The Addiction Connection

It was bad enough that Michelle had to pee in front of strangers in the Orange County jail cell. The Miami woman couldn't get ahold of the narcotic she had used daily for nearly fifteen years, and she suffered severe withdrawal symptoms. To rise out of bed without putting pressure on her throbbing lower back, she gripped with both hands the pipe that connected the top and bottom bunks, swung her legs around, and rested her feet on the cold concrete floor. The smell of disinfectant, deodorant, and dust that hung in the air nauseated her. Once standing, she trudged to the toilet, where she struggled with stiff fingers to unsnap her regulation blue uniform.

Turned out it didn't matter about peeing in front of strangers anyway. All the other women in the cellblock were asleep; the rows of bunks -- occupied by nearly identical lumps of human flesh covered by gray blankets -- gave the impression of being empty in the dim light. Michelle shivered. If only she could have rested for a while. Just shut her eyes for more than a few minutes.

That was in August 1996, her second jail stint. Thirteen years earlier the cops busted her when she was mainlining Dilaudid, a synthetic morphine compound. Back then, she explains now, her supplier had stolen a car, and she was charged as an accessory to grand theft. An Orange County judge later dismissed the charge after she had been in jail for 21 days.

Then in July 1996 Michelle and her husband were watching television at their North Dade home when Metro-Dade police officers knocked on the door. They informed her that they were arresting her on a fugitive warrant in connection with the 1983 accessory charge. The police weren't swayed by her arguments that the case had been tossed out. So she wound up back in jail, this time for two months, charged again as an accessory to grand theft.

But she refused to complain to the guards because she knew she had to seem tough. She just wanted out of that cell. Just wanted her drug. To warm herself, Michelle (she declines to use her full name for this article) placed her hands in her armpits and curled up on her stiff bunk, where she tried to nap. But sleep seldom came. "Withdrawal symptoms hit you heavy, like all the flu symptoms at the same time: backache, sweatin', freezin', diarrhea, throwing up -- all those," Michelle relates. "And no sleep, no sleep at all, hardly ever."

During the two months of mid-1996 that Michelle remained in that cell, she was wracked by bouts of insomnia, nausea, cramps, and cold sweats; they surged and abated in her body like rip tides. For 48-hour stretches she shook with uncontrollable seizures. Nightmares haunted her fitful sleep. "You think you are going to die," she recounts. "After three weeks you think it's over: 'I'm finally coming back to myself. I'm finally feeling normal.' But no, no. There's a second- and a third-stage detox. You're back. You're worse than you were at first."

A central Florida judge -- the same one who adjudicated the 1983 case -- finally determined that the fugitive warrant was a mistake and released her. Back on the outside she remained substance-free for about 40 days. Then, trembling with paranoia and anxiety, Michelle caved in to her desire for a drug many consider more addictive than opium, heroin, or morphine: methadone. "I was both coming off the drug and I was high-strung, nervous," Michelle recalls. "I had been used to being in jail with people watching you, saying, 'Do this, do that,' watching your most private functions. All of a sudden I had all this freedom. I was scared. Then there was the weakness of knowing what I would go through. Would I go back to using? Would I have seizures that would put me in the hospital?"

Her fears were understandable: Off and on for seventeen years, Michelle, now 35 years old, has been tethered to her regular dose of methadone, a legal, synthetic opium-based medication that two New York City physicians in the Sixties discovered could help wean addicts from heroin. But long-term addiction to opiates alters the brain's structure and creates a physical dependency that methadone neither cures nor curbs. It merely satisfies an opiate user's craving for about 24 hours, forcing him or her to re-dose -- often at a for-profit methadone clinic -- almost daily. Such a treatment regimen, known as methadone maintenance, can last a lifetime for some former heroin addicts.

These days when Michelle wakes up, her forehead beads with sweat and her hands turn cold as if she's undergoing withdrawal. Still, when she gazes in the mirror she can't help thinking how much she's improved in the five years since she stopped using Dilaudid, morphine, heroin, cocaine, and other addictive drugs.