Long time lurker, first time diarist(So please be gentle). Anyway, I'm worried and mad.
Worried about the obvious dependency my mom has to pain pills...
And mad, because the doctors and their years of prescribing medication helped facilitate this dependence, and I'm not sure how much they help transition people off the pills (at least a drug dealer on the street doesn't pretend to have your best interests in mind!!). I'm coming out of lurker mode to see if anyone has some insight, advice, or experience that may help in dealing with this issue.
I have found that I become increasingly upset the more I think about the relationship between doctor and patient in regards to pain pills. I find it unfair that only one of the two in the relationship is subject to the dark side of addiction, while the other can just move on to the next patient. To be fair, I am referring to my mom's situation specifically; and my view is more emotional than substantive. I have no access to the doctor(s) perspective beyond what my mom has told me so I am not attempting to make any credible conclusion.
What I can conclude and see is how desperate and scary this situation is becoming. There isn't anything thing necessarily "crazy" or "rock bottom" that has happened per se(yet). But the writing is on the wall and I am pretty confident that her battle with pain killer medication is at a critical juncture. I will provide a brief background summary, and then I will describe the current situation.
"Boozers are losers; abstainers are gainers" Man did I use to get a kick out of that saying when my mom would remind me how my great grandparents viewed alcohol consumption. As a teen, I really enjoyed partying and got caught multiple times by both my parents and the police. Aside from the horrific (and hopefully soon extinguished) smoking habit I obtained during this time, I have become a relatively healthy young woman that partakes in occasional and law abiding alcohol consumption. I have worked in the social services for 7 plus years and have witnessed and assisted many individuals in various degrees and stages of chemical dependency.
Over 10 years ago my mom was diagnosed with chronic fatigue syndrome. In layman's terms I was taught to understand that its onset is similar to that of arthritis (ebbs and flows), and that an individual experiences symptoms similar to the flu during severe spells of the condition (on a good day). A few years after this diagnosis my mom began suffering knee problems. Now at the time I was living in Arizona, and was not witness to the whole progression. That being said, before these conditions surfaced my mother was pretty adherent to the family saying of "boozers are losers, abstainers are gainers." When I moved back two and half years later, my mom was accustomed to a glass or two of chardonnay with dinner. Since I had just turned 21 at the time I thought this was pretty cool.
About 4 or 5 years ago I noticed the alarming amount of pharmaceutical pills in her medicine cabinet. Holy Shit! I made her go through each pill and tell me how each one corresponded to a condition. I offered some caution and concern about their potencies and long term effects. She told me she knew all of that stuff and was very careful to only take muscle relaxers or pain killers when necessary (I would say half of her arsenal were pills recommended by her Acupuncture doctor as an herbal remedy). I mentioned something to my dad, brother, and sister; and I was given the Chicken Little treatment.
About 2 or 3 years ago I met my parents for lunch. I was surprised as my mom ordered the chardonnay at that early hour, but it would become commonplace over the next few years. Anyway, we were getting ready to leave and my dad went to the bathroom. My mom asked me if she had already told me something or not, she hadn't; and that led her telling me that these pills are making her mind "foggy." She admitted to having problems distinguishing between realities because sometimes things just all ran together. We talked a bit, she said she never drove while on the pills, and that the pain was too severe to not rely on them. As she has/had mentioned multiple times "her doctor knows she’s not addicted." I asked if there was anything that could be done with the knee, and she said that her doctor was considering an operation for replacement. This idea had been pondered before, but was tabled due to the intensity of the surgery.
In 2009 she had the knee replacement surgery. She was excited for the procedure and told me how she was determined to live a life free from pain pills. Well, the surgery was a success, but I believe symptoms of the addiction are dangerously surfacing. The surgery was over three months ago, and she is now describing a whole new set of severe pain issues. Of course she still has chronic fatigue, but I'm assuming that condition on its own will not warrant the amount and level of pain medication she was once accustomed. Now, I am uncomfortable with this because I struggle with not believing or being skeptical of the pain she is expressing, but how can I pretend there is not an addiction issue.
And for that matter, what obligation do the doctors have in transitioning patients off of the meds. My mom is and has always been a staunch follower of the law (much to my dismay at times), but I am privy to how powerful drugs and addiction can be to ones judgment. Not to mention the shame, guilt, and denial that is also involved. I don't understand how doctors can prescribe narcotic medications for many years and then not be accountable to addressing the addictive aspects of their prescriptions. The doctor/patient relationship is set up as a knowledge holder providing remedy to a knowledge seeker. (I.e, I have a pain or discomfort so I go to the doctor to see what’s wrong, the doctor knows what’s wrong and instructs me how to get better). And if I cannot get better the doctor knows what to give me so I feel better.
I don't think I'm going out on a limb by assuming that there is a well documented and strong correlation between prescribing pain medication and the likelihood of developing an addiction. So why aren't the doctors proactively addressing this? I don't know, if a person has been relying or prescribed a drug for X amount of years; that person (at the very least) must undergo an evaluation to determine dependency. Having a doctor say you are addicted with supported documenation of their enabling might be easier for someone to swallow than coming to terms with it on their own. And I don't know, maybe they already do that? What about signing a consent prior to projected long term use that requires a patient to undergo a treatment program at some point, under doctor's care and instruction. Or educate or plan for terrible withdrawls? In the meantime, I've got to figure out my next move, and I have NO idea!
So I guess the purpose of this diary is for two reasons.
#1 to seek advice from anyone that has been in a similar situation or circumstance.
#2 to seek existing knowledge on the laws and policies surrounding a doctor’s obligation to a patient’s dependency in regards to prescribing pain medication.