Pill Man

under his chin as he looks at the skeleton standing a few feet away from him. He has been sitting in silence for several seconds, almost pensively, his weary-looking eyes filling with tears. It is not a real skeleton he is looking at, but he believes it represents the real him. He has stripped down one of the Halloween creatures he created several years ago, a replica of Frankenstein's monster, and rebuilt it using empty prescription pill bottles. They still bear the labels describing what ended up going into Huntley's body for 15 years: Percocet, Oxycontin, methadone - literally hundreds upon hundreds of pills he started taking after an injury to his neck and shoulder left him in chronic pain. The head is a skull - and when the model is plugged in, and an iPod with a pre-recorded message attached, he will tell you his story. Huntley's story. Meet Pill Man. When you look at him, in many ways you are looking at Huntley, a 46-year-old father of two who only just recently stopped taking the drugs that were originally prescribed to save him from pain. Instead, he says, they robbed him of everything. He started out on 10 milligrams of Percocet a couple times a day. Fifteen years later, Huntley was consuming 120 milligrams of methadone a day and 90 milligrams of Oxycodone every four-six hours. To say the doses were high is an understatement. As one local health professional who has been working with Huntley puts it, he was living under "a cloud of opiates." Another physician says Huntley's mind was "hijacked" by opiates. "This is me, I am pill man," says Huntley, who during a roughly hour-and-a-half interview at his home rubs his legs frequently, massaging them and saying they are a source of constant pain. He stops often in mid-speech, forgetting what he was saying. When he talks, it is with a passion seemingly fueled by anger, frustration and of course pain. "Fifteen years. They're talking about how it's an epidemic now? Epidemic? Fifteen years I was taking those things. Fifteen years." Pill Man is one man's creation; some might call it a robot because of the automated voice feature, one person who saw it referred to it as a sculpture. Call it what you will, but Pill Man is very much a part of the therapy Huntley has been going through the past several months as he struggles to maintain a life free of the pills he consumed every single day for much of his adult life. As it turns out, they consumed him. He is off the pills now and working with a team of physicians at Hahnemann Family Health Center. He has built Pill Man and, ready or not, he wants the world to meet him, to learn what years of prescription medicine use did to him. He wants doctors to realize there are other methods of treating chronic pain besides simply filling out a prescription and showing their patients the door. On Aug. 26 he will shoot a movie with Dr. Alexander Blount, director of the Center for Integrated Primary Care with UMass Memorial Health Care and UMass Medical Center. Earlier this year, he told his story to about 15 UMass physicians and introduced them to Pill Man. According to Blount, the movie, a documentary of sorts, will feature an interview with Huntley, along with an area primary care physician. The result is intended to be a training video for physicians and a learning tool for people in general. "People were very impressed," Blount says of Pill Man and Huntley's story at the initial meeting. "His message that you can take control of your life is a powerful message. We will promote it as something people can access for the sake of learning about behavioral issues with pain and medical issues." A DESCENT INTO DEPENDENCY

Pill Man is the visual that drives home Huntley's story, one that started about 15 years ago on Salisbury Street. At the time, Huntley had his own business, Frank's Painting and Wallpapering. He also did work for the Key Program, a program for at-risk kids that started in 1974. He had a wife - "She was my heart, she really was" - and two kids, one of whom, his son, has cerebral palsy. Huntley also enjoyed putting on Halloween parties for the neighborhood kids. He had a talent for building life-like models of horror movie staples such as Pinhead, Hannibal Lecter, Jason, Michael Myers, Bride of Frankenstein, and of course Frankenstein's monster. His descent into an addiction to painkillers threatened to take away all of what he held most dear. It was, in large part, successful. "I was driving down Salisbury Street and my arm jumped out of its socket," Huntley recalls. He does not remember the exact date, only that it was the late '90s, around 1998. As a painter, he relied on his arms and upper body for work. Not unlike a pitcher in baseball, he had gotten years of use out of them. "I don't know what I hit, but my arm felt like it came right out of its socket. My arm just popped and never went back." The injury led to two major surgeries, one of which left a noticeable scar on the back of his neck. In one of the surgeries, doctors used a piece of his hip to replace what had been damaged in his neck. He still has a metal plate there also from the surgeries. His primary care physician at the time, whose name Huntley did not want to share, started him on Percocet. "My doctor called me one day. I was working and I was still hurt," Huntley says. "He says, 'Frank, I want to stop Percocet and start a new drug called Oxycontin, it just came out. Percocet is going to eat your liver. This is a time capsule and you only have to take a couple a day because it will last like 12 hours.' So that's how we started." As time went on, Huntley says, his body grew accustomed to the pills. As can often happen with medications, he was developing a tolerance for them. That led to more pills being prescribed. "At first, I was given a couple 20 milligram pills in the morning," Huntley says, "but then [my doctor] said we have to do a substitute because we don't want to give you too many Oxys. He says, 'Have you ever heard of methadone?' So then I was on Oxy in the morning and methadone at night." Methadone, used to treat he**in addiction, is typically administered only through highly regulated clinics, in order to preclude Methadone abuse and to track progress with patients for whom the anti-opiate craving drug has been prescribed. SOURCE: rehab-international.org



The medication did its part, easing the pain while he was on it. When the pain would come, however, it was bad. While it is unclear whether Huntley developed it, there is a condition known as Opioid-Induced hyperalgesia, a condition through which some people taking opioids develop an increased sensitivity to pain. In short, the pills can end up having the reverse effect of actually alleviating the pain. WHAT HE LOST

Married around 1990, Huntley ended up getting divorced. He blames it on the pills. He stopped working in 2004, his business gone, unable to work because of what he says became a reliance on the medication. The pills, he says, ravaged his mind and body. "This medicine made me tired, made me moody, made me sick, oh my God, sick," he says. "I wouldn't go to the bathroom for a week because of this medicine, and then I'd have to go after a week. Do you know what that's like? When I first started taking the medicine I couldn't take a p**s. I'd be in the bathroom for an hour and a half. This medicine has very serious side effects." Some adverse reactions to Oxycontin have included: gastrointestinal disorders, chills and fever, anorexia, twitching, abnormal dreams, anxiety, insomnia, rash, tinnitus, abnormal vision, dehydration, agitation, urinary retention, voice alteration and dry skin. SOURCE: odprevention.org



That led his doctor to prescribe different medications to deal with the side effects. “I wouldn't fuss about it because the medicine was helping me. It never takes all the pain away, but it helped." Huntley laments that when Oxycontin and similar drugs first hit the market they were initially aimed at cancer patients and those who were in chronic pain. "They ended up writing it for everything," he says of some doctors. "They'd write it for knee pain, for everything." While he thought at the time he was taking the medicine it was helping him, Huntley says he knows now that is not true. "The medicine's not helping people, it's really not," he says. "It's hurting people. I was 125 pounds when I came off this medicine. Now I'm 170." Huntley says he realized he was addicted only when he got divorced. He says he had tried to live as normal a life as possible. Last year, he helped out at the Factory of Terror in Worcester, a haunted attraction popular during Halloween. More often than not, however, he says he would lie in bed, unable to muster up any energy. "They suck your brain away," he says of opiates. "They suck everything away. I had everything. My company was going big. I had everything with my ex-wife. It was amazing. And it just went away. I was weak, I was in pain." Huntley, who admits to using and quitting co***ne many years ago, long before his injury and use of opiates, ended up moving in with his mother in Maine for a while after his divorce. Throughout the course of his use of opiates, Huntley would see different doctors, depending upon where he lived. He did not, he says, shop around from doctor to doctor, rather he went to a primary care physician where he lived. TURNING POINT

Things came to a head in 2012, when Huntley tried to go back to his old physician. He was told the doctor was no longer with that practice. The doctor's partner would not prescribe the same levels of medication to Huntley, instead telling him to visit the emergency room. Doctors there prescribed 10 pills, Huntley says, and sent him back to the doctor. "They say, 'what are you up here for' and I say, 'because I'm Jonesing. I need my medication.'" Huntley says, adding the doctor once again refused him. On Nov. 6, Huntley went to the Hahnemann, home to an integrated primary care clinic that marries service by medical providers with same-day access to behavioral health providers. According to Dr. Christine Runyan, a clinical health psychologist at Hahnemann, Huntley was assigned a primary care provider, Dr. Christine Currington. "She was astounded at the amount of medicine he was on and was unwilling to provide that dose," Runyan says of Currington. "She wanted to work on gradually cutting down at the dosage. At the time, [Huntley] was not supportive of that decision. [Currington] also wanted him to go through our Chronic Pain Management group." First, however, Currington took the drastic step of dramatically cutting back Huntley's medication. For health reasons, she, like the previous doctor's partner, refused to prescribe the high doses of medicine to which Huntley was now addicted. Instead, she wrote a prescription for 10 milligrams of methadone, twice a day. Not long after that, she reduced it to 5 milligrams. "It was an incredible shock to his system," Runyan acknowledges. "He immediately went in withdrawal. Being on that medicine, it can change your pain threshold and sensitivity. My guess is, at the time, his head was not clear. It was being hijacked by this medicine." Over a 10-year span, from 1992 to 2002, the number of people treated in Massachusetts for abuse of opioids other than he**in (such as Oxycontin) rose from 325 to 3,089 - a 950-percent increase. SOURCE: odprevention.org



MOVE TOWARD RECOVERY

Off the pills now for nearly eight months, Huntley says the pain is at times unbearable. He does not have a car, so when he goes somewhere he gets there either by the offer of a ride or on foot. If he walks, he says he must stop several times before reaching his destination because the pain gets so bad. "The pain," Huntley says as he sits in his apartment, "is really bad. So much pain. Just talking to you. It's in the legs more than anything." It is not unexpected, Runyan says, because the pills Huntley was on likely served as a mask. "I think his pain now is legitimate chronic pain," she says. "He's in more pain now because he's not on the medicine." Despite being cut off the pills (his last prescription was late last year), having the pain come back even worse and initially balking at alternative treatment, Huntley relented. The Chronic Pain Management program involves eight sessions, with participants working with behavioral health providers on using other strategies besides medication to deal with chronic pain. Runyan runs the group with Dr. Jeanna Stannring, a post-doctoral fellow at the Health Center. They stress relaxation and meditation techniques. Huntley, Runyan says, was not initially enthusiastic about the idea. "He was very angry about being taken off the medication," she says. "He was just angry." That anger began to dissipate. In its place came acceptance. Runyan, who also works individually with Huntley as his therapist, started seeing an obvious change in his behavior. "He really transitioned from someone who was angry at the system to his head clearing and being a strong proponent for wanting to educate the public and educate physicians that increasing the doses of these medicines often times is not good medicine," Runyan says. Huntley says he has benefited from the group. Where just several months ago he would pop a pill, now he uses other methods, such as visualization. For Huntley, that is easy. One instance involving his daughter sticks out in his mind from when he lived in Maine. He used to travel by bus to pick up his children and bring them there. Along the way, there was a farm with cows. It proved a strong lure to his daughter. "This one time, she said, 'Daddy, Daddy, can we see the cows?' So two hours later we're there and we see the cows," Huntley says. A smile starts creeping across his face. "We go up to the cows and she says, 'Daddy, Daddy look!' The cow stuck his tongue out about 12 inches and she screamed and ran back to me, and that made me laugh and laugh. So that's what I think about when I'm in pain. That works. I put my mind somewhere else. It's my kids that I live for." Huntley also did something else for himself he had not done before: he sought out a meeting with Narcotics Anonymous (NA), something that led to a rather serendipitous moment. "I had never been to an NA meeting my whole life," Huntley says. "For some reason I started looking for a meeting, because I do want to tell my story. I want people to understand this drug can help you or this drug can hurt you." He got the address to a church where one of the meetings was being held, and as he so often does, Huntley walked. He ended up in a familiar area. "It took me an hour and half to get there," he says. "I walked right by the church, looking for the address. It doesn't dawn on me right away that it was at the bottom of the hill on Salisbury Street where all this pain started 15 years ago. Fifteen years later I end up at an NA meeting at this church." BUILDING PILL MAN

For reasons he still does not quite know, Huntley also had started doing something else that would turn out to be both therapeutic and fiercely personal: He built Pill Man. "I don't know," he says when asked why and when he started collecting his empty pill bottles. "I never threw anything away. I hate throwing things away. I just started collecting them. I'd put them in a bag. People would come by, like my daughter, and say, 'What are you going to do with all of them?' I'd say, 'I don't know.' But I loved to decorate. Over the years, I did a lot of Halloween stuff. I would have Halloween parties for the kids." So he started putting together Pill Man - empty pill bottle by empty pill bottle. "I got the idea from the Halloween creatures," he says. Huntley ended up stripping down a Frankenstein's monster model and using the skeleton as a frame. "I wanted to finally really show how many pills went in [to his body]," he says. "This is me. This is me more than anything." Pill Man now stands as Huntley's way of demonstrating what happened to his body. He is not content simply having it stand inside his apartment. He wants to show it to anybody who cares - and to tell his story. Blount is helping him do that, having met Huntley when he gave his presentation to doctors this year. "His story ... was unusual in some ways, but not unusual in other ways," Blount says. "I felt like he had found something very important, that he was doing some very important work. He seemed so committed to getting his story out. We're just trying to roll it into something useful for physicians and people in pain." The intent is not to lecture doctors on what medicine to prescribe, Blount says, but to learn that medicine does not always have to be the first resort to dealing with pain. PRESCRIBING PROBLEM

The discussion with Blount about Huntley's ordeal leads to a question about the way his medicine was prescribed in the first place. He does not believe the physician harbored any ulterior motives. "It was clear the physician was trying to help him with his pain," Blount says. "He wasn't trying to build up his practice. He was sympathetic, and over time the physician prescribed medication up to levels that were really quite high." He would like other doctors to learn more about the over-prescribing of medication and its implications, even though he realizes it can be difficult as a physician to deny medication to a patient claiming to be suffering severe pain. "They haven't seen the patient who says, 'I'm glad they gave me less [medication],'" Blount says. "I'd like doctors to be able to see that. I would also like people to see that, just because the doctor gives it to you doesn't mean you may not want to exercise your own judgment." Dr. Dan Alford is leading efforts to help educate doctors on better ways to prescribe opiates. The director of the Safe and Competent Opioid Prescribing Education (SCOPE of Pain) program, as well as director of the Clinical Addiction Research and Education (CARE) Unit at Boston Medical Center, Alford just last month led a session at UMass Medical School's Albert Sherman Center aimed at helping doctors deal with patients on opiates and other opioid medications as well as suggesting other methods of treatment. "I think in the past, physicians were more willing to increase dosages," Alford says. "I think there's a real push to minimize the doses and re-evaluate whether opioid use should continue. The tricky point is to sort out who's benefiting, who's addicted and who isn't quite benefiting enough, or is being harmed a little bit." Huntley, it turns out, was one of those people being harmed. He does not, however, blame the doctor that started him on the path to addiction. "I tell people, 'How could I be mad at my doctor? Fifteen years he never put me a day in pain,'" Huntley says. "And then I look at the effects. Yeah, he knew I was addicted. He said I would die on this medication, but he just wanted to take care of my pain. And he did." A user abuses injectable opiates (in the majority of cases, he**in) an average of 14 years before the user admits himself or herself into a treatment program. SOURCE: rehab-international.org



'FIGHTING EVERY DAY'

Blame and dwelling on the past are not the agenda Huntley wants to move forward. He knows exactly what he wants to do now and says he is fighting every day to do it. "I would like to get my body back," he says. "I've seen people come back from broken backs. I've seen people come back from amazing things. I'm going to keep fighting. I'm going to keep getting up and if people want to hear my story, there's a lot more to go with that. There's so much more that I want to tell and it really needs to be heard, man. "This drug doesn't discriminate. It takes every color, every race, it takes everybody it gets hold of. If you're in pain and this helps, God bless you, but you've got to be careful. And if it gets hold of you and if you want [recovery], you will get it. You just have to have the power within, and I'm still trying to find it. I'm fighting every day." Written by Walter Bird
Appeared in Worcester Magazine
http://worcestermag.com/2014/07/17/pill-man-one-mans-fight-overcome-opiate-addiction/25284