As we set out on our daily 40-minute trip to the methadone clinic, the sun is shining and the sky is clear and highlighted by blue tones – some deep and dark, like ocean water. My girlfriend, Samantha, is in her own world, singing along to the blaring music.
As with most days, I'm at war with myself. My moods swing. I feel my feelings, as they say, because the methadone is wearing off, and at this point in the morning I’m in withdrawal. After years of IV drug use, I have found something that I think is working, that is helping me move forward. So, some days I can see the beauty. And some days, the clouds gather.
But today is a good day, I decide. And just in that moment a loud pop is followed by a thump, thump, thump – the undeniable sound of a flat tire. It’s already the third flat tire we've had in two weeks. I sigh, pull over, step out of the car and pop the trunk. We have a jack, a spare tire and a wrench. The early morning traffic is heavy. I watch the vehicles race down I-70. The methadone is wearing off and I'm a little nervous.
I don't have time for nerves, though. The clinic closes in 17 minutes and we're still 14 minutes away. With the flurry of a NASCAR pit crew, we change the tire and take off.
I know what you're thinking, reader: "Why don't you leave earlier so you're not so stressed about making it on time when things like this happen?" You're right, of course. But some days it's a miracle just to have a running vehicle with a full tank of gas. And some days, it’s a miracle to have the motivation to get out of bed.
We make it to the clinic with two minutes to spare.
Methadone is one of the most heavily regulated drugs in the United States when used for addressing Opioid Use Disorder (OUD). It has to be dispensed at state and federally regulated clinics. If you take it for OUD, you must attend counseling and get drug-tested frequently. And you're tied to the clinic. That means, in most cases, like Sam and me, you have to go every day. These barriers keep me from medicine that helps me stay alive, that keeps me away from street fentanyl.
The rules and regulations don't always support better lives for people who use methadone. In many ways, Sam and I are victims of these regulations. When you break a rule and lose access to methadone, or must leave a clinic, it can be life-threatening. When the rules led to me being kicked me out of my last clinic, I spiraled. I went through withdrawal, became depressed and lost my job.
There's new legislation currently working its way through Congress. Sponsored by Sen. Ed Markey and Rep. Donald Norcross, the Modernizing Opioid Treatment Access Act, as it’s named, would allow for more methadone subscriptions by board-certified physicians who work outside of clinics. Rep. Norcross recently admitted that that bill isn't enough. He said that there should be greater access to methadone, and that the clinic model should end.
For me, methadone gives me a better quality of life.
There's no cookie cutter solution for OUD. I used to think the solution was abstinence. But after two decades of striving for perfection, I changed my goals and expectations, and now I find myself less disappointed, less depressed.
Just because I'm a person who uses methadone doesn't mean that I don't have dreams and aspirations. I've always been a dreamer. Sometimes I dream to a fault. But dreaming about a better future for myself and others keeps me going, keeps me from walking off into the woods.
These rides to the methadone clinic have become, at times for me and Sam, a kind of therapy. We use this time together to dream. Sometimes we dream about building tiny houses on our property because we've experienced homelessness and know what it's like to sleep in a car or in an abandoned building or in the woods. We dream of a recreation room, of counselors, of community support. We dream of a space for people who don’t often feel loved.
For ourselves, we dream of a better life, space to breathe, to maintain. And to keep dreaming.
Editor’s Note: A year ago, Jack Shuler wrote about the problem of access to methadone to treat opioid use disorder, especially in rural areas. Billy McCall taught him a lot about this issue, and so he asked Billy if he would write about it.
