My mother has severe RA in her neck, spine, both shoulders and both hands. She has just recently begun seeing a pain management doctor who has placed her on extended release Morphine. In the past, i have had to hospitalize my mom for rehab from perscription drugs. Because of this her PCP will no longer perscribe her narcotics, hence she is seeing a pain doctor.

Tonight, I go to her house to check on her and my mom was so high she couldn't hold a conversation. She held the TV remote to her ear and began complaining that she couldn't get a signal and she needed to make a phone call. This seemed VERY similar to an MDMA "Blow up" coupled with a really bad case of "incoherent drug talk". I need to stop here and say in addition to the perscribed morohine she is also taking oxycodone which i dont know from whence it came.

As I have given up on drying her out i need to know what she is in for with combining these 2 medications. The Dr. will not speak with me due to confidentiality (which i understand) however, I need to know what to expect as far as how this conbination will affect her already declining health.

Any advice or help would be extremely appreciated. My father has passed and i am an only child. The rest of the family has completely written her off so i am all she has. I just want to help but dont want to be an enabler. However i am a mother of 2 kids that have witnessed their grandmother in this state far too many times.

Please help

That depends on her tolerance to these medications, and how much of each she takes.

When addicts dry out or go through rehab, their tolerance is lowered. If they go back to the dosages they used to before they dried out, their systems are no longer tolerant, and they can OD (this is likely what you witnessed) and/or die from accidental OD.

If another medication (tranquilizer, muscle relaxer, others), or alcohol, is added to the mix, the combination can be lethal at much lower dosages/levels.

That the doctor will not speak to you does not mean that you cannot speak to him. Your mother can also sign a HIPAA release allowing her doctor(s) to talk to you about her conditions, care, & treatment.

Since you've been through this with your mother before, is it possible that you do know what to expect, and are seeking the courage and support to do it?

Doc

You can still send a message or call the dr and tell him what is happening, he may or may not act on that information though.

Concerns-
does she drive at all - and hopefully not in that condition of over medicated?

where are the new pills coming from? fake rx, illegal/off the street , or from a "friend"... if off the street or even from a friend it could be a wrong pill or different dose.

How is her status when not over medicated?

I Googled and the 2 can be used together , but proper dosages and drs care is the way to do it.
Basically if she is over medicating herself, anything can happen.

I totally agree with previous advise. DO try to get Mom to sign a release so you can communicate with her doctors. In the meantime, they can and should listen to what you say.

Thank you all so much for the responses. I am going to attempt to answer all the questions.

Because i have been through this with my mom she will NOT sign a HIPPA waiver because she does not want me talking to her doctors. When she went into Rehab it was not willingly. Unfortunately i had to have her baker acted because she literally went mad. She ran around the house and yanked all the faucets off the sinks for fear the Aliens were going to come through the plumbing.

She does (at times) drives in this state without my knowledge. I do all her grocery shoppibg, bill paying, run her errands and take her to all her doctors appointments. However, i will go to her house to check on her and she will be on yhe couch reading a magzine she picked up from a store i didnt take her to.

My mom tends to play what I call, "Physcian Roulette". One doctor doesnt know about the other doctor. So, her RA doctor will give her an infusion and a script for oxycodone then she will go to her PM (Pain Management) doctor (who has no idea what the other doctors are giving her) and get a sctipt for Morphene. The the following week she'll go to her Psychiatrist and get her Gabapentin and he doesnt know about the other 2 doctors.

I have attempted to talk with her psychiatrist and he wouldnt take my call. Her GP will talk with me (or rather listen) and as a result no longer perscribes her pain meds. I have not attempted to speak with her PM doctor and im thinking that would be the right step to take. I just think he deserves to know the WHOLE truth. I just know when i make that call my mother is going to lash out at me and then there will be no one left to care for her. If I talk to her PM is he required to tell her that i spoke to him? Or would he just manage her case accordingly?

~ This thought did not even enter my head until i read you post and there is a strong possibility you are very right with this staement. I fully understand that pain is subjective. Meaning whats pain to me may not be pain to you and the same vice verse. I know she is in severe pain, and that the pain she is in really does warrant the treatments she is being given. So, i dont want to come off as an uncompassionate daughter telling her mom to get over it. I am 100% supportive of anything the doctor's do to take her pain away. However, knkwing that not one of her doctors is aware of the other let alone the pain meds she is being perscribed it concerns me that she would be very likely to OD herself. She has lost nearly 20 pounds. She is 5'3 and has gone from 115 down to 92 pounds. Dressing her for bed last night i noticed that her thighs are the same size as her biceps and she had voided in her undergarments.

I think more than support i am looking for someone to confirm I have reason to be concerned and cause for reaching out to her PM doctor.

I really cant thank you all enough.
Dana

Dana, Welcome to NT.

IMO (and others are free to differ) you have reason to be concerned. What you call "Physcian Roulette" is commonly known as doctor shopping, which can hurt your mother, her doctor(s), and the other patients of those doctors. Many states now maintain Prescription Drug Monitoring Programs (PMP) to clamp down on this practice, and some states have made doctor shopping a criminal (felony) offense, but the rules/laws regarding these monitoring systems can vary by state.
See also: http://www.deadiversion.usdoj.gov/faq/rx_monitor.htm

This is a difficult situation. Medication addiction is a medical issue and your mother needs help. However, while it should be handled as a medical issue, don't look for the system to protect your mother. The system is often set up to point fingers/blame, and punish rather than help.

A doctor or pharmacist can tell you more about the PMP in your state/province.

It's very likely that your mother had to sign a contract with the PM doctor concerning doctor shopping, self-medicating, blood tests to verify compliance, etc., which she may be in violation of. This could result in her being dropped as a patient.

I'm not a lawyer, but from what I just read, some of this may hinge on the dispensation of the Baker Action you mentioned, depending on what the outcome was. Is she under the care of a psychiatrist or counselor?

I'm not aware of any requirement that he inform her. While, IMO, this is a medical issue, and should be handled accordingly, I'm not a medical doctor, and I don't know if anyone you discussed this with would be required to report it or not.

Another possibility might be for you to have a "hypothetical" discussion with her pharmacist or another health professional, even if just for information.

There are some other forums here on NT that you might benefit from posting questions in for other perspectives. Not everyone reads every group.

I have a relative with alcohol & psych issues; I'm not unfamiliar with the effects on families. This person lost their family support, spousal relationship, home, and child.

Doc

Dear Daughter,
I sure do understand your concern. These medications she is on, are the same ones I am on, but I watch what I take with extreme caution! I am under the care of a fabulous pain specialist. I don't doctor shop, and take no more than what is allowed me EVER! I take Morphine 30 mg. 2 x day. I have declined to increase it even though I need surgery. I also take oxycodone 10/325 4 x day. that is what I am allowed, however if I can keep it down to just one, when I reach that OUCH level, then I take one. My caution is extreme and i am very educated on the dangers of these medications. I have also been through withdrawls from a surgeon not paying attention enough to what I had been prescribed.
If your mom is abusing, this is not good. You must make sure she is just seeing one pain physician, and that her PCP knows exactly what she is doing along with the pain specialist keeping in touch with her PCP. Doctors must communicate with each other, and that takes some effort on your part.
If mom is getting this stuff off the street or through other means from friends and others, she is putting her self in grave danger. I was a single daughter too, so I know you care about her.
Do talk to your mother, find out exactly what she is taking and when and how much. Take this information to her PCP. Take it to her pain specialist. Just give them the information. You are not going to get a response from them, because of patient confidentiality. You can do this much for her. Forcing a person into treatment does not work.
Is your mother in true Pain is the question that needs to be addressed, and then to help her find the best help you can, so that she does not abuse the medications. Abuse does indeed kill. Florida is the worst state in the country about this subject. Doctors hesitate now to prescribe at all because of the amount of abuse down here. Legitimate pain patients have a hard time getting medications also, because of what happens on the street.
Please do seek some kind of intervention, and find out exactly what your mother is doing. I am NEVER in a befuddled state. I feel NO HIGH when I take these medications according to direction. I would not take more either to feel such a high. I already know my body is accustomed to these medications, and i am careful accordingly. The doctors and your mom need to be on the same page. I am here if you ever need to talk more about this. I have tried in every way shape and form to be an informed patient. I would help you in any way I could. I do wish you and your mother all the best. Your mother is welcome to contact me too. ginnie

[I sure did reply to her, to the best of my ability. Her mom is in danger, and I tried to tell her my experiences in dealing with these medications. Read the post, I hope in some small way I helped. I offerered to talk to either her and or her mother at any time. I am glad to Help Dr. Smith. We all need each other on NT. I would not have the strength I do, without the compassion and support I have found here.
I do hope you are doing OK these days. I have been up and running about a possible ankle surgery. I had been misdiagnosed, long story. I am on a good track now, and am doing fine. Keep in touch with me, and say Hi to your wife. your friend ginnie