“I’ve Got It Under Control” and 8 Other (Dubious) Reasons to Delay Opioid Addiction Treatment

We all drum up reasons to delay life’s hard tasks: Eh, it’s not that important. I’ll do it another time. There’s no hurry. 

It’s human nature to procrastinate. So, if you’re struggling with opioid addiction, it’s only natural you’d find reasons to put off treatment.

A doctor prescribed the pills, so it’s fine. I’ve got it under control — I still have a job! Treatment would be too miserable. I have a high tolerance, so I’ll be OK.

Does any of this sound familiar?

That’s okay! For folks with opioid use disorder (OUD), procrastinating and rationalizing are often first steps to recovery.

“People with OUD know deep down that something needs to change, but it’s a matter of finding the motivation and overcoming fears,” says Skyler Glatt, a social worker and Ideal Option’s director of community development.

Here’s a rundown of common reasons for putting off treatment — explanations that sound reasonable for a while, until a crisis or spark of insight makes the case for treatment more convincing than the case for avoiding it. 

1.     A doctor prescribed the pills, so it’s fine.

Nearly 80% of heroin users started out taking prescription pills, so the “doctor-approved” line of reasoning is quite common.

It’s the story Patricia, a 60-year-old grandmother in Maryland, told herself for a decade. Prescribed opioid pills after a car accident, Patricia continued to get refills after strenuous jobs left her with debilitating back pain.

“I thought, There’s nothing wrong with it because I’m going through a pain center. I’m getting the medication from a doctor. It’s all covered by insurance.”

But eventually, insurance stopped covering her pills, and when she couldn’t afford to buy more on the street, she turned to snorting heroin.

“My money was flying out the door,” recalls Patricia, now an Ideal Option patient. “I didn’t have money for anything else – groceries, gas, a pedicure.”

Only then did she come to terms with her addiction and seek treatment.

2.     I’ve got it under control. I still have my job and family.

“With opioid addiction you can appear normal for so long,” says Penny Bell, Director of Ideal Balance. “You don’t smell. You can be the best employee. Everyone loves you. You tell yourself: Look how well I’m doing.”

Emily was one of those stellar employees — until she wasn’t.

“I was a very functional drug addict,” recalls Emily, 37, who worked in medical billing. “I would tell myself, Oh, I don’t need help. It’s not that bad. I can still go to work.”

Even after she was fired for missing too much work, Emily stuck to her story, because she was able to land another good job, this time at a title company.

“I would just take enough pills so I wouldn’t throw up at work,” recalls Emily, who was addicted to fentanyl. “Then, on the way home, I’d stop at a gas station bathroom and snort the pills until my nose bled. I was a zombie but didn’t realize it.”

But she did realize she was making mistakes and missing deadlines at work, so she took a voluntary layoff to avoid getting fired.

At home she always had “some crazy excuse” to explain her disappearances and money shortages. “I’d tell my boyfriend, ‘I’m going to the store. I’m going to meet a girlfriend for coffee. I’m going to go get my oil changed. I bought something online and my account got hacked.’”

Overwhelmed by her lies, she finally confessed to her boyfriend and sought treatment at Ideal Option.

“One day I got the courage to tell him: ‘I’m spiraling out of control and running out of excuses.’ He was very understanding and said, ‘I wish you’d have told me sooner.’”

These days, Emily is genuinely a first-rate employee. She has become a certified nursing assistant and medical technician and took a job at a retirement community.

“It’s a total 180,” she says. “People tell me: ‘You’re a completely different person. Before, you were negative and withdrawn. Now you’re always smiling.’”

3.     If I stop using, I’ll lose all my friends.

It’s true: in recovery, you need to cut ties with anyone who uses, and that may leave you short on friends.

But consider: Are these people actually your friends?

When Emily first enrolled in Ideal Option, she returned to using within a month, largely because she stayed in touch with her old crowd. “They’d call and say, ‘Hey, I miss you. I’ve haven’t seen you in awhile. You should come out.’” 

But she soon realized she’d misjudged these “friends.”

“They don’t really care about you. They’re just your drug partners. I liked being popular, but really, they were just using me.”

Recovery affords you the chance to make new and better friends, whether it’s through self-help groups or hobbies.

When Ideal Option patients feel adrift without their old crowd, Penny Bell asks them: “Where do you think other people find friends? Where did you make friends in the past? What activities did you do before you were addicted? Why not do that again?”

Says Skyler: “There’s so much potential for finding positive, healthy friendships and relationships outside of using drugs.”

What’s more, cutting ties with drug-using “friends” may open the door to reconnecting with family.

“My family had totally cut me off while I was using,” says Nathan, 30, who lived on the streets for years and served half a dozen jail sentences. Once he enrolled in Ideal Option, he texted his parents and gradually rebuilt the relationship.

“They’re super proud of me,” says Nathan, who found a room in a sober-living house. “Now I just hang out with family members and a couple friends who don’t use.”

4.     I haven’t crossed the line. I haven’t put a needle in my arm.

During the years he used oxycodone, Joe, 34, often told himself: It’s only pills. I’m not shooting heroin.

“As long as I wasn’t shooting up,” he says, “I didn’t see anything wrong with it.”

Penny Bell hears this type of reasoning often. “People will say, ‘I’m not that far gone. I haven’t crossed that line. If I put a needle in my arm, then I’ll know I have a problem.’”

But then they move goal posts. “When they cross their own boundaries, they’ll say, ‘Well, shooting heroin is cheaper than going to the doctor for pills and dealing with all the co-pays.’”

Of course, that argument is a red herring, says Skyler Glatt. “Plenty of people have overdosed or lost their families and kids without putting a needle in their arms.”

Joe was among them. After one overdose, he woke up on a grimy mattress in an unfamiliar trailer, unable to hear out of one ear. Another time, a neighbor found him passed out in the laundry room of his apartment building. 

“It was all a wake-up call,” says Joe, now in recovery. “It was a crappy, tiring life, and I didn’t want it anymore.”

5.     The pills are helping me, not hurting me.

While working as a delivery-truck driver, Randy, 35, relied on fentanyl to feel normal.

When his parents told him, “You need to stop and reevaluate — you’re going down a bad path,” Randy shot back: “No, the pills are helping me. They’re taking the edge off.”

If he skipped a day, he felt like he had the flu. “I’d be like a hobbit and want to sleep all day. But as soon as I took the pills, I’d have the energy to go to work.”

He lost his job when co-workers reported he was high at work. Then he lost his car. Then his girlfriend left with their kids.

Only then did he stop rationalizing his drug use and seek treatment at Ideal Option. These days, he has his family back and a job as a fireplace installer. He’s amazed at how good he feels.

“Now, instead of feeling high and having energy, I’m sober and have energy. I’m really surprised.”

6.     I have a high tolerance, so I won’t get hurt.

Opioid deaths are constantly in the news — in 2019 alone, some 43,000 Americans died from an opioid overdose. Yet folks with OUD are able to convince themselves they are not at risk.

“I said, That’s not going to be me. I have a really high tolerance built up,” recalls Emily, who was using fentanyl daily. “Even though other people are dying, I’ll be fine.”

Says Skyler Glatt: “How many people who’ve overdosed thought that same thing? I’d be willing to bet 100% of them.”

7.     Treatment will be too miserable.

After a decade of heroin addiction, including stints in jail and years sleeping on the street, Amber finally faced facts: she needed treatment. Still, when she saw Facebook ads for Ideal Option, she hesitated to make the call.

“My first reaction was: No way,” she says. “I was afraid of withdrawal.”

Most patients are. Even when they learn about Suboxone — the medication that relieves withdrawal and cravings — they just don’t believe it works.

“I was definitely skeptical,” says Amber.

But with support from her husband and her mom, Amber forged ahead. She knew the first day would be the toughest; she’d have to experience a brief, medically required withdrawal before she could start the medication.

“What’s 24 hours of misery to get your whole life back?” Amber says. “That’s what I had to put in my head: It’s only 24 hours.”

Those 24 hours were grueling — “like the flu times a million,” with leg cramps, cold sweats, and diarrhea — but the misery ended abruptly, when Amber took her first dose of Suboxone at the pharmacy drive-through.

“By the time I got home, I was back to feeling myself. I didn’t even want to use. It’s like a miracle drug.”

8.     Going to treatment would be too embarrassing. Everyone would find out.

Even after Patricia admitted to herself she needed help, she wasn’t ready to admit it to her family.

“I was embarrassed to go get treatment,” she says. “You know how news gets around — cousins, aunts, uncles.”

But eventually, Patricia’s desire to get healthy won out. “I always worried about what other people thought, but finally I realized, I don’t care. This is for me.

Today, Patricia is grateful to have her life back. “Instead of just lying around the house all the time, I go out and do things. I pick my granddaughter up from school, and we might get an ice cream or go to the park. I take my mother to the grocery store. I feel like a person again.”

Though Patricia’s immediate family knows she takes Suboxone, all those cousins and uncles don’t. 

When you enroll in Ideal Option, you need not announce it to the world. You just need to show up for your appointments. “You can do this without telling anybody,” says Skyler, “just like if you’re seeing a therapist or any other doctor.”

9.     It’s too late — why bother? I’ve already lost my job, my kids, and everything else.

No matter what health conditions you may have, no matter what in life you’ve lost, recovery is available to you.

Amber, now a year into recovery, is still amazed at how her life has turned around.

“Sometimes I sit there and think: Wow. Ten years ago, I was sleeping in a ditch, taking my clothes off for drugs, and belittling myself. I had no self-confidence at all. Now I have a husband and a car and a full-time job. It’s like, ‘I am woman, hear me roar.’”

Amber adds: “I was that lost cause. If I can do it, anybody can.”

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