Expert: Crystal - 1/30/2008

Question
QUESTION: Can you tell me how long the cravings last when you stop taking oxyconton? My 20 yr. old daughter is trying to get off oxy's and her physical withdrawals are controlled somewhat by clonidine and a mild sleeping pill but she says her brain is screaming to use. She was on Oxy's for 5 yrs. and crushed and sniffed them. She says she used 40mg a day but her withdrawal symptoms are severe insomnia and bad leg twitchs.Is there any type of coping techniques to combat the cravings that help? She has not been able to see a councilor yet and has been withdrawing for 3 days. Ared flag for me is that she has constipation still and her doctor said she would be getting diarrhea. That has not happened. She is not on morphine or methadone but may be able to get on buprenorphine on the 7 of Feb. which is when her family doctor can see her again. Any suggestions for us (her family) would be appreciated. We are of course, very scared and concerned and don't know where to turn for help. Are there any good books on this?

ANSWER: Leila,

First of all has she stopped cold turkey? Were these given by her doctor? The withdrawal if she is completely off of them are extreme in a lot of cases where they have used for a lengthy period like she has and especially if it is with consistency. The thing about the brain craving is that it does so because the narcotic introduced into the body over a period of time changes the brain chemistry and function of the dopamine receptors. After a period of time the brain stops producing the receptors all together because the narcotic is constantly present. Some people find peppermint to be a good coping skill, the hard candies that she can chew on and also herbal teas help.  Hot baths are great for the leg cramps because it helps the blood flow and relaxes the muscles, also the constipation can be caused because of the withdrawal symptoms as well since the body is freaking out inside it retaliates for awhile. If it persists then you need to take her to the ER or urgent care. Are you monitoring her blood pressure at all? How often are you giving the meds? Remember I am not a doctor though. Are you looking for books for yourself so that you understand it better?

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QUESTION: Crystal;
She is trying to quit cold turkey because she told the doctor (and I was there also) that she did not want to go on morphine or methadone because they are addictive too. I am concerned that if she gives in to the cravings and uses again that the risk of overdose would be higher because her body does not have the resistance built up anymore. Am I right on this? She was never prescribed Oxy's for medical purposes and stared using them as a recreational drug with her friends 3-5 years ago. Her mood swings are tremendous and she has severe insomnia and I think that makes the mood swings worse. We are not monitoring her blood pressure and she is self regulating her meds. She is staying at her sisters and was quite 'out of it' last night because she took 5 of her sleeping pills . Her subscription is for .5 to 1 a night. I talked to her sister but I can't get K on her cell phone to ask her what is going on. She does have counseling today and I am going to phone the councilors' office to see if she showed up.

ANSWER: Leila,

The reason they offer the methadone is to help her get off slowly but I understand why she wants to just get off of them. I have seen it both ways and it is hard either way. Yes you are correct on the cross tolerance because once they have stopped using it is easier to overdose if they begin to use again. Someone needs to be monitoring her meds with her so that she doesn't hurt herself by taking too much. Has she experienced any other symptoms?

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QUESTION: Crystal;
 We just found out that K has stolen 900.00$ in forged checks from her dad. She forged these checks after she said she was no longer using. Should we bring in the police and charge her with fraud. I am afraid that she will harm herself if we do. No one is minitoring her meds, and I know she asked her doctor for stronger sleeping pills. I will ask her sister if K will give her the prescriptions. Should we be looking at an intervention type route? I am contacting you from Canada so can we legally get her into a facility without her consent?

Answer
Leila,

I am not sure what the laws in Canada are but I would absolutely do an intervention, maybe if you bring the police in without charging her and give her the ultimatum of either going to rehab or going to jail with the stipulation that she complete the treatment. There are two options because on the other hand you need hold her accountable for her actions and would have her charged for the fraud and push for the judge to mandate her into a treatment program.
Nobody in her condition should be monitoring their own med intake because they are in no way mentally stable enough when going through withdrawal to use accurate judgement. I would also contact her doctor if  you have the authority to talk to him or her and explain the situation and ask for help with which direction to take as well. They may know of a place there for her to go. Good luck.