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The Elephant in the Living Room

happyHBmomhhappyHBmom Posts: 2,070
edited 06/11/2012 - 8:48 AM in Pain Medications
I know I can't be the only ACOA here. How many know about the elephant in the living room? The thing that exists and everyone knows about, but pretends doesn't exist?

Well, I'm concerned that there's an attitude on this board that one thing that doesn't exist among normal, healthy people like us is drug abuse and addiction. Although we are a population as a whole where a small percentage will be expected to succumb to this terrible disease, it is something that just isn't mentioned.

It is the one thing doctors are never right about. If someone comes and says their doctor mentioned it, a board member is not allowed to agree with the doctor. Even if many doctors have labeled a person, the assumption is that if the person doesn't think they have a drug abuse issue, then they must not have one.

If new people post with "red flags" for drug abuse, they are often shunned rather than directed to support.

Given that a small percentage (yes, small, but still there) of people in pain management will develop drug abuse issues, should the mods not develop a policy regarding this issue?

Also, could recognizing abuse be something suggested to the owners as a topic of future articles?

I don't know. All I know is that I saw an opportunity for someone to get help lost because "being nice" was seen as not compatible with trying to help them recognize abuse patterns. I know that although we would never question a doctor who says "You have a herniated disk," I got my first ever warning on this site for agreeing with a person's doctor when they were diagnosed with a drug abuse problem because I "called him an addict."

To me a lot of that comes from a basic belief that people like us don't abuse drugs. That there is something to be ashamed of in having this disease.



  • For those who don't know about ACOA or the Elephant in the Living Room analogy,

    ACOA is Adult Children of Alcoholics.

    The Elephant in the Living Room is the alcoholism. It's so obvious you can't miss it, yet nobody's allowed to talk about it. Not talking about it allows the alcoholic to continue his/her denial, and makes the rest of the family "codependents." By not bringing it up, they allow the alcoholic to continue his/her behavior.
  • There is a disease (yes it is considered a disease with it's own ICD-9 code) called addiction/abuse. When you psychologically "need" a medication it is addiction. When you misuse a medication it is abuse. Now substituted for medication any of the following : alcohol, Advil/Tylenol, antacids, antibiotics, eye drops, muscle relaxants, narcotics and illegal drugs.

    This disease is as real as anything we talk about on this site. It is also very common among spine patients because of the intense pain we live with and the serious drugs we are given to try to combat that pain.

    I have dealt with addition and abuse in my family. As I have mentioned before we lost a family member to a side affect of addiction. I will never apologize for trying to help someone who presents the signs.

    As I said a little while ago in another thread we never know who is sitting at their computer writing a post. But it is classic behavior for someone who is addicted or abusing to seek help. They drop hints in a million ways. If we ignor these hints it's like sitting in the living room ignoring the elephant.

    If one person tells you something it's their opinion.
    If two people say the same thing think about it
    If three or more say the same thing it is probably true!!
  • Where do you draw the line on this matter? After I got the hardware taken out of ny back my ortho said I was fine there is nothing wrong all CT and x'rays were normal. But I was still in so much pain! At the time I was taking 120mg of ocxy a day. I started to feel like maybe I was a drug addict because my ortho said I was fine so I should not be in pain!! I checked my self into a detox center, my experience was great. The people were so nice. 2 days after I got out I was at home and my pain level was 10++ I started to lose my bowels. I got rushed to the hospital where they did an MRI and said it was normal. The doctor gave me perks for pain and I felt so much better. The detox did not work and I felt like a failure. I went to my GP and she gave me perks but I had to get them once a week from her which was fine. There has been time I took more then I should have so I was scared that this was becoming a big problem for me but at the same time the pain was better on meds. We did this for a year. During that time I tried to reduce my perks as much as I could I even went into withdrawl for a few weeks so I could get of this stuff But my pain was so BAD!! My family was worried about this too because the doctor said I was fine so I should be fine!! Well, In August I went to a different ortho by chance I told him that I have not had any test for my spine in a year! He was very shocked at this, he told me to come back in a week and wants me to have a CT ASAP.

    After the CT was done I came back to the room to wait for him to read it. I figured he would say that I just needed to build up my core and do more PT. I was wronge!! He sat down and said you must be in so much pain! cause your spine is a mess and we need to do surgery. He said my facet joints have worned down to nothing and I'm walking on bone to bone. The first thing I said is I DON"T HAVE A DRUG PROBLEM AFTER ALL!! He said no because you are in a lot of pain!! I felt so much better! So, thats where I'm at now, I'm on Morphine 45mg 3x a day my surgery is Dec 3rd. I have taken more pills but I just balance it till my rx day. I know I won't get anymore nor do I ask!

    What do guys think?? I hope you guys can understand this my grammer is awfull!!

  • This is a very difficult situation here on the forums. If it looks like a duck, quacks like a duck and walks like a duck, then most likely it's a duck. However, what is the likelyhood that confronting someone on a public board is going to make them seek help for addiction? More than likely, it will send them away to seek enabling elsewhere and just get you in trouble with the admins.

    This is not our living room where we're faced with a drunk parent sitting in a chair next to us. This is a mighty big room which makes the elephant rather small. We can't see faces and we're not flies on the walls of anyone's life here. And ignoring it here is not being an enabler because this is an open forum, open to the entire world. With that said, I see how someone in an ACOA situation would want to face this problem head on with tough love or whatever you want to call it when you see signs that you've seen many times in your life.

    But is it fair...HERE? To suggest that someone MAY have a problem is one thing, but to come out and TELL someone that they are an addict when you don't KNOW this person, you can't see this person, you're only seeing typing from someone who may be thousands of miles away in my opinion is not fair to anyone on this forum.

    As an authority member, I find it fair to suggest to someone that they may want to explore treatment because there are some red flags that suggest an addiction and leave it at that. To keep telling someone over and over is beating a dead horse and will lead to nothing but what we've seen on the forum recently. But to tell someone that they are an addict is simply not something that we can fairly say given the circumstances of this or any forum.

    Don't get me wrong, I know it exists here, probably more than we realize. But I have to go back to my original question: What is the likelyhood that some stranger on a board is going to make someone seek treatment for an addiction problem? If you think you can, then PMing with that person is the way to handle it rather than calling them out in front of everyone repeatedly. It's simply human nature to run screaming and crying when we're faced with a gang mentality. We can't and don't do interventions here, but to talk with a person privately that you truly want to help is not against any rules.

    Just my take.
  • Lisa you weren't either an addict or an abuser which you discovered when you finally saw the new orthopedist. What is great is that you were aware that your use of meds seemed excessive and kept looking for answers. Thankfully you found the answer.

    As far as drawing the line?? You don't. Obviously your family supported you through your quest. Should you or they have stopped looking for an answer? Should they have said "that's the best she can hope for"? Should you have said "my doctor said this is it" and left it at that? You listened to your first doctor and tried to stop taking the meds. When that didn't work you looked for another answer and didn't give up.

    If you and your family had kept silent where would you be now?

  • I am not suggesting online interventions! I am only saying that with something that basically amounts to medical advice, there are 4 choices:

    1) Only allow people who disagree with the doctor to post.

    2) Only allow people who agree with the doctor to post.

    3) Allow people to post their opinions.

    4) Only allow people to post support that doesn't imply agreement or disagreement (like current policy with imaging).

    Notice that discussing it such a taboo that I'm told I will inflame the whole board for even bringing up the subject! Mass hysteria, dogs and cats living together, TOTAL CHAOS!

    I think it should be less taboo, more everyday.
  • Thanks Kris. If I would have been silent I would just be wondering why am I in so much pain? I would have major depression and no motivation to try to live my life
    due to pain. Now, I'm able to work part-time go out with my friends and live. I was scared about becoming addicted and thats why I did something about it.

    Tony, I'm not wanting to start anything. I PM you and explained a little of how I feel why would I start anything? I almost get the feeling it's you who has the problem because all your post latly have been " stop trying to cause a problem" Up till now I thought the things you were saying were smart.

    Did I do anything wrong? Did I post this on a wrong site? I'm not feeling very comfortable at the moment!

  • Lisa, he isn't saying you are starting anything. He has no faith that wea can discuss this in a civil manner. That post was for me. So much hostility.

    Where do you draw the line? I don't know. I know many people are undertreated in pain management and there is even a name, pseudo-addiction, for under-treated pain that masquerades as addiction.

    We don't have the skills to differentiate here, but most of us form opinions. Should only some of those be shared?
  • going with this and what do you hope to achieve .i have stated a thread to try to calm thing down .,this one will only inflame the situation ??{LISA my comment not leveled at you }
  • For me, I shared that story because I think what I did was a good indecator that there are people out there who can be smart with there pain meds adn able to have a mature conversation about it. My story was about being valadated for my pain. HB - we live in such a judging society that it's hard not to judge when we read other posts. I do it! Just not sure why Tony is saying that to you?

    So, on a positive note.. When are they going to give you date?
  • I wouldn't worry Lisa, as I don't think Tony's comments were directed at you. I also don't think you had a problem with addiction either, but it's great that you sought help, because you were afraid you might have had one.

    Where I think it is healthy to discuss addictions because knowledge is power (!!!), I completely agree with what Cathie says, if you see red flags, make your suggestion about seeking help, and don't beat the dead horse. None of us here have the ability to diagnose addiction, especially since we only know what details a person may give, and we can quite easily miss some details that they do give. We also have no way in knowing if they are giving ALL the details, and, as Cathie said we are not flies on the walls in their home to see what exactly is going on.

    I'm actually working towards my diploma for addictions counselling, the reasons are twofold.

    The first is that I used to abuse alcohol, due to not dealing well with my PTSD. I don't say I'm an alcoholic, as I don't believe I was, I never craved it, never watched the clock waiting for my next drink, it never got in the way of my work or my life, or the people who were closest to me. I drank to forget on the days I couldn't handle the memories, flashbacks, anxiety attacks. And I seriously abused it. Then, because of one particular incident, I had a wake up call, and thanks to my hubby, I stopped, and stepped up my psych treatments to deal with my ghosts. So, in return, I would love to be able to help others in their struggles in addictions (be it alcohol, drugs, gambling, shopping, gaming, or whatever the case may be) who have been driven to those depths due to PTSD or other such illnesses.

    My other driving force, is because of where we all are. It irks me, to say the least, that so many of us are denied treatment because of people who abuse narcotics to the point of addiction. If I can help just a few, although it would be just a drop in the bucket, it could help those few to not become a number in the stats that are detrimental to us, and to recover from being there.

    Now, if only my headaches will ease up so I can take my courses consistently, but I will get there one day!!

    I have found though, especially recently, that people who have said that they're doctors treat them like seekers or abusers or whatever name you want to give it, people have jumped all over it. I do think that the elephant is big in this room, as everyone here is aware of it due to the narcotic side of the house. But sadly, we can't do much about it for people who we may think have a problem, as we may never know their story in it's entirety, all we can do is say "Seek help, talk to your doctor and family" and leave the rest up to the member to do that, and the professionals to do the rest.

    I would definitely be interested in seeing articles, or open discussions about it though! Well, as long as the discussions remained in generalities, or telling personal experiences, but as Cathie also said, that can be a slippery slope, it would be a nice idea in theory though!
    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
  • Cath you are correct that we can't hold interventions on the internet. When we hear from someone who describes addictive behavior bells go off for many of us. I wish I could reach through the computer and help them. But this can't happen.

    But there is the rare case where someone might listen. And more importantly by talking about the signs someone else might find a relation to their lives. If just one person says "gee maybe the PM doc was right" then it is worth all the talk and even the anger that always seems to spring up. If just one person reads the posts and say "omg that's my sister/brother/mother/father" then it's worth all the upset.

    I think HB hit on something important. Does SH have any info on addiction or doctor shopping or pain management contracts? Maybe some authoritative info on recognizing these problems would be helpful.

    All it takes is helping one person to make all this worthwhile.
  • Howdy HB, et al;

    I think many of us have had either friends, or family or maybe ourselves with alcohol or drug issues. My sister for example when we were teens - she OD'd twice. She almost didn't make it on the second one! Mother, alcoholic. Okay....

    With that said, I think in part that is why we get so passionate when we see 'red flags' (to us) come up. We are then leading into a post with our hearts. Then when we see the poster not even "listening" we get a bit stronger, hoping that they "will get it", but they don't.

    I feel too that the sensitivity button gets pushed on us too, as many have been labeled (mainly at ER's) as a seeker when in fact we aren't. So that hits a nerve (no pun) with us, in that if enough people with true and serious spine issues get labeled that way, *we* all end up suffering.

    We also probably don't get the true story about what is *really* going on with some posts, and partial information is kind of like we said in law enforcement "Suspicion is not Proof for Probable Cause"... Do I have the answer? Nope, but like you all, I sometimes let my heart lead. Sometimes that works gangbusters, other times well. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Let me make something crystal clear here. Anyone going around calling someone a addicted will be warned and depending on how bad the rest of the post is they will be banned. There isn't a doctor on these boards to be picking out a addict. Calling someone a addict is no different than stepping in the weight loss forum and calling someone fat or fattie. So anyone who thinks they have rights to call someone a addict, you most certainly don't. If someone has a question about feel free to pm me. There will be no name calling on these boards.

    To have a open discussion about addiction is fine. If someone really feels the need to reach out to someone why wouldn't you pm them in place of public bashing? That just seems to be something I have never understood. Members will say well i was trying to help the person and all you did was give them a public lashing. If you were really concerned, then you would sent them a pm and develop a dialogue with them? I have never seen anything good come from public lashings whatsoever.

    Most people whom seek counseling don't go out into the local mall looking for help, but they gain trust and confidence in someone and learn to talk to them. But some how here we get a bunch of people ganging up on someone and think they are going to listen? so for those of you who want to help and not start some band wagon, why not pm someone?

    It goes without saying there are a ton of post about medications lately. Not sure if it is because many can't afford surgeries and procedures anymore but can afford meds or why it is happening. Do I believe all of those members have drug issues, NO. I have a suspected there are some YES. But then once again I am not looking at them and reading the body language just the written words. Keep in mine we only know what someone is willing to tell us. But I also see the same thing with the spine issues themselves. Sometimes I read something and think better stay out of that post might be to judge mental. Sometimes i have walked away from my computer and came back and the same post is still there and when i re-read it, didn't read the same to me as the first time. Did I skim it or not have my full mind on the post, not sure. But we used to have a long standing joke around here, "step away from the keyboard".

    The thing you have to realize is that first off pain is purely subjective. So while two members could have the exact same diagnoses the meds may be on opposite ends of the spectrum as well. One maybe using no opiads and heading for surgery and one maybe using a boat load and contemplating surgery. Does it make one right or wrong, nope, just makes them different is all.

    So while I will let members talk about addiction there is no one on these boards qualified to say someone is a addict. If someone thinks they are please feel free to pm me your credentials and we can have spine-health verify them and do the medical membership. The judge and jury is out on these forums and no lynching is going to take place here. Heck for all we know the very members responding in this thread could be the ones in denial and need the most help and why seeking so much information on this topic?

    Here is some links on medications in general that spine-health has put together. As far as one of the mods writing forum rules on this specific topic, we address issues like this off the main forums and in pm's if we suspect a issue, the same way we handle suicidal post. They are sensitive by nature and that is where we address them in pm's. As far as spine-health writing some additional material I can check and see if it is something that we would like to address. I will update with that specific information and answer, when i receive one.

  • Finally somebody is doing something to stop this people from judging
  • tamtam, I couldn't agree more. One thing that struck me is that if I was reading these type of threads, would I join SH? I think that you are 100% right that the place for questioning addiction is via pm.
  • I guess I don't understand why a disease like addiction is equated with an insult like "fattie."

    I agree that none of us can diagnose abuse/addiction. But that still also leaves the question open when people have been diagnosed elsewhere.

  • http://www.spine-health.com/treatment/pain-medication/pain-killer-addiction-treatment

    I think this article is great. In the article, it states the statistics of people who become addicted and explains the theory of needing more pain meds because of the dependency on them rather than an increase in pain. I found the article very interesting.

    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • My take on this is really simple. Just walk away if you disagree, and let someone else provide encouragement to the poster.

    Name calling is never a good thing. If someone has an addiction problem, they certainly won't respond well to having a stranger tell them so. Form a friendship with these people, and then find a way to gently and tactfully help them, via PM, not a public bashing.

    Or if your fingers just can't stay still and you want to respond to the post, do it with kindness. You can still get your message across--the success of that message is all in how it is delivered!

    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • Great link, NOS, thanks!
  • It goes along the same lines. If someone has been told by a doctor to loose weight we wouldn't be rude to them and call them out on it. Same thing with addiction and addict. Isn't being over weight a disease? I am using that purely for comparison and there are many other types of examples that it wouldn't be acceptable in either. So my point is we are not going to call members out by any disease or illness. There are ways to discuss things without calling members names or using a illness or injury against them. Another example would be someone disabled who couldn't walk we would never except calling them crippled or lame. If we allow words like that to go on before long we will have other words like junkie, druggie and the list goes on and on. The line has to be drawn and I have drawn it quit clear it will not be allowed to go on.

    As I said feel free to talk about addiction, but everyone on these forums will refrain and treat members with respect. I have read a few lately and the lines are being crossed, so it needs to be toned down a lot. But there are ways to still discuss as I outlined above it one truly cared about someone on these forums.
  • I agree with you completely, Tamtam, thank you. I appreciate your post.

  • For me to jump in here and comment on a thread such as this one is rare. But I do have something to say on this point.
    Has it ever dawned on anyone that a true drug addict is not going to be on this or any forum seeking ways to get pain meds? NO...they are going to be on the street looking for their next "hit or fix" or what ever they call it.
    So what if someone runs out of their pain meds early? That is their problem, not ours. We are not walking in their shoes, all we know is our own pain, and not someone elses. Running out of pain meds early does not make them a drug addict....all it could mean is their pain is under treated and they need to speak to their Doctor about it.
    I do not comment often but when I do I always try to stick with the subject and try to be helpful. Before I post anything I read it over several times to make sure I do not offend(and check my poor spelling)then I ask myself if this is really helpful. I delete a lot and rewrite a lot and sometimes I delete it all without even posting.
    I do not go back and make several comments in the same thread UNLESS the person starting the thread ask me more questions.
    If someone posts a comment and I believe I have an answer for them but my answer may cross the guide lines by giving names or I think someone may take my answer wrong I tell that person I have sent them a PM. And that is how we communicate...by PM's
    That is my 2 cents worth. Now I must go wash a few dishes because I do have a life away from my computer.
    BTW....I started to delete all of this but....no...I am going to go ahead and post it. It does contain information that others could benefit from.
    I value my membership here and would never risk loosing it by bashing others.

    Thank you again Tamtam for saying what needed to be said. I always enjoy your comments. They are kind, helpful and to the point without offending anyone.

    Peace to All and may your day be as painless as possible.
    Patsy W
  • Pat I think you may be wrong when you say the addict is not on here. I can tell you from personal experience that many do in fact use the internet to meet people. They then plead for money or drugs. I have seen it happen first hand and it is heart wrenching. You would be amazed at the number of people who do in fact send money or meds.

    If you think I am exaggerating think of all the people you hear on the news who send money to collect their lottery winnings...only to find out after losing thousands of dollars that it is a hoax.

  • While I was waiting to see my doctor this morning, the TV was set to a news channel. There was a story about a recent study from the UK about what drug was the worst out there. Interestingly, the answer was not something like heroin or crack, but alcohol, I think it was mostly due to the fact that it is so socially acceptable. I did find it funny that the last part of the story was about the UK Wine and Spirits board (or whatever it's called) then made a public announcement that alcohol is not all evil and people do drink it without having any issues, lol. Anyways, just a little UFI and it made me think of this thread and the elephant in the room.
    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
  • So if you maintain the idea that drug addicts are all out in the street looking for their next high (in other words, as I said, drug addicts are all terrible people) would a poster who developed a problem feel comfortable asking for support? Would you want them to?

    A reference I read said that 18% of people addicted to prescription medications get them from their doctor. So, yes, a lot of them are getting them from someone else (that means a lot of people are getting the meds and selling them), but not all of them.

    I am less cynical than many about people with addictions. I would like to think some might come here seeking help. If anyone wishes to learn more, there is plenty of info out there. Just google prescription drug addiction.
  • My doctor and I also talked about addictions a little as well during the appointment. She told me that she worked with a dr at our local hospital here, who ended up becoming addicted and lost his license. His wife ended up in the hospital for some reason, and almost died because she went into seizure. They found out that she was addicted to dilaudid, he had been "treating" her for some kind of injury. When she was admitted to the hospital, of course they didn't know, so she went into such severe withdrawal, it caused the seizure. Turns out this guy was ordering it online from the states and getting it mailed, he had lied and said he was licensed, and was injecting her with it to treat her for her pain!
    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
  • I found this article really interesting. From WebMD

    Edited, see OP for link.


    Standards agreement and posting rules
    Please note that Spine-Health reserves the right to edit any messages posted or submitted or e-mailed to the Company and use them for content on the website or in other company materials. No e-mail solicitation or advertising of other companies, products, services, or web sites is permitted in the Spine-Health.com forums.

    Post Edited by Administrator Dave
  • oh my, that's a long one, my eyelids are drooping (and not just because of my horner's syndrome ;) ) so i'm going to come back and read tomorrow, sounds like a good one from how far I got though, thanks for sharing!! G'nite!!
    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
  • Patsy,

    Like Kris, I have to disagree with your assessment that we don't have drug seekers, or addicts on here. We had a 'new' member not even a month ago tell us his story of running out. No biggie there...but by his 5th post he literally was asking US if we had extra meds to give or sell him!!! Yeah, they are on here sadly Patsy...

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
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