I Need Advice About Addiction, Rehabilitation and Life Events.?

Question by Mike: I need advice about addiction, rehabilitation and life events.?
I have a friend, someone that I care about more than anything. She has no family but one brother. We are very close and there is a romantic interest on both sides. She is 26 and has never been diagnosed with anything. She tore her ACL and is addicted to Percocet 10/650 and is currently in rehab.

Her life events include the death of her mother at age six, her father was never around, brother moved away but when he could afford it paid for her and her boyfriend to move to the same city as him. He also paid for her rent and expenses. She became pregnant and gave birth to a stillborn daughter and her boyfriend let her two days after the birth.

She came to me and said she wanted to stop using the pills. I think that she wanted my help but feared that she would be too much for me (probably afraid I would abandon her). She ended up going to the hospital and they recommended she go to an Addiction and Behavioral Health hospital. It has been three weeks there and everything has gotten worse.
They have not decreased her Percocet intake 10/650 3 pills-4 times daily. When she was using at home they were 10/350 I think, isn’t that much Acetaminophen?
They are also giving her Fluvoxamine at 100mg-2 times daily and Clonazepam at 2mg-2 times daily. This scares me as I have researched these drugs very well.

They have recommended that she gets no visitors and stays there 60 days, amazing how that is what her insurance policy pays. I feel like they have talked her into thinking that she is powerless to stop her addiction or to deal with her life events. I pay for her insurance and canceled the policy so they will kick her out in seven days. She was a great person, very sweet and happy prior to the pills. Yes she had hard days but we would communicate, talk and share feelings and everything was ok. They list her as suicidal but I have seen her out in there “hope garden” alone. She is 100% inpatient. I got a letter from her and it said she wanted to leave but was afraid she would mess up what we have.

I am not a doctor or therapist but did solely help another person in my life beat a Vicoden addiction and some life issues. She has been clean for two years now.

My questions are:

I will not pay for any more “insurance mill “rehab facilities. I am going to take this on myself when they discharge her in 7 days. I am willing to be home with her for a year, I work from home. I will pay for a physiatrist once a week all I can afford. What advice can you give me if any?

What are the dangerous of these drugs that they added? I have the means to acquire Percocet from the “pain management doctor” that prescribed them to her for 9 months so can take her down slowly. He is scared I will report him and will give her anything I ask for.

Do you think that this rehab center is doing harm?

What do I do???? Help

I need real answers as this has turned into something bigger than it was. Thank you

Best answer:

Answer by Finnegan
I can completely understand the situation you have found yourself in. I am a huge advocate for drug and alcohol treatment facilities and their ability to help people better their lives. It appears that the treatment she is in is making the problem worse and when they discharge her she should seek another program. Taking on her problems could be dangerous for your relationship as well as for her life. Drugs are a symptom of the underlying problem of self, unless she chooses to work on her other issues there will be a high risk for relapse. As for the drugs she is currently taking, high doses of Percocet can be extremely hard on one’s liver due to the Acetometaphine. As one develops a tolerance to the opioids they typically will start taking more, taking too many opioids at one time can result in the acetometaphine becoming toxic and can result in liver failure – which few ever recover from. Furthermore, mixing drugs like Clonazepam, which is in the benzodiazepine family, with opiates can result in overdoses as well. Benzodiazepines can also be extremely dangerous to withdraw from if the patient is on such drugs for an extended period of time.

I can appreciate how much you want to help your friend and with your supervision perhaps you can help her kick the drugs. I would advise you to consider looking into other programs of recovery before you go down that road. There are treatment programs that exist that care more about helping people than they care about the insurance money. If you do decide to take it upon yourself to help her clean up, I would recommend an addiction therapist over a psychiatrist, while she may need to have psychotropic drugs monitored by a psychiatrist they rarely address the underlying problems with talk therapy which is what addiction therapists specialize in and what your friend most certainly needs.

I wish you and her the best…

Know better? Leave your own answer in the comments!

 

One Response to I Need Advice About Addiction, Rehabilitation and Life Events.?

  • David says:

    You are very seriously concerned about your friend which can clearly be seen by the length, structure, and quality of your written question, so I will do my very best to answer you. I have been using Vicoden which is slightly different than Percocet for about 5 years under a doctor’s care, and I have been off Vicoden for 3 periods of time during that 5 year span, so I am very familiar with rehab. However, with Percocet which Oxycodone/ Acetaminophen it is chemically slightly different than the Hydrocodone in Vicoden. The difference is that Oxycodone can create a physical dependency, so quitting is more difficult.

    You were a little unclear in her initial dosage before rehab; going from what you wrote, 10/350 3 pills 4x per day that is 120mg of Oxycodone and . 4200mg of Acetaminophen which is over the safe amount and has, most likely, caused some liver damage at this point.

    First of all, regarding your statement about about the means to acquire Percocet from the pain mangement doctor, let me say this about detoxification. You said they were wanting to stay 60 days, which is more than enough time to transition from her current usage to zero. The can also find a non-narcotic substitute to address her pain management as well as getting Xray or other more advanced images of her ACL so they can see what actual damage still exists.

    Second, the possible dangers of the other drugs they added: Fluvoxamine is an anti depressant for the treatment of Major Depressive Disorder and Obsessive Compulsive Disorder. Your friend is 26, and this drug carries an increased risk of suicidal thoughts or actions in young adults, so I would not recommend this drug, because it can not be used safely once she exits the rehab facility, and it will take time to be removed from her system. Their are other anti depressants that would be better. She needs to talk to a doctor about this, this is very important. Additionally, if she drinks coffee or soda with caffeine it will increase caffeine levels. You mentioned taking her to a psychiatrist. Make sure he has a thorough medical background questionnaire on her, and he should find the right anti-depressant. Maybe even bringing him in to transition her discharge would be even more helpful.

    Naloxone is an inverse opiod antagonist, and this drug will help her withdraw. I would have her talk to the Doctor, or even get a second Doctor’s opinion on this medication.

    Clonazepam is a benzodiazepine which has anti anxiety, anticonvuslant, muscle relaxant, sedative which is great initially for short term like her first 15 days as in in patient, but you can get addicted to these very easily and build a tolerance which may make your body think you need more of this drug, which is not recommended for someone in addiction recovery, so I would have her transitioned after the first 15 days to Clorazepate which I would use for only another 15 days while transitioning to zero mg per day of this medication. Clorazepate is very similar to Clonazpam but you will not build a tolerance to it, and while it is addictive, it is a good drug to transition to zero on for the second two weeks.

    I don’t think the rehab center is working in the best prescription needs of the patient, but you haven’t mentioned what else they are doing for. Like I said, a good hospital would definitely re-image her ACL and find out how much her actual pain needs are based on her physical condition. A good rehab center will have lots of outlets for the patient to occupy their time, as keeping busy and keeping your mind off the aggravation of withdrawal is important. So to answer your question, on whether the rehab center is doing harm depends a lot on what else they are doing to combat her addition.

    What you do need to do is, with her permission, speak with her doctors, and the psychiatrist you want to secure for her, and after the psychiatrist has had time to get a medical background on her and meet with her a few times, speak with doctors and the psychiatrist about what their exceptions are for her in home care and get a vivid plan from the doctors. Have them put in writing for you, so you can refer to it later. This is a treatment plan. It can show the first 30 days, the next 30 days, the next 90 days, and the next 90 days. To be honest Addition recover is life-time battle, but the war is pretty much hard fought and won in the first 6 months to one year following rehab. Once she gets out of rehab, and has been home for a days to a week, I would recommend she do something vocationally; either work part time (not full time at first) or educational depending on her current educational level and what she wants to pursue. Again, occupying time and staying busy are important. You don’t want her sitting around with nothing do but think.

    Mike, I hope this helps you.

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