A Doctor in Recovery from Prescription Drug Abuse
I grew up in East Tennessee in Johnson City, where I also live now. I really grew up pretty normal. Sure, I experimented with alcohol and marijuana when I was in high school, but never really had any issues. I did well in school and I played sports. Alcohol was a little bit of a problem in the fact that when I drank, I never drank just one drink. But I didnt drink all the time.
I went to college at the University of Tennessee in Knoxville, and although I was pretty much voted the guy who would be back home the soonest, I always had the ability to do really well in school. So I did well at UT and continued my drinking habits as they were. Luckily, I never really got into heavy drug use in college. There was a lot of marijuana around, and it was the 80??s, so there was a lot of powder cocaine and those types of things, but I never even experimented with it. I did smoke marijuana on occasion, but I mainly just drank alcohol through college.
I was an honors graduate from the University of Tennessee, and I got married right out of college. I met my wife, Karen, when we were freshmen, and we got married after we both graduated. At first, I went to work. I didn??t go to medical school straight away. I worked for a few years, and we had my son, Heath, four years after we got married. Really, I had no issues. I had athletic injuries through the years ?? I had ruptured my Achilles tendon, I had broken bones ?? and I had taken pain medication for those things after surgeries and really never had any issue at all.
Five years after I left the University of Tennessee, I decided that I wanted to go back to medical school. I studied for the MCAT and made a good enough score. I wanted to go back to my home ?? I was living in Knoxville at the time, which is about two hours west of where I??m from ?? and I went back to medical school there. On the second day of medical school, my classmates, who were from accomplished schools like Harvard, Yale, Stanford ?? all these places with big academic names ?? elected me their class president. Alcohol was an issue in the fact that I never was able to drink and stop drinking. I didn??t drink all the time, but when I started I just couldn??t stop. So when my classmates elected me their class president, I made up my mind that I could never let them see me drink. I didn??t want to embarrass them. So I didn??t drink any alcohol though all four years of medical school. Consequently, I did really well in medical school; my classmates even nominated and elected me for the gold humanism in medicine award which is the highest honor at our medical school for a graduating medical student. It was for the physician who showed the most compassion towards their patients; the most humanistic qualities. I was really honored by that at graduation.
The problem was that after graduation, all my classmates spread across the country to residency. About a month after they all left, I picked up alcohol at the beach. At the time, I was already in my second year of residency; I skipped the fourth year of medical school and jumped straight into residency as a fourth-year medical student. And the pressure was pretty high. I worked through my intern year, and during my chief resident year, I was getting ready to take a job with the university.
I was working really hard. I was moonlighting down at the state mental hospital, and I??d have patients come in who were substance abusing and doing different things, and I would take care of them. I started to hear their stories about substance abuse and their stories of alcohol use really reminded me of myself. I treated a lot of people who were struggling with alcohol who didn??t drink all the time, but they were binge drinkers, which is exactly what I was. I??d always thought that I had a problem with alcohol ?? I had a lot of alcoholism in my family on both sides, and a lot of mental illness in my family on both sides.
I took a job with the university after I got out of residency. The first day I stepped into a ready-made practice and saw 25 patients. And I started working away. Before I knew it I was covering three hospitals. I was working more than 80 hours per week. I had two children, Health and Haley.
I had had a dental procedure several months before and I had some leftover Lortab. One day I was driving home from work, and I was stressed out, and while I was sitting at a red light, I remembered that I had those Lortab at home. I thought, ??You hear all these stories of people using these drugs, I wonder how they make you feel when you don??t have pain.?? I remember having that thought.
And I went home, and I took those Lortab out of my medicine cabinet, which had been sitting there literally for a year, I broke it in half, and I took it.
I thought that I had found the answer for my depression problems, for my anxiety problems and for my pressure problems. Because I felt better. And that??s how my drug use started.
I went about my job. I was using half of a 5mg Lortab twice daily. Within three years I was using the equivalent of 500mg of Oxycotin per day. During those three years, the medical students voted me the outstanding instructor in internal medicine all three years. So while my drug use was progressing, I continued to do very well professionally.
I was the top producer in our practice as far as seeing patients and getting things done. I had opened a new practice in a town not far from the school. I was seeing patients there and the practice was growing. I opened a hospital practice that was growing as well. Really, it was a career path that was straight up. And my drug use was progressing.
After a while, probably about a month or so, I went from using a half of a 5mg Lortab twice a day to a whole Lortab twice a day. And then the day that really struck me was the day that I went from using one 5mg Lortab twice a day to two 5mg Lortabs twice a day. I just didn??t think anything about it. I felt good and I was doing really well professionally. But my use just skyrocketed. It really shot up without me really realizing what was happening to me.
My son at the time was seven years old, and my daughter was four. I had everything that I ever wanted. I married Karen, who I loved from the first time that I ever saw her. We lived in the house that we had wanted. I drove the cars that I wanted to drive, I took the vacations that I wanted to take, and I really didn??t have a money issue. I really had the life that I dreamed of when I started medical school. The problem was that my drug use was increasing and I was starting to require more and more medication to feel the same way.
At the same time, my home life just started to deteriorate. I was doing well professionally, but at home I became absent. When I got home from work, my wife would have dinner on the table and my kids would be sitting at the table and I would bypass them and go up to my room to lay in the dark. I basically started isolating myself. I lost interest in the things I loved to do ?? I loved to coach my son and my daughter in their sports, and I really just lost interest in those things. I lost interest in my life in general. I became dependent on the drugs.
I remember the first time that I got dope sick; the first time that I started to have withdrawals from the opiates. I had run out, and I had been about a day without them when I grew violently ill. I felt like I had the worst case of the flu that you??ve ever seen. I had an upset stomach, I didn??t have any energy, I had shaking chills, I was sweating, and I was like, ??Oh my goodness, what in the world??s wrong with me. I??m sick, I??ve got a virus.??
It never dawned on me that I was withdrawing from opiates.
And then when I got my hands on some opiates ?? I think it was Percocet at the time ?? I took it and I felt immediately better. That??s when I realized that I was physiologically dependent and that I was trapped. From that moment on, I would do anything that it took not to feel sick again.
I stole medication out of people's drug cabinets. As a matter of fact, that was my main source. I stole from my mother and my father. I made more money in one year than my mother and father made in their lifetime, and I stole medication from them. When I went to their houses they??d have medication in the cabinets from surgical procedures, dental procedures that they??d had, and I would take it from them. I took medication from patients, and then just replaced it. In my mind I wasn??t doing anything wrong because I was replacing the medication; I wasn??t stealing it ?? of course, I now know that that??s not true.
I got to the point where I didn??t eat. I would go to bed at night and remember that I hadn??t eaten during the day. My normal weight is about 215 pounds and I dropped down to 170 pounds. I looked emaciated. It was just a sad existence. I would see my wife at night praying that whatever??s wrong with me would be fixed and I would just look at her. I didn??t know what to say. I was hopelessly trapped and I couldn??t tell anybody. My life was falling apart.
I went to bed half the nights praying to God that I wouldn??t die in my sleep, and the other half praying that I would die in my sleep. That went on for probably a year.
I was practicing medicine in my home town and I felt like I was successful. I had made it out of the place where I had come from; I was the first person in my family to ever go to college. When I used to tell people that I wanted to go to medical school they laughed at me. And here I was. I had made it. But I was addicted to drugs and I couldn??t tell anybody.
In May of 2004, my favorite professor in medical school had come to me as a patient. I was honored. He had been a professor at that medical school since it was built, and he chose me as his doctor. I soon diagnosed him with lung cancer. He was in the process of dying and I took care of him, but I also took medication from him and then replaced it. He was my favorite professor. In May of that year he passed away and I did the eulogy at his funeral. And I didn??t cry. And at that point, I knew that I was done. I knew that I was going to die.
About a week later, on May 10th, 2004, our graduating class had their graduation ceremony. They named me their outstanding instructor for all four years of their medical school. There were probably 150 other professors to choose from. I was honored at graduation, and I had just been to the bathroom and used 160mg of Oxycotin during the ceremony. I remember standing up and thinking what a fraud I was. In my mind at that time, that was the last graduation ceremony I would ever attend. I thought I would die before the next one. I was 36 years old.
About a week later, one of my closest friends from medical school passed away, and my drug use just slung completely out of control. After that, I began taking medication basically on an hourly basis.
I started to have trouble sleeping. The opiates had made me so ramped up during the day; they gave me so much energy that I couldn??t fall asleep at night. I started taking benzodiazepines ?? Xanax, and Klonopin. Now I was not only addicted to opiate narcotics, but I was addicted to benzodiazepines.
In July, I took my son down to meet my father. He was going to take my son hiking. So I drove my van to the grocery store to drop my son off. I used to carry my drugs in the car with me in the drink holder ?? not in a bottle, they were just there where anybody could see them. Literally, there were hundreds of them in there. There were Percocet 10mg, Oxycotin 80 mg, Lortabs 5, 10??s, I had Fentanyl patches??I mean, you name it, I had it in my truck.
I could have sworn that my dad and my son had walked away, and as soon as they left, I reached over and I grabbed ten of the 10mg Percocet and I threw them in my mouth all at the same time. When I looked up, my dad was standing at the window of my truck. He looked at me and said, ??Steve, did you just throw a handful of pain pills in your mouth??? I said, ??No, Dad. No I didn??t do that.?? He had just seen me do it. And I told him no. He shook his head, he walked off with my son and they drove off.
The next day I was at work. I worked all day long, and my nurses started to see things in me; they started to see changes in me. When I came home from work, I rounded the corner at my house, and I looked up at the driveway and there sat my dad??s truck. I knew what it was there for. I knew that he was going to say something to me.
When I pulled up in my driveway and he said, ??Steve, I need to talk to you for a second,?? I said, ??Dad, I??m tired. I??ve had a long day, I??m worn out.?? He said, ??No, I need to talk to you.?? So, I got in his car with him and we took off down the driveway. I said, ??Where are we going, Dad??? ??We??re going to see your sister,?? he said. ??Well I don??t want to see her.?? I hadn??t spoken to her in nearly ten years, since my parents had gotten their divorce. She was about the last person on earth I wanted to see.
I said, ??What are we going up there for??? He said, ??Well Steve, I think you have a drug problem.?? And I said, ??Dad, I don??t have a drug problem. What you saw me take yesterday wasn??t pain pills.??
Another mile down the road, he looked at me, put his hand on mine, and said, ??Steve, I love you. You have a drug problem.??
I said, ??Dad, I do. I??m dying and I need somebody to help me.??
At the time, I didn??t think that there was anybody in the world that could help me.
We hadn??t learned anything about drug addiction in medical school; we hadn??t learned anything about drug treatment. I don??t know what I thought they did at the Betty Ford Center, everybody??s heard of that place, and I just didn??t think that there was anybody that could help me.
I thought I would lose my medical license. I thought that I would lose everything that I had worked hard for. I thought that I??d be ostracized in my home town.
My dad looked at me and he said, ??Steve, maybe. I don??t know. But none of that stuff is going to do you any good if you??re dead.??
I thought about that for a second, and it made sense to me. He was right. I felt like somebody had thrown me a life ring out in the middle of the ocean. And I grabbed a hold of it.
We went over to my sister??s, who was waiting at the door of her business and when we arrived, she hugged me. She had seen me at one of the local stores in Johnson City a few months earlier, and seeing how bad I looked, how much weight I had lost, she was worried about me. She started checking around, and she figured out that I had a drug issue. She hugged me and we were both crying, and she told me she loved me and that she was sorry for everything that had happened. I started crying, and my dad was crying, and we just got on the computer and started searching places that could help me.
I learned about the Physician??s Health Program in our state just by searching the internet. I called up the Tennessee Medical Foundation, which is the Physician??s Health Program in our state, and I self-reported and told them that I was addicted to opiate narcotics and benzodiazepines and more than likely alcohol, and that I needed somebody to help me.
They gave me the name of four treatment centers to call, and I picked one in Nashville, Tennessee, called the Center for Professional Excellence. I picked it because I was certain that when I told my wife that I was addicted to narcotics, she wasn??t going to let me come home. My college roommate lived in Nashville and I knew that he would let me stay with him until I got on my feet. So that??s how I picked my treatment center.
The next day, I got in the car with my dad, and I was still using ?? I had two pockets full of Lortab ?? and I used all the way to Nashville. My dad drove me to CPE, and I walked in and I met a guy named David Lesser, who was the medical director of CPE at the time, and he told me that I was going to need to go to inpatient detox at Vanderbilt University.
So I got in the car with David and my college roommate, and we drove over to Vanderbilt, and I was admitted to the Vanderbilt Center for the Treatment of Addiction for five days of inpatient detox.
And that??s where my life changed. It started that day.
I was admitted to the hospital ?? it was a pediatric hospital ?? and I was in the ward with 23 other patients. They were all young. There were a lot of street addicts, IV drug users, prostitutes, and about everything else you can imagine. I was the only one out of those 24 people who, at the end of their detox, got to go to treatment. The rest of those kids had to back out on the street.
I was put on a detox protocol for opiates, and on day three I was feeling worse, not better. I had forgotten to tell them about the benzos; I forgot to tell them about the Xanax and the Klonopin, and I became suicidal. I was put on suicide watch for 48 hours. They took my belt, they took my razor, they took my aftershave??they took anything that I could potentially hurt myself with.
My psychiatrist asked me if there was anything that I had forgotten to tell him and that??s when I remembered the benzos. So I told him, and they put me on a benzo detox protocol. They basically gave me medication until I went to sleep. I slept for about 24 hours and when I woke up I felt much better. I wasn??t suicidal.
Then I was discharged back to CPE and I met Chip Dodd. I underwent 90 days of inpatient treatment at CPE in Nashville and Chip Dodd was my lead therapist. I had never met anybody like him.
One of the things about treatment is being honest in all areas of your life. It??s about letting go of secrets. By August 16th, 2004, I only had one secret left. It was that I took medication from my professor who was dying, Dr. Bill Mayberry. I had told everything up until that point, but I hadn??t told that one yet. I had started to dream about it. So I went into to treatment that morning, and I told Chip that I needed to see him privately. He said okay, and we went to his office. We sat down, and Chip looked at me, and I told him everything.
He looked at me, his eyes planted firmly on my eyes, and he said, ??Steve, that??s bad.?? He didn??t tell me it was okay. He didn??t tell me that it was fine. He said, ??But I forgive you. And I love you.?? And I had never had anything like that happen to me. Everybody who had ever told me that they had forgiven me had only forgiven me up until they needed to throw it back in my face for something. For the first time, I believed him. I believed that he forgave me and I believed that there was nothing that I could tell him that was going to run him away. I believed that he was going to be there the next day, no matter what. I knew at that moment ?? August 16th, 2004 ?? that I was going to be okay.
That??s what treatment was. It was Chip Dodd teaching me how to handle my feelings ?? good, bad, indifferent ?? without the use of anything to change them ?? be it alcohol, be it drugs, be it work, be it anything. And being able to live my life on a daily basis, without needing something substance-wise to change the way I felt.
He taught me how to handle things as they came up ?? things that caused me to be anxious, things that caused me to be stressed, things that caused me to be worried, things that caused me to have shame, things that hurt me ?? he taught me how to handle those in a healthy way, that did not require me to drink alcohol or take narcotics. And I still use those tools nine years later.
While I was in treatment ?? it was all doctors, that??s all that they treated ?? they said, ??We??re going to have an addictionologist come in, and he??s going to teach you about the disease of addiction.??
So the addictionologist got up and started teaching us about the brain, dopamine and other things that make up the reward center of our brain. I was sitting there with guys who had been physicians for a long time. I was the youngest one by at least fifteen years. And when the addictionologist taught us about addictive disease, we all sat there with our mouths open.
We had all this education; we had all those hours in medical school and residency, and yet no one had ever said a word to us about addiction or addictive disease. And all of us were prescribers of narcotics ?? every single one of us. We didn??t have any idea as to the power and the physical dependency that narcotics are capable of causing.
And I knew, sitting there, that there was not going to be a student who graduated our school, from that moment forward, who didn??t have a basic understanding of addiction, addictive disease and prescribing narcotics as long as I had a say about it. And I dedicated my life to it at that point. And that??s what I??ve done for the last nine years.
Before rehab, in my first or second year of drug use, I gave a lecture to our first year medical students. It was awful ?? I was lecturing on cholesterol. At the time, I wasn??t participating in anything that our normal faculty members participated in ?? I didn??t read my email, I didn??t keep up with evaluations ?? I just didn??t think those things applied to me. My arrogance was through the roof. And the lecture was horrible. But I didn??t think anything about it at all. When I got back from rehab, several years later, I decided that I was going to start doing things the right way.
So I went back and got on my computer, and I read every single email that I had not read for three years. There were probably 4,000 of them. I deleted the ones that were obviously outdated, but one of the things I came across was the student evaluations for my talk. Those students, who were first year students at the time, were now at the end of their third year of medical school.
As I read what they said about my lecture, I sat in my office and cried. They said things like, ??I can??t believe that this guy is a doctor. I can??t believe that this person graduated from our medical school. What an embarrassment.??
And the thing about it was that they were exactly right. Spot on.
During the third year, the students are in their rotations, so they??re all spread out. I couldn??t get them all together, so I crafted an email to all of them. And I thanked them. I told them that their evaluations were correct. I apologized. Well, at the end of the year, they had the student award ceremony, where they award their outstanding instructors for the year. That year, it just so happened that the timing of the ceremony was after I had sent the email. And that same class picked me as the outstanding instructor for internal medicine.
When I went up to receive my award, the young lady who gave it to me hugged me and whispered in my ear, ??Dr. Loyd, we all read your email, and none of us could believe that was you.??
That was one of the most moving moments that I ever had in my life. They did not even recognize the person from their first year of medical school who came in and gave that lecture as the same person from their rotation teaching them internal medicine. That??s how different I was. I became a completely different person. When she whispered that in my ear, I had tears in my eyes. I turned to the rest of my students, and I was humbled.
While we were in treatment, they had us write down where we saw ourselves in five years, if we could remain clean. So we all wrote stuff down, and in five years, they sent it back to us in the mail. It arrived at my house five years later. I opened the envelope, and I almost laughed out loud at the things I had written down.
They were so miniscule, so short sighted and so petty that it was humorous to me. My career, my personal life, my family life ?? everything ?? has exceeded my wildest dreams.
Before, I was an average internal medicine doctor who was teaching medical students. I was a dime a dozen. Now, I??ve become a nation-wide speaker on the proper prescribing of controlled substances. I work as an expert witness for the Federal Bureau of Investigation, Tennessee Bureau of Investigation and the United States attorney??s office in federal drug cases against doctors for mis-prescribing. I have a nonprofit clinic where I treat IV drug addicted pregnant women. I have been the speaker at the National Association of Pharmacy Fraud Investigators, and I spoke at Tim Heaphy??s Southwest Virginia Drug Summit.
I found an area of medicine that is greatly overlooked ?? this is the number one health problem in the United States. There are very few people who talk about it. I??ve been very open with it. When I got back from rehab, my patients asked me where I had been, and I told them. I have not lived in the shadows. All of my students know. My career ?? my life in general ?? has taken a path that it never would have taken otherwise. I have not relapsed. I have nine years of continuous sobriety. My life is really unrecognizable.
It??s a dream, actually. I??m living a dream.
The thing that I try to do with the people who I see now is explain to them that this is not a moral disease. It??s not a moral deficiency. And there is help. There is no such thing as being too far gone. As long as someone??s alive, we have a chance.
By the time I die, I hope that addictive disease does not have the stigma that it has right now. In my obituary, I want it to say in lieu of flowers, I??d like money donated to help further the research on treatment and a cure for addictive disease.
I see people die every day of addictive disease. And I see their families hanging their heads in shame; I see their families not wanting to talk about it; they basically try to hide it. I see the looks on their faces when it??s brought up, and my heart breaks for them. I hope that one day we??re passed that. I hope that before I die, the stigma has changed. I hope that we can talk about it openly and honestly. I hope that it??s not seen as a moral disease, but as what it actually is: a disease of the brain.
Addiction is treatable, and people can have normal lives ?? and even lives that they couldn??t imagine. There is hope.
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