My sister in law was found unconcious last night and in ICU today. She is still unconcious but expected to live. She has had FM for 14 years and been in pain pretty much non stop. she is on heavy doses of all the normal drugs including morphine patches. Our family believes that her intense and constant pain is a result of being on so many drugs and such his doses for a long time. Her brain barely functions anymore. How do you know if FM patients have crossed the line into drug addiction or that they are in tremendous pain and need the drugs? We are not sure if her body just quit working as a result of a history of too many drugs or if she voluntarily or unknowingly overdosed. What is the best place for people to detox if they truly have chronic pain as a result of FM? My brother is in denial and says "we need to find her a pain management clinic" and we are saying he needs to find her a rehab clinic. How can we help?
I'm sorry to hear about your SIL. The drugs did not cause the pain of FMS. When one has FMS they are in constant pain.
You don't state what normal drugs she was on, however, she could have become addicted to them. Typically someone who is addicted will increase the dosage as their body becomes resistant to the usual dose. If this was her case, she may have overdosed and this caused her to become unconcious. When to much pain medication is presented, it causes respiratory distress and the organs can shut down. As a family member, I would want to talk with the physician who prescribed her the drugs to see what he had given her and why. Most people who use prescription medications for chronic pain do not abuse them.
The hospital should be able to tell you if she overdosed. She is in the best place she can be for now. Most hospitals have a detox facility attached. They will see that she gets the help she needs. Rehab. and a good pain management program would both be helpful. If she has an addictive personality, she may need counseling so that she won't abuse again.
FMS is very real...the pain can be mild or so severe that one is bound to a wheelchair. We have a very difficult time finding any one medication that will get the pain under control. Often times, they just do not work. Not knowing her level of pain, I can sympathize with the fact that in order to gain relief after 14 yrs., she may have tried more. It's so hard to live in chronic pain. If she really does need rehab., the hospital should tell him and discuss getting her the proper treatment.
If she is on an antidepressant called an SSRI or SNRI and taking Vicodin (Hydrocodone) or any other CNS central nervous system supressants she can pass out. It is not an overdose, it is a drug interaction.
SSRI and SNRI's are Zoloft, Prozac, Paxil, to name a few, SNRI - Effexor, Cymbalta, Pristiq.
Ultram taken at higher doses than prescribed with these can cause Serotonin syndrome which will cause you to pass out. If she says she has a shifting feeling in her head, with any of these drugs, it is definitely Serotonin Syndrome. When you move your eyes they seem to follow later, dry mouth, shifting brain, tired, disoriented somewhat. These are manditory in combination for it to be the syndrome.
I was on Effexor also when the psy. due to underlying depression
put me on Pristiq.
She admittedly neglected to tell me to discontinue the Effexor because they are similiar meds at similiar doses. Pristiq is simply better but together I was on an extremely high dose of SNRI for five days.
One night I got up to use the bathroom and passed out. I had to withstand Serotonin Syndrome and withdrawel from Effexor for a month of brain zaps, eyes vision not working, nausea, perceptual problems, paranoia in public etc.
She did not know what these symptoms were and told me to drink water. She is no longer my Dr.
Our family has had to endure such problems from 3 family members. My brother has overdosed from pain meds several times and been close to death. We have tried everything and we know he is in pain. He has had both lumbar and neck surgeries. What I have seen in these cases that not only do they have a predisposition to addiction(my brother a former drug addict) and a low level of tolerance for pain. Over the years he has been to rehab paid for by the family, and he loves pain clinics which he is currently in since they give them free access to almost any drug he wants including opiates. He has had seizures on many occasions as well as my nephew from taking too much pain killers. What we have also noticed is that they don't take the prescriptions as prescribed but forgets when he takes his medications and takes so much he has had several falls, been found passed out and not breathing and talks in a slurred or incoherent speech. Both have no concept of monitoring how much they take.
We have tried everything and it hasn't worked! What I do know from observing them is, the more medication they take, the MORE pain they have and both do better in everything when they take less medication because medication causes a rebound affect which produces more pain/addiction. Sorry to paint such a gloomy picture, I hope you are spared the many years of emotional and financial pain our family has gone thru to no avail. I do no this no amount of threat, pleading or assistance has helped.
It's not likely that her body simply shut down from years of pain med use. Often, when someone is taking high doses of very strong pain meds, it affects their memory. Unfortunately, short term memory loss is also one of the primary symptoms of fibromyalgia, so in her case, she's got a double whammy there. What probably happened is that she took her medication, and then simply forgot that she took it and took another dose. The fact that she is taking oral pain meds in addition to being on the morphine patch means that there's a good chance that her memory could be SEVERELY affected.
It might be time to look for another doctor for her. While fibromyalgia can be EXTREMELY painful at times, it sounds to me like the meds she is taking might be a serious case of pain med overkill. Several of my friends have fibro, as do I, and in addition I also have adhesive arachnoiditis, which is a lifelong, incurable inflammation of the covering of the spinal cord that causes the nerves in the spinal cord to fuse together into clumps. The pain associated with adhesive arachnoiditis is comparable to end stage cancer pain, and even I am not taking several different oral medications PLUS wearing a morphine patch! It really does sound to me like this poor woman is DANGEROUSLY overmedicated! I would get a list of her medications and call some pain management doctors and make an appointment for a consultation. Someone from the family should sit in on the consultation with her so that they can honestly tell the doctor what THEY see happening, in addition to her giving the doctor her own account. This way, if it IS a case of her being addicted and WANTING to take all these meds instead of being a naive, trusting patientn following the instructions of a doctor who simply likes to write prescriptions, the doctor will be able to hear both the point of view of the patient, PLUS the point of view of those who watch her go through her daily activities and can see how severely affected she is by the amount of medication she is being prescribed.
I am glad to hear that she will recover, but even though (my guess is) it was an accidental overdose this time, the next time, and there WILL be a next time if her short term memory is this bad, she might not be so luckky.
Try to relax and have a good holiday, and Monday morning when everyone goes back to work, call some other doctors and take her to whomever can see her the soonest. It's in her best interest to make sure she is safe being treated by her current doctor, because as I said, it sounds like an AWFUL lot of medication to treat fibromyalgia.
You are correct that as people become accustomed to their medications they build up a tolerance and need a higher dosage to get the same effect, but please don't confuse addiction with physical dependence. Every one of us who takes a narcotic pain medication has a physical dependence on it. Every one of us would undergo withdrawal symptoms if we were to just stop taking our medication cold turkey. Addiction, however, is characterized by FAR more than simply needing a higher dosage to get the same effect. If someone is taking a higher dose than necessary to control the pain because they no longer feel a buzz from their current dosage, THAT is addiction. If someone is going to different doctors for medication because just one doctor doesn't supply them with enough for their liking, THAT is addiction. But just because someone needs a higher dosage to control the pain because their body has become accustomed to the current dosage and no longer responds as well, that is simply a normal progression of the disease, a normal progression of opiate therapy, and is not addiction.
Thank you for taking my post in the way that it was intended, because after I posted it, I thought it might have sounded a bit "snippy", and if it did, I apologize. It was not intended in that way.
My reason for posting it was to clarify for the OP that it is sometimes difficult for family members of chronic pain patients to tell the difference between dependency and addiction, in fact, in my own experience, many of them don't know that there even IS a difference, which can make it miserable for the chronic pain patient.
I had a small family to begin with, but after I became ill, it got even smaller because except for one cousin, who is like the sister I never had, they ostracized me because I had become a "drug addict". I lost my home because of not being able to afford to pay the mortgage, but that was because I couldn't work, not because I was buying drugs with my money. They were all convinced that if I just "stopped taking those pills" my life would get back to normal and all would be well. I tried to explain to them what adhesive arachnoiditis is, and why it wasn't as simple as just "stopping the pills", and I was met with "yes, but don't you see? Making excuses for taking pills is typical of addictive behavior". It was hard enough for me to deal with the idea that some day my legs will stop working completely without also dealing with idiots who obviously had their own preconceived notions about what was going on and never bothering to do any research on my neurological disease, I decided that the only way I could deal with it and keep my sanity was to just forget about them and go on. My DH supports me 100%. He is there when I have bouts now of my legs not working, he picks me up and puts me in my wheelchair when I can't get there myself if I'm having a bad spell. I have friends who understand what the disease entails, and I have my neurologist, who is just the biggest comfort that anyone could have. Do I miss my family? Sometimes. Like on Christmas, it's depressing not having anyone other than DH, who is the original Grinch and hates Christmas, to spend the day with. But for the other 364 days of the year, it's worth not having to validate every action I make to them. It's worth it not to hear all their "advice", and having them just wave me off when I try to explain why that's not how it is, only to have them tell me "that's the addict in you saying that. If you would just stop taking the pills you would see." It I stopped taking the pills, I would lose what little mobility I still have, and would have nerve pain screaming through my body on top of that.
So, I said what I said because I wanted the OP to understand that while his relative MIGHT have a problem, not everyone who takes pain medication exhibits addictive behavior, and if this woman was taking too much, perhaps it was because her doctor prescribed too much for her, and she was just following doctor's orders. I just wanted to clear that up, because this is such a great place, and everyone is so supportive, I would never be snippy to anyone intentionally and wanted to make sure that was clear. :)
When someone is in consent pain and on high doses of medicine and probably did not start that way. After you take meds for pain, the more you will need them. I know where I live that going into a detox, they will detox you off the medicines and try a different route for her pain relief. She is addicted to the meds without a doubt. And will remain overdosing because she will always need more. There are other medicines for FB like Lypitor, and Cymbalta. These are drugs that really help. If she says they don't help. It could be the fact that they don't or the fact that she enjoys the narcotic ones better. I believe she will never get better until she starts over and gets off the narcotics. I thought FB comes and goes. Not stays a on going thing everyday and all day. I have it and it comes about every twoo weeks to a month. I do not take narcotics because I got to the point I liked them. I just couldn't stop. I got help and detoxed. If she doesn't want the help, there's really nothing anyone can do for her. I hope this helped even just a little. Please get back with me and let me know
I have had fibro for maybe six years, and the first two years, I had all kinds of problems, I didn't associate any of them with fibro. Two years in, it was clear I had it. I didn't know what it was, my doctor told me. I researched it, and I had all the classic symptoms. I was bedridden for a year with the all over body (and BONE) pain, nerve pain, swollen feet, SEVERE insomnia, not-restful sleep - I was always terribly fatigued, it took an act of God to get me up to wash dishes. I couldn't work, I couldn't hardly take care of my child - good thing he wasn't a little child. This is only part of what I went through. After a year or so, I finally saw a different doctor who put me on Neurontin, and after 2-3 weeks, I could tell a slight difference. Small, but I was excited about it. Two years later, my pain was gone!! I could tell it was going away. About April, I told my husband, if I keep getting better at this rate, I think I'll feel good enough to go back to work by Fall. Guess what? The last thing to go has been my sleep problems and daytime fatigue, but neither symptom are at the level it has been. It's much more nearer a normal range of functioning than before I got sick. I had to take pain meds, and I know they made a difference, in spite of what people say that narcotics do not help fibro patients. That's baloney. I fell into a severe despression - suicidal if it hadn't been for my son - and if I hadn't had medicine to keep me from an even deeper level of pain, I don't know if I could have bore it. I don't take the narcotics anymore. I don't need them. I do continue to take the neurontin - I want to cry when I say it was my life-saver. I discovered I had two levels of pain - one from the nerve pain (which was unlike anything I had ever known of before) and the other from an otherwise hurting back and so on, that was more muscle & joints. Back massages proved to be a Godsend. They offered better pain relief than the narcotics. I would cry and cry it would hurt so bad, and at the same time, beg my husband to keep doing it, because I knew I would feel so much better later. I was so desperate to not be in pain. I also think that everybody's experience with fibro is NOT the same. Some may need meds while others can do without. I don't think it's for any of us to judge another for their way of trying to fight the pain. We all understand the pain. The cycles of symptoms, the severity of pain, the points of pain are all different for each of us. Just because it's one way for you, doesn't mean it's that way for another. If we don't support each other on this, then who will? We have to stick together in certain places, so we all will get the medical treatment we need. And for awareness, so family members may not be so prone to judge us, but to support us. I don't know what I would have done if it hadn't been for my husband supporting us during this time, because I even tried to work, but I think both employers saw how I struggled, and they just quit calling me in. I was too sick. I would not have had anybody. I don't know what would've came of me and my son. I might relapse at some point, but I'm apparently not a "fast-cycler" of fibro symptoms, because I feel like it's almost in complete remission. I wouldn't doubt it comes back (nothing surprises me at this point) so I'm not taking this for granted. Everyday is a gift. Just wanted to share a little of my experience. I'm very very lucky to feel this well after suffering what all I have, especially the last 3 yrs or so.
Wanted to add, when I said "support us", I meant moral support, not just financial support. I noticed I went straight into talking about my husband actually working to support us, but that wasn't exactly what I meant when I first used the word, lol.
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