HUNTINGTON - Sitting in class at Recovery Point of Huntington working on his recovery, Kentucky native Jeremy Brown had a heart attack.
Heart problems were something he figured he would deal with at some point in his life due to family history, but his early 30s were not when he expected to have problems.
But Brown found out he had high cholesterol and diabetes, as well as four blockages that required open-heart surgery. That presented a problem. The drug he most frequently abused - morphine - was the drug doctors use to treat pain after such an invasive surgery.
"I was nervous," he said. "Having the surgery is scary enough. I kind of knew what to expect because my dad had it, and I knew about his rehabilitation. But I knew I couldn't go through it without pain medication. I sat down and told my doctor I was in recovery. He tried to make my transition from using pain medicine to not as smooth as possible."
The world is not set up for people in recovery. From American's drinking culture to the way the country's health care system runs, it takes time for a person in recovery to learn how to navigate the world.
"Typical triggers: large amounts of money, immediate romances, things that people with active substance abuse don't deal with," said Matt Boggs, executive director of Recovery Point of West Virginia. "In recovery, we learn to deal with those things more appropriately, but they can still serve as triggers and maybe take you back to a point and time when you were involved in dealing drugs, using drugs, and you had a big wad of money in your pocket."
Boggs said people in recovery need to learn how to manage money, build budgets, how to navigate relationships and how to manage their health and wellness.
"That's beyond the complex social service system that we have," he said. "That's just regular life occurrences we learn to deal with, and deal with appropriately and not use alcohol and drugs to numb the way we think we should feel."
Health care and recovery
When it comes to navigating health care, Boggs said it can be scary.
Take, for example, Jessica Grubb. The Charleston native had been sober for six months when she suffered a running injury that put her in the hospital. David Grubb, her father, said during Hillary Clinton's visit to Charleston, doctors and nurses were told his daughter had a history of addiction, but her discharging doctor, who was not originally on her case, prescribed her 50 oxycodone pills. She died that night.
"I'm sure Jessie went into the physician scared because she was going to have surgery and get pain medication," Boggs said. "That can be very scary for people because we know we can set that pattern off again really quickly with medication even though they are prescribed."
Sen. Joe Manchin, D-W.Va., introduced "Jessie's Law" in Congress earlier this year. The law would help ensure that medical professionals have full knowledge of their patient's previous opioid addiction when consent is given.
The law is currently in congressional committee.
Boggs said substance abuse disorder needs to be treated just as if it is an allergy to latex.
"It's flagged on their file. Physicians know, and they will not put anything with latex around that patient," he said. "The same thing should be with someone with substance abuse. There should be a point of contact beyond that person in the file so those people are notified of the potential for pain management or pain medication."
Boggs said they also teach people in recovery to not go through unnecessary pain.
"Don't become a martyr to say, 'Oh, I made it through without any pain medication,' " he said. "But you have an honest conversation with your physician and your support system so that everything is done very carefully."
Dr. Michael Kilkenny, medical director at the Cabell-Huntington Health Department, said he agreed with Boggs' assessment.
"You would have to tell them what you are in recovery from, what drugs you used and what kind of problems you might have as a result of your treatment options," Kilkenny said. "You have to bring up any restrictions you might be under. Some people in recovery are under surveillance and could get in trouble if they violated rules. Try to custom tailor an approach that will get the pain relief they might need, especially after an operation. We don't want to put them at risk for relapse and don't want to get them in trouble with any other agent. It's a matter of having a real specific conversation about that."
Kilkenny said if a patient feels they can't talk to their doctor, then if they have the means, they should find one they can talk to.
"Physicians do want to get the correct information to that person and do the right thing," Kilkenny said. "It's a deep philosophical trait in physicians, and they don't want to hurt that person."
"Respect your illness"
Brown said honesty was what got him through his surgery. His doctor gave him fentanyl instead of morphine. After he got out of the hospital, he stayed with his parents while he recuperated before he went back to Recovery Point. His pain medication was kept with staff and given at the allotted times.
"There were times after I came home from the hospital - you learn here about obsessions and how addiction is a disease and you get mental obsessions - being honest with my family when I started to obsess," Brown said. "You can trick yourself with medication in thinking you need the medication when you don't. So, be honest with yourself. Do I really need this, or am I abusing it?"
Brown did relapse, which was a result he said of not maintaining his recovery. He is back at Recovery Point working to get back to where he was.
Boggs said that is another side of recovery - it has to be maintained just like diabetes or any other disease.
"You have to respect your illness and understand you have to continuously do the things that have brought you to that point to guard against relapse," Boggs said.
He said watching Brown go through what he did was inspiring.
"First you are really worried because it's such an invasive and critical surgery for his well-being, but to watch him go through that spoke about his commitment to recovery," Boggs said. "He fell off and relapsed, and we know that happens just like any other chronic illness. That's typically part of the story. But we welcomed him back with open arms, and we are going to get him back on his feet and give him the opportunity to conquer life."
Follow reporter Taylor Stuck on Twitter and Facebook @TaylorStuckHD.