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Chemical Dependency on Prescription Medications

This article addresses the rapidly growing issue of developing chemical dependency on prescription medications, and what to do about it. The story below is one that I see in my own practice very often, and I consider it a tragedy that so many people are afflicted by this.

Dear Doctor Life Advice,

I was in a bad car accident that nearly ended my life in 2010. I suffered a fractured skull, broken ribs, hip, leg and foot.  I also suffered from a punctured lung, ruptured spleen and liver. I have had multiple complicated surgeries and my surgeon referred me to a doctor for the management of my pain. This doctor put me on 80 milligrams (mg) of Percocet along with 40 mg of Methadone and 30 mg of Valium per day. Since my accident, I have been on narcotic medicine around the clock. Three weeks ago my doctor accused me of selling the medication or taking more than I’ve been prescribed. He gave me a prescription of Methadone and Valium, with each one of them being half of what I normally take. He did not give me any medicine for break through pain. There has to be an answer. If anything, he should have gradually taken me off or referred me to another doctor instead of leaving me half of my medication.

Signed: No Relief

Dear No Relief,

This is a very common story I hear, and even though I don’t answer medical questions on this site, this is more of a chemical dependency and addiction question, so I will address it as best I can.

I am very sorry about your accident, and it’s obvious you suffered tremendously from the incident as well as all the surgeries and treatments you had to go through afterwards. Let’s acknowledge the amazing fact that you survived all of that! Unfortunately, after such traumatic injuries, it is very common for the injured person to be started on high doses of narcotic medications for pain. Narcotic medications are those that you build tolerance to, meaning that you will need more and more of to get the same effect. People also often develop dependence on narcotic medications, which means that they will experience withdrawal symptoms when they come off of the medication. The tragic truth of this matter is that often when patients are started on these medications, they are not told about the addictive and narcotic nature of the medication.  Some patients don’t know they are dependent on these medications until they try to stop them and experience withdrawal symptoms. Even more tragic is the number of deaths that occur due to overdosing on the combination of narcotics such as the ones you are on.

It is also very common for patients to be accused of misusing or selling the medication because of the high volume of the medications they receive. The matter is further complicated by the fact that the patients become dependent on these medications.  Patients will continue to experience severe pain and illness when they don’t take the medicine, which makes them beg their doctors for more, and doctors begin to suspect that the patient is “medication seeking.”

From what you are describing, I suspect you have become dependent on both the opiate class of medications (Methadone and Percocet) and the Benzodiazepine class of medications (Valium). You are facing two problems right now:

1- You have become chemically dependent on medications;

This is a serious problem that needs to be addressed. The best way to address this is to go into an in-patient rehabilitation program that will help slowly taper you off of this medication. If this cannot be an option for you, then the second option is to find a doctor that treats chemical dependency specifically and will slowly taper you off of these medications. You can also go to pain clinics: Just be aware that pain clinics usually continue to prescribe narcotics and many of them won’t treat you with the goal of ultimately eliminating these medications.

2- You have a chronic pain issue that you need to address;

Once you are weaned off of the narcotics, you will have to deal with the reality of your physical pain. This is a Catch-22 scenario because narcotics help your pain temporarily, but eventually ruin your life. If you manage to come off of the narcotics and get your life back under control, then you’re still faced with the issue of the chronic pain. The best way to address this issue is also to go into an in-patient rehabilitation program, because they will help you find alternative methods of treating your pain. The less desirable option again is going to a pain clinic and asking for alternatives to narcotics. I’ve had patients who have successfully had their pain treated with alternative methods such as implantation of nerve simulators. Other methods that have been known to work are biofeedback, acupuncture, and physical therapy.

Whatever you decide, you need to understand that chronic pain is a major problem in today’s society. Narcotics are only one in many ways of treating chronic pain, and in the majority of people, they lead to chemical dependency, addiction, and ultimately do more damage than good. You are going to be healthier getting off of the medications, but only if done in a more structured environment rather than just going off of them immediately. In addition, coming off of Benzodiazepines (Valium) “cold-turkey” may cause serious withdrawal symptoms that include seizure, coma and death, so you really need to be weaned off of this medication under the supervision of a doctor. Most doctors will require you to be hospitalized when weaning off of Benzodiazepines because of the high risk of these life threatening withdrawal symptoms.

I hope this information is helpful. For additional help, read my other article on The Addict Brain. Also, use search engines to look up treatment facilities for chemical dependency.

Doctor Life Advice

Sayeh Beheshti, M.D.