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malloc
01-10-2011, 05:13 PM
I'm in kind of a strange situation, and would like to know what you guys think of this scenario.

I have a friend, who've I known a while that is addicted to prescription, narcotic, pain killers. However, the problem is not so cut and dried as that. She has a legitimate reason for using the drugs, and is in a pain management program. I didn't even know she was a full blown addict until an incident that occurred on Friday. I knew she took pain killers for her condition, but I didn't know the depths of the problem she had with them.

Many years ago she was in an accident that left her with permanent, painful, damage to her knees, hips and back. She's been taking percocet and morphine in a pill form since then. She also has manic depressive disorder and is on other drugs to treat that, but I don't know what they are. On Friday afternoon, the purse-bag-thingy she keeps her prescriptions in was stolen from her car. She called me, and was completely inconsolable. I've never seen this side of her before. She was out of her mind crazy at the mere thought that she was going to have to go a while before she could have her prescriptions again. The pain management center was closed, obviously, and she couldn't get a hold of her doctor. She was asking me if I had any drugs of this type, if I knew anyone who had some for sale, etc. Only she was yelling, angry, and crying at the same time. She was threatening to kill herself, threatening violence if she didn't get her drugs, and was basically going completely mental! She hadn't even missed her next scheduled dose yet, so again, it was just the thought of going without that caused this reaction.

Then I found out even more. Sometimes she goes through her prescriptions too quickly, and buys more pills on a black market, which is apparently a pretty big and thriving market. I was genuinely concerned for her, and called the paramedics to check her out. The Sheriff's department showed up as well, and the deputies did a good job of calming her down, even though she used language and made statements I never though I'd hear from her in front of the officers. She didn't get arrested or anything though, and I told the deputies I'd look after her. Later on that night she got sick from withdrawal, and I ended up taking her to the E.R. After explaining to the doctor that she was in pain management, that her prescriptions had been stolen, and showing him the police report, the E.R. doctor wrote her prescriptions to keep her covered until the pain management office opened this morning. Within 30 to 45 minutes of getting these temporary prescriptions filled, and getting them back in her system, she was all back to normal.

This whole ordeal left me kind of baffled. I spent the weekend thinking and praying about this predicament, and still don't have a clue as to how to help her. In a normal addiction there are many programs which are designed to help people abstain from their poison of choice. In this scenario, she must take the pain killers in order to have any quality of life, she doesn't have the option of quitting them. Does anyone have any experience helping to manage this kind of addiction? It's like she's forced by circumstance to stay addicted, but she needs to learn how to manage the addiction. Does anyone even know where to look or where to start? Doctor's create this type of addict out of necessity. They can't "fix" the problem in any way, all they can do is treat the associated pain. There's got to be some sort of support framework for people in this situation, but I don't know what it is or how to find it.

I also have a concern that like most addictions, narcotic addiction might be progressive and in the future she'll require more and more drugs to get the same effect. Since she's supplementing her legal prescriptions with buying extra drugs illegally, there's a risk of overdose, fake medication, and all the problem involved with illegal drug use.

Any ideas would be greatly appreciated.

Rockntractor
01-10-2011, 05:19 PM
Have her mention tramadol to her doctor.

malloc
01-10-2011, 05:32 PM
I'll ask her about it. I'm not sure if just adding to or changing her prescriptions are going to be a solution though. I think she needs some sort of addiction counseling or treatment.

obx
01-10-2011, 05:34 PM
I am in a pain management program. I take some very strong narcotics. If I take the correct doses I do not get much of a high out of them. I know there is a possibility of it becoming a habit rather than a treatment so every few days I will go without and just endure the pain. I think your friend has started to enjoy the numbing effects and believes that is how she should feel. If she does not, then the pill must not be working. I would talk to her doctor about this and tell him everything you have told us. He will be better equiped to deal with this and I am sure he has seen this exact thing before. Good luck.

Articulate_Ape
01-10-2011, 05:37 PM
I am in a pain management program. I take some very strong narcotics. If I take the correct doses I do not get much of a high out of them. I know there is a possibility of it becoming a habit rather than a treatment so every few days I will go without and just endure the pain. I think your friend has started to enjoy the numbing effects and believes that is how she should feel. If she does not, then the pill must not be working. I would talk to her doctor about this and tell him everything you have told us. He will be better equiped to deal with this and I am sure he has seen this exact thing before. Good luck.

Good advice.

Rockntractor
01-10-2011, 05:40 PM
I'll ask her about it. I'm not sure if just adding to or changing her prescriptions are going to be a solution though. I think she needs some sort of addiction counseling or treatment.

It is non narcotic but for many types of pain is more effective than Vicodin, it won't make you high though.

Gingersnap
01-10-2011, 05:42 PM
If she's supplementing her meds, that's a problem. The only way to prevent that (because everybody develops tolerance over time) is to deliberately use less than the amount needed to control the pain and gradually come back up.......and then gradually go back down.....over and over again. It works to control tolerance but it's not exactly fun.

What non-drug treatments is she getting through the pain management place to help? Legit places usually enroll people in guided mediation classes, stress-reduction classes, yoga, warm-water therapy, and similar adjuncts.

If she can stop supplementing her prescriptions, it probably doesn't matter if she's technically addicted. If there is no cure for her pain (replacement joints/discs, nerve surgery, TENS, etc.), then what's the alternative?

malloc
01-10-2011, 05:57 PM
I am in a pain management program. I take some very strong narcotics. If I take the correct doses I do not get much of a high out of them. I know there is a possibility of it becoming a habit rather than a treatment so every few days I will go without and just endure the pain. I think your friend has started to enjoy the numbing effects and believes that is how she should feel. If she does not, then the pill must not be working. I would talk to her doctor about this and tell him everything you have told us. He will be better equiped to deal with this and I am sure he has seen this exact thing before. Good luck.

This is very good advice, I'm just not sure if her doctor will talk to me about it. We aren't related, so I'd have to convince her to allow me to speak to her doctor I guess. It's definitely worth a shot though.



If she's supplementing her meds, that's a problem. The only way to prevent that (because everybody develops tolerance over time) is to deliberately use less than the amount needed to control the pain and gradually come back up.......and then gradually go back down.....over and over again. It works to control tolerance but it's not exactly fun.

After her outburst on Friday, I don't think she's going to be receptive to this idea. If I can't talk to her doctor, I'll get her to try to gradually use less medication. I can't force her, but if she's willing to try it I'll help.



What non-drug treatments is she getting through the pain management place to help? Legit places usually enroll people in guided mediation classes, stress-reduction classes, yoga, warm-water therapy, and similar adjuncts.

I know she has some sort of physical therapy once or twice a week. I think it's the workout in a pool kind.



If she can stop supplementing her prescriptions, it probably doesn't matter if she's technically addicted. If there is no cure for her pain (replacement joints/discs, nerve surgery, TENS, etc.), then what's the alternative?

There isn't an alternative that I know of, unless there is a non-narcotic like Tractor was talking about that will meet her needs. I know next to nothing about all this, but I know for sure that isn't some sort of operation they can do to permanently fix the problem(s). I know they are going to try some sort of injection into her back, and they have to put her under for it, but I don't know what specifically they are injecting.

Articulate_Ape
01-10-2011, 07:03 PM
This is very good advice, I'm just not sure if her doctor will talk to me about it. We aren't related, so I'd have to convince her to allow me to speak to her doctor I guess. It's definitely worth a shot though.

Unless she is incapable of it, which it doesn't sound like she is, she needs to talk to her doctor. Trust me, as someone who has dealt with similar issues, she has to be the one to initiate this conversation. If she wants you there for support, fine, but she is clearly not a kid, so if she is not on board with it, then change is very unlikely to occur. As much as you might want to be the "fixer" in this situation, the best you can do is be a facilitator. The fix has to start within her.

Constitutionally Speaking
01-10-2011, 07:06 PM
Unfortunately in today's bureaucratic and litigious society, the doctor probably cannot even talk to you about it.

The HIPPA laws are pretty strict.

obx
01-10-2011, 07:22 PM
The doctor does not have to talk to you, all he has to do is listen. This doctor knows addiction is a risk with this treatment. He needs to adapt her program or risk his practice. You were pulled into this so no one can complain about anything you do.

Articulate_Ape
01-10-2011, 07:24 PM
The doctor does not have to talk to you, all he has to do is listen. This doctor knows addiction is a risk with this treatment. He needs to adapt her program or risk his practice. You were pulled into this so no one can complain about anything you do.

Have you ever met a lawyer?

Rockntractor
01-10-2011, 07:35 PM
Part of me says walk away and don't look back and be glad you didn't get married, it may not be nice but she is a mess and nothing short of a treatment center will do her any good.

malloc
01-10-2011, 07:51 PM
Part of me says walk away and don't look back and be glad you didn't get married, it may not be nice but she is a mess and nothing short of a treatment center will do her any good.

I am married, just not to this girl. :D

I want to help her out. The whole situation kind of sucks. However, before I go poking about in her business, maybe I should see if she actually wants or asks for the help. :(

Though as you can all tell, I'm an expert in this field and am in a perfect position to offer precisely the help she needs. ;)

Articulate_Ape
01-10-2011, 08:04 PM
However, before I go poking about in her business, maybe I should see if she actually wants or asks for the help. :(

Spot on.

Phillygirl
01-10-2011, 10:16 PM
Malloc, if she is going to the black market to supplement her meds, she is already in trouble. These are the most difficult patients to try to deal with, because there is a need for the pain relief that is legitimate. You should tell her doctor about the issue. But that is all you have to do to help. Addicts don't accept help until they are ready to want it themselves, not because someone else realizes they need it.