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Need help getting elderly Mom off Vicodin
Mom is close to 84, widowed for 2 1/2 years and addicted to vicodin. Her lovely doctor gave her Vicodin for many (>5?) years, for arthritis and other misc. pains.
She was out of control and would take 2 750s at a time, going through her monthly prescription in less than 2 weeks. She started taking Ambien mid-day so she could sleep through her cravings, but she denies that was why.
Now NONE of her doctors will give her any Rxs for pain any more -- probably because of her obvious addiction, but it does not seem that any of them had the nerve to explain that to her. I live in another state and am now caring for her in her home post-back surgery. Her back surgeon gave her only 20 to get her through post-surgery but made it very clear he would not prescribe them again. She took her last one today, only getting 2 or 3 a day, although she would have been through them in only a few days if I did not control the bottle. She becomes very argumentative when I tell her she can't have more. What do I do to help her through her withdrawal?
She insists only vicodin will do - all OTC pain relievers are worthless according to her. I've been painfully honest with her, explaining that vicodin does more to control her brain than to control her pain, but she won't hear of it. Her doctors have left me with an 84 year old addict going through withdrawal that doesn't even believe she is addicted.
Any advice?
She was out of control and would take 2 750s at a time, going through her monthly prescription in less than 2 weeks. She started taking Ambien mid-day so she could sleep through her cravings, but she denies that was why.
Now NONE of her doctors will give her any Rxs for pain any more -- probably because of her obvious addiction, but it does not seem that any of them had the nerve to explain that to her. I live in another state and am now caring for her in her home post-back surgery. Her back surgeon gave her only 20 to get her through post-surgery but made it very clear he would not prescribe them again. She took her last one today, only getting 2 or 3 a day, although she would have been through them in only a few days if I did not control the bottle. She becomes very argumentative when I tell her she can't have more. What do I do to help her through her withdrawal?
She insists only vicodin will do - all OTC pain relievers are worthless according to her. I've been painfully honest with her, explaining that vicodin does more to control her brain than to control her pain, but she won't hear of it. Her doctors have left me with an 84 year old addict going through withdrawal that doesn't even believe she is addicted.
Any advice?
Hi--
This is tough but I can relate. I don't think 20 pills is enough for post op pain even if she weren't addicted! Did the doctors only tell HER no more? Have you spoken with the surgeon? Maybe if he knows that you're there he'll feel more comfortable. At age 84 she shouldn't have to be in pain. On the other hand, if she takes too much she'll respiratory arrest! That's mostly what the docs are worried about.
If this were me,and it has been,I'd call and have a talk with the surgeon.
Good luck`
This is tough but I can relate. I don't think 20 pills is enough for post op pain even if she weren't addicted! Did the doctors only tell HER no more? Have you spoken with the surgeon? Maybe if he knows that you're there he'll feel more comfortable. At age 84 she shouldn't have to be in pain. On the other hand, if she takes too much she'll respiratory arrest! That's mostly what the docs are worried about.
If this were me,and it has been,I'd call and have a talk with the surgeon.
Good luck`
Honestly, I think its absolutely wrong that a 84 year old women should have to go through withdrawals, you need to get back in touch with her doctors, all of them, explain that you understand that your mom has a problem, and you will be there to limit her meds from now on, at the very least they should be able to put her on a slow taper off the medication! Now that she has taken her last one... its going to be horrible withdrawals, and withdrawals can make a younger healthy person very sick, they can even cause seizures! Be very clear that you will have control of the meds until she is off them completely! that is ridiculous. If no doctor agree's the only thing I can suggest is do a lot of research, try posting in the addiction forum, there are tones of people there that have been through getting off meds, they have will have great advice to help her be more comfortable. Good luck, and all the best!
Thank you so much for your quick and kind advice. I will call her surgeon and ask for a small amount to have on hand, but she has not had one in 2 days now and just told her physical therapist that her pain level is now only a 2. Maybe her addiction was not as severe as I thought, since she seems to have handled it better than I had expected based on her initial behavior over the past 2 weeks. Reason why she could not get any from doctors herself is that she had been referred to Pain Management, who gave her something other than Vicodin (not sure what it was since she had denied receiving anything from them for pain) and then she broke their protocol by getting (and taking) Vicodin from another doctor - not related to her back problem - so the Pain Mgt people said they would not give her another pain Rx. She is doing better and I will talk to surgeon for a back up supply. Thanks so much and have a Happy New Year!
R u sure that she is still also not in pain? Check her comfort level using the 1-10 scale. At 84 years old and with all those surgeries under her belt, I don't see the point in her having to suffer the rest of her life either. Would it be possible to take her to a good pain management Doctor who could control her discomfort? Could it be that she is forgetting when she took her last medication? Maybe she should keep a chart? Write it down when she took her last dose? Is she afraid of the pain? This could be a good talk to have with her Doc, if her pain is not being controlled it may look like addiction but really she may be suffering as her body has taken quite a few hits and may not be recovering as fast as a young persons would. Good luck! You sound like a really caring daughter to take so much time off to care for your Mom and I know you will do what's right by her:)
Inga
Inga
I'm glade to hear your mom is doing better, hope she continues to do so. You are doing all the right things, and I hope your right, about your moms addiction not being as bad as you thought. She will however need to keep seeing some sort of doctor, as I'm sure being 84 she will always have pain. they are a lot of other ways to control pain than narcotics, I know you mentioned physical therapy which is great, but look into other options as well. I wish you and your mom all the best! Happy new year!
Your Mom is lucky to have such a caring daughter to care for her. I am sure she appreciates all you do for her.
Please understand that chronic pain is very difficult for someone who does not have to deal with it to fully understand how it effects the mind and body. It is really ridiculous that after a major back surgery she was only prescribed 20 pills. That is just not right at all. Have you spoken to your Mom in depth about the medication. Dependence is totally different than addiction. For her to depend on her medicine to control pain is not having an addiction problem. Too many times Doctors gets this point confused. Also if she has been taking the same drug and dose for a long period of time she has built up a tolerance and needs more to control her pain.
I highly suggest that you find her a new PMP and get her pain under control. There are medications such as time release that may benefit her better than the short acting medications such as vicodin.
Please understand that chronic pain is very difficult for someone who does not have to deal with it to fully understand how it effects the mind and body. It is really ridiculous that after a major back surgery she was only prescribed 20 pills. That is just not right at all. Have you spoken to your Mom in depth about the medication. Dependence is totally different than addiction. For her to depend on her medicine to control pain is not having an addiction problem. Too many times Doctors gets this point confused. Also if she has been taking the same drug and dose for a long period of time she has built up a tolerance and needs more to control her pain.
I highly suggest that you find her a new PMP and get her pain under control. There are medications such as time release that may benefit her better than the short acting medications such as vicodin.
Thanks to all of you for your comments, which I do take to heart. I am taking Mom to Arizona with me next week, to recuperate and avoid the Michigan winter. My sister gave me a few of her Vicodin (they have the same GP) on the sly, which I will offer conservatively to Mom during our travel. I will definitely look into a Pain Mgt. Clinic in Phoenix area, and sit in on her appointments to make sure the doctor listens to her and that she understands what he/she says. I don't doubt for a moment that she still has pain - she has taken Celobrex for years for arthritis and apparently that was never enough thus the dr. gave her vicodin freely for many years. She also suffers from depression, especially since the loss of my Dad to cancer. I will make sure she gets the right attention, which may be a combination of pain management and counseling.'
You have a really rough road ahead of you. I went through something similar with my mother only without the addiction troubles. It's extremely important that you are with your mom at all of her doctor appointments. HIPPA laws being what they are, doctors can't give you any information or say-so in her treatment unless you are present and even better, have a signed release from your mom. As you get her set up with new doctors in Arizona, make sure she puts your name down as the person to release medication information to.
This is also a good time to look through your mom's legal paperwork. If she hasn't signed a general power of attorney, medical power of attorney and formed a will, now is the time to do it. The general POA is really important. That allows you to basically "become" your mother for things like banking and business transactions if she is unable to do so herself. If the time comes that you must put her into assisted living or a nursing home against her will, the general POA gives you the legal right to do so.
There are two options with these POAs are concerned. One is to make it effective immediately. That means if your Mom needs some banking done or say, dealings with Social Security, you can act on her behalf. That's a whole lot of power to be entrusted with, which is why it's so important to appoint someone you trust - literally, with your life.
The second POA option is more troublesome. It boils down to needing a doctor's written statement or court order that your mom cannot make rational decisions for herself. Only then can you invoke your power of attorney. That's the option my mom selected and the POA was worthless. No matter how bad her dementia got and how badly she managed her life and health - to the point of death - I could do nothing other than watch her die. In order to place her in a facility to get the care she needed, I would have had to sue my mother for a conservatorship. She could pull it together just enough in front of doctors and social workers to make that option an impossibility.
It boils down to a matter of civil rights. We all have the right to make our own decisions for good or ill. Making poor choices isn't against the law. The courts take a very dim view of rescinding those rights in all but the most obvious cases - with good reason.
This is also a good time to look through your mom's legal paperwork. If she hasn't signed a general power of attorney, medical power of attorney and formed a will, now is the time to do it. The general POA is really important. That allows you to basically "become" your mother for things like banking and business transactions if she is unable to do so herself. If the time comes that you must put her into assisted living or a nursing home against her will, the general POA gives you the legal right to do so.
There are two options with these POAs are concerned. One is to make it effective immediately. That means if your Mom needs some banking done or say, dealings with Social Security, you can act on her behalf. That's a whole lot of power to be entrusted with, which is why it's so important to appoint someone you trust - literally, with your life.
The second POA option is more troublesome. It boils down to needing a doctor's written statement or court order that your mom cannot make rational decisions for herself. Only then can you invoke your power of attorney. That's the option my mom selected and the POA was worthless. No matter how bad her dementia got and how badly she managed her life and health - to the point of death - I could do nothing other than watch her die. In order to place her in a facility to get the care she needed, I would have had to sue my mother for a conservatorship. She could pull it together just enough in front of doctors and social workers to make that option an impossibility.
It boils down to a matter of civil rights. We all have the right to make our own decisions for good or ill. Making poor choices isn't against the law. The courts take a very dim view of rescinding those rights in all but the most obvious cases - with good reason.
My mother is 89 years old and at her age has a lot of issues. Back pain, sciatica, she diabetic. And there are nights when she can't sleep and she hates over-the-counter sleep aides. So, for a number of years has be taking a sip of brandy to help her sleep. Well, a few weeks ago she fall during the night when she got up and hit her head,she's fine now and back home. When she went to the hospital they claim she high alcohol content. We were limiting how much brandy she could have by leaving a very small bottle to keep in the house but had now removed all alcohol because she might abuse it again and take another fall. Last night she was very nervous and I caught her walking around at 1:00 a.m.in the dark and that is scary because she could fall again. Is there anything she could take before bed that would help her to be less nervous and avoid what she calls the "heebeejeeebees?" Any suggestions would be appreciated. Thank you.
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