Addiction Medicine or Pain Management?

Question by Rox HC: Addiction Medicine or Pain Management?
My daughter has been brutally abusing nacotics such as vicodin( she can get a bottle of 120 Noco 10-325 and it will be gone in 4 days, a 30count bottle of vicodin 5 or 7.5-500 in less than a day) oh and get this she steals my vicodin and ativan and acts like she didn’t do it so I am sure you get the jist. It has gotten so bad the our insurance company has sent the offices lists of all the different people she goes to. That needs to stop now! That is embarassing, what if she really has a problem and goes to a hospital where noboby will help her because of her dangerous intake of medications or they may thing she is just making it up. I didn’t know if this was the right choice to make an appointment to let her see a doctor that does the SUBOXONE detox treatment so she can be completely off of all drugs or if I should put her in with a pain management doctor that may give her something for her pain (she was in a car accident and has pain at times, NOT ALL 24HRS of THE DAY. I am afraid that would be a risk because she knows how to milk it. She lives in my house and I believe the suboxone treatment would be the best way to go but I want to make sure she will not be suffering. I just want her to be herself again. I worry about this because sometimes with that back pain she can’t even get out of bed because her leg is numb and those are one of the very few times I know she has true back pain. Any thoughts or opinions as to what I should do? Like I said I think the suboxone way is the best way, I just found out last night that this girl has seen over 30+ to get narcotics, this is never how I viewed my daughter living her life. Her Uncle, Brother, and Grandfather died all soon within eachother and I think that triggered her use, along with being depressed and having panic disorders but narcotics won’t make the situation any easier. What happens when the high is gone? Anyways, I just wanted to make sure I am making the right decision by taking her to a suboxone doctor over a pain management docter?

Best answer:

Answer by Autumn
Ummmmm…..most doctors that prescribe suboxone are pain managment specialists. Why not let the doctor decide what is best for her? How can you be so sure that she’s not in pain all the time? You can’t know this unless you live in her body. Take her to a good doctor, let them decide how to treat her. And if she’s 18 or over, you can’t really force her to go to the doctor.

Answer by gma
You are making the right decision, treatment is her only hope, If she is not in pain 24 hours. The way pain pills work is they do give you a buzz at first but your system quickly adapts to that and the buzz goes away. Then it takes a higher dose to get the buzz again and on and on. There’s no end to it. It’s the buzz that she is after and that’s different than pain management. I’ve been in pain management for ten years so I know. 24/7 pain, it never goes away completely, pills help you cope with it, but it’s always there and everything you do aggravates it. If your daughter can learn to manage it some other way, chiropractic, yoga, physical therapy, bio feedback, anything that doesn’t involve pills she will have a happier life. Good luck Withdrawal is no picnic either but she needs to hang in there.

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2 Responses to “Addiction Medicine or Pain Management?”

  • Dr. P.:

    Rox
    In pain management it’s very unusual drug abuse (WHO collaborative study group consensus), so you’ll probably have some difficulty with a pain manage doctor to do such approach. I personally had just 2 cases in almost 15 years. Bur she is clearly overtaken painkillers. The difficulty here is that you are in front of an interface question, of pain management and drug addiction, so, one need to treat both at same time. For a better understanding, if someone is just a drug addict we just remove the drug (there is various approaches to do that). Bust if she’s in pain, she really need the drug. One characteristic of codeine and derivates (hydrocodone, etc) is its short half-life, about 3 or 4 hours. For somebody who has addiction the tendency is to increase the numbers of takes. Although methadone is not a first choice for pain treatment, it is a excellent option for opioid drug addiction. The reason for that is its long half-life, about 30 hours (some large individual variation exist-fact that lead us not to use it for pain). Objectively: in a drug addict clinic, with an experienced professional, substitute the short half-life opioid for a long half-live one (a more expensive choice is phentanyl patch). After withdrawal use only non-opioid PRN.
    If I can help in anything else, just let me know.
    Good luck

  • jack r:

    She should go to an addiction specialist first for detoxification and you should consider alanon for yourself so you can understand how her problems are affecting you. She may need to be in a methadone program rather than on suboxone if she is taking high amounts of narcotics. Suboxone can’t handle the big addiction problems. Most primary care and pain specialists will be out of their league handling her case. A multidisciplinary clinic with psychiatry, pain, and addiction would be best but these are very rare.

    As a side note, being addicted to pain meds may make them work less effectively or not at all.

    Don’t forget to take care of yourself.