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anxiety and insomnia causing increased drug use w is alarming my therapist?

T

TooOldForThis

Bluelighter
Joined
Jun 8, 2013
Messages
109
I have been on a number of medications, for various lengths of time. I have also been in therapy off and on for 10+ years. At my last therapy session my therapist threatened to call my doc if I continued to drink while on my meds. I currently take

5 to 15mg oxycodone over the course of a day (back pain) (started 5 years ago)
40 mg celexa at night (for anxiety and panic attacks), been on this for years
1 to 1.5mg klonopin at night for anxiety/sleep (been on this for 2 years)

Oxycodone for me is a stimulant. If I take it close to bedtime I can't sleep.

I also drink up to 5 drinks in an evening, but not every evening.

Given the relatively low doses of the meds, and the length of time I have been on them, I feel like my behavior is not worthy of my therapist calling my doctor (who prescribes for me). Also, the reason I told my therapist is that I was concerned that my behavior wasn't healthy, and wanted to work on cutting back on my drinking.

I don't want to actually overdose. How dangerous is my behavior?

Also, in the effort at harm reduction, what combinations are the most worrisome, in terms of what meds I am taking combined with alcohol?

I am a newbie, so please be kind if this is not an appropriate question to ask.8)
 
I do have to say, the drinking plus the meds (especially with the ones you are on) is pretty dangerous.

Oxycodone, while you may feel stimulation from it, is "depressing" your central nervous system. This slows down your heart beat, blood pressure, breathing rate, etc... Klonopin does exactly the same thing (although it's done in a different way than oxycodone) and while drinking plus the oxycodone is dangerous, adding the Klonopin on top of that makes extremely dangerous!

Klonopin and Ethanol (drinking alcohol) create their CNS depressing effects by heightening and potentiating the effects of the neurotransmitter GABA (gamma-aminobutyric acid). While it's not anywhere near as dangerous to take Klonopin by itself, adding "5 drinks" of alcohol on top of that will synergize with the Klonopin and make the 5 drinks feel more like 15 drinks. This leads to a dangerously slow breathing rate.

By taking oxycodone with that, you are adding EVEN MORE CNS depression on top of that. What is ultimately going to happen is, you will suffocate in your sleep.

Also, the oxycodone isn't what's keeping you up, it's the Alcohol. Alcohol is very well known to mess with your sleep cycles and literally does not allow REM sleep to happen. Therefore this keeps you up - not the oxycodone.
 
There's a real possibility that it could be dangerous, and you are essentially telling your therapist of activities that you do that may cause death or serious injury to yourself. I'm not an expert on that law, but that may allow for breaking confidentiality.

Not sure whether your system can safely tolerate those listed doses. To be honest, you should man-up and stop drinking 5 drinks a night if you have back pain, anxiety, and sleep issues. There are lots of rehab that you could be working at to get to the point where you aren't taking medications for everything.
 
Corazon said:
There's a real possibility that it could be dangerous, and you are essentially telling your therapist of activities that you do that may cause death or serious injury to yourself. I'm not an expert on that law, but that may allow for breaking confidentiality.

Not sure whether your system can safely tolerate those listed doses. To be honest, you should man-up and stop drinking 5 drinks a night if you have back pain, anxiety, and sleep issues. There are lots of rehab that you could be working at to get to the point where you aren't taking medications for everything.
Click to expand...

I concur. The alcohol is causing all of your problems

The alcohol is not necessary, is one of the worst drugs for you physically, and keeps you awake at night. As Corazon said, man up and stop the alcohol. If you don't kill yourself though over-sedation, you're going to destroy your liver and kidneys - especially since you're already taking medications that are extremely taxing on those specific organs.

You know you're doing something awful when even people on a drug forum are telling you to stop...
 
Appreciate the honest feedback. I knew I was heading down the wrong path when I spoke to my therapist, I just didn't expect him to threaten me. The drinking has increased in the last couple of months. I am not (yet), addicted, and don't drink daily. I will definitely take your comments seriously, and cut way back on the drinking. I think it is possible to work towards getting off the pain meds, but I am not sure about getting off the Klonopin, at least not yet. I have PTSD, and significant anxiety. I do not get any recreational pleasure out of the Klonopin, I only use it at night to try to settle down the demons in my head.
 
I don't know if your psychologist/iatrist can talk to your doc without a release of information signed by you.. even if they can't, drinking on the prescribed medication can be very dangerous as before mentioned. Your psych doctor could possibly be held liable if they had information that you were drinking while on those meds from your doc and that is why they are threatening to tell your doctor, besides the fact that they don't want you to die from meds they prescribed, or meds they know were prescribed to you. Just be very careful with these meds and alcohol, it is not safe at all... My stepmother is a chronic pain patient who cannot have comfortable living without pain meds, similar to you with your pain meds and klonopins because of your ptsd. She is a former alcoholic with 20+ years in sobriety and has struggled with overuse of her pain meds and has a lot of trouble using them. The solution is not to drink as you stated above even though this is much harder said then done. It is a very fine and HARD line to walk and I wish you all the best and hope you can find a way to take the meds you need with out problems
 
How long have you been on that dose of Kpin? It sounds like it may be time for a dose increase or med switch, if you're feeling the need to drink on top of 1.5mg clonazepam!
 
I was on 1 to 2 mg (varied depending on how bad the anxiety was) for a year. Then decided to taper off. I was tired of feeling like my brain was Swiss cheese. Getting off was HORRIBLE. It finally took 4 months. So, I was off of kpin for about 6 months. My anxiety and insomnia were so horrible I decided to go back on. I have been back on at this dose for 5 months. I hesitate to increase my dose because it makes me so forgetful. I also question how healthy it is to take kpins long term.
 
Long-term use of benzos is definitely not healthy, there are many neurocognitive side effects, varying in degree of nastiness, that people suffer from such use. Have you explored CBT with your therapist, for your anxiety and insomnia?
 
I need to find a new therapist, but have crappy insurance at the moment. Hard to know where to start (other than with the booze). The pain pills are super addictive, and I like them. The kpins are long term not healthy, and a bitch to get off of. It is so frustrating to be 50 years old and to be having these issues. I love the idea of not taking all of these pills, but I have chronic pain (after 2 back surgeries), and long term anxiety issues.
 
I totally understand, I am a CPP and have anxiety/insomnia as well. My prescribing physicians withhold benzos from me, despite the fact that I never abuse them, and don't drink whilst on my pain pills either. That can only be a good thing, really, as you will eventually fall into physical dependence of benzos no matter what, if you take them long enough.

I'd really look into cognitive behavioral therapy for your anxiety and insomnia. It is extremely effective!
 
I've renamed your thread title because partly it's misleading, and in other part discussion about medical law/procedure is not permitted. I'll leave this open for you and bounce it to The Dark Side in order for the discussion to continue regarding other questions/issues that you're facing since the drug portion of your post has been answered as best as possible.

Homeless -> TDS
 
Hey 2oldforthis..

I am sorry you are having some troubles.. what is the anxiety generalized.. why do you think the drinking has increased lately?

What do you mean by insomnia, you cant sleep or you cant fall asleep as soon as you would like.. I took benzos for years for anxiety and used to drink and take the benzos to get to sleep... now that im off them I found I still dont fall asleep but I also dont need nearly the amount of sleep i used to most likely because my the necessary processes that happen in sleep are facilitated that much faster, and more complete, than when i was drinking and taking the benzos.. the process of neurochemistry coming into balance took a while and i was tired for a bit, but whereas I used to wake up after ten hours of sleep unrefreshed I now wake up after six feeling way better and I have added an extra four hour onto every day, or as i like to see it a whole day of not sleeping every week. I was also able to get to the root of my anxiety and after twenty years of benzos I neither want or need them and am almost anxiety free, so if you want to share a little about your anxiety maybe there will be some good responses on how to better manage this uncomfortable emotion.

a really good technique for shutting down our heads before bed is mantra meditation.. it is specifically shut down that roucus of thoughts that rage on in our heads, sometimes so loudly at bed time.. the trouble with using drugs to do this is that with tolerance the rocus will find a way to run it loud party and then we will have to up the dose of dose, then the party will just learn to argue louder.. then we will up the dose, then we will have to sleep longer, and far less quality of sleep, and wake up groggy or with a damn hangover, then we take a benzo to kill the hangover, and the cycle continues.. and the post that explains the GABA correlation with the booze and benzos is spot on.. and if you ever want to see someone make piss poor choices give them a bunch of booze and benzos, not to mention they will sleep but it wont feel like they did. with the entrance of tolerance and the necessity of heavier use of alcohol on top of the benzos you could as others have stated get into a place where the is no benefit of going.. there is allot of discussion of anxiety around the dark side..

Its not so common for thread names to be changed but i'm going to go ahead and change this one more time.. hope you dont mind, post if you do and i will change it back.
 
increased drug use can cause anxiety and insomnia, especially if you're abusing alcohol/benzos.

I suffer from pretty bad insomnia and also anxiety. Meditation can help but really you just have to tire yourself out during the day, do not take naps and do not use benzos/alcohol to sleep as they fuck up your sleep architecture. There are a few sedatives/hypnotics that don't though, so i'd seek those out as alternatives. Once you mess with your sleep architecture then you're going to create more issues, like being tired all the time, sleeping 10 hours a day and not being able to sleep at night.

sticking to a normal schedule and having responsibilities usually keeps me in check, the second those things are gone then i am on my own clock which runs like a 36 hour day or something, stay up 24 hours, sleep 10-12, not a bad trade off but unfortunately the world doesn't work on that time.

i'd never talk about drugs with my therapist really; we'd just work on the underlying issues and i found that to be far more helpful than getting hung up on whether i was high on morphine and diazepam during our sessions or not, or going into great detail about past/current addictions or whatever else. I'd be concerned if i were your therapist as well, most people just wouldn't say they drink on top of those kinds of meds. Since the therapist knows, the therapist has an ethical obligation to ensure you're not going to kill yourself via CNS depression accidentally at least, which would warrant a call to your Dr.
 
Thanks for the replies. I think the drinking has increased because I stopped regularly seeing my therapist a few months ago. And it may be that my current dose of kpins is not working as well as it used to. I stopped seeing my therapist regularly because I felt we weren't making progress with my anxiety. Once I quit seeing him, I started drinking more, which concerned me. So I went back. That's when he threatened me. I understand now why he did that.

My insomnia is mostly the type where I can't fall asleep, but sometimes I fall asleep ok, then wake up in the middle of the night.

My anxiety has been diagnosed as PTSD, and also described as "free floating". I not only worry about the future, but have a tendency to replay past events (that turned out fine) and change the endings to be something terrible (always due to something bad I did).

I have tried going off the benzos before and always felt like life wasn't worth living if I couldn't get any peace. How long does it take for the brain to recover from daily benzo use?

Just to add to the mix, I also have an eating disorder (not nearly as bad now as in the past), and very occasionally self harm.

Thanks so much for listening. <3
 
i concur with everyone who's posted so far saying cutting out alcohol would be the first & probably most helpful step. whenever i drink more than a couple drinks, i sleep HORRIBLY. i wake up after a few hours feeling more exhausted than if i hadn't slept at all. :/

i'd look into tapering off the benzo dosage & possibly replacing the klonopin with a more specific aid for sleep. have you tried anything like lunesta or ambien? ambien works wonders for me when i have a night that i just cannot stay asleep. i don't take it every night or even every other night, but i find that the nights i do take it, it helps out tremendously. perhaps look into that on an as-needed basis? i'm not sure if it can be taken with the oxycodone, but maybe it could eventually replace klonopin on the nights that you really feel like you can't sleep.

you came to the right place <3 we're all here for you!
 
it's definitely the alcohol use that is destroying your mental health at this point. Alcohol absolutely destroys my sleep and causes so much anxiety that i cannot even get drunk from it anymore.

perhaps librium or baclofen would be a much better substitute for alcohol. As for benzo recovery times... they aren't too nice. if you have a severe anxiety disorder benzos are hell to come off of. The only way i could pull it off is a slow taper and then switching over to gabapentin/pregabalin/baclofen and tapering off those. Even switching over to etizolam and tapering that is much much easier IMO and IME, though it's a dangerous route to take. Long diazepam tapers work but recovery times for a dependent user can range from 6 months to 2 years or more. It took me about 12 months to recover when i quit benzos after being dependent for just one year. Even after all that shit i still went back to etizolam because my anxiety was destroying my quality of life.

I would try diazepam if you aren't getting anything out of clonazepam, i hate clonazepam, it consistently sends me on a manic high for some reason. People's responses to benzos are very subjective so if you haven't already, i'd try something else.
 
I do agree with most of what everyone is saying but I do want to point out that oxycodone also tends to keep me awake if I take it close to bed time most of the time dependent on the dose.
 
On the other side of coming off benzos, i came off of being on benzos for almost twenty years, klonopin for some (8 mgpd) of the time but xanax was at (6mgpd) for the rest, and I rebounded in less than two months to a place where I had less anxiety off them than i had on them, but I also found the root of my anxiety and put in the effort to rid myself of it. IMO generalized anxiety is a mood emotion that is telling you to you need to address a fundamental or big part of your life as it does not agree with you in some way, or anxiety that is triggered by something for shorter periods than generalized indicates that only a certain part of your life has something that needs to be addressed.. either way I would strongly suggest that CBT may have the key to help you rid yourself of that miserable emotion. anxiety is the pits and I hope you find some relief<3
 
Does CBT look for root causes of anxiety, or teach you how to manage the anxiety? It sounds like some of you have personal experience with CBT. I also think I will look into SMART recovery (I have had a bad experience with 12 step groups). I tried to search for SMART recovery to see if there was a thread that talked about it, but didn't have much luck. Can anyone point me in the right direction? Thanks.
 
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