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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by concerneddude on May 11, 2005, at 20:06:06
My wife had a bout of pleurisy. She was prescribed Oxycontin and Oxycodone. Also with in the same time, give or take a month she was started on Xanax for anxiety and panic attacks.
Her pleurisy is gone but she still feels pain. Except for the one period where she worked her self off the Oxy's she has continually had to take higher and higher doses of them.
Also she has run out of her Xanax early once and get's very high strung that something might go wrong and she might run out.
She said that she is still having problems sleeping and that the psychiatrist said she could take benydryl
Lately she has started slurring her speech 5 out of 7 nights a week and her eyelids also droop. It's almost as if she is drunk.
She previously self medicated w/ alcohol and spend the better part of a month in treatment and in a MICA outpatient program.
She get's very defense when ever we discuss the meds, even when she first started. Which appears to be addict behavior based on the experiences I had w/ the alcohol before.
In the evenings now, if she isn't all sleepy and slurring she is agressive. She did something recently which reminded me exactly of the alcohol incidents. After I fall asleep she starts yelling and screaming at me.
Another thing of interest is before when the alcohol abuse started to beging to get worse she had a period of high sexual arousal. That has happened now too.
If I try to talk to one of her doctors they will tell her I spoke to them and my life at home will be a living hell. I don't know which is worse dealing w/ the addicition or dealing w/ the fallout when I try to make sure all is well and get her help if she needs it.
I have 2 children in the household and my job has been very supportive over the years but I fear if another episode occurs that it will stop.
Am I blowing this out of proportion for my own fears or am I witnessing a new addiction?
She tends not to tell Drs she was inpatient because she says she gets treated differently and a few phsycologists and psychiatrists refused to see her.
Thanks,
Concerned and scared
Posted by Chairman_MAO on May 12, 2005, at 13:45:51
In reply to concerned that my wife may be abusing, posted by concerneddude on May 11, 2005, at 20:06:06
Some of the best advice, IMHO, for dealing with addiction can be found at www.peele.net. You can even email him and he will answer your questions for free!
Insofar as the meds are concerned, once your wife is able to be on the level about what she really is getting out over her drug-taking--"self-medication" or not, it doesn't matter, that's all pharmaco-medico-elitist-speak anyway--and why she isn't getting what she wants, maybe you can find a good shrink and get her on meds taht actually help. I know in the past what I thought I needed (amphetamine + benzodiazepines) wasn't nearly as effective as what I take now (MAOI + buprenorphine) at doing what I wanted. But I never would've been able to break my addictive patterns had I not been able to find a doctor who was sympathetic to my condition and truly wanted to help me achieve remission rather than simply following some orthodox SSRI-based treatment protocol.
Posted by ed_uk on May 12, 2005, at 17:08:27
In reply to concerned that my wife may be abusing, posted by concerneddude on May 11, 2005, at 20:06:06
Hi,
The aggression and slurred speach sound like Xanax intoxication, the dose might be too high. You really need to discuss your concerns with her doctors.
I think it might be useful for her medication to be dispensed in daily installments, supervised by the pharmacist. A long-acting benzodiazepine could be used to replace Xanax for the purpose of tapering. Long-acting benzodiazepines can often be taken as a single daily dose, the pharmacist could watch her take it. A 24 hour controlled-release morphine capsule could be used to replace OxyContin for the purpose of tapering. A 24 hour product would be useful because it would allow her to take a single supervised dose on a daily basis. I'm not sure what country you live in. Here in the UK, opioids are often dispensed in daily installments if a patient is thought to be developing an addiction. In the UK, diazepam (Valium) can be dispensed from the pharmacy in daily supervised doses/installments if a patient has developed an addiction to diazepam or another benzodiazepine such as Xanax.
Supervised daily consumption would prevent her from taking more than a days supply at once. It might be advisable for her to taper off the Xanax and OxyContin. NSAIDs such as ibuprofen are often effective in the treatment of pleuritic pain, acetaminophen is also sometimes effective. If she is still in pain you really need to find out why. A different type of anti-anxiety drug could be used in place of Xanax, there are many options.
Kind regards,
Ed.
Posted by Chairman_MAO on May 13, 2005, at 11:13:47
In reply to Re: concerned that my wife may be abusing » concerneddude, posted by ed_uk on May 12, 2005, at 17:08:27
A great option for the opioid problem would be a fentanyl patch. Unless she squeezes the liquid out to inject or something like that, they're simply not abusable (unless one started putting on tons of patches, heh).
A great benzodiazepine to use in cases of abuse is Tranxene-SD, which is a prodrug for nordiazepam. I don't know what the point of extended-release clorazepate is, but it would make it all but impossible to catch any kind of benzo buzz whatsoever. Nordiazepam alone barely has any abuse potential as far as I'm concerned.
Posted by Ritch on May 14, 2005, at 13:17:10
In reply to Re: concerned that my wife may be abusing » ed_uk, posted by Chairman_MAO on May 13, 2005, at 11:13:47
> A great option for the opioid problem would be a fentanyl patch. Unless she squeezes the liquid out to inject or something like that, they're simply not abusable (unless one started putting on tons of patches, heh).
>
> A great benzodiazepine to use in cases of abuse is Tranxene-SD, which is a prodrug for nordiazepam. I don't know what the point of extended-release clorazepate is, but it would make it all but impossible to catch any kind of benzo buzz whatsoever. Nordiazepam alone barely has any abuse potential as far as I'm concerned.
>
>
Hi, hope you don't mind me asking a question that's a little off-topic, but from years of taking different benzos for different durations, I get this particular and different reactions between diazepam and clonazepam. Diazepam produces a well-being effect nearly immediately and then it "wears off" after about 4 hours or so and then I feel depressed. Clonazepam OTOH, produces nearly an immediate depressogenic funk for about four-six hours then I feel quite decent six - twelve hours postdosing. Is this to do with the different metabolites vs. parents of these two different benzos and can you help explain that reaction and is it typical? Thanks for any response, just curious...
Posted by ed_uk on May 14, 2005, at 14:58:40
In reply to Re: concerned that my wife may be abusing » Chairman_MAO, posted by Ritch on May 14, 2005, at 13:17:10
Hi,
>Diazepam produces a well-being effect nearly immediately and then it "wears off" after about 4 hours or so and then I feel depressed.
I get the same effect from diazepam.
Ed.
This is the end of the thread.
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