When Pain Medication Causes Pain in Families

Dear Liz,

I need help with a very touchy topic in our household. My wife was given pain meds two years ago following a car accident. She says she still has back pain, so her doctor continues to prescribe medicine for her. The problem I see is, she runs out before the next refill is due--and gets pretty edgy, even panicky, until the next prescription can be filled. She has gone to another doctor, whom she calls her "fill in" prescriber, and pays cash. This all feels wrong and scary to me. We have three school aged children. My wife works part time now, and seems to do OK at her job--as long as she has her medicine. Trying to tell her I'm worried about it leads to arguments. But everyone is afraid to say anything because of her reaction. Otherwise, we've had a good relationship--but I am afraid this problem is getting worse and will cause big problems down the road. Do I tell her doctor she is seeing another doctor?

Anonymous

Dear Anonymous,

Prescription drug dependence is becoming one of the leading issues in medicine. Needing more medicine to get the same relief can indicate tolerance. Careful monitoring by a single physician will help a person manage their medicine and prevent further issues. Experts explain that the commonly prescribed drugs including OxyContine, Vicodin, Methadone, Darvocet, Lortab, Lorcet and Percocet, while effective for pain, can also cause a person's body to "need" the drugs in order to feel normal--in other words, physical dependence.

You described some warning signs, that your wife is getting into trouble by "drug shopping" and not being honest with her initial prescribing physician. Yes, please, let your wife's doctor know your concerns. Here are 10 warning signs of drug dependency:

1. Increased dosage--a sign that the prescribed dose is no longer working; 2. Change in personality--shifts in mood, energy, concentration can be the beginning of a person's focus changing to needing the relief the medicine provides 3. Use beyond obvious need (the initial injury or illness is subsiding, but the person seeks to extend their prescription). They may talk of how they are "still feeling the pain" and need the medicine "just a little longer."

The person may also complain about physician not "understanding" or denying refills; 4. Increased effort spent obtaining the medicine--the person may be willing to drive distances and/or visit multiple doctors to get more medicine--taking huge risks such as getting drugs illegally; 5. Social withdrawal--may become more isolated, avoid interactions with family and friends or change s in social circle; 6. Change in daily habits and appearance--personal hygiene and concern about appearance may decrease as a person is getting into drug addiction. A person may have a constant cough, runny nose and red, glazed eyes; 7. Shrugs responsibility -- a dependent person may call in sick to work more often, leave early, avoid routine chores; 8. Hypersensitivity -- may become over-stimulated by normal sights, sounds and emotions; 9. Blackouts and forgetfulness--a person may start to regularly forget events that have taken place, or things they have said or promised; 10. Defensiveness--trying to hide a drug issue, an abuser may become very defensive if a secret is being uncovered. Simple questions about or expressions of concern for their well-being may result in the person lashing out.

It is important to understand that it is common for people to develop tolerance to their pain medication and need higher doses to get the same level of relief. If chronic pain is the issue, seek out the services of a specialist in pain management.

In your wife's case, you may want to try attending her next doctor's appointment with her, letting her know you are concerned and that you want her to feel as great as she possibly can. Avoid sounding like you are accusing her, diagnosing her or calling her an "addict!"

That will alienate her and make you ineffective as a helpful support. Look out for the children's needs--especially safety: if you have concerns about her driving them while on the medicine. Sometimes, a family "intervention" with the help of an addiction specialist counselor may be necessary.

Ultimately, it will be up to her to work cooperatively with a doctor and other support, to get her medication issues under control.

(Contact Liz via asksharpliz@gmail.com. Liz Brisacher Sharp is a Masters level Licensed Professional Counselor in private practice with 35 years in mental health including serving as a school counselor, consultant, and mediator. Liz is known for her many years as a TV News and Weather Broadcaster, and as a long-time columnist for the monthly Lowcountry Sun. )