES. Just in this year, Serbia has got 4.000.000 euros (that is around 7.5 MILLION US DOLLARS) for improving health services, improving facilities, and improving mental care services (source:MINISTRY OF HEALTH, REPUBLIC OF SERBIA official web-site ) . How come, that from that amount of money, donations of all kinds, people of Serbia ENVY their neighbors for health system/services that they've got !?
So, do people have to BEG for money in "actions" like mentioned above, to get the right medications, therapies, or surgeries ; because of lack of "health machinery and tools" ? Or, it is just about our system, and certain people, that look just their own interests and do not actually care much about improving health services in their native country? Where did you hear, that there is a huge media campaign for buying 100 baby incubators? Action has finished just few days ago, and it lasted for MONTHS , called "Battle for Babies" (srb:"Bitka za bebe") - and hundreds of rich peoples have donated money, and just few huge multi-million/billion companies have donated certain amount of money for these, little heroes, that have nobody to write about their battles and wins nor, in certain unfortunate cases - losses.
My battle, on my own!
As you may know, from reading my previous Hubs, I am battling my heroin addiction, successfully, for over a year now. I'll not write again, what I've been trough to get here nor writing about details and stories of specific cases that I know - that are similar to mine - BUT, I will talk about MY LIFE BATTLE THAT SEEMS ENDLESS AND POINTLESS WITH RESULT OF DEATH. (with no pathetic behavior at all, or need for compassion or pity ) My battle for therapy, and reason for it, goes like this...
- Fast rewind, I've been using heroin I.V for 5 years since my 14th until my 19...close to 20.Intensively.
- In my 18th year, just few days after my entering in adult stage of my life, I called my parents to the table, and to talk and admit to them my problem with heroin.
So, my first battle to struggle my chronic mental decease: code F11.22 , opioid dependence with no autoimmune decease (hepatitis or/and HIV) ,began in April 2009.I've went to an neuron-psychiatrist, well-known with good reputation. But, it came that the "well-known" hadn't been "curing" someone - previously with opioid dependence. I was his first patient, in his 25 years of work, that he diagnosed F11.22. He was "okay", actually, because I was actually speaking with him(~45min), and have had some kind of sessions of psychological support of.But, it didn't help. He miss-judged my experience with addiction, and the level of insensitivity and/or cravings for heroin. I don't blame him - I was his first case.
- Failed therapy:
- Diazepam tabl. 5mg 1+1+1
- Rivotri (clonazepam) tabl. 2mg 1+1/2+1
- Effectin retard tabl.(A.D) 50mg 1+0+0
- Flormidal (midazolam) 15mg 0+0+2
- Nalorex tabl. (Naltrexone) 50mg 1/2+0+0 (cracked in a powder, drank with water, supervised - at least two days after last heroin use)
Shortly, after few months - 3 moths I think - I relapsed and got back on heroin... The "only" problem was that, this time it gets worse. I've got hooked up on midazolam and diazepam, from therapy beside my heroin addiction.The time was passing, as I was assuring my mom that everything will be "fine", and that I will clean myself up - and get back on opiate antagonist (blockader). But, the time was passing and neither were I "cleaning up" / detoxing myself either I was tempt to stop/reduce taking it....It was opposite. I was taking more and more heroin, as my need for it began to increase with dramatic speed, and I started to abuse methadone sold on street. THE REAL NIGHTMARE JUST START!
We went back to the selected doctor, asking for another opinion, as we said that previous therapy didn't help. My selected doctor, referred me back to the neuron-psychiatrist that I was before. We talked, he diagnosed me the same thing, BUT now with 12 day of home detoxification with synthetic opiate: Tramadol+benzodiezepines+anti-epileptics+antidepressants:
- Detoxification pattern:
Tramadol capsules 3+3+3 first four days, every other day after that period -1 one capluse. (3+3+3 x 3, 3+2+3,2+2+3,2+1+3,1+1+2,1+0+2,1+0+1,0+1+0,0+0+0)
Diazepam tabl. 5mg 1+1+1
Rivotri (clonazepam) tabl. 2mg 1+1/2+1
Effectin retard tabl.(A.D) 50mg 1+0+0
Flormidal (midazolam) 15mg 0+0+2
Nalorex tabl. (Naltrexone) 50mg 1/2+0+0 (cracked in a powder, drank with water, supervised - 24h after last tramadol 50mg use)
- ========================= THERAPY FAILED AFTER 6-8 MONTHS
Now things got serious! For the third time, I am going to my selected doctor, seeking for help, as I've relapsed for the second (official) time. I was relapsing after first time, I was escaping from house, followed by trowing out from the same - just to get high for one night, and get clean for 4 days, and I would come back and as a "honest proof" I would drink the "Nalorex" with no problems. Anyway, I've got to the doctor, AND FINALLY SHE GAVE ME AN REFERRAL TO METHADONE CLINIC! (actually psychiatric institution, department for addiction)
So, I went there, 55km away major city - the capital of autonomous province "Vojvodina", Novi Sad. Now, I was at the right institution for me, but they were all misjudging me, and underestimating my addiction issue. I was 18 years old when I got to the "TEAM", for my first time. I didn't except that everyone, including patients already on methadone or in some kind of treatment that they will underestimate me so much - even humiliate.I was so happy when I've heard my name "yelled" from the "office". There were around 10 doctors, some of them neuron-psychiatrists,some psychiatrists, some MD, sociologists, and the head of the team Methadone Clinic Chief and Specialists in neuron-psychiatry and forensic expert... I was standing in front of them, with my mother, telling them within given papers as a proof, that I have 2 prior attempts for getting off of heroin - but I haven't make it. They gave me one more chance to detox at home,and after that - hospital detoxification.
- Detox success, therapy- treatment (again same antagonist pattern) FAILED, after 6 months!
I came back to the team, after six months, and they were surprised! I have had then 19. years, so I was referred to the hospital then, but they didn't have empty place right then - so they gave me three boxes of Tramadol (50mg) to have while I'm waiting. Of course, I haven't used just Tramadol... heroin ,methadone, poppy tea...and tillidin.. I came to the hospital, and there I was for 12 days, and after Tramadol detox, again, they put me on SAME MEDICATION THAT DIDN'T WORK FOR HOW MANY TIMES NOW? Do You count? Hm.. It was 3 and now again , so THIS WAS THE FOURTH ATTEMPT WITH THE SAME MEDICINE THAT I'VE RELAPSED WITH! But it will not be enough...
It worked, for some time, I thought:" This is it, now, when I saw those faces in hospital - now way man that I am coming back there.". But, the environment was judgmental, community was refusing me as a normal person, when I came back to school - they thought that I am some kind of lunatic...everyone were avoiding me, scared from me... I was sensing that. I'm not stupid. So, anyway, I was still going "good". I've got graduated, and then...I supposed to go further to Academy, University or something like that.But the medicine, that I was drinking, the naltrexone - opiate antagonist - was driving me nuts. In my head, I wasn't "clear, or got off " from heroin AT ALL! Everything that I was thinking and dreaming was HEROIN,HEROIN and METHADONE! I was telling even my parents that I am gonna kill myself because just of my thought which I COULDN'T STOP! They were all over my head, how to fu-k up myself and my supervised ; that was supposed to give me the crushed medicine so I couldn't vomit it out or spit it. Crazy, but I (and everyone else did) would do it... And one night, I was with my , now ex, girlfriend. I bought 100mg of methadone, half a gram of heroin, and 30x50mg of tramadol.I cracked the "antagonist barrier" that was protecting my opioid receptors from feeling the opiates, and instantly overdosed. I woke up and E.R! I was DEAD FOR 45 SECONDS. After spending a night at E.R, I was replaced - again - to the same department where I've already been.Again, I've spent 12 days there, detoxing. In meanwhile , I had an hard argue with my parents/mom 3rd day when she came to visit me and bring me some sweets and food. I was so medicated/druged from high doses of benzos mixed with tramadol that I didn't knew what I am talking - FOR REAL! All I remember is that, she was refusing to accept that I really need now METHADONE MAINTENANCE and I was ready to accept it - even tho, I was against it, but reality was writing different story - and recreational use of,and after - the maintenance with it turned out to be my life saver. I knew, back then, already that I am gonna be part of maintenance with methadone - and that THAT is only thing that can save me from relapse new fatal over dose, and bringing family apart - not to mention risking HCV and HIV infections.My mother left, after that argue, and left me after that 3rd day without any phone calls or visits. I had no-one, and I was all alone in my head; blaming myself for what have said and what I've done to my family. I didn't stop crying, and I have put myself in serious condition with crying because of low blood pressure and heart beating - so they have had to sedate me heavily so I could stop crying. I remember that I haven't slept for 4 days, and starting to hick-up (don't know why) suddenly. Then, they put me new regime of therapy, with intramuscular dizapam 15mg + 30mg of midazolam at the morning, and same in the evening. At the noon, 2pm, I would get all that in pill form + some antidepressants (SSRI) and anti-epileptics even tho I haven't got any epi-attack ever. (maybe because of getting high doses of tramadol, and they can cause epileptic attacks, so as prevention - anti-epileptics) I was hoping that after this, second intra-hospital detox + 3 at home detoxifications + 1 fatal out-come with prior therapies with antagonist methods - something will change.It didn't!!!! Last day, my mother came, I've got the paper where it says that I need to drink the SAME medicine in front of medical technician. I was loosing my mind - definitely! (but only thought, in my mind was:"Just get me out of here!")
- DETOX SUCCESS , THERAPY FAILED AFTER 4 MONTHS!
After few months on same medication, with rational conversation with my mom, I told her that "buprenorphine" is registered at Serbia, and it is on "positive A" list of medications - so it should be free for those on maintenance with F11.2 diagnose. She asked me what it is, and I've told her that it is half antagonist (blockader of opiates) and half agonist (partial opiate). She asked me, what is the difference ? I told her that this medicine, what almost KILLED ME, is killing me inside for YEARS now, and I just can't stop thinking on how to get "high" on ANY opiate, and that this will satisfy my cravings for opiate abuse! She said, O.K , after little research of it...But, what we didn't know is that "buprenorphine" is registered in Serbia, but real maintenance is not available (trough national-health insurance) 'till day todays! What IS available is short detox with buprenorphine, in dept. where I was laying two times instead of high doses of tramadol or methadone (for those harder cases, as they though that I was "lighter category" because of my age).
5 A.M, September 2010, I am getting up - and started WALKING 60km to the Methadone Clinic to meet at 11am with Chief of Clinic , face-to-face and tell him that I will be forced to sue the Clinic for irresponsible treating of addicts! (fatal overcome of who knows what attempt WITH SAME MEDICINE that's not even registered , back then, for USAGE but you have had to buy it in several private pharmacies for 60euros per month pack) He was, shocked, because he didn't noticed my case, until I contacted him. He asked me, why "TEAM" haven't reacted and offered me "MMT" after second attempt? I answered that I don't know, and that this - what they do and done to me- is outrageus! I am loosing my mind, I cant sleep for 4-5 days sometimes - I said. After 10minute conversation, he told me to come in a week, on day when "TEAM" gathers, and that everything will be solved. I came with my mother, but the only problem is that she had in mind that I was looking for buprenorphine treatment....But what I've got is Methadone, the medicine that she hates as much as someone can hate something! I said to her that it hasn't be so long, and that methadone will SURELY help me!!!
- DETOX SUCCESS, THERAPY SUCCEEDED! I AM OFF FROM HEROIN FOR 1 YEAR AND TWO MONTHS NOW - AND I DON'T THINK OF COMING BACK!
- -------------------------------BUT EVERY STORY HAS TWO SIDES:
What I don't knew is that methadone will bring me big issues with my weight, and blood pressure. I have big problems with lethargy, concentration, disphoria (instead of mild euphoria), great depression, and constant constipation. Beside all this, I have often headaches and pain all over the body - and I am on 90mg now! I have more side effects, than therapeutic effects!!! I am thankful for methadone, BUT: how he saved me life, he will take the same very soon if I don't react. I still have cravings, little bit less but still .... And bad side effects from it. With rising dosage, I just get more and more side effects with greater insensitivity with no effect that I am chasing and what I supposed to get from SUBSTITUTE! (THE NAME IS TELLING EVERYTHING). Now the question is, do I need to start an "action" to get the right treatment for this mental decease that is treated in modern world for over 60 years??? I wonder, is it possible, even to have a chance to recover and get the right treatment for this kind of diagnose? Can we, patients on Methadone, that do not feel well on it - and the analysis are telling the same - can get the right treatment abroad, OR WE ARE DAMNED TO STAY AND DIE until in next 20 years something change (in Serbia) and we get the alternative for methadone?? There is about 30% of those who would go INSTANTLY on treatment with D.A.M (diacetyl-morphine) in countries where is an on-going treatment such as, exist - or treatment with S.R morphine. At least, S.R morphine and it advantage has been accepted - and it is a part of ongoing treatments in neighbor countries (Bulgaria,Croatia,Slovenia) - but Serbia, with 120.000 drug users and 22.000 heroin addicts (with same population and addict ratio proportion as Denmark) DOESN'T HAVE ANYTHING EXCEPT METHADONE ,AND (MAYBE NEXT YEAR) BUPRENORPHINE FOR THOSE "LIGHT-ADDICTS". What to do with the highest risk group, those who can't quit using heroin even on methadone? What to do with all those who have real bad side effects from it? Slow-release morphine maintenance,diacetyl-morphine, and hydromorphone (IV or sustained release) ARE THE RIGHT ANSWERS AND OUR HUMAN RIGHTS ARE GUARANTEEING US THE MEDICATION OF CHOICE - WHY CANT WE (IN SERBIA,MONTENEGRO,MACEDONIA,ROMANIA,HUNGARY...) HAVE IT LIKE THOSE IN OTHER COUNTRIES THAT HAVE MUCH MORE LESS PROBLEM WITH HEROIN AND OPIATE ADDICTION LIKE SERBIA FOR EXAMPLE??? (25.000 HEROIN addicts : 7.500.000 population) !!!