He’s Clean From Opiates But Really Struggling
Beach18 wants to help her son, in recovery from opioid addiction. He continues to struggle with Lyme's disease, misuse of benzodiazepines, chronic fatigue, and perhaps depression.
"Looking for guidance and resource recommendation for our son. He is a recovering opioid addict and finished a suboxone maintenance program in December 2017. He seems to be holding his own there, although I have had a concern a couple times since December. The issue is he has been prescribed Xanax for 10 years and a year ago there was an attempt to switch to Valium as it was longer acting. That attempt because of various reasons resulted in him being on Xanax and Valium for a year now.
We switched to a functional doctor as traditional doctors seemed to be making the problem bigger. A rapid detox, we learned, from interfacing with a benzodiazepine expert could result in death especially at the dose he has been prescribed and a taper is recommended. The functional doctor will work with us on a taper, but before tapering off Xanax and Valium ran a series of tests that showed his nutrient levels were very depleted, especially his amino acids. He was not strong enough to even endure a taper. The doctors words a year ago were — I have had people come to me with bad levels but none as bad across the board as yours. We worked with him to get his levels up and things were good in February except he still had chronic fatigue and pain. The doctor ran more tests and he tested positive for Lyme. That started an antibiotic regimen that destroyed his gut health. He will be starting IV therapy (Vitamin C and GSH) in 5 days as he still is quite fatigued and doctor thought he would be further along by now.
My concern. He is self-medicating at times with his Xanax and Valium (because of sleep issues), leaving him in dire straights the last few days before his refills are due. The functional doctor is not aware of this. With Lyme he is not strong enough yet to withstand any detox or taper. Yet he cannot continue as he is.
I don’t know if there is a facility that would work with him on a taper while being sensitive to his reduced energy because of Lyme. Or really what should we do? Ultimately, I believe, and I think he does too, that he needs a structured regimen, but we are not sure the timing is right yet. Yet, his self-medicating is a recipe for disaster too.
Also, his chronic fatigue has put him in a position to be completely dependent on us. He is 29 and has no job, no money, no car, no career (he did have one once). He still lives at home. This has him extremely depressed. He wants to be self-sufficient. He spends much of his time alone with his thoughts. My ‘vision’ (and his) had been he would feel better from Lyme and then move forward on the taper and independence. The Lyme recovery is taking much longer and his mental state is deteriorating. His words just tonight: "I have lost the tenacity to live."
I don’t know how best to proceed at this point. Any help or recommendations is appreciated."
Dear Beach18: Your son has been through so much. Being abstinent from opioids is no small feat! I am not trained to address the Lyme’s disease, but the fatigue you describe would be very hard on someone who is relatively newly sober. The combination of: alone, fatigued, isolated, with occasional insomnia and withdrawals from benzodiazepines, sounds like a bad one. Depression makes sense.
You are focusing on the benzodiazepines and with good reason. Along with alcohol, benzos are the only other class of drug that, in withdrawals, cause life-threatening seizures. Detox programs take benzodiazepine addiction seriously.
If your son is misusing these drugs, he may find it hard to taper off on his own successfully. Tapering off benzos has to be done very slowly, literally over a period of months. It will be much safer if he has a supervised detoxification, though I can’t vouch for how he will actually feel as he crosses the exit door after a short inpatient stay. Medical detoxification programs get you to the place of physical safety, not necessarily psychological or physiological health.
Your son needs hope to get through this. Both the treatment and recovery from Lyme’s and the detoxification from benzodiazepines will have an end to them. Perhaps independence and work have to wait for this end. If I were your son I would find it too stressful to try otherwise.
So, where is hope? Hope is in self-help meetings, online self-help meetings, a place of worship, perhaps. Can you help your son access one or more of these? Is there a good recovery coach near you? Insurance is starting to pay for coaches. I just tried a Refuge Recovery meeting and felt comfortable. See our list of self-help programs in the Resource Supplement. While the weather is still good, can you take walks together, or find some other light form of exercise, like stretching?
I hope that kicking opioids has given your son reason to feel his strength. I wish for you too, hope and strength, as you continue to love and care for your son.
Dear Beach18
From my experience with my daughter being on Suboxone maintenance program is the while she was on subs she was not depressed. She has suffered from depression and has not responded to the antidepressants in the past. I just wanted to mention this to you because going off the subs could be cause for depression
As far as the Lyme disease….I also have some experience with this as well. My older daughter has POTS and EDS and her symptoms are very similar to Lyme and in fact sometimes the two are confused. I can imagine this is very hard on your son and I am sure he feels at times he will never be well. Is he seeing a specialist for the Lyme? My daughter also suffers from sleep issues as well. Has your son had a sleep study done? This might be helpful and he might get some relief.
Lastly I wanted to ask if your son is getting enough exercise? I feel it is so important for him to get active and do what he can. This could really help the depression and it would really improve his physical state as well.
I wish I was more help with your Benzo problem…I hope you can find a one doctor that can oversee his care and that might be the answer to some of the issues you are having.
The words, “I have lost the tenacity to live.” may be a factor in getting help through a crisis center. One lesson I have learned watching my adult son withdraw from benzos is that the emergency room we took him to sent him home the next day as “stabilized” even though the crisis center was trying to find him a bed. Placements in rehabilitation centers are not easy to find. Four days later he was back in the hospital in withdrawal. Again, he was sent home after a week instead of to a rehab center. That was enough, however, for him to recognize that he needed to stop using benzodiazepines, and he knew enough to withdraw gradually. We sought a lawyer who specializes in addiction cases in order to seek a court order, but we were told that it was unlikely we would be successful in our county because he had a therapist which meant he was already in treatment. We were never worried about the fact that he was not self-supporting nor did we care what others thought about that. Our focus was totally on what our son needed through this crisis. He knew he didn’t have our approval, but he did know he had our love. Please know that you are not alone in dealing with this.
I am not a doctor, but have been involved in Substance Use Disorder treatment as a professional for over a decade now, and have had my own personal experience with benzodiazepine withdrawal years ago. Here is what struck me in the post from Beach18… “My concern. He is self-medicating at times with his Xanax and Valium (because of sleep issues), leaving him in dire straights the last few days before his refills are due. The functional doctor is not aware of this.” The doctor must be made aware of this, or it can very quickly slip into a serious medical issue. One of the major issues I have confronted in working at a Residential Treatment Center that I manage, is the ubiquitous situation we face with people being prescribed by multiple practitioners, none of whom are in contact with each other. When doctors are unaware of this, people can be using medications in ways that are dangerous and unintended. I know that the situation you are describing is a bit different, but the point is that if the person prescribing is not aware that the medications are being misused—you stated that your son is running out before his refill is due—then there is not much they can do to help. Covering this up is not going to help your son, and my suggestion is that you try to get him to sign a consent form allowing you to communicate with him (the doctor) so that he can be made aware of the situation. Secrecy is not an antidote here… it may in fact exacerbate the difficulties he is encountering. Hope this is helpful.