Living and Thriving Beyond Opioid Addiction
Ken Start is an optimistic, energetic husband, father and grandfather with a job and family he loves. It’s a life Ken’s fought for, but one he almost sacrificed to opioid addiction. For 15 years, Ken was addicted to prescription pain medication, an addiction that was finally broken with the help of Mayo Clinic’s Pain Rehabilitation Program and Addiction Services.
Not
long ago, Ken Start began a speech to a roomful of physicians by saying, “I
am your worst nightmare, the guy you do not want in your waiting room.”
Ken said the words jokingly, but behind the remark was a painful truth. For 15 years, Ken struggled against a crippling opioid addiction that developed after he received prescription pain relievers for spinal injuries from a car accident. Through the years, Ken lied to and manipulated his family, friends and physicians to feed his addiction.
But in 2004, Ken’s life changed course when he arrived at Mayo Clinic. Distraught and near suicidal, Ken’s trip to Mayo was a last-ditch effort to save himself and the life he’d built with his family. At Mayo Clinic, Ken met W. Michael Hooten, M.D., in Pain Medicine. “The morning Dr. Hooten walked in, that’s the day my life changed,” Ken said.
Change did not come easily for Ken, however, nor did it come quickly. But with Dr. Hooten’s support, Ken entered Mayo Clinic’s Pain Rehabilitation Center, where he was weaned off pain medication. Then in 2007, Ken returned to the program after relapsing. This time, pain rehabilitation was followed by treatment in Mayo Clinic’s Addiction Services Program.
Finishing
that program marked the start of a new chapter in Ken’s life — one defined by
sobriety, mindfulness, and a desire to shed light on an addiction epidemic
blind to age, race, color or wealth.
“Most
of the people I meet don’t know what I’ve been through,” says Ken, who’s
been sober for 12 years, speaks regularly about his journey and has written a
book about his experience. “I
don’t appear to be an addict. We are not out there living under bridges. We are
elders in the church. We are students. We are everywhere.”
Immediate addiction
Growing
up in a Dutch Reformed faith tradition in the small community of Fruitport in
Muskegon County, Michigan, Ken wasn’t exposed to drugs or alcohol. Even as a
young man, he rarely drank.
But
after just one dose of the opioid Vicodin, Ken was hooked. “Not only did I
love the pain relief from the Vicodin, I loved the feeling it gave me,”
Ken says. “I’d never felt like that before. Things went down so fast and
severely. By the following year, I was in my first rehab.”
Like
most of the drugs Ken took, the Vicodin prescription came legally from a
physician following a 1991 car accident that fractured Ken’s lumbar vertebra. The
relative ease and legality of getting prescriptions allowed Ken’s growing dependency
to increase unchecked.
“Before
I left my first orthopedic surgeon to go to the next guy, I’d started looking
up pills in books,” says Ken, who’d bought a prescription guide to find
stronger medications.
After
surgery to repair the damage from his accident, Ken began physical therapy. Although
the therapy was intended to help with his pain, Ken recognized that reporting
less pain equated to a decrease in medications, so he lied to receive stronger
drugs.
“I broke my parents’ heart. My wife, I broke her heart.”
Ken Start
By
fall 1992, Ken was in crisis. High on drugs all of the time, he was oblivious
to the damage he was causing his family. “They had no idea what to do. This
was back when opiates were supposed to be this miracle thing, and we didn’t see
them with as much danger as we do now,” Ken says. “I broke my parents’
heart. My wife, I broke her heart.”
After
one particularly hard night, which devolved into angry words and tears, his family
took Ken to a mental health facility hoping he could clean up. There would be
five more attempts at rehabilitation throughout the next 12 years before Ken
found his way to Mayo Clinic. “Mayo was the final and best miracle,”
Ken says.
Intense, multifaceted approach
At
Mayo Clinic, Dr. Hooten offered Ken a lifeline. “He was with me a very
long time,” Ken recalls. “He said, ‘If I can make the plan for you,
will you take it?’ Something hit me that day, and it was God’s grace.”
Ken’s clinicians in the Pain Rehabilitation Center quickly recognized the severity of his problem, Dr. Hooten says. “He clearly had an indication for pain management. But at the same time, he had an overlying opioid use disorder.”
Under normal circumstances, kicking an opioid habit is extremely difficult. For opioid addicts with chronic pain, quitting is even harder because when they stop using opioids, the drug’s pleasurable, mind-altering effects and the pain-relieving benefits go away. “It’s doubly difficult for individuals with chronic pain to stop using opioids,” Dr. Hooten says.
During
the three-week outpatient pain rehabilitation program, patients learn
behavior-based interventions, including exercise and occupational therapy. They
also become familiar with cognitive-behavioral interventions, which are mental
tactics to help manage pain, and related anxiety and depression. “Patients
learn how to develop nonpharmacological coping strategies, like distraction,
mindfulness and relaxation training, which is very important,” Dr. Hooten
says.
Patients
learn ways to eliminate pain behaviors, which are nonverbal cues, such as
grimacing, that convey pain or distress to others. While pain behaviors are
vital for survival, they can become a powerful way for those dealing with chronic
pain to influence how they are perceived and treated.
Ken
successfully weaned himself off drugs during the program. “I did exactly
what Dr. Hooten told me to do, and he got me through the first three weeks,”
Ken says. When he left the program, Ken says he felt terrible. But he was
clean.
Recovery after relapse
Back
at home, Ken stuck to Dr. Hooten’s recommendations and stayed sober. “Everything
was going pretty good,” says Ken, adding that once he was off drugs, his
pain decreased significantly. “With my doctor’s help here, I started going
to 12-step meetings. I started working full time. I was doing presentations and
had a good sobriety going.”
Then
two years later, during a wedding reception, Ken slipped on some ice and fell.
He broke the spinal
cord stimulator he’d had implanted years earlier. Surgery
to remove the device resulted in Ken acquiring a drug-resistant infection. Treating
the infection required another surgery, another hospitalization and the
reintroduction of opioids. “My mind went right back to it, right where I
was before. I fell hard,” Ken says.
Ken
went back to work, but he did so under the influence of pills, as well as
alcohol, which he stashed in his office. His boss took note and said he couldn’t
work there unless he cleaned up. Ken attended an evening rehabilitation program
close to home, but it failed. By summer 2007, Ken was in free fall, and he
reached out to Dr. Hooten. “I’m one of those students who didn’t catch on
fast enough,” Ken says.
Relapse,
says Dr. Hooten, is a common problem with addiction and recovery. “Of
course he relapsed,” Dr. Hooten says, reflecting on Ken’s situation.
“He was continuing to use and was using quite a bit of alcohol with the
opioids, which is very dangerous.”
“I bought into recovery, and I’ve been there ever since.”
Ken Start
Ken
returned to the Pain Rehabilitation Center and completed the program once more.
After he finished, he stayed at Mayo Clinic to continue his treatment in Addiction
Services. But maintaining sobriety was a challenge. One evening, Ken met up
with another patient, and they walked to a grocery store where they purchased
cans of aerosolized whipped cream and balloons. Soon Ken was high on the fumes.
“The
next day, Tom, my addiction counselor — what an angel he was — took me into the
hallway and said, ‘We really don’t think you’re taking this seriously, and if
you’re not going to buy into this, maybe you should exit the program and go
back home.’ And I said, ‘That’s fine. I’ll go back home.'”
It
turned out that wasn’t an option. Ken’s wife took a stand and told him that if
he wasn’t going to try, he couldn’t come home. So Ken stayed. He found a
sponsor. He began working the 12 steps of his program once more. “I bought
into recovery, and I’ve been there ever since,” Ken says.
Relationships strengthen sobriety
Although
the firm, yet compassionate care Ken received at Mayo Clinic was important, the
most important factor in Ken’s successful recovery, according to Dr. Hooten,
was the support of Ken’s wife, Sheryl. “If his wife would have left him — and
she had ample reason to do so — his world would have collapsed,” Dr.
Hooten says. “She is one of the heroes in his story.”
“The relationships I had with the staff made a huge difference.”
Ken Start
The
steadfastness of his wife was the lynchpin of Ken’s recovery, but the people he
met at Mayo Clinic also were instrumental to achieving sobriety. “The
relationships I had with the staff made a huge difference,” Ken says. “The
people I met — the nurses, the advanced-practice nurses, the social workers —
those people invested in me.”
Ken
continues to visit Dr. Hooten several times a year and, at Dr. Hooten’s
request, Ken has spoken to physician groups about his journey through addiction
and recovery. “I still have accountability to him. I want to be successful,
and I want to do well. And it helps to see his face,” Ken says.
While
Ken’s years of sobriety have helped heal the wounds caused by his addiction,
scars remain, he says. But knowing that he and his family survived the nightmare
fills him with gratitude. “I’ve been in enough rehabs and have lost a lot
of friends who have died to overdoses now,” Ken says. “I have so much
to be thankful for.”
HELPFUL LINKS
- Learn more about opioid use disorder.
- Read about the Pain Rehabilitation Center.
- Check out Addiction Services.
- Connect with others talking about addiction and recovery on Mayo Clinic Connect.
- Explore Mayo Clinic.
- Request an appointment.