The heavens and hells of prescription amphetamines
by Robin Rage
Hey, I finally quit smoking! It was actually pretty easy once I got off the speed I’d been hooked on for the past year. It’s called Vyvance — an amphetamine, like Adderall, prescribed for people who can’t pay attention (ADHD), can’t stop eating (binge eating disorder) or can’t stay awake (narcolepsy). With the possible exception of ADHD (and who isn’t feeling restless and distracted these days?), I didn’t have any of those problems. I was just bored and wondered whether, despite my long and sordid history of substance abuse, the white coats would give it to me.
And they did! For free! (Free for me, anyway; MaineCare and Medicare picked up the tab.) Crazy, right? They even upped my dosage and then re-upped my scrip month after month, with virtually no monitoring — no pill counts, no tests, no follow-up counseling, nothing.
Yes, true believer, that’s what I’ve been up to since the summer of 2017: proving to myself that I definitely don’t have ADHD, and that speed, while certainly fun and fascinating, is also quite addictive and destructive. After abusing the drug for many months, suffering debilitating crashes and acting like an utter bitch, I finally decided last summer to ride the high one last time and then quit. I knew that if I didn’t give it up I’d have a heart attack or a stroke. I have a box in my closet with letters to my loved ones, to be opened upon the event of my passing. I’d like to keep that lid closed awhile longer.
Also crazy: this was all perfectly legal. Here in Freeport U.S.A., the Town Council banned recreational pot shops and social clubs (despite the fact more than half the voters in town approved the legalization referendum two years ago). I can’t walk down Main Street smoking a joint, but I can jitterbug all over the place mad-jacked on speed without anyone hassling me — even with a pocket full of pills, long as I have a bottle with my name on it.
So, kicking this speed habit — totally my choice, I swear. I never discussed the decision with my provider. I just didn’t refill the scrip last July. Why talk to your drug dealer about contemplating quitting anyway? They’ll either talk you out of it or sell you something else. It’s business, brother man!
The professional drug counselors I spoke to for this story were of two minds about prescription pep pills. One said this may be the biggest drug epidemic in the state. Another said she thought the real problem was that uppers like Adderall and Vyvance aren’t being prescribed to more people who need them.
That second opinion is hard to believe. It’s remarkably easy to get highly addictive, Schedule II drugs in Maine. If I, Robin Rage — with my five drunk-driving convictions, traumatic brain injury and laundry list of other warning signs — can get a free and unmonitored supply of speed at the corner drugstore every month, then the real question is, Who can’t?
A quick history of speed
Amphetamines were first synthesized by a chemist in 1887, but it wasn’t until the 1930s that a drug company figured out how to profitably market and sell speed to the public. Among the first commercial uses of the drug was the treatment of depression during the Great Depression. As Nicolas Rasmussen argues in a 2006 article published by the Journal of the History of Medicine and Allied Sciences, pep pills were the precursor to Prozac: “amphetamine established the need — the market — for anti-depressants that a succession of later drugs … have filled since,” he wrote.
The drug company Smith, Kline and French had much more success with its Benzedrine decongestant inhaler, which was also introduced in the ’30s. It didn’t take long for miscreants, like college kids cramming for exams, to figure out how to abuse them (remove the chemical strips and chew ’em to release the speed faster).
During World War II, soldiers on both sides of the fight gobbled “go pills” by the tens of millions. In his 2016 book Blitzed, German writer Norman Ohler revealed that though the Nazis put addicts to death by lethal injection and sent other dopers to concentration camps, Hitler and his officers were big proponents of drug use on the battlefield, especially tablets of the newly patented drug methamphetamine. By the war’s end, the Führer himself was shooting a precursor to oxycodone called Eukodal to bliss out, followed by twice-daily shots of high-grade cocaine to rev back up.
The public’s need for speed kept growing over the next three decades. The drug had a huge effect on the arts, from Kerouac’s prose to Auden’s poetry, Lenny Bruce’s humor and Charlie Parker’s jazz. British mods used “Bennies” to fuel their all-night R&B dance parties. Sir Elton John’s “Bennie and the Jets” is all about kids high on speed — they’re “so spaced out … but they’re weird and they’re wonderful.” Long-haul truckers have relied on speed pills to make a living (they’re the “whites” that go with the weed and wine in Little Feat’s “Willin’.”), and housewives turned to Benzedrine sulfate tablets (a.k.a. “Mother’s Little Helper”) to get through another “busy dying day,” the Stones observed.
Speed’s not just for freaks — jocks love it, too. In Major League Baseball, uppers like Dexedrine (“greenies”) have been helping players through long games and seasons since at least the 1950s. Hell, league officials didn’t formally ban speed until 2006, and punishment for the first offense was a frown and further testing. Keep in mind that amphetamines have been illegal without a prescription since the Controlled Substances Act passed in 1971. Other Schedule II drugs include cocaine and all the good opiates.
Geeks also grok speed. The Netflix documentary Take Your Pills, which came out earlier this year, examined the pervasive use of prescription crank in Silicon Valley and on Wall Street, where young techies and execs take the drug to stay awake and stay competitive in those high-pressure environments.
Amphetamine use dropped in the 1980s, partly due to the increased availability and popularity of coke, though national surveys tracked a sharp rise in the use of over-the-counter “stay-awake pills” among students — high-school seniors’ reported use rose from 12 percent in 1982 to over 25 percent in 1988. This helped set the stage for the explosive increase in prescriptions for Ritalin and Adderall to treat kids and young adults diagnosed with ADHD. In 1990, 600,000 kids were on legal stimulants; by 2013, that number was 3.5 million. A New York Times Magazine story from 2016 cited data that about 16 million prescriptions for Adderall were written in 2012 for adults in their 20s and 30s.
Something else helped boost those skyrocketing speed prescriptions: the 1994 publication of Driven to Distraction, a book by Drs. Edward Hallowell and John Ratey. The bestseller convinced millions that attention deficit disorder was practically as common as daydreaming (one of ADD’s symptoms), and could be managed with pep pills. Among the concerned parents who read the book and had an ah-ha! moment concerning their kid’s shortcomings were my adoptive mom and dad.
Dexys Midnight Run
In the late 1990s, after my second OUI, I blew off my final month of probation and headed to Memphis. When I returned to Maine a few months later, I was, of course, arrested. Upon my release from Kennebec County, my mother and I went to see Dr. Charles (I’ll leave last names off here to protect my legal dealers’ identities), an English fellow, then practicing in Lewiston, who’d given me a scrip for Zoloft years earlier that briefly sent me into a wonderful state of hypo-mania. Dr. Charles said if we didn’t do something drastic, I could get into more trouble down the line. He blamed my bad behavior not on booze, but on ADHD. When Mom put me on the bus back to Memphis, I had a bottle full of Dexedrine for the ride.
In those days, I took prescribed meds as prescribed. I was a citizen back then, remember? In fact, I think I was still a state-licensed Certified Residential Medication Aide (CRMA). I’d never really trusted pills — didn’t think I could control the dose the way I could with booze! If you took a pill, you were stuck on that bus till it reached its destination, which may or not be your destination. Pills were for treating sickness, not having fun. Booze was for fun.
Plus, before Dr. Charles started scribbling scrips for me, I’d been in the Alcoholics Anonymous crowd, where it was believed that reliance on any medication was a slip-up, made you a heretic, a poser. That short period of bliss I experienced on Zoloft changed my opinion. I came to believe that I was a drunk because I was mental, and being mental, there had to be a pill to fix that. I could never recapture the happy mania of that first Z episode — similar antidepressants (like Prozac and Paxil) didn’t work — so I returned to the sober-drunk-sober-drunk cycle, the edges getting sharper and rustier with each turn of the blades.
The bottle of Dexys I took to Memphis made no impression on me, and I didn’t bother to try to get a refill from my doctor down south. I came back to Maine in 2001, and five months later, in February of 2002, I got mugged after a party and got the traumatic brain injury.
My adoptive mother had narcolepsy. She’d fall asleep suddenly, and far too often. For this, she was prescribed Ritalin. After the brain injury, I started “borrowing” her Ritalin. I wasn’t interested in speeding for the sake of speeding, I just wanted to be able to drink more Orloff (that fine Russian vodka bottled in Lewiston) before passing out. Eventually someone noticed the Ritalin was disappearing a little too quickly, and mom’s medication was switched to something far less fun. No one confronted me about it — that was how my family rolled. So much for Ritalin.
When I got the apartment in Freeport two years ago, I also got my very own diagnosis: post-traumatic stress disorder. The mind storms were horrific — anxiety and paranoia. Waking each morning with this stabbing terror, as though I’d fallen asleep on watch and was suddenly surrounded by the Forces of the Unforgiving.
The PTSD was the result of your humble narrator being in a safe, quiet place for the first time since 2008. All sorts of mental baggage from the alcohol abuse and jails and betrayals and suicides and overdoses and homelessness and so on, shit I never had time to process during the chaotic years, came home with me. Compounding the problem, I was now separated from the streetniks who’d become my community (and experiencing withdrawal from the many drugs guests would bring when they visited my old crash pad in Bayside, The Vatikan). When the adventure ends, the hero goes home, right? By the time my adventure was over, there was nothing to return to.
I switched from my primary care physician to a psych nurse to have easier access to a greater selection of meds with less oversight. This provider tried a series of different drugs during the first six months, but none of them did much good. I was about to ask her to put me on Thorazine, the heavy antipsychotic used to treat schizophrenics, but then one day in August of 2016, I just stopped. I decided to just knock it off, quit all the pills. I know that sounds crazy, but I felt that if I continued to let this chemical river carry me along, I’d end up institutionalized.
Nine months later I was on the speed train, heading nowhere, fast.
My speed year
I grew up believing that if you were a physician, if you’d earned that distinction, then you were among society’s most virtuous and competent members. I hadn’t expected to be handed a scrip for speed in the spring of 2017, and when I did, I was able to rationalize it by telling myself that this provider must know what she’s doing. Can’t fool a professional, right? Certainly not in this town, in these times.
We both had our roles to play: she was the doctor, and I was the documented dope-smoking alcoholic. Drug-seeking behavior would not be out of character were someone to improv my role. She knew my medical history, including notes I probably hadn’t seen myself. When I mentioned that I’d been prescribed drugs for ADHD before, she readily agreed that another go-round would be a fine idea. She should have thought of it herself, she added, what with speed being such a good drug for people with brain injuries. Without further investigation or ado, she wrote me a scrip for 30mg Vyvance. This was a “starter” dose, she said, and may have to be increased. I was to phone her in a week with an update.
Off I went! I killed the first 30-day scrip in a week, and it was fun. I called my provider and told her I’d noticed a difference with the Vyvance, but it had been slight. She dutifully upped my dosage to 60mg, and even though I’d been given two scrips for the same drug in one month, the fact the second was for a different dosage allowed insurance to cover it. (Come on, people, this is the stuff you learn in the parking lot outside Narcotics Anonymous meetings, on day one!)
When that scrip ran out, I must’ve sensed danger. I told a couple of people close to me that I’d been punking around with speed, and that’s why I’d been such an asshole recently. I called my provider and, without going into detail, left a message saying I’d decided the Vyvance wasn’t for me and to please discontinue it, and thank you.
Once off the V, I had a streak of genuine productivity. I wrote an article for this publication (“Life [and Death] in a Disorderly House,” August 2017). Then my daughter got married, and I wrote about that, too (“On the Occasion of My Daughter’s Wedding,” February 2018). Afterward, I guess I just got bored again. Another call to my provider and I was back in The Matrix. Only difference is, here it’s the blue (60mg Vyvance) pills, rather than the red, that send you back down the rabbit hole.
What was it like to spend a year on speed? Well, like I said, at first it was fun. Speed is fun. Whether you suffer from anxiety, depression, social phobia, whatever, if you do some speed, you’re gonna feel some relief. You might even decide it’s the cure. No, dude, it’s just the speed — fun at first, then just another addiction.
I couldn’t snort the shit like a benzo drug (Xanax, Valium, etc.) or a 1990s oxy (that just clogged me up), and I didn’t shoot it (I haven’t been there yet), but I popped those pills like Pez. Speed helps people with attention disorders by enabling them to focus and complete tasks. I could definitely focus, but it was usually on some inconsequential subject that seemed absolutely fascinating at the time. I’d sit in one spot all day reading about extinct clerical orders of the medieval church in Asia Minor, while listening to Mahler and constantly checking the windows. I kept a list of businesses running commercials on YouTube that didn’t give me the option of skipping after three seconds, vowing to never use their product or service — never! (I still have this list.)
So many things pissed me off this year, so many pressing thoughts and bright ideas crowded my head — mandatory drug testing for all political candidates! — and I desperately needed to get it all down on paper, to do these revelations justice. I stayed up night after night after night, writing pages, chapters, entire books that I’d inevitably destroy at the end of the trip, dismissing all that work as speed-driven crap. Other times, I just couldn’t decode the scribbles — after the first twenty or so pages, I stopped seeing the lines on the paper, and hell, who can wait for lines?! I eventually switched from longhand to typing on the laptop so I couldn’t rip up the results in disgust.
After switching to the 60mgs, I’d polish off a 30-day supply in two weeks. By the end, I was killing the scrip in four days. Amphetamine is not a “party drug” — not for me, anyway. Just the opposite, actually. The paranoia was always there once I’d passed the first sunset on speed, strong enough to keep me off the phone, off the bus to Portland, creeping around the apartment in silence like a tweaking crackhead, as though any noise could alert an invisible enemy to my presence, causing some confrontation I could never quite imagine the specifics of, but always feared.
Thankfully, I didn’t really need to leave my island. I could focus on anything, no matter how mundane, and the dumbest task became a mighty mission. Humans just got between me and the target of my obsession, and whenever that happened I would react angrily and often nastily, hurtfully.
I never did speed with anyone, never shared it or sold it. A good measure of the addictive nature of a substance is how freely it’s shared with friends, right? You might tell yourself that you don’t share your speed because that’s illegal or unethical, but really, brother man, you wouldn’t share your shit regardless. This ain’t weed, dude. I enjoyed the drug way too much to sell, trade, share, gift or even horde it. One of the reasons I told only a few trusted associates about the drug was the two types of responses I’d come to expect. The first response would be justified, horrified concern: You must stop! I wasn’t ready for that sort of pressure. The other response would be, Can I have one? I wasn’t ready for that pressure, either.
My old street partner Kosmo lost some teeth not long ago punking around with meth. When I finally quit, he wanted me to refill my scrip. He said people wouldn’t drive up to Freeport for marijuana, but would happily travel to wherever he was if he had some speed to sell. In Portland, pharmacological amphetamines are a lot more accessible than trailer-made meth, and usually sell for under $5 a capsule.
In the midst of the madness, my mind created a lesser demon named Mephit, whose greatest weapon against me was gravity. But wait, it gets better. I started giving human traits to inanimate objects. After several things fell off my rickety bookshelf, I gave the objects remaining on the shelves a loud, threatening lecture: The next mischievous fucking knickknack that decides to jump off will be thrown away — after being immediately destroyed!
This is the kind of shit you admit that scares the hell out of people. It will certainly result in fewer dinner-party invites, but so be it. It happened. Speed is one of those drugs that you really don’t get the picture of its effect on you until you find yourself pretending you’re not on it. It’s like being stoned around your mom or your boss, that sudden panicked awareness — Holy shit, I’m fucked up!
After the ride came the crash, a period of withdrawal painted with strokes of paranoia, depression, agoraphobia and other assorted terrors that lasted a week, sometimes two. The ever-widening space between speed trips consisted of cloudy hours and blurry visions. I remember Busby showing up one day in a fog, like Billy Zane visiting Zoolander in the wastes of New Jersey in Zoolander 2. We talked about a bunch of articles I’m only now beginning to write.
The ups and downs were becoming intolerable. Then, last January, I’d just started my New Year’s speed ride when I got a message that Kosmo had overdosed, had crossed over. (Turns out he hadn’t died, he’d been incarcerated, which likely saved his life; I’ll tell that tale another time.) The news made me acutely aware of my own mortality — the acuteness only a handful of speed pills can produce. As my own heart pounded away in a cloud of cigarette smoke, overworked, overtired, undernourished, it occurred to me that this drug I was abusing could stop my machine just as easily as Kosmo’s allegedly had.
I knew I had to quit. It just took awhile. My initial plan was to call my shrink and, without divulging any deep details, simply cancel the prescription again. Then I decided it would be better if I saw her in person. But, damn — the dilemma of the labeled — if I’m honest with her about abusing the V, I’ll get “red-flagged” as a junkie and I’ll never get anything but Vistaril and designer placebos for the worried well. Never anything fun or interesting again.
By the time I’d considered and reconsidered all this, it was time for a refill. Fuck it! I figured. One more time!
This turned into six more times. It was last July when I got my last refill. I’ve always hated the power dynamic between dealers and clients, and had become resentful of the need to get more drugs to abuse. Twice the scrip wasn’t refilled on time, and once it was delayed for an entire week! (My prescriber had billed the wrong insurance.) Good thing I hadn’t been taking the shit as prescribed, right? If I’d been taking one pill a day for a year and then my supply was interrupted for a week, I’d have been crumpled into a ball.
The invisible epidemic
When I started researching this subject a few months ago, I found a lot of articles online about over-prescription — of opiates. Nothing on speed. Searches for “amphetamine abuse” usually led to sites that were actually promoting ADHD meds, support sites for people diagnosed with ADHD or for the parents of children on speed.
When I started tossing out e-mails and messages to providers in Maine, the response was minimal. These are the same people who’ll talk your ear off if you want the skinny on opiate abuse, but they didn’t have a word to say about amphetamines.
Peter Wohl — Zen master, registered Maine guide, and longtime addiction and mental-health counselor — got back to me. “It’s so easy to get Rx happy meds,” he wrote. “That may be the largest, but unseen epidemic in the state. Very few people are minding the store. Speed, benzodiazepines and of course medical marijuana, all the major food groups. Add a little suboxone and you can be in pharmaceutical nirvana. There are a bunch of docs who are also giving out suboxone without any testing, counts, etc. Probably at least 9 out of 10 don’t do counts, especially primary care offices.”
Jenn Wurfel, an alcohol and drug counselor in Portland, had a very different take. “With my client load I have had over almost 9 years now, I have yet to meet someone who says they are here because they were given meds for their ADD/ADHD,” she wrote. “I actually tend to see the opposite, ones who say they were never diagnosed or they were never treated when they were kids and so they couldn’t focus in school and goofed off, gave up.
“I have just been intrigued by how many clients I have had over the years that almost say lack of treatment for their ADD/ADHD probably led to them going down the wrong road,” she continued. “I have not had anyone who said they felt their ADHD medication started their addiction off. I find this actually very interesting. But then again I think most say, due to them not addressing their mental health, whether it be anxiety, depression, etc., that lead them to seek a way to self-medicate.”
Toward the end of my speed year, it occurred to me that if I couldn’t unfuck myself chemically, I’d go back to talk therapy. Luckily, my prescriber had a therapist she shared an office with. I saw her only once, maybe twice. She turned out to be a social worker with a background in Narcotics Anonymous, with no knowledge of a basic approach like “Seeking Safety,” a treatment method for people like me with co-occurring PTSD and substance-abuse disorders.
Don’t get me wrong: this therapist seemed caring and was very professional. If we’d met up many traumas ago, we might have developed a constructive relationship. But at this point, it wasn’t worth the trauma of the bus ride.
So it was back to the benzos. My prescriber had me on Ativan for a while last year, but that was a pretty bad experiment, too. I think I ended up requesting that be discontinued, as well, but when I tried to get more Ativan a few months later, she told me the benzo-prescribing process had become a pain in the ass. Instead I got Wellbutrin, Abilify, Venlafaxine, Trazodone, Prazosin and a bunch of other stuff that didn’t work, yet never stopped coming.
Now I have this huge bag of pills that I’m dumping off at the Freeport cop shop on Monday. Or, if not this Monday, then the Monday after. I swear.