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Psychological addiction to Vicodin
June 2, 2012 2:53 PM   Subscribe

How to get over psychological addiction to Vicodin?

A few years back, I had a terribly painful surgery, and was given Vicodin for pain for quite a while. I'm bi-ploar, and found that long past when I needed them for the pain (it will always hurt, I can bear it), I needed the Vicodin just to feel okay. I don't take a lot of them, I throw up if I take more than 5-7 of them a day, but it's enough that when I don't have them, I miss feeling what has become normal for me. Without them, I have no energy, feel no pleasure. I'm not depressed- I certainly know what that feels like, and I have no physical withdrawl symptoms.

My medical doc is very careful how much and how often she'll re-order them, since she knows my psych diagnosis, which has been well controlled for quite a while. I don't double- dip prescribers, and I'm a medical pro and have changed specialties so that I'm not tempted to divert them.

So, that's the background, and here's where I need some advice. I can't, I WON'T go to AA or NA. I'm intensely private and will not discuss this with anyone. It's simply not in me to. I want to quit and I can't just cut back, I have to stop, and I have. But how to manage the craving? I miss feeling okay. I don't drink and I don't get high, I don't find it pleasant, so the Vicodin's my only problem. I just want to manage the craving and hopefully get to a place where I feel okay without the damned Vicodin.

Any thoughts or experiences would be most welcome, and I'm glad you guys are here for me.
posted by anonymous to Health & Fitness (9 answers total) 1 user marked this as a favorite
 
Sorry to be the bearer of bad news, but everyone I know who has had an opiate problem that could be dealt with on their own has pretty much just had to wean themselves down to a level they could quit without having life threatening withdrawal symptoms and then tough it out for a week or two until they got back to vaguely normal and then deal with the longer term not-quite-right feeling that lasts up to several months. Hopefully the longer term adjustment won't be as long term for you since you aren't consuming nearly as much as they were.

I find hobbies and exercise (biking, in my case) to be the best way of keeping myself away from bad habits and reducing cravings. I suspect the exercise should help with your energy level issues.

And do have hope. My friends were..consuming..oxycontin as if it were their meals and then using vicodin as snacks throughout the day and 4 out of 5 managed to kick the habit and have stayed away from it for over a year now. It took a while to get back to "normal," but they did get there. I think the most important part is not forgetting to take care of yourself just because you're in a funk. That the funk is drug induced isn't so important.
posted by wierdo at 3:07 PM on June 2, 2012 [4 favorites]


If you can take 5-7 a day you will suffer from withdrawal.

The reason why NA and AA work is because they are psychologically empowering. Those methods can eventually convince a person that they are ABLE to quit.

You can do this on your own with self hypnosis. I know, that's very much right out of left field, but it serves the same purpose and I prefer it because it's totally personal. Check out some resources on the subject on the web and the library. It can certainly hook you up!
posted by snsranch at 6:51 PM on June 2, 2012


Is there a reason you can't ask an addiction medicine specialist?
posted by nestor_makhno at 8:03 PM on June 2, 2012


There are lots of people who can take painkillers and anti-anxiety medications and then just be done with them when the pain is gone. I don't understand those people at all, and so I won't talk about them.

Then there are people who take something necessary for pain and it finds... a small crack, a fissure. It fills it with something that seems to improve their lives. So well, in fact, that it makes the crack wider-- wide enough that it becomes a hole. But no problem-- it fills that hole too! Take it away, though, and that hole is left wide open. Not only open, but raw-- if someone were to even look in the direction of it, it would hurt. And it's crazy, because maybe that hole hadn't been there to start, but it sure as hell is there now.

And that's what you're dealing with-- the absence of something that created its own problem and solution. Maybe the crack was a little low self-esteem; maybe it was hurt from childhood (but for people like you and me, it's often all of that plus un- or under-treated psychiatric issues). And while you took the pills, all those FEELINGS got smashed down in a really pleasant way. Maybe you've done stuff you wouldn't have done while not on the pills (the crack gets wider). Maybe you decide that the you ON the pills is the REAL YOU.

But you're in a good place. Somehow, against a lot of odds, you've gotten yourself to the point where you know the pills have to go. This is good. You can do this.

But you really need to deal with this hole. Most people can't heal it without first addressing the underlying psychiatric issues. How are your meds-- are they working for you? This is your first question. The meds are crucial, because they are the webbing with which you can begin to get the hole to heal. Get those addressed-- check in with an actual and real psychiatrist. These are absolutely your key to finding your way to peace.

Next, you need to talk to someone (anyone! therapist! internet stranger!) about these FEELINGS that are getting un-smashed as the haze of the first few weeks fades. Feelings make the hole become so obvious, so painful, so insurmountable-seeming. Just getting these feelings out of you and into the world is your second crucial task.

Third, find a way to forgive yourself. I used AA for this at the start, but haven't gone in a long time, and I'm sure there are other ways if you look for them. See also: therapist (above).

I'm bipolar too. I take 19 pills each night -- all from the psychiatrist, none mood-altering-- that make my life manageable. I've been clean for almost five years. And I have an awesome life-- married (with puppies), house, business. You can do this, but you really need to bring someone into your circle on it or you'll struggle more than you have to. Please MeMail me if you want to talk!
posted by mireille at 10:27 PM on June 2, 2012 [7 favorites]


when I don't have them, I miss feeling what has become normal for me.

Yes. I understand.

You know what, though? After you stop taking the Vicodin, you will develop a New Normal. At first, this normal will suuuuuuuuuuck. That's OK. It's temporary. Your body is on your side here -- it wants to heal, and it is engineered to produce feel-good chemicals once it resets. How long that reset period will be for you, I dunno. But you'll pass through it, and you will feel pleasure again, and you will get your energy back.

Here are some things I found helpful:

Prior to stopping, do what you can to make your living environment as pleasing as possible. Stock up on super delicious food. Clean sheets and towels. Stockpile escapist reading, movies, what have you. The idea being that your environment will positively enforce you.

Then, pull the plug on the drugs, and treat the days/weeks as if you are getting over a nasty infection. Be gentle with yourself. If you need to take long naps, take 'em. Slow your roll; let your amazing body and mind rebuild at its pace.

You totally don't need AA or NA. There is no moral failing or character flaw to address. Just some behavioral modification, some patience, some willingness to sit through discomfort. You can do this thing.
posted by quivering_fantods at 10:55 PM on June 2, 2012


The only thing that worked for me was eliminating the access. I'd take some in a heartbeat if I had access. Junk food also helped; it gave me something else to look forward too. And the "focused" feeling you've been getting; it's also known as getting high.
posted by Brocktoon at 12:01 AM on June 3, 2012


There are anonymous online support forums. Try http://www.soberrecovery.com/forums/substance-abuse/, for example. You could treat these forums as "read only" and glean ideas from many people who are going through similar feelings.
posted by telstar at 12:35 AM on June 3, 2012


You say you have a "psych diagnosis." Do you still have access to the doctor who diagnosed you? Are you seeing some other sort of therapist? If neither of these. you have your medical doctor. It seems like one of these professionals can give you professional advice.

Opioids affect different people differently. The usual rule of thumb for anyone who is taking a fairly large does of an opioid for a finite length of time (to manage post-surgical pain, e.g.) is that they should plan on weaning off the pills at the end of the use. That is, for example, a week of taking half as many pills daily, then halve that number the next week, then halve than number again the week after that. Eventually there will come a week (if you plan this out and do it correctly) when you've got exactly 7 half-pills (or whatever) left in the bottle, and that's the last week you're going to be using.

What helps is to remind yourself that the feeling not-normal is in itself "normal," that is, it's what most people feel when they stop taking opioids after using them for a while. The other thing you can remind yourself is that this unpleasant sensation is a function of your body's resetting itself (call it "detoxing" if that helps you) and that consequently, as a result of that "resetting," you are eventually going to achieve an acceptably normal (capable of pleasure, etc.) feeling without the opioid.

What I say above seems to be true for most people, i.e., if they wean off and have a realistic sense of the temporary sensations associated, the process can go fairly smoothly. But as you say, there is sometimes need to manage craving, and groups like AA and NA have a pretty good track record with exactly this sort of thing. If meeting with groups like these is indeed completely out of the question for you, then you may want to consider working with a health care provider who can offer similar support.
posted by La Cieca at 12:49 AM on June 3, 2012


A few things stand out from your post.

First. Cravings, lack of pleasure and energy and needing the pills to feel normal are withdrawal symptoms. Anyone who takes a narcotic daily over years will develop some degree of physical dependence and will have some level of physical withdrawal in proportion to the volume and potency of the drug they've been using. This isn't a psychological problem so much as it is a normal and predictable neurological response to long term exposure to a substance that by its very nature affects the mechanisms in your brain that regulate mood, pleasure, and energy. This isn't a failure of will or character on your part. It's just how these things go. And by the by, opiate withdrawal is not fatal.

Second. I applaud your effort to be mindful, proactive and responsible with career choices that put you in the path of temptation to abuse the medications. That says a lot about you. What concerns me about you switching specialties is that it suggests your relationship with the meds is guiding important life decisions. It hints that the gradual ceding of control over a life to the drug as begun.

Third. You're not talking to anyone. This is a scary, lonely place and in my experience not much good can come of it. It doesn't sound like much good has come of it. It hasn't helped you solve this problem so far and I really don't think not talking to folks will help you quit and stay quit.

Fourth: My hit from your post is that you are still taking the meds as prescribed, aren't doctor shopping/hopping, aren't (I assume) running out early and supplementing from the street. You've noticed way earlier than many folks that something is amiss and you need to do something about it. This is very encouraging. Good for you.

So. What to do? Talk to someone. If you can't taper on your own is there someone who can help you do it gradually with some strict control measures in place? Could your doctor and a friend help you with this?

I like the suggestion of talking to an addiction specialist, even if it's just for outside perspective and options. Opiate dependence is a strange beast in the drug world. It's really one of the few drugs you can become dependent on without abusing. If your worried about the consequences of an evaluation, pay for a private practice specialist out of pocket and don't go through your insurance. Substance abuse treatment records have the strictest confidentiality standards of any medical or mental health specialty. Your job, doctor, family whoever won't find out unless you tell them. Getting help a specialist might feel a little more private.

I'm not at all saying you're an addict. I am concerned that the combination of long term use, the dependence, not talking to anyone, altering your career around the meds and your bipolar read to me like a situation that sounds like a can of gasoline. It's all stable now, drop a match on any of this and you could be in real danger.
Best of Luck to You.
posted by space_cookie at 2:04 PM on June 3, 2012


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