Detox Unit Stigma

[RASCOLIVICTIM]

Hi folks I have a question for my wifes sister if its OK to ask it here. If not please just ignore it and I apologuze. She has been taking Halcion for sleep, Zanax (for help to cope I guess, not really sure), and recently got put on Lyrica due to an outbreak of shingles. She is a transplant patient and has had a rough life for the last 20 years. Well her transplant doc has been giving her the meds and on her last visit told her that he and the other docs in the group decided to stop prescribing anything not directly related to the transplant. In other words only anti rejection meds. He told her to check into a unit and get off the meds except the anti rejection meds. Before she saw him (last week by the way) she had made up her mind to get off all of it anyway. She had already stopped the pain med she had been on for quite a while before she saw him and that shows she is serious about it. The likely reason for the shingles is an ortho gave her 3 steroid shots in a 2-3  month time period for very severe pain as her "hamstring" was torn loose in her pelvic area. She was seeing him to find out what was causing such severe pain in her pelvic area and the orthoquakologist gave her the steroid shots and actually told her to walk it off. Her PCP gave up on the ortho finding the cause and ordered an MRI and viola' no wonder you hurtin so bad. I am bad about rambling and I am sorry if its a nuisance to you. She has enough meds to taper and get off everything within about a 6 week period and wants to do it that way.BUT her supportive husband wants her to check in for a 5 day detox. Anyhow can anyone tell me if she will get red flagged and labeled as an addict or abuser if she goes to the unit. If she does my wife (her sister) is afraid she will have a hard time ever getting pain meds or sleep meds for now on. Transplant patients have a LOT of trouble sleeping due to the anti rejection meds. She is also afraid the treatment will fire up shingles again as stress can bring it on.
Thanks for any advice you can give in advance!!

[RASCOLIVICTIM]

You are exactly correct Tuckamore. All she is guilty of is taking meds her transplant doc prescribed. And actually a little less than prescribed. Of course he prescribed for complaints she came in with. More later gotta share;
Got some great news! Today she went to a nurse practitioner she sees occasionally for "small" problems. She highly reccomended the pyscharitist (tore that word up!!) We found out about for her. And she is going to prescribe the meds she needs to stay at her reduced level she is at nowto cover her until she sees him in two weeks! My wife is sooooo relieved and de-stressed, which in turn de-stressed me! He has an excellent reputation for helping folks taking anti depressants. She also said he has helped a lot of folks in our area. It usually takes 3-4 months to get in so he must have had a cancellation. A Great Big Thank You  to ya'll for your comments they are greatly appreciated.

[Tuckamore]

Yes it is a low dose. Hopefully the NP can help her - they usually work under a physician that can guide them both.

Again I suggest she not go to detox - unless I'm missing something I just don't see the need - or rationale.

My Best,
~Tuck

[RASCOLIVICTIM]

OOPS Typos
Gosh I should have proofread that!
Again;
If shes not up to it she will get her to make an apt. with --etc
i am using a phone to post and it shows!
Thanks again

[RASCOLIVICTIM]

You are right its a pretty loww dose. I dint know why her specialist did her the way he did. He gave her a prescription for pain meds the same day. She has not even taken one of them.She is keeping them in case she needs them as she can not take any NSAID at all.She is going to a nurse practitioner tomorrow and uf she isn't up to it she is goubg ti ger her ti nake an aot. With a highly reccomended pscyhcaritist (spelled atroshishly ha). Thanks a lot for your input..

[philnoir]

At such a small dose, how could one call this an addiction?

Addiction is a psychological condition, defined by specific aberrant behaviors like obsession, drug seeking, idealization, and abuse. Addiction leads to quality of life deterioration, functional deterioration, loss of work, alienation, and other psych-social problems.

Taking .25 mg of alprazolam as prescribed TID is a minimum maintenance dose.

While no trained doctor would recommend stopping benzodiazepenes without a weaning plan, your sister is at such a low dose that weaning would be simple.

Why put her through any stigma of addictionology when the weaning could be performed by any competent PCP?

[RASCOLIVICTIM]

Thank you so VERY much for your post. She was only taking one and a half .25 mg a day of zanax. A half in the morn and a whole at night. She is going to get in with a new doc as soon as she can for help on it. She dont realize it but she will probably need to stay on an antidepressant simply because the anti rehection meds are really goin to mess with her.
Thank you again!

[Tuckamore]

All questions are welcome here - an so are all ppl. We may not be able to help or offer the best suggestions but we always try.

First of all here's a link to our Substance Abuse Forum: http://www.medhelp.org/forums/Addiction-Substance-Abuse/show/77

No I am not suggesting she has a problem with addiction. You were very clear in your description. My heart goes out to your poor sister-in-law and all she is facing. It must be very challenging at best. Back to the Addiction Forum - they are the experts in the arena of detox - and will offer more suggestions. Sarah is a wonderful source of information and is the CL there - but they are all good. A large wonderful group.

Now for my comment. I do believe if she goes into detox she may very well be labeled as an addict - and have difficultly obtaining opiates and other  Schedule II and III medications.

There are medications that can help her through withdrawals that her current physicians may be willing to prescribe. Chat with them about that. She'll need to eat healthy, get plenty of exercise and well hydrated. If she has a favorite hobby that may help as distraction is also important. I'm afraid she's in for a bumpy ride.

Xanax (Alprazolam) trade name Xanax is in the class of benzodiazepine. It has some nasty w/d sx the most important is seizure. However in a controlled discontinuation study of panic disorder patients, the duration of treatment (3 months compared to 6 months) had no effect on the ability of patients to taper to zero dose. In contrast, patients treated with doses of XANAX greater than 4 mg/day had more difficulty tapering to zero dose than those treated with less than 4 mg/day.

Helicon is a also a benzodiazepine - it too can have severe 'withdrawal' effects when stopped. Such effects can occur after discontinuing these drugs following use for only a week or two, but may be more common and more severe after longer periods of continuous use. One type of withdrawal phenomenon is the occurrence of what is known as 'rebound insomnia'. That is, on the first few nights after the drug is stopped, insomnia is actually worse than before the sleeping pill was given. Other withdrawal phenomena following abrupt stopping of benzodiazepine sleeping pills range from mild unpleasant feelings to a major withdrawal syndrome which may include abdominal and muscle cramps, vomiting, sweating, tremor, and rarely, convulsions.

Withdrawing from two benzodiazepines may be hazardous and she should have a serious discussion with her physicians. A PMP may be of help. I hope she'll also consider a consult with a good PMP. She needs to be safe.

She's also correct that this stress may flare her Shingles. She's going to require some good support during this time, both medically and emotionally. This should not be a do-it-yourself plan,

Please let us know how she is doing. I'll look forward to your updates - and as always, best of luck to you and your SIL..

Peace,
~Tuck