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He Mixed Cocaine & Opiates…Now He’s Newly Sober But Something’s Off

depression

Mothra gets the feeling that something is off. Her son, newly sober, is removed and passive.

"Update on our son who is poly-addicted and has mental health issues. This most recent run of his was the worst we've experienced in the 20 plus years of his addiction. This time along with heroin, cocaine was involved which made his words and actions very self-threatening, along with the fact that the law AND the bad guys were closing in. Thankfully he had frightened himself into detox, followed by a brief stint in TSS, and is now in a sober house far enough away from our area. He is slowly coming out of his fog, physically and mentally and I'm so very grateful that for now things are ok.

My concern is his demeanour, which seems removed and passive. Right before he gave in to detox he expressed suicidal ideation. He is taking his antidepressant at a lower dose so as not to run out before an upcoming evaluation. We stay in touch by phone or text and try to keep the conversion "normal" while offering lots of encouragement and we try to see him weekly if he's willing.

I just get the feeling that something is "off." We have always been very close and I feel he's walling off. I'd like to hear from others who might feel this way – and I'd like some guidance on what to say to him, if anything, about this.

Thanks."
 

We’ve followed along with you on this latest episode with your son and are heartened to hear he was successfully kept in treatment and is now in a sober house. What a relief this must be for you.
 

Stimulant Abuse Is On the Rise

Your son added cocaine to the drugs he was using in this most recent relapse. Stimulant abuse is on the rise. One hypothesis is that opioid users are discovering it in greater numbers and mixing it with the opioid for a better high. In a study we are running on those newly released from jail, I am seeing anecdotal evidence of new cocaine users amongst opioid users being treated for opioids. They are substituting cocaine or crack as a way to get high when opioids are no longer an option.

With the possible exception of methamphetamines, no drug surpasses cocaine in its high or its low. When the cocaine wears off, the world is bleak and dark and pointless.

It takes time for the mind to recover from cocaine but it does recover.

The other thing to keep in mind is this: the longer-lasting symptoms of withdrawal from opioids, often glossed over, include insomnia and depression and can last well over a month.

Your son is also lowering his anti-depressant so as to not run out before he can be seen by a prescriber.
 

Sober Loved Ones Who Have Difficulty Finding Motivation for Daily Activities

In our work over the years, we have seen Loved Ones who stop the drug use but are left flat, passive, and scared. They struggle to find work or to do any of the daily activities of life. This, despite being treated for depression.

It is frightening for the family, many of whom thought that getting rid of the drug use would mostly solve the problem.

Have you talked about your fears with your son?

“I am scared for you, can you think of something we could do that might help? Could we get you a workout group, a gym membership, a bicycle? Can we help you find more peer support groups? We are here, we love you madly, we will do anything that can help. Do you need to get to a prescriber more quickly? Do you want us to look for one?”

Is your son on a medication-assisted treatment (MAT)? An agonist therapy like buprenorphine might better support this transition.

Can you talk to the house manager at his sober home without upsetting your son, just to mention your concerns?

Reminding you son that you are here, that you love and support him, and offering to get more services to him, is likely where the line must be drawn in terms of what you can do. Your son is in a structured environment and is hopefully getting some case management to help with services.

Thank you for taking us along in this important process with your son. You are helping all of us to better understand the struggles and the successes that are possible.

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  1. Hi AIR community. Our son is still hanging in at the sober house, but I fear by his thumbs. I’ve been worrying a lot about his current status – he’s got about 2 mos sobriety at this point and says he’s having trouble getting to meetings and finding work without transportation, though we have noted only minor, sporadic effort. Work and meetings are important issues for sure, but today he called to say he wanted his vehicle which is here at our home.

    This vehicle is a huge trigger for him…it’s where he used, scored, slept and did so many illegal things to get drugs. In cleaning it out while he was in detox I found all sorts of syringes, pipes, and more (this is nothing new – in fact I’ve done this so many times that I’m numb to it now). Anyway, there’s no sticker, insurance has lapsed and brakes are very bad. He wanted us to help him get it so that he could drive it back to the sober house – 1 and 1/2 hours away and work on it.

    This is after he got his tax money back, also another trigger. We refused, saying that, yes, it’s his vehicle and he can take it anytime he wants but we’re not comfortable helping him with it in any way for many reasons, pointing out to him all of the above, plus if he gets stopped he will go to jail on outstanding warrants.

    Trying to follow some guidelines we offered: a bicycle to get to meetings, job searches and the gym, help via Uber, and encouraging him to network during meetings (his shame and anxiety make this hard I know.)

    This time of early sobriety has always been difficult and fearful for us and him, and sometimes I think he becomes so fixated on getting something he wants that he doesn’t stop to think; it just becomes all-consuming. I’ve seen him embrace sobriety in the past but don’t feel he is making his best effort. I don’t trust his motives either. He brings things up like making a doctor’s appointment or going to a day program 3 times a week, but when asked about them they haven’t happened, or he has an upcoming appointment which we never hear about again.

    Later he called back, saying that, yes, perhaps he hadn’t thought things through, and that he knows this need for immediate gratification has always been a problem and that he will try to be patient and will make more effort to get to meetings and network, and he’s sorry that he probably caused me stress and worry. Next request: instead of a bike, would we help him address a warrant (traffic) by taking him to the courthouse and helping with the fine? His dad felt that was doable and agreed, but I’m not sure if we’re being manipulated yet again.

    This rollercoaster ride of emotions: hope, fear, anger, helplessness, numbness, etc. is taking its toll. We’re trying to do the right things to help while staying away from enabling – but it’s so hard to know what’s right. Plus I’m so tired of it all that it’s even a chore to do the modules lately. I did go to the serenity spot today. Thanks for any comments.

  2. Thank you, Dominique, for your response. Yes we recently did get him a gym membership which is helping. I visited today and we also went to the library where he got a card and some books. He likes to read self help, spiritually based literature, and felt he was too cognitively “muddy” – his word – before now to even try to read. I saw this as a good sign. His dad is checking in with the house manager weekly as we are currently paying the rent and he feels he’s improving.

    Today he was to have a phone intake with a counselor and also get a physician referral. I encouraged him to try to expedite this based on his meds running out soon, but will offer help in this area – that’s a good idea if he will accept it. I don’t know the outcome of the call yet, but assume there will be a waiting period before the case management process will begin. Also his insurance plan was just changed to a different provider through mass health and we don’t know if it’s accepted in his area.

    He has used MAT in the past with poor results as he feels he is still using plus they often make him feel very sick and he quickly falls into abusing and selling them, which amps up the SUD and heroin and cocaine are easy to get and cheap. He can sell a couple of subs and is halfway there to a bag of heroin. He’s going to one or two meetings a week, transportation and self consciousness about asking for rides being the issues. We got a bus schedule today too. We do not give money but could find out how to get him a bus pass.

    We walked on the beach today and it was lovely just talking about anything…He even laughed a little, which was great. Recovery always comes up but I am trying to redirect to normal talk as much as I can. It is obvious that we are both apprehensive about what will happen next. Based on his improved demeanor I didn’t want to rock the boat by talking too much about it. It was a good day and I cherish our time together.

    After 20 years of experience, we all know, including our son. this stage of improved mental and physical clarity is a dangerous time – he can get stronger in his will to push on, or he can get so scared of sobriety that he falls back into using. More recently it’s been the latter. He gets “bored.” Plus the legal system is requiring attention and fear of jail time is weighing heavily on his mind. My own hyper-vigilence has taken its toll on all of us, and I’m trying not to let it show while I try to find my own way. Tools I’m learning here in AIR are helping.

    Will keep checking in. Thank you and bless you for all that you do.

    Mothra

    1. Thank you for all these good ideas. People enter long-term recovery at all ages. Sometimes getting worn down by the cyclical nature of relapse helps to see the glaring pattern that is their life. I see beauty in the relationship with your son. We are with you.