It is currently Mon Aug 21, 2017 12:57 am



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 24 posts ]  Go to page 1, 2  Next
Author Message
PostPosted: Fri Jun 19, 2009 8:37 pm 
Offline
Average Poster
Average Poster

Joined: Fri Jun 19, 2009 8:17 pm
Posts: 11
HI my name is Rob and i am 38 years old.. i messed around with percocets for years and could always walk away... then oxycontin 40s and still could walk away... until i couldnt.. not too long ago 4 years or so... but today i have been on suboxone for a year and have not touched another opiate in that time.. i am down to 2 mg a day... but i have never spoken to anyone about this problem and i am starting to understand i need someone to talk to and councelling or forums may hold the key to my future success or failure... I am terrified of suboxone.. have had some side effects which have me worrying which have caused severe panic attacks and anxiety which kind of keeps me in a constant loop of taking a drug i dont want and panicking about it the rest of my day... i am really hoping to chat with like minded folks and if possible find a meeting to go to locally to help with my feelings of being alone as no one in my life knows. I was astonished at how well i felt initially on suboxone... then started to have issues months after the fact and now feel like i want more than anything in this world to get off them and live my life right... i will not take anything in its place and i am dead serious about getting better... i hope i may be of some assistance to someone as well... and i look forward to talking with all of you and please dont hesitate to discuss anything with me as the only thing i think missing from my ability to walk off this drug is a support system which i hope i may have found a peice of that puzzle here with all of you... have a great night and i anxiously look forward to talking Rob :wink:


Top
 Profile  
 
 Post subject:
PostPosted: Sat Jun 20, 2009 2:26 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Apr 27, 2009 12:47 am
Posts: 1496
Hi Rob, welcome to the forum.

I'm sorry that you're having such a struggle with anxiety. I've been through that wringer, and I think there are a few others around here who have as well. That's a hard thing to deal with when you're trying to get your life right.

Have you been able to get resolution of your side effects? I know I found that at a lower dose (2mgs or so) some of my side effects went away or were considerably less. But I think there are some that just don't go away until you're done with Sub.

You absolutely need to talk to someone about what's going on in your life. This is a good place - people are pretty non-judgemental and understanding. Keeping stuff in and isolating ourselves is really bad for our recovery. Plus, there always seems to be someone who's made it through what you're going through and you can learn from their experience.

I know that if your anxiety is triggered by thoughts, CBT can be really helpful. I also found the SMART recovery website to be really helpful in that regard. SMART is not a 12-step group, it's based on REBT. They have a library of resources that has some good stuff in it.

I hope you're able to find some community here. I definitely have. Keep posting, and if there's something you don't want to share in the forum you can always use the PM function. We also have a chat room.

-Allie

_________________
You can't stop the waves, but you can learn to surf.

-Jack Kornfield


Top
 Profile  
 
 Post subject:
PostPosted: Sat Jun 20, 2009 11:05 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Tue Dec 30, 2008 8:48 pm
Posts: 415
Location: Ohio
Hi Rob,

It is nice to know you have managed to stay away from your DOC while on Suboxone. It is hard to change, but it is possible. I feel compelled to ask why you are in such a hurry to get off Sub? Even from 2mg you should take your time to wean off completely. What symptoms are you experiencing? If I know more I could offer some suggestions. I am on Sub too, and a college student studying to be an addictions counselor with a focus in addiction medicine.
Suboxone has helped with my psychological issues a great deal, and I am fine with staying on it. If you want off, do it slowly- you will do much better that way.


Top
 Profile  
 
Our Sponsors
 Post subject:
PostPosted: Sun Jun 21, 2009 12:43 am 
Offline
Site Admin
Site Admin
User avatar

Joined: Sun Feb 24, 2008 11:03 pm
Posts: 1544
Hi Rob,

Thanks for joining us here. My opinion will quickly become apparent to you if you read my posts; here is my opinion in a nutshell, from an e-mail I wrote today:

Opiate dependence (once oxycontin, now in Wisconsin largely heroin) has become an epidemic in many parts of the country. Traditional treatment has always been a long-shot at best; even 90 days of residential treatment has one-year or 5-year sobriety rates of 50 and 15%, respectively. Outpatient or treatments shorter than 90 days are pretty much a waste of time. But in 2003 Suboxone started being prescribed-- buprenorphine combined with naloxone. The naloxone is not needed for the drug to work; buprenorphine is a 'partial mu agonist' that eliminates cravings for opiates. It works very well-- IF you see opiate dependence as a chronic illness that needs chronic treatment. People take one pill each morning, and their addiction is held in remission. This is not methadone, which is essentially replacement therapy-- bur rather gets to the heart of addiction, which is the desire to use, and turns it off. It can be prescribed with refills, also unlike methadone.

The problem? Even though we all know that opiate dependence IS a disease, there are people who see Suboxone as a threat to something-- I'm not sure what. I have been recovering myself for 16 years; I hear from people clean for a few months who insist people on Suboxone 'aren't really clean'-- the people ON Suboxone have a hard time seeing that they have a disease, instead seeing it as a moral problem, so they are quick to stop the Suboxone as soon as their lives get straightened out-- only to relapse soon afterward. It is truly a fascinating story; my hope is that eventually we will look back and laugh at how addiction 'used to be seen', as a moral failure-- and hopefully we will eventually treat addiction with this or other medications, without all the guilt and other feelings that go with addiction.

My goal with patients, Rob, is to help them accept that they have a disease, and to let go of the guilt they have for taking a med for their illness. Once you understand it from that perspective, the idea of stopping Suboxone starts to look silly-- at least as silly as stopping the chemo that is treating a young person's lymphoma. We KNOW that people who simply 'hope to avoid using' relapse-- almost universally. So why do people see 'stopping Suboxone' as an option?

As for the side effects, I often point out that as treatment for a fatal illness, the side effects aren't bad. Compared to chemotherapy, for example, Suboxone is a deal!

You probably didn't ask to become an opiate addict; you have paid your dues. If you take your Suboxone down too low, you will start getting cravings again; it acts like vicodin if you take it in low enough doses. You are better off taking enough so that one daily dose will keep your addiction turned off all day-- 8 mg is plenty for that-- and then work on doing exactly that, i.e. work on taking it each morning ONLY, NEVER in response to 'needing' it. If you do that, you will eventually feel like your disease is exactly that-- a disease--- and you can get on with enjoying life, WHILE taking the suboxone that will keep your addiction in remission.

Just my opinion...


Top
 Profile  
 
 Post subject:
PostPosted: Sun Jun 21, 2009 6:50 am 
Offline
One Month or More
One Month or More
User avatar

Joined: Thu Jun 18, 2009 5:32 am
Posts: 35
Quote:
My goal with patients, Rob, is to help them accept that they have a disease, and to let go of the guilt they have for taking a med for their illness. Once you understand it from that perspective, the idea of stopping Suboxone starts to look silly-- at least as silly as stopping the chemo that is treating a young person's lymphoma. We KNOW that people who simply 'hope to avoid using' relapse-- almost universally. So why do people see 'stopping Suboxone' as an option?

As for the side effects, I often point out that as treatment for a fatal illness, the side effects aren't bad. Compared to chemotherapy, for example, Suboxone is a deal!


I would think that depends on the definition of disease that you use. If by "disease" you mean an identifiable collection of symptoms with a largely predictable progression then, sure, addiction is a disease, but if by "disease" you mean the common vernacular definition of an illness that normally is either contracted congenitally or through random contact with an infected host, then by that definition opiate addiction doesn't seem to me to be a disease at all. Unlike most things we consider diseases, the onset of opiate addiction is 100% behavioral, so I personally think that if you consider addiction to be a disease, it is clearly one that carries some culpability for the addict. The person who chain smokes for 40 years has some culpability if/when they come down with lung cancer, but even people who never smoke a single cigarette sometimes come down with lung cancer. On the other hand, nobody who hasn't volitionally used heroin will have become a heroin addict. Virtually noone who hasn't ever volitionally taken more than the prescribed AND minimum required dose of pain meds develops an opiate addiction. One gets into opiate addiction by making bad choices of the will. It's true that addiction quickly gets ahead of the addict so that in the vast majority of cases the addict can not simply "will away" her/his active addiction, but in a very real way we DID ask to become opiate addicts by playing around with more than the required dose and/or by using illicit opiates.... at least as much as a person who repeatedly runs recklessly across the interstate at night, while blindfolded and wearing all black is asking to get run over. Neither person really wants the worst to happen, but by the behavior they choose they make it highly likely.

Interesting analogy you present comparing an addict stopping suboxone to a young lymphoma patient stopping chemotherapy. What oncologist would recommend keeping such a patient on chemo indefinately? Rather they prescribe running through a limited course of treatment, then stopping the chemo, and if the cancer ever flares up again then an additional course of treatment. They don't just put a patient on chemo indefinately and when the patient complains about it's unpleasent side-effects tell them that they are better off than they would be if they let the cancer progress unabated. I think it makes sense to treat opiate addiction in a similar fashion, i.e. treat it when it's a full-blown active disease and get it under control, then stop the treatment.

Just as a recovered lymphoma patient needs to be very dilligent for the rest of her/his life to insure that the lymphoma doesn't flare up again (or for that matter another form of cancer appear) and if it does to immediately seek treatment..... the recovered opiate addict needs to be very dilligent for the rest of her/his life to insure that they don't slip back into active opiate addiction (or for that matter another form of addiction, like alcoholism) and if it does to immediately seek treatment. Yes, relapses of opiate addiction can kill the patient, as can relapses of lymphoma. However, I don't see the need to remain medicated for life because of a past struggle with opiate addiction, anymore than it would make sense for a young recovered lymphoma patient to remain on chemotherapy for life.

I understand that the current vogue in the medical field is to "manage" diseases rather than "cure" them. It's much more profitable for a drug company to get you on a pill that you will need to take for the rest of your life than a pill that fixes your problems in a limited course of time. Likewise it is much more profitable for a doctor to have a patient that will need to see them monthly for life to manage their disease than a patient they only treat briefly during a recovery period, but I feel that the ultimate goal needs to be patient care and quality of life, not the profitability of doctors and big pharmaceutical firms. Having said this, I acknowledge that there are opiate addicts who will rush back to active addiction the first chance that they get and that such people are probably better to remain on a drug like suboxone indefinately, as a form of harm reduction. However, I don't agree with encouraging anyone who has ever struggled with addiction to opiates to remain medicated on a replacement opiate like suboxone for life, particularly when said patient shows determination to live a life clean of opiates.

Just my opinion...


Top
 Profile  
 
 Post subject:
PostPosted: Sun Jun 21, 2009 11:06 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Apr 13, 2009 2:11 am
Posts: 427
Location: Fishers, Indiana
Unfortunately in my experience dilligence and determination have had absolutely nothing to do with me staying clean. I tried using those techniques right before both my relapses :cry: So far I feel very let down by them. You're rationale for not keeping an addict on a lifetime of treatment ( be that medication or a 12-step like program or SMART) didn't work for me either. Each relapse my family had to wait for me to completely run out of ways to get more drugs and hope that I didn't kill myself or others or end up in prison in the process all of which nearly happened before I'd even consider starting treatment again. I've known several people now pretty well who didn't continue a lifetime of treatment and after a relapse are now dead because they couldn't think reasonably enough while using after said relapse to consider getting back into treatment :x It still breaks my heart.

I also loved the way opiates made me feel even taking only the prescribed amount while most others I know hate how they make them feel. I have have family members who end up sleeping most of the day after taking an opiate while I get hyped up and very euphoric. Dopamine I think most would agree is the most important component in determining our behavior and actions. That being said I know people who will ditch their wives in order to play golf because they love how golf makes them feel even though they know there will be harsh consequences for their actions ( like sleeping on the coach). That being said if some are willing to do such irrationale things for something that causes a very minor dopamine release comparatively to say that caused by drugs why would we expect drug addiction to give the addict much of a choice in when and if they stop using or if they will stop and think reasonably about what they're doing?

Just my experience though :wink:

_________________
"If you're going through hell, ....keep going!"
-Winston Churchill


Top
 Profile  
 
 Post subject:
PostPosted: Sun Jun 21, 2009 3:35 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Apr 27, 2009 12:47 am
Posts: 1496
I take antidepressants even though I'm not depressed anymore. I can understand an argument for only taking them during a depressive episode or a crisis and then going off them when things are under control. That makes perfect sense. There are probably some people out there who will have one episode of major depression in their lives, treat it with meds and therapy and, taper off the meds and be pretty much fine after that.

My depression has proved to have a cycle of remission and relapse. I've had long remissions, up to two years, but eventually I've relapsed every time. I think there's an analogy to addiction here because some of my depressive episodes were triggered by behavior: I stopped exercising, I took on more responsibilities and got too stressed, I moved and had no support system, I stopped taking my medication because I thought I was finally "over it."

So now I choose to just stay on a lower dose of my meds when I'm not actively depressed. Then I have somewhere to go when I get depressed, and I've found that my depression does not get as bad as quickly as it does when I'm off my meds. I have side effects from antidepressants, but in my mind it's a fair enough trade off for not wanting to kill myself daily.

I view opiate addiction in a similar way. There are probably people who got out of control with the pills for a little while, go on Sub, get their act together and never go down that road again. I'm even one of the rare people who believe that moderate use is possible for some people. This view is based on personal experience, your mileage may vary.

For opiate addicts that have tried repeatedly to quit, who have sought treatment more than once and have repeatedly relapsed back into active addiction, who found that upon relapse their addiction had in fact progressed - well, they are not the person I'm talking about in that last paragraph. They are probably not going to take Suboxone for 3 or 6 months, taper off and be fine.

It worries me when I hear that people want to taper off Suboxone when they're not already feeling very stable in their recovery. I understand the desire to avoid certain of Sub's side effects and I know why Suboxone is the first thing we all blame when our mood or energy level goes south. But I almost never hear people say that they tried something else to mitigate their side effects (or what they perceive to be side effects) before they just up and started tapering off the Sub.

I did the exact same thing myself. I started feeling shitty, went online, read a bunch of horror stories at another Sub forum and decided I needed to Quit Right Now. That was a bad decision, and tapering that quickly made it all worse. Through trial and error I found other ways to cope with what was going on with me. My fatigue had other causes, as did my depression. I got through it and am now in a place where tapering off - with my doctor's support - seems like the right thing to do.

As to the onset of addiction being 100% behavioral - I'm not sure that I even agree with that statment, but for the sake of argument, let's just say it's true. The fact that I "asked" to become addicted to opiates means what? Do you have a point in bringing that up, other than to imply that addiction's not a real disease?

_________________
You can't stop the waves, but you can learn to surf.

-Jack Kornfield


Top
 Profile  
 
 Post subject: Here is where i am at...
PostPosted: Sun Jun 21, 2009 4:04 pm 
Offline
Average Poster
Average Poster

Joined: Fri Jun 19, 2009 8:17 pm
Posts: 11
Thank you for your responses and let me clarify some of the questions raised by my initial post... i have not up until now had any feeling for wanting an opiate of any sort since beginning til this very moment at 2mg a day... not to say this wont be the case if i continue to wean off.. I unlike many of you do not have a support system in place... that is i do not have all of the people in my life aware of my issues.. i have one person and infact i am canadian and go to the usa to get my script as when i began suboxone was not here yet.. it is now how ever i have a great relationship with my doc and he gives me months of script and allows me to stay on or come off at will... i believe that the greatest motivators for me wanting off is to stop the hiding of my issue... always worried about having to go to the hospital for surgery or emergency and them not knowing i am on suboxone .....also i believe it or not now that i have been bitten have become shy about taking any drugs.. wont take a tylenol at this point, totally terrified of the interactions between sub and all the other drugs listed... and lastly i have become so afraid of the power of this drug or any opiate that i have become anxious to the point of having anxiety with almost every dose... the lower the less anxiety i feel..i think it is psychosomatic but since being on this drug i have developed neuropathy and have had deja vu episodes as well as joint pain and creeping pressure in my scalp.. off of which is better the lower the dose... so for these reasons alone i have decided to give weaning off a try... i dont think it is for everyone but i think it may be for me.. i am going to look in my area for a NA meeting or even phychologist to see to aid in my mental state and i in the end i am stuck on suboxone for ever i guess i dont have a choice but to wait for the next medical advancement to come along and reset my addiction... keeping my fingers crossed.. but i dont feel cravings at any dose yet.. will continue to very very very slowly drop down and see how far i get... this website and smart have been very important for me as this is just about all i get in conversation of my problems with anyone.. and for that i thank you all very much.. please feel free to get in touch with me or respond to my postings as it is invaluable to me and helps me not feel alone.. thanks doc too for what you do .... it takes balls to put yourself out there and i commend you for your honesty.. thanks all .. anxiously await your writings..Rob


Top
 Profile  
 
 Post subject: clonazipam???
PostPosted: Sun Jun 21, 2009 4:13 pm 
Offline
Average Poster
Average Poster

Joined: Fri Jun 19, 2009 8:17 pm
Posts: 11
sorry all meant to add this in the last post... as i have mentioned i do suffer from anxiety and panic attacks.... originally from ocd which tells me a head ache is a brain tumor and heart burn is angina... well when i went to my sub doc he said how are you .. i said fine.. had a bad anxiety attack and took a half of a .5 mg clonazipam.. he said that is how people of sub die and or spark back up there addiction... it really helped but i as i have said now have panic attacks taking any drug and wont even look at the clonazipam... is it that dangerous .. i know people of methadone who take it ... i certainly wont if it is but it is rough sometimes and i used to get relief for the occasional atttacks..any insite would be greatly appreciated ...thanks Rob


Top
 Profile  
 
   
 Post subject:
PostPosted: Mon Jun 22, 2009 8:46 am 
Offline
One Month or More
One Month or More
User avatar

Joined: Thu Jun 18, 2009 5:32 am
Posts: 35
Matt2 wrote:
Unfortunately in my experience dilligence and determination have had absolutely nothing to do with me staying clean. I tried using those techniques right before both my relapses :cry: So far I feel very let down by them. You're rationale for not keeping an addict on a lifetime of treatment ( be that medication or a 12-step like program or SMART) didn't work for me either. Each relapse my family had to wait for me to completely run out of ways to get more drugs and hope that I didn't kill myself or others or end up in prison in the process all of which nearly happened before I'd even consider starting treatment again. I've known several people now pretty well who didn't continue a lifetime of treatment and after a relapse are now dead because they couldn't think reasonably enough while using after said relapse to consider getting back into treatment :x It still breaks my heart.


Hey Matt2,

Sorry, I should have been clearer. I meant to say that I don't think medicating indefinately is always required. To my thinking staying active in a 12-step group or SMART or another recovery program is all part of staying dilligent, not letting yourself get rundown or apathetic about your recovery and to always stay mindful that active addiction (relapse) is always waiting in the wings.

Cancer survivors are taught many skills... how to better take care of themselves (e.g. diet, exercise, sleep, etc..), how to monitor themselves for signs of a relapse of their cancer (or another cancer) and how to seek out professional help at the first indication of such, etc... Cancer survivors also need to see their doctors for more frequent check-ups than those who have never battled cancer. Often they are encouraged to participate in cancer survivor support groups and such.

Likewise, an opiate addiction survivor needs to learn and practice many similar skills to better care for themselves, be always watchful for signs of pendng relapse and how to seek help for that and so on. I believe one learns and practices these skills thru participation in a recovery program, be it 12-step, or SMART or whatever... or sometimes thru professional therapy. Apathy about one's recovery is the leading indicator of pending relapse, in my opinion.

Yeah, I agree that it is extremely difficult to "think" your way out of an active opiate addiction (including a replase). The dilligence and the recovery program and all are to avoid the relapse or to to catch it at the early slipping, not to bail you out after you've had your fun and blown thru all accessable resources. Again, I think active opiate adiction requires treatment in the vast majority of cases, be it ORT with a drug like suboxone or methadone, intensive counseling or behavioral therapy, inpatient detox, RODA/UROD, ibogaine or what have you.... or perhaps a combination of therapies. The sooner one seeks such treament the less damaging the relapse will be.


Diary - My comment about us "asking for opiate addiction" was a reply to the doctor's statement in the post directly above:
Quote:
You probably didn't ask to become an opiate addict; you have paid your dues.


In a way, the doctor is right. Nobody goes to their high school guidance counsellor and tells her/him that when they grow up they want to be a junkie. I was just pointing out that although we never desired to become opiate addicts, it was our own dysfunctional choices... choosing the short-term buzz over our long-term health, that put us on the path to becoming opiate addicts. I feel it is important to acknowledge and address this, otherwise we doom ourselves to repeat our dysfunction thinking and end up in relapse. I don't know about this doctor in particular, but much of the addiction treatment/recovery industry in general seems to be hyper focused on convincing the world that addiction is a disease just like any other disease, that it's not an addict's fault that they are where they are anymore that it is a kid with leukemia's fault that she/he has that disease, that an addict shouldn't feel any more guilt, shame or remorse for their "disease" than the leukemia kid feels for their disease, and so on. I personally believe that such an approach does a grave disservice to the opiate addict. If one does not acknowledge their dysfunctional choices and actions that got them into active addiction in the first place.... What chance do they have to correct that dysfunctional thinking enough to avoid getting sucked right back into active addiction at the first bump in the road?

Rob - Clonazepam (Klonopin) is a benzodiazipine, like Xanax, Valium, Ativan, etc... Buprenorphine and benzos, when used together intravenously in fairly high doses have proved fatal is numerous cases. Used orally/subligually together the risk is greatly reduced, but its still not encouraged unless medically necessary. Benzos on their own can be very addicticting and I think your doctor is smart to discourage your using them. Also it is a dangerous practice to fall back into the habit of taking a pill to "fix the way you feel".


Top
 Profile  
 
 Post subject:
PostPosted: Mon Jun 22, 2009 4:03 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Apr 27, 2009 12:47 am
Posts: 1496
You know, I really don't think it matters much that it was my "disfunctional choices" that led me into opiate addiction. I recognize that a large part of my addictive behaviors stem directly from disfunctional thought processes and behavior patterns. Those thought processes long predated my use of opiates, and many of the behavior patterns were set in motion early in my life by forces that were in fact beyond my control.

Can I blame the psychiatrists that first put me on antidepressants when I was 14 (and my parents for giving them consent) for infecting me with the idea that pills can make emotional problems go away? Maybe I can fault the man who sexually assaulted me as a young teen. How about the society that I grew up in - which soundly endorses the idea that there is something, somewhere, outside of ourselves, available for purchase - that will fix that empty feeling so many of us have? How about blaming my ancestors for the faulty genetic material that laid the foundation for my mental illness? Crappy chemical filled environment causing me to feel ill all the time?

Thinking back on it, I truly believe that my use of opiates was a rational decision given the context in which I made the choice to do it. Hindsight is always 20/20, so it's easy to look back and say: "I never should have taken that first vicodin," but really, how was I supposed to know? I'd used it before for pain and nothing bad had happened. Plenty of other people use opiates and don't get addicted. I was taking a calculated risk. Unfortunately, it was a risk that didn't pay off. Tell me again why I should be feeling any guilt, shame or remorse about this?*

Now I know for sure that I shouldn't use opiates unless medically necessasary, and then only for the minimum time required. I take full responsibility for that going forward, because my health is my responsibility. Whether I brought addiction upon myself through my disfunctional choices is irrelevant really. To my mind, blaming myself is just as stupid as my mom blaming herself for my problems. I had the personality characteristics, the disfunctional thought processes, and the environmental influences that were all conducive to developing an addiction. If it wasn't opiates 2 years ago, it was probably going to be something, somewhere down the line.

And more important than just not using opiates any longer (imo) has been discovering and rooting out the beliefs I held which led me to abuse opiates in the first place. Most people today are running around, never examining their thoughts or belief systems, totally unaware of what's really going on inside their heads. Western culture is not really self-reflective or based on each person having a profound inner awareness. This leads to people doing all manner of stupid shit - not least of which is abusing drugs.

I think the medical community is just reacting to the stigmatization of drug addiction/addicts. Advocating the position that addiction is a disease just like any other disease does remove the guilt and shame that has traditionally been generously heaped upon people suffering from addictions. You may see guilt and shame as advantageous to the treatment of addiction, but I think it more likely serves as a barrier keeping sick people from getting the medical treatment they desperately need.

*This is not to say that I haven't apologized for the mistakes I've made and people I've hurt in my life, some of which were related to my abuse of opiates and some which weren't. But I think the important this is to move forward, try to fix what can be mended and learn from my mistakes.

_________________
You can't stop the waves, but you can learn to surf.

-Jack Kornfield


Top
 Profile  
 
 Post subject:
PostPosted: Mon Jun 22, 2009 6:57 pm 
Offline
One Month or More
One Month or More
User avatar

Joined: Thu Jun 18, 2009 5:32 am
Posts: 35
Hey Diary,

First, I am so sorry about the crap you had to suffer through. It's a very imperfect world and there is not a lot of objective fairness in the way life's challenges and sufferrings seem to be handed out. I suppose we all have some life impacts that effected our road to addiction.

As I understand it, ADs are given to counteract congential neurotransmitter imbalances, not to treat one's short term feelings and emotions. They don't even start to kick in until you have been taking them for weeks. When I warn against "taking a pill to fix the way you feel" I am talking about the way addicts use chemical means to adjust how they are feeling at the moment, not about restoring overall physical and mental health. If you expand the idea that far, even antibiotics are taken to improve the way you feel, but that is not what I am talking about.

The rest of your post I found a little confusing. You seem to be saying that it doesn't matter whether or not I made past mistakes, I am not going to make mistakes in the future (regarding addictive behavior). But unless you acknowledge that your past decisions were mistakes... how does one change their decision process so that those dysfunctional decisions are not simply repeated? If everything that happened to you or me in the past, and the ways we responded to those things that led us into addiction were totally beyond our control..... How can we reasonably expect to influence whether or not we fall back into addictive behavior in the future? If we are all just victims of the whim of the fates.... Why even discuss recovery as the fates will do with us as they please?

The irrational beliefs you talk about rooting out ARE the basis for our dysfunctional choices of the past. Examining your life is all about acknowledging the mistakes of the past (as well as the successes), then working to adjust your thinking and behavior so that those mistakes are not repeated. To take the attitude of "I did what I had to, it wasn't my fault!" is to doom yourself to repeating those mistakes. You can't fix something until you accept that it is broken and needs fixing. This includes our behavior.

I agree that there is not a lot of positive in wallowing in guilt and shame.... such an attitude becomes dysfunctional in it's own right. I'm certainly not suggesting addicts walk around in sack clothe, flagellating themselves. But refusing to acknowledge any culpability in the problems and situations that our behavior has gotten us into is equally dysfunctional and blocks us off from being able to really address the root of the problem, in my opinion.

In my experience, addicts have no need for exogenous guilt and shame. Whether they chose to acknowledge it or not, they have plenty of endogenous guilt and shame. It's unfortunate that the world feels the need to heap on external guilt and shame anyway but I don't see that changing anytime soon and the medical community's pleas that addicts are innocent victims of their addiction just rings disingenuous to the majority of the population. If we, as a society, are going to pathologize every dysfunctional and undesirable behavior.... we might as well burn all our laws and replace them with the DSM-IV, fire all our law-enforcement professionals and replace them with counsellors, close all our jails/prisons and replace them with therapy centers.... then sit back and enjoy the anarchy.


Top
 Profile  
 
 Post subject:
PostPosted: Mon Jun 22, 2009 8:00 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Apr 27, 2009 12:47 am
Posts: 1496
I was being kinda facetious about the can I blame this or that for my addiction thing. Even so, as a young patient caught up in the psychiatric system there were most certainly pills on offer for many uncomfortable or undesireable moods. AD meds might not work for a few weeks, but a xanax or a shot of thorazine certainly do their work in a matter of minutes.




Quote:
but much of the addiction treatment/recovery industry in general seems to be hyper focused on convincing the world that addiction is a disease just like any other disease, that it's not an addict's fault that they are where they are anymore that it is a kid with leukemia's fault that she/he has that disease, that an addict shouldn't feel any more guilt, shame or remorse for their "disease" than the leukemia kid feels for their disease, and so on. I personally believe that such an approach does a grave disservice to the opiate addict. If one does not acknowledge their dysfunctional choices and actions that got them into active addiction in the first place.... What chance do they have to correct that dysfunctional thinking enough to avoid getting sucked right back into active addiction at the first bump in the road?



Maybe I'm misunderstanding your point. In this quote you seem to be saying that addicts need to feel guilt, shame and remorse about the fact that they are addicts because they brought addiction on themselves by choosing to use drugs. Is that correct?

Or is it just that addicts should feel somewhat more guilty/shameful/remorseful than someone who contracted a disease through no fault of their own?

And how do you assign the blame and guilt for various diseases - especially ones that have an environmental or behavioral component?

Quote:
The rest of your post I found a little confusing. You seem to be saying that it doesn't matter whether or not I made past mistakes, I am not going to make mistakes in the future (regarding addictive behavior). But unless you acknowledge that your past decisions were mistakes... how does one change their decision process so that those dysfunctional decisions are not simply repeated?


What I'm saying is that I don't see how it's important for me to assign a bunch of blame to myself for causing myself to develop and addiction to painkillers. I was sick long before I ever picked up a pain pill. That sickness was/is probably a combination of my genetics, my environment, outside forces and yes, decisions that I made that were all within the context of that sick brain of mine. There is no separating "me" from my diseased brain that helped me make those choices. Since the instrument that I was using to make those choices was broken already, I'm not going to waste time blaming myself. I just want to learn the lesson that hey, this coping tool is no bueno so I'm not using it anymore.

_________________
You can't stop the waves, but you can learn to surf.

-Jack Kornfield


Top
 Profile  
 
   
 Post subject:
PostPosted: Tue Jun 23, 2009 5:05 am 
Offline
One Month or More
One Month or More
User avatar

Joined: Thu Jun 18, 2009 5:32 am
Posts: 35
The positive role of guilt and shame is to drive a person to accept and take ownership of her/his past mistakes and to motivate them to take corrective actions to insure those mistakes won't be repeated. That's about it. Beyond that, guilt and shame become corrosive and self-damaging. There is nothing healthy about sitting around torturing yourself about your past mistakes. All the penance in the world won't undo a single past mistake.... yet without some level of remorse a person will never feel the need to change. Thus guilt and shame do fill a vital role in recover.... particularly recovery from opiate addiction.

Addicts in general and (IMHO) opiate addicts in particular become experts at self-deception and deflecting blame for their actions.

For example:
- "It's grandma's own fault I stole her pain pills. She knew I was in pain and should have offered them to me."
- "If God didn't want me to take these extra pills... He shouldn't have made me wake up feeling so crappy."
- "I have been thru a lot of crap, I deserve this chemical vacation!"
- "I just need to use to get me thru this next important event and THEN I'll quit."
- etc, etc, etc....


Opiate addicts have already fine-tuned their skills at deflecting responsibility for any of their behaviors which feed their addiction. When many in the recovery industry come along and tell them; "Don't worry about it, you are sick.... you have a disease.... It's not your fault.", this only serves to reinforce their dysfunctional behavior. A "sick" person can't help themselves and gets a pass from society.

If you wake up Sunday morning to find that your roommate has puked all over herself and the floor as well as peed all over the couch..... it makes a big difference to you WHY she did it. If she did this because she has stomach cancer and couldn't help herself.... you are likely to feel bad for her, treat her kindly and be willing to clean up the mess. If she did this because she enjoys going out with her girlfriends on Saturday night and getting shitfaced drunk.... and came home in that state the previous night.... too drunk to help herself...... Does she really deserve the same sympathy, grace and accommodation? .... even if she is struggling with the "disease" of alcoholism?

Addicts are already experts at deflecting blame for their behaviors. Having the medical community's "disease" endorsement only reinforces and legitimizes this dysfunctional behavior and makes it far less likely that the addict will ever feel the need to modify such behavior. Why try to fix something if it's just a characteristic of your newly accepted label? Without accepting responsibility for our mistakes.... I just don't see how we can be motivated to avoid repeating them.

If you walk outside your front door one day and get hit in the head by a golf ball that some random joker teed off from his back porch, 3 blocks away because he was pissed-off that he got fired that day.... it's gonna hurt and it's gonna suck, but there isn't much you can do to prevent it from ever reoccurring. If, on the other hand, you get hit in the head by a golf ball while you and your friends are loitering at the far end of a driving range..... it's quite possible that you can recognize that it was a mistake to loiter there, change your behavior, and significantly reduce the likelihood of such an unfortunate injury reoccurring. If, however, some therapist comes and convinces you that getting hit by the golf ball had nothing to do with loitering near the driving range and that you shouldn't feel any embarrassment for doing so..... you are not likely to change that behavior and therefore you won't reduce the likelihood of such an injury reoccurring.

I agree that the things that we do and the places we end up are the result of many factors, however, we can't do anything to change our genetics... we have very limited ability to change our environment and outside stimuli.... but the one thing we are able to manipulate is our cognitive thought processes and the decisions those processes lead us to.


Top
 Profile  
 
 Post subject:
PostPosted: Tue Jun 23, 2009 2:17 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Apr 27, 2009 12:47 am
Posts: 1496
I guess I just don't agree that accepting responsibility for our actions and acknowledging that addiction is a disease are mutually exclusive. Maybe we'll just have to agree to disagree on that point.

Since we both seem fond of analogies, I'll try for one. It's not perfect, but bear with me. In type I diabetes, sugar makes a person very ill. Until they are diagnosed, they don't know why they're getting ill. Sometimes (like with a guy in my English Comp class last year), they are deeply in denial that anything is really wrong - even while they drop weight and are incredibly thirsty and tired all the time. In my friend's case, he was building a house for his dad at the time, and his illness made him crave sugary drinks. He said he drank several 2 liter bottles of Pepsi every day. Sometimes he fell asleep at the wheel driving home from work, once nearly crashing into an oncoming truck.

This behavior went on for months. He couldn't really say why he didn't just go to the doctor, other than the fact that he is stubborn, and that the symptoms he was having (extreme fatigue was the most troubling to him) were in his mind just signs of laziness that he needed to overcome. He also hypothisised that his brain wasn't exactly fully functioning.

Eventually, he passed out at the construction site while his dad and brother were there. The coudln't revive him and called an ambulance. Unsuprisingly, he was extremely ill and his blood sugar was off the charts.

Now he manages his illness (because there is no cure) with insulin and diet. He knows that there are things he has to do (take medication, check his blood sugar) and things he has to avoid (alcohol, high-sugar foods) for the rest of his life. Of course he acknowledged that he did stupid and irresponsible things during the worst part of his illness - driving while extremely fatigued, drinking all that soda, not seeking medical attention, and that doing those things exacerbated his illness. He knows now what to do and what not to do moving forward.

I could say that everyone knows drinking 4 or 6 liters of Pepsi a day is terrible for your health, and that it's more dangerous to drive while fatigued than it is to drive drunk. He should be ashamed of himself! He rationalized these behaviors away according to his belief system and that was dangerous and wrong.

But it doesn't really matter, because he finally got medical attention (even though it was not of his own accord), he now knows what his disease is, recognizes that if he doesn't do certain things for the rest of his life he will die from this disease. The fact that he doesn't want to die is enough motivation for him to do what he needs to do to stay healthy.

For me, it wasn't guilt and shame that compelled me to get treatment for my addiction. I wanted to get treatment because I didn't like the way my life was going and I wanted to change that. If anything, guilt and shame were factors that delayed me calling for help. I didn't want to be painted with the addict brush because of the negative stigma attached to being a junky. I wasn't like "those people" after all. I was just a mom, a college student, I'd had the same job for years, I had chronic pain.

Maybe I'm some kind of unicorn or something, but never in the course of my treament have I had any medical professional say to me that this isn't my fault or I shouldn't worry about it. That's not how the disease was explained to me at all. I was just told about changes that occur in the brain, and that there might be a genetic component that makes some people succeptible to becoming addicted while other people aren't. It wasn't presented as a legitimization for my behavior so much as a framework for understanding why I found it do hard to stop on my own, why certain changes in my personality were manifesting, and what I needed to to to fix the situaion. I didn't take that as excusing me for any wrongs I did while I was using. If there are treatment professionals who are telling people that, then they are probably doing more harm than good.

As to our cancer patient and our alcoholic - I do believe that they deserve the same level of compassion, but that doesn't mean that I'd react in exactly the same way. While the cancer patient will likely need care and assistance in cleaning herself and the couch, and then perhaps I'd need to assess if this level of care is something I can deliver on my own; the alcoholic I would need to firmly make clear my expectation that she clean up her mess and then set a boundary for her participation in my life. Perhaps if she won't get help for her disease then I will have to choose not to be her roommate any longer.

But I still feel the need to recognize the humanity of both of these people struggling with their respective diseases. Neither of them needs my judgement or scorn, both of them need compassion and understanding. I think it gets a bit tricky when, for addicts and alcoholics, compassion bleeds over into enabling.

So, I guess after this book I've just written, I believe that it's possible to recognize that addiction is a disease while still expecting those afflicted with the disease to be responsible for both rectifying past wrongs and taking steps to live in a healthy way in the present and future.

_________________
You can't stop the waves, but you can learn to surf.

-Jack Kornfield


Top
 Profile  
 
 Post subject:
PostPosted: Tue Jun 30, 2009 9:51 pm 
Offline
One Month or More
One Month or More
User avatar

Joined: Thu Jun 18, 2009 5:32 am
Posts: 35
I guess the diabetes analogy might make sense if opiate addiction was shown to be caused by the body's inability to create sufficient quantities of endogenous endorphins (the way type I diabetes has been shown to be caused by the body's inability to create sufficient quantities of insulin). Of course for the analogy to hold true, a sizable portion of diabetes sufferers would also have to be able to correct (or negate) their blood sugar problems without chemical intervention, using only behavioral therapy, peer-support groups, faith-based programs, etc...

I agree that we need to acknowledge the humanity of and have sympathy for anyone who is suffering, whether it be from cancer or addiction or poverty..... but for what other "disease" would you expect the afflicted to be responsible for rectifying past "wrongs", that were artifacts of the disease? Would you expect your diabetic friend to make amends to the work crew because he passed-out on the job site? Would you expect the cancer patient to make amends for puking, passing-out and soiling herself? I believe the label "disease", as commonly understood in our vernacular, comes with a rider indicating "she's the victim, it's not her fault, she can't be held responsible". As an addict this is great to hear.... but it just doesn't ring true. Because of this connotation I hesitate to apply the label of "disease" to addiction.


Top
 Profile  
 
 Post subject: In response
PostPosted: Wed Jul 01, 2009 11:22 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Tue Dec 30, 2008 8:48 pm
Posts: 415
Location: Ohio
Your response is the very reason I choose to not personally use the "diabetes" or "cancer" analogy when discussing addiction as a disease. Addiction is a brain disease, sometimes a symptom of some other psychological disorder, a self medicating situation. Scientific research has shown valid proof that the brain of an addict is quite different from the brain of a non addict, even before ever picking up a drug/drink- the predisposition exists.
If someone you knew had bipolar mania and took you on a wild adventure which ultimately put your life in danger, would you expect an apology? I would and I did. I have a friend who is bipolar and during a manic episode, she decided that it would be fun to drive 100 MPH on neighborhood streets while running stop signs.She was not medicated at the time, and after she came to her senses, she felt remorse. It would be similar for an addict who did something erratic as a result of their disease.
As far as blame is concerned, I have to say that just because addiction is a disease of the brain, it does not give an addict an excuse to behave a certain way.As with any disease, it needs to be treated appropriately.Whatever method of treatment, as a result, addicts are taught to accept responsibility for their actions.If someone looks at addiction as a free ride to do as they please with no repercussions, they are in active addiction and need treatment to learn how to manage their disease.

_________________
"It is never too late to be what you might have been!" - George Eliot


Top
 Profile  
 
 Post subject:
PostPosted: Wed Jul 01, 2009 2:30 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Apr 13, 2009 2:11 am
Posts: 427
Location: Fishers, Indiana
actually Euph the majority of diabetics (90% according to several sources I checked) are type II ....meaning that the majority could more than likely manage their disease with change of diet, exercise, losing weight, etc...

Let's say addiction isn't a disease, just to for the sake of argument :D What you're saying Euph, "unless my elementary schools teachers didn't do their jobs in teaching me reading and comprehension.... it seems pretty clear that" you think addicts have a healthy normal thought process that isn't diseased. The problem with this argument is that no one in their right mind would choose to give up their relationships with loved ones, risk losing custody of their children, risk legal trouble, or throw away well paying jobs that required many years of expensive education, or ultimately "choose" drugs even over our primal drive for self preservation. Do people who are psychologically healthy (not diseased) contemplate or attempt suicide because they are unable to stop using drugs despite all that they've lost? Does a normal healthy mind obsess uncontrollably about drugs? Does a healthy brain make decisions without even stopping to factor in consequences (which has been proven many times in the case of addiction by brain imaging)? Even if you choose to not see addiction as a disease, then addicts would certainly meet the qualifications for a multitude of other psychological diseases/disorders.

_________________
"If you're going through hell, ....keep going!"
-Winston Churchill


Top
 Profile  
 
 Post subject:
PostPosted: Wed Jul 01, 2009 3:53 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Apr 27, 2009 12:47 am
Posts: 1496
But we all know that mental illnesses aren't REAL diseases, like cancer or diabetes. It's more like a moral failing or a demon possession or just a weakness, such as.

_________________
You can't stop the waves, but you can learn to surf.

-Jack Kornfield


Top
 Profile  
 
 Post subject:
PostPosted: Thu Jul 09, 2009 5:46 am 
Offline
One Month or More
One Month or More
User avatar

Joined: Thu Jun 18, 2009 5:32 am
Posts: 35
Matt2 wrote:
actually Euph the majority of diabetics (90% according to several sources I checked) are type II ....meaning that the majority could more than likely manage their disease with change of diet, exercise, losing weight, etc...

Let's say addiction isn't a disease, just to for the sake of argument :D What you're saying Euph, "unless my elementary schools teachers didn't do their jobs in teaching me reading and comprehension.... it seems pretty clear that" you think addicts have a healthy normal thought process that isn't diseased. The problem with this argument is that no one in their right mind would choose to give up their relationships with loved ones, risk losing custody of their children, risk legal trouble, or throw away well paying jobs that required many years of expensive education, or ultimately "choose" drugs even over our primal drive for self preservation. Do people who are psychologically healthy (not diseased) contemplate or attempt suicide because they are unable to stop using drugs despite all that they've lost? Does a normal healthy mind obsess uncontrollably about drugs? Does a healthy brain make decisions without even stopping to factor in consequences (which has been proven many times in the case of addiction by brain imaging)? Even if you choose to not see addiction as a disease, then addicts would certainly meet the qualifications for a multitude of other psychological diseases/disorders.


Type I diabetes was the analogy presented, so it is what I responded to.

As for your school teachers-- you might want to request a rebate check because that isn't what I was saying at all. Obviously addiction thought processes are neither healthy nor normal, rather such dysfunctional thinking and behavior works against the addict's own long-term best interests. Addiction has surely caused plenty of destruction and disruption in addict's lives. Yet, I question whether such dysfunctional behaviors are best labeled with the term "disease".

People who don't control their tempers are likewise working against their own long-term best interests. By flying into rages they destroy relationships, create problems at work that often lead to their firing, sometimes get themselves arrested and imprisoned, and negatively impact their health and their blood pressure-- all things that no one in their right mind would choose. Yet most people don't consider those with a bad temper to be suffering from a disease.

Likewise people who choose to act promiscuously often do so against their own long-term best interests. More marriages have been sacrificed and relationships trashed (particularly relationships with one's children) because of the behavior of habitual infidelity than because of addiction. Additionally, promiscuity often greatly increases the risk that a person will contract a dangerous or fatal STD. Do we then label the cheating spouse as an "innocent victim of disease"?

Shyness often functions against the long-term best interests of the shy person. Such behavior closes them off from fulfilling relationships and friendships, innumerable lucrative business prospects are passed on because the person is too bashful to speak up, etc... Should we stamp shy people with the DISEASED label and medicate them for life?

I could continue with a nearly endless list of dysfunctional behaviors that work against the person's long-term best interests (e.g. over-eating, laziness, thrill-seeking, etc...) and have negative impacts on people's lives and health. None of these behavioral maladies are widely accepted to be "diseases", although there are a plethora of industries dedicated to providing professional therapy to correct these behaviors. Something doesn't have to be labeled a "disease" to be unhealthy and dysfunctional. If I choose to not leave my bed for 6 months, while eating nothing but McDonalds food and smoking 4 packs a day, at the end of the 6 months I will be very unhealthy, though not necessarily suffering from any particular disease.

There are plenty of diseases that negatively impact the behavior of a person where that person is not responsible for their behavior. Autism, Down's syndrome and Alzheimer's come to mind. However, applying the label of mental disease as a euphemism for behaviors that are disapproved of on a societal level serves only to inject ambiguity and confusion to the definition of the term "disease".

Personally, if calling addiction a disease makes it possible to get more funding and resources for addiction research and developing treatments (pharmaceutical and otherwise) then I am all for it. However, from a practical perspective it seems more accurate and useful to describe addiction as a maladaptive behavior. A dysfunctional learned response for dealing with life's stressors and moods. By identifying the dysfunctional and destructive thought processes that lead us into addiction (and keep us there), we become able to then work to correct our cognitive algorithms and associations, to replace dysfunctional thought processes with healthy ones.

Sure, addiction is harmful and entrapping and not the kind of thing you can just will away nor the kind of thing anyone would wish on themselves. Yes, most people in addiction will need assistance to stop the craziness and rebuild a "normal" life. Clearly anyone who has fallen into the hole of active addiction needs to be hyper-vigilant to not step in that hole again. And, yeah, different people have different inherent susceptibilities to addiction and active addiction can cause measurable changes in the brain over time. The same things could be said about any number of dysfunctional behaviors. I, personally, don't believe that such factors warrant classifying addiction as a disease, at least not as "disease" has been traditionally used in our society. If we expand the understanding of "disease" to be any malady that negatively impacts a person, then sure addiction would fit that description, as would biting your fingernails, but I see no value in such redefinitions.


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 24 posts ]  Go to page 1, 2  Next

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: No registered users and 1 guest


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Our Sponsors
Suboxone Forum latest topics RSS feed Subscribe to the entire forum
 

 

 
Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

Powered by phpBB® Forum Software © phpBB Group