Photography by Jeff Coulson Image by: Classic Shortbread<br />Photography by Jeff Coulson
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Photography by Jeff Coulson Image by: Classic Shortbread<br />Photography by Jeff Coulson
You might think becoming addicted to prescription drugs can't happen to you, but three women share their candid stories—and prove that it absolutely can.
Canada is the second-largest per capita consumer of prescription opioids in the world (only in the United States do people pop more pain-relief pills every year), and according to data from QuintilesIMS, a pharmaceutical services and information company, Canadian pharmacies filled 8 1/2 million prescriptions for prescription sleep aids in 2015—to the tune of $205 million.
It's no surprise, then, that the use of prescription drugs has become one of the biggest public-health issues in the country, especially considering the rise of fentanyl, a powerful opioid that has made headlines over its potential for abuse. In addition to opioids like fentanyl, benzodiazepines, which are used to treat anxiety and sleep disorders, and stimulants used to treat attention deficit hyperactivity disorder (ADHD) are the other most frequently abused prescription drugs in Canada—and addiction has become an increasingly common outcome. To shed some light on how easily it can happen, three women—Canadians with regular lives, jobs and families—candidly shared their stories.
Lisa van de Geyn's story
Insomnia affects about 40 percent of Canadians, so it's no wonder many of us are resorting to sleep aids to get some rest. Lisa van de Geyn reveals what happens when you become so dependent that you can't get to sleep without your "nightly vice."
Photography by Liisa Sefton
My relationship with prescription sleeping pills started the day I got out of the hospital after giving birth to my second daughter. Granted, the timing was strange—new mothers are supposed to be sleep-deprived and up at all hours with their wee ones. But not me. That first night home, and every night after, I slept like, well, a baby who sleeps through the night. I was guiltily knocking myself out, sometimes for 10 hours at a time (and with my psychiatrist's blessing), to dull the pain caused by lingering postpartum and prenatal depression and anxiety.
Without drugs, I'd lie awake doing what my psychiatrist calls "catastrophizing." I'd think about all the things that not only could go wrong but that, in my head, most certainly would go wrong: Peyton was going to die of SIDS. My husband, Peter, was going to be killed in a car accident on his way to work. I'd never feel happiness again.
As the time ticked by, I'd get so panicked about not sleeping that I'd spend more time berating myself for not being able to stop the incessant chatter and drift into dreamland.
The thing about depression and anxiety, though, is that a lack of sleep does not do a body (or mind) good. In fact, it exacerbates the already-raw symptoms. When I didn't sleep, I was miserable, easily aggravated and angry. My worrying was off the charts. But I simply wouldn't—couldn't—close my eyes without knowing I'd swallowed a pill and, soon, my sadness would break for the night.
I'm far from alone. In 2015, the Canadian Centre on Substance Abuse estimated that about 10 percent of the population needs the help of pills to get enough shut-eye.
Even though I slept, I never truly felt rested, so I'd spend my days exhausted; I didn't have energy for the kids or my husband, or to leave the house. Concentrating at work got increasingly harder. My self-esteem plummeted.
Then, about nine months ago, after more than 5 1/2 years of taking the benzodiazepines lorazepam and clonazepam, zopiclone (a nonbenzodiazepine sleep aid), quetiapine (an antipsychotic used off-label as a sleeping pill) and trazodone (a sedating antidepressant), I came across a magazine article about the long-term effects of chronic sleeping-pill use. When I saw the words "memory loss"and "dependency"(which I already knew I had) and read about the possibility of seizures and—the one that scared me the most—a shorter life span, I went cold turkey and ceased taking my nightly vice.
It was excruciating. I wish I could put my head to my pillow and magically start snoring, the way my lucky husband falls asleep each night. No, learning how to sleep again without my beloved pills took time and energy. I often felt nauseous, headachy and dizzy without them—it was like my body was in withdrawal. When I couldn't settle down, I'd watch TV or read, trying to tire myself out. By 3 or 4 in the morning, I'd finally succumb to sleep, but I'd wake a mere few hours later. Many a night, I'd lie awake for hours, tempted to reach into my nightstand drawer, but I had finally done the math, and the fear was enough to help me resist. In all those years, I'd rarely missed a pill. At one or two a night, I'd ingested a staggering 1,986 capsules, give or take.
I wish I could say I've now weaned off them fully, but no such luck. I still take a pill every week or two, when I have a particularly rough day or can't quiet my thoughts—but I'm cutting back. I pay more attention to good sleep hygiene, my bedroom's cooler and I read historical nonfiction instead of staring at Candy Crush. If nothing else, I can sometimes sleep without taking a pill a night. It's a start.
Michelle Gray's story
After Michelle Gray visited the emergency room for what felt like the world's worst stomachache, the doctor on duty put her on Percocet. She'd remain on opioids, steadily increasing her dosage, for years.
In November 2008, I started having horrific abdominal pain—so bad that I had to go to the emergency room, where the doctor on duty told me he saw something on my liver, but he wasn't sure what it was. So he said he was going to give me a prescription for Percocet, and the next day, I'd get a call about seeing a specialist in internal medicine at the hospital.
When I went to see the specialist, he ran a gamut of tests over the course of a few months. My mother was a nurse and thought it might be my gallbladder because I had pretty standard symptoms, so we figured the doctor would pick up on it soon. But he never did, and all that time, I was in pain and taking Percocet. Eventually, the specialist put me on oxycodone because he said Percocet was harsh and that I shouldn't be taking that much—I think I was on 12 a day.
This went on for three years, until 2011. I was sent for test after test, but I wasn't getting a lot of answers. At one point, the specialist thought it might have something to do with spinocerebellar ataxia, which is a hereditary disease I was diagnosed with in 2004; it's similar to multiple sclerosis and affects balance and speech. Pain isn't normally a symptom, but the specialist just didn't know what was causing it. It got to the point where the testing stopped and, instead, the strength of my prescription for oxycodone slowly rose. I'd see the doctor and he'd ask if I was experiencing pain, and I was, so he'd increase the dose. At my peak, I was taking 10 80-milligram pills a day, plus 10 20-milligram pills for breakthrough pain.
And I thought I was functioning quite well. I was doing everything I could. I was going to every appointment; I brought my husband, my mother-in-law, my mother. But I was on so much medication that I didn't feel anything. I was so numb. If I cut myself, I barely felt it. But I was still having abdominal pain, if you can believe it. Then, one night, I had so much pain I went back to the emergency room, where they discovered 23 gallstones jammed into the bile duct. (Apparently, they can be hidden and hard to detect, or they can move up and down. Yet, I can't help but think, Maybe if testing had continued, it might have been caught earlier.)
Within a week, my gallbladder was removed, and I didn't experience that abdominal pain ever again—but here I was on all of this oxycodone. I was addicted. My body had become so accustomed to it that I needed to take two 80-milligram pills just to get out of bed. It was no longer about solving pain, but it wasn't about getting high—it wasn't anything like that. It was functioning. Because once you have that much in your system, you can't manage without it
But I didn't want to be addicted. Right after my surgery, in June 2011, I made an appointment with the specialist to discuss getting off oxycodone; he said, "Let's book a followup appointment to discuss that."So we did. For October.
I couldn't wait that long, so I cancelled the appointment. My family doctor didn't have a lot of experience with addiction, so he referred me to Dr. Kenneth Lee, who put me on Suboxone, which is slowly replacing methadone as the drug to help wean people off opiates. It stabilizes the opioid receptors in your brain, so you don't experience withdrawal. Even if you took an opioid, it wouldn't work. You can lead a normal life again. But not long after I started taking it, I found out I was pregnant. I had to switch to Subutex because Suboxone had not been approved for use during pregnancy.
When I had a problem with my liver enzymes, the hospital wanted to take me off Subutex and put me back on narcotics to prolong the pregnancy. I was screaming and fighting over it; in the end, Dr. Lee had to come to the hospital and say, "No way."As soon as I gave birth, though, I was back on Suboxone. I'm still on it, and I might always be. Then, a couple of years ago, I was diagnosed with breast cancer. I had a seven- by seven-centimetre tumour in my left breast, and the cancer had spread to my lymph nodes. I had to have a mastectomy and reconstructive surgery. My first thought was, How am I going to get through this without being put on any drugs? I was on a pain pump when I came out of the operating room, and the hospital did give me a prescription for a narcotic, but between the Suboxone and ibuprofen, it turned out that I didn't need anything more. While I was in the hospital, I was offered stronger painkillers, though. Frequently. The nurses were like, "Really? You don't want anything? Are you sure?"There were a lot of confused looks. Sometimes, it can be difficult to explain why—there's still judgment, especially since you can't always get into how it happened.
I don't think anyone should be afraid of painkillers; there's nothing wrong with saying, "I'm in pain and I need something."But always pay attention to the red flags: how much you're on, when your dose increases, if you experience withdrawal. Do your research about your doctor, too; I didn't know my specialist was known for prescribing opiates. I was naive. But I think a lot of people are naive when it comes to painkillers.
Lori Sampson-Timmons' story
Degenerative disc disease caused Lori Sampson-Timmons so much pain that her doctor prescribed painkillers to help her get through the day. And he kept prescribing her painkillers well after the pain lessened.
I have a condition called degenerative disc disease, and after my daughter, Paige, was born in 2003, it started getting worse. Before I got pregnant, I only needed to take Tylenol 3. But after my maternity leave, when I went back to spending most of the day sitting at my desk job, the pain was terrible. I'd been going to the same physician for 40 years, so when he prescribed Endocet, I trusted him.
The drug worked for a little while, but within a few months, the pain wasn't really going away, even though I was taking more and more pills. That's when the doctor switched me to oxycodone. With oxycodone, your body almost becomes immune to the amount you're taking, so you've got to keep taking more. By that point, the back pain wasn't as bad as it used to be—but I still had to take the pills so I didn't start to go into withdrawal.
At the time, I think I knew I was addicted, but I pushed it to the back of my mind. I was just worrying about when I could have my next pill; I counted them all the time to make sure I had enough to get through the next day or two. But even if I didn't, my doctor was always on call for me.
Eventually, I realized that I didn't need oxycodone to get through the day; I needed it to get through the next hour. But it was my husband who really made me realize I had to get off oxycodone; he said I was like a stranger to my family.
So I went back to my doctor for help, and he put me on Ativan, which was supposed to help me get off oxycodone. He also put me on Ritalin. To this day, I'm not certain why—maybe he suspected ADHD? I now believe he shouldn't have done that, but I thought he had my best interests at heart. Then again, he did once ask me, if he wrote up the prescriptions, would I sell them on the street so we could split the money?
He ended up retiring, and when I found out he was leaving the clinic, I cried and cried and cried. I was so panicky. All I could think about was where I would get my pills. But that turned out to be the best thing that could have happened to me. I have a new physician now, Dr. Ponnampalam Sivananth. My husband chose him from a list of doctors who were accepting new patients. On my first visit, he looked at my medications and just shook his head, like, What's going on? We have to fix this. From the first day he met me, he took responsibility for my health—unlike my doctor of 40 years.
I had been able to transition from oxycodone to Ativan in a month. It was a terrible month, but only a month. It has taken me a year to get off Ativan and I'm now in recovery. But oxycodone has had the worst effect on my health; it took over my brain and my body—I don't remember much of that time. My husband will say something and I'll have to ask him what he's talking about: "When did that happen? Really, what year was that?" I get panic attacks now, and I'm suffering from depression and sleep deprivation. My psychiatrist says it can all be traced back to the oxycodone.
I was so ashamed about being addicted to oxycodone. I didn't want people to know. I don't think my husband even really knew the extent of how bad it was until I started coming off it. That's the worst thing about being addicted to anything, that it's such a taboo subject.
But it shouldn't be. If I could wear a sign that says "Don't take oxycodone," I would.
A dress from Elroy Apparel. Courtesy Leanne McElroy Image by: A dress from Elroy Apparel. Courtesy Leanne McElroy
The Sundew Hat is one of our all-time favourite easy knitting patterns for winter—a super easy pom-pom beanie that is sure to be worn again and again.
Quick to knit and extra-cozy, the Sundew Hat is the perfect cold-weather accessory. Whether you are looking to knit a thoughtful last-minute gift or your own quintessential hat, the Sundew Hat is a crowd-pleasing favourite with its classic design and soft texture. It looks great when worn slouchy, and just as cool with the brim rolled. We designed the hat in our luxurious Alpaca Wool yarn, which perfectly balances the softness of alpaca with the structure of wool. The yarn is a pleasure to knit with and the pattern is easy to follow – you will be so pleased with your results, you’ll want to make a Sundew Hat in every colour.
The Sundew Hat is a good beginner project as the thick stitches are easy to see and you will be able to wear your finished hat in no time. Because the stitches are chunky, it is easiest to follow the instructions and begin knitting the project with round needles and then switch to double pointed needles when required to complete the crown shaping. The hat is finished with an oversized pom pom. This special touch is easy to make – you can purchase a pom pom maker or create a pom pom the old-fashioned way using cardboard cutouts. Before attempting to make a pom pom, we find it helpful to watch online tutorials, which ensure that you achieve the right look on the first try. You also have the option of buying a pre-made pompom, or leaving the hat without any embellishments at all. Either way, you’ll have a beautiful hat that you’re sure to love!
- 2 Skeins of Americo Alpaca Wool (30% Superfine Alpaca / 70% Wool) 100g / 87 yards (80 m)
- 6.5 mm (US10.5) 16-inch (40 cm) circular needles and set of 6.5mm (US10.5) DPNs
- 1 stitch marker
- Yarn needle
Note about the yarn: Alpaca Wool is available through Americo Original online and in select yarn stores. You can substitute for other bulky/heavy worsted weight yarns like Americo’s Highland Simple Twist, Copito Medio, or any bulky/heavy worsted weight in your stash.
Finished size is 20-inch (50.8 cm) circumference by 11.5 inches (29 cm) long. Yarn has considerable stretch; one size will fit most head circumferences
13 stitches = 4 inches (10 cm) in stocking stitch using 6.5 mm (US 10.5) size needles or size needed to achieve gauge.
K, k: knit
P, p: purl
DPN(s): double pointed needle(s) - a needle with points at both ends; used in sets of 5
M or PM; //M//: stitch marker or place marker; denotes stitch marker dividing sections
Ribbed/rib/ribbing: a pattern stitch – has vertical columns of knit and purl stitches, side by side, with elastic properties. Examples: (K1, P1) aka 1 x 1 ribbing, (K2, P2) aka 2 x 2 ribbing etc.
St-st/stockinette /stocking stitch: a pattern stitch – in circular knitting – knit every round
k2t (slant to R): Knit 2 together (a decrease) - insert the needle into the front of the 2 knit stitches from left to right. Draw the yarn through to the front both stitches from the needle
Using 6.5 mm (US 10.5) 16” (40cm) size needles, and Alpaca Wool yarn, cast on 64 stitches, //PM//, and being careful not to twist your stitches, join in the round.
Round 1: (K1, p1), repeat to the end of the round.
Repeat this round for 4.5 inches (11.5 cm)
Change to stocking stitch (knit every round) until stocking stitch measures 4.5 inches (11.5 cm), and you have a total of 9 inches (22.8 cm) from the beginning of your work.
Note: When the stitches no longer fit comfortably around the circular needle, change to double pointed needles.
Round 1: (k6, k2t), to end of round. (56 stitches)
Round 2 and all even rounds: knit to end of round.
Round 3: (k5, k2t), to end of round. (48 stitches)
Round 5: (k4, k2t), to end of round. (40 stitches)
Round 7: (k3, k2t), to end of round. (32 stitches)
Round 9: (k2, k2t), to end of round. (24 stitches)
Round 11: (k1, k2t) to end of round (16 stitches)
Break yarn leaving an 8-inch tail. With yarn needle, thread through remaining stitches, tighten to close the top of the hat and secure inside the hat.
A pom pom maker can be easily made using cardboard and scissors. Instructions are readily available online. A commercial pom-pom maker can be purchased.
Weave in all loose ends.
Americo Original is a Canadian yarn company and online knitting shop with its own line of quality yarns, knitwear patterns and accessories. Americo’s yarns are made exclusively in the Andean highlands of South America, using only natural fibres, including luxurious wool, llama, alpaca, cotton, linen, silk and cashmere. Americo and its in-house design lab are based in Toronto, offering international shipping from its online store: americo.ca/shop.
We polled family doctors from across the country, and they laid down the law on eight things they wish we'd do—or stop doing.
According to our panel of general practitioners, Canadians aren't always doing what they should to make the most of doctor visits—and skipping out on these crucial tactics could lead to a delay in diagnosing serious conditions. Here's what our experts say you should add to your patient checklist.
1. Stop feeling shy
Many of us hesitate to talk to our physicians about sensitive issues (think substance abuse or sexual health—or even gender identity). But honesty and openness are important, both for fostering a good doctor-patient relationship and for ensuring that you get the best care, says Dr. Laura Pripstein, medical director of the Sherbourne Health Centre in Toronto and a staff physician on the family health team. That's why it's OK to try out a doc before committing. Dr. Pripstein recommends booking an initial visit to see if your potential doctor is a good fit. "You want to see if this person seems like someone you can talk to, someone you feel comfortable with," she says. And if you don't think your doctor understands or respects your concerns, don't be afraid to find someone new. "If you feel you can't ask questions that might be embarrassing, you don't have the right provider," says Dr. Pripstein.
2. Don't come to your appointments unprepared
Get the most out of your time—and your doc's—by arriving at your appointment with a clear plan for what you want to discuss, says Dr. David Ross, an associate professor of family medicine at the University of Alberta in Edmonton. "It's good to have patients think about their problems from when the issue began, then look at it chronologically to the present," says Dr. Ross. Making a prioritized point-form list in advance helps ensure that you don't forget anything or mix up the order of events, he says. Then, work with your doctor to address the most serious issues first.
3. Choose your family doc over the walk-in clinic whenever you can
Yes, a clinic is convenient, but what we gain in easy access, we lose in familiarity. "I think it's really valuable if people can connect with a family physician who they'll be able to see long term, rather than just looking for the quickest way to access care," says Dr. Maurianne Reade, a physician with the Manitoulin Central Family Health Team in Mindemoya and M'Chigeeng First Nation, Ont. A family doctor will know your medical history and will keep it in mind when suggesting treatment—so, for example, if you've recently taken several courses of antibiotics for a UTI, your physician will likely look for a different course of action if you come in with another infection. According to the most recent statistics, about 4.5 million Canadians don't have a regular family doctor. If that's you, contact your provincial College of Physicians and Surgeons, or check to see if your region has an online registry (Ontario has Health Care Connect, while Quebec launched a web-based family doctor finder last year). "It's important to know that we doctors are privileged to share in your stories and to help you through difficult times," says Dr. Reade.
4. Share what's happening in your life
There's a reason your doctor wants to know where you're working, if you're dating and how the kids are—and it's not just because she likes you. (Though she does, we're sure.) Physicians need a picture of their patients' lives beyond their specific health symptoms and conditions, especially when they're first getting to know you, says Dr. Stephen Wetmore, the family medicine chair at the Schulich School of Medicine & Dentistry at Western University in London, Ont. "Doctors need to know these things to understand how your lifestyle and habits may be influencing your health," he says. So when you're talking about your exercise habits, your health history and whether you smoke, drink or use drugs, mention your employment status, family obligations and intimate relationships, too, says Dr. Wetmore.
5. Be a better googler
Doctors know you do it (hello, late-night web searches), but they would prefer you to ask about good sources of information, rather than going rogue online. They also want you to be honest about your fears if you've read something particularly upsetting. Physicians can't address your concerns or point you in the right direction if they don't know what your fingertips have been up to. "The thing we want our patients to do is ask us for the most reliable Canadian websites to go to as resources," says Dr. Heather Waters, an assistant professor of family medicine at McMaster University in Hamilton.
6. Don't think your symptoms are "no big deal"
If you've noticed you are having more headaches than usual or are sleeping more or are eating less, you might not think to tell your doctor—but you should. There's no set of rules for determining which symptoms are worthy of investigation or discussion, says Dr. Wetmore, but make a note to mention anything that is new or has changed since your last appointment. "You should bring up things like sudden weight loss or fatigue that seems excessive," he says. "It could be a sign of a larger problem, or the cause of a developing problem." Evenif it doesn't end up being serious, seeing your doctor will help ease any anxiety you might be feeling, and that's worth the visit, too.
7. Talk about what you're taking
Tell your physician about any herbal medications and alternative treatments you take, says Dr. Mel Borins, a University of Toronto associate professor and author of A Doctor's Guide to Alternative Medicine: What Works, What Doesn't, and Why. It's important for patients to share what's working for them and for doctors to be open-minded about therapies outside their own practice or traditions, he says. This is also a concern when it comes to conventional meds, especially if you're pregnant; there are only 23 medications specifically approved for use during pregnancy— yes, out of every available drug—which can leave women feeling anxious about taking prescription or over-the-counter drugs when they're expecting, says Dr. Robyn MacQuarrie, an obstetrician-gynecologist in Bridgewater, N.S. But don't stop taking your meds as soon as your pregnancy test comes back positive. "It's really important to talk to your doctor instead of stopping cold turkey," says Dr. MacQuarrie. Physicians can help you determine the risks and benefits of using different drugs, and they can let you know when the effects of not taking a medication while pregnant may be worse than taking it— which is the case with some antidepressants.
8. Avoid diagnosing yourself
You know doctors don't like it when you come in prepared with a diagnosis you've made thanks to the aforementioned Dr. Google. But do you know why? It's not because they think you're encroaching on their territory! Rather, they worry that a serious medical problem might get missed or you'll cause yourself unnecessary anxiety over something not serious. That's because not everyone has the most common symptoms of a particular condition. Plus, men, women and different ethnicities can have varying symptoms for the same problem. For instance, Dr. Reade's community has a large proportion of people with diabetes, which can affect the warning signs of cardiac disease, a major killer in Canada. Instead of the usual pain or pressure on the left side of the chest or arm, men and women with diabetes may instead have spells of profuse sweating with weakness. And, of course, women who don't have diabetes can have differing symptoms, too; sometimes, a heart attack can feel like acid reflux or come with sudden nausea, vomiting and lightheadedness. So always tell your physician if your symptoms are surprising or strange—like a headache that feels different than usual, for example. And if you're worried about a specific diagnosis, be sure to bring that up, too.