Need information

[JAS4Yeshua]

Reliable web links, phone numbers, etc.

I'm afraid (about 99% positive) my wife might have become addicted to narcotic medication. I grew up in a stable Christian home, so addiction is something I'm only familiar with from a distance. I know the textbook signs, but in reality it is much harder to determine.

Back in 2004, she had a major surgery, known as a Whipple. She had a tumor on her pancreas, and they had to remove the tumor, part of her pancreas, part of her intestines, part of her stomach, her gallbladder, and "rewire" her digestive system. This surgery is more dangerous and invasive than abdominal surgery, and recovery is difficult, and painful.

Over the next couple years, she has grown more and more "immune" to pain medications, so that they have to continue to give her stronger pain meds. In addition, the past few months, she has been struggling more with nausea. Problem is, these things are also post-complications of the Whipple surgery, even now, two and a half years later.

Almost every day since Thanksgiving, she has needed to go the hospital due to nausea and vomiting. The only thing that works for her now is phenergan for nausea, and diloted for pain. Unfortunately, the doses of diloted is so high that it drops her O2 sat into the 70s (forcing her to be on oxygen) and completely knocks her out. I was concerned that the nausea was now related to withdrawl, but the ER doctor said she had no withdrawl symptoms.

After the couple hours the medicine takes to wear off, Michelle seems alert and active, as if everything is alright. For relative purposes, she acts normal. She still has pain, but she says it isn't at the original level. She also claims (as most addicts would) that she isn't addicted. She says it is all related to the surgery.

I'm having a hard time believing her, and am at a loss. I did call an 800 number for the national abuse hotline and spoke with someone yesterday. He was very helpful and sent me some information. I'm just wondering if anyone else has some information, especially in regards to regular ER visits for narcotic medication. Even more would be if someone is in a situation similar to my own, and how they handle a loved one in this situation.

 

[chilehed]

Reliable web links, phone numbers, etc.....

Sorry to take so long to reply, but after I read your post I honestly had to take a deep breath, pray and meditate on it. You really need professional advice that I'm not capable of providing.

I've had a couple of surgeries and had to take Oxycodon for the pain, but it was really short term and I was able to stop in a couple of days. I have friends in recovery who've been on meds long term due to things like spinal degeneration, and it's really tough - some have abused them, some have not. Some of them decided to live with the pain rather than risk abusing them... it really stinks.

But we all come from long lines of addicts, and apparently are genetically, socially and spiritually predisposed to falling into chemical abuse and sick relationships. How the meds effect someone without all of that prior baggage I don't know...

I really don't know what to say. I know that there are legitimate reasons for even someone like me to use painkillers, but I have to do it with great support from my sponsor, friends, and God - and I have to make sure to talk very clearly with my doctor. I know someone who had an "addictionologist" - don't know exactly what the specialty involves (or even if it's a legitimate medical/psychological specialty) but perhaps you could find out.

The best suggestion I can make is to see if you can find a Nar-Anon group in your area. http://nar-anon.org/index.html

You and your wife are in my prayers.

 

[JAS4Yeshua]

Obviously, I'm not looking for professional advice on the boards. I don't believe that is allowed in this forum (for good reasons). As such, I'm looking simply for referrals for information and opinions from others (if any opinions are available).

We are out of town for the holidays, visiting family and friends. I didn't think she should come, and her father was going to remain with her while I traveled, but she wouldn't take no for an answer. She has been admitted to a nearby hospital last night after they discovered a stone on her appendix, which is probably responsible for the month of hospital visits.

Despite this, my concern remains, and I will continue to look for more resources that might be able to support. I thank you for the link you have shared with me, and will add that to my list. All I know is that this is new to me, and I'm just trying to get through it with the Lord, and with the help of Brothers and Sisters from my church.

 

[chilehed]

I imagine that a stone in the appendix could cause a lot of adverse symptoms, and I pray that she'll be feeling better after it's taken care of.

My experience has been that when I've been in no pain because of the meds, as they wear off the pain I feel seems relatively intense. But given my history, I have to (in advance) decide that I'm going to force myself to take just barely enough meds to take the worst of the edge off so that I can sleep at night, but not so much that I'm comfortable. Then as soon as I can live on plain Tylenol, I do it. It's just too easy for me to talk myself into thinking I need more meds than I do, and I've known too many people to fall back into active addiction again to want to risk it myself.

 

[JAS4Yeshua]

They did do a number of tests, and what they saw on the appendix turned out to be nothing, and not requiring surgery. Turns out she was extremely constipated and backed up, which caused this round of nausea, vomiting and pain. They gave her a laxative and put her on a limited diet temporarily, and told her to take a laxative regularly to keep herself regular.

While there was a legitimate reason for this latest situation, I still am going to be following up on this, and if she starts wanting pain meds again, I'm going to follow through as necessary. I never expected to be in a situation like this, and have no experience with it. This makes it very difficult for me to know exactly what to do.

 

[chilehed]

So glad it didn't require more surgery. Could have been caused by the pain meds, my understanding is that constipation is a common side effect of many of the opiate-types such as dilaudid.

You both continue to be in my prayers.

 

[BlessEwe]

When any drug is taken for over a month or less the body finds this to be the normal. It sounds like she has been through so much and is so blessed to have you in her life.

It is good that you are looking into it more, but I am sure you will find that it is your wife who needs to make the discission to get off of the drugs and if she can with the pain she is having. Again it is good that you are looking into it more. Al-anon is a great place for family, great support there. And Nar-Anon as chilehed suggested.

 

[zsepthenne]

I commend and applaud you on being what sounds like a caring, concerned husband.
Tolerance to medication is usually a bad sign. I know both of those meds are addictive. I was addicted to benzodiazipines at one time. Those were very hard to get rid of.
Check your phone book for addiction specialists. Some of these are psychiatrists. Or even check some of the recovery centers. Some medications have been very effective in keeping back the opiate cravings for some. My sister-in-law has struggled with this for many years.
In my prayers.

 

[YourBrotherInChrist]

JAS,

You're going though a huge trial right now, and my prayers are with you and your wife. My recommendation to you is for you to learn all that you can about the signs of addiction now, either to ease your mind or to prepare you for the worst.

First of all, it is crucial to distinguish between dependence and addiction.

From a presentation on pain management by Dr. James Eckman (slides 51 and 52):

DEPENDENCE vs. ADDICTION

• Physical dependence
  • Physiological Problem
  • Expected response to chronic opioid administration
    • Characterized by onset of acute withdrawal syndrome upon cessation of opioid or administration of antagonist
    • Downward titration is necessary to prevent symptoms
      • Decrease dose 15-20% daily and stop
• Addiction
  • Psychological Problem
  • Behavior pattern of drug abuse
    • Craving, overwhelming involvement in obtaining drug, using it for other than pain control, using drug despite negative physical, social, legal, or psychological consequences

BEHAVIOR SUGGESTING ADDICTION

• Continued substance use despite adverse consequences
• Frequent intoxication at times of major commitments or when use is dangerous
• Spending excessive time obtaining, using, and thinking about the substance
• Reduction in social, occupational, or recreational activities due to substance use

Given her medical condition, your wife may very well be dependent on her pain medications. However, what you need to watch out for are the signs of addiction. Is she lying to her doctors about how much pain medication she takes? Is she going to multiple independent doctors in order to receive double or triple the dosage that the doctors think she is getting? Your opening post did not address these questions.

Respectfully, if your wife's doctors are truly aware of the amount of pain medication that she is actually taking, I would defer to their judgment, seeing how they are the trained professionals and you are not. If her pain medications are causing her to be groggy at times, this can be discussed with her doctors to see if there are better alternatives. However, it really isn't for you to judge whether her pain is bad enough to justify her being on pain medication.

What you need to watch out for, as the first sign of addiction (as opposed to dependence), is your wife lying about her pain medications, especially about how much she is taking.

I hope this helps.

 

[YourBrotherInChrist]

P.S. Talking to an experienced substance abuse counselor would be a good idea. I'd recommend just going by yourself for an initial visit, and then taking it from there based on the counselor's advice. One suggestion:

http://www.chservices.org/
Toll Free: 1-800-696-0610

 

[JAS4Yeshua]

JAS,

You're going though a huge trial right now, and my prayers are with you and your wife. My recommendation to you is for you to learn all that you can about the signs of addiction now, either to ease your mind or to prepare you for the worst.

Thanks for the added info. That is exactly what I'm trying to do here, is research and learn. This is a very difficult situation, and you're correct, a huge trial.

First of all, it is crucial to distinguish between dependence and addiction.

From a presentation on pain management by Dr. James Eckman (slides 51 and 52):

DEPENDENCE vs. ADDICTION

• Physical dependence
  • Physiological Problem
  • Expected response to chronic opioid administration
    • Characterized by onset of acute withdrawal syndrome upon cessation of opioid or administration of antagonist
    • Downward titration is necessary to prevent symptoms
      • Decrease dose 15-20% daily and stop
• Addiction
  • Psychological Problem
  • Behavior pattern of drug abuse
    • Craving, overwhelming involvement in obtaining drug, using it for other than pain control, using drug despite negative physical, social, legal, or psychological consequences

BEHAVIOR SUGGESTING ADDICTION

• Continued substance use despite adverse consequences
• Frequent intoxication at times of major commitments or when use is dangerous
• Spending excessive time obtaining, using, and thinking about the substance
• Reduction in social, occupational, or recreational activities due to substance use

Hard to say, but it sounds more like dependence than addiction at this point.

Given her medical condition, your wife may very well be dependent on her pain medications. However, what you need to watch out for are the signs of addiction. Is she lying to her doctors about how much pain medication she takes? Is she going to multiple independent doctors in order to receive double or triple the dosage that the doctors think she is getting? Your opening post did not address these questions.

As I don't know her pain level, I can't say if she's exaggerating her pain to get meds or not. My guess is that she isn't exaggerating, but that the medicine might be amplifying it. She has been told by several doctors (including the one at the ER yesterday) that the more narcotic medication one gets, the greater the pain feels. Once in a while she might go to a second hospital if they didn't treat her enough at a previous hospital, but that isn't often.

Respectfully, if your wife's doctors are truly aware of the amount of pain medication that she is actually taking, I would defer to their judgment, seeing how they are the trained professionals and you are not. If her pain medications are causing her to be groggy at times, this can be discussed with her doctors to see if there are better alternatives. However, it really isn't for you to judge whether her pain is bad enough to justify her being on pain medication.

Believe me, I'm not trying to justify anything. I'm trying, with the help of the Lord, to determine what is best. If she is addicted, that is a greater problem than the pain, but at the same time, we (she, her doctors and I) need to find the right way to handle it, right treatments, right medications, whatever.

What you need to watch out for, as the first sign of addiction (as opposed to dependence), is your wife lying about her pain medications, especially about how much she is taking.

I hope this helps.

She isn't lying as far as I can tell. I control her medications as a result of bi-polar problems, so she can't abuse them.

P.S. Talking to an experienced substance abuse counselor would be a good idea. I'd recommend just going by yourself for an initial visit, and then taking it from there based on the counselor's advice. One suggestion:

http://www.chservices.org/
Toll Free: 1-800-696-0610

Interesting you gave me that link. I had bookmarked it previously. I found it via searches a couple days ago, and it is located a couple buildings down from where I work.

Thanks to you, and everyone who has posted, for their feedback and links. I will add that Michelle has stated she wants to find alternatives to narcotics as well, but still denies addiction. Her pain management doctor won't open again until Wednesday, and she will be setting up another appointment to work out the next steps.

 

[YourBrotherInChrist]

Interesting you gave me that link. I had bookmarked it previously. I found it via searches a couple days ago, and it is located a couple buildings down from where I work.

I looked it up based on the location in your profile. There really is no substitute to face-to-face contact with a real life professional. Internet and phone can only convey a small portion of the entire problem.

Her pain management doctor won't open again until Wednesday, and she will be setting up another appointment to work out the next steps.

You should express your concerns to your wife's pain management doctor as well. He is in an excellent position to know all the facts.

Good luck to you and your wife!

 

[JAS4Yeshua]

After a few conversations, and a couple more ER trips, Michelle has finally realized that she is too dependant on narcotics, and may even be addicted. We have an appointment at 2:30 today with her pain doctor to talk about what to do, and work with him and the hospital drug rehab to get onto a pain management routine that will eventually remove narcotic medications.

 

[LoG]

After a few conversations, and a couple more ER trips, Michelle has finally realized that she is too dependant on narcotics, and may even be addicted. We have an appointment at 2:30 today with her pain doctor to talk about what to do, and work with him and the hospital drug rehab to get onto a pain management routine that will eventually remove narcotic medications.

That's great as long as she is convinced of it herself and not because you were. If she truly is addicted then there is more to her coming off of it then you controlling her intake. There are emotional, mental and spiritual aspects to the disease of addiction she will need to look at because addiction is only a symptom of deeper issues.

Further, addiction is a family disease. All members tend to be affected by it in some way shape or form and it is a secondary theme running throughout your posts in this thread. Many may see your actions as that of a thoughtful, caring and loving spouse but from the perspective of Al-Anon or Nar-Anon there are some behaviours that could have a negative impact on your wife's recovery.
It is to be hoped that you are as willing to look at your own issues as you are your wife's and as has been suggested by other posters, attend some meetings of Nar-Anon and/or Al-Anon to learn how to deal appropriately with those suffering from addictions.

I am not trying to be antagonistic here but do get a strong sense that there is more to this then just your wife's potential addiction to narcotics. I think you will get a lot of benefit from those meetings.

God bless you and yours.

 

[chilehed]

After a few conversations, and a couple more ER trips, Michelle has finally realized that she is too dependant on narcotics, and may even be addicted. We have an appointment at 2:30 today with her pain doctor to talk about what to do, and work with him and the hospital drug rehab to get onto a pain management routine that will eventually remove narcotic medications.

Was just thinking of you. Hope all is well, you remain in my prayers.

 

[JAS4Yeshua]

Michelle has stopped the narcotics. She was put on a medication (not subutex, but another one similiar to it, with subutex as a base component). That medication made her sick, and she stopped taking it. Even though she stopped, she hasn't gone back to narcotic medication, and hasn't been in pain. This is still the first week, so things are still a little rough. I know they will get better soon.

 

[Debi1967]

I'm having a hard time believing her, and am at a loss. I did call an 800 number for the national abuse hotline and spoke with someone yesterday. He was very helpful and sent me some information. I'm just wondering if anyone else has some information, especially in regards to regular ER visits for narcotic medication. Even more would be if someone is in a situation similar to my own, and how they handle a loved one in this situation.

I am also on the phenergan for nausau and have to be taking large doses of pain meds on a daily basis. Sometimes the pain meds I have at home don't work effectively and then I have to go into the ER for Morphine. I take Tylenol 3 at home because I refuse to go any higher. I have been at times sent home with temp prescriptions of oxycotin though for a short amount of time (say 2 or 3 days worth)

I suffer from Fibromyalgia which is a pain related illness that works with the nervous system to cause unrelated pain for no reason. I also have IBS and I have a paralyzed diaphragm on the left side.

Am I addicted to my meds as I stand now probably because I also take seizure meds as well. But as the Doctors have already told me it is either I live in horrendous amounts of pain or I take the main maintenance medication that they are giving me.

See I realize that I am probably addicted because I am a Recovering Alcoholic and former Drug Addict of narcotics (non-legal, cocaine) so I have been down the road of living that lifestyle in a different way and of seeing it's destructive effects.

However it is really hard to note it in yourself when the doctors themselves are medicating you with drugs that can potentially be addictive, even if you may need them. The fact that you may need them is irrelevant to the fact that they are still addictive to you. I think sometimes doctors should be more aggressive in alerting us to this fact and that we can and may potentially become addicted during the process of recovery or while taking care of a long term illness like mine.

I think that it is imperative that you take the time to talk to her doctor about your concerns for your wife. Ask him is the potential there for her to be addicted at this point given how much she is taking these drugs on the daily basis or whatever basis she is taking them.... From there I think that you and your wife should ask the doctor if there are alternatives to using such high powered narcotics in order to surpress her pain. Sometimes there are.