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Posted 1/30/2008 3:20 PM (GMT 0)

 Hi Everyone,

I'm new to this forum and I'm in need of some feedback please.

Approximately five years ago my husband was prescribed oxycontin for back pain and osteoarthritis.  He immediately began abusing this med by snorting it.  At one point he was abusing more than 380 mgs. on a daily basis.  He then switched to fentanyl patches and immediately began abusing these by freezing and eating them.  During these times he was also prescribed oxycodone for break through pain.  He detoxed twice and was off pain meds for nearly a year.  about a year ago he made the decision to go back on pain meds.  He made his new doctor aware of his history of abusing pain meds and his doctor prescribed 15 mgs. oxycodone 3 x daily and 15 mgs. methadone 3 x daily for pain.  Since being prescribed these new pain meds, he has not taken them as prescribed.  Instead, he takes 6 oxycodone and no methadone per day for the first two weeks of each month and then when he's out of the oxycodone, takes methadone for the remainder of each month to keep from getting drug sick.  He tells me he does this because when he takes the methadone with the oxycodone it makes him too sleepy, and that the way he takes it at least gives him two good weeks out of each month, and that this way he takes less methadone than prescribed each month.  I have also caught him snorting his oxycodone on occasion....he tells me this is NO big deal!  It is a huge deal as far as I'm concerned, especially given his history! 

My question is......am I crazy, or IS there need for concern here???

Thanks.

Posted 1/30/2008 4:56 PM (GMT 0)
Hi Trust,

You are right...it IS a big deal. It's a HUGE deal. I'm sorry he's put you in this situation. Since you asked for feedback I'll give you my opinion. Since he's abused drugs every time they've been given to him, if I were you I'd report him and force him to detox. Tell his doctor who will then take action. I know this sounds harsh but he's playing Russian roulette with his life. Every time he takes the time release ones by crushing them he's getting a huge push of the meds. It can stop his heart among other things. If you want him around much longer it looks like you have to take some action since he won't. If you've had it with him then leave. Sorry to sound so cruel but he's put you in situation and you should not have to live this way. I'm sure he's turning your life into a nightmare.

Please keep in touch,
Chutzie
Posted 1/30/2008 6:58 PM (GMT 0)

Hi Chutzie,

Thanks for your speedy reply.  I truly appreciate any feedback I can get as these past five years HAVE been a nightmare. 

My husband hasn't taken oxycontin or fentanyl for three years, but has been taking six 15 mg. tabs of oxycodone daily for the first two weeks of each month.  When he runs out of oxycodone, he then uses methadone the last two weeks of the month to keep from getting drug sick.  He sees nothing wrong with doing this, and tells me that's what works for his pain.  He also occasionally crushes the oxycodone (not oxycontin) and snorts it.  He tells me he hardly ever does this and that when he does it's NO big deal.  What do you think of the way he takes these pain meds?

My husband does have chronic pain from back problems and osteoarthritis.  I have gone to his doctors in the past and he has been discharged from several practices, only to find another doctor.  He always tells his new doctor of his history of drug abuse.  I am prepared to go to his doctor again.  My concern is what will he use for pain control when and if he comes off opiates?  He has tried nerve blocks, high doses of ibuprophen, prednisone shots etc.

Thanks for your help Chutzie.

Posted 1/30/2008 7:03 PM (GMT 0)
trust4me
My heart goes out to you. I know how it can feel watching someone hurt themselves and feel helpless to make it stop. You have defenite and valid reason to be concerned. It is a double edged sword for those who need pain management and are addicted to opioids. It sound like he went back on pain management well intentioned by being honest with this doctor but was unable to control his use when he began taking them again. You may want to speak with his doc first. They may be able to recommend some addiction treatments. Getting your husband in a room with you and his doc may be more successful than approaching him solo. Knowing that you and the doc are not going to help him abuse his medication may put him in a position of admitting he needs real professional help, not just to stop the meds. There are addiction specialist who specialize in pain management if your husnbands pain is so bad he is unable to function. But forcing him into a situation in whch he knows that everyone is aware of what is going can be more beneficial because you then having backing from the doc.
I hope you find some comfort and are able to help and support your husband in getting some help.
I work for years as an addictions specialist before I got sick, If you need to just chat or vent a little, I'd be more than happy to give you my email
Posted 1/30/2008 7:57 PM (GMT 0)

Hazel and Gramps,

Thanks so much for your responses.  You are wonderful people to take the time to respond to my situation.

My husband tells me his pain got worse when he was off pain meds and that's why he decided to go back on them.    No, I'm not sure he wasn't getting pain meds someplace else during this time.  If I talk to his doctor and get him to come off pain meds, I'm going to insist on periodic drug tests????  Does that seem reasonable? 

Does anyone have any suggestions as to what he might try next for his pain?

Gramps, why is it unsafe to start and stop methadone?

Thanks for all the feedback.  It's sooooo helpful.  And, thanks for just letting me vent.  That is also VERY helpful.

Posted 1/30/2008 8:50 PM (GMT 0)
Honestly If his pain were that bad he wouldnt crush his meds and run out...his only concern is not going thru withdrawls..not saying he doesnt have any pain but Its obviously controlable..the pain releif from from oxycodone is far more than methadone...and Oxycodone and oxycontin are the same thing...well they are when you crush them up...oxycodone is the active ingredient in oxycontin...
Posted 1/30/2008 9:21 PM (GMT 0)

hi,

I am also new to this site, I have learned so much about pain management from the people who seem to understand it more than the Dr's. as all who search for support and answers they can not get from the medical field this site is a blessing. I myself have suffered ongoing pain issues and have tried many meds for releif, it saddens me to hear stories such as this, as I am not an addictive or abuser type of person (not judging anyone) so when I hear about all of the ways people can find to abuse the meds that they are prescribed for their pain, I am just trying to understand and educate myself & seek support. I am so thankful I have not secummed to trying such activities. As I don't have a sollution to your dilema, all I can do is pray for you and your mate. Hope things turn arouind for you. we are all here to support each other.

 

Posted 1/31/2008 2:27 AM (GMT 0)
Gramps,

Good point but it sounds like he has quite the tolerance for opiates..and if hes taking 15mg methadone pills hed need more than he has to OD on something...but one never knows..crazier things have happened
Posted 1/31/2008 4:07 AM (GMT 0)

I truly feel for the situation you are in. I know you said that both of you have told doctors what's going on, but have you been specific? Like freezing the patches and then eating them, or snorting the oxi.  If he's just told the docs he's had to take more than prescribed, they might not be getting the whole picture.

Have you looked into an addictionologist? They are better eqquiped to deal with addicts who have valid pain issues.  Please do something before he hurts or kills himself, he is on the edge with these behaviors.  I know you love him, but don't love him to death.

My thoughts are with you,

Melissa

Posted 1/31/2008 8:42 AM (GMT 0)
Hi trust4me-periodic drug tsts are alwyas okay. But it also sounds like he may benefit from a controled enviorment like a rehab or even a detox. Going cold turkey off any medicationn can be dangerous. And I would never say anyone ahould do it alone. Opioids usually pose less risk than any other substance for withdrawls. But everything can pose some risk even if its ant-depressants. Your husband may need tolearn not only how to keep himself from going back, but what alot of his triggers to using the meds are, like stress, boredom, anger, or certain places he goes that trigger the thought of getting high. If he is willing to admit he has a problem and refuses rehab or detox, NA or narcotica anonymous can be very helpful. It is unfortunite that no matter who you speak to he going to have to be the one to agree to help. You can only find different ways to talk to him and set up senerios that cause him to hit bottom, as many addicts or alcoholics wont ususlly get help if they have not had any negative consequences. So telling his DR about what he is doing could pose a negative cosequence when they refuse to nolonger medicate him. Telling him you love him and want to help him but that you will no longer allow him to hurthimself and you by using his medications in the way he is. But you have to follow through on what you say. If you tell him your going to tell his DR, do it. If you tell him he has to move out if he doesnt stop, do it(only an example) Addiction is a very fragile subject for anyone addicted to anything until they get the help they need. But its important to remember addiction is a disease, its not a character flaw. Although its always a choice to take that first pill or drink or whatever, after he does he truely does not have any control. He cant stop. It doesnt mean he cares any less or that your lives are less important to him, it is something he cannot contro;. My husband who is in recovery always tells me it is like a light switch that gets flipped on after that first pill or drink.
Even though it usually has to be there decision to get help, I hope you can find a way to reach him and help him understand that you only want him to be safe and healthy.
Posted 1/31/2008 8:42 AM (GMT 0)
Hi trust4me-periodic drug tsts are alwyas okay. But it also sounds like he may benefit from a controled enviorment like a rehab or even a detox. Going cold turkey off any medicationn can be dangerous. And I would never say anyone ahould do it alone. Opioids usually pose less risk than any other substance for withdrawls. But everything can pose some risk even if its ant-depressants. Your husband may need tolearn not only how to keep himself from going back, but what alot of his triggers to using the meds are, like stress, boredom, anger, or certain places he goes that trigger the thought of getting high. If he is willing to admit he has a problem and refuses rehab or detox, NA or narcotica anonymous can be very helpful. It is unfortunite that no matter who you speak to he going to have to be the one to agree to help. You can only find different ways to talk to him and set up senerios that cause him to hit bottom, as many addicts or alcoholics wont ususlly get help if they have not had any negative consequences. So telling his DR about what he is doing could pose a negative cosequence when they refuse to nolonger medicate him. Telling him you love him and want to help him but that you will no longer allow him to hurthimself and you by using his medications in the way he is. But you have to follow through on what you say. If you tell him your going to tell his DR, do it. If you tell him he has to move out if he doesnt stop, do it(only an example) Addiction is a very fragile subject for anyone addicted to anything until they get the help they need. But its important to remember addiction is a disease, its not a character flaw. Although its always a choice to take that first pill or drink or whatever, after he does he truely does not have any control. He cant stop. It doesnt mean he cares any less or that your lives are less important to him, it is something he cannot contro;. My husband who is in recovery always tells me it is like a light switch that gets flipped on after that first pill or drink.
Even though it usually has to be there decision to get help, I hope you can find a way to reach him and help him understand that you only want him to be safe and healthy.
Posted 1/31/2008 8:42 AM (GMT 0)
Hi trust4me-periodic drug tsts are alwyas okay. But it also sounds like he may benefit from a controled enviorment like a rehab or even a detox. Going cold turkey off any medicationn can be dangerous. And I would never say anyone ahould do it alone. Opioids usually pose less risk than any other substance for withdrawls. But everything can pose some risk even if its ant-depressants. Your husband may need tolearn not only how to keep himself from going back, but what alot of his triggers to using the meds are, like stress, boredom, anger, or certain places he goes that trigger the thought of getting high. If he is willing to admit he has a problem and refuses rehab or detox, NA or narcotica anonymous can be very helpful. It is unfortunite that no matter who you speak to he going to have to be the one to agree to help. You can only find different ways to talk to him and set up senerios that cause him to hit bottom, as many addicts or alcoholics wont ususlly get help if they have not had any negative consequences. So telling his DR about what he is doing could pose a negative cosequence when they refuse to nolonger medicate him. Telling him you love him and want to help him but that you will no longer allow him to hurthimself and you by using his medications in the way he is. But you have to follow through on what you say. If you tell him your going to tell his DR, do it. If you tell him he has to move out if he doesnt stop, do it(only an example) Addiction is a very fragile subject for anyone addicted to anything until they get the help they need. But its important to remember addiction is a disease, its not a character flaw. Although its always a choice to take that first pill or drink or whatever, after he does he truely does not have any control. He cant stop. It doesnt mean he cares any less or that your lives are less important to him, it is something he cannot contro;. My husband who is in recovery always tells me it is like a light switch that gets flipped on after that first pill or drink.
Even though it usually has to be there decision to get help, I hope you can find a way to reach him and help him understand that you only want him to be safe and healthy.
Posted 1/31/2008 8:49 AM (GMT 0)
Sorry- I have no idea why it copied up so many!!! I wasnt even done saying something!
Its always a good idea to seek out an AL-ANON meeting in your area. AL-ANON offers support for loved ones and family members of alcoholics and addicts. There are many many wonderful people there who are always happy to share there stories and help with advice in anyway they can. No matter what happens or what your husband decides, you should really take advantage of there support for yourself.
Posted 1/31/2008 3:58 PM (GMT 0)
I don't have much to say about this... But you do need to get him help, he's not only hurting himself and you, but he's also hurting the rest of us. I'm not trying to be an a-hole, but this type of abuse is why there is such fear in prescribing these type of pain meds! Snorting his pain meds is a partial sign that his addiction to opiates outweighs his pain. When oxycodone is insufflated it gets to the receptors quicker, but it make is have a lower absorption, meaning the pain relief affects last less time(I'm not 100% on this, but I'm pretty sure). If he does indeed need the oxy for pain management, he needs some type of help. What I do to ensure that I never let myself take more than I'm supposed to is I just give my meds to my wife. I think I have the ability to control myself, but it's just an extra measure to keep me in check. maybe you need to take control over his narcotic pain pills and act as a "babysitter". Please get him help, before he hurts himself!! And equally as important is you need help! It's hard to watch a loved one do this, you should seek out counseling and maybe as HazelB said, go to Alanon. Alanon will help teach you to cope living with an addict. Best of luck!
Posted 1/31/2008 4:49 PM (GMT 0)

Hi Everyone,

Thank you all so very much for your help and support.  I've learned many thiings in the short time I've been at this forum. 

My next question, now that you are all aware of our situation, is......what would someone who has tried large doses of ibuprophen, nerve blocks, etc. use for pain control use if opiods are no longer an option.

Last question...promise...does anyone feel that once a person has been addicted to opiods that they can/should ever take opiates again for pain control?  To me it would be like an alcoholic trying to drink just one beer??????

Thanks again everyone!

Posted 1/31/2008 5:25 PM (GMT 0)
You might want to consider talking to a GOOD pharmacist, they might be able to help come up with some meds to talk to his doctor about. Managing chronic pain is really a tough issue, and when drug abuse comes into play you have to think outside the norm and exhaust all options. My sister in law is a pharmacist and she has given me some awesome info to go to the doctor with.

I forgot to ask, has he ever been on Celebrex? It really helped me but my insurance won't cover it and it's way to costly out of pocket for me.

And what type of pain is it he's feeling? Muscle or nerve type pain? I know he has osteoarthritis, but does he have other pain issues?

Post Edited (03Mach) : 1/31/2008 10:50:44 AM (GMT-7)

Posted 1/31/2008 7:51 PM (GMT 0)

Thank you Gramps for the FDA warning.  I'll pass it along.  Maybe it will make a difference if my husband reads this for himself.

03 Mach....My husband has osteoarthritis, stenosis and degenerative disc disease.  He's had several back surgeries.  I'm wondering if anyone suffers with this same type of pain, and if they have any suggestions for pain control other than pain meds.  And, does anyone think that once a person has crossed the line and abused opiates, that they can/should ever take them for pain relief again?  My feeling is that it would be like an alcoholic trying to drink just one beer?????

Thanks again for all the posts.

Posted 1/31/2008 9:55 PM (GMT 0)
There are actually some addicton and chronic pain speciailists that you can look for that specialize in treating pain with or wothout opioids. You have to do whats right for you and your husband. If he suffrs on a daily basis, he may see no other option but to get what he thinks will help even if its by unhealthy means. Thats why talking to a professional is very impotant. Like I said its a double edged sword for those addicted and in chronic paain, only a pofessional is going to be able to help set up a treatment plan for your husband. Gramps has some great suggestions for you. Theer are also alternatives to medications such as accupuncture and accupressure that have shown to help with no only addiction but with withdrawls and chronic pain.
Posted 2/4/2008 2:37 PM (GMT 0)
Hi Everyone,

Hope you all had a great weekend!

A few more things I'm wondering about....when my husband is sitting down, he's constantly falling asleep.  It's more than falling asleep though.  He can have the t.v. remote in his hand with his hand up and pointed toward the t.v. set.  He starts to fall asleep, his hand slowly drops, and his head slowly drops.  He can put the t.v. on the guide, fall asleep as soon as he puts it on the guide while we're both sitting there, then I have to say his name to tell him to select something.  I know these meds can make a person sleepy, but this is not like normal falling asleep.  I've never seen anyone fall asleep with the t.v. remote pointed toward the t.v. with their arm VERY slowly falling down.  Also, he's up all night, hardly ever sleeps.  Sometimes when I get up in the middle of the night and go downstairs, he's almost face first on the coffee table. Is this the way people on pain meds fall asleep?  Do any of you do this?

Thanks for all the help.

Posted 2/4/2008 4:13 PM (GMT 0)
That's how an addict on a high "nods out". Your husband is an addict. He is abusing his medication. You can't fix this problem. Treating an addict's pain is one of the most difficult things for any doctor to deal with, and most won't even take the job.

You have some big decisions to make. Are you going to stay with him while he goes down this path yet again? If you can get him to agree to treatment for his addiction, will you stay with him through that? Or will you leave him to his addiction and get your own life in order?

You can't trust an addict. He is lying through his teeth, and will lie, cheat and steal to be able to keep getting his drugs from whatever source. I'm sorry, but your husband is in deep, and he isn't likely to break out of this by himself, or even with only you to help him. You could start checking on different in-patient rehab programs in your area that are hopefully covered on his insurance plan. Have the information ready. When the time comes, you'll have to issue an ultimatum: get off the drugs and go to rehab, or I'm gone. End of story. Have your bags packed and ready to walk out the door when he refuses, which he probably will.
Posted 2/4/2008 6:42 PM (GMT 0)
So people who take their pain meds appropriately don't fall asleep like this?  Also wondering if staying up almost all night every night is a side effect of taking pain meds?  Also, do people who are on opiates always have trouble with their spouses or significant others, as my husband tells me they do? 

Posted 2/4/2008 8:45 PM (GMT 0)
Some people do fall asleep like that, but only when first starting on the meds (a week or two). I am not sure what you can do for him. The issue with methadone causing heart problems when starting is because you are just getting it into your system, what happens is you get what is called a QT prolongation, and that is what can kill you. It is rare and if he does not have a history of heart issues, or better yet is he has had an EKG that turned up good than he does not have much to worry about in that department. OD I think is your biggest issue, though now that he is so tolerant the likelyhood of that is not as great as it would be is he was jsut starting to abuse opioids. Methadone does have a long half-life and can build up in someones system causing an OD, it also can be present after the long after the effects from it fade, so if he then took a large dose of another opioid, drank alot, or something else like that, he could OD because it would have a synergistic effect with the methadone in his system. Good luck, I cannot really recommend what to do. An addict will be an addict, it will be dificult for you to change that no matter what you do, unless he wants to change. Even if you go to the doc and get his drugs cut off, there is a good chance he will go to buying them off the street, where he will spend much more money, risk arrest, and generally lead a more destructive life. I am against having his doctor stop the prescription without consulting your husband first. No matter what, he will use drugs and be an addict until HE wants to stop. Remember that, that is why it is so complicated. I wish you good luck though, I know this is probably very tough for you, I really hope things work out.

BTW The reason methadone lasts so long really does not have much to do with the fact that it is synthetic, their are plenty of synthetic opioids with short half-lives, it is because it takes a long time to metabolize and it is very fat-soluble so it takes a long time to work out of your fat into the blood, where it can be metabolized.
Posted 2/4/2008 8:56 PM (GMT 0)
Trust- I have been on some pretty heavy duty pain medications for about 8 years. I have never had any problems with my spouse or family. Believe me, my husband will tell me like it is, and he has no complaints (well, other than I always hurt so he doesn't have the services of his wife enough!) I also do not fall asleep anything like he does, and never have for that matter. Some people get a rush, euphoria, or ecitability from the meds, especially if they are abusing them. He is probably getting the euphoria and rush of energy, which is why he stays up all night. He needs help because soon it is going to take him more and more of the medication to get his high and he will run out....then have to deal with withdrawals until his next appointment which are VERY ugly.
Posted 2/4/2008 9:21 PM (GMT 0)

Thanks everyone.

I think he uses all his oxycodone the first two weeks of each month, and then uses the methadone for the last two weeks to keep from getting drug sick, but I also wonder if he takes his meds this way to be sure to keep his tolerance to both meds from increasing?????  I also know he has traded some of his methadone with our son for some of our son's oxycontin during the second half of each month when he's (my husband) out of oxycodone.  Our son is also prescribed pain medication for chronic pain, but has also abused his meds in the past.  This situation scares me to death.  My husband tells me he has only done this once or twice.  If I ever do go to my husband's doctor, it will be because of this situation.  Don't see how I can sit back forever worryinig about something happening to either my husband or my son.  If anything were to happen, how would I ever live with myself, knowing I could perhaps have prevented it?  Does anyone think I should go to my husband's doctor?  I know if their doctors cut them off, they could get their drugs on the street, but then at least if anything were to happen to either of them, I could go on knowing I did everything I could possibly do.  I wish I could feel confident about what the right thing is to do, but I NEVER can! confused sad sad

Posted 2/4/2008 10:17 PM (GMT 0)
I personally think you should go to his doctor. By trading with your son he is giving your son a medication that is not prescribed for him and could interact with something else he is taking.... This is dangerous for both your hubby and son. You keep bringing up contacting his doctor, so you KNOW it is the right thing to do, and that would be the first step in keeping your conscience clear. It is okay to lean on us for support and to give you confidence in what it is you need to do. I personally believe you have the confidence to do the right thing, but it is just scary for you....just think how scared and horrible you would feel if you lost your husband or son (or both) to drug overdoses. You need to know for yourself that you have done everything in your power to help them or it will eat away at you, you can prevent something bad from happening.
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