Last month I treated myself to my heavenly bi-annual facial. I love facial days because I get a great massage on the only part of my body that doesn’t hurt. The products, touch, relaxing music – the whole dreamy vibe makes me feel like a queen while providing a much-needed hour of pain distraction.

There’s no better aesthetician than Carmen. In fact over the past 15 years I’ve followed her to four Los Angeles salons. But despite her hands of gold, Carmen’s always struck me as a sad, empty character. Someone who doesn’t value her life. A few years older than I, she’s had a failed marriage with no children – and too many partners to count. Carmen looks like a million bucks, but when she smiles her eyes betray her. She appears to be asleep.

This go around Carmen gave me some disturbing insight into her “deadness” – as well as the pain world’s opioid problem.

While spreading on a bright pink mask, she told me about her new boyfriend – an unemployed biker from a well to do family. Natch. She went on to tell me about a trip they’d recently taken to Sedona and how she couldn’t face seven hours home with Josh’s non-stop verbal ramblings. Besides his Ferrari convertible, Carmen shared he’s got a crazy-making case of ADHD.

Without a hint of shame or reservation, she casually revealed her remedy. To stomach her time with Josh, Carmen took half of one of his Norcos along with a Xanax. She then laughingly told me about the nightmare that ensued. Unwittingly, she broke the Norco in half because she was mixing Josh’s drugs. But as she learned from him later, the Norco has a time-release agent. So rather than the drug slowly entering her bloodstream, it hit her full on.

Still giggling with a far off look, Carmen described her bad trip, and I’m talking about the drugs. “I was completely zonked. Couldn’t even lift my head for most of the drive. I can’t believe I didn’t die!” Stunned, I told her to please never again take medications prescribed for someone else. I also pleaded with her not to mix his drugs. They’re not candy.

Perhaps prying a bit too much, I asked Carmen why and how Josh was getting Norco. I told her that folk with chronic pain are having lots of trouble getting opioids. She paused, then sheepishly offered, “Oh, he used to have a bit of back pain.” She told me that Josh worries too about not being able to get his Norco. In fact, he “stockpiles” it and pours his prescriptions into “big jars and more jars.” My mask must have cracked when my jaw dropped.

With an exclamation point, she finished, “Oh my doctor will give me anything anytime I want too.” Carmen made it crystal clear that she and Josh were popping these opioids, not for pain control, but for recreational use.

In one hour I got a startling, first-hand account of one of the big reasons we have an opioid epidemic in this country. Multiply Carmen and Josh by many millions who aim to get high and have “feel-good” doctors who are happy to accommodate. The big question is – why are some doctors terrified to give a single opioid script to a person with high-impact pain when others are comfy dolling them out “by the jars” to folk who want to party, exposing them to the real possibility of overdose?

I learned well from my HMO reform days that when people die from healthcare it always comes down to the bottom line. But who’s making the killing here? Wealthy patients who pay cash? The doctors who get an unending stream of customers who need their high? Or is it the pharmaceutical companies who’s reps are plying the drugs? Perhaps all three. I don’t have the answer and hope this can be a conversation starter for decision makers.

In any case, I now understand the deadness in Carmen’s eyes.

XO Cynthia