Man Has Life Back after Overcoming Opioid Addiction

Podcast Transcript

Kyle: Hey everybody welcome to The Comeback. I'm your host Kyle Michael Miller. During this episode we're talking with Terry Keith who has been sober for almost two years after struggling with an addiction to alcohol, prescription pills and heroin. Dr. David Streem and Rudy Kump from Cleveland Clinic's Alcohol and Drug Recovery Center will also join us, but first, here's Terry in his own words.

Terry: My name is Terry Keith and I'm 44 years old. I started using alcohol when I was 18 years old and that led me to start using alcohol, heroin, cocaine, ecstasy and pretty much anything I could get my hands on. I worked in the restaurant industry, and I started drinking in the morning and at work just to get through the day. I hid my addiction from everyone for a long time or so I thought. By the end I was using fentanyl, carfentanyl and alcohol. I overdosed five to six times and I was saved by Narcan each time. In 2017 I decided to get clean, and I spent three days in the detox unit. Now I’m proud to say that I've been sober for almost two years.

Kyle: Terry, Rudy, Dr. Streem, thank you so much for joining us today.

Terry: Good afternoon.

Kyle: Terry, what made you want to get clean after eight years of being addicted?

Terry: It was just time to grow up and realize that it wasn't normal to be preoccupied with drinking and using drugs constantly. It’s not normal for people to be overdosing and hiding it from their friends and family. I think that was a big wakeup call that I kept overdosing and that's not normal.

Kyle: Take me back to the beginning of your story, when did you first start using drugs and alcohol?

Terry: I was just a shy teenager from a middle class household, and I really wasn't around drugs and alcohol that much. But as soon as I had my first sip of alcohol I knew I had found my way into something that I enjoyed immensely and I crashed and burned immediately. I was in jail and in rehabs right off the bat before I turned 21, but I pulled it together. Long story short, as I got older, started suffering from some of my emotional immaturity and basically not being able to handle life, I turned to alcohol and drugs and it just got worse and worse.

Kyle: Did you ever think it was going to be as bad as it was?

Terry: I did not. That's for sure.

Kyle: Can you take me back to your mid-20s, which I believe is when things really started to get pretty chaotic for you? What was going on in your life during that time?

Terry: I had chosen to focus more on drinking and using drugs. At that point working and going to school was put to the wayside. I was homeless and it just was one of those things where it didn't seem that bad. Even not having a house, or going to school and being responsible. Not having anything that a normal person in their 20s should be working on such as a family, or just even just getting a degree wasn't normal, that’s for sure.

Kyle: What was a typical day like for you?

Terry: You know, it was just a matter of staying out of trouble and figuring out where I was going to go, the people I was going to hang out with that wanted to do what I want to do. And basically, it only went so far.

Kyle: Did you keep it a secret?

Terry: It was a secret. But I think after a while everybody kind of knew, but the use of alcohol and drugs is a very touchy subject especially among some families and friends. I mean, they really don't want to step on your toes even though you might be struggling. In my case, I was struggling but no one really stepped up to bat to say anything. I don't have any resentment or hurt feelings. But looking back, if I saw someone like myself struggling, I think I would try to step up.

Kyle: Did your employer find out? Did they know?

Terry: I think eventually. Thanks to fentanyl and carfentanyl I was able to keep using drugs. Alcohol is legal, so that's one thing as long as you're not drunk on the job. With the carfentanyl and the fentanyl I was able to keep functioning and passing tests. People were just thinking that I had some kind of mental illness or I was dehydrated. Whatever came out of my mouth was really what they were believing.

Kyle: What was the most difficult part of your journey?

Terry: Surrendering. I protected my drinking and my drugging like some people protect their loved ones, or their pets, or jobs, or careers, or their savings. I mean, I thought that my drinking and drugging was more important. I had every excuse in the book not to give that up. And when I knew that the time would come, I had to put that down and realize that was it. It was over.

Kyle: And things got pretty serious. You overdosed six times.

Terry: Yes. It was a matter of thinking that every time I would get out of the hospital or be revived I would say to myself, ‘okay, it's not that bad. I still have a job, I'm still doing my own thing’. But it was a matter of, that’s not normal you know? And along the way overdosing in hospitals, in courtrooms, in other places is not a good thing.

Kyle: What made you want to you get help? What was that turning point for you in your story?

Terry: I’m slightly embarrassed to say that it was, I think it was kind of petty for me to say that I didn't want to lose my job. I had gotten a second chance, found a good career and was concerned about it. But the thing was by being threatened that I was going to lose my job, which I basically did, it gave me the push to say okay this has got to change. I listened to the people that told me what to do and they provided faith and hope. I put my life in their hands and everything worked out pretty much like they thought it was going to.

Kyle: Rudy, isn’t that the first step for a lot of people, they have to decide that they're going to make a change?

Rudy: Pretty much. Kind of come to terms that even if I feel differently I can still decide I need to change and give something else a shot. You know we say your best thinking got you here.

Kyle: When patients like Terry come to see you, what's the typical process that they go through?

Rudy: Typically they would call up and we would set them up with an assessment to determine the level of care and what their needs are. We would outline all of the offerings that we have and give our recommendations about what we feel. Then it's up to the people like Terry to make a decision about, ‘yeah we'll do this’. Some people will say, ‘oh sure that sounds like a good plan’ and then they’ll never show up.

Kyle: A lot of people don't know the difference between detox and treatment when they come to a program like we have here at Cleveland Clinic, how does that work?

Rudy: So a lot of people refer to inpatient and they'll say ‘I don't want to do inpatient’ where they think they're going to be sort of locked away for 30 days someplace. More typically refer to that as residential, detoxification as a medical process. It's a very short process relative to a residential stay where the body's getting rid of those chemicals and preparing one for the psychological component of addiction. And that's where we will transition them from the medical unit down to the behavioral health unit and start the process through either an all-day outpatient program or a half day outpatient program. They get a lot of education and opportunity for psychotherapy. We're trying to change sometimes a lifetime of addictive thinking, the distorted thinking that favors ‘well if I do the same thing I'll get a different outcome this time’, which never happens. So we try and point that out to them through groups and also through the people that they come into treatment with and they end up with. I think there's something, there's some faith that determines who's going to be there with who, how they learn from each other, and how they teach each other. So that's a big component. We have volunteers, people who were through the very rooms and seats that people are sitting in. Then they come back and they offer their strength, hope and experience. And that resonates very loudly for people who find that here's somebody who has a day off or a spare hour in his day and he comes in to talk to us. Wow. I'm not sure I would have done that, but we're very grateful.

Kyle: Dr. Streem, the CDC’s most recent report says that 70,000 Americans have died of overdose in 2017. Do you think that we have seen the worst of this epidemic, and are we making headway?

Dr. Streem: Well I do think things are changing. Whether they are changing for the better, or just changing and things are going to be different going forward? I think that remains to be seen. In Cuyahoga County we're on pace to reduce the total number of opiate or overdose deaths by about 5 percent or so which is still more than 2016 but less than last year. The concerning thing to me is that the number of fentanyl and carfentanyl deaths. These are types of opiates that are hundreds and even thousands of times more potent than heroin. Those percentages are still increasing quite rapidly. We will see if those numbers will decrease along with the total numbers, or if the overdose numbers will begin to be comprised mainly of people dying of overdose of fentanyl and carfentanyl. By the way, also a majority of the cocaine supplies that we're seeing all over the country are increasingly contaminated with fentanyl, carfentanyl and other opiates and those numbers are increasing as well. It's a time when we're hoping for the best, but we're watching the numbers very closely.

Kyle: Who are the typical people that are overdosing?  What’s the profile look like, the demographic?

Dr. Streem: Our county medical examiner's office would tell you there are people from all over the county, all different walks of life, all ends of the socioeconomic spectrum, all parts of the city and the county and we have certainly seen that.  People who've been in treatment and people who haven’t, people who have long histories of addiction problems and people who don't. So it really spans the whole gamut of older teens, young adults and even older adults.

Kyle: Does that make it harder to treat patients and to stop this from happening? Is it harder to pinpoint because it's affecting so many people?

Dr. Streem: I'm not sure about that. I think we realize the danger that exists in every patient who comes to us for help. So everyone is vulnerable and everyone needs a safe, nurturing place to get best practice, gold standard, high quality addiction treatment. And that's something that Rudy and I and the rest of the staff are extremely passionate about.

Kyle: What are some of the common myths out there about addiction? What can you debunk for us today?

Dr. Streem: Well, I think two main points maybe to make is first of all, this is primarily an issue of will or discipline. We've known many, many people who are extremely disciplined, bright, high-achieving people who have developed terrible addiction problems. In order to accept that myth, you'd have to accept that these are fundamentally weak or undisciplined people. And after almost 20 years of doing this work and knowing a lot of those folks, I can tell you that that's just simply not true. The other myth is the degree to which people have to be fully ready to accept all the elements of treatment. Right at the beginning, Terry described very eloquently how he wasn't really in some ways totally ready, or willing and that he had a job that he didn't want to lose and that was not a decision that he made to put his job at risk, but his job was at risk, and that factor helped him to move his ambivalence. So when he walked in our door there was still some element of ambivalence I'm sure. But the part of him that realized that the current situation was unacceptable and needed to change was enough for us to work with. And even though there was a part that still wondered probably whether he could make such a big change in his life, there was also a part that realized that the current state was unacceptable. So ambivalence is something that we work with a lot. And for people to come in and say ‘I think I need treatment but it's only because of this or that’, or ‘I might have a problem, but I'm not sure’. All of that, we can work with all of that.

Kyle: Terry, what would you say to somebody who's in a similar spot today that you were in and they’re trying to take that step to recovery?

Terry: I would say that the world is missing out on the best version of themselves. Not being sober and struggling, the world's not getting the best of you. And you can take the time out to find help. I mean, you can do it. And I'm a big believer that a lot of people say they don't have time, ‘I can't do it. My job, my family, my children, my pets.’ It goes on and on the excuses. If I saw someone like myself I would say, ‘hey, you know you're on probation in two cities, you can't drive a car legally, and people are scared to be around you. Why don't you just take a moment and talk to somebody about this?’ And that's probably the best answer I can give.

Kyle: How has your relationship with your family changed since you've gotten sober?

Terry: I think when you go through recovery you learn that life is going to change. You learn to deal with it on a day-to-day basis. You know, you're going to get out of whatever facility, treatment, outpatient/inpatient, and sometimes you're going to find out that life can throw you a curveball. But with the right support and by listening you'll be able to handle those curveballs. And I know I've had some changes in my family and the ones that I cherish the most are my immediate family. I could hang out with my mom all the time and feel like I'm getting back the time that I was not paying attention to my family because I was too busy. And I think that I'll never get that back. And I look forward to the moments I get to spend even if it's just the movies, or going to the park, or doing something stupid. It doesn’t have to be grand, it can be a simple conversation.

Kyle: So we're going to play a quick game with you called Go Fish. I'm sure you've heard about it before. We have a fish bowl right here in studio. If you want to take the lid off there are three questions in there and you can pick them up one at a time. Read the question and then give us your best answer.

Terry: Well the first question I grab was, who gave you the best advice and what was it? Well, this gentleman right here, Rudy gave me the best advice. He said meeting makers make it. It's a very simple phrase but it just deals with, to get traction in life I got to keep going to meetings. It doesn't matter what kind of meeting. As long as it's related to substance abuse, alcohol, heroin, I mean pretty much any 12-step meeting. I even go to agnostic meetings. I hang out with people who are very touchy on the subject of religion. But the thing is I keep an open mind. I keep going to meetings and they provide me serenity. They slow me down and it makes me realize that I'm not alone. We as people in recovery are hiding in plain sight.  And by seeing people tell their story or even offer advice or complain, it makes you realize I'm not alone. So, meeting makers make it.

Kyle: All right, want to pull question number two?

Terry: Here we go. What advice do you have for others? I think that my advice is to get help. Take the time to ask for help. And if you're going to ask for help, apply yourself. I went through one time with the outpatient and I did not stay sober. Things got worse. But if I would have just wholeheartedly listened, maybe tried… but my advice, just ask for help. Don't be afraid.

Kyle: Go fishing one more time.

Terry: What's one thing you cherish now? That is definitely my family. Having an honest line of communication and having their trust. Knowing that they're getting me for the good and for the bad. That's definitely what I cherish.

Kyle: Rudy, Dr. Streem, do you guys have any final thoughts before we close up?

Rudy: Well you know, Terry is a great example of success. But for every Terry there's 10, maybe 20, 30 others that don't make it. It's a really difficult disease kind of like oncology, more of your patients don't make it than do. But it's the Terrys that keep me going. It gets me out of bed and gets me into work the next day. Knowing that there's at least somebody out there who has benefited from what you do. And we'll just keep trying with the others.

Dr. Streem: I think that Terry's story is incredibly inspiring. It's something that has motivated many of us to get into this practice. To provide hope and a nurturing, healthy environment for people to make a big change in their lives. And that big comeback that Terry has made, and we've helped a lot of other people to make, it’s been a tremendous honor to be a part of. I know Rudy and I and the rest of the staff are continuously working to try to help our programs have the best possible outcomes and implement all the best most effective treatments. Whether it be medical or psychotherapy, groups, individual. Anything that's out there that has good science behind it, we're going to do our best to implement and make available to our patients to give them the best odds of success.

Kyle: That’s great. Thank you guys all three for being here today. Terry, thank you so much for sharing your story.

Terry: Thank you for having me.

Kyle: It's really, really brave and I know there are a lot of people that are going be helped by it.

Terry: I hope they listen.

Kyle: Thank you to everyone listening. You can find additional podcast episodes on our website http://my.clevelandclinic.org/podcasts, on iTunes, SoundCloud, Stitcher and Google Play.