Expert: Peter L. - 4/18/2010

Question
hi I am involved in doin an intervention on someone who has valid injuries from two car accidents. Sh has been perscibed oxi and morhine ( can u believe it). Anyway she has also started smoking coc and meth so an intervention is necessary. How do we address the pain in the intervention?

Answer
Hi Barbara,

I find the prescribing of the drugs you mentioned, and the whole opioid medication family of drugs, rampant. I'm nor surprised this person is being given these meds, and I would imagine no one asked about her drug history which, I'm assuming, is extensive.

Is a professional doing this intervention?  I recommend that only a trained person respond to this situation.  

The pain issue is complicated.  I run into this all the time, and there's no clear solution.  I basically leave it up to the individual with the pain issue:  "You have been prescribed pain medications but you are an addict.  You are being medicated with the same drug that causes you problems in your life overall.  You will only get worse by becoming more addicted and developing further tolerance to these drugs, so you use will inevitably have to increase."

So, it's up to them if they want to try to get off the meds, or move toward a non-opioid medication like Tramadol.  Problem is, addicts automatically set themselves up mentally to believe this drug will not work, so guess what!  It doesn't!  In the final analysis, one has to either live with increasing symptoms of drug dependence in the quest of being pain-free, or find a way out.  As I said, I leave it up to the person.

I hope the subject of this intervention will understand the need for treatment.  If she cops out to the pain argument, and short-circuits the discussion with talk that there's no alternative to the pain meds, then she should accept the likelihood of worsening addiction.  Her use of the cocaine and methadone is obviously a major issue, and if she's not willing to address these things ultimately, she should be allowed to determine her own fate, and those around her who are impacted by her addictive behaviors have a decision to make.  Either put up with it, or get away from her.  No one should suffer the consequences associated with living with an alcoholic/addict, after giving that person chance after chance.

Regards,
Peter