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Addiction: Living with an Addict Community
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IS HE ADDICTED?

My husband takes a Focalin prescription, 3 X 15 MG pills, 3 times a day.  I just recently found out what this is costing us since my insurance will not cover it...basically at least $1400 per month if not more!  This on top of the $1000 per month in health insurance I pay.  He has had is truck repo'ed, has lost his checking account, has lost customers and is in debt for taxes and other things, all the while telling me that it was due to overhead costs, etc, for business.   Obviuosly it is his med expense that is the cause of this, yet he says nothing else works and he has to have it,  perfectly willing  to accept that we are now in a state of extreme hardship so that he can get his meds.  He even borrows money from others, saying that he needs it  for work supplies when it truth he is buying his meds with it., getting us into an even bigger hole.  I say he has an addiction...he says it is necessary for him to take it in order for him to work every day.  What do you think? HELP!
2 Responses
185545 tn?1331078466
Wow! $2400 for prescription and insurance cover per month is an exhorbitant sum. That would stretch the budget of many families. Im not suprised he had his truck repossessed. Its obviously become a tremendous personal and financial burden for you both. The behaviour  you describe has all the hallmarks of addiction but it would be imprudent and improper of me (or anyone else) to diagnose anyone addictions from the information you've provided let alone someone I have never even meant. .

However, I have posted the questinaire from the soon to be published DSM V,  a long anticipitated update on the DSM IV(Diagnostic and Statistical Manual of Mental Disorders IV). The following questoinaire is used as a preliminary diagnostic tool meant to help physicians/medical professionals identify addiction.  As his spouse, you may be able to answer many of the questions on his behalf and possibly draw your own conclusions with regards to his substance use/abuse?

BTW, they  (the American Psychological Association) dont like to use terms like addictiction and dependance. The DSM V now sees them as two sides of the same coin or opposite ends of the same spectrum. They used to have separate diagnoses for someone who abused drugs versus someone who uses them as prescribed but becomes dependant. The difference between the 2 is now decided by a severity scale. High scores indicate addiction/abuse. Low scores indicate dependence.

Substance Use Disorder

A.  A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by 2 (or more) of the following, occurring within a 12-month period:
1.recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household)
2.recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
3.continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)
4.tolerance, as defined by either of the following:

a.   a need for markedly increased amounts of the substance to achieve intoxication or desired effect

b.   markedly diminished effect with continued use of the same amount of the substance
(Note: Tolerance is not counted for those taking medications under medical supervision such as analgesics, antidepressants, ant-anxiety medications or beta-blockers.)
5.withdrawal, as manifested by either of the following:

a.   the characteristic withdrawal syndrome for the substance (refer to Criteria A and B of the criteria sets for Withdrawal from the specific substances)

b.   the same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms
(Note: Withdrawal is not counted for those taking medications under medical supervision such as analgesics, antidepressants, anti-anxiety medications or beta-blockers.)
6.the substance is often taken in larger amounts or over a longer period than was intended
7.there is a persistent desire or unsuccessful efforts to cut down or control substance use
8.a great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects
9.important social, occupational, or recreational activities are given up or reduced because of substance use
10.the substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance
11.Craving or a strong desire or urge to use a specific substance.
  
Severity specifiers:

Moderate: 2-3 criteria positive

Severe: 4 or more criteria positive

http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=431

All the best for you both.
Kind regards Jeremy. Recovered Ex-Addict
82861 tn?1333457511
Whether he is technically an addict or is kind of a peripheral question, although lying about why he needs money is a red flag.  The problem is that his use of this medication is causing both of you severe financial, mental and marital problems.  

For casual readers here, Focalin is basically speed prescribed for ADHD and is highly subject to abuse, which is why it's a schedule II scrip.  It's available in both extended and immediate release formulas and apparently the IR forumula does have a generic equavalent. According to RXlist, the highest dose pill is 10 mg.  If you check the focalinER web page, they do have discount coupons available.

Since he refuses to consider changing meds in spite of all the negative consequences (another big red addiction flag) and considering that you're married, you have some legal issues that you would probably need to talk to an attorney about.  Because laws can vary state to state, you may be able to at least protect some of your money from him while he's so casually blowing it while under the influence of a mind-altering substance.

I also encourage you to try a few Al-Anon meetings.  You don't have to say anything unless you want to and you'll learn the truth about addiction - what it is and what it isn't - and how to more effectively deal with an addict.  It takes work to live with a substance abuser.  Al-Anon can teach you some skills to make that work easier.  :-)
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