How to come clean, or do I come clean to therapist

[achemicalreaction]

Hello. I’m new here so apologies if this isn’t the right place for this post.

so backstory is in order:

In April of 2016 I told me then psychiatrist I was addicted to oxy and needed help. He was my psych of 15 years. Almost a father like figure. He then proceeded to direct me to some rehab programs, and refused to be my psychiatrist anymore. Wouldn’t even give a call or exit interview. He did refer me to another psychiatrist however. After I completed a full detox program, the rehab center would not allow me to use support groups because of my Xanax prescription for a slew of mental health issues since my teens. Old shrink referred me to a new shrink, who also promptly lowered my dosage of Xanax, which I complied with and am completely comfortable with. I must note she and I butt heads frequently, she is sort of some upper class psych who went to Yale and I think she think she’s I’m fucking scum, but she sees me for a charity fee in agreement that I see a therapist every week. So, back in May 2016 I did all this, got clean and tossed around by docs, the old shrink dumping me hurt pretty hard, as I was honest and asked for help. Started to see a psychotherapist but she was still in training, and I couldn’t deal. Tried for six months with her, but all I got was “you need to see me twice a week, and what are you feeling etc.” so, I then went and found my current therapist, who I fucking adore.

The problem is, i relapsed hard just a few months after, I think August 2016. Maybe September, and have been lying to them both by omission since.

I am deathly scared to lose the little support I have for mental health, but do I need to tell them? I am almost sure the psych will toss me to the curb, but unsure about therapist. Likely she would have to tell my pysch about the relapse.

Any advice appreciated.

 

[Grinders Kiefers]

In my experience, holding that stuff in causes a lot of undue stress and anxiety, and I start to make up stories in my head about how it's going to play out. Chances are, your expectations won't line up with what actually happens. I think the best way is to just tell your therapist straight up what's been going on, and how you feel about it - make sure they understand that you think you may lose your psychiatrist by sharing this information. It may be uncomfortable but you will most likely feel better once it's over. Good luck, you'll make it.

 

[G.R.S.H.]

Have you ever discussed what happened with the original psyh with your current psychs? That may give you an idea of how they will respond to a now situation. Also, do you want to get clean again? Are you still currently using? How did the relapse affect you emotionally? Mentally? Do you know what triggered the relapse? It sounds like you mental health is important to you, how is keeping the secret affecting you?

Hope-grsh

 

[achemicalreaction]

Thanks both for the replies. Grinders, you are right, it causes stress in that I am afraid I am not taking care of my root issues to the fullest extent possible. But I am also way more worried about being thrown into a hospital for benzo w/d because I am absolutely not ready for that and am confused if I even have to do that. I’ve been shamed by using Xanax and then told the exact opposite.

Grsh, my newer psych is a colleage of the one who dumped me. I do want to get clean again, on day 5 atm, oxy addiction.
the relapse... I guess I don’t know how it’s affected me emotionally except that I feel I’m not making any permanent progress in my life - , and depression setting back in. I used in order to be productive or even excel in my career, and to show up socially. I started to use after a third suicide hospitalization (ideation that time only) not consciously, started recreationally and from my boss, but there it is. As far as the secret, I do feel some guilt, but I also feel protective over what has been an otherwise stable year in many years, even though I relapsed.

 

[G.R.S.H.]

This last relapse- did anything happen to trigger you seeking more? Like when you very first used, and the suicide attempts, what happened this time? If you can identify that, you can go a long ways in figuring out 'why' and dealing with those root issues.

 

[achemicalreaction]

It took me a few hours, but, I think I can identify a couple things, sort of an overreaching theme. I think I’ll talk that discovery out more in depth with my therapist. Haven’t decided on how to proceed yet but will give myself some more time to decide.

thank you again, every bit is immensely helpful.

 

[Jabberwocky]

Hello. I?€™m new here so apologies if this isn?€™t the right place for this post.

so backstory is in order:

In April of 2016 I told me then psychiatrist I was addicted to oxy and needed help. He was my psych of 15 years. Almost a father like figure. He then proceeded to direct me to some rehab programs, and refused to be my psychiatrist anymore. Wouldn?€™t even give a call or exit interview. He did refer me to another psychiatrist however. After I completed a full detox program, the rehab center would not allow me to use support groups because of my Xanax prescription for a slew of mental health issues since my teens. Old shrink referred me to a new shrink, who also promptly lowered my dosage of Xanax, which I complied with and am completely comfortable with. I must note she and I butt heads frequently, she is sort of some upper class psych who went to Yale and I think she think she?€™s I?€™m fucking scum, but she sees me for a charity fee in agreement that I see a therapist every week. So, back in May 2016 I did all this, got clean and tossed around by docs, the old shrink dumping me hurt pretty hard, as I was honest and asked for help. Started to see a psychotherapist but she was still in training, and I couldn?€™t deal. Tried for six months with her, but all I got was ?€œyou need to see me twice a week, and what are you feeling etc.?€ so, I then went and found my current therapist, who I fucking adore.

The problem is, i relapsed hard just a few months after, I think August 2016. Maybe September, and have been lying to them both by omission since.

I am deathly scared to lose the little support I have for mental health, but do I need to tell them? I am almost sure the psych will toss me to the curb, but unsure about therapist. Likely she would have to tell my pysch about the relapse.

Any advice appreciated.

Welcome achemicalreaction! What you describe reminded me a bit of my experience. In any case it's totally normal given the rather dire current state of affairs when it comes to "addiction medicine."

I take it the drugs you've primarily struggled with are opioids? Is that what you relapsed with? Would you describe what the relapse was/is like?

Try to keep you head up, as you still have a hell of a lot of option. Specifically regarding therapists and psychs, it took me many, many tries working with different clinicians before I found a couple I clicked with (knock on wood, although I don't know how much I like my GP - he seems little intimidated working with someone who is open about once being labeled as "severe opioid use disorder", but otherwise seems like a fine guy).

And beyond individual providers, there are still lots of options in terms of treatment related stuff you can try. What were the treatment programs (detox and rehab iirc) you have tried so far like?

 

[achemicalreaction]

Welcome achemicalreaction! What you describe reminded me a bit of my experience. In any case it's totally normal given the rather dire current state of affairs when it comes to "addiction medicine."

I take it the drugs you've primarily struggled with are opioids? Is that what you relapsed with? Would you describe what the relapse was/is like?

Yeah, if you say was addicted to “...” I have found most medical practitioners to completely change face, or tone, or willingness to work with you. Which got me in to more trouble in the end. I was at a 150ish mg of oxy habit for a couple years prior to 2016. I don’t really remember exactly when t started, as I am now realizing the boss who gave my percs did so back in 2012? Not sure when it because daily. Some of this is in my thread. So, I detoxed in 2016 at an outpatient facility. They wanted me off Xanax as well, which was terryfying because I’ve been on it since I was 15. The detox involved being given 13 different medications to deal with coming off the oxy. They gave me Ativan instead of Xanax. Which made no sense to me. I was also on other medications at the time, like Webutrin and Seroquel, and taken off those in order to participate in rehab. So as you can imagine, the detox was very bad. But I didn’t die and kept going and giving samples. This was mostly so I could get a physiatrist to agree to see me. I was given whatever the pill form of Vivitrol is at then end, but stopped because it gave me a three day panic attack. I honestly can’t remember what year but I was hospitalized twice for suicide maybe six months before my oxy use started (once out of choice and once by police).. I kept using because it kept me alive, and able to hold a job down after a tough two year period of job and financial instability, and childhood sexual assault surfacing.

The relapse.. the rehab facility would not allow me to use their smart recovery groups as I was on benzos. I relapsed a few months later because I wanted to participate in life and was depressed. My best friend was getting married and another was having her first child. I wanted to show up for my friends. Around this time I got a break in my career and didn’t want to lose that either as I was still depressed and the work is quite mentally challenging. Which brings me to now. Somewhat stable year of self employment, but depression crept back in and don’t want to lose what I got even if I got it by dosing oxy. Guessing depression got back in because I wouldn’t raise my dose above 60mg on oxy unless it was for something stressful or particularly social. So yeah, 10 days of being mostly clean (a 36hr fuck up in the middle there). I want to see if I can feel “normal” like I do when I take an opiate, something I have rarely experienced in living memory.

Try to keep you head up, as you still have a hell of a lot of option. Specifically regarding therapists and psychs, it took me many, many tries working with different clinicians before I found a couple I clicked with (knock on wood, although I don't know how much I like my GP - he seems little intimidated working with someone who is open about once being labeled as "severe opioid use disorder", but otherwise seems like a fine guy).

And beyond individual providers, there are still lots of options in terms of treatment related stuff you can try. What were the treatment programs (detox and rehab iirc) you have tried so far like?

thank you for the encouragement. I guess I’ve been doing NA the most, but got a sponsor through AA. I don’t want to be negative as I see it has helped many people. I have gotten a couple positive things from the meetings. At the moment I’m just overwhelmed with it all though. I’m considering myself to be detoxed as there are no more doc in the house and would be difficult to get more quickly. Have an old friend crashing here for a few days which I think will help as well, because I find distraction to be what is working the best. BL is helping a lot too, some is triggery but a lot is good. This is my third time trying to post from phone as it keeps logging me out, so sorry if it’s a bit disjointed.

oh and I almost forgot again, I did tell my therapist and she was supportive or at least did not dump me and said she understood which I believe she does. So I feel very very lucky there and relieved.

 

[Jabberwocky]

Sounds like you have a pretty good idea what you're doing actually.

In terms of meetings, please keep in mind there are lots of avenues for recovery and wellness outside 12 step stuff. If you find it helpful, roll with it, but don't let it define the limited of what you try either. It's always good to try branching out and exploring various alternatives when it comes to moving on from something as consuming as the whole opioid thing.

If you've been mostly off oxycodone for ten days or so recently, it will be easier to come off. Given how long you've been taking oxycodone, you'll probably have a bit longer withdrawal period off the oxycodone. More like ten days as opposed to seven. But something else to think about is that, given how long you've been taking oxycodone, you would probably benefit from a slower transition off opioids. That is either tapering on oxycodone for a while before getting off, switching to something else like morphine or methadone and using that to taper off, or doing an extended buprenorphine taper.

Don't let this get you down, as plenty of people have been able to go from a significant habit to not using any opioids, but a lot of people find a transition period where there are opioids being used but to a lesser degree prior to jumping completely off. Sometimes it makes the transition a bit smoother.

Detoxing under professional care can make it a little easier, but the real question is what comes after detox. The conventional wisdom says IOP, meetings, maybe sober living, maybe ORT or Vivitrol, etc. IME it works better to use something to transition off the opioid being used (tapering it, or better yet switching to something else and tapering) while also doing stuff related to professional treatment (could be IOP, but could just as well be therapy or other stuff) and finding peer support outlets (could be recovery oriented meetings, could be other stuff where one finds peer support). Obviously it doesn't look like naltrexone is a good fit for you.

Just trying to suggest you take both a short and long view of the field. Short view could include how you're going to get off oxycodone (again I suggest the more gradual taper/detox as opposed to just dealing with the intensity of acute withdrawal as it, but whatever sounds best to you). Long view would be more about how to maximize your chances of success staying off.

Sounds like you're not unfamiliar with this whole process though, regardless of how well it might have gone in the past. Having some idea of what it to come/going on can be a big leg up. Feeling super confusing, depressed and/or desperate can be dangerous, as we well know.