Death Grip (19 page)

Luisa and I duck into a department store and buy Chupa Chups lollipops. We take the suckers to a park bench and something—either the pacifier effect or the sugar—brings me down. For a moment. Then the menace returns: As we walk, I can feel it radiate from each sweat-glossed brick in Ljubljana's medieval labyrinth. We drive south that evening toward another climbing area in the Jovian Alps. We stop at a village café for cappuccino. Inside, the locals have flowing beards, long teeth, and names like Drago. They eyeball us, say something about “
due Italiani
,” and I think that they want to kill me and rape Luisa. I go to the bathroom and splash water on my face. I'm completely out there, fucked up and paranoid.

I'm not sure why the Valium withdrawal has returned, and so fiercely. It just has. We had a little fun the first week at Misja Pec: Luisa “borrowed” a vial of liquid Tavor—Italian lorazepam—from her parents' medicine cabinet and we'd sip it at night in the van. If I'd been thinking, I might have realized that even a few days taking lorazepam would zero out the withdrawal clock. But I am a pillhead—I probably wouldn't have cared. You should know that about me: For years and years, if I saw something in your medicine cabinet and knew it would get me off, I'd “borrow” it. If I saw the droopy-eye icon, any prescription ending in -pam or -cet or -din or -done, if I saw that admonishment not to mix the medicine with alcohol, to drive, or operate heavy machinery, I would “borrow” a few pills or perhaps more if I thought my crime would go undetected. And if I knew you'd just broken a leg or an ankle but didn't really like those “pain pills that give me a bad stomachache,” I'd hound you for leftovers until you forked over the bottle. This is how pill junkies operate. Never mind that I usually had pills of my own: Yours were always better.

Thudd-idd-bupp.

H
ere's a surprising thing about
I
taly
: For all its Kafkaesque bureaucracy and old-world stodginess, they have lax pharmacies. The doctor issues a prescription and specifies the dosage, then you take that slip of paper to the pharmacist, he stamps it, fetches your pills, and then hands back the prescription. So, unless the doctor has specified, say, “No more than two refills,” you can take that same paper to as many different pharmacies as you like—unless and until the day a pharmacist takes a closer look and sees a telltale proliferation of stamps, and reclaims the scrip. At which point, of course, you just return to the doctor for a “refill.” Luisa's aunt is a general practitioner, and I mention one night when we visit their apartment that I'm having trouble sleeping. It's October; I've been in Italy since June.

“Prenditi questi,”
she says, handing me a prescription.
“Sono un po debole, pero ti aiutano ad adormentarti.”

Take these. They're a bit weak, but they will help you get to sleep.
I look down: Ativan, one milligram, box of twenty pills, refills not specified.
Bingo!
Because I have Slavic features—thick stubble and a hard Russian jaw—and because Torino is overrun with barely tolerated Eastern European immigrants, I send Luisa to the pharmacy for me. How many times? Three, four, five, six? At some point, they reclaim the prescription, but by then it's February and I've decided to leave anyway. I'm out of money, my entry visa is expiring, it's clear that my job is thanks mainly to Luigi's generosity, and I miss Colorado. I've spent the last two months holed up at Bagnolo, renting the studio apartment downstairs from Luisa's family's place. I'm living in a converted livestock-feeding area: a
mangatoia
. It's frigid up there, hard against the Alps, but kerosene for the heater is expensive. It's cheaper to buy jug wine, roll up in a blanket, and swill—and take Ativan. I'm ruddy-cheeked, depressed, and fat, and Luisa has taken to calling me
biscottino
(“little biscuit”) when she comes up to visit and sees me festering, sloshed in my bedroll. We have another black Spinone now, Magó, and I take him on runs past the eleventh-century castle up the road and on into the foothills, along winding tracks sheathed in frost and littered with fallen chestnuts. My legs are heavy, clumsy, slow; I wheeze with effort. Three days a week I drive to Torino in a beater Peugeot, arriving late after the best parking near the office is taken. I'll often park on a side street, a dirt strip without streetlights that's used come night by
i tossici
(junkies), by
le troie
and their johns. Dirty hypodermics and thousands of frozen condoms full of rotting jism crackle underfoot. There's no avoiding them.
Crunch-crunch-crunch
, I slog toward work. Everyone, apparently, has his vice.

Thudd-idd-bupp.

R
ifle,
C
olorado, spring 1997.
I
've
ended up on Colorado's Western Slope, house-sitting for a climber couple, two friends who've traveled to Australia. One has gifted me twenty Valium, leftovers from a trip to Thailand. The pills are gone in a week; I need melatonin to sleep. Luisa comes out for a month and we take a walk down to the Colorado River one afternoon, down by the “Dumpster Barbecue” rest area. I feel crazed, scared, nervous about being out and about in a town full of what I perceive to be predatory rednecks, even though the hoariest locals roaring by in jacked-up F-250s don't, I'm sure, spare us a second glance. I'm paranoid is what I am—benzo paranoid. In time it dissolves.

That July I climb my first consensus 5.14, a route that all climbers who have redpointed it consider to be inarguably of that grade. I've met my lifetime goal; all the starving and striving and training have paid off. It's a hundred-foot route called
Zulu
in a giant upside-down bowl named the Wicked Cave. The climb takes its name from two spectacular back-to-back “dynos,” or dynamic leaps, between volleyball-sized holes. You need to be as tall, strong, and dynamic as a Zulu to execute the moves, is the idea. I climb it on my fourth afternoon when a cold front comes through. On my second day of effort, I made it two-thirds of the way up but was too pumped—my forearms flush with blood and lactic acid—to stop and clip the bolts. And so I gunned it for thirty feet, sprinting from hold to hold hoping to reach a better stance. I wanted so badly to climb 5.14, I was willing to take that risk. Groaning with fear and exhaustion, my elbows chicken-winging skyward with imminent muscular failure, I finally fell, dropping sixty feet into the trees, snapping branches. So much force was generated that I burned the sheath of my rope as it zipped through the carabiners.

Nothing changed; being a “5.14 climber” changes nothing. I still feel exactly the same inside. I still want more. I'm not taking drugs and I enjoy being clean, but I
still want more.
Two days after
Zulu
I'm already sniffing around for the next project, the next redpoint campaign, the next big rating. When you set out to look over the horizon, you find only more horizon—it's no different with drugs, no different with rock climbing, no different with anything. If you don't immerse yourself in the process, you will never stop craving.

Then something happens: A tick bites me, perhaps at the organic tomato farm where I work, planting and tending to a one-acre field. I'm living hand to mouth, uninsured, dirtbagging, and so let days elapse, a week, until a rash covers my belly and the headaches are so fierce I can't peel myself off the floor. I lie facedown on an area rug by the TV, moaning, until my buddy Charley, out visiting, says, “Man, we need to get you to the doctor.” At the clinic they find a tick-borne malady and put me on Cipro, a strong floroquinolone antibiotic. It quickly kills the infection, though I'll suffer joint pain and hot aches for months. I'm back to climbing within days, but what I don't know is this: “Quinolone antibiotics … displace benzodiazepines from their binding sites and should not be taken by patients on, or recently on, benzodiazepines,”
1
as Dr. Ashton has written. And I have no idea, as per the collective benzo wisdom I'll find on one Web site later, that “Floroquinolones are probably the worst type of medication to be taken during withdrawal or recovery and should be avoided at all costs,” as they have a “very strong antagonistic effect” on GABA receptors and can cause adverse reactions.
2
I have unwittingly sabotaged myself.

The anxiety and the depression return with a vengeance. As autumn thickens into a marrowless, necrotic gel, I feel a black screen creep over my eyes, develop a nervous stomach, take to running the country lanes around Rifle to pound back the fear footfall by footfall. I mourn the separation of each leaf from the cottonwoods lining the roads: the absence of spirit as each yellow-brown folio shivers to earth, there to dissolve. I move back to Boulder to find work, look up my therapist Jack, and ask for a psychiatric referral. Just Paxil at first, ten milligrams to help with the depression—I tell this new doctor, “Dr. Porridge,” my Valium story and we both agree that benzos should be a last resort. I begin landscaping for a climber friend, a bon vivant with no “off” switch, like me. He's always holding, and after an eight-year hiatus I start to smoke cannabis again. Just a little at first, to help with aching muscles and job-site tedium: moving rocks, stacking them, unstacking them, restacking them, digging holes, filling holes back in. But I'm soon puffing with gusto when my old friend Ativan returns to dull the weed paranoia. I've talked it over with the psychiatrist, and we reach an agreement that since Ativan is a different benzo than Valium, and since I've never technically
abused
Ativan, it's worth a cautious try. Just twenty or thirty a month to help with anxiety. No big deal.

Have the doctor and I been totally honest with each other?
I can't answer, even now. We both know my history. On my end, I should have been open enough with myself (and him) not to request benzos, ever. I should have taken this opportunity and walked away from tranquilizers for good. When he agrees to prescribe them I do feel a little dirty, as if I've put him in a spot. Yet he, the medical professional, might have known better as well, and when I try to quit the pills eight years later I will wonder if his insistence that the benzos have stopped working because of comorbid substance abuse and that the mortal terror I feel as I taper is a rebounding panic disorder—and, later, a diagnosis of bipolar disorder—has more to do with him covering his ass than with any clinical certainty.

In June 1998, the twenty or thirty Ativan a month become sixty-two: two per day, every day. I take a single one-milligram pill in the morning, and the second at night: two white blips barely larger than pinheads, what the doctor calls “prophylactic treatment” or “benzodiazepine therapy.” The idea is that panic attacks are prevented before they can start. This is precisely how patients often find themselves trapped: A doctor prescribes “anxiety medicine” on a daily, long-term basis, until down-regulation and tolerance withdrawal set in. Then to offset the tolerance withdrawal, often misdiagnosed as a worsening of the underlying anxiety condition, the dose—and attendant problems, from worsening anxiety and depression, to “emotional anesthesia” or emotional blunting, to gastrointestinal issues, to bizarre neurological issues like tinnitus, parasthesia, and perceptual disturbances—begins to climb.
3
This is what happens to me: Despite my past history of Valium abuse, I will not horde or recreationally abuse the benzos I'm prescribed during this period. Just like a good patient, I will take them only as directed (with only a rare few exceptions—out climbing) like so many others who, despite no prior history of or concurrent substance abuse, find themselves hooked. Take a study group of fifty consecutive patients (ten men, forty women) referred to a National Health Service clinic Dr. Ashton oversaw from 1982 to 1994. Located in the Wolfson Unit of Clinical Pharmacology (part of the University of Newcastle upon Tyne) and run as part of the Royal Victoria Infirmary, Newcastle upon Tyne, Ashton's clinic was originally called the Clinical Pharmacology Clinic but later simply became the Benzodiazepine Clinic. More than three hundred “brave and long-suffering men and women,” as Ashton writes, passed through during those twelve years; most were outpatients, and about 90 percent successfully came off the pills while working with Dr. Ashton on tapering schedules that she and each patient had customized. The patients had been referred by their general practitioners, mostly upon requesting referral help with prescribed-benzodiazepine problems that they themselves had noticed. Dr. Ashton was the clinic's sole physician and worked with each individual on a week-by-week (and sometimes day-by-day) basis, with the aid of supporting nursing staff.

In Ashton's study group, all the subjects had been on benzodiazepine therapy for one to twenty-two years, none were drug or alcohol abusers, and all presented with symptoms so troubling that they wished to be rid of the pills. Their issues were not mere chimeras of hypochondriasis: While on benzos, ten had taken drug overdoses requiring hospitalization, yet only two of these had a history of depression prior to benzos; after several years, ten had developed “incapacitating” agoraphobia; nine had had exams for GI complaints ultimately chalked up to irritable bowel diverticulitis or hernia; three had been diagnosed with multiple sclerosis, a diagnosis not later confirmed; most complained of parathesiae in conjunction with panic attacks; and two had “constant severe burning pain” in their hands and feet.
4
Yet in general, after these patients freed themselves from tranquilizers, the symptoms abated over time—a clear indication of the source of their woes.
5

I'm neck deep within a month, though I must confess that benzodiazepine therapy rather suits me. My little orange bottle makes me feel special, simultaneously confers something that not everyone gets to have—a psychiatric diagnosis: anxiety—and a “cure” I happen to find chemically agreeable. Like each weekend's project rock climb or prospective alpine adventure, so, too, do I use the pills as enticements, as carrots-on-a-stick to get through the day. At work landscaping, I start each morning with Ativan and a “hippie speedball” (espresso and kind bud) with my boss, smoke all day in the work truck or at the rocks, come home, take my second Ativan and drink Malbec, and just keep that buzzed, glowy feeling burning like a well-stoked ember. I come by my addictions honestly—it's almost a family tradition. On my father's side, his older sister drank herself to death by her mid-sixties; she'd struggled with panic attacks, including periods of benzo addiction, all her life. On my mother's side, she'd had the eating disorder, her mother was an alcoholic, and my uncle died of a heroin overdose in his mid-thirties after years in and out of jail.