Opioid Dependence and Mental Illness

Pile of pills

I’m not an addict. I’m not! I’m mentally ill. I have Bipolar Disorder. I also suffer from chronic pain in my lower back.

My primary care doctor (PC… PCD? Uhh… let’s go with MD) had been prescribing me oxycodone for the server and persistent (chronic) pain that I’ve had for years. After being active and doing something super strenuous like gardening for 15 minutes I think I’m dying. I’m exaggerating of course, but when I work as hard as Atlas does while holding up the world my eyes leak, I whimper and sit down. Sometimes I end up laying on the floor. The floor is such a very bad idea. If I straighten my legs my whimpering becomes desperate and I realize I’m crying. If I forget myself and straighten my legs I’m done. I can’t move. The pain paralyzes me.

I’m NOT an addict.

When I can think again, I try to find my phone. If I can’t find it right away I feel the panic rising and it triggers thoughts and emotions I thought I’d had under control.

This last time I thought I was managing my mania and depression (mixed state, rapid cycling) pretty well. I haven’t bought piles and piles of books on ducks or Oprah or how to be an astronaut. Honestly, I really haven’t. But please, don’t ask me what I’m thinking about. Also, I’ve been able to get out of bed AND wake-up in the morning and even go for walks. My depression skips through the dandelions with the mania comingling into a mixed state, which is always confusing.

I’m not an addict.

After many months of giving me a legal way to get my the Oxycodone I take for pain legally, and for free. The label on the bottle says I’m to take the little unassuming pills three times a day. They are 20 mg. Currently, I’ve convinced the assistant fellow at the pain clinic to reduce my Oxycodone to 20 mg twice a day.

I’m not an addict.

I’m mentally ill. I have Bipolar Disorder, ADHD, chronic pain, and other stuff.

I was referred to a pain chronic clinic… ah… chronic pain clinic, where my Oxycodone prescription was reissued. A five-minute verbal probe, that’s what it took for the doctor to determine whether or not I needed the narcotic. We didn’t talk about Bipolar Disorder or any potential interactions the Oxycodone might have with drugs that are meant to manage my wild emotions or tame my fantastic panic attacks. I’m not certain she has any record of my current medications. She asked questions, and I quickly tailored my answers to fit what I thought she was waiting to hear. She made a few notes on a paper as small as her palm. I wondered if she was actually making notes that she could refer to later. She thought for a few seconds and then wrote the prescription. I sighed in relief.

I’m not an addict.

A while later, like over a year or maybe two, I’m still taking the narcotic. The clinic has new owners and staff. They no longer asked me questions. Sometimes they required a urine test. Then, they stopped asking me anything at all. We spent my appointment chatting. I started asking if we could please try to figure out what was causing the pain and try to deal with it by correcting the problem. I wanted the pain to stop.

They didn’t listen. They wrote the prescription without hesitation.

I’m telling you, I’m not an addict.

My mental health drug dispenser began paying attention after I updated her about my drugs and included Oxycodone in the list. She stopped talking about whether or not my meds were working to stabilize my moods and started talking about “Black box” warnings.

She had my attention. I started to panic.

At the time I had over five medical people prescribing medications. They didn’t know what the other office prescribed me. They relied on me to tell them the truth. I didn’t have to tell anyone I was taking Oxycodone. That got me thinking.

I’m not an addict.

Later…

I’m still asking the medical folks to figure out the cause of my chronic lower back pain. I’m still not getting results. I’m getting way too much Oxycodone every bloody month.

Because I can, I’ve been researching my of collages of illnesses, disorders, and psychological malfunctions.

Ah ha! Black box warning. Do NOT take anti-anxiety medication (benzine’s) – death may result.

Oxycodone 20 mg

I recently saw Dr. T, my very superior knee surgeon. He saw the condition of my spine when he was looking at the x-rays of my hips. He was making certain that my persistent knee pain, post second replacement, wasn’t being caused by anything running amock in my hips. He was eliminating any possible cause of my knee pain before he even considering using surgery to further correct the inept effort Dr. B made the initial knee replacement. Dr. B successfully replaced my knee, but that’s where the project ended.

It sucked. My leg from the knee down, well, it kind of turned the wrong way.

Dr. T corrected the first replacement. He tried to minimize the damage his surgery could do while trying not to blow up my entire joint… okay, the joint that was already gone.

Dr. T showed me the x-rays he’d just had taken and explained where and why he left Dr. B’s “efforts,” while replacing the replacement. A month ago we tried a shot to relieve the pain and keep from having to have surgery again.

Nope. I’ve had no relief from the pain. In fact, my brain was overjoyed and thought that my knee was doing awesome. Holy cow! I should NOT have knelt down like that! Looks like surgery is probably what our next conversation will be about. I’ll need to be on pain medication again…. I intend to be off Oxycodine ASAP. I would really like to have some kind of painkiller to take after surgery – assuming I have it. Always be prepared! Sigh…

I’m not an addict.

After my constant complaining about my back pain that happens every time, I do regular human type activities involving the lower back. I’ve finally had x-rays of my back taken. Holy heck. Next stop is at a spine doctor.

The online personal information provided by my medical organization includes this: Opioid Dependence.

My chronic pain clinic instructs me to continue taking the Oxycodone. I haven’t been able to identify any specific relief from the pain in a long time. I have never felt any “fun” results from taking it. It has never made me feel sleepy.

I have found that taking Oxycodone at bedtime with the medication I take for Restless Legs Syndrome (RLS) helps me to get to sleep and not wake up in agony caused by the RLS.

Am I an addict?

“Taking opioids over a long period of time produces dependence, such that when people stop taking the drug, they have physical and psychological symptoms of withdrawal (such as muscle cramping, diarrhea, and anxiety). Dependence is not the same thing as addiction; although everyone who takes opioids for an extended period will become dependent, only a small percentage also experience the compulsive, continuing need for the drug that characterizes addiction.”*

I’m mentally ill. In my opinion taking any medication, especially one that alters my brain chemistry (opioids do this), should be thought about and discussed with other medical personnel who are also responsible for my continued living – and to live my best life.

Am I an addict?

No.

I have Opioid Dependence.

Dependence. I can live with that, but look, let’s get rid of that too. Okay?

{I have Bipolar Disorder. I’m a little manic now. I’m using it to write and post while I can. So, for now, I will post often because tomorrow, I may be depressed and unable to say what’s on my mind. I may not have anything on my mind.}

* https://ghr.nlm.nih.gov/condition/opioid-addiction

Bipolar – I Think You Should Take Fewer Pills

I’m going to notify my counselor that I must be rid of my med provider as soon as it can be arranged. I’ve told Arthur, my counselor, that I don’t feel that Jamie (med provider) is working in my best interest. My next appointment with her she started right off by confronting me about what I’d told Arthur. I confessed thit it was true.

It got me no where.

She says that I’m on too many pills and she doesn’t want to add anymore. Apparently, this is her rational for not giving me medication that might actually have helped me.

I’ve been practically begging for something for my anxiety that only get’ s increasingly more consuming with each passing day

This whole school year has been like a nightmare.

She doesn’t want to give me more pills? Bull!! It is not her choice to decide whether what other doctors prescribe me for illnesses she knows even less about than I do.

She has repeatedly used this as an excuse not to give me something that could prevented me from my brake down. I have high cholesterol, my thyroid is out of whack, I have chronic horrible lower back pain, I have FM, RA, OA, a facial tick (probably stress related), PTSD, and have recently been diagnosed with IBS-d. It’s a crap load of stuff, but they have all been dealt with by someone more intelligent than she is.

I’ve asked each and every visit for something to help with the burning anxiety. She refuses. She gives me fewer chill pills.

Does she think I like taking a handful of pills twice a day? Moron.

I’ve finally had a breakdown. I blame her. In December I confessed I’d been having thoughts of harming myself. I’d hidden that for years, but at that point it was too much, and I confessed it.

She did nothing.

If I can’t trust my med provider to guard my mental wellbeing, than who will? There aren’t many options here.

I’ve started to shake, Twitter, and twitch again. I’m graduating today. My anxiety that mixes like a charm with my mania and depression making my constant mixed state even more confusing and painful. It’s too much to handle anymore.

I’m firing her. She truly doesn’t have my best interests in mind. I don’t need one of my medical professionals contributing to my madness. That’s just sick.

Bipolar – Med Provider Day

I’m unstoppable.

I’ve been trying to sleep, but it eludes me like a chicken running for its life.

I’m going to see my med provider at 10 in the morning today. I hope she listens this time. If she doesn’t I’ll be requesting someone else and informing them of why I’m choosing to under go all the stress that comes with a decision like that. I’ve had enough.

I’m going to confront her with the facts. I’ve been keeping a list of my symptoms since I saw her 30 days ago. It has grown quite long. It looks even worse than before I was being medicated.

I’m unstoppable.

My pain management guy and I had to ween me off one of the long acting pain killers I’ve been taking for a couple of years because of supply issues. I went from 100 mg twice a day to 50 mg over night because there wasn’t anymore to be found anywhere. No one knew it was going to happen so there was no helping it. It didn’t feel so great. Then we kind of gradually weened me off the rest. Now my pain level is constantly higher. Also, the torn fascia in my foot still isn’t healed. It’s painful. I got special shoes for it today. But as the compassionate woman said while I walked around and around testing shoes, my foot was going to feel soar and tired. It still is. It wasn’t fun.

All this has added to my overall stress level, as you can imagine. Withdrawal is never a good time, nor is added pain.

I’m unstoppable.

I will be thankful if my counselor, Arthur, can make it to my appointment. He said he’d try. He feels it is important for her to understand my mental state from his side of the equation. He’s been with me two previous visits.

It hasn’t helped.

I’m still choosing to be unstoppable.

I may stumble, and I may fall over and over, but this damn illness is not going to continue to run my life. I’m very ill. I’m too exhausted not to fight anymore. I feel like my life has been a waste.

I’ve had enough.

I’m unstoppable.

Help me. Or, stay out of my way.

I refuse to stop!

Bipolar – Being There for My Kids and Real Anxiety

We did something amazing today, something we haven’t done in a very long time, my three kids and I all made dinner and ate it together around our family dining room table. We did it alone, without their girlfriends and significant others. It was nice. It was unfiltered. It was honest.

My son and our cars were some of the topics of conversation. My car is doing really well, solid, for being over 200,000 miles. My son, wants out of his relationship with his live in girlfriend. She (girlfriend), is not doing as well as my car.

She’s a bit on the mad side and I do mean both mad-angry and mad-bonkers. He’s concerned she might do something to him if he breaks up with her. I hate to see him going through that fear, that pain. I was in a similar situation myself many years ago and things did not go well. Today the digital actions of the other person would be illegal. I don’t think this girl has the resources or the wherewithal to try to make his life hell like I experienced.

I must tell you one thing I think is particularly amusing that she does every week. I thought I was being nice when I was moving and going through my cookbooks, when I let her pick some out to take for her own. I shouldn’t have let her have the one on Herbs. It goes through all the major cooking herbs and talks about how they are used. So, being the incredibly wise girl that she is, she is going through the book and making a dish around one herb at a time.

Unfortunately, she isn’t a cook. She sees her herb of the day and then Googles it and picks the top recipe and decides to make it for dinner. For example, they had mint the other day. The recipe called for dry mint in a certain amount. She sent my son to the store for fresh mint. Then she added the fresh mint to the recipe in the same amount that it called for as DRY. Yeah. He’s been getting sick a lot. She also has no concept of cleanliness in the kitchen and uses knives and forks for raw meat and other foods at the same time without washing them. It’s no wonder he’s losing weight. It’s a wonder he’s alive. Her lack of common sense with cleanliness in the kitchen really troubles me.

Without going into the grimy details let me say that he’s smart enough to know that he’s made a mistake and that he needs to disengage himself from her asap. I’m gratified that he knows I meant it when I said any of my three kids could home if they ever need to. I don’t have any fear that he’s scared to live with me. There was a time when that might have been true.

My anxiety is going up and down but is mostly manageable especially now that I’ve seen my med provider Sara and she’s standing with me. She sees the stress the pain management doctor is putting me through and is concerned about the affect it is having on me.

I’m feeling supported tonight. I reached out to a friend tonight that I haven’t talked to in a while and she was there and open to chatting even though she’s feeling lousy. It feels good to be able to do stuff with people. I still have homework to do tomorrow, but I’ll do that tomorrow. That, and watch the Seahawks!

My well of anxiety is still open and active, but I’ve taken steps to try to control it. For the short term it seems to be working. It isn’t a forever fix, but at least I made it through the first week of classes and am almost ready for the second week. (I attend school at one of the University of Washington campuses.)

I made a major accomplishment this first week of classes: I went to two movies and had the kids over to dinner which are all time consuming activities. Last year I couldn’t have done that. It isn’t that I’m not afraid I won’t have things done on time or good enough, it’s just that I have to listen to my family when they remind me of what my GPA is and that people work full-time and go to school full-time and spend less time studying than I do. Okay, it’s that and meditative music all night. Well, that and my doctor sanctioned chill pills. I can take them when I need one and not feel guilty.

It makes a whole huge difference to have the support and two-way trust with my doctor. I tell her the truth about how I’m doing and what I’m taking and she doesn’t abandon me and tell me to just talk it out with my counselor. Sometimes counseling and medications have to go hand in hand. At least, that’s what I’ve found is true. All areas of my life have to work in concert to make me function.

I picked one thing at a time and as fast as I could I got the pieces working for me. I failed a lot and still have a lot of setbacks, but right now, I feel 60% pretty good. I’ll take that all day.

I started trying to deal with the extreme anxiety by talking with my counselor who immediately went to find my med provider knowing it would take more than thinking to help me. Then I listened to meditative music and “talk downs” I found on YouTube. I searched for something like “meditation sleep music”. Try it. I recommend it. Now I listen to “Soundscapes” on my local cable provider all night. And I’m exercising every few days, playing with my dog and training her and keeping up with my house cleaning chores.

Monday I have classes and then seen the pain management doctor… that worries me. Ok, now I’m needing to chill again. I’m so silly.

Bipolar – Anxiety Rising

(Sept. 04) I’ve been sitting here trying to think of how to begin writing this and I’ve been getting nowhere. School is coming and I’m stressed out about that.

I have tremendous back pain and I go to a pain management doctor for my pain medication. The doctor that I’ve been seeing for like two years has stopped working in pain management and has opened a family practice. She was great. She really worked with me and worked to manage my pain knowing that I have Bipolar Disorder, PTSD, GAD, ADHD and so on. She was the one who prescribed my chill pill (medication anxiety) that I started taking during the school year last year when I had an anxiety meltdown.

The new pain management doctor started out by accusing me of selling my oxycodone and refused to refill my chill pill. I had a prescription of Oxycodone at the pharmacy to pick up which she didn’t take into account. I didn’t do anything wrong. I don’t like her. I don’t trust her with my health. My next visit to her she accused me of breaking my pain management contract by not bringing in the second pain medication I’m on. I was never told to bring the bottle in with me. Oxycodone yes, the other stuff, no.

My back has been bothering me.

My facial tick is back. It comes with anxiety like snow falls in the mountains… when the cold and precipitation is sufficient, the snow comes. Actually the vicious tick came with my beginning to take Gabapentin gain instead of Lyrica (Gabapentin can also be used for anxiety as well as for FM, which is why I tried taking it again).

FAST FORWARD TO TODAY Sept 28

I’ve been taking my chill pill daily. I survived my first day of classes because of the pill. I usually wake up in a cold sweat whenever anything remotely stressful is going to happen during the day. Like, for instance, going back to school.

Anxiety is such a huge part of my being right now that although I’ve lived in my new house for about two months I haven’t been to the grocery store by myself even once. I needed to buy some poetry books from the bookstore about 20 minutes from my house and instead of just going and getting them I called my eldest daughter and bribed her (I’d buy her a book if she’d come with me) to come with me. I just find it stressful to do things alone. I do not have a rational reason. I’ve done all the thinking and reasoning about my anxiety that my counselor and I have come up with and the anxiety does nothing but get worse.

I stopped taking the Gabapentin and the facial tick immediately started going away. When I’m stressed it comes back. I hope it isn’t permanent.

I see my med. Provider (the gal who manages my mental health medications) Sara in the morning. I’m asking her for something to treat the sever anxiety on a long term basis. The chill pill is great but it’s for a crisis and not meant for long-term consumption.

I get so wigged out about things that earlier tonight I already mapped out in my head the route that I would take to get to see Sara and then called my daughter to make sure that I could get to the grocery store from where I was coming from. I’m planning on going to get some milk on my way home in the morning. I need to do it on my own. I think if I have the chill pill I can.

It’s amazing. I wish I could take it all the time. I’ve been having to use it to go to sleep at night. When I don’t take it I’m awake until after 2 or 3 in the morning. Then I wake up sweating. I’ve even resorted to listening to relaxing meditative music/waves on YouTube all night. I found a channel on my TV provider to listen to that works as well called Soundscapes.

The struggle I’m having with anxiety is so severe that I’ve not been willing to blog and that makes me sad. My counselor has put forth the idea that perhaps my mania is manifesting as anxiety and that It’s really part of my Bipolar Disorder. I sort of hope that’s the case. If it is, I’m confident we can deal with it.

Why haven’t I been in to see my med. Provider sooner? She’s been booked. It’s been over a month since I last saw her. I’ve talked to her on the phone and my counselor talked to her on my behalf too.

Hopefully tomorrow I can communicate clearly how absolutely painful this anxiety is. My counselor is supposed to go to that meeting with me. I hope she can actually make it. It would give Sara a clearer picture of what’s going on with me.

Now, I’m going to listen to Rachel Platten’s “Fight Song” then I’m going to go to bed. I might read for a few minutes. Maybe one or two. Seriously, that’s as long as I’ll read.

I have high expectations for my visit with Sara and Rebecca (my counselor) in the morning. We got this. I have to believe, we got this.