Rustie struggled with opioid dependency during pregnancy. Photo / Supplied
Rustie can't decide what the lowest, darkest point of her life has been.
There were the times she bought methadone from strangers in public toilets. The days she crushed Panadol into her own vomit and took it to pharmacists to try convince them she'd thrown up her prescription medication.
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The isolated moments where she stood in the shower every morning for nine months with her hands gripping her growing belly as she cried and apologised to her unborn baby. And then there were the heartbreaking weeks that followed, reports news.com.au.
"Of course, my baby was born addicted to benzos and opiates," the 56-year-old Australian told news.com.au while detailing her 32-year dependence on prescription medication.
"I was breastfeeding, so he was getting it through my milk — but when I stopped breastfeeding that's when he went through withdrawals, big time. Six weeks old. He had these black rings under this eyes and this high-pitched scream — you've never heard anything like it. His face looked really black around his eyes. Really dark. [Doctors] told me that that's what would be happening. And I knew as well."
It has been 10 years since Rustie ended her three-decade dependency on opioid and benzodiazepine medications. And she's not alone in the struggle.
Abuse of prescription drugs in New Zealand is "creeping up in quite a dramatic way", Associate Health Minister Peter Dunne warned in 2016.
Bee Ismail, ScriptWise chief executive said: "People don't even realise that some of these pain medications contain opium.
"When we see a name of Endone, codeine or OxyContin, people think it's just a painkiller — but it's opium-based. And people get addicted to opium or heroin."
Opioids are used to treat acute pain. The prescription drugs are legal and easy to get. But they can be more lethal than illicit street drugs.
For many struggling with opioid dependency, it starts innocently. Often with a simple trip to the doctor about an annoying pain. That's how it began for Rustie, who went to a GP at 17 for persistent and chronic back pain. She was given a prescription for Panadeine Forte and Valium.
"[The pills] alleviated the pain immediately. If someone says you can go to a physio which might take two months [to see benefits] or you can take a tablet which takes 20 minutes, it was a no-brainer. You didn't have to think about it."
Rustie managed the medication for a while. She worked in the disability sector and, at 21, won an award for her contributions. But the pain persisted. Hospital stays and surgeries followed. And so did more medication.
One hospital visit during the '90s included injections of pethidine and morphine and introduced Rustie to Endone and OxyContin.
Her decision to move to a small rural town in northern New South Wales meant doctors gave her more medications.
"Because I lived so far out and I was in such pain I also had take-home injections of pethidine. So I was on a lot of OxyContin, pethidine, Physeptone (a tablet form of methadone) and Valium," she said.
"Had I been taught I need to be responsible for my pain, that would've helped. What happened was we made the doctors responsible. No one said, 'Pull your head in, mate, you're gonna have this [pain] for the rest of your life."
Still, it was only just the beginning.
By the late '90s, Rustie's dependence on prescription medications was rampant. She would take too much and run out. This meant she had to go to extreme lengths to get more.
"I'd go back to the same doctor usually and try to manipulate — and if I couldn't, that's when I'd do the things like meet someone in a public toilet and buy methadone," Rustie said. She now works in educating medical professionals on doctor shopping, said.
"But sometimes I would go to other doctors. I was really close to the border, so I could go over the border."
During an inquest into opioid deaths in Australia this week, NSW chief pharmacist Dr Judith Mackson told Deputy State Coroner Harriet Grahame a NSW rollout of real-time prescription monitoring — which would help stop doctor shopping — was far from being implemented.
Rustie continued: "I once vomited in a bowl and mixed up some Panadol in it and took it to a pharmacist and said I vomited up my medication. I smashed up my medication and injected it into my leg and got abscesses in my leg and had to go to the theatre."
"It's embarrassing — going to any lengths. Not just going to doctors and using language and getting them to feel sorry for me — there's other stuff. It's not just being tricky.
"I hitchhiked 38 kilometres to sell my sewing machine … took it to a pawn shop to get enough money to get extra drugs."
Soon after in 1999, while living in Western Australia, Rustie fell pregnant. And her struggle intensified.
"Talk about addiction being a f***ing monster. Fair dinkum," she said.
During her pregnancy, Rustie said she couldn't stop taking the medications because of her back pain, so she obeyed medical advice and followed the prescribed dosage.
"But it was a lot of medication," she said.
She was taking nine 80mg oxycodine tablets and five 5mg Valiums a day along with other anti-depressants, as prescribed.
"Every day, without a word of a lie, in the shower, hands on my growing tummy crying my eyes out and apologising to this beautiful little person that was growing inside me," she said.
"Of course, my baby was born addicted to benzo and opioids."
"He'd shudder and startle. As opposed to a baby that's soft and floppy and warm. He was a bit tense and startled," she said.
After the birth of Harry, Rustie began to up her dosage again. At about five weeks, she noticed the more she took, the better Harry slept. So she stopped breastfeeding. And that's when her newborn baby went through withdrawals "big time".
"People around me tell me I'm a good mum. I took him swimming, I read to him, we'd go to the Wiggles. But I wasn't there emotionally," she said. " It blunts your emotions. I didn't know I was blunt until I wasn't blunt."
Bee Ismail of ScriptWise said deaths caused by opioids alone can either come from an overdose or prolonged use.
"What we're also seeing in coronary data is a mixture of medication — prescription of opioids and benzos that have led to death," she said.
Two of the six deaths at the centre of the inquest which began this week involved both types of drugs. In recent years, the combination cocktail has also been detailed in the toxicology reports of Heath Ledger and Tom Petty.
Concerns about a hike in fentanyl-related deaths have also raised concerns. Fatal doses of the synthetic opioid — which is 50 times stronger than heroin — were found in Prince's system following the singer's 2016 death.
"In most cases most paramedics put on gloves to handle a fentanyl patch — you could overdose from just handling a fentanyl patch. That shows how strong this medication is," Ismail said.
During Rustie's 32-year dependence on opioids and benzodiazepine, she didn't fear death. Mainly because she didn't think these medications prescribed by her doctor could be lethal.
"I don't know how I'm still alive or why. I didn't know you could die from them. That never crossed my mind," she said.
In 2007, an unsuccessful attempt at doctor shopping led to Rustie being put in contact with addiction expert Professor John Curry. She signed up to his pilot program that weaned her off benzodiazepine over three months.
Ten years later, she hasn't touched a benzo since. She still takes a dosage of opioids, but only as prescribed.
Her son is happy and healthy. She's taken in a foster son. And she now works part-time and assists in educating medical professionals on addiction and doctor shopping.
"Since I stopped taking benzos and opiates so erratically, my life has changed exponentially. I hear different, see different, feel different, taste different. I was really blunt. It's like I had no soul," she said.
"Now, I'm happy. Like, high happy."
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