Category Archives: Oxycodone

Insidious Black Box


I apologize for the length of this post. Please consider reading the entire post. It’s very important. Your life could depend upon it. (Robin)

Emotionmasks insane faces

I take two medications that I considered to have a Black Box warning. They both depress breathing. Together they can stop my breathing altogether… There are other dangers.

I have chronic pain with Bipolar Disorder and Generalized Anxiety. I am prescribed both Oxycodone and Clonazepam by two different providers. They both know that I take both medications.

I see a pain management specialist for my pain. I have for some time now. To be treated there, I have had to sign a contract that governs my behavior with regards to taking pain medications, I have to take a pee test every time I go in and they count my pills every time as well.

My med provider handles my Clonazepam prescription for anxiety. I suffer from extreme anxiety. Sometimes I feel like my brain is going to explode. Recently, this woman, who is the 4th or 5th provider I’ve had since I started going to this clinic, told me that I’m more likely to kill myself because of anxiety rather than depression. I was always told that a depressed person was more likely to commit suicide when they started to feel better. When they started feeling better, they finally would have the energy to follow through with their suicidal inclinations. Apparently, there is more to it than that.

My counselor and every med provider I’ve had is intimately aware of my massive anxiety and my inability to get it under control. We’ve tried all the counseling type of solutions including Cognitive Behavioral Therapy (talk therapy), mindfulness and other techniques. I’ve not had success with any of them.

My med provider is content for me to only take Lamotrigine, which is primarily to treat my Bipolar Disorder depression symptoms, and not to take anything other than Clonazepam for anxiety. From talking to her, it appears that this is primarily to treat the depressive symptoms that I experience. I have not been able to get any of the med providers who have treated me to give me anything for anxiety other than Clonazepam.

She, my med provider, told me at our second meeting, that people with anxiety are more likely to commit suicide than people with depression. Since I suffer primarily from anxiety, you would think someone would have warned me of this. I understand now why I feel so self-destructive while I’m exploding with anxiety.

She has told me that her goal is to get me off the Clonazepam completely. Now that I’m taking my runaway anxiety and the real chance I will kill myself because of it more seriously, I’m also taking the mix of these two medications seriously. I always have, but my frantic response to my anxiety has created a situation where I’m so afraid of what might happen if I stop taking the drug for anxiety.

I’ve always felt like I’m most insane when my anxiety is at its peak.

I understand that long-term opioid use for chronic pain is not the most effective way to treat it. I’ve wanted to find a different solution for a long time. My pain management provider doesn’t offer other alternatives than pain medications.

I normally don’t want to die. I’ve always had urges that are normally short in duration towards it, but I haven’t had times when I sit there with my bottle of Oxycodone ready to take it all. But, I could.

I’ve never told any of my mental health caregivers that I have suicidal thoughts. I know that my community does not have good facilities to treat acute mental health emergencies. I don’t want to become one of those people who is shuffled into a hospital emergency room with a guard sitting outside my little room. That’s what they do. I have first-hand knowledge of this.

So what’s the answer? Do I chance dying in my sleep? Or do I chance ending my life while I’m awake? Both are real dangers.

I’ve decided to deal with my feelings of self-destruction now. With the danger of the two medications and my new understanding the relationship between anxiety and suicide, I have promised my family that I will talk to my counselor on Wednesday when I see him. I will admit that I think about suicide. That’s a huge step for me.

I’m afraid. Admitting how I’ve been feeling for years is like admitting that I can’t control the one area of dealing with my mental health that I always felt I could say I didn’t have a problem with. I’ll finally be admitting I have no control over my depression or my anxiety in relationship to staying alive.

As I say, I don’t want to die. When my anxiety runs away I cannot always control myself. I can become violent and destructive. I break down and cannot function. I become paralyzed yet also hysterical.

Yesterday I talked to my mother and all three of my kids and admitted the truth to them. My youngest who is a psych major at the same university that I attend (so is her partner) said she had been wondering if that was a problem for me. They all agree that they would rather I call them than I call a suicide line. I’ll talk to my therapist about that.

I have tried to learn to practice mindfulness several times in the past. I never fully committed to it. Mindfulness was just part of the learning experience in one of my classes I just finished. It’s time for me to review the materials I have about it, I have lots. I need to try to learn how to harness it’s potential in earnest this time. My life depends upon it.

I have a particular fear: I’m terrified of my anxiety. I know what it does to me. I sometimes feel the insidious devil of insanity creeping through my mind trying to take over, and it literally shreds my mind.

If you have any Black Box warnings for medication yourself, please take it seriously. Now that I am self-aware of my true situation I’m ready to find a way to deal with my symptoms.


My main medications:

Chronic Pain – Oxycodone / Nucynta

Anxiety / PTSD – Clonazepam / Benzodiazepines

Bipolar Disorder / Depression – Lamotrigine


Oxycodone – Warnings

“To make sure this medicine is safe for you, tell your doctor if you have:

  • a history of drug abuse, alcohol addiction, or mental illness
  • if you use a sedative like Valium (diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others)”

Clonazepam – Warnings

Risks from Concomitant Use with Opioids
Use of benzodiazepines, including Clonazepam, and opioids may result in profound sedation, respiratory depression, coma, and death. Because of these risks, reserve concomitant prescribing of benzodiazepines and opioids for use in patients for whom alternative treatment options are inadequate.

Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases the risk of drug-related mortality compared to use of opioids alone. If a decision is made to prescribe Clonazepam concomitantly with opioids, prescribe the lowest effective dosages and minimum durations of concomitant use, and follow patients closely for signs and symptoms of respiratory depression and sedation.
(The above Warning is taken from:
Concomitant: (synonyms: attendant, accompanying, associated, related, connected)

Lamotrigine – Warnings

To make sure lamotrigine is safe for you, tell your doctor if you have:

  • A history of depression or suicidal thoughts or actions
  • Some people have thoughts about suicide while taking this medicine. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Nucynta – Side Effects for Health Care Professionals

Psychiatric – Common (1% to 10%): Insomnia, confusion, abnormal dreams, anxiety, depression, irritability, nervousness, drug withdrawal syndrome, restlessness, sleep disorder, hallucination, depressed mood.



Benzodiazepines may be used in the treatment of anxiety, panic disorder, seizures, or sleep disorders.


Bipolar – Changing Meds Again


My title “Changing Meds Again” isn’t meant to be a negative statement. It is a part and a way of life for some people. People like myself.

I have many, many issues in the weave that is ME so please do not take what I say about myself and my plans (treatment and such) and assume they will work, or not, for you. They may, but that’s between your med provider and you.

Anyway. I’m at the point where my med provider (this time we’ll call her Toni) Toni, has put me on a “don’t argue, come see me every two weeks until this is straightened out.” schedule. Actually she told me something about my nerves and getting them to calm down. ;0)

Today I started Lyrica for FM. I’ve been waiting for 6 months for this to make it through insurance. (There’s that word again.) Speaking of nerves, it should help quiet a great many of mine I look forward to the possibilities.

Also, in the morning I start back on Wellbutrin. I was on it years ago and it seems like a good thing to try again.

Toni: “Are you depressed?”
Me: “When? Like right now?”
Toni: “All the time. Over all the things, would you say you are mostly happy or mostly sad?”
Me: Hemming an hawing… “Like all the time?”
Toni: gives me a look of ‘honestly, you silently scream depression creating irritation’
Me: regretfully admitting “Okay, yes, depressed. I didn’t want to admit that.”
Toni: “Because it confuses you being a mixed Bipolar?”
Me: “Yes!”
Toni: “Because you’re a manic depressive.”
Me: “Yes!!”

I’m on wellbutrin. I start taking it tomorrow (Thursday) morning. We shall see.We shall see.

Heres my medication list for Bipolar and other mental alphabet soup:
Lyrica (not directly in the list, but a major player in my new “list”)
Oxycodone  (not directly in the list, but a major player in my new “list”)

I fired my counselor. Talked to the head guy of counseling assignments. I explained the problem. She is only 4 years practicing while I need someone who can handle me. All of me. From the head to the toe… toes. From my head to my toes. Eh. From Arthritis and FM, to Bipolar and ADHD, from chronic pain to degenerative disk disease/arthritis in spine. I need someone who can help me focus and go through my day still being me but maybe being more experienced and work in biofeedback, mindfulness and neuroplasticity. With my medications I think this is the next logical step.

Medications are not going to fix me. They will hopefully allow me to function without… you know don’t you? Without the craziness running what feels like all the rest of my life.

I need to be able to manage. I must be able to succeed and what I want to do.

Bucket list? That’s for babies. Try barrel mitigated by soup.

Be well my friend. More later. I’m going to begin answering questions some people have been asking. I hope it will be helpful.


Bipolar – PENS & Oxycodone


I love pens. I really, really want to get one of those very expensive jobbies. I saw some in a gift boutique downtown Wednesday afternoon. They were 2013 models and at a bargain 50% off the normal $450 and $300. Oiy! Maybe not today. I’d love to get one for myself and one for my eldest daughter. We both love to write.

Writing can be a passionate thing. It is with me. Always with me I’m investing something of myself when I write whether it’s something blatantly obviously personal or if it’s something going on in my head that I want to talk about.

Right now I want to say something that I think is very important so sit up and read carefully. I’m putting this in terms of applying to myself so I know this from personal experience.

I have chronic pain. I have something wrong with my L4 and L5 disks, degenerative disks all the length of my spine, osteoarthritis, and fibromyalgia. I have a twice replaced right knee (replaced twice in two years, the first time it didn’t work) known as a TKR. I am 51 years old and I must say I do not appreciate needing to go to a pain management specialist and taking narcotics… every day.

I’ve been having what i can only label as nightmares now that I’m taking closer to the prescribed amount each day. (I also take Tramadol but that gives me migraines after a few days use). I don’t normally have nightmares. I was having trouble discerning reality fro dream when I would wake up in the morning.

Tonight I woke after another “nightmare” and remember something quite startling. When I was “incarcerated” in a facility to recover for my TKR the second time because my parents were moving and my kids wouldn’t be around to care for me giving me meds and such. It was a horrible experience. Besides generally feeling like I was incarcerated I was on Oxycodone at my maximum dosage every single time I could take it. The staff were only too happy to let me have it.

Unfortunately I had several nights in which I had terrifying and convincing hallucinations. It has taken me a long time to admit they didn’t really happen. Add to that, that I don’t remember my eldest daughter calling me daily from the MacDill Air Force base where she works as an air traffic controler. We live across the country from each other and that eats at my heart. We’ve always been close and the distance is difficult. But I don’t remember her calls and I know that bothers her. She took care of me during my first recovery and had to go through my even having two blood clots below my surgical knee. That was also a nightmare.

Last night and tonight I’ve been about at the level of Oxycodone that I was at in the rehabilitation center (read: nursing home) and I’ve started having hallucinations, not nightmares.

I suspect my use of pain medications is on the way down. We’ve tried a number of things and nothing seems to help.

I have an idea that I am sure will help. Ever hear of neuroplasticity? I’m sure you’ve heard of Luminosity, that’ s neuroplasticity. For me, this will mean using mindfulness to “remap” my brain and in doing so enable my actual brain structure to interpret pain differently. It won’t seem painful to me.  I guess I could put it like that without going into detail right now. I will soon though.

Neuroplasticity is becoming my key to dealing with my much of my troubles. Think of it, how awesome it will be to control my chronic pain, Bipolar, FM and OA… at least to a degree. Many advanced meditation practitioners are known to change their brains in a manner like the mindfulness I’ve mentioned.

Mindfulness. Neuroplasticity. How great to have the possibility of using these disciplines to help myself!

I’m not likely to be drug free… but I’ll get as far as I can.

I’ll talk about Mindfulness and Neuroplasticity in depth soon. They are very important disciplines that science backs up. I mean they are both proven scientifically to work in the areas I need. They impact many other things too.  After all, they are not confined to “topics” the brain considers. They do however, change the brain in ways we cannot comprehend considering the vast expanse, the last frontier as they say. At night I’ve taken to listening to Pandora. I searched and found a Mindfulness station to listen through the night. It’s playing right now. I finally decided to subscribe. Know why? The commercials were scaring me as I slept. Ew.

Watch your consumption of drugs like Oxycodone. You could have side affects you would think would anticipate.

Be cautious. Be ever vigilant.

Catch you later.I’m trying to stay awake for a while. Those hallucinations were getting very weird. Scary.


Bipolar 1, ADHD, FM, PTSD, Anxiety, Chronic Pain, OA – Now What??


If I’d started my blog off listing all my bits of my alphabet you might have clicked off and dismissed me as a hypochondriac. Personally, I might have too. However, the fun facts pile continuously up and I wonder if I might be much older than my drivers license says I am.

I’m 51 degrees old. Wait. 51 years old. Yes, that’s it. I think it’s time I leveled with you and give you my “medical” life. I am much more than my medical stuff. I’ve had my right knee replaced twice – in just two years. I know, that’s very young to even have it done once, but twice on the same knee… Skip that. Here’s a “brief” list. Each item is a medically real thing for me.

Bipolar 1
Chronic Pain
Degenerative Disk Disorder
2 Total Knee Replacements
Allergies – environmental, biological and food
Stress – Excessive
Dentures – Full

I’ve also had a ruptured appendix, broken ankle, blood clots, carpal tunnel syndrome, rage… I think you get the idea.

Over the last couple of months I’ve thought I’ve been falling asleep while driving. It freaks the freak out of me. No matter what I do I don’t seem able to prevent it. I even pull over and try to nap just so I can complete a 40 minute drive home. I’m not able to nap when I pull off the road. I try. No go. I can sleep in a parking lot when I’m too tired to drive, but it’s not working now. I sing, I scream, I pound my feet on the floor, I hit my steering wheel… Nothing helps.

It’s very scary. No, it terrifies me. Suddenly I’m about to rear end another car or find myself drifting to one side or the other. I’ve been asking my health care people what it could be. I eventually got around to my pain management specialist. I described it to her and asked if she thought it might be any of my many medications. Like my med provider, she didn’t think so. She wanted to know if I was born prematurely. Nope. Seizures? Nada.

Michelle, the pain specialist, asked if I could describe what happens as a “loss of time”. Maybe I’m not really falling asleep. Maybe I’m just losing time and tune back in just seconds later. Do I remember actually falling asleep or feeling sleepy. No. I’ve even tried coming home and trying to sleep. Not sleepy. No naps.

She sent me home charging me with looking into Absence Seizures. She knows I love to research stuff. I appreciate that she lets me learn and talk with her about my health care. I have read a bit about Absence Seizures. I think she might be right. Before I left she agreed she would get me in to see a neurologist she likes to use in a city about an hour from here. I’m going to have an EEG to see what’s going on.

New bipolar med on Wednesday… Friday a possible new diagnosis to add to my alphabet soup. Know what I keep thinking?

… Well shit.