blui

i've been worried about our 20 year old son. as i've posted before, he has mental health issues as well but we've recently discovered that he's been sneaking pain meds that his dad has been prescribed.

last night, he came into our bedroom while we slept, took my husband's keys, opened the garage, and searched until he found the pill bottle. he took probably 10 out of the 30 or so that were out there. this means that his dad is probably going to have to go several days without the medication he really needs -- his foot was crushed last march and it causes pain with every step.

we got up and our son was up and talkative -- which is our clue that he's been using. however, he let us believe that his new anti-depressant was kicking in real well -- he started it Monday. he is a quick responder, but it was still too quick.

his dad lost it a little bit -- he get's really mad about it. it hurts his feelings that his son would lie to him & steal from him. i just get really sad -- maybe it's better to get mad now & then? a few hours later, our son admitted that he doesn't have control. his words were that it gets the best of him. and he agreed that he'll see someone about the problem.

there won't be an issue of him getting the meds again at our house. my husband is on his way out to some other property we own with a camper on it to lock everything up there. our son doesn't like to go out there, so he doesn't even know how to get there by himself.

any opinions on whether this is a real admission of a need for help? or more addict talk to appease us?

at least he didn't give me the "it's my life choice" lecture this time.

i'm going to spend some time looking into what places around here work with our insurance and what the process is -- we're thinking outpatient at this point.

Chino

You'll know if it's real or BS when you present treatment options to him. I'd strongly encourage inpatient if you can afford it. My daughter did outpatient first, and it didn't have .01 impact compared to being immersed in it 24/7.

blui

well -- i've made him an appt for next monday afternoon

we could afford inpatient, our insurance this year has put mental health in with the physical health, so inpatient would probably take us to the max out of pocket for him -- it's $2000 per individual/$3000 per family -- his psychiatrist appt's will already cut into the $2000 -- so it would cost us something less than that.

if he didn't have such terrible social anxiety, i'd definitely go that way.
i'd be afraid it would set off another psychotic break unless we could find a good dual diagnosis facility. everytime he has a breakdown, i worry that he won't come back to us. i hate to say it, but the psychosis is worse than addiction -- if you've never spent 24/7 with someone who doesn't sleep and is completely paranoid/delusional, it's hard to explain.

we never put him inpatient for mental illness issues because there was never a bed available when we were in crisis mode. i wonder if it's just as bad for substance abuse.

at least we can make sure he doesn't have access to any opiates before the appointment.

ElegantlyWasted

Sounds like you're doing the right thing. Only thing
I would add is to confront him directly about sneaking the pills. Sounds like he is in denial. Reasoning would be something like this on his part... I did take the pills, i want the new meds to work, I'll act as if they are working AND everything will be ok. On your part enforce concrete boundaries and call him out on his bs. In a twisted way he is right that it is his life and he can do whatever he wants. He needs to get to the point where he changes the way he goes about things to get it. Have you tried some cbt in conjunction with the meds... group therapy and cbt can work wonders on social anxiety. Best of luck with treatment

blui

his dad confronted him about the pills -- it hasn't been the first time over the past week or so.

it seems he's ingenius about getting them no matter how we lock them up on this property -- so now his dad is moving them to another property that son doesn't have access to.

i would love for him to do some CBT -- he's sure he's so unique that he'll be the person it doesn't work for. either that, or he'd do anything to not have to open up to someone new.

he did go to therapy once, but it was more to humor me. both him & the doctor gave up on it after about 3 months.

to be honest -- i'm not sure if he has normal, vanilla social anxiety that CBT would help -- or he has more of a psychotic disorder that is closer to paranoia. extreme paranoia is easy to spot, but mild paranoia is harder to say for sure.

here's an example from when i know he wasn't on any drugs at all -- and before anything else got bad.

when he was about 12 or 13 (he went through puberty like overnight at 11 and i think that's when things really got started), we were in the drive-thru at the dairy queen. there was a younger boy -- maybe 8 or 9 -- sitting at a table near that section of glass with his parents. my son got really mad, was sure that boy was staring at him and disrespecting him in some way. the boy never looked my son's way. it was over in a few minutes, and things calmed down, and i hoped it was something isolated.

the funny thing -- when he's on the opiates -- he's completely normal. there's no paranoia, no social anxiety, no general anxiety, no depression. his psychiatrist says he's numbing himself -- but my lord, if he could get that from a substance that wasn't dangerous -- it would be a miracle.

the place we're going to on monday has a psychiatrist/addictionologist on staff -- so that's good too.

i'm feeling kind of crazy myself -- maybe this will be a blessing in disguise? maybe this will push him to get the counseling/therapy he needs in addition to his meds.

oh -- a question for anyone out there too -- on the treatment center's website, they have something about adult intensive outpatient treatment that's 3 nights a week for 3 hours. they say that the person has to commit to abstain from all mood altering substances -- what does that include?

i can see the opiates, but what about nicotine, caffeine, psych-meds?
i'm thinking that asking him to quit smoking at the same time as quitting the opiates could be a mistake -- caffeine he could give up no problem -- i don't think giving up his psych-meds are an option.

blui

just wanted to add -- on calling him on it, and his reasoning.

no way he wouldn't know he'd get caught. he knew we were counting the pills and putting them where we thought they were out of reach.

he would know it was just a matter of time.

just he knew we wouldn't beat him or anything, the worst thing that would happen is that we'd be mad/disappointed -- and that we'd lock them up better -- and that getting help would no longer be optional.

we've been through that before with him when he was resistent to go to the psychiatrist -- at first, both of us had to go with him.

i know he's 20 -- but 20 when you're mentally ill is not the same as a normal 20 -- and if need be, we'll both go with him.

maybe he wants help though? it's hard for him to admit he's not in control of anything, even to himself -- maybe doing it even though he knew he'd get caught is his way of asking for it without actually having to ask for it if that makes sense.

teke

just to let you know, i'm praying for you and your family. i pray that your son gets the help he needs. i agree with chino, you know if he serious when you offer him recovery.

PJSparks

Hey - just to say that I know how confusing it can get when mental illness includes both manic/depression +/- psychosis, and addiction to opiates. You end up just not knowing where to start sorting it out! But hang in there - SR saved my sanity

xxx

blui

thanks teke -- i hope so too

i'm sorry for being so long on this site -- i've been touch typing for most of my life it seems -- i'm in the tech field -- and i type about as fast as i think -- i'd hate to know my wpm speed -- and i kind of spaz out about things -- i've had every kind of emotion possible in the last week and i'm a mess.

he was such a good kid growing up -- and was good as a teenager -- he never got in any trouble -- i don't have any practice being firm with him. it'll be hard for me to do it now -- or maybe i'll step back & let his dad handle it more than usual -- he knows he can manipulate me, but not his dad.

coffeedrinker

Sounds like you have some reasons to be hopeful. It sounds like he is on board with going to this appointment you have made:

the place we're going to on monday has a psychiatrist/addictionologist on staff

I really don't know about the setting himself up to get caught - doesn't sound like a really big cry for help or anything - he just wanted the pills. I wouldn't make too much of that. Can he articulate very well? If I thought I was in trouble (and it sounds as if you guys have a pretty good relationship) I would just say "hey mom, I think there may be something going on." But, I don't know your son.

Chino hit the nail on the head. Guessing if he'll want to opt out isn't really productive, but my cyber-gut says he is pretty content with the way things are right now. Why do you think he might want treatment?

about this question:
about adult intensive outpatient treatment they say that the person has to commit to abstain from all mood altering substances -- what does that include?

depends on the program/facility. I have heard some actually require quitting nicotine, but I think those are very rare. Coffee? some yes, some no. Prescrip. meds? Pretty sure most are fine with this. Dual diagnosis is very common. I often wonder if it's a chicken vs. egg argument. My contention, though, is that the addiction has to be arrested before true mental health can even be approached. It masks so much.

And I am so glad you will be meeting with an addictionologist. Ask his/her take on your son's "completely normal" when he is on the opiate med.

he was such a good kid growing up -- and was good as a teenager -- he never got in any trouble -- i don't have any practice being firm with him.

me too. my oldest daughter truly was the perfect child, from infancy on. not just hindsight, either - i often said it. well, on til around the age of 15-16 that is. she started wanting to drop her activities, slowly acquired a different group of friends, and different kinds of friends (not the "bad" kids, just different than the super-goody's she had once been one of) oops, sorry, not my thread.
anyway, she is now a 21-year-old floundering, only moderately responsible young woman who is soon to be, or already, an alcoholic.
anyway, the point i wanted to make was i too, neverhad to be the heavy. she was so easy.
my advice on this one is sure, let your husband do the heavy lifting. but! it is good for you to set boundaries and enforce them anyway! it is one way we love ourselves.

good luck on monday!

blui

thanks coffeedrinker

he can articulate when he wants to -- he can be very persuasive

the thing about him wanting to get caught, maybe that's just me trying to spin it for myself. i'm sure he would be content with the situation if we just let it continue, but he knows his supply has ran out -- so maybe that's the ok, i'll get help now thing? i should just stop trying to guess

we do have a pretty good relationship, but he's also stubborn and won't want to admit he's in trouble -- maybe not even to himself. he's got that guy thing where he thinks he can handle almost anything on his own. he will tell me if he thinks he's having a mental breakdown, but these pills really hold him together.

we'll see how much argument i get when he finds out i've made the appointment. he was up from yesterday until around noon today and was probably still high when he went to sleep. he'll be really irritable when he get's up -- we're onto his pattern now.

but he's going. he's at least going to show up.

he hated the psychiatrist at first too.

it's kind of ironic -- i remember his first visit. he came out of there so mad that he was prescribed meds. called the dr the "candy man", said all kinds of stuff to me about wanting him to be medicated -- and now he trusts the dr & is comfortable with him. now -- all he wants to do is pop pills. maybe that's him getting back at us?

well -- if they want me on pills -- i'll be on pills.

somehow, it's about control.

he was prescribed adderall which is terribly addictive -- he gave it up (made him rage)
he tried smoking pot -- he gave it up (made him more paranoid)
he tried drinking -- he gave that up too
he is most definitely a drug of choice person

i'm so sorry about your daughter too -- i hope she finds her way

blui

update

i didn't really talk to him about the appt or anything when he got up last night. i asked him how he felt -- he said about normal -- meaning depressed, etc.

this morning he said he felt like he was going psycho -- his words. he said he felt "tired of the world" -- which when questioned he said he didn't mean suicidal, just when he get's like that, he get's delusional. (he has psychotic depression).

i told him about the appt, he really didn't say anything at all.

i'm going to talk to him some more tonight and probably call his psychiatrist tomorrow morning (he's off on thursdays). all this started up a few months after he went off his main anti-psychotic -- maybe the opiates have allowed him to keep it together for the past year?

we had the whole conversation about how some people just need psych meds forever, just like if they were diabetic or something. he said it made him feel like an endless loop of problems.

and if he had to be dependent on something, why couldn't it be something fun?

now i'm not sure if it's better to take him to the drug treatment place for counseling -- or to get him into something to help him accept that he's got an illness that could be lifelong and that he's far from the only one -- or maybe the treatment place can handle both things???

just not sure which way to turn or what the best thing is to do.
guess i'll get his pdoc's opinion

Chino

I hope you're able to find a place that handles dual diagnosis and he isn't resistant. His pdoc should be able to give you choices, and hopefully he has first hand knowledge with one or two.

outtolunch

My daughter, now 21, has had more diagnosis than you can shake a stick at.

It was like someone gave her a punchlist when she hit puberty and by golly, she has hit most of them, including but not limited to ADD, eating disorders, suicide ideation, deression, bipolar, schizoaffective disorder and just about all of the mental and emotional disorders in the book. They became her identity.

She also believes she is unique, so unique that she knows everything and could not become addicted to drugs. She was mistaken. .

This "nothing works because I am unique" thing so often predetermines the outcome, because without effort, there is nothing. In my daughter's case, the variety of prescribed meds opened the door to self medication. She too found opiates to be the answer to everything.

There is a fine line between immature cognition and the rest of the issues, especially in teens and young adults. When I look back on the past several years, I realized my own role in all of this and that was to take care of business, for her....to do for her, what she could do for herself and always trying to fix her. And the sicker she got, the sicker I became.

She eventually found heroin. I put her into three back to back rehabs. The rest has been up to her. She is doing better now and I believe is drug free, for now. She is also not on any prescribed medications and is reasonably clear minded.

I guess the point of all this is to suggest that you take a close look at what you are doing for him that he could do for himself. Does he attend school or work? Can he volunteer somewhere, doing something, if school or employment is not an option? You cannot be his warden forever.

Of course this should be vetted with his MDs to make sure all are on the same page. I feel for you.

blui

outtolunch -- your daughter sounds very much like my son -- and i'm probably pretty much where you were. i know that i do more for him than i should.

however, i take ownership of that. he'll from time to time remind me that he can do some things himself and that he's an adult. i definitely have control issues and i'm part of the problem. i also own the fact that i'm most likely co-dependent and an enabler.

i think that his prescription drugs opened the doorway for him to try illegal ones -- like you say with your daughter.

one thing that complicates matters is that he is either an extreme social phobic or operates on a low level of paranoia all the time -- even medicated. this means that being around people he doesn't know is often a very bad thing. he can go overnight from somewhat normal to being sure that people are coming to the house to kill him and jumping at every sound.

he graduated high school -- he went through 3 psychotic breaks in those 4 years, but he graduated. he tried a few classes at community college, but each time he would become paranoid -- sure that people were whispering about him in class and he was feeling very threatened. the last thing that happened had me very worried. he was sitting outside on the steps working on an architectural drawing for an art class and a teacher wiped his feet too close and kicked dirt & dust towards him -- he took it as very disrespectful, followed the teacher to his class, & maybe said something -- not sure how it went down, but he came home kind of afraid the police were going to be involved.

i look at things like the virginia tech shootings & some other things -- and that could be my son. i don't know exactly what happened at school, but i've witnessed him mis-interpret threats from people when there was no threat at all. i've also witnessed people react to him in very strange ways and treat him badly as well. so i'm always torn about what to believe. but what i know is that he absolutely believes it. and, if he hurts someone, the criminal system will not care if he has a mental health problem or not -- they'll let him get his treatment or lack thereof in prison.

between that and he missed so many classes because he would have panic attacks on the way there -- get to school and not be able to go in -- come home feeling terrible because he just couldn't go in.

i know i can't be his warden forever -- i don't want to be -- but he is more disabled by his fear of people than anything else i can imagine. actually, we're kind of at this point because i had to let go last year and leave him to his own devices more than i had been doing -- his dad was almost killed in a motorcycle accident last march, and for awhile i pretty much lived at the hospital. and since then, we've been focused on his dad's recovery which is ongoing.

i would love for him to do anything outside the house -- anything at all. he wrote me a 2 page letter last week which would have broken anyone's heart about how he can't be around people -- how it would drive him completely crazy again. i do think that a lot of the drug issue is because he is bored and lonely.

anyway -- thank you for your comments. i know i sound like i'm full of excuses, but i do get what you're saying -- and you're right about it all -- and it's nice to know he's not so unique. your story about your daughter gives me a lot of hope.

by the way -- last week, i did tell him that he wasn't so special that he was the only person with these problems -- and that he wasn't so unique that no one would be able to help him. he was all sarcastic with the -- well, thanks a lot mom, that makes me feel sooooooooooooo much better.

outtolunch

I too, used to wonder, sometimes, when she was very disconnected, way before drugs, if this is how the family of some mass murderer felt, before it all went down. In my case it was Lauri Dann who shot/killed many young children, at a school, in Winnetka, Illinois, shortly before my own daughter was born.

The reality is, that in my daughter's case, she hurts herself, not other people But oh my, I know how you are feeling. And then there were the air vents in the house with eyes watching her and her perception that her life was being filmed and don't get me started about animals who watched her.

On the flip side, my daughter is consumed with all things social...articulate, engaging and incredibly polite and charming , yet unable to maintain friendships.

Back then, I sought therapy for myself to learn how to cope with something I could not control....my daughter's emotional stability. Perhaps this could help you , too.

blui

i've been considering therapy for myself -- i'm riding one wave of crisis to the next

my son is the opposite of you daughter socially -- he isolates himself terribly, but can maintain a relationship once it's established.

did your daughter just kind of outgrow all the paranoia & delusions? my son's pdoc said many people do when it starts off so young, that they get past it and go on to live "normal" lives -- i hate that word

outtolunch

She's still more paranoid and delusion prone than the average ( whatever that means) 21 year old, but miles from where she was just a few years ago. Some of this has got to be attributed to some cognitive maturation.

Speculation on my part that her almost year on the street may have contributed to putting some of her fears and paranoia into perspective. Or maybe that's just me looking at it from my perspective. Know what I mean?

blui

i do know what you mean. sometimes i wonder if he's really more stable, or if it's just my attitude of the moment has changed.

Spiritual Seeker

IMO- find inpatient treatment center that specializes in " dual-diagnosis "

mental illness + addiction

that has major therapy component with clinical licensed therapists on staff as well as
addiction treatment