This article originally appeared in the January 1999 issue of Esquire. Upgrade your membership to All Access and read every Esquire story ever published.
I couldn’t tell you how much money I made last year. I lose my checkbook once a week. I have no idea where my passport is or my birth certificate or the photographs from my wedding. I can't remember where I spent last Christmas, But I know where all my Vicodin are. There's one Vicodin in the breast pocket of my black suit, six in my desk drawer at work, two in my golf bag, and thirty-three in the bottle in my medicine cabinet. There’s a half of one in the bottle of Tylenol in the downstairs bathroom, four in the glove box of my black car, six in my white car, and one on top of a paint can in the basement. Last week, my wife vacuumed a Vicodin off the floor of our bedroom. She told me about it at dinner that night. “If you dig that out,” she said, “we’ll know you have a problem.” I haven’t. Not yet.
Vicodin, my Vicodin, is a wet pleasure if there ever was one. It slickens you, sends you loose against your pain, so you loll and roll in the wake of your old mood like a flag on a pole in the middle of June. You feel slippery but taut. Thriving but thoroughly released. The full-out Vicodin hum is like the enormous relief that follows a really fine shit. You want to talk. You want to slide up and tell the barmaid your troubles. You can listen to hers, too, and dispense advice with acuity and sympathy in equal measure. You can. You will. You want to. You are speaking into the Vike.
It is the painkiller of choice for thousands of drug users, legal and illegal both. I’m here to tell you, they take it because it works. Doctors set you up on Vicodin when you’re so badly hurt, cut so deeply, damaged so thoroughly, that you can’t stand it. They might start you out hard—say, two 5-milligram tablets every four hours. What they’re hoping is that you’ll get a leash on your pain, gain control of it. But within days, the same doctors want to ease you off the Vike. They tell stories, give warnings and admonitions. You hear them, too. Addiction scares you. You start to keep an eye on yourself.
But real pain is just that. Real. Real like a soul sister. Loyal, intimate, the sort of friend who whispers to you while you’re sleeping or just as you wake. So you mind your pain. You listen to it while it chats. You wake up when it screams. You take your Vike.
At least I do.
I’ve been on and off Vicodin for almost a year and a half. I started on the standard, plain-Jane 5-milligram dose after a car accident and moved to the stronger, 7.5-milligram Vicodin ES (which stands, sensibly, for extra-strength) following my subsequent surgery. I usually take two a day, but I’ve taken as many as eight in a day when things got really bad. I once took six to get through a round of golf. Last summer, I took two so I could stand in the ocean without fear of a big wave, then took another one when I got out so I could lie in the sun without stiffening in agony. While I was writing a departmental report last spring, I found that I could not sit up in a straight-backed chair to write. It was a Vicodin moment.
Going off it, which I did once for two weeks, leaves me sleepless, shaky, testy, and dry-mouthed. I dream about Vicodin when I’m not taking it. I hoard it when I am. I have taken it in every conceivable combination and dosage. I’ve dry swallowed it on my way to work. I’ve doubled the dosage on my prescription label routinely. I’ve ignored the warning stickers and doled it out to friends and relatives for every manner of reason—injury and hangover, curiosity and redemption, because they asked for it, because it works, because I wanted someone to know the Vike.
Conversely, I have buckled down and refused to give it out or veer from my prescription for weeks at a time. Still, only one truth comes out, no matter how I use it: When I don’t take Vicodin, I live in pain.
And I’m afraid of the pain. Any fool would be, although there’s more to it, since I’m also afraid of the Vicodin—mostly of losing the Vicodin. Because I really take pleasure in it. I look forward to the pure escape, the heady rush—and not just the gift of painlessness but the opportunity for joy.
If pain really is my sister, then Vicodin is my brother. I love it, lean on it, count on it. I miss it when it’s gone, and I fight it when it’s around. I try to remember a time before the arrival of Vicodin. I think and think and think.
They want me to stop. My wife. My physical therapist. My brother. My brother-in-law. My masseuse. My secretary. My mother. My friends.
My doctor wants me to be careful. His nurse agrees.
When I picked up the last prescription, my pharmacist, a solid guy with crisply set hair, placed the bottle on the counter and looked me straight in the eye.
“What are you doing?” he said, holding the bottle fast to the counter.
He was worried.
I was five months past my surgery, three weeks past the date when I’d promised him I’d quit. He’d warned me about Vicodin from the very first day I ripped down my first script, soon after the accident.
“Careful of this stuff,” he’d said back then, just after I’d entered the new life, freshly adrift on the sea of constant pain, entirely sure that I would someday be rescued.
When I’d asked him why, he gave me my first warning about addiction.
How would I know when I was addicted? I’d asked.
He’d raised an eyebrow.
“You’ll know, Tom,” he’d said. “This stuff will give you the heebie-jeebies.”
I’d laughed and told him I’d be mindful.
Now, eighteen months and dozens of refills later, I was tense. I knew he was only doing his job, raising a warning flag, and one part of me wanted to thank him for asking me what I was up to.
“Same as ever,” I wanted to tell him. “Making do. Limping through. Scuttling down the hall. Hiding from my pain, the landlord of my existence.” But instead, I found myself reaching for the bottle angrily, squinting a little, hissing at him as if he were a manservant who had overstepped his bounds with the lord of the manor.
“What did you say?” I asked.
Feeling the heat, he stammered back, “I mean, how are you doing?”
I snorted and shrugged, swiped my AmEx card, then, before signing, tore open the bag to see if they’d given me a refill this time. They had not, the bastards. I thumped the cylinder against my palm.
Every once in a while, I see myself in moments like that—anxious, distraught, more than a little angry with everybody around me—and I think: You are a fucking junkie. So I tally my days, check my journal to take stock.
If things look a little scary, I might quit, right then and there. I can do it, too. When the pain is lying low, I can go several days without the pills. The sun shines. The streets are full of children. My dog is a formidable companion once again.
I stand on my porch and survey the truth of it all. I’m no junkie, I think. I was using a drug, using it correctly for the most part, darn it. For a day, I might believe I can make it, that my pain has withdrawn permanently and without grudge.
But then I’ll feel the twinge on a ride home or in my chair at work; my shoulders tighten; my right arm aches. I get a shot of it when I ease myself into a kitchen stool, the world turns, and suddenly I’m on my couch, flat out on a heating pad, ignoring my wife, tearfully snapping at my children, lying there in a sleet storm of pain, kicking myself for ever taking off the warm, silky Vicodin jacket in the first place.
At its worst, the pain runs like a dull blue electricity through every part of my back and shoulders. It jangles me at first, then twists me under unceasing muscle spasms. I twist into a hunch, then twist smaller still. I might set about pacing before it gets really bad, before it reaches the point where I’m left feeling that my entire upper body is an active, fresh impact bruise, the kind you might get from a baseball bat or a right cross. My body is an assemblage of alien sensations. My head aches. My eyes throb. The tissue of my muscles seems sore and infected. The sinew feels ill, my bones like unwelcome inserts.
Every time I start back up, I halve the pills. I do it more to stretch my supply than as a nod to the fears of my friends and caregivers. Still, it seems to me a priestly gesture, the cracking of the host a reminder of the mysterious, luscious depth of the pill I’m about to take. Within a day or so, I’m breaking the pill in two, then swallowing both pieces in one gulp.
Like anyone in pain, I think about myself all the time. What am I? A guy who stumbled upon a great drug, a medicine that gave him back what he wanted so desperately: his old self, the one he lost in an accident before the drug, the one who could be funny and happy with his friends, wise and fair with his children, who would run a basketball court and hang Sheetrock without a thought to his back or his neck or his pain level.
First there came a car wreck, a dense collision, the spray of glass, a snapping of the neck. Then the year of waiting out the muscle weakness, the numbness and the ever-present ache in my upper back, neck, and arm. I’d ruptured a disk between my C-5 and C-6 vertebrae and herniated two others. Plain and simple, I had whiplash, what my specialist described as a boxer’s injury, cervical trauma. Through the months that followed, I tried Tylenol, Tylenol 4, Tylenol 3, Flexeril, Soma, Soma with codeine, Daypro, naproxen, Darvocet, Motrin, and aspirin. I staved off surgery by sampling various forms of physical therapy, acupressure, massage therapy, electrostimulation, manual traction, mechanical traction, home traction, heat therapy, and Swiss ball therapy.
Directly after the accident, I was sure I could feel the old me rising back up through the injury, the way you know, when you have the flu, that you’ll return to health. Part of you wants to enjoy the soup and the blankets and the attention from the people who suddenly love you more sweetly and resonantly than they used to. You loll in it a bit. Truth is, I felt lucky to be alive, and the pain seemed something like income tax, the reasonable price of good fortune, a price unpaid by the lucky friends and relatives in remote and distant states. My further good fortune seemed to be that my doctor was forthcoming with the painkillers, which I liked more for the idea of having them than for their taking. It seemed prudent to have a supply. I looked forward to the end of the pain, to having a spare Darvocet or Vicodin on hand in the medicine cabinet.
Still, after several months, the pain gnawed at everything I did. I was bored with the therapy and the tests and the sheer grind of three appointments a week. I told and retold my story—my accident, my pain, my prognosis—so often that the whole thing began to feel like bad fiction: poorly paced, predictable, and wildly unfair in its treatment of the protagonist. Months pressed into a year. Prescriptions stretched out into multiple refills.
There came a dark night, as there always does, in March, when I thought about killing myself. I was watching ice-hockey highlights on cable television, thinking how incredibly painful it all appeared, how furious everyone seemed, what an absolutely foreign and forbidden world all of that was to me then.
I flipped channels and watched a guy haul a tiger shark onto a dock. The sheer weight! Never again! Flipped next to a made-forTV movie in which three women were having a pillow fight. Carnage. A man transplanting astilbe into his spring garden. Kneeling. Ouch. It went on.
There wasn’t a single image on television that night that didn’t appear to involve an unbearable, indescribable measure of pain. I’d quit playing basketball, racquetball, and softball in the year since the accident.
I had always held out some hope of coming back, of returning to an active life. Now it hurt even to watch. I was living like an arthritic house cat. I was thirty-seven.
I had surgery soon after, then leaked through three months of recovery in a motorized recliner, strapped into a neck brace. The numbness departed, my strength returned, and the pain did nothing more than shift gears. Now here I sit, repaired but damaged. Cleaned up but messed up.
I am aware that no one should feel too sorry for me. In a world where people are burned in any one of the three degrees, flipped off of motorcycles, injected with heavy metals to fight off disease, buckled by arthritis, and twisted by dystrophies and syndromes too sundry and random to catalog, I am in the bush leagues of tragedy. My neck hurts. I take Vicodin. It works.
They produce twelve tons of Vicodin in this country a year, a fact that elicits some contradictory responses in me. First, I think that that’s a lot of pain. That’s one great, seething nation of pain. And at one time, I wouldn’t have believed it—I would have just assumed most people didn’t know how to suck it up. The new me, however, the expert Vicodin user, calculates just how much Vicodin twelve tons is. Would it fill up an entire sport-utility vehicle? Surely. Would it fill, to the very ceiling, my living room? I’ve got that figured at twenty-eight hundred cubic feet. I bet it would. Twelve tons would probably collapse my whole house, creating a Vicodin pit in my basement. Or would it fill an entire freight train, one of those really long ones, the kind that throbs through my town every night at 9:30? Perhaps. The sad part of this whole green-eggs-and-ham approach to Vicodin production is that, even when I picture my house pathetically collapsed under a great mountain of horse pills, I feel just a little morsel of peace inside my gut at the thought that I’d be able to pick through the rubble to get my Vike.
Vicodin is a simple drug, really. It’s a high dose of hydrocodone, a semisynthetic narcotic cousin to codeine, laced with a normal dose of acetaminophen. But in equal doses, hydrocodone is six times more powerful than codeine. That you can buy both ordinary codeine and acetaminophen in over-thecounter, safe-for-kids-under-twelve form would seem to belie the immense potency of Vicodin. Unless you use it—or prescribe it. In the pantheon of controlled substances, it holds its own at schedule III. Which is to say it is in the family of legal drugs just below Demerol and morphine, wedged in at schedule II, and just above Miltown and Valium, which reside at schedule IV. Two steps above it, at schedule I, are drugs such as heroin and marijuana. Like them, it has a street value, a market demand, and it sëlls for up to six dollars a tablet.
Of course, before I started my affair with this pill, I knew Vicodin the way most people do—as the popular though hard-tofind street drug that Brett Favre loved too much, the one that hooked Matthew Perry. The real deal. Tylenol was a skinny little Finger Lake of a painkiller. Vicodin was Lake Fucking Michigan.
I’ve known precisely what too much Vicodin could do to me from the very start. My pharmacist has faithfully stapled crisp, laser-printed warning sheets to my prescription bags, listing out the trouble to come: the constipation, the anxiety, the outright fear, the confusion, the shortness of breath, and the reduced liver function. (This last admonition is no joke: Taken for long periods of time, Vicodin can greatly reduce the liver’s ability to flush toxins from the blood—and that can kill you.) But there on the list, directly following DIFFICULTY URINATING and DIZZINESS, sits the single, somewhat musical word describing the one side effect that has given me the most trouble: EUPHORIA. Plain and simple. Giddiness, happiness, comfort, joy.
Take enough Vicodin and you start to feel that you deserve euphoria on a daily basis, that you are ready for it by early afternoon or in the morning after coffee when the workday starts to wobble under the weight of your pain. Feeling such entitlement, your brain leaps forward, creating a completely illogical formula: Pain equals pleasure. Once you’ve accrued enough Vike-made ebullience and know the potential for so much more, you put off the hard question, the one on everybody’s mind: How will you give it up when the time comes? And that day will surely come.
They give it to me sixty tablets at a time. Early on in the life span of a prescription, when I’m flush, I carry a pill in my shirt pocket at all times. Oblong and chalky, the pills leave a fine dust on everything they touch. I go generic, and the imprint on the tablet is cryptic and sincere, WATSON 3 87, it says.
About thirty minutes after I take one, I feel a liquid rush in the center of my chest and start to sense what I can only describe as a fierce and abiding sense of the world’s potential. The sun shines brighter. Windows gleam. I feel a need to talk, to explain, to pay bills, to read books, to deal with things. Suddenly, I’m out of the pain storm, throttling upward, unable to shut myself up, though what I say isn’t nonsense. I am clearheaded and reflective. Stick me in an adirondack chair at that moment, hand me a margarita, and I’ll go rhapsodic on your ass. Then I might take a nap.
My wife calls this chattiness “speaking into the Vike.”
I know when it’s happening. I like when it’s happening. It has nothing to do with the viscous sloppiness of the drunk or the bleary ramblings of the dope smoker.
Vicodin leaves you comforted, wanting more. The experience is something like watching a great movie. You relish every minute, crave the next scene; at the same time, you mourn the passage from one reel to the next.
God bless the opiate. For once, after hours or weeks or months of wanting less—less pain, less tension, less of what my body tells me—I now want more. More comfort. More love. More relief. More insight. More Vicodin. If I’m lucky, and smart, I have it.
I wake up each morning and sit on the edge of my bed and stretch my neck exactly as I have been taught. I shower, extra long, extra hot on the top of my back, step out, and leave a warm towel hanging over my neck before I open the medicine cabinet to grab a toothbrush and my bottle of Vicodin.
I pour the entire bottle out onto a washcloth and count the pills. I do it by counting pairs, the way I’ve seen the pharmacist do. I push two to the side, put the rest back in the bottle, check to see that the cap’s secure, and close the cabinet. Depending on how my neck feels, I may or may not take one right then. If I’m working hard to quit, I might even put one back, after counting the bottle again. Sometimes I even shake the heavy cylinder just to hear the tympanic rattle of the pills. This way, I always know when someone is stealing my pills.
I usually carry two downstairs. One pill is for taking; the other is for hiding. I have little nests of Vicodin all around my life. The more I hide, the further I feel I can stretch my supply. It’s an odd illusion. If the house is chock-full of pills, burgeoning little piles populating all of its tight spots, it seems a survivable place. Besides that, if I break up a prescription bottle in this way, no one, save me, can know exactly how many I’m taking.
My son and I are walking up the stairs to my office on a Sunday afternoon. He’s five, and he’s jabbering on about what he wants, what he likes, what he needs. “I love Beanie Babies. I love them,” he says. “I’m addicted to them.”
He’s addicted to a lot of things, he says. “I’m addicted to watching my feet go up the stairs, too!” I don’t know where he picked the word up, but he uses it in the big, sloppy way people do these days. Where would he not see signs of it? Sitcom characters pant for their lattes. His daycare teacher uses nicotine patches. Public-service commercials blare the warning chorus.
In his own way, he’s in on the game I’ve been playing. I spiral inward, from liking something to wanting it. Like it? Need it? Can’t live without it?
Where do I draw the line? I call the experts, dialing the number of a regional mental-health center. A perky voice offers help from the get-go.
“I need to talk to someone about prescription drugs,” I say.
“We don’t prescribe drugs over the phone, sir. Most of the doctors here are therapists. They—”
“About a problem with prescription drugs. I want to know if I might have a problem.”
I am transferred to a consultant, who, I’m told, will administer a referral test. The new voice, thick and musical, wants me to believe. One yes, I’m told by the voice, and I might be an addict. Problem is, I’m all yeses. Yes, I want my medicine. Yes, I’m sleepless without it. Yes, the thought of being without it makes me anxious. I’m forming my own questionnaire, even as I answer theirs. Have you ever taken a painkiller on a plane? Yes. Have you ever chewed a Vicodin just for fun? Yes. Have you ever leapt for joy when your prescription was refilled? Yes. Have you ever taken a pill at the counter of the pharmacy before you even paid for it? Yes. Have you ever stuck a Vicodin in the middle of a piece of steak? Yes. Have you ever dreamed that all of your food was white and dusty? Yes, and yes again.
Remember: One yes and you might be me.
The trouble with the survey they read me is that it begs for declaration. Lay yourself out. See yourself for what you are. One of us. One of us. One of us. The test is rigged with a subtle incredulity that’s built in—“Twenty questions and you didn’t have one yes? What are the odds of that?” The yes trigger in these surveys implies that you must make changes. In the culture of addiction, there is no standing still. Face facts, and then get with the program. Why not? Your HMO will cover it.
Predictably, when I reach the end of the phone survey, the voice tells me my yeses might indicate a problem, that I might want to make an appointment. “I’ll transfer you,” the voice says. Before that happens, I admit I’m working on an article, that I’m exploring the notion of addiction. “You’re trying drugs for the article?” the voice says, concern peaking through like an erection.
After the reassurances, I ask about the prevalence of prescription drugs on the street. “Are they easy to get?” I ask.
“What do you mean?” the voice asks.
“I mean, where do you go to get them?”
The voice is cleared. There is a shifting in the seat. “I can’t tell you that,” the voice says. “You’re an addict.”
Lately, the families in my neighborhood have been gathering before dinner, grouping together on one porch or another, where the adults go on about their days, about Ken Starr or Bill Clinton, about our various children and their passions. Some drink wine while others poke at hummus with triangles of pita bread.
Sometimes when I am driving home to all of this, I think: “Too bad they can’t make a liquor like Vicodin.” I can even imagine the taste of a drink like that, the warm trickle of euphoria on the back of the palate. I’m thinking of something that I could share with my friends during our evening happy hour. It’s an odd thought, one that I shake off quickly.
My mistake is that I’m thinking they’re like me, that pain defines their every moment, that they, too, need to leave the pain behind for a while to make a moment like this work. I have forgotten the way the world operates, and I’m thinking like a chronic-pain victim: narrow, obtuse, and egocentric. My own need dominates the way I judge the needs of everyone else. The sad part, of course, is that I would assume they’d want such a drink. This is the addict in me thinking, the guy who hoards the painkiller for a time when need is not an issue.
Truth is, if you dish out servings of desire like slices of a big Virginia ham, then fondness is only a portion or two away from need, and need is only a sliver away from addiction. I’ve grown accustomed to cruising this buffet table, fueled by the hunger of movement and pain, need and desire.
Name me what you will. Addict. User. Miserable slob. I’m no fool, though. I know how this will play out. This article will creep its way along the lines from my wife, distinctly concerned and vaguely embarrassed, to her friends, the fellow nurses, to their friends, the doctors. For weeks, I will defend myself to the people I work with, the people who care. I’ll beg off their concerns. “I wrote myself out of it,” I’ll say. “It was an act of will,” I will tell them. While I brag about what I did, the more somber ones will call this whole thing by still more trite and familiar names: an act of desperation; a cry for help.
I can see myself then, turning away from all of it, sure I did the right thing in revealing myself, secure in the knowledge that I’ve passed through the trap I’ve set for myself. But finally, someone will name my doctor specifically, and another person will copy these pages or tear them from this magazine and send them along, and then, wham! It will be over. Just like that.
My doctor, fine and prosperous, will think he’s been played for a fool (which, I should point out, is not true). He will cut me off. My calls to the voice-mail prescription-refill line—that cavernous black hole of my anxiety—will go unanswered. What else can they do? I’ll have named myself for them, and they’ll react the only way they can. No more Vicodin. No refills.
So I’ll savor the last few tablets, dig around for forgotten stashes, take the pills only in emergency situations, until one solitary tablet is left in my desk drawer. It will sit there like a staple, or a paper clip, or a bullet. The last Vicodin. Just another thing in my drawer, a thing I can use, a thing that holds other things together.