• Chronic Pain Following Surgery

    Rock bottom became the solid foundation on which I rebuilt my life.

    - J.K. Rowling

  • Pain Killer Addiction and Suboxone Treatment

    Rebecca is a female in her 50’s who presented with a long history of substance dependence. She reported that she grew up in an alcoholic household, and that alcohol dependence preceded her by at least two generations. She reported, “Alcohol was always present while I was growing up. “My Dad was a functioning alcoholic, was financially successful, belonged to a prestigious country club, and never really wanted for anything.” She reported that she began her path to drug and alcohol abuse in High School, stating, “It was fun at first. My house was the party house occasionally it would get out of hand, but no real trouble.”

    However, after Rebecca went to college she began drinking daily and at one time required treatment for alcohol poisoning. She also received a DUI and had to go to a “diversion program”. She also related, “I was a psychology major and knew what to say and not say to avoid being diagnosed an alcoholic.” She continued to drink and began experimenting with other substances such as cocaine and cannabis. During this time her behavior was spiraling out of control with blackouts and “drunk-dialing” family and friends. By this time both her father and her sister had gone into treatment for alcohol abuse, and had achieved sustained sobriety.

    However, after Rebecca went to college she began drinking daily and at one time required treatment for alcohol poisoning. She also received a DUI and had to go to a “diversion program”. She also related, “I was a psychology major and knew what to say and not say to avoid being diagnosed an alcoholic.” She continued to drink and began experimenting with other substances such as cocaine and cannabis. During this time her behavior was spiraling out of control with blackouts and “drunk-dialing” family and friends. By this time both her father and her sister had gone into treatment for alcohol abuse, and had achieved sustained sobriety.

    While in college Rebecca became engaged to be married, and when her family came into town to help plan the wedding they were so concerned about her condition that they arranged for an intervention, and she agreed to enter inpatient rehabilitation. While in rehab she tried to manipulate the conversations staff members to avoid the diagnosis of alcohol dependence. After she left rehab she refused to continue with outpatient follow up treatment. She was able to maintain abstinence for about six months and then began using cannabis until she became pregnant. She was once again able to stop using, until her daughter was about age two. At this time Rebecca began actively using cocaine. After a few years she had a realization or “a moment of clarity,” and began going to a twelve step program near her home and maintained sobriety for seven years.

    She then sustained and injury in a rock climbing accident, fracturing her pelvis. She developed a chronic pain syndrome and was prescribed opioid pain medications. Once she began doubling up, “I was off to the races”. She was using more and more narcotics, and she was receiving prescriptions from multiple physicians. She noted, “With my x-rays, it was a cinch to get those doctors to prescribe more and more pain killers.” She then began getting ordering opioids on the Internet and had them delivered to her office. Her drug use was also affecting her family life, “I was not there, I was nodding off and not present for anything.” She was then confronted by her son and her parents and she agreed to go back to inpatient rehab. She entered into a program in the Midwest and was started on Buprenorphine (the active ingredient to Suboxone). However, she was tapered off this medication while still a patient at that facility. She completed treatment there, this time “honestly,” and upon discharge agreed to enter an Intensive Outpatient Program (IOP). While at the IOP, she became very disappointed in herself, as despite her best efforts she was still having frequent strong cravings, and was afraid she would relapse. We discussed her history and her treatment options, and we decided that she would be an excellent candidate for Suboxone treatment maintenance. She restarted the medication and felt a great deal of relief, reporting that her cravings were alleviated. She continued in her recovery program and resumed her peer and family supports. Rebecca has been sober without relapse for eight years and counting.

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    Washington DC:
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    Northern Virginia:
    McLean 22101- McLean 22102 - McLean 22106 - Great Falls 22066 - Arlington 22201 - Arlington 22202 - Arlington 22203 - Arlington 22205 - Falls Church 22041 - Vienna 22181 - Alexandria 22314