Addiction and depression have run in my family for at least three generations. The women are anxious and depressed. The men are addicted and depressed. There seems to be a strong genetic component to this. Antidepressants have severe side effects for us and do not work that well. They make us function better but not feel better. They also leave us feeling unbearably hostile. These feelings do not subside when one stops taking the drugs. It is as though the medication knocked something out of balance in our brains and our brains do not return to normal just because we stopped taking the drug.
There is a subset of patients with major depression that respond far better to opioids as a treatment for depression than they do to conventional antidepressants. (Opoids and Depression) My brother and I are in this category. I found this out quite by accident when I was given opioid pain killers for medical problems that were severe enough to require hospitalization and surgery. For the three days I was on the drugs, I felt normal--not euphoric or high--but normal. After I stopped taking the drugs, I fell into a depression that can only be described as biochemical torture. I did not resume taking the drugs but four years after the last time I took them, I still have not fully recovered from the depression. I have tried exercise. Contrary to all the glowing reports, it does not work wonders for all people with major depression although it may help some. Acupuncture helps but is expensive. A natural diet helps but when you are clinically depressed, it is difficult to be consistent about this for the time it takes to heal.
One brother has struggled particulary hard with addiction because he has both a genetic predisposition to depression and addiction and severe back pain--he has metal rods in his spine--that is only completely relieved by opiod pain killers. He also has a classic symptom of endogenous depression: opioids make him feel well--as they did me-- while withdrawal from opioids induces crashing, suicidal depression.
Several years ago, a friend of his recommended that he try methadone. This worked amazingly well. It controlled his pain, took the edge off of his depression, and halted his cravings for other narcotics. He was able to visit his doctor once a month and get a 30-day supply of the drug. In fact, he even weaned himself down from four pills a day to two. He was able to work part time as a printer and bring in some money.
Then the FDA decided that methadone could not be used for pain relief but only for the treatment of addiction. The way methadone programs are set up, this requires daily visits to a clinic--and daily fees. If the patient appears high, he is denied treatment. Of course, my brother cannot stand the back pain and the suicidal depression that follow withdrawal and so he inevitably shows up high and is refused treatment. Even if he did not show up high, the daily fees are prohibitively expensive and are not covered by insurance.
Because he cannot obtain methadone legally, he has resorted to using oxycodone. He has spiralled into out-of-control addiction. The printer he was working for fired him. Many days he is too drugged to get up and take his son to school. Because withdrawal from oxycodone is both physically and psychiatrically unendurable, he lies and steals to get money to buy the drugs. My mother sleeps with her door locked. Instead of sleeping in a nightgown, she sleeps in a pair of pants with pockets in which she keeps her money. My brother sold a crystal bracelet my nephew gave my mother--his grandmother. She cherished that bracelet and is heartbroken that it is gone.
He has stolen from hs preteen son. He took $160 and, although he denies it, pawned his fishing reels. My nephew started his first day of school this year sobbing his eyes out in the car on his way to school because his reels were gone. He has stolen small amounts of money from me as well. He lives with my mother and anytime I walk into my mother's house, I either lock my purse in the car before I enter or keep my purse over my shoulder. My mother and I spent last Christmas watching him passed out on the floor. Fortunately, his son was in California visiting his mother. My mother and I spent Christmas Day driving around and comforting ourselves with the thought that we had had worse Christmases.
On one level, as someone with a depressive disorder that responds to opioid drugs, I do understand the pain and desperation that drive him to these actions On the other hand, I am frustrated that his actions impair my own interests.
The love that hopefully exists among family members has dissolved in a sea of lies, thefts, bitterness, and distrust. Our family has been finacially and emotionally drained. We will never recover what we have had.
This was all unnecessary. If the FDA had let doctors decide what is best for their patients and understand that individual needs differ, we would not be going through all of this. The FDA really needs to remove itself from the doctor-patient relatonship.
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It would seem that his use of other drugs may now made him appropriate for methadone as an addict???
ReplyDeleteActually, methadone is now used by many doctors for pain relief but they are not allowed, in the US, to prescribe it for addiction.
The costs for treatment may vary quite a bit. You might consider a call to seveal local clinics.
Yes, he will have to go in every day but if he does well he can "earn' up to one mont take home medication.
Most every state has a State Methadone Authority. You might ask some questions there. Consider anonimity when you call.. use a pay phone if concerned.
http://findtreatment.samhsa.gov/ufds/abusedirectors
http://www.jointogether.org/resources/methadone-clinic-locator.html
Also.. Buprenorphine may or may not be appropriate. There are locally licensed MD's who offer Buprenorphine treatment. Buprenorphine has it limitations but you get treated without having to go to a clinic every day and you can pick up the medication at a pharmacy.
http://buprenorphine.samhsa.gov/bwns_locator/
Hope this helps you.