Mother needs help

[Eddie1111]

I posted a question in the regular forum but here it says Expert forum.  I need to know if anyone has had any experience with Residential ************** centers,  We had to put our mother into one a few weeks ago for Opiate abuse.  Mentally she is starting to really struggle and it is starting to scare us as a family.  She has never had mental stability issues but is starting to really have severe mental problems.  She has been off all opiates for a week.  She has been taking them for pain issues for 15 years now. All her prescibs have been legit from doctors but they gave her too many and too much and almost killed her and got her completely addicted.  She is in a 45 day 12 step treatment home with other people with similar problems.  We have so many concerns about her prognosis and if she will always have mental issues without the drugs in her system.  We want our supportive, smart, loving mother back when she gets out.  We are just hoping we made the right decision.  

[122 Tactical Fighter Group]

Even 1mg of suboxone is a strong dose of a narcotic.........sub is active down to microgram levels......doesnt sound like the  taper was done very well to provide for her geriatric and emotional health.....  When many get toward end of sub therapy they taper to 1/4mg .....then they take that 1/4mg every other day for a week or ten days and then every third day for a week.......its  long process to do properly and with fewest complaints from patient..........

[Eddie1111]

Thank you Jeffrey,  We will have to play it by ear.  I know she wants to stay and all she wants is to get better.  I feel like she is a little different then many drug users.  Yes she is a drug user but she has always been a legitimate user.  Always had legal prescrips and has never crossed the lines quite like some have.  Now she has quit though her mental health has become such an issue.  She was totally functioning and normal when she was on the drugs other than fatigue and sleep issues.  She just started taking way too much and it was making her really sick.  Is it possible that the rehab center is pushing her too hard mentally and it could be causing her damage that was not there before?  Is it possible that they are tearing her down so much that it is hurting her.  I knew her before she ever took drugs and I knew her during taking the drugs and now I don't know her.  Will she come back or how can we get that caring, happy person back?  It doesn't seem like this process is worth it at this point.  When she was on the suboxone taper and was still only on 2mg a day she was very happy and very pleased with her progress,  5 days after she quit taking her last 1mg dose of soboxone she started to go completely crazy and scared and can't sleep and thinks her life is in danger by other people in the clinic etc.  Is this normal?  Our family is so confused because the treatment center won't even let us talk to her or see her right now.  We don't know what is happening.  They councilors are acting like they are kind of concerned and I just wonder if I need to watch for something in particular or pull the plug on the treatment I paid for.  We don't have the money to do this again so it really has to work. Thanks for your time.

[J T Junig, MD PhD]

My own treatment was in a residential center;  it was 'open ended', meaning they kept the person until they were sure you 'got it'. I was there for over 3 months.  In general, a person needs a good 90 days or more, so they may look for a halfway house for your mother-- if they do, you would do your mom a tremendous favor by forcing her to stay away from home for as LONG as possible.  She will keep insisting that she needs to come home, and you will feel more and more guilty... but home is where she got sick, and so it is NOT a place where she will 'recover.'

The irony is that as long as a person is arguing to leave the center, they probably should be staying there.  You know they are ready to leave when they are afraid to go, and want to stay at the treatment center forever.  Good luck-- I hope things work out.  Understand it is NOT about education;  they have to actually change your mom's personality, and that is very difficult to do.  Avoid being pulled into fights with the counselors;  in general you will help your mom by always supporting the counselors.  The addicts do everything they can to try to avoid change, including enlisting other family members to fight for them.

The success rate for opiates is unfortunately not that great;  probably well below 50% for one year of sobriety even in a more 'mature' person.  That is why I am comfortable prescribing Suboxone;  there just are not many good options out there at this point for opiate dependence.