How I Got Addicted to Fentanyl in My 20s

This article originally appeared on VICE Belgium.

Like many of us, Max van Rijsewijk dabbled in a little reckless behaviour in his youth. Growing up in the Netherlands, he spent a lot of his younger days riding horses, but there was also a fair amount of partying and doing coke and pills. Then one day, he was involved in a serious car accident that forever changed his relationship to drugs.

During his recovery, Rijsewijk, 27, was prescribed oxycodone and fentanyl, both synthetic opioids believed, at the time, to be a safer alternative to morphine. Invented in 1959 by Belgian doctor and pharmacologist Paul Janssen, fentanyl is most commonly used as a strong painkiller or anaesthetic. It’s way stronger than other opiates – up to 100 times the strength of morphine and 50 times that of heroin.

In the years since Rijsewijk’s accident, the addictive potential of synthetic opioids has become well-known; particularly in North America, where more than 1,500 people per week die from taking some type of opioid. In the past decades, Europe has also seen an increase in opioid prescriptions, especially post-surgery, but stricter guidelines have so far prevented a wider public health challenge.

For many people, like Rijsewijk – who took these drugs to recover from surgery without truly understanding the risks associated with them – the consequences on their lives have been devastating. Now in recovery, Rijsewijk tells VICE the story of his addiction and what it took for him to seek help.

We met people who used more drugs than we did, including GHB. Even then, I noticed I was pushing the limits. I was often the only person in the group who didn’t know how to stop – it was hard for me to accept when the party was over.

In March 2016, I was in a car accident. I drove fast during evening traffic, about 100km per hour on a road with a speed limit of 70km per hour. I’d already had a few glasses of red wine, and when I dropped something on the floor I tried to lean down and grab it. My car flipped four times. I broke my back in eight places, broke four ribs, collapsed my lung and damaged the nerves in my back. It’s a miracle I survived.

In the hospital, you’re usually asked to discuss your pain level a few times a day. And every time the level was over six or seven out of 10, they gave me a pill. I had no idea what it was until my mom asked. ‘“Oxycodone,” they said, “which is less addictive than morphine.” That’s how they sold it to me, and I was a bit naive for not doing more research. 

After five days, I was allowed to go home and was told to stay in bed. I was supposed to start physical rehab, but I never did. They gave me a big bag of morphine to take home that should have lasted a whole month. In the beginning, it made me really sick, but it did ease the pain.

Two months later, I was still in pain, even though everything was healing well. So to help with that, they prescribed me fentanyl and doubled my oxycodone prescription. They told me I’d need to take more to get the same effect, but that it was “normal”.

I realised I was slowly becoming dependent on the drugs. In the morning, I’d wake up feeling sick, sweating, shaking and having diarrhoea. That would all go away after taking the drugs; within 20 minutes, I’d feel really good. The drugs filled a void, especially since I was no longer able to ride horses. And so I became addicted to them, both physically and mentally. 

During the week, I’d sneak in a few more [than prescribed] and by the weekend, I’d run out and be suffering from withdrawal symptoms. It would start with palpitations, sweating, shaking, anxiety, depression, crying fits and pain all over my body. The after-hours physician service came to know me because I’d try to get [oxycodone and fentanyl] from them when I’d ran out.

After a while, I picked my life up and went back to work. I started working every day of the week so I’d be able to afford my prescriptions. But at some point, the pharmacy wouldn’t give me any extra medication [on top of my regular prescription]. I’d used up all the excuses, like saying my bag was lost or stolen. So I had to get through it, the sickness [was so bad] I couldn’t even leave the house.

That was when I started searching on the black market for more drugs, so I could make it through the weekend. I’d reached the maximum dosage of both medications, but my body needed more. I ended up selling my own prescription boxes of fentanyl for more money, so I could separately buy a higher dose. 

I sold them to people in Belgium, the Netherlands, and Germany. People with the most random stories: a pilot who sold to someone who worked for the police, a paramedic, an addiction counsellor… All the while, my addiction ate up my money. I’d drive from Arnhem to The Hague in the middle of the night and get just enough fentanyl to get through the day. The next day, the search started again.

If I’d had unlimited access to these drugs, I’d be dead by now. I always had to plan and calculate how long I could stretch my stash. I’d think, ‘Take this many milligrams at this time to avoid getting sick, then I need this much for the night after – do I have enough money to buy more?’

This went on for a long time, until I couldn’t handle it anymore. My family noticed I wasn’t doing well. I was leading a double life so that I could keep it all a secret – I felt there was nothing else I could do.

I was admitted to rehab for the first time in 2018. They asked me if I wanted to learn how to regulate my usage or quit. If you ask someone with an addiction this question, you know what the answer will be. Everyone wants it to be true [to regulate one’s usage], but it doesn’t work. I ended up not finishing the treatment programme because I broke the rules [by consuming more than what he was supposed to]. My addiction didn’t go anywhere. I was always looking for something to replace it.

After a year and a half, my medication ran out and I couldn’t get it anywhere. That’s when I tried heroin. I knew someone who sold it, and because I had such a high tolerance for fentanyl, I figured it would make me less sick. I just wanted to fulfil the obligations of the day. But when I tried it, I still felt just as ill as before. 

For a long time, I hid behind the fact that I was taking “medications”. That word doesn’t sound as bad as drugs. Fentanyl is ultimately much more dangerous than heroin, but heroin has such a bad reputation. I felt ashamed for stooping so low. When I told my mom what I’d taken, the word heroin scared her the most.

I was picked up by an ambulance several times. Once, I had taken a different drug – Suboxone, which is used to slow down the effects of opioids – and it gave me such horrible withdrawal symptoms I had to be hospitalised. They gave me 20mg of morphine every thirty minutes and it didn’t help at all. 

Things got worse and worse as time went on – I was hurting everyone around me. At some point, I voluntarily went into isolation for three days. On the first day, I used up all of my drugs and money and locked myself in a studio above the barbershop where I worked at the time. I’d decided to go through withdrawal, and it felt awful not being in touch with anyone. By mistake, a photo of my drugs ended up on the barbershop’s Instagram account, which made everybody aware of what I was doing. But I was so sick I couldn’t even touch my phone. My battery died and the photo remained online for an entire day.

On the third day, I fled to my mother’s house. I was so embarrassed about the condition I was in that I hid in the shed for two days. She found me there and got help.

That was the moment I thought, ‘I give up, I don’t want to live like this anymore.’ I was super skinny; I’d destroyed my body. I knew that if I went through this all over again, I’d die. There were moments of pure desperation when I had no place left to go, not even the hospital, because they wouldn’t give me morphine anymore.

A few weeks before that incident, we – my mom, her partner and I – had decided that I would seek help. I went to SolutionS, one of the best rehab centres in the Netherlands. I had a spot starting in two weeks. I remember thinking, ‘Oh, that’s pretty soon,’ and made up a thousand excuses for postponing it. I even called them to ask if I could have more time. 

They said, “Max, this is the most dangerous time because you’re going to have to say goodbye to your drugs.” People tend to use a lot right before they get admitted, and oxycodone and fentanyl can easily cause an overdose.

My drug use turned my relationships upside down, too. My partner saw me go downhill, and he often confronted me about it. We’d live apart for a while, then move back in together. Luckily he always saw me as someone who was sick; he saw that I was trying to fight it. 

We’ve been together for ten years, and I was addicted for seven of them. He’s seen me black and blue so many times because I’ve fallen down the stairs or something like that. Our relationship has become unbalanced because he’s been living his life, but mine has stood still these past few years.

My relationship to addiction has now changed. On Sept. 14, 2022, I moved to a sober home and accepted my disease. I’m now learning how to deal with it for the rest of my life. My partner still distrusts me, but now that I get regularly drug-tested, he and my loved ones are more at peace.

There’s a zero tolerance policy here. The main difference compared to the last time I was admitted is that I don’t want to use anymore. That was a necessary realisation. My relationships were hanging on by a thread, and this was my last chance with everyone I loved.

Accepting that I can’t use ever again is still difficult. In 2018, I was hung up on the thought that, ‘I couldn’t do anything anymore.’ I felt so sorry for myself. ‘Everyone else is allowed, and I’m not,’ I kept thinking. 

In the end, we don’t choose to become addicted, but we do choose to heal. I’m trying to make things right and hold myself accountable, because I no longer want to hide behind my disease. Not everyone sees it as one, but it definitely is.