Why are the psychiatrist and psychologist pushing methadone so hard?

[Halif]

I've been seeing a both a psychologist and a psychiatrist for a few months, and basically things have gone from bad to worse.

The psychologist referred me to a psychiatrist because she believed that I needed my medication reviewed by a specialist, and I wholeheartedly agreed. 100mg of sertraline isn't doing much that I can tell, but I 've been on it for a couple of years, and I do know that if I stop taking (even tapering off slowly) I DO feel worse. Hardly ideal.

The thing is, after I repeatedly asked about confidentiality and was assured by both of these professionals that, barring a court subpoena, nothing I said would be passed on to ANYONE. I stressed again and again that I do not want to be stigmatised, and although I've had a very bad year and a bit, prior to that I was a pillar of the family after my father died. I worked very hard and supported my mother and brother - neither of whom had jobs at the time. It was stressful at times, but I don't regret it for a second.

So, eight years of full time work and not a cent in the bank. Now I am not working because I can't handle life anymore. Simple. I cracked under years of built up pressure. I just need a break to recover and work through some stuff. But I can't take a break because the bills don't take a break - they only go up.

The psychologist referred me to Centrelink and told me to apply for a kind of fixed term (3 months) break period from work which comes with modest payments. As I don't get sick pay, like many others on so-called "casual" contracts which are in fact full monday to friday jobs with lots of after-hours unpaid work. I don't work, I don't get paid. Simple.

Anyway, Centrelink gave me many, many forms to fill out with details relating to nothing (eg. what is the estimated total value of all your household possessions - including soft furnishings; eg. curtains.... no joke, this is really a question). I told them I was having trouble with the forms and could I have some help. They said that's not really what they do. But as a "privilege"(he actually ysed that term) if I turned up thee next day at 8:30am they might find someone to help.

Well, that someone helped me by looking at 70 pages of filled out documents... actually he looked at page 1 an 2 and then said that my partner earned too much, and hence I was ineligible for anything. He then said I was in fact filling in the wrong forms and what I needed was a medical report to be filled in by my regular GP. I said "What about the psychiatrist? YOu know, the specialist? Don't you want to see his letter?". No, he did not. He didn't want to see anything that I had spent hours compiling.

I took the form to the GP, who tapped his computer and then accused me of being dishonest in the past, because it was on record that I was a heroin user. So who the fuck passed that on? He reluctantly filled out the form, refused to script me diazepam anymore - which I am dependent on - and shook his head as he looked at me. So now I need to find a new GP.

I took that fuccking medical form to the psychiatrist and said "What's this for? What am I supposed to be doing?".

He told me that was not the right form. He took the form and placed it in his desk. He said that I do NOT have a mental illness, rather I am going around in circles taking illicit drugs and I need to.... drum roll.... get myself back on track BY TAKING METHADONE!

He said this again and again and again. I asked him how he could tell me what I was or wasn't, what I had or didn't have, after seeing me three times for 30 minute sessions in which he talked about lithium as if I might be bi-polar (fucking news to me) and talked about other medications, but never wrote any scripts.

I got very annoyed by the implication that I was essentially fine, but just dragging my feet. He didn't ask ANYTHING about my life. When I walked in he asked what the fucking weather was like outside. This is how it was every session.

I said "Thanks, it's good to know that I don't have a mental illness after all and I'm all better now" as I walked out, and he fucking followed me out telling me I must get on methadone.

So: do people in the counselling/psychiatric world get commission for putting people on methadone. I told him over and over tha I didn't want it.

What the fuck?

 

[opi8]

The fuck is we live in a fucked up world. That is all.

 

[justsayknow]

So: do people in the counselling/psychiatric world get commission for putting people on methadone. I told him over and over that I didn't want it.

What the fuck?

I doubt they get commission but psychiatrists usually solve problems by prescribing medicine so he obviously see's your main problem as opiate addiction and thinks Methadone is the best way to help. Also they have to be seen to be doing something and if you leave with a script/referral for something that has been proven to treat x condition then that is a success for them regardless of wether its what you want or not.

With regard to the confidentiality I'm pretty sure there is a register for people who are drug dependent in most states. I know in WA there are penalties for GP's who don't notify the register when they become aware that some one is dependent. I'm sure there are some GP's who don't always notify though. Also I'm not sure how it works in your state. It seems like a real disincentive for people to seek treatment though.

 

[justsayknow]

Also Centrelink processes are fucking nightmare. It depends on whether you get someone who knows the system well or not. Luckily you persevered and got someone on the second go who could help you and the GP also did the right thing by signing it. I would be interested to know when and how your details were recorded regarding the heroin use.

 

[Crankinit]

Just keep looking for a decent doctor man. So many arrogant, judgmental, egotistical morons in that profession, but there are a percentage of decent ones too. Just gotta keep trying till you land one with that rare combination of being competent at their job and an actual decent human being who treats their patients as the same, instead of like lab rats.

 

[Halif]

It seems like a real disincentive for people to seek treatment though.

You're damn right it is. I've put off mentioning anything drug related to any medical professional because I don't want to be stigmatised.

Know why?

Because my father died of liver failure. He drank a lot. It wasn't quick death. It took five months and was messy as hell. I saw, first hand, the hospital staff treat a dying man with contempt, and a so-called 'counsellor' humiliated him in what was supposed to be a therapy session in which I had to sit in on (the idea being that I was to "learn" from his "mistakes" - I didn't realise this until later).

THe counsellor was abrupt, thoughtless, and a man who I still hold a bitter hatred toward - even though I met him that one time.

He said to my father: "Do you know what happens if you keep drinking?"
My father said: "yes" (he was hardly conscious as he was on Xanax and half-dead - way too late for therapy)
The counsellor said: "What happens?"
Father: "What?"
Counsellor: "What happens if you keep drinking? Say it out loud"
Father: "I'll die"

He was a condescending cunt and if I wasn't so numb at the time I would have knocked him the fuck out right there. After the session, his parting words were to me: "You know this condition is genetic. You should be aware of your behaviours."

Thanks fuckhead.

So that was about eight years ago. I never wanted my substance use to be known, and I've taken great care to be responsible as possible. I've never had an accident, never had issues with police, never had any trouble at all. That's what I want - to be left alone.

Now, what's happened, I realise, is that by repeatedly giving me the "wrong" forms, but always collecting them and filing them, they have built up a detailed profile of my financial situation, history of depression and medication, and now illicit drug use. Fucking liars. The psychs the social workers...

I cannot tell you how angry I am about this.

 

[justsayknow]

Now, what's happened, I realise, is that by repeatedly giving me the "wrong" forms, but always collecting them and filing them, they have built up a detailed profile of my financial situation, history of depression and medication, and now illicit drug use. Fucking liars. The psychs the social workers...

I'm not sure Centrelink would feed that information back to a GP. Unless there's something on the medicare system. Like I said I would be interested to find out how it got on there. You could put in a FOI request?

Do you have a user association in your state? Over here we have WASUA and they are great they have a treatment officer who uses a more client centered approach. So its not going to be pushing methadone on you. Thats if you are even seeking treatment at the moment.

 

[Halif]

^Hey, thanks for that info.

I suspect the psychiatrist passed on the info despite my explicitly asking him not to, both verbally and written on paper. Honestly, I regret getting into this in the first place. I'm nearly 35 and I've seen counsellors, psychs, and psychologists before, and it's never gone anywhere. Centrelink drove me nearly insane when I was a young guy trying desperately to find work, and I avoided them for the next 15 years.

I have been put off the whole thing and I don't want anything to do with the government or medical systems when I have a choice in the matter. At this point, I'm considering just doing a rapid, killer taper (off the opiates) in my own way. Then try a super slow benzo taper, with benzos that I source myself seeing as no one will write a script for me anymore suddenly.

Very disappointing, the whole thing. I'm saddened and frustrated by what I have experienced and witnessed first hand by people who are meant to be carers or help people get better when they are very ill or vulnerable. Instead, I've seen judgement and being told things that weren't true.

Very disillusioning.

 

[justsayknow]

Did you ask the doctor for a withdrawal plan and tell him how frequently you are using the benzo's? They are meant to help out with withdrawals but I suppose it would be difficult to discuss with him if he is anti drug use. I guess if you can source elsewhere then no problem but he really should do a taper plan or refer you to a different doctor if he has a problem with you or with drug users in general. Not sure what state you are in but there are quite a few contacts in the stickies at the top of ADD that might be able to help. Good luck with it.

 

[oldirtybizza]

I don't get your beef with the doctors and not getting scripts, you have a benzo problem so why would they Rx you them. You are also on the system as a heroin user, that's game over for getting meds.
In a way they are doing their job here, they aren't drug dealers. Perpetuating your addiction by providing scripts isn't doing you any help in the long term either.
At least they offered to put you on Done which depending on your situation could provide some stability and a means to improve your situation.

"He said that I do NOT have a mental illness, rather I am going around in circles taking illicit drugs and I need to.... drum roll.... get myself back on track"

^I don't know your situ, but seems like legit advice. Addiction is a fucking hamster wheel and it's very hard to accomplish things in your life outside of drug use or to get perspective on your own situation when you are in the midst of it. sometimes you don't know when you're in the middle of a storm , if you get the analogy.

Don't want to seem harsh bro, I feel for ya. Although I have a valid medical issue, due to having an OD a little while back my Rx situ is also fucked , that's just how it is. And the truth is 99% of people don't "need" these meds, I mean it's nice to have them but it's also nice not to have to rely on doctors and their pills for your happiness and wellbeing.

 

[justsayknow]

I would have a problem if some one had promised me confidentiality and then put me on a drug dependent register. Although I couldn't say from the info provided if that's what happened. It does happen though.

Agreed that GP's have a responsibility not to let people become dependent on benzo's. But if they are already dependent then helping them taper safely would also be a responsibility.

 

[mork]

I find the younger doctor's these days a very well clued up to this shit...

 

[Halif]

"He said that I do NOT have a mental illness, rather I am going around in circles taking illicit drugs and I need to.... drum roll.... get myself back on track"

^I don't know your situ, but seems like legit advice.

This was the part that got me wound up (I mean when the psych said it). He hasn't asked me a single question about my family history - running like a poison river down the maternal side is severe depression; hospitalisations, suicides, lobotomy (yes, really - my now deceased grandmother had one of the last of those operations performed in Australia).

He didn't ask me how I felt in the past, during childhood, before I used substances. This is why I didn't want anyone to know about the substances, because the second they hear it, they make their mind up: this guys fucked himself up on drugs.

What about my childhood? The bizarre episodes of strange behaviour that scared me and my parents between the ages of 5 and 10. What about my teens? I had a little alcohol and smoked (cigs) from a pretty young age, but compared to my peers I didn't really get into smoking weed until I was 18. I had severe depressive episodes throughout my teens - before the weed.

Through my twenties I went on and off medications (anti-depressants) and substances (mostly psychdelics and weed). I took a THREE YEAR break from all substances (including alcohol, nicotine, and caffeine). That was a very interesting time in my life. Very hard. I learned a lot, but I became increasingly neurotic and melancholy. During that time of no relief via self-medication I had some of the worst periods of depression in my life.

I've learned through trial and error, that no matter what I do, I get depressive episodes which come randomly and utterly independently of my external circumstances. it has been the bane of my existence. I really want to know why, or at least how to control it.

The psychiatrist did not ask me anything about my life, my attempts to improve my health and wellbeing... nothing. He said that I was "lucky" to have got away with buying and using illicit drugs. He said that I needed to stop going in circles and take action.

Do you know how that makes me feel?

Do you know how much effort, over how many years I have put into trying to understand why this happens to me? No, because nobody ever asks me. All they hear is something about drugs, and they make their judgement. Case closed.

I am so sick of hearing that. Get your act together. Stop messing with drugs. Take some positive action.

How about asking me what I've done so far? I'm busted my balls trying everything, because this condition is horrible and makes me want to die. I love my partner, mother, brother, cats. I appreciate so many things, but I feel as if I exist in a permanent state of internal pain. Because it's internal, and thus invisible, people don't understand it. As far as they are concerned, if they can't see it, it doesn't exist.

OK, fine. But a psychiatrist is supposed to listen and work with a patient and HELP THEM. What I got was a thinly veiled lecture and an accusation of being a hypochondriac who is trying to mooch money from Centrelink.

I rarely get angry, and when I do I can control myself. But if only you could see how I feel about this. I am sick to death of being denied and essentially told that I don't know what I experience. It's akin to telling someone they don't exist, and increasingly this is how I feel when I deal with the system.

I was extremely insulted by his insistence that there is nothing wrong, and that I merely need to pull up my socks and get on with it. He had about as much empathy as a dog turd. He might as well go up to someone in a wheelchair, with no legs, and tell them to just get up and walk, stop wasting time in that chair.

I hate to feel this way, this is how my father spoke in his last few years, but mostly in this thread I relate to this:

The fuck is we live in a fucked up world. That is all.

 

[mork]

don't stop looking for a psychiatrist that is right for you - it took me many many tries before I found one that listened to me and worked with me. At the moment, I have one that gives me options for medications and allows me to alter my dose as required.

What state are you in?

 

[Halif]

Thank you very much. I'm in Victoria.

However, I have had too many bad experiences within the medical system to be able to go back in any capacity. This may seem drastic, but bear in mind that I'm nearly 35, and have seen 6 different specialist practitioners over the years, and various GPs, and have had ONE good experience.... with a counsellor who I couldn't afford to see more than twice ($120 an hour is a lot).

I'm sick from the medical system and have had enough.

I appreciate your thoughts, though. Thank you.

 

[heythatsmybike]

Methadone ---> Super addictive ----> Greater consumption ---> More Money ---> Excessive Profits ---> Pays for Dr. Holidays for the whole family! ---> More Prescriptions---> More Money ---> Excessive Profits ---> Pays more for Dr. Holidays and their whole families! ---> Social Perpetual Machine

Why would they want to cure an addict?

 

[Halif]

Heythatsmybike: Yeah, I feel like I'm wearing a tin foil hat somtimes and being overly cynical, but I'm afraid I think that is likely exactly how it goes.

It sickens me to think that we as a society have come to this. Exploiting people for superficial shit. Trading a person who you are supposed to be helping, a person who is on the edge, for some perks or holiday or whatever.

Is it really that way? How far does that corruption go? When did the medical system become an evil enterprise which neglects people's needs or actively pushes them towards courses of action (like methadone) which they know will make them worse?

What the fuck? Where am I living? What is this place? Did I miss the subtle slip from the middle ground of the earth-plain to the lower rungs of hell?

Funny thing, though. Recently I have had contact with people who have been extremely helpful in a practical way. Some of them were friends, some colleagues who I hadn't really got to know before, and some who I either just met or have never met face to face. People are helping me a lot.

So my intense frustration and hatred - and I don't use that word lightly, but I mean it for this - for the incompetent, corrupt government and corporate systems dominating the mainstream world is being balanced out by the incredible kindness of people around (and not around) me.

Thanks to all who've helped me on this board, whether it be through words of encouragement or offering helpful and practical advice... it's all appreciated and it's helped me to keep the faith.

People are OK, it's the system which is rotten.

 

[Christ!]

Heroin use is viewed as risky and Doctors are trained to put users on maintenance as a way of stabilizing/avoiding overdose. It's just the protocol.

Unfortunately it's never one size fits all but I can understand why your psychiatrist stopped doing you benzo scripts (his job would be on the line if anything happened to you)

Sounds like you've had some lousy experiences, and it doesn't exactly seem right that someone who promised you confidentiality put your name on a register. He might have had to do it, but he should of at least talked to you about the situation.

 

[Halif]

it doesn't exactly seem right that someone who promised you confidentiality put your name on a register

There's nothing right about it. I told him why I wanted the confidentiality and stressed how important it was, and he assured me that unless I said I was gonna go and kill someone soon, there would be no need to let anything I said leave the room. One week later and it's on the fucking computer system. What am I supposed to think now? Obviously I'm not going back to him, and it'll take a miracle to convince me to see anyone else in that system.

I put off seeking help for YEARS because I was afraid I'd be stigmatised and it would interfere with my life. Who knows what I will want or need to do in the future? Who knows how this could come back and bite me in the butt hole?

Also, as I mentioned earlier in this thread, I saw first hand contempt from the doctors who treated my dying father. It was not my imagination. They were also abrupt and heartless when speaking to my mother. When my mother was a nervous wreck and desperate to hear about his condition and if there was any chance of improvement, a nurse told her "I think it's time you accepted that your husband will never leave this hospital" and walked away. That night my mum drank so much she passed out in a pool of her own puke and I had to carry her to her room and clean her up as I had done with my dad the last few weeks every time he collapsed. Think that didn't affect me? Course it fucking did, but I had no time to do anything, because suddenly I was the only functioning adult in the house. My brother was too young to help out. I drove everywhere, I organised everything, I handled my dad in the hospital when he got angry and confused and wanted to leave the place, I carried my mother around because she was virtually catatonic.

After my father died, we found that we were almost $50,000 in debt due to medical treatments which weren't covered, overdue bills, maxed out credit cards which punished us with compound debt. So I pulled my socks up and got a job and worked and worked and looked after everyone. So yeah, I got into drugs which took away some of the hurt and helped with my depression. I could have used someone to talk to a bit, but I had not the time nor money, and I was still suspicious of counsellors and such after my earlier experiences ( I saw three before I was 20 - my depression pre-dates my drug use by years), and the best one was benign and kind but couldn't really do anything. One was indifferent. The last was arrogant and offensive.

So finally, I tried again and now I regret reaching out so much that it hurts. People reading this may think I'm a sensitive litter flower, but nobody knows what shit I've lived through. The shit I wrote above doesn't even compare to the internal suffering which seems to come and go without reason. Yeah, we all have our problems in life, and I'm sure there are people here who are in some way worse off than me, but that's pointless. There's always someone better off or worse off than you.

The point that I want to make about why I'm so upset (by which I mean I'm furious) is this: not one of these people has ever asked me WHY I DO DRUGS. They just say stop doing that, it's bad for you. They say I have to help myself, because you can't just sit and wait for a miracle. Yes, this recent psychiatrist really said that. He didn't actually ask anything about what I was doing. He didn't seem to think anything much of me at all. He had made up his mind the second I mentioned drugs.

And for all the judgement and stupid advice, not one of them has ever asked me: What have you done to try and help yourself? NEVER. If they did, I'd spend two hours telling them about how many things I've done, how many times I've changed my life, pushed myself into challenging situations, tried different spiritual practices, had lengthy periods of TOTAL sobriety - regular six month breaks and a big one, THREE YEARS of nothing, not even coffee. Travelled extensively. Joined sports clubs. Followed a naturopath's (very expensive) diet to the letter for three months.

It doesn't matter how I twist myself like a Rubik's Cube to see if something helps - IT (the depression) always comes back. Randomly. Sober. Drugged up. Single. With a partner. A good job. A bad job. None of it makes a difference. The depression is always there, coming and going like the weather. And I can't stand it anymore. I'm all done in from trying. So about two years back, I stopped bothering and just did what made me feel normal: opiates. I took as much as I wanted. Everyday. I didn't bother about tolerance breaks or getting dependent. Because as far as I was concerned, it was that or death. So, look, I'm still here. Yeah, I'm addicted to drugs and I'm not in great health, but I'm here. If I get another few years, then that's a bonus, as far as I'm concerned.

 

[Christ!]

Not judging you mate. Sounds like some huge amounts of shit you've been through very frustrating/devastating.

I think the 'system' has always been this way to some extent. I don't think it's corrupt exactly it just doesn't serve everyone in the best way all the time. By all means vent...lots of us can relate. I got lucky and my second GP was fantastic...saw her for 10+ years but unfortunately she moved.

My new GP blazes through patients and barely seems to have a minute to spare. Everytime I go to see him he asks to take my blood-pressure... which is great, except that he's so obviously checking for trackmarks! lol. He never makes a note of it and always does it after 'ohhhh, so you were on subutex' (I never was an IV user) - he never remembers anything about me, always repeating myself...

Throughout my youth I probably saw 10+ doctors/psychologists/counselors etc. Won't try and convince you that it's worth it to keep trying...sounds like you're fed up for now. There are good people out there though. All hope is not lost.

I think you'd definitely be after a good counselor. Almost everybody is going to say stop the heroin use, and try and get you to stop...that would be their main priority because they think you're in danger. It even concerns me a bit when I read 'using heroin, using benzos' (be careful with that obviously) - too bad you don't live near me, I know a very good counselor (although haven't seen her in a while) She lived in a hippie commune, done her fair share of drugs and currently working on her PhD - probably the most thoughtful person I've ever met. So wise and caring/understanding and non-judgmental.

I take it you've tried the SSRI/anti-d route?