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What to do - support needed for caregiver

Im not sure what to do anymore. Background: my wife has legit back/spine problems. Without getting into too much detail, she has some numbness in various areas of her lower body, pain all the time, and a condition that neurosurgeons have argued about giving surgery to (ultimately deciding that its too risky for her age, and that she should deal with the pain as long as she possibly can before resorting to it). She's in her 30's. She has been prescribed 12 a day (max dose) 10/325 norco, 2 soma per day, and 4 or 5 oxy 5mg per day. In the past she has tried time released stuff (Ms contin/morphine) that left her with urinary retention (and a 3-day hospital visit that was very scary). She thinks that the break in between doses gives her body a break and allows her to urinate more freely.

Here is the problem. She often runs out of her medications around the two week mark. Maybe 16-18 days. That means she is taking heavy amounts of her medications when she first gets them, then goes through the cycle of running out and "detoxing" or "withdrawling", or whatever you want to call it. She is obviously taking large amounts of Acetaminophen, maybe 5000-6000 a day sometimes, which seems to be the most dangerous part of the equation to me. Soma could be around 4-5 a day, and I have seen her very much uncoordinated and slurring her words. We have been fighting about this stuff for years, and i have considered leaving as I am suffering with severe anxiety that I relate much of this to. We fight about this stuff often, and when she runs out, she gets depressed and will often take Kratom to fend off the withdrawal symptoms.

I come to you as people with pain asking what to do. She often says things like "I would rather live a shorter life and get to do the things I want to do/be out of pain, then live a long life in pain." And I get that. But at the same time, i know there is a better way to be dealing with the issue of medications. From my perspective, I don't think she will ever be able to administer her pain meds in a responsible way to herself. When she has them, she takes them.

Any advice on what to do would be appreciated. I have threatened to tell her doctor, and she gets furious and says if I do that they will never give her pain meds again...and I would basically ruin her life. I have tried to go to the appointments, but she wont let me. I have suggested therapy, but she hasnt gone even when she has promised she would. I have considered going to her parents and laying it all out there intervention style, but haven't. I am afraid she is going to die....overdose, or get liver damage or something. I am sorry that this post is so similar to the other one, but i needed some place to get this out. Any advice on support services for myself would be welcome as well. Thanks


  • Helen3Helen3 Posts: 205
    edited 10/28/2013 - 8:39 PM
    She may b in serious pain, but also sounds like serious addiction an of course abuse.

    Who knows what she telling the doctor. She might not know she is endangering herself.

    Call the doc before something happens to her.
  • LizLiz Posts: 7,832
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    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • I know exactly what you are experiencing and am so glad after our talk you decided to share with everyone. Some of us who deal with this daily all have different ways of dealing and sometimes not dealing with our loved ones addiction. I have been through the anger, guilt, tears. Went from wanting to leave to thinking I am the only help he has to wanting to leave again. His anger at me when he is out of meds and knows I just had mine filled used to make me feel guilty but not anymore. Still hurts when he says mean things though.

    I can almost guarantee her doctor knows what she takes and if she is getting from numerous sources. Do you know if she has gone to ER or Urgent carebor even another doctor or dentist. I found a new one today when I opened his EOB from insurance and he was given pain meds by his dermatologist after a couple procedures he had. I was furious but his doc will know when he checks the DEA website. I worked for same doctors office that we both use for 7 yrs. And along with my doc who I worked for also would check each new patient coming in for pain and for patients wanting meds early. Most were honest but there is always one or two who shopped around and got from numerous providers.

    I cant tell you what is best thing to do because I dont even know. This is by far the hardest thing I have ever had to deal with. Some days I will see a little glimpse of the old him I fell in love with and think I will give him another chance. Then the adfict appears and I just try to avoid him and spend less time around him. You sound like such a kind and loving husband and i truly am sorry you are going through this. I just wonder if we can hold out until they hit bottom and want help or if they will survive long enough to get that help. I have been helping myself by AA meetings and friends and family going through same issues.

    Please PM me anytime and I sent Pm with my email on it. Hang in there. We are a tough bunch dealing with our own pain along with this.

  • Your partner is in trouble and needs help. There is no question that you should act - NOW.

    I have been on narcotic therapy since 1998 though John Hopkins Medical and I live alone. However, I know what it is like to have some days that you need more meds and some days less. When you start taking your meds off label and running out early you have a problem that needs to be addressed.

    Pain management is tricky especially in this day and age. I would be concerned that bringing the problem to the attention of the pain management provider would cause problems because most are not set up to deal with addiction. The PM could just cut your partner off or do something that would be very difficult for both of you to cope with.

    I would research an addiction program - or set up and appointment with an addiction counselor or whatever you think would work best for you and your partner. Do your research, talk to lots of people and make a lot of phone calls to make sure whatever you decide is the best place to begin with for you and your partner.

    Tell your partner - either you go to an addiction counselor or meeting or join an addiction program or whatever (have it set up ahead of time ) or tell them that you are going to call the PM doctor and tell them everything.

    I would have a paper trail - copies of a month of prescriptions or copies from the other doctors who are providing additional drugs or whatever you have and show them that you are going to give this info to the PM doctor unless they start and finish the addiction program. Not just try it - or go a couple times - finish the program (or whatever you have set up ahead of time).

    Trust me - no matter how horrible the situation will initially be - both of you cannot continue to live like this and your partner's lives are in your hands.

    The word co-dependency comes to mind also. There is a lot to that word but by not acting you are supporting the actions of your partner and making it easier for them to continue their life threatening behavior.

    Please help them.

    I am currently slowly going down off my meds because my last surgery helped so much as far as pain goes. I am not having any problems cutting out meds and going down. If I started to take all my meds in the first two weeks of the month and run out early - I would RUN to any program that would help me figure out what was happening.

    I work part time and I am very athletic. I find that distraction works a lot in terms of not thinking about pain. Also, if I had someone who was helping me all day long with grocery shopping, making meals, paying bills etc - it would be a lot easier to take more meds and do less all day long. That is where the co-dependency comes into play.

    Please do something for the both of you - it will save your marriage and your partner's life!

    I will be praying for you.
  • sandisandi Posts: 6,343
    edited 11/02/2013 - 12:33 PM
    Welcome to Spine Health. I have told many posters the same advice that I am going to give to you. You already know what needs to be done and yes, she is going to be angry. The Tylenol issue alone is a major concern since for anyone taking tylenol on a daily basis the recommended daily dosage is no more than 3 grams and most doctors are recommending no more than 2 grams or 2000 mg per day due to liver concerns, If she is taking only the prescribed amount then she is already at the daily max dose for tylenol....let alone in order for her to run out of medications two weeks early, she has to be taking twice her daily allotted amount of Norco/Vicoden. Soma has a potential for addiction, and if she is running out early for that, she is also in danger of respiratory depression and simply not waking up......the combination of medications will at some point result in her overdosing, most likely accidentally but eventually she will continue to use up the meds even faster and her body will be unable to compensate.
    The best thing that you can do for her is to contact her doctors and let them know what is occurring and how long it has been happening. Even if she will not allow you to go to the visits with her, you appear to know who her doctor is and you need to call them and tell them. While the doctor can not legally discuss her care with you, giving you information, there is nothing that says you can not contact them and tell them what she is doing.
    As difficult as this is, she is not going to seek help on her own until she is forced to do so.
    As far as her need for ongoing pain treatment goes, opiates are not the only option available to treat pain. There are many other medications that are currently used to treat pain, and other modalities as well.
    I know that considering telling her doctor is difficult but if she refuses to see that she has a problem , is using another substance just as dangerous to get through the withdrawal period , she is going to be caught, sooner, rather than later.
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