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So where is the line between drug abuse/addiction and necessary use?

milagro

Bluelighter
Joined
Jul 13, 2012
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124
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U.S.A
I wish to preface this entry with a statement: Do not judge me, do not tell me I did wrong.
At this point, I can only benefit from words of support and suggestion. I am a CPP that cannot live on the meager wages granted by the government. Not at this point anyway.

I found myself in a bind last week with my meds stolen out of my car ~150 5mg Pills Oxy ir among other items. It was a parking lot under surveillance so it was a simple smash and grab while I was working inside. I had some OC, and a few IR left but I was working a job that left me in such abject pain that I had to use them up a week before my refill.

Many BLl’ers told me that I should try a taper. I had 20 pills to last 2 full weeks. That left me in a nearly impossible situation. Oh, I tried to taper but from 100mg/day to ~25 mg/day while working an incredibly physically demanding position. I am a cpp and have been for nearly 8 years.

By the second day of the taper it was apparent that I was in deep shit. I would not call my PM for an early refill as I had to do about 8 months ago due to misplacing my meds. I have to travel for work and only have one place to keep the major supply but when I am gone for 48 hours, I have to split them up. No more dabbling with numbers.

I thought in reading other BL’ers suggestions about kicking a ~100 mg/day oxy habit that there were some decent suggestions. I started with pst and it didn't do jack. I believe I wasted money and made such a mess trying to get it right, I got a minor buzz but nothing to calm the WD of OXY.

I then went to loperamide as it had eased symptoms in the past but I only used it for a couple of days. Almost an entirely useless detox med for a full detox period of time (8days).

So, I was faced with attempting to do it on my own. I did not know if I am simply weak or I truly needed medical help detoxing.

On the second day of abstinence, I was climbing the walls and my “sober” roomate was
asking questions.
I choose to call it RBS, restless body syndrome as it affected more than
the legs. My arms were in spasm, my entire body racked with horrible symptoms,
no sleep in two days.Then came the depression and lack of communication ability. I
thought about the scene in Trainspotting when Ewan Mceggor's character is going cold turkey WD to the point he was hallucinating, screaming bloody murder.

At that point I knew I needed some professional help so I called a detox center. I was granted a bed immediately because I was in active WD.

Here's where things become strange. I am certain that many reading this have been to a detox facility. I saw people dealing with my exact symptoms and some that had minds that were completely blown away by chronic alcohol /drug abuse. Let’s just say. That it was an eye opening experience. Never an empty bed and stories horrific to me during group meetings that I simply could not relate. I could not get the group meetings and the people being physically abused as a children, etc, etc. I have had extreme psychological abuse from a single mother, father passed away when I was 12 and I barely knew him. I eventually realized that I did not belong. Or did I? That is my question to anyone that views the contradictions between physicians that prescribe theses addictive substances and the people in the detox clinics that believe in complete abstinence.

I sat through a couple of groups that were completely nonsensical to me. I have a M.S in science and worked as a med tech for 15 years until chronic pain made it impossible to meet my FTE and I was forced to resign. Enough touchy feely:

QUESTION

So where is the line between addiction and a legitimate prescription from a doctor with 40 years experience in anesthesiogy? One who believes in opiate therapy for me because every other attempt-Nsaids, acupuncture, injections, a rhiyzomtomy, Buprenorphine none of which did anything to ease my pain and instead gave me an ulcer, a spinal headache, and other complications.

I tried ‘core exercise” and it helps somewhat but when my back goes out it does so for ~2weeks-month and that is regardless of core strengthening.

I am confronted with being labeled and addict, or am I a psuedoaddict(?), that must go through intensive outpatient and stay clean an sober or use the only medication that has worked in the past. I cannot lose the job. I thought I could handle it and never use while on the job but it is physically tormenting every minute of work. Had I told them up front of my disability, I would have never been hired. This has been the case for over 50 jobs I am qualified for but being disabled is a Scarlett Letter.

This is a conundrum I tried speaking to the nurses about at the detox facility as well as the Doctor who looks like she just came from Medical School. They push Clean and Sober all the way, groups that mean shit to me, intensive outpatient with people I saw that are true bangers, huffers, with stories that blew my mind about friends dying, multiple ODs, and on and on. I am simply trying to lead a productive life. Any suggestions? 6 days clean and I am emotionally raw and in a massive amount of pain. I am popping Ibuprofen to the point that my kidneys will fail in time. So What now? I have prescriptions for more oxy to last until Spring but I am confused having seen other people addicted to opiates and whatever "mood altering substances they used". Some, mostly alcoholics, barely able to speak coherently.

Where is the disconnect between these two fields of health care? One being the detox unit's point of view, and the physician's with twice as much experience handing these pills out in hope that the patient can re-enter society?

By the way, I wasn't stupid enough to give the detox facility any doctor's contact information but with the new pharmacy laws in this state I do not know what the detox unit is legally allowed to do.
 
Buprenorphine should have given you full relief from the terrible state you were in, but I guess not. What dose did they give you? And did you say the buprenorphine gave you side effects?
 
I had given up on the thread since I had no replies but I appreciate you taking the time to provide a response. I have used Buprenorphine in the past and after an induction of 4mg x 4times/day I leveled off at 8mg/ day and occasionally missed taking the med entirely because it has such a long half life.

I know this belongs in another forum but should a mod choose have it moved, so be it. When taking Subutex, it took about 3 or 4 days before I noticed my appetite returning, far less pain, and a relatively normal feeling. No buzz, euphoria, but definitely a decrease in BASELINE pain. The problem with bupe for me was that it was not covered by my insurance and was nearly 100 dollars for a month's supply. They would cover suboxone but not plain bupe HCL( subutex ) for pain.

Secondly, I was not able to achieve any success with medications for breakthrough pain while on bupe. My PM doc said she had people using oxy for BT pain while using bupe but it simply did not work that way for me. The worst bupe side effect was the excessive sweating. That made it difficult to interact socially since I would look like a nervous wreck following constant flop sweats.

I was afraid to ask for a supplement of bupe from my PM doc to ease the WD's because I had lost/misplaced my meds 8 months ago and I could not tolerate being subjected to random pill counts (I live 50 miles from my PM) and being suspected of misusing or abusing my medication. The PM clinic is extremely strict when it comes to early refills or lost/stolen pills. They don't care if a police report was filed or not.

Back to my original question: I believe someone began a thread that asked a similar question to mine on the same day that I began mine. What meds allow you to lead functional lives? I work now in addition to SSD but I am racked with pain after I finish my job and I only work ~15hours/week. The Oxy allows me instant relief from the pain. I never use while working. In a way it is a choice between the lesser of two evils.

I specifically chose this detox unit because they prescribe buprenorphine shots for people coming off opiates; I THOUGHT. I was denied a shot by the attending because she believes in suboxone + intensive outpatient treatment or complete abstinence and I left very confused. It is my own fault I suppose because I would not give them information about my pain clinic and told them of my failed long term use of bupe. I know for a fact that they would have contacted my pain clinic and the medications that work(oxy IR ER) would have been taken away from me. I am the type of person that needs to be in control and I will decide when it is time to give up opiates. Like I said in the original statement, I have tried almost everything for the pain and the side effects from oxy are minimal in comparison to all the other therapies/procedures I have tried in the past. The WD's, unfortunately, are complete hell.

There is no question that a little bupe would have helped me. I chose to ride it out and keep hush about my PM doc. I watched other pain patients give information about their doctors and they were left to being discharged from their PM clinics or being pushed into using suboxone and group therapy. Perhaps I was naive but I wanted to be safe rather than sorry.

I left the detox facility clean but in horrible pain and depression wondering what is considered "proper" administration of pain meds vs. addiction? I simply wanted to know what others thought. Should I return to full mu-agonists, or remain clean and unemployable? Was I the drug addict who had no control over my use of medication as the detox facility led me to believe?

They feel PM is a practice left for terminally ill people only. Maybe this should be moved to the Pain Management thread?
 
I really feel for you! I, like you, am a CPP and have been for over 25 years. Yes, it's a fine line between addiction and dependency. My father used to say I was addicted to pain meds and my response used to be, would you deny a diabetic insulin because they're addicted to it? Dependent/addicted, who cares? I need what I take to be semi-normal and if that's what it takes, so be it. No, I do not advertise I take what I take and wouldn't advise it. No one who knows me would ever guess I take enough narcotics to probably hospitalize them but again, so what.

Please, for your own sanity, reconcile the reality of the situation. If you truly need them, then you do. If you're abusing them, buzzing around all the time and generally miserable, then you might have a problem. Please feel free to contact me if you wish to discuss in more detail (I hope I'm not breaking any rules by saying this). Good Luck!
 
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