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Addiction and Substance Abuse

Worried

09/05/2005

Question:

Today I received a reality shock. My husband, who just had major surgery less than 3 months ago had a psychotic episode today. I found him holding a knife to his throat and repeating paranoid delusions about people trying to kill him and watching him. He has been a chronic drug user for over 20 yrs. He has periods of time where he doesn`t use anything for months and then he relapses. I don`t know what to do. He has never received professional treatment and today when asked, he refused. He was seeing a psychiatrist on an outpatient basis, but he felt that the doctor was "drugging him up" on antidepressants. He says he would like to live with zero drugs, but his actions say differently. He has had a very traumatic life including his heriditary heart condition, the loss of both his father and brother and he is the only one left besides his mom who is older and he is the sole caretaker. I would like to know if there is any program that would help him without using medication as the sole treatment. He has never received grief counseling and does not seem to possess any positive coping mechanisms for stress. He primarily smoked marijauna, but has since graduated to benzodiazepines prescribed by his doctor, hydrocodone, and cocaine. What can I do to help him? I am worried he is going to end up either having a stroke or bleeding to death. How can I convince him that he needs help? The majority of his friends are chronic drug users also and he seems to think that because he hasn`t hit rock bottom like some of them, that he doesn`t have a problem. Right now he is sleeping. I want to talk with him tomorrow. I hope this is his rock bottom. I can`t take much more. Please help me.

Answer:

Hello, It sounds as though your husband is very ill and is in late stage addiction. If the doctors were unaware of his Benzo addiction, he probably didn't receive detox to prevent hallucinations or DTs. He could also be having a cocaine psychosis if he used cocaine before experiencing the hallucinations. He needs admission to a treatment center ASAP. All will use appropriate medication that would substitute for the Benzos and then they would be weaned off. Cannabis chronic use also causes depression and lack of motivation.

Treatment for addiction consists of teaching non-chemical methods to deal with life on life's terms without addictive drugs. He would have to get off everything. He can't use anything including alcohol in the future.

As far as what you can do, here are some suggestions. You could call his doctor to see if they will help intervene on him. If he is threatening to hurt himself or someone else, you can have him probated to a psych unit, but he needs the help of an addictionologist urgently as well. You should also put limits on what YOU will tolerate. If YOU are unwilling to live like this then you must set boundaries for yourself. You need help as well since this is a family illness. For YOU there is Al-Anon which helps people understand tough love. If YOU continue to tolerate this craziness, you will get sicker and so will your husband. He could die.

There are also treatment specialists who will arrange a formal intervention in which everyone concerned about him meets and plans and rehearses what they want to say to him in a firm yet supportive way and then give him the ultimatum to get help NOW or he will face consequences. You must decide what you are willing to say. You might say you are leaving him until he gets help or ask him to leave. Though this is hard, desperate measures are often necessary to help someone. Be advised though that you should never threaten something that you know you won't do if the time comes that you must act on your threats. The police will also come if he has a weapon and forcibly take him to safety if that is necessary.

I recommend you go to Al-Anon immediately. It is a support group made of others like yourself who care and live with alcoholics and others addicted to other substances. YOU must take care of yourself especially if you have children being affected by his addiction. Take care of yourself. Short of the things I outlined above, the only person you can change is YOU!!! Good Luck!

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Response by:

Edna M Jones, MD, MRO Edna M Jones, MD, MRO
Emeritus Clinical Assistant Professor of Family Medicine
College of Medicine
The Ohio State University