Greetings to the community. I’m looking for advice on a situation.
Before I met my wife, she was a heroin user. Based on her history and behavior of use, neither of us really categorized her as an “addict,” but she was a user. She kicked it right before we met and stayed off it for years, promising it would never again be an issue (which I trusted).
However… She recently relapsed.
Owing to a number of factors, chief among them surviving cancer and (likely, though as yet un-diagnosed) RA, along with a number of other influences like family history and (probably) poor diet and exercise habits, she is in a great deal of chronic pain. We have spent years trying a great deal of medical (professional and otherwise) treatments to no avail. The pain was affecting everything; her mood, her ability to be productive, her ability to concentrate and achieve her goals, everything.
So, without my knowledge and (as was claimed) to her own shame, she started using again. Small but regular quantities to (as was claimed) manage the pain but not “get high.” When I found out what was happening, I confronted her about it and insisted I be allowed to help rather than kept in the dark. She admitted I’d handled the situation in the most supportive way she’d imagined and agreed to cease use and seek treatment, attending a Methadone clinic within the next few days.
She has been a model patient; attending daily and regularly, passing all UAs designed to find usage of substances not prescribed, and completing her assigned therapy appointments. (Though, she does not take her take-home doses as prescribed, preferring to mete them out differently to deal with the pain in a more targeted way.)
However, despite constant dosage increases, she has not reached what she considers to be a “therapeutic dose” (described, by her, as “enough to remove the pain and not be jonesing for another fix”).
This is all backstory. Where I need guidance is in how to deal with the current situation: She has become mean. She is grossly intolerant of most things, responds harshly and with malice to the needs of others, and has a generally sour disposition. She can’t stand criticism, is unable to complete most tasks that require focus, and has lost all compassion within her. She sleeps most of the day (upwards of 15-18 hours), is incapable of bringing herself to complete chores (even the most basic, like washing a dish or changing a diaper on our child), and appears to have no interest in anything.
I have dealt with depression my whole life and I recognize and empathize with many of these struggles. However, I try to believe that most of this can be attributed to the amount of pain she must be experiencing, and I have no experience with that myself. I also have no experience with Methadone treatments, though I have a pretty expansive knowledge of addiction (and many expert resources available to me).
I bear no ill will towards her and feel nothing but a desire to be supportive. I just (apparently, by the lack of progress) don’t know how to do that properly. I need help understanding what she is going through and how I can do more or less of something to make her more successful. I’m sure there are many schools of thought around these issues, and I’ve been purposefully general so as to cast a wide net at the range of possible solutions. I reach out to the community to help me learn about her/my options in the hopes I’ll get some good ideas of what I might try.
Thanks for reading this rather long description.
You seem to be a great partner. As someone that’s lucky to have one as well I know how much that can matter. Doesn’t mean it’ll all end up roses, but you seem to be doing everything you can to support her (including, critically, getting support/intel for yourself). No guarantee, but a critical element in it all.
It might not be just the pain making her behave like that, for what it’s worth. As someone that’s been on a half dozen different opioids (though admittedly never heroin, but from codeine up to fentanyl and many between/beside), I know I got… irritable. Easily and instantly aggravated. Not that I chose to behave like a bastard, but every little thing needled me, rose my hackles in way even the most intense stuff didn’t do before I got on opioids every minor annoyance, pain, distraction, interruption hits ten times harder. I tried to contain my response, and often failed. Realizing that was one of the things that pushed me to quit, despite the pain (not a pain survivor, just trying to stay pain surviving). None of that excuses the behaviour. I was not reasonable, I was sharp, and with a deep internal aggression and at times meanness. Nor does your wife’s state excuse hers. But it might partially explain her altered behaviour. She’s not just dealing with the pain, she’s dealing with a soup of junk messing with her brain. They reinforce the other, too. Methadone was one of the ones that brought it out more in me, but ymmv.
Are there friends (hers or yours) that understand and can offer support? Either in helping to guide her to a better path, helping you stay upright, or helping the both of you stay sane together. People with experience with addiction, chronic pain (or, ideally, both) especially, but aside from that anyone close to you (& trusted by your wife) with a good head on their shoulders.
“enough to remove the pain and not be jonesing for another fix” is a trap. They get linked, even if you’re careful. If you’re desperate for another fix, you’ll experience it as pain (physical, or ‘just’ mental anguish). One way to try to keep stuff level would be to have a set ration per day that’s limited enough it takes budgeting but expansive enough she’s not in too terrible a state. Depending of the dose/opioid I had set a ration for myself (max X pills per day, max Y pills per week. Any exception I had to get my housemate’s ok on, and a no was final.) This will only work if she’s willing to cooperate, and only if she can make herself (with help) to actually follow through on it. But it dropped my dose a good 20%, which made a big emotional difference. It came with a secondary boost due to the added sense of control. I chose to give my meds to my housemate, so that I couldn’t break my own rules. She gave them only when I could convince her. If you can be that person for her, or if someone else can, it might help. A risk here is hoarding. “I don’t need the pills now, but I might in an hour, it’s my last dose for the day so i’ll take the pills and put them somewhere safe if I need them later”. I’ve fallen into that trap. If your wife isn’t fully willing to cooperate, this entire idea is on shakey ground. I chose to let my housemate search my room (in I “I trust you but should/will verify” kind of way). If stuff got caught, all of those were taken away, and i’d have a harder time convincing her to give me any for a while. I hadn’t hoarded much, but for your wife that also depends on how well she’s able to stay away from that.
It sounds like your wife is struggling. It sounds like she’s probably trying her best, but not succeeding. She’ll need to accept that before she can change her path. You’re there for her though, so she has a shot. If she’s willing to work for it. It would also greatly help if she’s accepted that she’s taking the stuff for the pain, yes, but also the high. And that’s understandable; it’s important to understand that because if she doesn’t, she won’t be able to better her behaviour around it. It’s fine that she’s got the urge to take it to feel not-shit (because post-high you very much do feel shit), but it’s not fine to hide from that fact or not act on it.
I have no words other than good luck. Recovery isn’t a straight road and she has to commit to it herself. You’re going to have the really tough choice of staying or not. Protecting your child with or without her. Making choices for the best outcomes are hard and no one but you and your support network will know enough to give you actual sound advice.
Open communication. If she isn’t in therapy beyond her treatment seems like family therapy could be beneficial. Frank and honest discussions. Not being gas lit when you SEE what is happening and she says it’s something different will cause more friction but may be needed.
Best of luck, what a rough road you have to go through. Hope you have the support you need.
I appreciate the kind words. We’ve done couples’ counseling in the past and I’m considering bringing it up again.
RA is Rheumatoid Arthritis? Her joints hurt and it feels like she’s burning alive from the inside out? That’s how I feel, though I don’t have RA specifically. I do have other autoimmune problems though, and I think we’re eventually going to confirm that RA, fibromyalgia and other autoimmune diseases are just different expressions of the same problems.
I’ve been in chronic pain for most of my life, getting worse as I aged. Doctors were not very helpful until I got the right ones, but even then I had to do a lot of the work on my own.
If she’s in chronic pain and her diet is shit, then I’d bet you dollars to donuts it’s because of that (perhaps coupled with autoimmune issues). I recently had a Mediator Release Test done which measures food sensitivity. There are a ton of things that I eat on a regular basis that I didn’t know were bad for me, and I’d already stopped eating gluten a year ago.
I can’t have corn, soy, beans, jalapeños, sunflower, wheat, chicken, cheddar cheese (specifically), mushrooms, etc. Do you know how hard it is to find prepared foods that don’t contain any of those things? Nigh impossible.
I’m doing my best to get all of it out of my diet though because I can’t stand to live in so much pain all the time. It eats who you are as a person no matter how tough you think you are. Eventually it changes your brain to be wired differently.
Even if food isn’t what’s causing her problems, consider having her (and you too) read the book Back In Control by Dr. David Hanscom. It’s not just about back pain even though Dr. Hanscom is a back surgeon. He’s been through suicidal levels of chronic pain, driving him into unemployment and despair. He found his way back, and in the book he outlines the steps to get out of the Abyss your wife is in. The book should help her see straight enough to be able to do the work it’s going to take for her to get better. It’s possible I’d be dead today and not able to tell you about all this had it not been for that book - though it was only a starting point.
I’m cutting off my wall of text here, but if you have questions or whatever, let me know.