First call goes unanswered and the initial feeling of panic sets in. Did he go away for a couple of days without telling me? Did he change his number? Is he done selling for good this time?

Second call with the same dismal outcome, and the nausea, cold sweat, and body aches take full effect. Third call. He answers, and it’s an endless car ride to the meet-up. I exchange cash for a bundle of 10 neatly packed tiny envelopes, and the blissful ride home takes mere seconds.

Shut the door, dim the lights, put on a 1970s rock ballad, roll up a dollar bill, and we have liftoff.

An immediate rush of excitement tingles beneath my skin as my cravings leave me, like water slipping off a perspiring glass. It’s a high incomparable to any substance I’ve ever experienced. The bitter taste in the back of my throat is well worth the warmth starting in my chest, spreading to every extremity. Any thoughts I had prior to liftoff, good or bad, have dissipated. Before long, that neatly packed bundle of 10 tiny envelopes is no more. Panic sets back in. First call goes unanswered.

Let me start off by saying my relationship with addiction is not the result of a solitary event, a lack of willpower, or a complete loss of moral values. Drug/alcohol addiction is a very complex disease, and I mean disease in a very literal sense of the word. It comes with physical as well as psychological symptoms, both of which lead to the relapsing nature of the disorder. Unfortunately, there is no cure for this disease, and the only treatment is a lifetime adherence to sobriety.

The Early Years

Like many addicts, my struggle with drugs and alcohol started well before I picked up my first drink or smoked my first joint. Sports and music, for a while, were my constructive escape routes when faced with loneliness, anger, feelings of inadequacy, or any problem. But they could only suffice for so long.

My first real drug was trouble. In a house with five siblings and a single mother doing her best to hold it all together, I found trouble was an easy fix to come by. As I got older, I began perusing other avenues to find my daily dose of trouble, which ultimately led me to my first run-in with drugs and alcohol at age 14. Although rambunctious as a kid, I was also highly introverted and often withdrew myself from social situations. When I discovered alcohol, I thought I had found my solution to becoming more personable and a new way to dull my emotions. But like sports and music, it provided only temporary relief.

Perhaps the most common misconception regarding addiction is the amount of time it can take someone to become an addict. Movies and TV will tell you it happens right after the first “hit,” but addiction, like any disease, is a matter of progression. The chemicals found in most drugs travel through the brain’s communication system disrupting the way nerve cells send, receive, and process information. To cause this disruption, drugs either imitate neurotransmitters or overstimulate the brain’s “reward circuit,” where dopamine is released.

As a person’s tendency to abuse drugs progresses, the brain reacts to this constant surge of dopamine spikes by producing less of it. When natural dopamine levels begin to plummet, so does the ability to enjoy a drug’s “high.” To regain the normal dopamine function, users need a larger amount of the drug to achieve the same effect. We have reached tolerance.

While I was able to chalk my first encounters with other drugs — marijuana, painkillers, Xanax, cocaine — up to “experiments,” over time this curiosity led to frequent use. By the time I reached my freshman year of college, some of my older friends introduced me to a tiny blue opioid analgesic called oxycodone. What started off as a few pills every couple of days soon spiraled into full-blown addiction. Now, I wouldn’t say I was completely naïve to the effects of drug dependence, but I was in no way prepared for what came next.

Tiny blue pills that consumed every day of my life. Flickr

Around three months into my everyday use of oxycodone, I woke up fresh out of my drug of choice and immediately knew something was wrong. Getting out of bed was next to impossible; nausea was in full effect, my body ached all over, and I went from hot to cold every few minutes. Ironically enough, the only remedy for my symptoms was what started them. So for the next couple of years, incessant thoughts revolved around spending my time, money, and resources on a drug that was causing my health to rapidly decline. That all changed two years ago, but not for the better.

The Transition To Dope

It seems almost comical now to think about my next brilliant decision in the downward spiral that had become my life. While dealing with a particularly nasty set of withdrawal symptoms, I was confronted by a drug dealer with no oxycodone, but something else. At $10 a bag compared to $30 a pill, in addition to being the only option for getting myself out of this current slump, heroin seemed like the only logical decision, right? Compared to alcohol, marijuana, or even oxycodone, this next stage in my addiction, right after college graduation, progressed quicker and became more demanding than anything I was prepared to handle.

Upon entering the brain, heroin is rapidly converted to morphine before binding to the molecules of opioid receptors, located in areas of the brain and body responsible for the perception of pain and reward. These same opioid receptors are also found in the brain stem, which controls blood pressure, arousal, respiration, and other automatic processes critical for life. Insert the reason for my overdose here.

Thankfully, not all drug overdoses are fatal. Those few hours of my life have been erased from my memory, but I do remember thinking I had done too much. The next thing I knew I was face down on my bathroom floor surrounded by blood and vomit. It’s a miracle I survived, considering I was alone. Of course, that didn’t stop me from meeting up with my dealer later in the day.

Pretty soon I found myself with a severely fragile respiratory system, a dependence that required my new drug of choice at all hours of the day, and withdrawal symptoms more intense than anything I had ever experienced — not to mention my clever financial decision to switch to a less expensive drug had backfired, considering I had to buy a lot more heroin to achieve the rush I needed.

The thought of quitting or going “cold turkey” had crossed my mind more than once, but the need to chase the initial high surpassed any rational thought I may have had. After countless nights falling asleep hoping I would wake up the next morning, a knack for “nodding off” while performing important tasks, and feeling prisoner to a drug that simultaneously tried to kill me, I decided to finally get help.

28 Days

Following repeated attempts at “white knuckle” sobriety, I knew the type of help I needed was not one I could provide myself. So thanks to a more than understanding employer and a family who would rather not see someone they love slowly kill himself, my next stop was a rehabilitation facility in sunny Florida. Admittedly, I had no preconceived notion of what awaited me in rehab, but due to nausea, vomiting, muscles aches, lack of sleep, and all of my other favorite withdrawal symptoms, I was pretty much up for anything.

I spent my first week in rehab on a Suboxone Taper to treat the withdrawal symptoms caused by opiate addiction. There is an ongoing debate in the addiction community surrounding the use of Suboxone and other drugs used to treat dependence. While I do agree these drugs can cause their own form of dependence, when you’re in the full swing of withdrawal you’ll do anything to pull yourself out.

Picture suffering from an unrelenting runny nose that eventually turns into a head cold. Before long, nausea and vomiting require a bucket by your side at all times. Don’t plan on getting comfortable because muscle aches, restlessness, and going from scorching hot to blistering cold every couple of minutes makes sitting still next to impossible. Also don’t plan on “sleeping it off” because even a minute of shut-eye is out the window.

I spent my next three weeks in rehab trying to convince everyone I had beaten my addiction and would never look back. At the time, I had no way of knowing this was only my disease trying to pull me back in. Heroin had consumed my brain to such a degree that even after detox it still held some real estate up there. This effect was only heightened by the overwhelming flood of emotions that came roaring back after 10 years of being suppressed by drugs and alcohol. The next few months involved the second stage of addiction recovery: Post Acute Withdrawal (PAW).

One of the hallmarks of PAW is the transition from physical symptoms to more emotional and psychological symptoms. To sum it all up, even after leaving rehab I was plagued by constant mood swings, anxiety, lack of energy, irritability, and trouble sleeping, which is accompanied by vivid “drug dreams.” Here’s where private counseling sessions, Alcoholics Anonymous, or similar programs come into play.

By taking a step back and seeing my addiction from a different point of view, I learned that drugs and alcohol were never my problem but my solution. It was time to find a different solution and one that would last longer than that initial rush I got from heroin or any other drug. That would involve something I had dreaded my entire life: vocalizing my feelings and emotions.

Justin Caba
Justin during a speaking engagement at The Center for Living in New York City. Justin Caba

There is a lot of misunderstanding about what goes on in an Alcoholics Anonymous meeting. As I said before, there is no cure for addiction. The necessary help offered by an AA meeting is the platform to hear stories you can relate to and share your own Experience, Strength, and Hope. AA is not about solving your need to abuse drugs and alcohol. Again, there is no cure. AA is a blueprint for how to live a life that does not require the use of drugs and alcohol.

I have no doubt that I will wrestle with my need to abstain from drugs and alcohol even on my best days, and the only way to keep my skepticism at bay is by sharing the feelings and emotions that fueled my addiction in the first place. That’s one of my reasons for writing this piece: purging my emotions on paper. Another reason has to do with breaking down the stigma associated with addiction, a stigma that I feared would define me for the rest of my life even before I got sober. The final reason is connected to the 12th and final step of AA:

"Having had a spiritual awakening as the result of these Steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs."

For anyone else struggling with addiction, I can assure you there is help out there. I cannot promise it will be easy, but I can promise it will be easier than trying to keep up with a way of life that will eventually destroy you and everything you love.

Today I have been without drugs and alcohol for nine months, and “today” cannot be stressed enough. There's really no one thing to keep me from going back. If I were to rely on a loved one and something happened to them, then my sobriety could fall apart. It's up to me to hold it together and not look too far ahead. Thinking about how I am going to stay sober for the rest of my life can be daunting, but staying sober just for today doesn’t seem so bad.