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"A Vacation From Life" Paul started using alcohol in his teens to deal with his feelings of failure, he says. He came from a high-achieving family and was constantly anxious about failure. "In high school and until college, I never had to work very hard at anything," he says. "That thought made me feel worse. . . . I almost needed to produce failure." Paul was a casual-to-moderate alcohol drinker in college; then, in graduate school, he was introduced to other drugs, including heroin and cocaine. Paul says he was drawn to the drugs because they gave him "a small vacation from life." He had taken opiates before, after dental surgery, and he remembered how good they made him feel. When he injected heroin, he says, "I felt an inner peace like I had arrived at home and found what I was looking for all my life." Heroin, he adds, didn't make him sleepy but instead made him "calm and clearer thinking." The euphoria made him want more. "I never thought I would become addicted, despite the fact that I was injecting it," he says. "I was able to maintain a fairly normal life." But the pressures of life fueled his drug use. When Paul was preparing to apply to medical school, he found out his mother was dying of breast cancer. She wanted Paul to come home to Ohio so she could spend more time with him before she died. Paul applied to medical school near home and got in. He thought going home would put an end to his drug-using since he was leaving behind the friends he did drugs with in Oregon. But he was mistaken.
Getting Hooked Paul considered his foray into heroin and cocaine "a fling." Unfortunately the relationship grew to be more like an abusive marriage. In attempting to cope with medical school and the pain of watching his mother die, Paul started drinking more and turning to drugs. His mother had a lot of pain killers around, and he would steal her morphine occasionally. "Clearly my using wasn't like it used to be," he says. "It was no longer experimental. In retrospect that was when I started getting more addicted." In medical school Paul's focus on his drug habit became more intense. "When I finished a test, I would think about drinking or snorting cocaine." Thoughts about how to procure the drug became a constant, he says. "I didn't know how to get out. I was so hopelessly trapped." After Paul's mother died, he started working in a laboratory at the medical school where he had access to pharmaceutical cocaine. Occasionally, he would inject the drug for a more intense effect. In the later instances, he sometimes became paranoid and near-psychotic. Because he binged periodically but didn't use the drug all the time, however, he was still able to attend classes and appear to be coping with the pressures of medical school. After finishing medical school, Paul returned to Oregon to begin his residency. Paul looked forward to going back to the community of friends he had left behind with whom he had first started using heavy drugs. "Part of my distortion was that I thought these people were my family," he says. "They looked after each other."
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