Fireweed3 reports on her Loved One’s fragile state. After testing positive for a number of drugs, she seemed to be motivated to clean up and focus on recovery. But with a partner who was still using, she faced a series of disappointments. That relationship is now falling apart, she is vulnerable again, and is only halfheartedly participating in recovery activities.
Just as I suspected, my daughter's cannabis use led to relapse. After allowing a couple of "friends" from treatment crash in her garage space (not allowed by the way), she tested positive for oxy, benzo, THC and meth. After vomiting for 2 days, and not tolerating food for several days, she cut ties with those "friends" and focused on her recovery and relationship with boyfriend.
At that point, I implemented your suggestion (to use boyfriend as the reward). It worked! It motivated her to attend NA meetings more regularly and to follow through with a few more tasks/responsibilities.
However, her boyfriend continues to use, and his instability is causing her emotional pain. He promised to take her out this past week, only to show up late and high on Xanax. He wasn't present for the outing, and he said harmful things to her (weakened her already fragile sense of self). Long story short, their relationship is unraveling and she's struggling not to use. Two nights ago, she came into my room at midnight, searching the closet for Qtips. When I asked why, she said, "I just took a shower, I need to clean my ears." A year ago, I may have been naive, but not now. She took her Qtips back to the ADU. I texted her and told her I was feeling scared that she may use (heroin) to numb the emotional pain (as she has done recently). Then I tried to hand my fear/worry to the universe.
Anyway, now that boyfriend may not be in the picture, I need to find other ways to incentivize/reward follow through with recovery activities. Back to the drawing board…
A couple questions:
When you suggest Suboxone, I assume that's because of her intermittent IV heroin use (while "in recovery") and the risk of overdose. Would she even meet criteria for MAT? I will send an email to her psychiatrist, but I'm not sure she qualifies, given her history of poly-substance use including meth/heroin (goofballs). Please share your thoughts.
Also, curious about your comment in another post, when you stated that stimulant misuse (Adderall) is more psychological than physical. Does that premise apply when someone snorts it as well? Or is nasal inhalation of prescription stimulants a sign of addiction?
Thank you, as always.
Your daughter is struggling in early sobriety. She continues to live in your garage apartment and the boyfriend is no longer really in the picture. You are asking about Suboxone for your daughter and are concerned she would not meet the criteria. I am not sure what criteria clinics are using to prescribe Suboxone. I know that even intermittent use is quite dangerous since street drugs are being mixed with fentanyl more than ever. So yes, goofballs would qualify.
The concern clinics have at the forefront are the people coming in whose only intention is to get on the drug in order to sell it on the street. Suboxone is being used prophylactically: it is being prescribed to people who are not currently addicted and using, but who are in danger of using again. This is the case with the jail I work in. We are regularly taking people who have been in jail for months, ostensibly drug free, and putting them on Suboxone just before they get out, as a preventative.
The Suboxone would add one layer of safety for your daughter, reducing her urge for opioids. It would put her under the eye of professionals who would urine test. It should also require psychotherapy.
Regardless of the method of use, whether you snort, shoot, swallow or smoke, how you get the drug into your system doesn’t alter the fact that the drug is in your system. Adderrall is not designed to be snorted. People crush and snort a drug to get more of it, more rapidly, into the system. Doing this causes them to feel a rush that doesn’t always happen when swallowed.
So yes I would say your daughter is misusing the Adderall. Let’s think about this though. If she is taking the Adderall as a way to avoid the methamphetamine, this is a better option. It is reducing the harm of her otherwise shooting goofballs.
Getting her to see a psychiatrist for Suboxone would be the next step. Having the Adderrall in her urine should be addressed by the Suboxone provider.
Meanwhile, your daughter continues to bump along…. a little NA, a little Adderrall. You are doing a good job with her – and with yourself. Your observations are sharper, your communications more concise and strategic, and you are using valuable tools to reign in your thinking when you see it going in a negative direction. Keep this up! You are continuing to be a positive influence. Right now, she is in that very very uncomfortable place, where you continue to use a little and chip away at recovery activities. In AA, they say a belly full of booze and a head full of AA. Very uncomfortable.
Watch her access to cash if you can. Use your good CRAFT skills to gently move her towards Suboxone as a next step.
What a life for you! This is a raw and painful time. You have been doing great work, holding a strong yet loving stance, and we commend you – this isn’t easy. Well done flipping the script and using the boyfriend as a reward. I’m glad this worked, even temporarily. It sounds like their deteriorating relationship is a mixed blessing. It gives her more emotional turmoil to navigate, which is unfortunate in her current state. But it also serves to distance her from the the disappointments and added drama of being with a using partner. Clearly he was not showing up for her in a positive way. There are valuable lessons here for her that may well help protect her in the future. But whether she sees this clearly now, or will see this over time, is out of your hands.
So turning back to what is in your hands… Now that you’re back to the drawing board with the rewards, focus on daily things. Think small: a smile, a good meal… This is ultimately hers to figure out. You are partnering with her, continuing to get her resources for recovery. You’re turning away from your daughter’s problems as often as you can to return to your own life… Working to maintain this very difficult balance. We are here for you. And we’re grateful for what you are sharing with us.