AboutJacqui Expertise Harm reduction (is it a dirty word in America??) - ie: needle and syringe programs, prevention of blood borne viruses such as HIV and hepatitis C, questions about dependency on opiates and other substances. Questions about treatment (particulary methadone and buprenorphine).
Experience Manage a primary health service for people who inject drugs, and have worked at that centre for 6.5 years
Organizations Registered as a provisional psychology with the Victorian Psychologists registration board (this is for psychologists working under supervision or currently studying a masters). Much of my experience is related to my work rather than to my studies
Education/Credentials Bachelor of Arts (Humanities), Bachelor of Psychology with Honours,
currently studying a masters of clinical psychology, completed one half of a graduate certificate in Addiction studies (transferred to psychology as it had better career prospects) - lots and lots of short training courses.
Awards and Honors Presented at international conferences (Harm Reduction Conference in Thailand and Melbourne)
Expert: Jacqui Date: 5/18/2008 Subject: girlfriend is a chronic pain suffer which has lead to severe addiction
Question HI AND THANKS FOR LISTENING. i AM INVOLVED WITH A WONDERFUL WOMAN...BEFORE THIS HAPPENED SHE WAS THE WOMAN OF MY DREAMS. SHE WAS ON ANTI-DEPRESSION MEDS (EFFXOR),SLEEPING PILLS AND WITHOUT MY KNOWLEDGE A MILD PERCOET HABIT. sHE HAD SOME DEPRESSION DUE TO A FAILED RELATIONSHIP PRIOR TO OUR MEETING WHICH WAS WHY THE ANTI-DEPRESSION MEDS CAME IN. SHE ALSO HAD A TRIGGER POINT BACK PROBLEM WHICH IS WHERE THE MILD PERCOCET ADDICTION CAME IN. tHE FIRST TWO MONTHS WERE WONDERFUL AND WE EVENTUALLY MOVED IN TOGETHER. sHE DECIDED TO GET OFF ALL MEDICATIONS DUE TO OUR FUTURE OF HAVING CHILDREN. THIS IS WHEN IT SEEMS SO MANY OF THESE PROBLEMS STARTED. I though she was only withdrawing from effxor which I have heard was not pleasent. It wasn't to say the least since I wasn't aware she was trying to withdraw from percocet at the same time. The withdraw was bad enough that she couldn't do it and incurred some chonic back problems on top of the previous that she had where she was stifled in pain. Now due to being in chronic pain she has gone back on all medications and due to the pain increased not only what her pain clinic has prescibed but also we have bought over and above pain medications on the street to alievate the pain. She now is on sleeping pills, effexor, 50mg fenantyl patch and resorts to 12 to 15 percocet mixed in with doses of 40mg Oxycontin. It has costs me 500/week and now I am in financial distress and I have only provided the pain killers since she was in legimate pain and couldn't see her like that. Now though this has turned in full blown addiction where she is afraid of the withdrawal and going through what she went through previously. She does want help since she knows the drugs are destroying her life but at the same time without the drugs would have debilitating pain. We have fought on this subject and I feel like I am enabling her but at the same time have no choices and don't want to treat her as an addiction since she is really a pain patient without proper care or compassion. SHe is very scared, suicidial and has extreme guilt and low self esteem. I am now in a position where I can't provide the monies nessary to keep to meds up and have low self esteem from not being able to take care of this wonderful person. I should add there is a 5 yr old involved that she had from a previous marriage that has been witnessed to all of this and the fighting unfortunately. I am worried about her and despite everyone saying just leave her I want to stand by her and provide love and support for her cries of help yet don't have the financial resources to find proper care for these withdrawal programs that she would enter into. I have been looking into methadone treatments yet don't want her to feel like a drug addict when this started not from recreational use but from pain treatment. Any help would be beautiful and thanks again from listening. I wouldn't wish this on anyone from with point of view.
Answer Hey Marty,
Sounds like you have been a fantastic support, but it is all just getting too much. Also, don't feel the need to make excuses for her drug dependency (I hate the word addiction) as I have empathy for anyone in this situation, whether they started from recreational use or from pain or whatever. Unfortunately the way the system is, if you want to drink copious amounts of alcohol a day, that is fine, but if you want to take copious amounts of opiates, that is not. Anyway, that is the world we live in (well the world you live in is a little less sympathetic than the world I live in - I am in Australia with a slightly more humanitarian way of looking at drug use issues).
There seems to be a lot of complexities going on with your partner. So, I will tackle each drug one by one:
Effexor can be habit forming. The thing that annoys me about the use of this drug is that it is not meant to be used as a treatment for depression on its own. The best results from the clinic trials from Effexor and drugs like it, combined it with psychological therapies. On its own, it can lift mood, but even the drug companies own literature says that it isn't by very much. So, firstly I would suggest some counselling would be helpful. I particularly think this is the case given that you said her depression came about after a bad break up with her last partner. Think about it this way, the depression is caused by a situation - so isn't it better that it be solved by looking at better ways of dealing with the situation, and trying to make sure it doesn't happen again? We do live in a "pop a pill" society, so people feel that they need to take something every time they feel bad.
You haven't given me much detail about the sleeping pills, but remember that these drugs can be extremely habit forming as well. In fact, benzodiazepines can have very very serious withdrawal effects that can result in seizures and extreme anxiety. Ultimately though, the problem with sleeping tablets is that they are good for occasional use, but unfortunately after you form a tolerance to them, they actually make it harder to sleep and make you more anxious.
Finally, opiates are difficult to come off. And if there is a legitimate pain problem, then they are a legitimate drug. I don't know what city you are in, but one option is a methadone program. I know that this probably doesn't sound like fun, and I must say that the US is not renowned for its methadone programs - they are generally quite restrictive. If you let me know what city you are in, I might be able to do some investigating. The reason that I suggest methadone is that it is not going to cost you much and you won't have to risk getting arrested when you are buying pills off the street.
I wonder what the back problem is. Has your partner been linked in with a (good) medical practitioner who can offer some advice about this? Do you guys have health insurance? If the back problem is unfixable, then the only option may be staying on some kind of opiate pain relief, and the fentyl patches are good. Is the issue that she is having breakthrough pain, or the tolerance is getting too high? I know of people who have been on the same methadone dose for ten years or so and never needed to go up, but they were people who were on it because of depdenency problems not chronic pain.
The last thing I wanted to say (and I note I said 'finally' two paragraphs ago, sorry have just got carried away!) is that you are a great support, but you also need to look after yourself. $500 a week is a lot, and it is a shame that you have to pay this. I know you love your partner, but you also need to look after your own needs. If the fighting gets too much, couples counselling might be a plan. Conflict can have really negative effects on children, so you are right to be concerned.
If you would like to get back to me and provide a bit more info, I would be happy to follow up on a few things for you.
