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Mental Health I'm BI-POLAR with PTSD and am denied meds because of Opiate addiction

G

g.bentham

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Joined
Sep 2, 2014
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Winnipeg
I have Bi-Polar, PTSD, severe anxiety disorder and episodic insomnia and have been refused the gold standard, common medications associated with these condition because Dr.'s worry they have abuse potential, and I'm opioid dependent. How many else out there struggle with this problem?
60For years after I left the military I struggled with insomnia, anxiety and PTSD. Therapy helped, but at the end of the day, I would have never functioned without my combination of Xanax and anti-depressant medication. Soon though, I was introduced to OxyContin and before long was shooting it. Within a short period of time, I got caught and my Dr. was notified about the opiate addiction. I was put on the waiting list for a methadone program, and in the meantime my Dr. maintained my previous meds and started prescribing OxyContin as well, until I was able to get into the methadone program.

When I started the methadone program, they said I could continue with the anti-depressant but Xanax was an absolute no-no. I reluctantly agreed, and have been on and off methadone ever since. Since that time, I have also been diagnosed Bi-Polar, and have added Quetiapine, Bupropion, Abilify, Zopiclone, Sertraline and Lamotragine to the daily med intake (and am at this point taking 60mg of methadone). When it comes to my panic attacks however, and when the PTSD is jolting me out of my sleep, I feel that a benzo would mean the world to me. I would happily drop just about everything else I'm taking to get that prescription back, but its verboten when it comes to someone 'who might misuse it'.

Has anyone else dealt with a situation like this?
 
I haven't dealt with that situation, but i may be able to offer some insight.

It sounds horrible. I'm sorry for your experience.

Since you have a documented history of drug abuse, doctors are much less likely to prescribe you drugs of abuse. Have you asked your doctor if (firstly), how and when you might be able to continue therapeutic treatment?

Being a veteran must be tough, again. Especially for a war which cost the US economy hundreds of billions if not trillions of dollars. And for oil.

Please stay on your drugs. There are other drugs to treat panic attacks. Paxil is one you might want to ask your doctor about. Also, bupropion and abilify might increase propensity for panic attacks. Have you told your doctor about your symptoms. That is the only way they can help you.

Your doctor was very compassionate to prescribe you an opioid while waiting for methadone.

Good Luck
 
how about gabapentin/pregabaline for the anxiety and mirtazapine/seroquel in a low dose for a good night sleep?
And you take a shitload of medication by the way wich is not always the answer, you should consider skipping a few to see what happens, after maybe there is more room for talk?
i think the last option would be to order some rc's like etizolam but that would be a last resort since i am against them.
good luck my friend
 
Are you a combat vet? does Canada have a Veterans care system? or is all care wrapped up in your social medicine system? not that it matters much, veterans care has been taken over by the good ol boys club of bean counters and crooks, they use to be sympathetic to veterans needs. If I had it to do again I would have told them to shove their bi-polar diagnosis up their bullshit psych artist's ass! that diagnosis is a cop-out for lazy physicians who don't want to or cant do their job's. Of course you have a imbalance! My circumstances of course are different then yours, In 2006 a Army Col. diagnosed me with chronic fatigue syndrome/Fibromyalgia. "What the fuck is that" I exclaimed! 8 yrs later I'm AFU, all fucked up! After my step father and Mother were ravaged by cancers in 2005 & 2012 I was reading a story in the American Legion Magazine on Solvent exposure on Camp Lejuene from 1958-86, shit we were there in 73-74. After a year of suffering from MS/PD symptoms, I started looking into my symptom history and figured out the cause of my problems, it was exposure to (TCE,PCE,BENZENE's) I don't know what you did in the Military or where, but check it out! you maybe be suffering from something different all together. Stress leads to pain, pain leads to depression, pain and depression leads to nervous system disorders. find a neurologist current in treatment's and you will get the treatment you deserve! Opiates, Stimulant's, Anti Seizures, Snri's, Beta-Blockers, Nootropic's, Vit's, nutrition support. Stay alert, Stay Alive! Good Luck Soldier!
 
That's horse shit YOU NEED TO FIND A BETTER DR AND YOU CAN. You should google psychiatrists who SPECIALIZE in addiction, find one with good reviews, Call them...
ask them flat out (or the secretary ) I need medication for my mental disorders and if you aren't open to prescribing meds I can't be a patient. I cannot function with meds.
Tell them about your frustrating situation. I can almost guarantee you you'll find a shrink who will give you meds.
Careful with the benzos if you get em, please.
Sorry about this man. I'm lucky to have a Dr. who listens more than he talks and prescribes the right stuff
 
g.bentham said:
I have Bi-Polar, PTSD, severe anxiety disorder and episodic insomnia and have been refused the gold standard, common medications associated with these condition because Dr.'s worry they have abuse potential, and I'm opioid dependent. ...

When I started the methadone program, they said I could continue with the anti-depressant but Xanax was an absolute no-no. I reluctantly agreed, and have been on and off methadone ever since. Since that time, I have also been diagnosed Bi-Polar, and have added Quetiapine, Bupropion, Abilify, Zopiclone, Sertraline and Lamotragine to the daily med intake (and am at this point taking 60mg of methadone). When it comes to my panic attacks however, and when the PTSD is jolting me out of my sleep, I feel that a benzo would mean the world to me.
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Two things- First, you're not being refused the "gold standard" of BP medications. The "gold standard" of BP medications is Lithium. It's also the most commonly used. Do you know why they don't have you on Lithium?

Secondly, Xanax is a LOUSY sleep aid- it'll become ineffective very quickly. If you really feel that you need a benzo, then go for something like klonopin. If you need a sleep aid, go for a Z-drug.
 
I would recommend against Xanax as it seems to be the benzo that get's people addicted the most. If you need a benzo for anxiety a long acting one such as Valium or Clonazepam would be a much safer choice. As for sleep well i never found Zopiclone to be physically addictive but everyone is different and i seem to get off easy when it comes to benzos and drugs like them.

I am prescribed morphine for severe chronic pain and i am prescribed Clonazepam for GAD and panic disorder. The clonazepam also is used to treat the nerve pain i get so that's another reason for me to be on it. My current doctor knows i have a history of drug abuse but he still treats me as i have about 2 different neurologists and a chronic pain doctor who agree that only strong opioids are going to do anything for my pain. Plus my doctor is more sympathetic then most as he's a good ol guy who's seen it all more or less. If Ketamine ever becomes standard treatment for nerve pain i'm saying fuck the morphine and getting on that ;)

Sometimes doctors are so anti-benzo that they wont give them to anybody regardless of previous history. I had a doctor refuse to give me even a few Valium when i had a full blown panic attack in his office and nearly passed out. He wrote me a script for Paxil i think which i chucked in the garbage right away. You can't get anywhere with doctors like that. The cunt told me that he only gives out benzos to old people dying of cancer or something to calm them down. Such a compassionate cunt indeed 8) . It's really a matter of finding the right doctor. I have been on 6mg's of Clonazepam since about 2006 and i have only run out early a few times and the only time i have been through benzo wd's was when i was away from my doctor and a now ex g/f made off with most of my morphine and clonazepam pills. I just don't find benzos with the exception of temazepam to be worth abusing really.
 
If you're trying to get something for Insomnia, there are many non-benzodiazepine or GAMMA analogs to try.
Antidepressants Mirtazapine and Trazodone specialize in sleep
Also Gabapentin, buspar, and Lamictal can help with sleep
 
The best benzo for anxiety/not getting addicted IME is Ativan. Lorazepam is quick-acting and effective, and has less side effects such as drowsiness than valium
 
Trying2Iso said:
The best benzo for anxiety/not getting addicted IME is Ativan. Lorazepam is quick-acting and effective, and has less side effects such as drowsiness than valium
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I would disagree with that as Lorazepam is rather short acting compared to say Clonazepam or Valium so you will have to redose more often. For anxiety you may want to try Valium first as it has a really long half life and tends to be less addictive then more potent benzos. Plus it's the easiest benzo to taper off from. It causes somewhat more sedation in some people then clonazepam or Ativan but unless your taking huge doses it shouldn't be a problem really. Clonazepam is a good one too as even though it has a shorter half life then Valium (still a half life of about 2 days though) it tends to last longer then Valium. I have been on Clonazepam for ages at high doses and i can skip a day easy without feeling any real withdrawal symptoms. With Valium it's metabolites take time to build up in your system but if your taking it regularly you will start to notice it building up in your system and lasting longer.

If you need something for insomnia i would actually recommend maybe a tricyclic anti-depressant like Amitriptyline, Trimipramine or the even more sedating Doxepin.
 
I've been taken off my clonazepam --during a panic attack benzo's do in fact "mean the world". I myself am struggling with the idea of being without the prescription. I wish I had more to offer, but all I can offer is best wishes.
 
That's standard practice as benzodiazepines are clearly contraindicated for methadone. Most deaths on methadone occur with the addition of benzos. http://www.ncbi.nlm.nih.gov/pubmed/20132123

There's also the fact that you've been known to abuse drugs in the past, and this again means doctors are not meant to give you abusable drugs other than those used for replacement therapy. On top of all this, you're already on a massive arsenal of drugs, each additional drug non-linearly increases the chance for complications (far greater risk of morbidity or potentially mortality). Moreover, the use of BZDs for people with bipolar is questionable and may worsen the condition: http://www.ncbi.nlm.nih.gov/pubmed/20193647

God only knows what Xanax + methadone + quetiapine + bupropion + ablify + zopiclone + sertraline + lamotragine would do the body!

So those are the reasons this is happening, and to be honest with you: they're very well-founded reasons.

If you've got bipolar anxiety then sodium valproate (Depakote) does wonders. It works by increasing levels of GABA in the brain -- the same neurotransmitter which benzos increase efficiency of -- but it holds no potential for addiction/abuse.
 
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You are not being denied the gold standard for BP disorder. Secondly it is very common in my experience to see doctors trying to not prescribe Benzo's to those with addiction problems who are also taking other strong narcotics like methadone. To be honest you are on a large amount of meds. I would hope that my doctor would do what he could to try and not get me addicted to another seriously dangerous sedative hypnotic like Xanax or Ativan. I use gabapentin for my anxiety . Works pretty good. Good luck. Maybe try exercising. Now some people do require benzos but most doctors try and not keep people addicted to both opiates and depressants. Vets die all the time from med combinations very similar to the above regimen when adding another sedative like xanax.
 
Almost no doctor will prescribe any benzo to someone on methadone. Just too much liability. Every clinic, or person I have known on methadone has said the same thing. You're not being singled out.
 
lazylazyjoe said:
Almost no doctor will prescribe any benzo to someone on methadone. Just too much liability. Every clinic, or person I have known on methadone has said the same thing. You're not being singled out.
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Is Methadone actually more dangerous then say Oxycodone, Morphine, Dilaudid, Fentanyl,etc to mix with benzos or is it just a policy that clinics have? I have been on everything from Codeine to Fentanyl for my nerve pain and not once did a doctor mention taking me off Clonazepam. I have heard that Methadone can possibly cause worse respiratory depression say Morphine and if that's the case it would make sense.
 
You will probably not find a doctor to prescribe any benzos while you're on methadone. There is a very dangerous interaction potential with too many CNS depressants and it can cause seizures and respiratory depression, leading to death. They're also probably going to be very careful prescribing you a sleep aid for the same reason. As far as the lithium someone suggested, that can cause blood toxicity and extreme lethargy, so it might be a no no as well with the methadone.
You are on a lot of medication, and as someone above stated, more is not necessarily better. I would ask your doctor about what you might be able to do to both treat your panic disorder and try to consolidate some medications, perhaps switching to some with multiple off-label uses (Seroquel, for instance, is an atypical antipsychotic used for bipolar disorder and is often also prescribed to treat insomnia).

Good luck to you. I can't imagine what you're dealing with but I'm sure it is awful. I really hope you get the help you need.
 
I think that due to methadone's long duration and the propensity of addicts to abuse their medicine that its a great risk factor. When a client dies on a doctor it makes them look very bad indeed.
 
^ I was prescribed Temazepam for sleep on top of my 6mg's of Clonazepam a day when i was on the fentanyl patch. I noticed i sometimes nodded out real quick but that's about it. Granted although i never bothered abusing fent after the first few tries as it has basically devoid of any euphoria i did abuse the Temazepam which is the only benzo i find to be euphoric.
 
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