ule and medication load were dead giveaways. All she had to do was
speak up, which she eventually did, and state her concerns, and these
concerns were factually based, a crucial factor in the approach that
we'll turn to later.
3. Weight loss. My weight dropped about 60 pounds in the time
from my first prescription to when I was caught at work, and that was
a telltale sign that Claudia was quick to pick up on. Not only was I
overworked, exhausted and more secretive than ever, but my body
was showing the signs of my disease as well, and like everything else
in the process, I'd lost control. Weight loss isn't the surest sign of
someone who's addicted. For some, though, it's part of the package.
4. Unusual clothing. Wearing long sleeves on a warm day is never
a good sign. I didn't start shooting fentanyl intravenously until the
final stages of my spiral, but when I did, I began covering my track
marks with long-sleeve shirts, another item on Claudia's list of suspi-
cions. She'd ask and I always had a lie ready to go, usually something
about having the flu and hooking myself up to an IV at work. Before,
I'd been slipping the drugs under my tongue, but as any recovered
addict will report, you develop a tolerance very quickly and intra-
venous injection is usually the last stop before the abuse becomes
dangerous and unmanageable. I began injecting my supply at the end
of a long day, usually the last to leave, alone and at serious risk.
5. Mood swings. Irritability might seem a less objective clue, but it
shouldn't be overlooked. When I was in the throes of my addiction, I
was exhausted because my heavy workload became entirely motivat-
ed by how and when I could get the meds I needed to allay withdraw-
al symptoms and stay on task. I was less social and more focused on
4 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • D E C E M B E R 2 0 1 7