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 – 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.

Robin