This was my follow-up post in the addiction discussion room:
To: All
Thank you all for your kind words and support. I'll try to address some of the questions and comments with this post. I am positive that she does not take the esgic all the time. She truly is a slave to the pain and when the big wave of pain comes, she'll do anything to make it stop. We have been to countless doctors, neurologists, specialists; we've even been to the Diamond Headache Clinic in Chicago. Usually, doctors seem to care and want to help the pain and are confident they can solve the problem. After several months, when they don't make any significant progress, they treat her as a nuisance and tell her she just thinks she's in pain. By the way, one of my best friends is a pharmacist, my father is an MD, she's a nurse, and she's been a pharmacy tech. So she knows how to work the system and knows her meds. I’m fully aware of the effects from the combinations of all her medications. And I know what they’re all prescribed for. I believe she does need some of them, but I think others could be phased out. I truly believe that if she just lived a healthier life, stuck to her meds as prescribed, and exercised she would have the strength and drive to make it through the tough spots. It worries me to tell the doctors about the magnitude of her abuse because I’m afraid they’ll take it away all together. It really is the only thing that gives her relief. She absolutely demonstrates addictive behavior. But like I said, she doesn't want anything to do the esgic when she's not in pain. It's just that once she starts taking it for a bad one it goes on for days. If we HAVE to be somewhere that she has to fake she's not in pain, it's really hard on her, she usually pulls through, and then the next day she's 20x better.
I'm sorry to just be blunt, but your wife is an addict. Not a doubt about it. The presence of pain is no excuse, ever, to take a mixture of meds that slur your speech and make you stumble around-- that is not a person treating the pain of a headache, but rather a person treating the urge to medicate.
Your story is very common, and to be frank, there is no way to have what you want. She will never be able to just take pain pills for a headache, and avoid all the other stuff that is ruining the marriage and everything else. Her only hope is for some brave doc to really take on the problem, and take on the anger from you and her, and find a way to get her off everything. If she went to any major university with a decent headache treatment program, that is surely what they would recommend, if not require.
There is no way to know if she is 'really' having headaches. I doubt SHE can even tell anymore-- people who take addictive meds for headaches for years tend to get headaches when they need to use meds-- not the other way around.
Addiction does not require daily use, or even monthly use. It is common for addicts to go in and out of control over time, particularly if they have sufficient medication to avoid running out in between episodes of loss of control.
The most likely diagnosis for your wife's headaches would be post-analgesic headache- I doubt she is having migraines. Migraines have a number of features that stand out besides the pain of headache; the 'scintillating scotoma' in the visual fields, pronounced nausea, photophobia (avoidance of light), vertigo for basilar artery migraine, and pronounced patterns, such as tending to come on AFTER a stressful situation, rather than DURING stress, aggravation by too much sleep, and sensitivity to certain foods.
You are in a tough situation, and while I could be wrong (heck, anyone can be wrong!), this IS the addiction forum. I suggest you give up the idea of finding a 'happy medium' to using opiates, benzos like xanax or clonazepam, or fiorinal (which is a barbiturate). Two of those three classes of medications cause more headaches than they will ever treat. Her best chance lies in getting sick enough of her current situation to go in for a safe detox-- do NOT do it at home with these medications. There is a good chance that she is taking much more than you would ever guess, and the withdrawal from these medications can be fatal. After detox, she would serve herself the best by entering a residential treatment program that is at minimum 30 days-- I think that 90 days would probably be needed to get her to the point of starting to feel better, and to find out who she is inside-- who she is without the option of taking chemicals. If she does this, she has a good chance of finding a life. But I realize that the odds of her seeing her situation as it truly is will be slim.
I was in treatment with a guy who developed a fungal infection in his brain that almost killed him, and left him with hydrocephalous and horrible headaches. He also became an addict. Unfortunately, the pain prevented him from accepting his addiction, and last I heard he was using again. The term for that is 'terminal uniqueness'-- when an addict cannot see him/herself as similar to the other addicts, but is forever different, the difference allowing for a life of using. I'm sorry; at some point you may need to do what is necessary to protect yourself.