TDS Social anxiety and opiates/xanax...pending hospital visit..... advice?

[randomness]

I've been self-treating myself for chronic social anxiety (something I've had all my adult life and I'm now 41) with opiates and xanax...not a smart thing to do I know all about the addiction, tolerance and withdrawal issues.. I used to drink to cope, but can no longer do that for health reasons. My social anxiety is SEVERE. I'm not talking about shyness, I'm talking about complete social avoidance. I won't open the door, or answer the phone unless I'm doped up.

Anyway I discovered opiates via Tramadol for a knee injury and found it had a remarkable effect on my social anxiety and withdrawn personality.. it made me feel more social and normal. I've become semi-dependent on opiates and use different ones, but mostly Subutex and Tramadol which I cycle on and off.. doses are very low (25-50mg tram and 0.25mg - 0.5mg Subutex).

Subutex is currently my opiate of choice as I find it less stimulating than Tramadol.

As for Xanax, I take 0.25mg - 0.5mg daily, and if I have something very stressful or difficult to do, I'll re-dose once or twice but I never take more than 1mg.

Xanax is the main thing for my anxiety..it just kicks it completely and I can do pretty much anything I would normally find terrifying.

But I have a problem now.

The long-standing knee injury I mentioned turned out to be a serious medical problem which now requires surgery and I'm due in hospital in a few weeks after I undergo a pre-op assessment at the hospital.

Although I'm not fearing either the pre-op or the operation itself and time in hospital (or even the weeks of physiotherapy after) because of my friend Mr Xanax... what I am worried about is whether I should tell the hospital I'm developed a degree of opiate tolerance and taking Xanax?

As to how tolerant I am, it's hard to say for sure. I can tell I have some tolerance because normal doses of codeine don't do much to me. And even the low doses of Tramadol and Subutex which would give some people a buzz don't give me any euphoria or anything.

Hmmm. How do I even explain this without sounding like a junkie or insane person eh. Not even my GP knows as these drugs are not scripted in the normal way (let's just say I have private doctors and access to stuff).

There's no way I can face a pre-op at the hospital without Subutex + Xanax to get me through it. I just can't do it.

I can however probably stay off opiates before admission day and during the hospital treatment, but I will have to take Xanax on the morning of the op, and while I'm there to keep my anxiety at bay.

I'm wondering how safe this is when I'm going under a general anesthesia for surgery? They do say you're not to eat or drink anything eh and any meds are to be declared before.

As I mentioned, the doses I'm taking are low so are unlikely to be a problem I would think.. but still.

What do you guys think? Should I tell the hospital I'm taking Xanax and have some degree of opiate tolerance, is there any need to?

I don't experience any major withdrawals if I don't take opiates for 24-48 hours, apart from feeling lethargic and demotivated. I felt that a year before I started opiates and I think it's due to depression or just my poor health.. but the opiates have a kind of stimulant effect like caffeine and make me feel fine and functional so I can get stuff done.

I guess the sensible thing to do is to declare both the Xanax and mention I'm taking Tramadol for a long time just to air on the side of caution (maybe not mention Subutex).. but I really want to avoid any difficult questions at all, and getting into the whole business of why/how I'm prescribed them etc since they won't be on my medical history etc.

If I DONT come clean, there's a good chance they may take show up on urine or blood samples at my pre-op and test me positive for opiates..Subutex is equal to Heroin pretty much I think..so they may pull me aside and ask if I'm taking heroin?? I'm also worried they will see me without clothes in the pre-op as I'm very thin and underweight/malnourished due to the opiates which suppress my appetite. They're likely to put 2 and 2 together and think..junkie.

Would welcome any advice.. I'm getting a bit worried as the pre-op date draws nearer! Maybe I should just call the hospital dept and explain the situation on the phone?

 

[ArtVandalay]

You need to tell them about the suboxone. You don't want to go into precipitated withdrawal do you?

 

[xxpurplehazexx]

^^ I agree, you definitely need to tell them. I'm 22 and also have miserable social anxiety.

 

[Z-girl]

You need to tell them, and you can't tell them on the phone - when you get to hospital you will have doctors talking to you and you will end up having to explain it to them in person, that's just how it works. Also, doctors simply don't take a medical history from someone on the phone.

I know this is going to be hard to implement, but you need now to not try to figure out what the consequences of telling them will be. The fact is, you have to tell them what medications you're on, because you don't understand the pharmacology of anaesthesia and how your current medications and tolerance will affect the drugs they use in surgery. Anaesthesia is a hugely complicated and exacting science - they need to know what medications you're taking (especially ones that act on the central nervous system, like the ones you're on), so that they can keep you safe during surgery.

I know you're worried about what the consequences of telling them will be, but surely it's more important that the doctors know what they're dealing with so they can keep you safe, and alive.

 

[Cartesia]

Just sayin but firstly..

where I'm from, they would not drug test someone before an operation. theyd take that on your word. if it turns out you were on something you didnt declare - theyre not liable anyway. they also wouldnt decide you're a junkie just because you're underweight. That bit is probably just your anxiety coming up with some silly stuff.

Secondly.. you absolutely have to tell them what you're on. Ideally I would say you should arrange a time to talk about that before you are in preop, in case they have to can the whole thing. But I know what its like to suffer anxiety, so I know you're gonna be putitng that off till the last minute. But you HAVE to tell them - what youre on (any and all) , and how much.... This is so you dont get yourself killed. If that doesnt worry you, think about how the operator etc are going to feel when you kick it on their watch.