Expert: Peter L. - 1/9/2010

Question
QUESTION: a family member who is an prescribe addict has faked illnesses to get drugs.  He is successful each time.  He has faked having his appendixes -- had it removed and it was healthy, he claims to fake a black widow spider bite, he has broke bones on purpose, cut himself, the list goes on.  

Now he is saying that he has low white blood cell count, really high red blood count and his doctors don't know if he has cancer yet  but have started him on chemo therapy just in case.  This sounds crazy to me that a doctor would do this.  

My question is do you know if someone could fake cancer, do chemo and get pain pills?  I have read that there are lots of things that lower white blood cell counts -- that aren't cancer.   Diet will lower a white blood cell count.  He also says he is receiving plasma while doing the chemo -- but the plasma isn't working.

I don't know what to do with him -- I am tried of his BS but, I would hate to turn a cold shoulder on him if he is really sick. I know the guy would do anything to get his fix.   What do you think?

ANSWER: Hi ML,

What you're describing strikes me as pretty far out there in terms of anything I've ever seen.  But no question addicts (in my experience opiate addicts in particular) will do just about anything to obtain and use their drug.  The label "dopefiend" evolved from the ruthlessly corrupt behaviors of heroin addicts in pursuing their addiction. No one is exempt from being a target: family members, spouses, employers, landlords, co-workers, etc. all can be manipulated or stolen from.

So do I think someone could fake any illness (no matter how tragic this "illness" is to those around them) to obtain pain pills?  Absolutely.  

I think this communicates about the nature of opiate (or other) addictions.  A person elevates their relationship to a substance above any other relationship.  They want to get high, have to experience the "feeling."  With opiate addicts it might be put this way: it's the best dinner, best sex, best vacation, best sunset, best anything, all at once.  Who could resist it?  Very few, and that's why we have such a tragedy occurring with opiate addiction in this country.  No other class of substances in my 25 years of working in this field terrifies me as much. We have a big problem on our hands.

This member of your family needs addiction treatment.  He will never stop these behaviors unless he suffers extreme consequences like a legal or health problem.  I would speak to him about getting help, and maybe provide some treatment resources in the area.

Hope this is helpful to you,
Peter



---------- FOLLOW-UP ----------

QUESTION: Thanks for the information -- he is in AA and the last I heard has a sponser.   This has been going on since he was a kid.  In the last year he faked siezures -- was completely doped out of his brain ( had the hospital staff jumping)rolled a car (got a DUI and I am sure hurt)This is the second car accident in a year thats drug related, fell through steps(this did something to his hip and leg needed pain meds)He broke the step put a rug on top of it and staged it, fell off a  high deck (broke a bone in his foot)the bone he broke in his foot I believe he broke it and then jumped off the deck stagging an accident,went to the hospital on work related injuries and was diagnosed (in april)as having ADHD, depression and aniexty -- and is on meds for these.  I don't believe he is ADHD the guy is 37 they would figured that out a long time ago.  I was told that ADHD med can get you high if your not ADHD. I live out of state but still close by, Everytime my mom comes to my house there is a crisis going on with him. -- He disappeared for 36 hours had everyone freaking out, another time had my mom on the phone for hours because he was hysterical because he was being thrown out of my other bros house. This time he wanted my mom to come home cut her visit with me short because he has cancer. My other bro hates the bro with the addiction, my mom thinks there isn't any problems and that addiction bro can't get a break.  My mom has begun to act strange (they live together with my aunt) He use too live 3000 miles away but, moved back about a year and a half ago. In that time everyone was talking -- now my dad only talks to my one bro -- not me or my addict bro. The addicition free bro isn't talking to my mom or my addict bro. Iam only talking to the addicition free bro -- its a mess. Its just one thing after another non-stop.  I am sure there is stuff that he has done that  I don't even know about.  The thing is this all can get very consuming if I allow it.  Now with the cancer issue -- if I shut him out and he has cancer I will burn for it.  but, if I don't then I can become consumed by it and chance are he doesn't have cancer then I have wasted time, energy and life on him.  I am finding it hard to put things into perspective.  Any suggestions for me?

Answer
ML,

You are facing one of the classically difficult dilemmas of addiction in the family.  How to gauge support vs. enabling.  You are probably familiar with the term enabling, and even codependency, which describe how the helping relationship becomes self-defeating for all.  If you'd like more information about these terms, you can google them and you'll find a lot of web sites and books explaining them.  

Now I'm not saying you or anyone else is acting in these ways, but the situation is ripe for it.  Keep in mind you did not create your brother's behavior, so can't be responsible for it.  He's going to do what he wants to do.  

I have seen cases of lifelong addictive behavior, which seemingly does not respond to treatment, or hardly anything else, except legal troubles. In fact, some of my clients consider being locked up the best thing that could have happened to them.  They were on a runaway train with further collisions in sight.  Drugs have likely severely damaged your brothers brain chemistry and he is subject to severe distorted thinking.  He likely had mental health issues as a child that predisposed him to addictions.  And the more he uses, the worse his mental health, and the more he needs and seeks substances.  

Overall, I've found enabling and codependency to be counterproductive.  I know a couple people who were enabled to death (literally!).  I always felt that if these two were told to leave home and fend for themselves, they would have been pushed into the social service system where they would have gotten evaluations and probably treatment.  They certainly needed it, but rejected it, sometimes arrogantly. Maybe the hard knocks on the street would have woken them up.  Other people don't believe in the tough love strategies, feeling one must always "hang in there" with the addict or alcoholic until they see the light.  But what if they don't?  Should family members continue to suffer on a daily basis as they watch their loved one self-destruct?  Do these family members have a right to some form of quality of life?  I believe they do, and therefore find enabling - and failure to impose a "tough love" strategy - ultimately more destructive then showing the addict/alcoholic the door. But like I said, you'll see opinions all over the map about this.

I just can't advise you here, as I can't know what you'll be comfortable with.  But I hope my viewpoint is helpful.

Best wishes,
Peter