Losing Hope for Recovery

FLSmitty · Apr 17, 2009

Hi Krissy,

When you say "I relapsed on Percocets" did you mean you were getting them without a rx or straying from the prescriber's directions? It sounds to me like you have some very concrete (and painful) medical issues. Needing pain medicine for a painful condition, does not a relapse make. When seeking care it is very important that your physician is aware of and participates in your substance abuse recovery, as well as treating your physical conditions.

I herniated a lumbar disc a few years into my recovery and required opiates on top of epidurals for a considerable time. Although a few different specialists were involved in my tx, I made them all aware of my recovery status. I received all prescriptions and injections from ONLY the pain management doc (no shopping allowed). I relied on my wife to see that I stuck with the dosing schedule and didn't monkey with it for the purpose of altering my mood.

All that said, it was somewhat difficult to taper off. The line between physically limiting pain and my expectation that I should be pain free all the time got a little blurry. I followed the instructions, didn't lie, cheat or steal for more meds and got over the hurtle.

You must take care of yourself before you can care for anyone else. Don't stop working your program if you are taking pain meds; go to the meetings. Follow the doc's instructions and address your physical issues. If you aren't doing the right thing, then get some physician input and assistance. And then, you just start again, don't make a big deal out of it; it took me 1/2dozen starts to get it right. It sounds trite and overused but, it really is as simple as staying focused on today - not next week or month - and just do the next right thing.

SuesquatchRN, BSN, RN · Apr 17, 2009

Krissy, I am sober in AA, alcoholic.

That said, I am not against prescribed medication when it is used for its intended purpose.

Keep going to meetings. Don't accept speaker slots and don't celebrate. But goodness, girl, don't cut yourself off from your lifeline. THAT is the disease talking, trying to first get you away from the rooms, and then - to getcha!

:)

CharliRN · Apr 18, 2009

Hi Krissy, I've been where you are and you gotta get to meetings !! If you need Rx's for pain then you must take them for the legititate reasons you mentioned. I must have missed something ? Why can't you go back to work as a nurse ? And there are treatments for interstitial cystitis. maybe too, an antidepressant that helps also by working on the pain pathways... I'm routing for you...

TuTonka · Apr 18, 2009

Krissy:

I had a friend awhile back and he was an addict . He fell off the wagon many times. The last time he did his wife told him she could not go through that again, Either he went to Rehab and it took or she would leave him.It was that statement he grasp on to and it pulled him through it. He is still in Nursing and doing well....now. He was where you are at obviously with some differences but he had a very strong peer group and they did not give up on him to which I'm sure he is and was grateful.I do not know what state you are from but IF you are from Oklahoma their peer groups there really help some people. I wish you love and luck with this disease.

TuTonka

jackstem · Apr 18, 2009

Krissy,

I am so sorry to hear of your physical pain. I did a quick search of the internet regarding Interstitial Cystitis and found a couple of links that might be helpful. If you've already read these I apologize for the redundancy.

http://kidney.niddk.nih.gov/kudiseases/pubs/interstitialcystitis/

This site has information about clinical trials for IC.

http://www.ichelp.com/ResearchCenter/ClinicalTrials/tabid/185/Default.aspx

As for taking opioids for pain control. My first thought is this...because we are recovering addicts does not mean we must suffer with little or no pain control. Substance abuse, or the more correct term, substance MISUSE is defined as using a substance for non-medical, non-prescribed reasons. If you are taking an opioid, as prescribed, for a chronic pain condition that can't be controlled by other means, that is NOT relapse! Let me say that again.

If you are taking an opioid, as prescribed, for a chronic pain condition that can't be controlled by other means, THAT IS NOT RELAPSE!

I attended a half day seminar on chronic pain management in the recovering addict today (talk about a God-incidence). The physician that provided the seminar is the medical director of a leading addiction center in NE Ohio. He is a board certified addictionologist, board certified internal medicine doctor, and consults frequently with pain management specialists when chronic pain patients also have addiction histories. He said a multidisciplinary approach is one which will provide the best chance for effective pain control while minimizing the risk of return to active addiction. He also made it very clear that recovering addicts and/or those with active addiction DESERVE effective pain control along with monitoring by lab/toxicology studies, frequent evaluations by both the physicians treating the pain as well as those treating the underlying condition.

A couple of years ago I heard a pain specialist/addictionologist say he has a very simple but effective way of determining if the use of opioids for chronic pain is appropriate or is becoming a problem. If the patient is taking the medication as prescribed and is able to participate more fully in activities of daily living, then it's most likely appropriate treatment. If the patient is taking the medication and is withdrawing from activities of daily living while at the same time asking for additional prescriptions and exhibiting signs of abuse (doctor shopping, multiple pharmacies, etc.) then admission to inpatient treatment center for an evaluation and more intense treatment of both the pain and addiction is warranted.

Ask your doctor(s) for a pain management consult. Also, ask about an "opioid contract" with your doctor. I can provide additional info if you're interested.

Using pain medications as prescribed for a chronic or acute pain is NOT a relapse! It is NOT relapse.

American Pain Foundation

http://www.painfoundation.org/page.asp?file=ManageYourPain/Intro.htm

National Kidney and Urologic Disease Information Clearinghouse

Interstitial Cystitis

http://kidney.niddk.nih.gov/kudiseases/pubs/interstitialcystitis/

American Pain Foundation Resource Locator

http://www.painfoundation.org/ResourceLocator.asp

http://www.painfoundation.org/page.asp?file=Links/Cystitis.htm

Prayers...

Jack

Tweety, BSN, RN · Apr 18, 2009

Good posts above. Taking pain medication for pain is not a relapse, although if your drug of choice is pain medication it surely can mess with your head.

Even if you relapsed through diversion and not following MD's prescriptions, it's doesn't mean there is no hope for you to pick yourself up and recover. I relapsed so many times I lost count, but am 12 years sober now. Hang in there.

Get help.

HM2VikingRN, RN · Apr 18, 2009

Please get together with a good pain doc. I think that pain is an illness unto itself which can and should be treated. A couple of the antidepressants do help with managing chronic pain and could be explored with your provider as a treatment stratedy. I am truly concerned for you.

I dont have any words of wisdom other than to keep working with your support people.

krisssy · Apr 18, 2009

i would like to thank all of you for taking the time to answer my questions and help me plus share your experience , strength and hope.

to answer your questions and explain more thoroughly: i have been taking my medication exactly as prescribed by my urologist. i forgot to mention that i also have been given valium as a muscle relaxant 2mg. 3x a day. i have never taken more than prescribed. i became very worried about getting addicted again, so i put myself back in the original rehab for a 10 day evaluation. they took me off both drugs with a methadone and ativan detox. when i finished the detox, they put me on baclofan and lyrica. within a few days, the pain was so bad that, after trying a shot of torodol with no relief, my husband came and took me to the er where they had to give me dilaudid. even that didn't take away the pain, just put me to sleep. i came home and still tried to be off the addictive drugs, but i was in agony. with my family's knowledge and approval, i am now taking percoset and valium exactly as prescribed 3x a day. the pain is now under control.

i have to admit that i never told the urologist about my addiction problem for fear of him not giving me the medications i need. i have become so frightened of this pain and being unable to control it. thurs. i have an appt. with a pain specialist who has helped someone else i know who has interstitial cystitis. he has helped her enough that she is able to go back to medical school on the pain meds he prescribes. i know i should tell him about the addiction disease i have, but how can i take a chance of him not treating me? i want to go to meetings, but i am afraid to drive on pain meds. i want to work in the rehab, but they would never hire me using addictive drugs. i am not well enough to do regular hospital nursing care with lifting etc. the rehab job involves mostly giving out meds, checking blood pressures and transferring orders onto the computer which i could handle easily.

the bottom line is that while using these addictive meds, i do not feel safe driving or working. i am literally confined to my home unless i go out with my husband, and i do do that. not taking the meds confines me to home because i am in too much pain to drive or work or even go out with my husband.

jackstem, i will read all the websites you sent me and get back to you-maybe pm you. thank you.

hnm2viking-i am on cymbalta, and i have tried elavil. the elavil helped for a few weeks. after the gynecologist examined me, the pain came back and has not gone away again since dec.

i am also probably facing a rectocele surgery which will require more pain killers.

btw, do you know of nurses who work and drive while taking pain killers by legal prescription for real pain issues?

thank you all again.

krisssy

NeedchangeofPace · Apr 19, 2009

Krisssy,

You must be 100% honest to your Dr. regarding your addictive past. She/He may be more cognizant of addiction than you may think. They may be able to monitor you more closely than other patients. Who knows they may even come up with an mixture of different things to help you along and manage the pain that you endure.

Even though my problems stem from alcohol, I too am very careful as to what I take for my back when it goes out on me, sometimes the pain is excruciating, but I know that the meds are for a reason..pain management. no more no less and definitely "not for fun".

You need to let go of your fear of not telling your Doc of your addictive personality. Remember be honest, it pays dividends maybe not right away, but maybe tomorrow or the next day.

If you don't the truth will always come back and bite you in the A$$ (

We are pulling for ya!!

Mark

Rascal1 · Apr 20, 2009

Krissy, you're getting a lot of great advice and support here ! And I must agree with what others have shared that you are not in relapse behavior when you take medications as prescribed. It is wise to remain truthful to your MD.,your family and yourself. My thoughts are with you ! :redbeathe

southernbeegirl, BSN, RN · Apr 23, 2009

krissy, you didnt relapse. i wish i could just hug you now. go to a meeting! you need the support. we all know we are in a bad neighborhood when we isolate and get inside our own heads!

i have 2 herniated discs. i've been able to take ultram 2 times/day for a few years now. it took me a while to figure out that as long as i dont take tylenol with it im ok. with the tylenol i got the high from it. i talked about this honestly with my doc, my husband, my sponsor, my groups...anyone that owuld lissn, lol.

sometimes we have to have pain meds. but that doesnt mean you've relapsed or are less than anything.

be proud of your sobriety and celebrate your birthday!