Derrick Mobley MD

An excerpt from my addiction memoir: Pieces of a Man: #doctor #son #father, A Physician’s Journey Through Addiction

All was going well for six months after my return home and then it happened – I relapsed. I felt it coming but I could not identify the feeling until it was too late. I had never had three years of sobriety before. Since I initiated my cocaine use 20 years ago, the longest period of abstinence had been around 7 months and that was while I was in a treatment facility.

I relapsed at my cousin’s house in South Philadelphia. Strangely, it was the exact location where I last used cocaine before I was arrested and imprisoned three years earlier – where I stopped was where I started again. I was completely devastated. True to my pattern, once I started I lost complete control- nothing had changed and perhaps my addiction had worsened. I was overwhelmed by a voracious, insatiable appetite for more and more of the drug. It was like I was trying to make-up for all the times that I couldn’t get high while I was incarcerated and I was supremely embarrassed and ashamed about it and tried to hide my relapse from my family and friends.

I had sworn off cocaine numerous times while I was incarcerated never thinking that I would touch it again for all the misfortune, pain and injury that it brought to my life and the lives of those that I loved dearly: the loss of freedom and career, the poverty, the homelessness, the physical injuries. How could such suffering be insufficient in deterring my use of cocaine? It was inconceivable – but it happened. But it had to be just a minor slip. No way was I going to re-enter the crazy, destructive world of the cocaine canines. Then it happened again. Then again. I knew I was in trouble – I had awakened the beast.

Addiction is an incurable disease and it is also an anomaly of human nature and of the human spirit. It is repeated attempts at total self-destruction that defies the basic instinct of self-preservation. It represents the ultimate inner conflict: hating something so much and yet somehow desiring it equally as much. It is unlike any other any other disease in medicine except the autoimmune diseases (lupus, rheumatoid arthritis) where one cell type attacks other cells within the same person (self killing self).

Sobriety is addiction in suspension. When relapse occurs, the action picks up exactly where it stopped. I was back in my full-blown addiction: awake for days, spending money that I could not afford to spend, feeling hopeless and depressed. Once again I was disappointing my children, my parents and myself. Once again I was failing to meet the basic responsibilities of fatherhood, something I cherished dearly. I wasn’t giving my children the kind of father that I had been fortunate enough to have as a child. That really hurt!

A dangerous conflict arose one day. While I was in the midst of a serious binge, it occurred to me that I was to report to my parole officer the following morning. I had been awake for two days and still had money to burn. It was my usual pattern of not stopping by drug use for anything once I began the destructive process. The only matter of importance to me, while under the influence of cocaine, was getting more cocaine or money to buy more cocaine if I didn’t have it in my pocket. In the past, I had missed days at work and lost good jobs because of this huge dark cloud of irresponsibility that descended upon me whenever I was used the drug. It was only the immediate access to cocaine that was important to me. I’d deal with the loss of income at another time when I as was forced to look at reality because there was no more money or I was utterly fatigued. This was just me on cocaine – nothing mattered and I hated me on cocaine.

However, in my status as a parolee, my parole officer had the authority and power to strip me of my freedom which was something that I developed a great appreciation for after losing it for three years. I wanted to impress her as a truly rehabilitated offender and a recovering addict dedicated to a life of sobriety. Not showing up for the appointment would, at the least, arouse suspicion that I was falling short of those goals. I knew that my appearance was telling of fatigue and an over-stimulated nervous system and I was indecisive about what to do while the cocaine continued to call me. At this point I was getting high just to avoid thinking about how much I had “fucked up” again.

As a testament to how much I cherished my freedom, I was able to put the drug down and make the appointment – a truly rare occurrence for me. Had I been a more experienced parolee I would have chosen to not show up and offered a medical excuse for my absence.

When my parole officer took one look at me she knew something was amiss. I was mildly diaphoretic and exhibiting involuntary movements of both upper and lower extremities. My speech was staccato and my eyes were reddened and evasive. I had tried to gather my composure during the 40 minutes that I had to wait to see her in a waiting room with other parolees. I judged my appearance and behavior by their reaction and stares upon seeing me. The cocaine told me that I could fool the parole officer into thinking that I was not under the influence of a drug, however, a spot urinalysis drug screen turned up positive for the drug. I didn’t even try to beat the test as I had successfully done in the past.

I was reprimanded with a 7 pm curfew but fortunately not sent back to prison. I learned later from experienced parolees that it is better to miss a parole appointment if the urine is “dirty” and reschedule the visit for a time when the drug would be undetectable. Speculation about drug use is better than the hard evidence of a positive urinalysis.

On my next visit to my parole officer, I wasn’t high but I had used cocaine two days previously. I spent $90 on a urine adulterant that was guaranteed to beat the test so I confidently gave the urine sample but was subsequently told that the test was positive. I denied using cocaine but she insisted the test was positive. Through her persistence, I was duped into confessing my recent drug use – the test had actually been negative. For parole purposes, a confession is as good as if not better than a positive test – my admission was a big mistake and it was a big deal to her and her supervisor. I was placed in a cage for several hours while they decided my fate. Since I only had 2 months remaining on my parole sentence, I was sent to a halfway house as a halfway back (to prison) resident.

I deplored my new living arrangements: four sets of bunk beds in a one large room and a shared bathroom. The quality of the food was horrible. There was a large day room with one TV and arguing residents about which programs to watch. I didn’t like the set-up but it wasn’t prison. The facility was grossly mismanaged but I only had myself to blame for being there.

After a 2-week blackout period I was permitted to leave the facility for official business-like medical appointments and outpatient drug treatment. Everyone there was required to receive public assistance that the facility tightly controlled.

At the two-month junction I was granted the privilege of 12 and/or 24-hour passes. On one of these passes I slipped up and used cocaine after unintentionally finding an old crack pipe in my mother’s house. I held it in my hand for minutes just looking at it and trying to resist the urge to buy cocaine to put in it. I eventually succumbed to the desire and went on a terrible binge. I showed up at the facility 2 days late not knowing what to say or what to expect from the administrators. I was reprimanded with numerous restrictions but fortunately they did not inform my parole officer of my waywardness. I was determined to use my gratitude for not being sent back to prison to fortify my resolve to stay sober.

A few weeks after my parole ended and I was released from the facility I started using cocaine again. Why? Truly, only God really knows. It may have been my dismay about my station in life – no money, no job and my convicted felon status or it may have been just a permanently entrenched bad habit or there may have been some deeply embedded psychological disturbance that lay beneath my consciousness.

Sandy had re-united with me at this time. I warned her of the bizarreness of drug behavior and that I thought it was not a good idea for her to be involved with me. She thought that she could help me but I knew that at this point that it was an inside job for me to stop getting high. She was baffled when she was initially exposed to my drug – seeking behavior and my dilapidated state of being after a cocaine binge. Despite having virtually no previous direct experience with drug addiction she hung in there with me as best she could. It was embarrassing for me to have her witness this very dark side of my existence but I couldn’t convince her to wait until I was ready for romance.

Subsequent to another positive urinalysis with my probation officer – my parole had ended- I recognized the necessity for me to get professional help. I arranged to be re-admitted to the drug treatment facility that I was paroled to a year earlier but this would be the last time that my insurance provider would pay for my drug treatment as an inpatient. I understood and concurred with their assessment. I had been treated numerous times throughout the years, only to relapse in a matter of weeks to months after being discharged. There was nothing more for me to learn about desisting drug abuse; I just had to practice what I was taught on a daily basis. There are really no shortcuts in the recovery process. There are different pathways to recovery but no shortcuts.

My daughters with Sandy and I had, at best, a partial and superficial relationship. She was pressuring them to communicate with me thinking that our improved relationship would strengthen my motivation to achieve a lasting sobriety. They were hurt by my relapses. Drug abuse was not a part of their world; they didn’t understand it and were intolerant of it. Drug abusers conjure images of self-centered, unilaterally-focused, weak-willed people that live only for one purpose –their next opportunity to use a drug. In reality drug abusers are much more complex than that.

Sandy was tremendously supportive of my inpatient treatment program and a major source of encouragement and inspiration. It was the same motivating spirit that she instilled in her children who were attending or had graduated from some of the best colleges and universities in the country. As a mother, she was a great catalyst for achievement but as a mate there were some problems. The total control that was necessary and extremely productive as a single parent had to be tempered and sometimes harnessed when dealing with an independently- minded adult. She struggled in making the transition from mother to mate because she had been a strong mother for so many years.

I finished the inpatient program in the same month that I finished it a year earlier, December and decided that I was done with treatment programs, insurance or not. I had to end this love/hate relationship with cocaine permanently. One of my requirements under my parole/probation was to look for and hopefully find employment. It had been several years since I attempted to find legitimate employment. My last position in Philadelphia was as a substitute high school science teacher. The work was inconsistent, the students were unruly and the pay was far less than what I was used to as a physician so I stopped accepting assignments because I was making more money with my hustle. I was self-employed but my business was illegal. I was my own boss, deciding when, where and how long to work. There were days of good revenue and days of not so good revenue, overhead costs and payroll expenses. Those days were over now. I had to find a real job.

It was difficult finding decent employment because I had an 8-year gap on my resume and three of those years were spent in prison, emerging as a convicted felon. I also had an extensive substance abuse history and I was a prime candidate for age discrimination at nearly 50 years of age. I wanted to teach science subjects again but my criminal history was a problem for the local school board. The nature of my convictions, fraud, was a huge problem for many potential employers because it was a trust issue. I encountered numerous rejections. Most times I didn’t get past the application/resume submission phase of the job-hunting process. It was a terribly frustrating and demoralizing experience.

Finally, I secured a job as a passenger van driver for an airport limousine company but it was an abusive position. I worked 12 to 16 hours a day 6 days a week for a salary that is too embarrassing to mention even in this book. However, it was clean money and an honest living. It was the first mile on a long road to recovery. The problem with the job – besides the low pay- was that my shift ended in the early morning hours just past midnight. It was the wrong time of day for a recovering addict to be traveling home with a few dollars in his pocket. Those are the bewitching hours. The only people on the streets in my neighborhood were those using drugs and those selling drugs. I fell again – repeatedly.

There were times when I would spend my entire paycheck -which wasn’t a lot of money- but conceptually it still was painful. I began missing days of work without pay that profoundly affected my paycheck as well. I found a second part-time job for a company that graded tests for school districts and I missed days from that job, too. I always performed my responsibilities very well while on the job but the missed days were a problem that reflected badly on my reputation as an employee.

It is rare that a cocaine addict has enough money to smoke cocaine to his heart’s desire. I used to have it like that but now I was far from enjoying that twisted privilege. When I found myself thinking about returning to criminal activity – prescription writing – so that I could buy more cocaine I knew I had to stop using cocaine. There was no way that I was going to risk going back to prison for committing the same crimes nor was I not going to risk going back to prison for any other crime. I was already taking a huge risk every time I purchased cocaine from a drug dealer. I could have been arrested at the time of purchase or arrested for drug possession or for driving under the influence of a drug. The literally unbearable part of the relapse was the renewed disappointment and pain that I was causing my loved ones.

That kind of psycho-emotional pain is indescribable. Suicidal thoughts abounded in my head. I had to overcome this shit!

I felt a greater sense of hopelessness when, during this time, I received the results of my criminal appeal to the Superior Court of Pennsylvania. I had been hoping for relief from the stigma of being a convicted felon but I lost the judicial ruling by a 2:1 margin. The three-judge panel ruled in my favor on one of the seven issues submitted to the Court; the others were rejected. I was stunned and dejected by their decision because I knew my legal arguments were formidable and cogent. The dissenting jurist wrote a 10-page opinion that was fully supportive of all my issues. This gave me some satisfaction but I was to remain a convicted felon for the rest of my life, barring a pardon from the governor. I just had to live with the bad decisions that I made in my life as a consequence of my drug abuse. There would not have been a criminal case had I not used and then abused cocaine. My life could have been much worse. That’s how I had to look at it.

I found tremendous strength and unwavering support when I rededicated myself to the 12 step program. I found a sponsor, established a home group, began praying regularly and developed an unwavering determination to free myself of the grip of cocaine. I had to eliminate all contact with anyone who used cocaine and had to be extremely cautious when traveling through areas of the city where I had used cocaine. I had problems conforming to some aspects of the 12-step program of recovery in the past but I had no choice at this point. Every way that I had tried to get and stay sober had failed me. The 12-step program worked for many addicts that I knew who were now leading drug free and productive lives were. It was the only game in town – at least for me.

I gradually began to see progress in my fight for sustained sobriety. I had to humble myself yet maintain a certain amount of self-confidence and commit to a spiritually driven lifestyle, not doing what I wanted to do but what was the right thing to do. I didn’t want to die addicted to cocaine. I didn’t want my children to live with that reality. I wanted my parents to see their son return to a life without drug interference and my children to have a responsible and interactive father. Even though I lacked the financial resources that a father normally provides, I possessed a wealth of knowledge and personal experience about what they needed to do and not do to lead successful lives.

I will probably never fully comprehend the truly unconditional love of a mother to her son or the immense capacity for forgiveness of children towards a wayward parent. They are manifestations of a sublime reality. My mother endured the burden of witnessing her son descend from a promising career in medicine to addiction, poverty, dereliction and imprisonment and there was nothing she could do to stop it. She just had to bear the pain and pray that God would see me through my troubled times. She observed the extremely erratic and compulsive behavior induced by cocaine abuse over and over again. It was horribly frustrating and sad for her but she has always been there for me in times of genuine need.

My children tolerated repetitive disappointments and numerous instances of irresponsible and irrational behavior even though I always tried to keep my fatherly duties separate from my cocaine indulgences. I never wanted them to see me in a crazed state of mind. However, on one disastrous occasion, literally the worst day of my life, my two worlds collided as a father and an addict.

I was a thousand miles away from Philadelphia to attend my oldest daughter’s high school graduation. She was graduating two years ahead of schedule and I was extremely proud of her. While looking for my hotel, I stopped at another hotel for directions and as I was re-entering my car a woman asked me for a ride saying that she was in a rush to get home and taxi service was heavily delayed. I initially refused to help her several times but when she continued to plea for my assistance I consented even though I had my young twin sons in the backseat and didn’t want to expose them to strange people. As I was taking her to her destination she asked to stop at a small motel to purchase some marijuana. When she failed to leave the motel room within a reasonable time I knocked on out the door to tell her that I was leaving. What I saw was something that I did not need to see. Surprisingly, it was not marijuana that she was buying but crack cocaine. Deluded by my addictive thinking, I entered the hotel room, bought a small quantity of the drug then began smoking. Once I started, I could not stop especially with a pocket full of money.

After finding my hotel room, with the woman still with me, I put my twin sons to bed then went to purchase more cocaine at a nearby housing project. Instead of purchasing and leaving I decided to test the product right there. I ended up leaving my young sons in a hotel room alone overnight while I smoked cocaine in a housing project. I just couldn’t put the pipe down, not even for the safety and welfare of my children. I nearly ruined my daughter’s graduation when I was forced to admit my cocaine problem to her and all her extended family members. It brought tears to her eyes just like it is doing to mine now as I recall the events of that day. It destroyed her huge admiration and respect for me and I ended up in jail for filing a false police report in my attempts to cover my irresponsible addictive behavior.

I wasn’t looking for cocaine that day but cocaine found me in the most uncanny way. I don’t do those kinds of things anymore, but the memories continue to haunt me and keep me moving in the right direction. Those four children that were born so closely in time (1988 and 1989) are now all in college, even the one with mild cerebral palsy. I thank their mothers for this and take little credit for the great children that they are.

Why did I get high time and time again for so many years despite experiencing severely negative consequences? I don’t know for sure but that is part of the definition of addiction – continued use despite negative consequences that would normally cause a person to stop. Perhaps, also, on some subconcious level it was in pursuit of a more perfect world…a world that I could only experience artificially and for only minutes at a time and at great expense – which, in reality, made it imperfect. From a curious indulgence 23 years ago, arose a series of tragic manifestations of the frailties of the human psyche and spirit. It all began with one false move and one bad decision. Don’t let it happen to you.