Expert: Peter L. - 1/20/2011

Question
My boyfriend became addicted pain pills at a young age when he required surgery. He did go to rehab, but I think it was only a 30 day program and has had out patient sessions throughout his twenties. He was able to stay clean for a while but had a car accident last year which required further surgery and further pain medicine. When I met him he was on a daily dose of methadone. He was completely honest with me and he seemed normal. Except for his occasional sleepiness. He really desired to stop taking the Methadone. He was "tired of a pill ruling his life" so he asked his doctor for suboxene. I believe he tried to wean himself off the suboxene to fast. He relapsed and now I am unsure of anything we had was ever real. Do addicts always feel the need to lie even while on methadone? I never distrusted him while on the methadone. He was on the suboxene for 2 weeks and I noticed a difference in his moods and just him being distant. I know he knows that he hurt  me so deeply with all his lies during the last 2 weeks. He would disappear for the whole day and lie about where he would be. I imagine now that he was using because he finally said that he needed to go somewhere. But when it came down to the moment, he was a totally different person. He is very smart and a smooth talker. Was this him always being manipulative? I believe that he is very depressed and needs help with that as well. Having surgery so young and a doctor that was over prescribing pain pills got him addicted in the first place. But would he have still become addicted because of his depression and family issues. Maybe this was just all a way to cope. In no way am I condoning his addiction. I just want to support him but not hinder him as well. I am so lost and confused myself. I am now understanding so painfully that I cant save him. He needs to want to change for himself. I am struggling so much right now because he has only been in a long-term facility for about 1 week. I know that he needs to focus on himself but do I need to stop this relationship now. I am lost!

Answer
Hi Jane,

I started in this field working in a methadone program treating heroin addicts, and now, some 27 years later, am finding a huge increase in this population.  Where I work we talk about this all the time.

Many years ago I first heard the moniker for opiate addicts "dopefield."  I thought about the word "fiend" used in the context of a drug addict.  A fiend is not considered a friendly being.  I think, for many people, an opiate addict can seem like some kind of evil being, always lying, scheming, manipulating.  I will go out on a limb and say here that most of us working in the addiction treatment field would say our opioid addict patients are characterize those traits the most.  Let's just say, they're the "best" at it.  Why is this?

Opiates produce an incredibly compelling high.  They rapidly produce addiction and withdrawal symptoms.  I think the discomfort the withdrawal produces can be unbearable for opioid users.  The want relief at any cost.  I think that is why someone will behave in irrational, self-centered ways.  They "need" the drug.  There is no "I'll just deal with it."  

Drug use will often cover up depression and anxiety, and help someone hide from pain, abuse, traumatic histories, and anger.  

I'm glad you have recognized that you have to let him change for himself. You can be supportive, but he must follow-up on treatment.  And yes, addicts will lie when they're on methadone and Suboxone.  They might use other substances, also.  

Have you considered counseling to help you cope with this very difficult situation?  It might help you to talk about what you're feeling with a professional.

Best wishes and I hope your boyfriend can be successful in his recovery.

Peter