I quit smoking 4 years ago next April. I was able to quit through the use and in spite of a drug called varenicline, also known as Chantix. I cannot recommend it to anyone. Let me tell you what it was like.
P.s. This turned out highly personal, but I consider it a public service for internet searchers so it’s going up.
I was a smoker for around 15 years, had tried quitting a handful of times, but nothing ever took. The longest I ever lasted was 2 weeks in college, until a bad paper gave me the excuse to start up again. I tried gum. I tried the patch. The best I got to was rolling my own, which had the effect of lowering the number of cigarettes I smoked in a day.
It’s hard to quit smoking! I once talked with a guy who had quit cocaine and alcohol, and he said that cigarettes and coffee are the two hardest things to stop using, in his experience. Actually, he said caffeine was the worst of the four, but cocaine was way easier to stop using than quitting smoking. At least that made me feel better about my failures when I heard that. Incidentally, he was the guy who turned me onto rolling cigarettes. Good guy. Don’t remember what his name was.
There are a lot of things going on with nicotine and cigarettes. For one thing, it hooks into the same neurological system as food rewards. So when you crave a cigarette it literally has the same feeling as if you are starving, at least in terms of need. That means that quitting smoking is akin to deciding to just not eat anymore, forever. Try fasting. That kind of quiet desperation for food is what denying a nicotine addiction feels like.
Another feature of nicotine is its affect changes based on how you dose. Quick bursts have a stimulant effect, slow bursts have a sedative effect. If you see a smoker doing quick pulls on in succession, they are trying to wake up. If you see someone taking leisurely draws, they are relaxing.
It’s kind of fascinating, and that’s the one thing I really miss about smoking: the ability to control my mood dynamically. I would describe it a more acute, pinpointed form of antidepressant. You have an upper when you need one and a downer when you need one. As another aside, I’ve read several places that a lot of therapists don’t actively advise their bipolar patients from quitting smoking, because those patients are effectively self-medicating in real time.
All of this doesn’t even count the social and habitual aspects of smoking. And the self-justifications. To make a long story short, it’s rough. Nothing but respect for people who quit an addiction, nothing but sympathy for anyone who can’t.
So, this is the situation I was in, the year leading up to my wedding. This was the year I decided to quit and to try chemical intervention. I didn’t want to go into my wedding as a smoker. I didn’t want to be skipping out of my honeymoon every several hours to have a cigarette. I wanted to be a person who could do this thing and be in charge of my own destiny; not have addiction in charge of me.
I went to a doctor. I got a prescription for Chantix. I had heard about it from my brother, who once tried it with some success. Prior to starting the treatment, I read the insert and was mildly amused by the list of serious side effects. It sounded like no one should ever take this drug. Not and be happy about it, anyway.
Basically the drug binds to the receptors normally hit by nicotine, but without quite the same effect. What this means is you can smoke, but the nicotine doesn’t do as much because the receptors are already bound. And because Chantix doesn’t have the same effect as nicotine, you end up losing the chemical dependency. That seems to be legit. Smoking just didn’t feel as good anymore. It was kind of a let-down, but I was happy to find something that looked as if it would work.
I was advised by my doctor and also the drug inset to alert my family and some close friends about the treatment, and ask them to be monitors for me. A the time there was a known slight risk of depression with taking the drug. I basically asked my boss and a few people to just touch base with me and ensure I was still feeling pretty good and not about to off myself or anything.
I was on varenicline for maybe 6 weeks before I eventually took myself off because I started feeling really weird. There was a certain unreality over the world. Kind of like everything was a little spacey. I had a hard time thinking. Thank God I never got into a car accident — it’s come about that car accidents and near-misses are a common side-effect. But the problem with Chantix isn’t necessarily getting on, it’s stopping.
To be clear, I didn’t just quit the meds cold-turkey. I slowly reduced the dosage in the same pattern as I increased the dosage when I started (they have you ramp up). Then I was off. I didn’t have quite the same desire for cigarettes anymore. I kind of craved the pills, actually.
However my moods were all jacked up. At the time I associated it with wedding stresses, problems with my family, etc. I had a lot going on and I thought it was just normal life overwhelming me. In retrospect it was chemicals jacked up in my brain. For one thing I developed aphasia, something that’s with me to this day. Aphasia is where you consistently hunt for the right word. I used to be pretty quick at that, but now my brain just locks up hunting for the right term. The unreality I experienced while on Chantix went away, but the hard-to-think stayed with me.
For another I became increasingly depressed. I did, in fact, have suicidal ideation, which is a fancy term for “thinking about throwing yourself in front of a train”. I also experienced a gradual crescendo of panic and anxiety and paranoia. The scariest event was an evening I woke up at about 3 in the morning, scared to death. My mind was racing, I felt like the world was crazy. The darkness seemed to hide a sense of spinning madness outside our apartment.
I remember laying there terrified that I was becoming schizophrenic. I was terrified I was having a psychotic break. I thought I was losing control of the entire world and I couldn’t do anything to save myself. I clutched Nicole lying in bed next to me, and I was terrified she would find out I was crazy and I would lose her.
We were in the midst of planning our September wedding and I had just received the sword I was going to wear at the ceremony — I was so thankful it was down the stairs. At the time I knew if I just kept myself in bed upstairs everything would be fine. I was afraid that if I were near the sword I would pick it up and just run out and start trying to kill people with it.
I clutched Nicole and reassured myself with her wholeness and sanity. She was real and solid. She was asleep even though the world was spinning outside. Eventually I fell back asleep in exhaustion. To this day I think her presence may have prevented me from going insane. I’m so glad she was with me that night — I guess score one for living in sin.
Two days later I stayed home from work and cried the entire day, for no reason at all. Nicole took me to the 4H Fair to cheer me up, but I thought the animals could sense my mental disturbance and that validated my fears. I could tell Nicole was worried, but I didn’t know what to tell her. I was scared of myself and scared of losing her if she knew the truth of my craziness.
It turns out that experience is actually kind of common. Side effects now include “hallucinations”, “psychosis”, and “harm to self and others”. So at least I know I’m not crazy in thinking I was going crazy.
That night was the lowest point of my unexpected chemistry experiment. The night of insanity happened in late July and I hobbled along until mid-August when I started to feel as if things were resolving in the world. I started to gain some perspective and not view everything through depression, hysteria, and panic.
I really don’t know what was going on in my brain, but I’ve hypothesized that either 1) it takes a long time to get Chantix out of your system, so I just had to wait for it to go away, or maybe 2) Chantix just seriously set my chemistry out of whack, and it takes awhile to get it back into shape. I had a happy wedding and enjoyed the honeymoon.
But it was over a year after that before I felt fully normal again.
I think Chantix is still prescribed, but now it has more precautions and notes on it. You should read the Wikipedia section about varenicline’s depression and suicide risks. I didn’t know about all that information when I started, just rumors of it and nothing concrete. The controversy section on that page is interesting, too.
Here’s the funny thing: my brother has been on it twice now and didn’t have any mood-effects. It also didn’t help him quit, so there’s that.
In the end, my feeling about the whole Chantix experience is that it’s as if I took a hardcore psychedelic. My chemistry changed. I feel like a slightly different person. I already mentioned the aphasia. I have a friend who talks to me about schizophrenic people he knows, and I feel like I understand what he’s talking about. I’ve been there, at least for a little while.
This is the positive takeaway: in the darkest points of this tale, during the times of depression, there was one thought that always cropped up. “I bet a cigarette would make me feel better.” But I resisted. I never bought a pack of smokes. I even developed a practice of stopping my breathing when I walked by second-hand smoke, so I wouldn’t inhale it. I powered through the end of my addiction while I was going crazy. Who knows, maybe being crazy is what it took. It was a year of developing a sense of will.
That’s the happy ending to all of this. I still don’t smoke. I still have no desire to smoke. But I can’t thank Chantix for that. I’m claiming it as my own.