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Right when I think I've made good progress with acceptance, coping, etc something ELSE comes along and I don't know how to deal and just want to scream.


Since late 2014 my mom has been taking opiate pain meds. It started out legit with a major shoulder surgery, but after that healed other pain ailments started popping up, mostly back pain. I didn't see her as often then and she always downplayed her use. As the years went by I noticed she always had a script.


Eventually an MRI of her entire back was done & it showed nothing to warrant chronic pain let alone pain that required daily opiates. So that doctor stopped prescribing and referred her to a pain management place.


I know she got pills from them but also injections that "never worked" & the scripts continued. Still the whole time she minimized her use saying she only took them "once in a while" when she was "really in pain".


Then she moved here.


Found a PC right away & he would not prescribe opiates & told her she would have to go to pain management. So she went to a "wellness" clinic of some sort, basically where people go to get pain pills. She had to sign a "pain contract" that she could only get pain meds from them.


By this time I'm paying closer attention & even mentioned it on this board before. Again, she played the game & got pills and injections but the injections never worked. She would never let me go to those pain appointments & keeps me totally out of it. So I started to count her pills. I was able to determine she was taking between 1-3 a day, depending on her supply. This whole time she lied to me when I would casually ask if she had needed any pain meds lately... "Oh no, only every once in a while". Meanwhile I'm counting the pills and know that's a lie.


Talked to my sister & husband about it. Mostly my husband because my sister is out of state & likes to keep this situation at arms length & always has. We decided not to confront her because the use didn't seem excessive. My impression was that she used the pills to kind of regulate her mood. I was also afraid that if I confronted her & told her I counted her pills she would hide them & make sure I couldn't do it again as her defensiveness around me has gotten worse with time.


When she left for PA she left with 150 pills. My guess is she told the pain doctor she would need them for several months, but what happened is when she got to PA she got a pain doctor there too.


Anyway- I have no idea when she had her last opiate but by her second day here she was complaining of tooth pain & made an appointment for the dentist. Turns out all she needed was a cleaning. No other issues. No reason for "pain". Then some vague complaints of abdominal pain started, but nothing too bad. She then went to an Urgent Care center, without telling me & only told me when she got back last Friday that she went "because my side has been hurting". She got checked out but they did not give her any opiates. Just said it was likely muscular. That Friday she made an appointment with the pain doctor for the following Monday (yesterday).


Sunday we always watch football, so I invited her over to eat & watch the games. She came over but left after about an hour. She ate & seemed okay. Next thing I know she calls me and wants me to take her to the ER for her pain. I was afraid not to so I had to call Uber to take us since I had drank 3 beers.


LONG eve & she got admitted. End result, all scans & tests were negative. NOTHING wrong, but she got some opiate doses. She canceled the pain doc b/c she didn't think she would be released but she was by 11:00 the next day, with NO opiates. Her nurse told me she had "concerns" about the opiates.


We're home less than an hour and I see she is gone and track her. She's at the pain doctor even tho her discharge instructions were to take Tylenol. Later she lied and told me she hadn't gone anywhere.


I'm at a loss as to what to do about this.

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If anyone withdraws this woman suddenly, as in no more opiates she could well die. You know that, I hope. She needs pain withdrawal help. With access to the "pain clinic" (and I didn't even know they existed anymore) she will get her opiates. I have a friend who is addicted and this is recognized by both her and her MD. She has the pen to address an accidental overdose (works like an epipen, but has the instant antidote to opiates) and you need this on hand as well.
In all truth there is nothing that you CAN do about this but do not EVER let her move in with you, stop taking her to ER, and level with her; the entire family to meet with her and tell her that she is suffering from addiction. Do not get POA for health care for this woman if you don't want to suffer what the families of addicts across our country suffer.
When she is admitted someone with her should suggest drug testing on blood so they know what they are dealing with.
And above all, when she chooses (IF she chooses) to stop it must not be sudden, or indeed it will end tragically almost certainly at this point.
You need now to go to Al-anon, and you need to get all the information you can on what you can do. You are the daughter of an addict. I am so sorry. You are not alone in this nations where Moms, Dads, Sisters and brothers, children, friends are trying to deal with rampant addiction.
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ExhaustedPiper Oct 2019
Thank you. At the ER and when she was admitted Vicodin PRN is listed on her med card, so they knew. Her blood work only showed impaired kidney function but that is not new.

I know she got a script yesterday so she won’t go into WD anytime soon but I know this needs to be addressed.

Alva I don’t know how to tell my mom I’ve basically spied on her to find out what’s been happening, she will be so furious I can’t even imagine and she will go to great lengths to make sure I can’t do it again. Even at the hospital when I was a short distance away from her and talking to the doctor giving him basic info for her admission she yelled from the bed “Come over here and talk to ME!”, meanwhile he had tried and she was all over the place with basic questions so he wanted me to answer so it wouldn’t take forever. Her cognitive impairment was apparent to them I’m sure.

At times I don’t know how she can be so resourceful, like with her drivers license and scoring these pills yet she also has dementia. Maybe because she was always so smart and lived independently for so long? My dad died when she was 54 so she’s been living alone for 20 years. Oh she also told the doctor she didn’t have a neurologist here “No I didn’t get one yet, I just moved here from PA”. So afraid they might find out about her diagnosis.

For now, as in the coming days I am going to check her use. Do you think if she keeps it at no more than a few pills a day I should make an issue? Is it harmful, physically, if she doesn’t go into WD? I need to find the answers to those questions. I don’t think she risks taking too many because she doesn’t want to run out, but I’m going to look into that pen you mentioned that seems like a good idea to have just in case.

I’ve also considered talking to the pain doctor myself and asking him to wean her off appropriately, even though he doesn’t have permission to talk to me, she made sure of that. But again if she finds out I contacted him she will be livid.

BTW I do have a DPOA, but I don’t see how that matters here, what am I missing? She’s not deemed incompetent so I was under the impression it is useless unless she instructs me to act on her behalf.

Thanks for listening and the advice.
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Piper, try this.

This is not YOUR mother. This is Barb's mother. This is the mother of a dear friend, but this mom has always been somewhat selfish, narcissistic and has a "my way or the highway" attitude.

What would you advise this friend to do?

We all know that you can't save an addict if they dont want to be saved.

Frankly, other than telling her treating physicians what you suspect, I don't think there is a lot of intervention you can accomplish on your own.

How about start going to AlAnon meetings and let mom's chips fall where they may?

Yes, she might die. But perhaps THAT is precisely what she is seeking.
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ExhaustedPiper Oct 2019
I would tell you to stay far, far away.

Thanks Barb. Ultimately it probably will come down to letting the chips fall.

Last night I was thinking about how I fear and avoid confronting her, like her wrath is the ruling force of the world, but really, when I break it down I can see how irrational my own thinking is on this.

If she gets furious and doesn't speak to me, so what? If she decides she's going to be her resourceful self and move, that's even better.
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I know your mom has been diagnosed with dementia. My MIL has begun to travel the road of vascular dementia. There are things that are way off while others seem perfectly reasonable. One thing I have really noticed in her is that some traits are really enhanced. In MIL case major case of vanity. (To the extreme) Doesn't want to use her cane or O2 in public because "they will think I'm old", um you're 92, you are old tho I'd never say it to her. Oh these bags under my eyes, I need to do something about them they're terrible, maybe I should have a doctor remove them. Oh look at this wrinkle, how am I going to get rid of it. And on it goes. She can be stubborn and sneaky, she has also lost her stops and doesn't care what hurtful things come out of her mouth as long as she gets her own way, I actually stand there and watch her take her meds so I don't find them later. She can and does manipulate people to try and get her way when told no. Your mom has been addicted for a while and is use to manipulating everyone to get her fix. These actions which are ingrained into her way of thinking may be enhanced. She will appear more convincing and more adept at obtaining them for a while. The hiding her problem and lying about taking the drugs or getting a new refill are also her old normal. You've got a can of worms going on. As her poa and her diagnosis of dementia is there any way you can have a meeting with her doc, set an appointment up for her the following week, have her admitted to the hospital for "testing" to find the source of her pain and then have her transferred to detox unit? In my opinion, an outpatient program would not work. Too many do outpatient programs because they are ordered to and stop off to get their fix on the way home from meetings. Depending on how she is doing after detox, time for placement for her safety and your peace of mind that she will not be able to go to pain clinic and relapse. What's going to happen when she forgets how many pills she took and overdoses? Tough decisions and tough love needed to help her and by extension helping you and your husband. Either that or time to make the state her guardian and you jump off the carousel before she drags you down any more than she has.
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Thankfully, the medical community is more defensive about prescribing opiods anymore, although the determined addict will work very hard at getting them. You can contact a drug rehab clinic and talk to a counselor and maybe discuss an intervention. You can only do so much, but that's probably as much as you CAN do...except do not enable her in any way (that's where AlvaDeer's suggestion of Al-anon is spot on). You need to know very clearly what enabling is and looks like in your relationship if you don't want to be part of the problem. Also, lock up your valuables and mind your wallet when she comes to visit. Seriously. Yes, the addiction will cause your mom to steal from you. I'm so sorry for this situation and your mom is yet another victim of those drugs. FYI I think it's Narcon that they use for overdoses. Peace to you in the midst of all of this.
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AlvaDeer Oct 2019
Yes, thanks. I couldn't remember narcan. Think it goes by another name now as well, nonoxalone or something. That should be on hand. And wow, Geaton, good on the locking stuff up.
I am afraid these pain clinics still exist, esp. in the South, and they give these out like candies to this day. My friend is in California and she is having a hard time getting her "stuff" now, but I think close to time in this state where you will be forced onto the street or not at all. The hospital ERs are sincing their "drug seekers". And the info is being spread. But wow, what a problem.
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I Think I read somewhere that people who have taken opioids over a period of time when they go off of them feel pain where there isn't any. I just read that you need to be weaned off of them. Which I feel a pain specialist should be doing that for Mom. Finding other alternatives not continuing to give her the opioid. I wonder who Mom is going to. Pain management teaches you how to control your pain. Not making u an addict in the process. Read this article.

https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-to-use-opioids-safely/art-20360373

If it were me, I would have Moms records sent to the new PCP. I would ask for an appointment to see the doctor and pay out of pocket for it. No, he can't discuss what has been done for Mom and why but u can tell him what you see. The phantom pain she has. You can request that she have a blood test just to see how many pills she does take. And then tell him about the pain management, not working. Here's another article about how over time opioids lose their effectiveness.

https://www.healthpartners.com/blog/why-opioids-make-pain-worse/

Does ur Mom have Dementia? If so, she may be just imagining the pain.
With Dementia there comes a time when family needs to take over. Try to get Mom to an neurologist. Tell a white lie and say he maybe able to help with the pain. Make a list of what you have been seeing and give it to the receptionist. It will help the doctor ask the right questions. Tell the receptionist you are there for a competent evaluation because Mom is not handling her healthcare correctly.
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Piper,

I am so very sorry for the situation you are in. It’s horrible. I lived with a heroin addict since I was 7 years old. My oldest brother got hooked at 13. He succumbed to peer pressure with his best friend. The rest is history. It’s a long road to travel with lots of bumps along the way.

Yeah, he tried methadone unsuccessfully. It’s sad that I have memories of being in the car parked outside of a methadone clinic as a little girl. There are so many memories that I wish I could erase from my mind. So many things that a kid should not have seen and heard. The worst was watching him overdose. About the only positive thing that came from it is that I have never nor will I ever stick a needle in my arm.

Addicts will do ANYTHING to get a fix. They can’t help it. It’s a medical issue. No one truly wants to be an addict. It usually takes more than one stint in rehab to beat these demons. Hell, even a stint in prison didn’t help my brother beat it. They do drugs in prison.

He tried getting drugs from the pain clinics but he always tested positive for street drugs so he would be turned away.

When he got HepC I arranged for him to go on hospice. My Lord, he tried lying to the hospice nurses by saying his OxyContin meds fell on the floor and he stepped on them or he dropped them in the sink and they went down the drain. Nurses aren’t stupid. They didn’t buy his crap. He quit hospice at that time and went back to buying heroin on the street.

He had a horrible motorcycle accident, just about died but he had such a high tolerance for drugs that what they gave him in the hospital didn’t even take the edge off of his pain. He actually asked me to go score heroin for him. I went out into the hall and broke down. A lovely nurse told me to cut him off and take care of myself and my mother would have to deal with me no longer caring for him. It was hard. I loved my brother. I hated the addict. I had limited contact with him, then eventually no contact because he made my life a living hell. Even though he didn’t want to hurt me, it’s what addicts do. I stepped away for good. He was furious with me for not going to buy heroin for him.

Then one day I got a phone call from his friend. He was back in hospice. He was like a cat with 9 lives. He walked out of the facility. Shortly afterwards though he went back in. I took my mom to see him. Everyone was there. I forgave him. He died. That was how my brother finally quit drugs. I made arrangements for his cremation and burial.

I always told my kids that if they followed my brother’s footsteps they would possibly end up with Aids, HepC, in jail or dead. My kids told me the reason why they didn’t do drugs was because they saw the devastation that it caused.

He had a good heart. He did many good things in spite of being an addict.

At one time he even owned his own business and was successful. He lost his partner and his business due to drugs. He was controlled by drugs but somehow controlled it too. I would see him throw himself into a room and ‘cold turkey’ it. Was bizarre. Most people cannot do that. But the urge to go back to using always sucked him in.

I tried so hard to help him. I begged him to do rehab. They have to want it to work. You can’t make them. I pray that you will be able to resolve this issue. It is so difficult and challenging.
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I suggest that u call the neurolgist and see if his findings include incompetence. If they say she is incompetent than ask that a letter be written so ur POA can go into effect. You will now be the Parent and her the child. Yes, its hard and she will fight you all the way but you need to know u are doing it for all the right reasons. As her Dementia progresses she will become like a child who can no longer make informed decisions. Know that this will not be the Mom u grew up with. Your job now is to keep her safe. It is no longer what she wants, its what she needs.

I had a hard time with Caregiving and my Mom was fairly easy. Mom went to an AL, better but I still had certain responsibilities. Money ran out so she went to LTC. Her Dementia was in the last stage. I found a really nice NH. Mom was always clean as were the residents. So I allowed them to do her laundry. All her needs were met and my responsibility was to visit. Please, don't take Mom into ur home.
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Piper read the durable POA. It may have gone in to effect the moment it was signed.
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Piper, is there anyway you can open the conversation with your mother about her drug problems without revealing you have been counting her pills? Just talking about the fact that she is still using opiates years after her injury and then expanding into all the problems/side effects of prolonged use? including adding to her cognitive and balance problems? How once someone becomes addicted, a doctor's supervision is necessary to stop?

I would look for a rehab program (maybe outpatient) with experience helping seniors with other health problems. They may be able to advise you how to get your mother into treatment. Even if your mother remains on an ORT drug for years, it's much safer than the opiates.

You may have to pursue guardianship to get your mother into treatment and keep her clean. Vascular dementia is "strange" in that some regions of the brain are very degraded at the same time other areas still seem to function almost normally. Some states have granted limited guardianships over adults (not just seniors) based on just drug addiction. I suggest you consult an elder law attorney to see what the legal environment is in FL.
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Great suggestion about getting social services involved on next er trip. Dementia and you have medical poa, they can assist in getting her admitted to detox, medically controlled since it is opioid addiction, then once clean on to AL facility where she will not be able to access them or get out to refill her perscription, especially if facility is aware of her issues, they will take appropriate steps to ensure she has zero chance to get more. As medical poa you can "lock" her down in AL. No trips unless she's physically with you and only you. She knows how to play others and will do so to get her fix. Be prepared for her to promise, be sweet, transform into agression directed towards you, accusations that she needs meds, how cruel you are. Ignore it, especially when in front of her. You can break down later when you get home. Alanon is a great suggestion, they can help teach you how to deal with your situation that is good for you. Good luck, keep us posted.
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