Addiction in the Waiting Room – How to go to the Doctor in Sobriety

Almost all addictions to prescription drugs begin in the doctor’s office. It’s a truth that’s sad to admit. These men and women are charged with keeping us healthy, not locked in a battle to get off narcotic medication. Yet every day, more people accept prescriptions for what unknowingly sets the stage for addiction. Some are naive and think they will never get hooked, but chemical desire is often stronger than shere willpower. Anyone can become caught in the dangerous cycle of addiction. And without proper understanding, innocent patients find themselves hooked in an instant.

For those patients with an addictive past and already diagnosed addicts, the doctor’s office can be a frightening place. Patients with an addictive past view the doctor’s office through one of two lenses. Either the doctor is a conduit for getting health, or a candy shop for getting “what they want.” If the doctor is not privy to an addict’s history and sees no reason against prescribing narcotics, some doctors can be quick with the prescription pad.

Physicians unwilling to dispense drugs leniently will likely lose addicts as patients. In a desperate attempt to find willing practitioners, addicts may resort to “doctor shopping.” This process, invented by addicts, results in dependent men and women bouncing from physician to physician until he/she finds the desired narcotics. Recent changes to law make this process punishable by fine and imprisonment, though persistent patients doctor shop regardless of the consequences.

Other addicts who, particularly early in recovery, may easily find themselves walking out of the doctor’s office with a prescription for potent painkillers or benzodiazepines. A physician simply takes a symptom, such as pain, and unknowingly prescribes an opiate to a heroin addict. Once a heroin addict, recovering or not, possesses a prescription for opiates, thoughts that travel through the mind transform into an entirely different train. Suddenly, (for purposes of simplicity, this article uses the pronoun “he” to substitute for “addict,” though you could easily substitute she for it too) in a rush of adrenaline, the addict faces an impossible conundrum – he can either tell someone the truth, risking others thinking he is using, or he can lie, take the drug and relapse.

But that’s not a healthy perspective on this situation. That’s precisely correct. Remember, addiction warps the mind. “Stinking thinking” is a saying in recovery, and it refers to our tendency to view situations with a warped perspective. Instead of viewing this as an opportunity to demonstrate recovery principles, our addict likely views it as a dark situation ripe with danger. And though that may be true, what’s truer is that this situation offers the chance to practice what he’s been taught – honesty in the face of dishonesty, integrity in the face of impairment.This is why it’s so important for addicts, whether seeing a new doctor, psychiatrist or staying with their current one, to disclose their substance abuse history. Physicians usually make a note of something as important as that. Ethical doctors will treat a substance abuse disorder as the illness it is, rather than treating the addicted patient as a criminal to be discarded at first opportunity.

If you suspect you’re becoming dependent to something your doctor prescribes, now is the time to discuss it. I’ve spoken with many patients who regret not airing their concerns to a doctor earlier. You don’t want to be that patient – someone who blames a doctor for prescribing medication their symptoms suggested. It’s crazy to think that people blame a doctor for prescribing opiates after complaining about pain, but they do. No doctor can force pills down your mouth without a court order. If you’re reading this article, there’s an excellent chance you don’t fall into that category. But how can you tell if you’re becoming addicted?Tolerance: Are you taking more than you originally had to achieve the same effect?

Refills: Are you finding yourself in need of refills before it is time to refill?

Taking pills not as needed: Are you taking medications when you need them or when you feel like it?

Trouble stopping: Do you get sick or present withdrawal symptoms when you miss a dose or do not take one for a few days? Are you taking them to ‘stay well,’ knowing that if you do stop, you’ll likely feel off.  Though you are likely familiar with some symptoms of narcotic withdrawal, this is probably a good place to supply a reminder.

Withdrawal is a serious condition that happens when use of a substance is lessened significantly or stopped suddenly. The severity of withdrawal will vary depending on many factors including (but not limited to) the substance abused, duration and frequency of the use and the overall health of the patient.If a dependent person is already in poor health, he is more likely to experience withdrawal symptoms on a more uncomfortable and painful level than someone who is in fair health and not abusing prescription drugs as long. Signature withdrawal symptoms associated with prescription medication withdrawal include (you may experience some, all or none of these):

  • Shakes/tremors
  • Excessive perspiration
  • Extreme anxiety and panic
  • Headache
  • Nausea with or without vomiting
  • Severe depression
  • Fever
  • Insomnia
  • Diarrhea
  • Intense cravings for the drug
  • Depersonalization
  • Depending on the drug abused, hallucinations or delusions

Withdrawal is the body and brain’s reaction to the chemical dependence that has formulated to a narcotic addiction – it is complicated, serious, and dangerous. There are both physical and psychological withdrawal symptoms that can be severe enough to interrupt a normal life. In some cases, namely those of acute benzodiazepine withdrawal, these symptoms may be life-threatening.

If you or someone you know has been taking prescription narcotic medications regularly, and is experiencing any of these symptoms, professional medical attention should be sought immediately. Let me say that again to really drive home the statement:

If you or someone you know presents withdrawal symptoms from prescription medication, seek qualified medical assistance as soon as possible.

It is never a good idea to stop a prescription narcotic medication “cold turkey” and most definitely not without a doctor’s advice. If symptoms are serious, a physician may refer an addict to a detoxification facility for withdrawal under qualified medical supervision. Of course, anytime narcotics are involved in the past, present, or in the future of an individual’s health, the guidance of medical professionals should never be taken for granted. But it shouldn’t be taken divorced from the input of others either. This means that, when beginning the process of removing dangerous prescription drugs, seek the advice of not a doctor, but also men and women who work in the addiction recovery field. Their input and experience often helps to compliment a doctor’s direction.   

You should also realize that most medical professionals see more than one patient a day. Some see more than twenty or thirty. Doctors aren’t infallible – they forget, get confused or neglect to read a chart or medical history. Physicians are humans capable of making human errors, and unfortunately, those errors sometimes negatively affect patients. Only patients maintain a full awareness of their medical history. Therefore, it is critical to remind a medical provider of their past, and that burden falls solely on the patient. No one else is responsible. No one else can be blamed.

The doctor-patient relationship is primarily based on mutual trust. A physician must be able to trust their patient will be honest no matter what. In turn, the patient must be able to trust that their doctor won’t prescribe a medication that may jeopardize recovery. But almost all medical professionals develop a strong sense of ethics, thus it’s unusual for a doctor to prescribe opiates to an individual he/she knows has a history of heroin abuse.

  • Have a frank discussion about your past with your healthcare provider
  • Address your concerns openly with the doctor, don’t be afraid to ask questions
  • If your physician has questions for you, answer them as honestly as possible
  • Let the doctor know the very real risks of prescribing a non-narcotic medication to you
  • Have a plan in place in the event taking a narcotic medication is unavoidable.

For example, if you’re undergoing surgery, there’s a strong chance you will need to be temporarily placed on painkillers. Or if you suffer from an authentic mental health condition, there’s a chance you might be placed on benzodiazepines. Discuss this situation with a sponsor and others in recovery to formulate a plan should something like this happen to you.

So take solace in the fact that physicians and the medical community are here to help, not hurt. Be honest and unafraid to speak up, and the likelihood of you leaving the doctor’s office with recovery, as opposed to with prescriptions, is very good. 


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