Worried about daughter doing at home detox

[mariedc]

I am concerned about my 20 year old daughter who has been withdrawing from heroin the last four days. In short, I am worried that her mindset is not there for giving this up for real.  

I have visited her everyday, brought her chicken noodle soup, made sure she is taking her vitamins and anti-seizure meds, and making sure she has plenty of Gatorade.  I offered to stay with her but she refused. She had a girlfriend stay with her the night of day two, and her boyfriend has been around.  She is so far managing--she has Klonipin and  Ativan from her psychiatrist (for her anxiety problem) and had a quarter of a suboxoone pill on Friday, but she misplaced the pills she got from a friend and hasn't had anymore.

She has done heroin off and on for about two years.  A year ago she went to rehab and got kicked out after a week for having an anxiety attack they couldn't handle.  She was clean for six months then relapsed, suffering an overdose.  Her heart rate was 10 beats a minute when the EMTs got to her.  She was off for a month, used sporadically for two months and was clean for three months.  She called me last Wednesday to say she had been using once or twice a day for the last eleven days and needed help.  I got her in for an assessment at an outpatient rehab the next day and she gave me her drug supplies--there were nineteen used needles.  I offered to put her into medical detox but she refused because she didn't want to be away from home.  She will go for individual therapy Monday, then see their psychiatrist and do her first group on Tuesday.

I am worried because she is wallowing in her room smoking cigarettes and watching DVDs.  I can't convince her to go outside for a walk and get fresh air.  She has not bathed for days though I bought her lots of Epsom salts.  She has gone to NA off and on for a year and half.  She went Friday night and people there told her she'd be miserable for days two to six and she seems determined to fulfill that.  I told her I read days two and three (which she has finished) are the worst, and she might not be too bad after that as she had not been using long, particularly if she goes for walk a couple of times a day and takes hot baths as recommended.  

At the same time she is complaining that her psychiatrist won't giver her Xanax and the klonipin and ativan aren't working.  (I am not a fan of all the psych drugs she's been given.) She refuses to believe that if she continues taking these she might get a benzo addiction, which is very difficult to kick. She is already saying that she doesn't think she can take three hours of group therapy because it will make her too anxious.  I reminded her that our deal was that if she couldn't make outpatient work, she'd have to go inpatient.  She was upset I brought this up, and started angling for just individual therapy.  

I have been really supportive but my patience is wearing thin as it doesn't look she is really ready to take on the hard work of true recovery.  I understand withdrawal is very difficult and it's still a bit early; am I judging the situation too harshly?

[Pat1956100]

Oh wow, you have been through a lot but it sounds like there is a light at the end of the tunnel.
I hope it all works out Marie.

[mariedc]

Update.

I was right to be worried--she used the night I posted this (Sunday).  However, she did tell me.  She missed the psychiatrist appointment at her outpatient rehab on Tuesday because she had a bad seizure (wallowing in withdrawal I guess means you get a pass from taking your anti-epilepsy medication).  

She called me at work and I could tell she was in distress but she was speaking gibberish.  I rushed to her apartment and got here 10 to 15 minutes later and  found her convulsing on the floor.  I called the ambulance because 1) the seizure could have been ongoing since the call and you are supposed to call if a seizure is over five minutes, 2) earlier in the day she told me she had taken ambien, elavil, a Xyprexa strip, and two ativan late the night before to sleep I wasn't sure what that could have been doing, and 3) I didn't know if heroin was in the mix.

It was apparently an extremely busy day with medical emergencies.  The EMTs took her down into the ambulance and her vital signs were okay and they were thinking of taking her back to her apartment rather than taking her to the hospital though she was still unconscious.  We have a number in our area and some were refusing patients because they were full up.  Then the EMT shone a light in her eyes.  Her pupils were not pinpoint but they didn't react to light.  So they had to call it in and he was muttering that they probably should give her Narcan, but that would be up to the hospital as her other vital signs were okay so they really couldn't dx an overdose.  

At the hospital she was put in a gurney in the corridor.  A peppy older doctor ordered a CT scan.  An ophthalmology resident came down and examined her eyes.  She was put on IV fluids and they gave her IV Toradol (esssentially very strong motrin) for pain and IV Zofran for nausea.  How cool is that for withdrawal residual?  I took her home much perkier and she ate a good dinner.  The next day she didn't remember any of it, amnesia being a hallmark of epileptic events.

Last night she had a negative drug test--so very likely she hadn't done heroin on Tuesday and the nonreactive pupils were from the seizure.  I am going on a long business trip a week from now and she asked to go along (she has always refused in the past).  She said she's like to get away for a while as it was just too easy for her to get drugs.  She's been out of ambien and klonipin for several days now but is still hanging on.  She'll see the outpatient psychiatrist this Tuesday and I am hoping she'll accept to do naltrexone (no suboxone at this facility).

Thanks for all the support earlier.

[Sthdown]

FORCE THE EPSOM SALTS ON HER IN A WARM TO HOT BATH! It helps tremendously!!!!

[Sthdown]

I'm not a fan of all of those drugs being mixed together. If she has an RX for those MEDS. Give the Xanax to her on a 4 hour interval. This is comming from experience. Onces u hit withdrawal. U feel as if nothing is working when in fact it really is. All u can do is run her a not Epsom. Bath. It will make her so relaxed she won't be abke to walk to her own room. So u wil have to GUIs her and maybe carry. Her. But it WILL reliefe some of the pain involved. Her joins are killing her at this pint and her teeth will be coming ber very soon. Its best for he to sleep as much as she can but the last 3 days of detox. Which takes a little over a week im some cases. TAKE AWAY HER PHONe and keys! Otherwise she WILL find a fix right under ure nose. So be careful. Remeber Epsom salt,hot water, sleep. It helps with a lot of the pain. Don't completely take way the Xanax right now too. That will come later once she is off the heroin for about 4 weeks. Then gradually ween her off of that too. Remember i went thought almost the EXACT SAME EXPERIENCE. I fought and clawed atthe friend who saw me through this terrible time but it was worth it in the end. i am now on a med that works very well for my pain thanks to an understanding doctor. ( i have dibilitating pain in my lumbar area that shoot lightening bolts down my leg)  but once i got off the Oxymorphone thanks to my friend tony and lots of him fighting me to take those baths. After i cleaned up about 8-9 days later. He forced me to work out so my muscles wouldn't deteriorate anymore than they already have, i HATED HIM through the whole entire process. But my i am thank full got everything tony did for me. I guarantee it will be the same for you :)

[Pat1956100]

Well I see her as a 20 year old with more problems than she can handle on her own.  Will you be able to talk with her psychiatrist tomorrow?  
I also wonder if she really misplaced the suboxone.  Addicts don't misplace their drugs.  We check them 5 times to make sure they're still there.
This is a tough one because of the anxiety and her other problems.  I can see why it would be so hard for you to just walk away.  You can't let her walk all over you though and if she doesn't want to bathe or go for walks, don't worry about it.  
Please let us know how she makes out tomorrow.  

[mariedc]

She does have anxiety and sees the psychiatrist for this.  I can't see any progress beyond prescribing benzos and I wonder how much they are helping because she is still having anxiety.  All I can see is another potential addiction. She has been put on a variety of SSRIs and none has helped.  The new psychiatrist was convinced it was because she had npt been on them long enough or at a high enough dose but finally gave up and conceded she was not responsive to SSRIs.  She can have over the top anxiety attacks where she pulls her hair, hits herself, gets paranoid and hallucinates.  One time she tried to jump out of a second story window.  Still, I managed to handle these without calling 911--the rehab couldn't, not too impressive. The benzos have eliminated the severe attacks, I will give them that.  I am thinking she needs really intensive therapy for the anxiety but the psychiatrist hasn't pushed this as far as I know.

[Pat1956100]

Does she really have anxiety issues?  You said she got kicked out of rehab because of an anxiety attack they couldn't handle.  
It sounds like her anxiety really needs to be looked at right away because it's stopping her from doing so many things that will help her stay clean.
If her anxiety is real, it should be dealt with by a professional.

[vicki595]

How frustrating...I sure understand your dilemma here...One week to get it together sounds fair and I agree about the Xanax. None for her...

Get some rest and stay close. Good Night-

[mariedc]

About the Xanax--she was prescribed that initially last year but I found she was selling them to get cash so she was switched to klonipin.  She only started complaining about them being ineffective when she took up heroin recently.  I don't know much about these drugs but I understand Xanax gives a high that is hard to get from klonipin or ativan.  My first thought on her wanting to be back on Xanax is that it's because it has higher street value.  Apparently the psychiatrist won't give her Xanax now because I reported suspicions that she was selling it.  

I will se how her first week at inpatient goes--if she doesn't make appointments and therapy she'll have to go inpatient.

Much thanks for all the support.

[mariedc]

After I posted, I saw additional comments.  I started going to Naranon about two months ago and it's been helpful.  A sort of sign of progress is that I stopped searching her room for needles, so I didn't discover her drug use as in the past.  Rather, she came to me reporting use and asking for help.

I wish she would do more on her own but there are limitations.  She can't drive because of seizures so I have to take her to doctor appointments.  She is unable to work or go to school owing to chronic pain and other health issues that haven't been properly diagnosed mostly because there are suspicions they may be psychogenic. So she doesn't get serious attention from doctors and if the problems are psychogenic she's not getting appropriate psych care.  So frustrating to have a drug like heroin in the mix on top of everything.

[vicki595]

No you don't have to go with what you agreed to! When you know it's not going to work you're just allowing yourself to be manipulated into keeping a promise or agreement that's so wrong...It looks to me as though she's stalling to avoid the inevitable.

The benzos are huge here. She's already taking two different ones but prefers Xanax. The others don't work? Do you believe that?  She really needs in patient treatment and you, my friend, need support. I hope we can provide a little of what you need to keep strong.  Let us know-

[mariedc]

Thanks for your replies.  I really do want this to work, but know I have to hold back as it is her recovery not mine.  I went to the outpatient program two months ago in preparation for this eventuality.  After I described her situation they thought inpatient would be a better choice, but said she could come when the time came--they've had other patients they have talked into inpatient.  She has refused inpatient on the grounds it would cause too much anxiety and unfortunately the bad experience at the rehab a year ago supports her case.  So the compromise was try outpatient first and if that doesn't work, she'd have to go inpatient.

She has a number of health problems, as well as psychiatric issues and has got into a mindset where a pill is the solution to whatever ails her.  
I am frustrated she won't give other approaches a fair chance for her health problems (including chronic pain--a big trigger for drug use) and psych issues. She's avoided real therapy saying it's fine to go to the psych once a week--she makes it to the appointments only because the anti-anxiety meds are doled out 7 days at a time.

I know none of this is right, but realize I just have to go with what we agreed even though I already see it not working.  It's a struggle to stay positive but I'll try--one gets so tired of this..

[Livenbfree]

I am sure your heart is broken seeing your daughters life so out of control and it is so very kind of you standing by her, but this is all up to your daughter weather or not she stops taking drugs she does need all the help she can get. My mother had 3 of her children as heroin addicts one has HIV one is still using at 56 years old, it's so very hard as a parent not to enable our loved ones, if you can find a Noranon meeting it may help you understand what you can do to get through this rough time.  It was a challenge but I over came my addictions to drugs and now live a good live as a mother and wife! I wish you the best but get as much help for yourself as well

[atthebeach]

Hello and welcome. Mom ,you are making sure she is taking her vitamins, you got her all the supplies, you called outpatient, you offered to put her in detox.
She has to do things for herself. It is her recovery. I know it is natural as a mom to want to "help" her, but she needs to help herself.
She almost died and then she went out again. Already talking herself into a anxiety attack at group.
I know this sounds harsh but please step back and let her figure it out herself.
You can't make everything right for her. We can't love them enough to make them clean.
She needs to face the consequences of her actions, you have to detach with love. Have you been to nar-anon or al-anon?
Let go and let GOD.
There is always hope,
Keep the faith
Sending prayers,

[OxyTired]

Tough position you are in and you are really trying to support her.

The lying around watching DVDs is ok, but I get the sense she is marking time until she can get some Xanax. Kind of "I won't do this without it."
Trading one pill addiction for another is not making progress.

No matter how much you love her and support her, she needs to really be done with pills to succeed. That's up to her. In the mean time when she is detoxing her emotions with be all over the place and her logic won't make sense to you. If you have some boundaries set, stick to them, trust yourself and your own judgement.

When I was detoxing, my RN wife was very kind, patient, and understanding-and took no guff or bs from me.

Keep coming back for support, my drug was oxycodone. Others with direct experience with heroin. Good luck and bless you.

[ActingBrandNew]

"am I judging the situation too harshly?"

No...not at all. Look, Im an ex heroin Iv user. Today is my 4 years clean. Your going to have to let your daughter fall flat on her face...on her own, in order to get clean. Im not saying she wont do it at your house...but I doubt it. But maybe Im a pessimist. From what you wrote though...about all the "comfort" meds, etc...I get the feeling that your daughter isnt really ready. Im thinking that an in patient program is the best. Just my opinion though. Just make sure your taking care of YOU. Really!  I know you want to be there for your daughter but you have to let her experience her bottom. Once she does that...all she can do is rise.