Substance Abuse/Detox Nursing Forum ???

live4today, RN · Jul 3, 2002

I'm a nurse dealing with myself as the patient. I've been on Celexa almost two years now, and want to be weaned so badly from it, but I'm afraid if I go off the medication, I'll become severely depressed again. So...would you say I am addicted to taking an antidepressant because coping with real life would prove to be too traumatic for me? :nurse:

NancyRN · Jul 4, 2002

Cheerfuldoer, your upbeat posts have always been an inspiration to me! Now I find out they're drug induced!

Seriously, have you thought about a regular exercise program? There is new research which proves that exercise can be just as effective as antidepressants.

I've been having to resort to Ambien to get to sleep these days. Not good, not good at all. Nursing is not healthy.

Mama Val, ASN, RN · Jul 4, 2002

No...

Look at your patient that you are treating and how you are responding to their treatment.

Does your patient want treatment, are they there for a quick fix and a place to stay for a while or are they there by court order.

Is the patient honest with you and in the greatest of moods or are they evasive, lying to you (and themselves), agitated and already withdrawing from drugs a/o alcohol.

Has this patient been in treatment 10 times before and again promised that this is the last time or is this the first time this person has gone thru DTs, hallucinations, cravings and had a seizure and now just wants you to be with them as they shake and sweat in the bed.

Have you talked this patient out from under a bed because he keeps seeing the headless woman walk past his door or he attacks you because he thinks you are an alien who is after a substance in his blood.

Or do you care for the paients who have no control over what drug they get and are born addicted and don't know why they are in so much agony.

All the hard work you do to get this person healthy and on the road to recovery and then a month later you see them again drunk/stoned sometimes pregnant (again) and the process starts all over again...you think to yourself why bother

And lets not even start to talk about the codependent families these patients bring with them.

These are the addicts I am refering to.

Sorry, like I said I am a little bias on this. Sometimes I feel like I am part Nurse Ratchet, Judge Judy, Aunt Bea, Nurse Hathaway and me all rolled up into one

MollyJ · Jul 4, 2002

Hi Mama Val,

Can't help but notice that you are from Alaska where I believe alcoholism is a bit more common per capita.

I am a nurse who was, until recently, doing drug prevention in a school setting. I am not a drug and alcohol tx nurse, although some of the nurses here have some experience in that realm. I usually take notice of what gets posted in the domain, because I really have gotten grabbed by the area, though I consider myself a public health nurse.

I don't know if the topic would get more discussion in it's own forum or not. The general nursing forum seems to get the most play and the Psych Nursing Forum, which I check out on occasion seems pretty sporadically posted.

I've always said that it was truly funny that I ended up in drug prevention because as a former ED nurses, drunks were the bane of my existence: potential for violence, recidivism, hard to evaluate, time consuming, loud and rude. I don't think any of that has changed.

However, I have joined many in the field of addictions nursing in agreeing that nurses' knowledge base of the addictions is wanting. I say that out of my own steep learning curve that I had to amass in order to learn about addictions to do prevention.

Let me just respond to one piece of your post. The hopelessness of addiction is the hardest part I think. The addict fears the hopelessness of their situation and the nurse is repelled by it. Let's face it, we like situations we can fix.

Early on in my prevention job, I was reading everything I could get my hands on. One source said the counselor or school preventionist must be able to communicate a sense of hope about addiction and that it is not a hopeless situation. I think I almost gagged on that one. I viewed addiction as hopeless and disgusting. So I had to sit with that a little bit. I had to notice how many people actually made it in recovery. I had to get some comfort with the idea that addiction, as a diagnosis, is something that we can never say, "We've fixed that for once and for all." The addict must never lose sight of the fact that they might drink or use again. But hypertension, diabetes, heart problems and numerous others are problems that are chronic and must be managed.

I also had a drug and alcohol counselor say to me that addiction wasn't the "worst" thing that could happen to a person; that their were many other psychological diagnoses that he would greater dread seeing his children have. That was an eye-opener to me. I began to have a more positive and hopeful perspective on addiction and believe me, when you are working with teens who are in trouble with their use, YOU MUST be able to transmit a sense of hope to them and their parents.

I wish that nurses could learn simple, brief intervention techniques to use with problem and addicted users. And we need to learn never to confront or intervene with someone under the influence; it just doesn't work.

In working with addicted or problem users, no one is more important to the success of rehab than the user themself, but family, health professionals and friends are so important. Knowledge is power.

Thanks for bringing up this important topic.

OBNURSEHEATHER · Jul 4, 2002

Originally posted by NancyRN
Seriously, have you thought about a regular exercise program? There is new research which proves that exercise can be just as effective as antidepressants.

Yes Nancy. I haven't heard of this official research, but I can tell you that my own unofficial research proves this to be true. Just about 30 minutes 3-4 times a week greatly increases my mood and energy level. And it's free...

Heather

live4today, RN · Jul 4, 2002

originally posted by nancyrn
cheerfuldoer, your upbeat posts have always been an inspiration to me! now i find out they're drug induced!

seriously, have you thought about a regular exercise program? there is new research which proves that exercise can be just as effective as antidepressants.

i've been having to resort to ambien to get to sleep these days. not good, not good at all. nursing is not healthy.

hello nancy...in response to your comments...i'm hoping that first statement in your post was meant as a joke...being that there is no chuckle emoticon behind the statement. :uhoh3:

rest assured, nancy, that everything i believe in and stand for has not been altered by taking an antidepressant. never never never in my entire 50 youthful years have i ever been addicted to anything except baby ruth candy bars! :rotfl:

as for the exercise regimen??? now...that's where you and i and heather agree...exercise is without a doubt a high energy booster. i use to teach aerobic classes, and now i walk my butt off to lift my moods and condition my heart and body. i highly recommend exercise to anyone whether they take an antidepressant or not! keep that body and mind moving because we lose what we don't use!!! :kiss

OBNURSEHEATHER · Jul 4, 2002

Originally posted by cheerfuldoer
Never never never in my entire 50 youthful years have I ever been addicted to anything EXCEPT Baby Ruth Candy Bars!

and allnurses and buttered buns... :rotfl:

Seriously though, I think Nancy was kidding. That's how I took it anyways.

Heather

live4today, RN · Jul 4, 2002

Thanks Heather...I know she was kidding...Nancy...I know you were kidding okay...just rolling along with the punches life throws me...aint it a bytch most days? :rotfl:

Oh the buns, oh the buns, oh the pee-pickin' buns! Now...THAT would be the cureall for any woman's depression. :rotfl:

duckie · Jul 4, 2002

If taking a medication that highly improves the quality of your life, makes you a more pleasant and in control person counts as an addiction, then I am adicted to Paxil and I always will be. With the unbelievable results I have had since starting Paxil, my MD told me he truly believes I have been clinically depressed for maybe as many as 20+ years and I do not doubt this. I have NEVER felt so good, had such a positive outlook on life and had this kind of energy. I feel like God opened up the sky and said, "My child, you are reborn." I was taking 20 mg per day and they did have to lower my dose because even with the 1mg of Xanax BID, I had so much energy, I couldn't control it and would just go and go until I was nearly out of control and then I would pass out. This happened several times. It was very scary because the last time my B/P was only 80/36 and my pulse dropped to 42. Scared the begeepers out of my hubby but since he works in the nursing field also, he got me up and walked me until I came to and vitals started increasing. My doc says he has never seen anyone do this good on the med I am on. My doc says it is possible I will be on a maintainance dose for the rest of my life and I have no problem with that. When I can work circles around the gals half my age, can chase my hubby around the house like a teenaqer, I have no complaints and if it's not broken, DON'T FIX IT!!!!! I did try to wean myself off Xanax but just couldn't handle the hyperness. I will ask MD to lower it to 5 mg. once he goes to maintainance does. My Pharmcist is a real jewel and saved me tons of $$$$ by cutting larger doses to make 10mg. It went from being $75.00 a month to 25.00 a month. I don't think anyone should consider a medication an addiction that improves your quality of life. If you were diabetic, would you take insulin????? Same difference. Go with God and I thank you Lord for giving me peace of mind and a brand new life!!!! Hugs to all.

Editorial Team / Admin · Jul 4, 2002

:p I am of the opinion that as the physical maladies are helped by medications, so there can be maladies of the brain's chemical make-up or transmission of messages or whatever, that are helped by medications. If the brain is not functioning as it ought, one has symptoms (depression, volatile behavior, bipolar, etc). We (as "the medical field" in general) are so much more tuned in to the physical symptoms denoting physical illness, than to the subtle behavioral and mood symptoms that may denote malfunctions of the brain. I am a neophyte on this subject but my interest has been stirred by reading about ADD/ADHD, and by the writings and research done by Dr. Daniel Amen (http://www.amenclinic.com), as well as others (another poster in a ADD/ADHD thread mentioned an opponent of ritalin, etc meds for most ADD'ers -- WITH a GREATLY modified school curriculum, one that, unfortunately, I cannot see happening until pigs fly). E.g.: Behavior mod is good if the pt is receptive, but if the messages have trouble getting through to the proper area of the brain, you're not gonna see substantial results. Some patients have trouble filtering out the necessary from the unneccesary sensory bombardment: they hear, see, feel EVERYTHING and try to process it all at once = sensory overload!! Most of us can be selective about what we pay attention to, they cannot. PT has a whole area of expertise in this area of Sensory Integration Deficit, and therapies to improve one's filtering abilities (yes, Physical Therapy! I was amazed to learn of it).

There is so much we don't know about the brain and its functioning. The older I get, and the more fantastic things I hear about, the more I am convinced that medicine as we know it DOES NOT have all the answers (it tries real hard), and I am open to possibilities of treatment from other sources. I need to really research and study these alternative treatments, tho', as there are snake-oil types out there too! People are all so different, what works for one person may not work for someone else . . .

Hmm, here we are diverging from the original post, and me gettingdiarrhea of the mouth again. . . See ya! -- Diana

Editorial Team / Admin · Jul 4, 2002

BTW, Duckie I'm so glad you're feeling better!!! -- D