Finding hope after a mental health and addiction crisis

Charleen Pule is a case manager for a community mental health center in Hawaii. She helps people with serious mental health and addiction issues – 2 issues that she is deeply passionate about.

Pule has her own history of substance abuse and mental health issues. But she received the care she needed from Kaiser Permanente’s addiction and recovery services in Honolulu, Hawaii.

Now her life is back on track and she relies on her experiences to help others.

A story of trauma and pain

At a young age, Pule suffered trauma.

“I grew up in a tornado,” Pule said. “My mum has bipolar disorder and my dad used to abuse her. And I was sexually abused when I was 8.

As an adult, Pule faced physical and emotional health issues. Like her mother, she was diagnosed with bipolar disorder. And for years, she had chronic hip and back pain.

After undergoing gastric bypass surgery in 2008, she began taking prescribed liquid opiates to manage her pain. She had previously taken opiates for the pain. But when she took them in liquid form, it was the first time she had felt high from a painkiller.

“It was a euphoric high and I liked it,” Pule said. “In addition to my pain, the opiates helped cover up my psychiatric issues. They hid everything. I started using more than I should have, even when I wasn’t in pain. I was hooked.

A mental health and addiction crisis

Within a few years, Pule experienced serotonin syndrome. Serotonin is a chemical messenger in the body linked to mood and many other functions.

Symptoms of serotonin syndrome include restless feelings and an elevated heart rate. At its worst, it can cause muscle twitching, loss of coordination, and even hallucinations. Without treatment, it can be fatal.

Serotonin syndrome can result from taking several medications that affect serotonin. Since many psychiatric drugs affect serotonin levels, Pule had to stop taking all of her psychiatric drugs for a while.

This meant that his bipolar disorder had not been treated.

“I was in crisis without my meds,” she said. “I went into a full blown mania.”

Around the same time, Pule’s doctors stopped prescribing him opiates due to addiction issues. She started using crystal meth, an illegal methamphetamine.

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