How not to prescribe meds to dual-diagnosed alcoholics/addicts

23536

23536

Bluelight Crew
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Stop resisting!
My opinion is pretty simple: Doctors who prescribe benzodiazapenes or opiates without at least ASKING a patient about their drug an alcohol use are reckless. Doctors who prescribe benzodiazapenes or opiates to a patient whom they KNOW to be an addict or alcoholic are not only breaking their “First, do no harm,” vow but also criminally negligent (unless they have set up a medication treatment protocol that involves very strict monitoring).

This is a phenomenon that really torques me. I write and talk about it whenever I can. If I had a buck for all the alcoholics and addicts who got a ‘script for a benzo or opiate from a doctor who either didn’t bother to ask about their drug/alcohol use or wrote the script knowing they were addicts or alcoholics, I would be a very, very wealthy woman.

Heck, my dentist, who knows I’m a recovered alcoholic, gave me a ‘script for Percocet after I had a tooth pulled. I have talked with him often about addiction because he has had new patients come in and ask for a prescription for a specific painkiller and then never come back. He knows I will not so much as use his mouthwash because it contains alcohol. He is a great dentist but he thought my “problem” was just with alcohol – not drugs. He wouldn’t blink if I asked for nitrous oxide (such a lovely drug…)

The problem becomes a catastrophe when dual-diagnosed addicts and alcoholics try to get medication for their depression/bipolar/schizophrenia or whatever. Word of advice doctors: Give us antidepressants, anti-psychotics, anti-anxiety meds that we cannot abuse – drugs that will NOT get us high. We are addicts and alcoholics and we always will be!

full http://blogs.psychcentral.com/depre...ibe-meds-to-dual-diagnosed-alcoholicsaddicts/
 
He knows I will not so much as use his mouthwash because it contains alcohol.
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I had a counselor in rehab who was an NA fundamentalist and refused to gargle with Scope or Listerine, and exhorted all her clients to do the same. I think if you are so out-of-control that mouthwash will make you relapse, then you belong in NA. The reason I've never been able to take NA seriously is the more unstable members seem to think that everyone is as fickle as they are, and they radicalize the whole fellowship. What's worse, it seems that their extreme philosophy dominates most rehabilitation centers.
 
235360287471352662 said:
I had a counselor in rehab who was an NA fundamentalist and refused to gargle with Scope or Listerine, and exhorted all her clients to do the same. I think if you are so out-of-control that mouthwash will make you relapse, then you belong in NA. The reason I've never been able to take NA seriously is the more unstable members seem to think that everyone is as fickle as they are, and they radicalize the whole fellowship. What's worse, it seems that their extreme philosophy dominates most rehabilitation centers.
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Absolutely. I have to agree with you on this. I also have a hard time taking such organizations seriously for the reasons you mentioned. Well there's also other reasons as well for me personally but the one's you mentioned are plenty good enough.
 
Some people are addicted to the alteration of consciousness in general and not necessarily one family of psychoactives...
 
whoa man, who are you calling a dumb bitch? Bluelight is not the place for that kind of rhetoric, and it has been shown in numerous studies that a predisposition to addiction includes all substances that activate the reward centers of the brain.
 
^whatever, I have problems with alcohol (well under control as of right now) and benzos (which im working on) but I absolutely hate opiates and cocaine and cannot stand the feeling of them. I am also prescribed zopiclone for sleep and have very rarely been using it sooo I dont think it applies to every body so I think its total nonsense that because you are addicted to one thing you will form addictions to any other substance that could be considered habit forming.
 
I can't stand alcohol - on the other hand, I'm on methadone because of a financially draining/lifestyle changing opiate habit.

I do somewhat agree with the OP's concern of doctors prescribing - say - a high dosage of a strong benzo to a recovering alcoholic (etc.)

At the same time however, I've been Rx'd Dilaudid 8mg for post-surgery pain and the doctor knew I was on a stable dosage of methadone. Does that make him reckless? I dunno.
 
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^I too much prefer opiates to alcohol. Although I enjoy amphetamine, benzos and...okay...I do enjoy alcohol to a certain extent.

Alcohol addiction (and drug addiction) runs in my family. My opinion is that addiction is addiction (at least when you're talking genetics).
 
Newbierock said:
Wonder how many alcoholics have relapsed because of using mouth wash?
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You would be surprised.

They get a hint of alcohol taste in their mouth... and there goes the whole bottle... and a very crude trip to the hospital.

Same applies to hand sanitizer and some types of lotion. Even Isopropyl rubbing alcohol...

It is very real...
 
If listerine makes you relapse then you should be in AA/NA. I was a alcoholic and i drank some pretty awful tasting liquors but mouthwash wouldn't send me off down the road to buy a case of beer.

Also yeah alcoholics would be more inclined to abuse benzodiazepines but not every alcoholic that get's prescribed a benzo ends up as a full blown benzo addict. I have been taking them for ages due to anxiety i covered up with alcohol and the fact that my anxiety got worse after i quit drinking. I'm prescribed 6mg's a day (though i usually only take 4mg's) which is alot but i can count the times Ive run out on one hand which is not bad after over 5 years of use.
 
The main problem with this line of thinking is that it right off the bat excludes a huge section of the pharmacopea for medical use based on their legitimate or perceived recreational or addictive potential. Having a seizure? The doctor's an enabler sadist for shooting you up with Ativan. Opthomologist prescribes you Tropicomide drops? That evil bastard, didn't he read the reports about Russian addicts injecting that shit?

Drug users and addicts are just like everyone else- they get hurt, they get sick.
 
I don't think it should exclude access to these drugs, but it does warrant closer monitoring by the prescribing doctor. I mean, it would be great to see Drs and pharmacists work together on these cases, and not have it increase out-of-pocket expenses.
 
if mouthwash makes you relapse im afraid your only hope would be inpatient rehab. if your impulse control is that fried due to addiction then IMO NA/AA isnt going to help much. you would need a serious amount of time in an inpatient facility.
 
Tchort said:
The main problem with this line of thinking is that it right off the bat excludes a huge section of the pharmacopea for medical use based on their legitimate or perceived recreational or addictive potential. Having a seizure? The doctor's an enabler sadist for shooting you up with Ativan. Opthomologist prescribes you Tropicomide drops? That evil bastard, didn't he read the reports about Russian addicts injecting that shit?

Drug users and addicts are just like everyone else- they get hurt, they get sick.
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Not to mention the fact that there are laws protecting patients in the US, laws that say that all patients are entitled to adequate pain relief.

The nurse practitioner that runs the triage at my local public hospital is an NA disciple (I've seen her at meetings) and absolutely refuses to allow opioids to be prescribed to anyone below 30 (I've noticed), sending people away with a Toradol injection and an ibuprofen script. My girlfriend has come close to mutilating her on several occasions.

And let's not even begin to discuss methadone. My methadone program used to require me to attend meetings. The policy at these meetings is that methadone patients are not allowed to speak.
 
And let's not even begin to discuss methadone. My methadone program used to require me to attend meetings. The policy at these meetings is that methadone patients are not allowed to speak.
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what was the point of not allowing you guys to speak?
 
^summarized here:

Members on drug replacement programs such as methadone are encouraged to attend NA meetings. But, this raises the question: "Does NA have the right to limit members participation in meetings?" We believe so. While some groups choose to allow such members to share, it is also a common practice for NA groups to encourage these members (or any other addict who is still using), to participate only by listening and by talking with members after the meeting or during the break. This is not meant to alienate or embarrass; this is meant only to preserve an atmosphere of recovery in our meetings.
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http://www.na.org/?ID=bulletins-bull29
 
It goes to show you just how far opiophobia has rotted the ethics, education and treatment practices of American health care. But it works both ways. Doctor's will freely distribute Buprenorphine and say it is non-addictive in dosage units 40x higher than that needed for pain relief (Temgesic = 0.2mg; Subutex/Suboxone 8mg), liberally prescribe Benzodiazepines and amphetamines/ATS's with some 'less abuse potential' gimmick for all manner of problems, etc. We let pharmaceutical companies decide what is and is not acceptable in a narcophobic atmosphere.

EDIT:

Thankfully many MMT programs have implemented their own in-clinic Methadone Anonymous groups. Basically NA for Methadone patients; Bupe patients encouraged to attend as well. I think it's a farce, but there are people who have had a positive experience from meetings even if that did not mean 'working the program' the way the God Squad intended.
 
Being a Dual Diagnosis patient myself i would like to just share a little story.

When i went to my family Gp for a methadone script about 12/13 years ago , i soon realised that i could munipulate him, after about 6 months by using basic reverse psychology i had manged to get a weekly rx for 300ml of 10mg in 5ml temazepam elixir & 84 10 mg diazepam .
I am still on benzos to this day and i take some responsibility for the situation but the Doc who gave me that insane script is still practising & from what i hear has learnt little from what happened with me.

i think that he doesn't want to admit that he Fuked up , BIG .
 
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