Dilaudid/Seeing an Addiction Specialist

[clheithoff]

I posted awhile ago about my husband who has a dependency/addiction to dilaudid after 16 months of many surgeries, chemo, radiation and hospitalizations from rectal cancer. He has been on dilaudid for 16 months every day.  He currently takes 2mg pills 5-6 times a day.  I have known for sometime that this has been a problem but with surgeries etc the doctors somewhat had their hands tied.  And through in he has a very bad cancer they threw the srips (3 docs) at him whenever he needed them.  He is painfully thin (130's when he was trim at 170s) and has no appteitie.  They put him on Cymbalta to help with mood and eating.  No go. I feel until he is off the dilaudid nothing will help.  I had to yell from the rooftops to nurses and doctors to understand what was going on.

Anyway after spearheading by me with his surgeon and oncologist we are seeing an Addicition Specialist, Dr. Peter Coleman.  Of course my husband does not think he has a probelm except that the drug alleviates his pain. I believe the pain is the drug wanting its next pill.  It has hurt our immeidate family and he does not even see it. Both my teens and myself are in counseling.  His family does not think anything is wrong and that I am a negative wife.  I was wondering what to expect at the doctor appt.   My husband is too thin and weak to withdraw from home.  Will they admit him to hosptial to help him wean off?  I can not do it at home with my kids seeing this. Will they want to put him in a program.  This doc runs a big institute for addicts.  But the cancer thing is an odd part of the puzzle.  Can anyone give me some direction on what to expect? HELP!
Chris

[mr.lucky66]

He may be in pain and really need narcotics. It's a tough call. These so called addiction specialists are often regular doctors who took a weekend course to perscribe suboxone. I don't think that's a good option for him because he doesn't sound like an addict and sub isn't that good for pain. He sounds like a sick man who is depressed and takes narcotics for pain. all the best

[salsinator]

GO SEE DR. COLEMAN.  I completed a detox with him back in June after being on Vicodin for years and Suboxone for nearly 4 years.  The detox process is the best solution that I could have hoped for and I was very comfortable for the entire time.  I am more than happy to speak to you over the phone about the process and any fears that you may have.  It was the best decision that I ever made!  Please, for your husbands wellbeing as well as yours - go to the appointment.  Withdrawaling on your own is horrible - I have done both.  

[salsinator]

Dr. Coleman is not just a weekend addiction specialist.  He is also a family doctor and pain specialist.  He was also an addict and has been specializing in addiction for over 20 years.  He knows what he is doing.  If your husband truely does need to be on pain meds, Dr. Coleman will assess that and treat him accordingly.

[whitie]

maybe in his case, he should be on them. perhaps its best at this stage......

[scaredmom330]

I am no expert, but sounds like maybe he needs to be on them in the stage of his life. if he doesnt feel like he has a problem and it sounds like he is really in pain and in need of them. so is it him or you that wants him off and thinks there is a problem?

[mpace6983]

Is he cancer free? If he is still having severe pain,you might be being a little rough on him. Is he taking the dilaudid orally? Dilaudid is very effective IV but there are a lot of analgesics that are more effective when taken orally. i.e. oxycontin. hope everything works out.

[whitie]

yeah I was wondering about the dilaudid...............that dont sound right to me??

[mr.lucky66]

the dose of dilaudis he is on isn't that much. If taken oraly, dilaudid isn't nearly as potent and what you say he's taking is a very average dose at best. Like someone else said he may need it and he doesn't sound like an addict.

[clheithoff]

Ok...Don't know if you will all continue to read the posts.  He has stage IV rectal cancer that spread to the liver.  The odds he was given were not good.  He is currently in remission with no active cancer.  His surgeon or onc do not understand his pain issues.  They have to do with the rectal muscles spasams.  I have given 18 months to helping him and been sucked down into the depression too.  I climbec back out.  I truly believe there is some pain but the dilaudid and the depression numb him into not dealing with the hand he was dealt.  He dedcided to do the dliaudid because he liked the IV stuff so much.  He never liked percocet and never tried oxycontin.  I knew things were bad when he got sick and could not keep the dliaudid down.  They hospitalized him and he begged the nurses for dilaudid.  They were busy and I thought he was going to go crazy.  I knew it was the withdrawal.  Then in June he had some minor sugery and he begged the nurses for more of the IV dilaudid because it was not working...guessing he had built up a tolerance.  Anyway I believe Dr. Coleman is one of the only board certified addition specialists in the country.  Have heard great things.  His oncologist is very upset with him that he is messing himself up while in remission..almost asking for cancer to come back by not taking care of himself.  So I am in  this weird place.  Having to protect him because of the cancer. Making sure everyone does not feel sorry for him and just keep throwin hiim the scrips while my family falls apart.  He days consist of sleeping and living in a recliner in the bedroom.  He only comes out to go to work a night job for about 7 hours.  The kids and I have totally lost him.  He is a shell hiding away from the world.  He just has to have his pill every 4 hours or he gets very cranky.  My son is angry with him...my daughter feels sorry for him.  Whew..thanks for all the info.  
Chris

[mr.lucky66]

This is a tough situation and one that could be best answered by a pain specialist MD. I don't think anyone here can really say that he should stop taking it. Is he taking it IV? It could be that this isolation/depression isn't all from the drugs it could be end of life stuff. very complicated all the best

[mpace6983]

I agree w/lucky66. Something doesn sound right. 2mg every 4 hrs. If he was using I.V. maybe. Back in my war days I was shooting 4-4mgs evere 2-3 hrs. I cant understand why they dont have him on something like M.S. contin or methadone. But again im with lucky, this is really complicated, but im not sure getting him completely off drugs may not be the answer.I know its been hell on you and the kids but try and be empathitic. and remember an intervention with an addiction MD is not a license to beat him up. That will just make him more resistant to any options. A really heartfelt GOOD LUCK for you and your family.

[recwife]

Where is Dr. Coleman Located?

[worried878]

Does he have a bag?  cancer of the rectum that has spread to te liver is not a good prognosis...most would have a colostomy or ileostomy bag at this point if the drs saw hope...when cancer spreads to the liver..it means it has metastasized/spread/ thru most of the body..when a dr goes in a sees no hope of changing anything often they do not bother with these procedures..as it is just not gonna help anything

I dont mean to sound harsh nor disagreeing with ur dilemna...i am not there so i dont see how badly these drugs hurt ur family///as mr lucky said///dilaudid is poorly absorbed orally...i took a 2mg pill one time and felt nuttin..chronic pain patient and nurse posting here..it is a drug of choice for IV drug abusers as it is not absorbed well orally...so like mr lucky stated/this is not a high oral dose...i see people take more than that amt IV all the time//// but this doesnt help ur situation

Thing is i am trained to worry bout comfort measures when someone is slowly dying/reaching the stage he is at...as heathcare professionals our gears switch...the rule is to keep a patient comfortable at this point...now if he is raising cane bout the meds and out on the streets buying them,,,then  i would see a problem...if he is not then possibly he is just physically addicted...it is very possible he is dying.if it has spread to his liver....and i  am not a dr...has his dr gave u a prognosis?   listen to the prognosis...weigh it out in ur mind...addiction to dilaudid at this point is probably not on the priority list of ur husbands problem list/ if the dr says he is indeed terminal...it is an awful thing to know u r dying..we all will but having a forewarning is very devastating to people//i hope i die quickly//like in my sleep//i dont want to know months away that  will die...i would need alot of support just to out of the bed each day...I would talk /a serious talk with his cancer dr...they often leave u out of the loop unless u demand the attention..demand it..get the facts...but cancer that has spread to the liver is never a good prognosis,,i do agree if he is causing havoc over these pills and u have a family to protect...then u need to act...or perhaps all of u need to c the dr together so u understand the devastation he is experiencing....my prayers r with u

[salsinator]

Dr. Coleman is located in Richmond, Virginia.  Go to:  www.thecolemaninstitute.com for more info.  He also has clinics in Kentucky, Chicago, and Las Vegas.