In many ways, it was a perfect storm of addiction risks that overwhelmed Dr. Peter Grinspoon. In his memoir, Free Refills, Grinspoon recounts his descent into drug abuse, his successful recovery journey, and subsequent return to medical practice.
As a child, Peter was traumatized by the death of his brother Danny, who died from acute lymphocytic leukemia. His father, Lester Grinspoon, a prominent Harvard psychiatrist used cannabis to ease the suffering of his dying son and has been promoting the legalization of marijuana for decades.
Like his father, Peter self-medicated the pain of losing Danny. He started using marijuana at 12. Other drugs followed in high school and college. After deciding to become a physician, Grinspoon discovered prescription drugs in medical school. It’s a career that will give him easy access to opioids.
Initially, that access was limited and Peter felt he was in control. His board scores were excellent. The Boston University School of Medicine attested him an “outstanding fund of medical knowledge” and recommended him as “outstanding candidate.”
The praise came at a high price: Peter worked hard and to cope with the stress he started hunting for samples and stealing drugs from nurses’ stations. “Slowly, imperceptibly, as medical school went by, my seeking out, obtaining, and use of these medications escalated,” he writes.
After med school, Dr. Grinspoon was “matched” at the Brigham and Women’s Hospital in Boston and from now on he had his own prescription pad. Pandora’s Box opened wide, in Free Refills, Grinspoon compares the situation to “giving a book of matches to a pyromaniac.”
The access to controlled substance for a doctor is almost unlimited. “When I made bad choices, it was very easy to make bad choices,” Peter told me. But choice soon evaporated.
“At the beginning it was a choice to take Vicodin, but in the end I had very little control because of the physical addiction. You lose more and more control as you go along. You get trapped in it. Addicts are the most miserable people on earth.”
Peter started to work long hours in oncology where he was “forced to imagine what Danny must have gone through in the final weeks of his life.” On top of everything else, Peter had not much emotional energy left for his fiancee after the 36-hour shifts at the hospital. He used pills and cannabis to be able to sleep.
The substance use disorder made Peter cross one line after another. First, he was stealing pills, then fraudulently prescribing narcotics to himself, and finally colluding with addicted patients.
In February 2005, Peter’s medical career came to a grinding halt when two law enforcement officers showed up in his office. He had been writing Vicodin prescriptions for his own use in the name of a former nanny. It certainly didn’t look good: Grinspoon was facing criminal charges, the medical board suspended his license to practice medicine and his marriage was in serious trouble.
Fortunately for Peter, the Society to Help Physicians and the medical board demanded he go into a rehab program. The SHP has been criticized for its tricky mission of being both an advocate for physicians while also policing them. Dr. Grinspoon felt pressure from all sides—if he doesn’t go into residential rehab as suggested, he will certainly not get his license back, might go to jail and be denied access to his two children.
His recovery journey began with 12-Step meetings that felt alien and somewhat cultish to Peter. The rehab center was located in a southern state far away from his home in Massachusetts and the approach felt too Christian for an atheist with Jewish heritage.
However, Peter later realized that being around other recovering addicts and taking a three-months timeout was exactly the right thing for him. It gave him time to take an honest look at his condition far away from the usual stress and temptation.
The “extreme makeover” turned out to be only the beginning. Peter learned the hard way that a few weeks are rarely enough to achieve full recovery from addiction. Upon his return to Massachusetts, he had to deal with a parole officer, regular drug tests and a failing marriage. And then he happened to find a bottle of Vicodin.
“Everything I learned during ninety days of rehab was displaced by an unexpected rush of euphoria. All thoughts, sense, and accumulated wisdom were circumvented by my body’s anticipation of what was to come next,” he writes in his memoir.
The power of addiction can hardly be described more accurately. This time Peter has a support network, though. After the slip up, he immediately called his best friend from rehab and his therapist there. He informed the SHP, his psychiatrist and his parole officer, too. Being honest about the relapse turned the threat of sanctions into support for Peter’s continued recovery.
The safety net for physicians which felt coercive at first turned out to be the support he needed. With five years of aftercare and something very tangible to fight for, Dr. Grinspoon was able to retain his medical license and is now seeing patients again. He is also an associate director of the Society to Help Physicians himself now, helping colleagues who are in crisis.
At Decision Point the experienced staff of licensed counselors provides individualized therapy based on the unique needs of each client. Understanding addiction as a chronic disease means that it's possible for symptoms of addiction to periodically recur. In traditional recovery settings, relapse is seen as a failure. Increasingly, however, the field of addiction medicine is coming to view relapse as an acceptable aspect of normal recovery, and that the goal of treatment should be ongoing reduction of the number, duration and severity of relapse.
Free Refills by Peter Grinspoon, M.D. available at Hachette Books