‘How’s Amanda?’ A story of truth, lies and an American addiction
“What are you even saying?” Libby said, and so Amanda began unwinding the lies she had been telling her mother for the past week. That day she jumped out of the car in Southwest Detroit and then disappeared for 12 minutes? She had been trying to find Sammy, but she had also been trying to buy heroin, and she hadn’t been able to find any. The appointment five days earlier that had been postponed at the last minute because of insurance? She had actually canceled it and then made a series of fake phone calls to confuse her mother. That night earlier in the week when she said she was going to sleep over with her twins? She had stayed with them for a while, played with them and taken them to a movie, but then she had found a babysitter and gone to a motel with a friend, where she had gotten high on $50 worth of methadone, a long-acting opiate that was still running through her body now.
It would be at least two weeks before the methadone was out of her system and she could pass a drug test. In two weeks, Amanda said, “I’ll probably be using and back out on the street.”
Libby started to shake her head and bite her nails, cursing under her breath. “It’s always the same with you, isn’t it?” she said.
“I need the shot now or I’ll never do it,” Amanda said. “I can deal with the sudden withdrawal.”
“I can’t believe you’re even asking me to do this,” Libby said, but she had already decided that she would help Amanda, even if it required going to extremes. Withdrawal might send Amanda to the emergency room, but it was still safer than going back on heroin.
Libby went into the bathroom and came out carrying a small bottle, and they drove together to a clinic wedged between a liquor store and a pharmacy near the Detroit River. Amanda checked in at the main desk and then waited outside the front door, smoking a cigarette until a nurse came out to get her. “There are a few things we need to go over first,” the nurse said, leading her back to a small exam room.
She explained that the shot was an opiate antagonist. She explained that if Amanda still had drugs in her body the shot would cause an immediate and severe reaction: muscle spasms, cold sweats, abdominal cramps, vomiting, diarrhea, fever, impaired breathing.
“When did you last have opiates in your system?” the nurse asked.
“I’m not really sure,” Amanda said, looking down, picking at her nail beds.
“Has it been over 14 days?”
“I think so.”
“No heroin? No Suboxone or methadone?”
Amanda looked across the room at Libby, who stared back at her and nodded. Amanda sat for a minute and thought about telling the truth. Her appointment would be rescheduled. No shot. No muscle spasms or impaired breathing. She would be outside in a few minutes smoking a cigarette, and she could catch a ride to Southwest Detroit and be high within an hour.
“Yes. I’m clean,” Amanda said finally. “It’s probably been, like, 20 days.”
“We’ll need to do a drug test,” the nurse said, handing her a small cup for a urine sample. She said the test was mostly for record keeping.
“Right now?” Amanda said. “I don’t really have to go.”
“That’s fine. You can do it after the shot,” the nurse said.
The nurse left and returned with a long needle. “I’m not ready. I’m not ready,” Amanda said, and then she said to just do it and closed her eyes. The shot was over in 10 seconds. She thanked the nurse, went into the bathroom to leave Libby’s urine sample and then hurried outside. She lit a cigarette. She took a deep breath and wiggled her toes and squeezed her arms and rolled her neck and decided she felt . . . fine. “I think I’m actually okay,” she told Libby.
“You’re great. You’re clean,” Libby said. She looked at Amanda with relief and then reached over to squeeze her shoulders. “Twenty-eight days without having to worry about this nightmare.”
“I can’t believe I actually did it,” Amanda said.
“Pretty damn brave,” Libby said, but now as she looked at her daughter she saw that her face was turning pale and there was sweat on her forehead. Amanda’s right leg began to tremble. Her left leg jolted forward and she almost fell to the curb. She dropped her cigarette and crawled into the back seat of the car. “Take me to the emergency room,” she said, and Libby started driving.
By the time they arrived at the hospital 10 minutes later, Amanda was in full withdrawal because of the methadone that had still been in her system. She couldn’t stand, so Libby got her into a wheelchair. She couldn’t steady her hand to fill out the intake forms, so Libby helped do them for her.
“Heroin?” the receptionist asked, because the hospital had already seen 11 of those cases in the last 24 hours.
“Yes,” Libby said, and then added: “Recovering.”
“Okay. Have a seat and wait to be called,” the receptionist said. They sat in the waiting room for five minutes, then 10, then 30. “I need medicine,” Amanda began to moan. “Put me to sleep. Give me something.” She started to tremble and then convulse. Her arms swung wildly and collided hard against her legs. Her muscles cramped, and she slumped in the wheelchair and slid toward the floor. “Can I get some help over here?” Libby asked, but nobody answered. Amanda threw up in the bucket, in a trash can, and then all over the bathroom floor.
“How much longer until we get seen?” Libby asked, and finally after about half an hour a nurse came out to check on them.
“Sorry, ma’am,” she said. “We’ll get to you soon.”
“But there’s no one else here,” Libby said, gesturing around the empty waiting room.
“We have to go by priority,” the nurse said. “People who are having chest pain come before other things.”
“And this isn’t a priority?” Libby said, pointing to Amanda, who now was crying and saying that she needed a sedative, that she wanted to be knocked out. She had vomit caked in her hair and welts rising on her legs in the places where she’d been hitting herself.
“She’ll make it,” the nurse said, looking down at Amanda. “We see a lot of addicts in withdrawal.”
“She needs help,” Libby said, her voice rising. “It’s too much. Can’t you see that?”
The nurse walked away and then a few minutes later a doctor came out into the waiting room. He grabbed Amanda’s wheelchair and started rolling her back into triage. He told Amanda the hospital would take good care of her. He said she would be out of withdrawal and feeling better within three or four days. “Congratulations on Day One,” he said, but Amanda didn’t seem to hear him. Every nerve in her body was on fire. She was sick. She was clean. She was scared. She was feeling all of it now, so many sensations rushing in at once. “Please,” she said, reaching up for the doctor’s arm, tugging at it. “Make me feel nothing.”
