Opiates addiction and pain management... sorting lies from truths

[SistersHelp]

Hi... I'm looking for some opinions from people who understand how to manage pain in the context of opiate addiction.

My sister is currently taking OxyContin for back pain. She is highly addicted. The director at her rehab centre has been urging her to go to a detox centre and get completely off the opiates so she can work the program properly when she gets back.

My sister says no way.

She says she is afraid of the back pain returning. And she says her doctor doesn't recommend coming off the opiates.

This seems fishy to me.

But I am highly distrustful of my sister because she has been dishonest about all this for so long.

So... for those who are in the know... how have you dealt with situations like this? Are there options? Not seeking medical advice... just want to know if other options aside from a life of opiates exists.

[Sugah]

The willingness to get clean has to come from her. You can't give it to her, and, at least for me, until using became more painful than getting clean, I wasn't willing.

What's her back condition, if you don't mind sharing it?

Peace & Love,
Sugah

[SistersHelp]

Hi Sugah,
Well, that's a really good question and it's a large part of the friction that currently exists. No one really knows for sure what's going on with her back. She was born with a slightly smaller left leg than right and it has always caused her to walk kind of askew. Over time, I think, this gait has caused her to have some back issues.

She has, however, been very dishonest about what's really going on and has claimed all kinds of medical problems that aren't real. She has pretended to have cancer, multiple sclerosis, and a whole host of other problems that she doesn't really have. Basically, it's nearly impossible to discern truth from fiction because she is so committed to find reasons to keep taking the OxyContin.

We've requested that she sign a release of information for the director of her recovery centre to talk directly to her doctor so some of this mystery can be sorted out.

Thanks for your reply... you're absolutely right when you say that the willingness to get clean has to come from her. Right now she's more interested in finding a doctor who will support her decision to take Oxy.

[Latte]

There was an Intervention episode with a lady who needed pain meds but also wanted to get clean. I think that they sent her to a rehab that specialized in pain management too. I know that Celebrity Rehab had a star that needed pain medicine also and they were working with him too. He decided to leave but I know that if a person is honest in wanting recovery that there is a way.

We have a member here who decided to go with a pain pump. Maybe he will chime in here.

There are many chronic pain patients who manage their pain without opiates. I am one. I focus on entire body health. Exercise, nutrition, vitamin supplements, meditation and distraction.

My thoughts are with you and your family.

[kj3880]

This year, I had to get off of opiates and learn to manage my pain without them (rotator cuff injuries) to recover completely from addiction. But I don't know your sis' story. She might have more pain than I do at this time. Some people do need pain medication for long periods of time legitimately. My Dad has to take them for the rest of his life for horrible pain. These people do become physically dependant on opiates, but it can keep them functional.

It's impossible for us to tell because we aren't in their situation how much pain they are in. A lot of people are under-pain-medicated in our society according to the Society of Pain Mgt Doctors' web site, because of fear of addiction. As a result of this, and after having been in serious enough pain to need opiates after my surgery just to get out of bed, I try never to judge anyone else's pain management needs. That is best left to the doctor and the patient to decide. You can't see pain.
KJ

[SistersHelp]

Originally Posted by kj3880

That is best left to the doctor and the patient to decide. You can't see pain.
KJ

Thanks KJ, you're right. That's exactly what makes it so difficult to know what's best for everyone involved... and I appreciate the reminder.

[jazpoppy]

SisterHelp;

Well, you can look at it this way: She may just be exaggerating her pain, or she may REALLY need opiates to manage properly, that's if she has exhausted EVERY OTHER medication, Physical Therapy, and other NON-Narcotic methods first and pain has really ruined her life so she has a real need. It does sound kinda like she likes the oxy for more than just the pain, but I DON'T KNOW. If she really does need narcotics, methadone would be a better way to go, but I'm not a doctor she would need to talk to hers. If it turns out that she really does need narcotics pain management, she can get recovery and still take narcotics for her pain, its NOT EASY, but if she has a TEAM of doctors, counselors, sponsors, and family support, and she is NEVER in control of her own medication, it can be done. I am living proof (I take the methadone, I don't get high, I just get pain relief, and my bf gives me ONLY what I'm prescribed each day, and I go to meetings, have recovery friends, and stay on top of NEW INNOVATIVE approaches to pain management so I may NOT HAVE to stay on narcotics for the rest of my life. Think of it this way, there is a group called Over Eaters Annonymous, they are addicted to FOOD, but they can't stop eating food, we all need food to live, but through their recovery, friends, family, doctors, support groups, sponsors, and counseling, they CAN eat safely without relapsing to "abusive behaviors" towards food. Try to find out more information about her pain issues, I may be able to tell you where she should go for more information on how to alieviate her pain without narcotics or at least without a LOT of narcotics. Good luck.

Love

Jaz

[SistersHelp]

Jaz, thanks so much for this thoughtful and informative reply. My sister hasn't exhausted the other options you've mentioned and I would really like to see her try some other avenues... however, she is extremely reluctant to even try. Makes it difficult because of course it's her decision to make and since I can't speak to her doctor myself, I only get the information she chooses to give me. And unfortunately, she doesn't have a good history of honesty. I had no idea methadone could be administered to control pain... I have a lot to learn and I appreciate enormously that you've taken the time to educate me a bit. I love your food analogy and it helps me put things in perspective!

[barb dwyer]

Hi Sister -

One thing not mentioned in your first post that jazzie touched on is -

I'd be more concerned if she was going through her entire 'script in like ...
a week.

I mean, if she's taking the medication as prescribed -
You'd be amazed what won't get you high when you're really in pain.

Now speaking as turly unique addictive personality with great pain -
I too can become 'afraid' of pain when thinking about going off pain meds.

Now that I've dealt with other types of addiction ...
I've learned that ... they're two completely different animals.

[jazpoppy]

Thanks Barb! I agree with everything you said in your post. Wish I didn't have the stubborn pain that I have, and wish I could truly not have to take ANYTHING to get through the day so I pray that one day I can at least get relief from chronic pain enough to not have to rely on medication. I haven't been high off pain medication since I was actively using and drinking! But I still feel the little part of me that gets angry that I cannot live medication free. I used to be the type that didn't like taking aspirin for a headache! But I've come to terms with the fact that I cannot stop taking my SSRI (anti-anxiety and anti-depressant medication, its in one pill) medication, I've tried a few times to wean off and BAM, I'm back to square one with agoraphobia, anxiety attacks, severe depression, and relentless crying jags. So if that one little pill keeps me walking straight on the path of life, and keeps me from going "NUTZ", I can live with that!

SisterHelp;

Does you sister take her meds as prescribed??? I don't remember if you mentioned how she takes her oxy. If she is taking it by the prescription label, but is afraid to try to get off of it for fear of pain returning, maybe she needs to have her doctor try her out on a "drug holiday", which is a short period of time that the doctor weans her off her meds so slowly that she should not withdraw like a junkie coming off herion, it should be more gentle. The while she's weaning off, other alternatives could be started up, like a lidocaine patch (non-narcotic numbing patch that the Dr. can prescribe to put on her back to help numb nerve and muscle pain), Physical Therapy (slow and gentle at first, working upward), massage therapy, and possible a TENS unit. She'll know right away if she NEEDS the pain medication or just WANTS it. Of course this won't "cure" her if she WANTS it she's going to have her doctor put her right back on it, and then things may go downhill until she hits a bottom (hopefully a high bottom, like an intervention from you and your family and friends coaxing her to get addiction help) OR she really NEEDS it and will just take it as prescribed while continuing to do alternative therapies as well. Because most likely, if she just likes the Oxy for a buzz, she won't continue the alternative therapies, and she'll have excuses for not doing so. So if you can find out if she's abusing those pills (running out early) that can help you decide how to go about helping her find her way to sobriety before anything really bad happens (like overdosing, or getting cut-off by her doctor if he finds out she's abusing the pills, and so on). You sound like a wonderful and concerned sister! You can't make her stop if she's off and running, but you sure can try to steer her away from becoming a real full-phledged junky that starts lying, steeling, and cheating for drugs. I really hope she is taking the Oxy for pain only and is not abusing them. I am praying for you and her.

Love

Jaz

[hairgirl]

Your sister is the only one who can make the decision, but her mind is clouded by fear.Fear of the pain of a real injury and fear of pain from withdrawal.They are very different, and the withdrawal pain can be allot worse and trick a person.Pain is scary, but I feel it is a necessary part of healing.I know it is hard to understand, but her actions should tell you if she needs someone to intervene.If you sense opiate abuse, there is a justifiable reason to have concern, but again it is up to her.Nobody can get forced to change, it comes from within.