Drug OD case: Airline pilot and wife

[athena53]

I really think the darn opioid pain relievers started a whole lot of people down this road. I follow a lot of BBC podcasts on this and also saw it early on in large Worker's Comp. claims- lots of people addicted to expensive pain meds after a work-related back injury and a few unsuccessful surgeries. Heroin is now easier to get and less expensive (I'm told) so some people have switched to heroin.

DH had a creaky back and would get a prescription for Oxy, Hydro, etc. He hated the side effects so would take maybe 2 or 3 and put the rest away. I cleared out about 4 bottles past their expiration date (disposed of properly) after he died. It used to be extremely easy to get- I think I've posted here before that 3 years ago I had dental implants placed and got a prescription for Oxy or Hyrdo- 25 pills, one refill, without asking. I never filled it.

After DH died there was also some leftover morphine. I was a bit tempted to try it but I like my brain the way it is and that stuff scares me. Fortunately, a guy in our church was leading a medical mission to Haiti and happily accepted DH's last bottle of Hydrocodone (over 100 pills) and the morphine.

I still have a bottle "just in case" but the only time I ever tried it was years ago when I developed terrible pain from an abscessed tooth one night after we landed in Budapest and DH gave me one from his stash. It did nothing. I had the tooth extracted the next day.

 

[Newventurer]

Theft of leftover prescriptions is a common way users access the drugs, especially your kids friends. Come into your home. Ask to use your bathroom, rummage through the drawers.

Our police dept has an anonymous drop off for drugs no longer needed. Put them in a ziplock and drop them off, take them out of potential circulation.

Have a son that was a substance abuser in high school we bought the drug test kits at Walgreens and administered them to him ourselves. He straightened up, we were lucky.

 

[Lisa99]

My leftover vicodin saved me last week from misery.

My back went out while we were in Arizona. We have no insurance there so had to drive home to Nevada to get to urgent care. That was the longest 3 hours ever!

Urgent care prescribed tramadol and prednisone. I took the tramadol when I got home and got zero pain relief. I had a full bottle of vicodin from surgery 2 years ago that I filled but never used so switched to them. I was worried about taking them but was in so much pain all it did was take the pain level down to a barely tolerable level.

Took them for 3 days then switched back to tramadol but stopped all pain meds on Friday. Seeing a back doctor tomorrow to find out why I have no feeling in my right foot. Afraid I did some nerve damage. Walking with a limp since I can't push off on that toe but at least I'm walking.

I can't imagine the 3 days without the vicodin but I'm afraid of them so stopped as soon as I could.

 

[Sojourner]

skydiving is an accepted way to get quite a rush, and pretty deadly from my limited knowledge, so there is an example of risking death for something that can easily be avoided without limiting life.

The skydiving analogy is an interesting one, for several reasons.

First, skydiving is nowhere near as fatal as getting high on large doses of opioids on a regular basis. Apparently, the fatality rate for skydiving in the U.S. is 8 in one million. Contrast this with deaths due to fentanyl in the state of West Viriginia: 40 out of 100,000. And those 100,000 include all residents, not just fentanyl users, so the rate of death among fentanyl users must be something like 100x higher.

The rush most people get from skydiving is intense and completely exhilarating, probably somewhat like a drug high. But to do an apples-to-apples comparison between that and getting high on fentanyl every day, you'd have to make some adjustments. For example, would anyone with a functioning brain go skydiving on a regular basis if it was widely known that their one and only parachute (no backup) had a failure rate of 1 in 50, or even 1 in 100? This is what I don't get about someone like Prince. He was someone of reasonable intelligence, so he had to know the astronomically high risks of fentanyl, a drug 50 times more powerful than heroin. Yet he took it over and over and over again -- probably steadily increasing the dosage due to tolerance -- surely knowing that he would eventually overdose and die, just based on probability. Truly hard to understand how anyone's mind could work this way.

 

[MRG]

lTruly hard to understand how anyone's mind could work this way.

That is the insanity of addiction!

If you look online the entire text of "The Big Book of Alcoholics Anonymous" is available, this text is used for many addiction treatments including drugs.

On pages 37-38 the authors attempt to describe the insanity of the disease with a pedestrian as the addict. It does a fair job of describing the bizarre behavior.

 

[samclem]

. He was someone of reasonable intelligence, so he had to know the astronomically high risks of fentanyl, a drug 50 times more powerful than heroin. Yet he took it over and over and over again -- probably steadily increasing the dosage due to tolerance -- surely knowing that he would eventually overdose and die, just based on probability. Truly hard to understand how anyone's mind could work this way.

We aren't very good at reasoning even under the best of circumstances. None of us. Our brains use lots of built-in shortcuts that help us quickly grasp situations and make decisions (through pattern-seeking, previous experience that we can't even consciously describe, etc). But an addict has had his neurochemical circuitry hijacked, they are absolutely not capable of making rational decisions based on ultimate risk/reward. Addicts have been known to sell their children for enough money to buy a fix. They didn't start out as "bad people." The drugs have so taken over their pain/pleasure apparatus that they cannot make the kind of decisions you are describing.
Should we hold them accountable for their actions when they are in this condition? That's a big moral question. We do not hold minors and mental incompetents fully responsible for their actions, and addicts have many of the same judgemental deficits we see in children. But I know they can be a threat to themselves and to others, so that argues for some type of action.
And as for the folks selling this stuff? Addicted or not . . . .

 

[Scrapr]

Prince was injured early in his career. Back injury IIRC. So that is likely how he started. Then the thrill of performing probably led him to stronger & stronger painkillers. Which led to off duty dosage.

Addiction and addictive personalities are a terrible thing

 

[Tadpole]

Do the opioids require greater and greater doses to address a constant pain? If so, is the cause of some overdoses simply the amount required to alleviate pain or does some else take over as the reason the person is taking the drug? I was injured very badly in a car wreck and kept on various opioids for several month ending with oxycodone for a month or two. When the oxycodone was "no refills" I saved ten pills for good measure and spent two days sitting up in bed crying while, at the same time, laughing at myself for being such a cry baby. I never understood why because it wasn't pain that produced my reaction. However, I had never felt a high or any other effect other than the pain relief. It was just a useless craving type feeling.

 

[Teacher Terry]

I think one of the hardest thing is when kids have children and get into drugs. Then it leaves the grandparents in a terrible spot. They have to raise the grandchildren or let them go into foster care. Luckily my son never had any kids as his addiction lasted 20 years. I met a couple in their 70's caring for a 15 and 2yo. They had the 2 yo on leash as he was very active and they were very overweight. She could not even sit to watch the old faithful geyser because the kid was constantly on the go. I honestly have no clue what I would have done if ever faced with that situation. Years ago when i was a SW in WI if the parents could not get their **** together after a year the parents rights were terminated because they wanted the kids to get adopted before they got so old that no one wanted them.

 

[Fedup]

I have back pain but for years, I just buy Tiger balm from Rite Aid and it does help. I stock up a supply of it so when my husband hurt himself, it does help relieve some pain. Recently my daughter asked for a jar for her business partner. He hurt his back somehow. All my problem seems to be going away now and I rarely use them any more. Same with my husband and his heel. I think he had PF. But for a while Tiger balm was the go to to help alleviating pain without taking anything orally.

 

[Koolau]

The expression I have heard describing "why" people use addictive substances goes something like:

To those never addicted, no explanation is possible. Among those who have been addicted, no explanation is needed. YMMV

 

[MRG]

The expression I have heard describing "why" people use addictive substances goes something like:

To those never addicted, no explanation is possible. Among those who have been addicted, no explanation is needed. YMMV

I have never heard that and it's an excellent description.

 

[Sojourner]

Do the opioids require greater and greater doses to address a constant pain? If so, is the cause of some overdoses simply the amount required to alleviate pain or does some else take over as the reason the person is taking the drug?

It's my understanding that with fentanyl and heroin, the addict really has no way of knowing the strength or potency of the substance they're taking. It comes in a powdered form and is almost always "cut" with other powdery non-drug stuff, making the true potency completely unknowable. And with fentanyl in particular, the exact dosage really matters because it is so incredibly powerful. Only 3 mg of fentanyl can kill an average-sized adult male. Yet these addicts blithely go about their business, buying it, snorting it, injecting it, like they know exactly what they're doing and exactly how much they're taking. This kind of blindly repetitive, reckless behavior almost invariably ends up being fatal if continued for long enough.

There is a good documentary on YouTube about this called "Death by Fentanyl".

 

[NW-Bound]

The expression I have heard describing "why" people use addictive substances goes something like:

To those never addicted, no explanation is possible. Among those who have been addicted, no explanation is needed. YMMV

And it does not have to be drugs either. I have told the story of a guy who was caught and fired from megacorp because he surfed the Web for pornography at work. Why he could not even wait to go home to do it?

It would be simpler to explain if he did not have a PhD degree from an Ivy League school. Perplexing.

 

[2017ish]

It's my understanding that with [black market] fentanyl and heroin, the addict really has no way of knowing the strength or potency of the substance they're taking. ....

Not just true of these drugs. One wonders how long Halsted would have survived with his cocaine and morphine addictions in today's world.

 

[Koogie]

Apropos. Apparently opioid addiction can happen in as little as a few days..

with-a-10-day-supply-of-opioids-1-in-5-become-long-term-users
https://arstechnica.com/science/201...ply-of-opioids-1-in-5-become-long-term-users/

"'The longer a person uses opioids, the greater the risk of forming a deadly addiction. But just how long does it take to switch from being a short-term user—say, while you’re dealing with pain after a surgery—to a long-term, potentially problematic user? A few weeks? A month?

According to a new study, that transition could take just a matter of days.""

 

[Walt34]

Apropos. Apparently opioid addiction can happen in as little as a few days..

with-a-10-day-supply-of-opioids-1-in-5-become-long-term-users
https://arstechnica.com/science/201...ply-of-opioids-1-in-5-become-long-term-users/

Interesting, and scary. I still have some Percocet left over from a prescription last April that is in fact a refill but I never felt the desire to take one when not needed for pain. But perhaps I'm just lucky.

A few weeks ago for some reason I was looking up how long it took to get addicted to prescribed opiods and most of what I saw seemed to indicate ~30 days, taking them continuously for that period. I've never come close to that.

 

[bmcgonig]

Interesting, and scary. I still have some Percocet left over from a prescription last April that is in fact a refill but I never felt the desire to take one when not needed for pain. But perhaps I'm just lucky.

A few weeks ago for some reason I was looking up how long it took to get addicted to prescribed opiods and most of what I saw seemed to indicate ~30 days, taking them continuously for that period. I've never come close to that.

I had a friend that used to get high on Vicodin whenever he got his hands on it. I once said to him something to the effect that I never feel high when I take one of those. His response: "I take 4"

So those of us who never get high on these things have probably just never taken a high enough dose.

 

[NW-Bound]

As described earlier, I went through two major surgeries and two minor ones in the last few years. I read about people getting addicted from legitimate medicinal use, so did not want to tempt fate. I would take just enough to cut the pain, and no more, and that was only 1/2 the dosage they said I could have, even while in the hospital. I also weaned myself of the drug as soon as I could.

I read that people take alcohol along with the drug to enhance its effect. Knowing that, I would not "try to see what happens". I guess people who push to the limit and experiment are the ones who get themselves hooked. I am too chicken, and see no reason to try either.

 

[MRG]

Interesting, and scary. I still have some Percocet left over from a prescription last April that is in fact a refill but I never felt the desire to take one when not needed for pain. But perhaps I'm just lucky.

A few weeks ago for some reason I was looking up how long it took to get addicted to prescribed opiods and most of what I saw seemed to indicate ~30 days, taking them continuously for that period. I've never come close to that.

I was on a high dosage for longer than that. I was told in 2000 from a pain management specialist, "We generally don't see physical withdrawal symptoms until 6-8 (5mgx325) doses daily x 6 weeks of use", this was Oxy.

I believe that was the current thinking at the time. I am sure it's probably been updated.
I can tell you that scenario brought on withdrawal symptoms for me. Honestly I thought I was having a panic attack when it occurred. I described that to him and his advice was to reduce the dosage by 25% every 3-4 days as I could tolerate it. He made it very clear he'd not prescribe more than needed to perform the process. There was no need, I'd been stupid too long.

 

[Persn]

I was a public defender and represented thousands of drug addicts and alcoholics over the years, often people with underlying mental illness. Treatment is usually required to get a person clean and sober, and it often doesn't work the first time around...or the second...or the third. But eventually a person may have the "moment of clarity" often cited by people in recovery where they begin to get it.

In the meantime, Alanon can really help family members come to terms with a loved one's addiction.

And just because treatment has failed before doesn't mean it will fail again. Many addicts really do want to get clean and have a normal life. Putting people in jail leads to what we call "institutional remission" and without treatment or at least a sober support network, it usually ends the minute the person leaves jail.

 

[Sunset]

The skydiving analogy is an interesting one, for several reasons.

First, skydiving is nowhere near as fatal as getting high on large doses of opioids on a regular basis. Apparently, the fatality rate for skydiving in the U.S. is 8 in one million. Contrast this with deaths due to fentanyl in the state of West Viriginia: 40 out of 100,000. And those 100,000 include all residents, not just fentanyl users, so the rate of death among fentanyl users must be something like 100x higher.

The rush most people get from skydiving is intense and completely exhilarating, probably somewhat like a drug high. But to do an apples-to-apples comparison between that and getting high on fentanyl every day, you'd have to make some adjustments. For example, would anyone with a functioning brain go skydiving on a regular basis if it was widely known that their one and only parachute (no backup) had a failure rate of 1 in 50, or even 1 in 100? This is what I don't get about someone like Prince. He was someone of reasonable intelligence, so he had to know the astronomically high risks of fentanyl, a drug 50 times more powerful than heroin. Yet he took it over and over and over again -- probably steadily increasing the dosage due to tolerance -- surely knowing that he would eventually overdose and die, just based on probability. Truly hard to understand how anyone's mind could work this way.

I don't think skydiving is as deadly as OD'ing on drugs, but still dangerous.

Of course sky-divers don't jump every day or two, if they did, I'll bet the death rates would go up as they became more casual and comfortable with jumping, due to less attention paid to checking stuff.

Personal experience about skydiving, I talked to a boss at work BBQ about the recent death from skydiving in the paper. Turns out about 5 years earlier, he and 4 others would go skydiving.
During the past 5 years:
# 1 went splat. (not his words).
# 2 went splat.
He quit skydiving as felt it was too dangerous.
# 3 went splat and was in the paper for me to mention to him as an interesting story

To me that is a 60% death rate, maybe most folks stop after a few jumps ?

One guy was still jumping, but it's lonely....

 

[Sunset]

I had a friend that used to get high on Vicodin whenever he got his hands on it. I once said to him something to the effect that I never feel high when I take one of those. His response: "I take 4"

So those of us who never get high on these things have probably just never taken a high enough dose.

Or you can use a pill crusher/hammer to make it a power and mix it in a booze drink.

 

[check6]

I think one of the hardest thing is when kids have children and get into drugs. Then it leaves the grandparents in a terrible spot. They have to raise the grandchildren...

That is currently happening on my wife's sister side of the family.

 

[Badger]

With all the discussion on opioid addiction what is someone to do if they have chronic pain? I have gone through 5 major surgeries in the last 5-6 years. Spinal nerve damage resulted in a lumbar fusion and right leg peripheral neuropathy with a limp. Rotator cuff surgery on both shoulders required drilling holes in bone to reattach muscle but couldn't help the progressive arthritis.

I have been prescribed oxycodone/hydrocodone that I only use to take the edge off of the chronic pain when it gets too bad. I limit to one pill once or twice a week because of addiction concerns. I've been prescribed just about everything on the market but none work without some undesirable side effects.

Everything for pain management seems to have a physical addiction. Marijuana for pain control is not available in my state and is illegal even though it is not physically addictive (psychologically maybe) so that is not an option.

Discussing opioid addiction helps warn of a dangerous side effect and educate regarding a problem. However, I don't hear of anything being done to effectively address the problem of chronic pain management?

Cheers!