Thanks for Reading my post in Advance.

I have a friend who has been suffering from Depression for a few years and was drinking, but in September suffered from a Shoulder injury at work and now is suffering from Reflex Sympathetic dystrophy in his right/dominant hand and is moving to his left hand.

Since RSD his drinking has gotten a lot worse and He has been admitted to ICU twice in two weeks once for extreme malnutrition and now for swelling of his feet and legs.. I am pretty sure he was an alcoholic before the RSD, but now it has become his excuse for Drinking. He tells me he cannot sleep for the pain in his hands without drinking. I do not know if this is an excuse or a justification, but i do know it is wreaking havoc on his body.

He has not been formally diagnosed with RSD however a neurologist confirmed the diagnosis while his initial stay in the ICU. He has lost his job and insurance because he is not able to work with the RSD which is just fueling his depression.. He will only take calls from his brothers and myself and rejects any other's calls, so i feel that if I cannot get through to him no one will be able too.. He lives over an hour drive from me and his closest brother so we are not able to monitor him and will not leave where he is currently living.

I have told him that he needs to get a formal diagnosis of RSD so he can apply for disability as he is quickly running out of savings. But i feel the alcoholism is keeping him from doing what he needs to do, instead locks himself into his room and drinks his days away.. I also fear even if he gets to see pain clinic they will not do anything with his level of drinking.

I am completely at a lose to what to do to help him, but i fear he will not last long at this rate...

1. Does Marijuana help with the pain? I have read where some people say it does, and if he could off set the Alcohol with Marijuana i think it would be helpful just to get him to stop drinking..

This is a difficult one. I can see why you are so concerned about your friend.
The alcohol, while it does dull the pain, also aggrivates the nerves that are involved in RSD/CRPS. You are correct in that certain meds are off limits to him if he has an alcohol problem (they can be deadly.) Pain Management Docs can diagnose and do nerve blocks which can be helpful in the very early stages of RSD/CRPS. This would of course be a doctors call, but he might could get those even w/ the alcohol problem. Most pain docs will drug screen, so it will help his treatment in all ways to be honest about the alcohol.
Second, if he is willing, he very much needs a pain management/substance abuse counselor. If he is willing is key there.
It seems to me that proper diagnosis and looking at treatment options, both for RSD/CRPS and the alcohol problem, are the first line treatment options here. You are a good friend to sitck by him. I hope this will be of help in some way~mama mac

There are a lot of issues here.

1. Alcoholism
2. Depression
3. Probable CRPS / RSD
4. Loss of Job
5. Diminishing Finances
6. Closing off from Community
7. Dependency
8. [Edit] Medication Prescriptions

He may indeed be using alcohol to deal with the pain, which really is not an effective means, and/or he may be using pain as an excuse to drink. My fear with the introduction of Marijuana would be that he would either add Marijuana to his other substance abuse or that he would trade one substance abuse (alcoholism) for the other (marijuana). This is a very complicated case. I would recommend him admitting himself to a drug treatment center. While there, they will help him peel away the various layers, so he can deal with them each accurately and professionally for his benefit. CRPS / RSD being just one of those issues.

Hello Alan,

How very sad for your friend. It must be terribly difficult to bear witness to what is happening with him. Two recent ICU admissions are certainly alarming.

I agree your friend needs treatment but he has to be interested and invested in it, often difficult with alcoholics. The best way to reach him may while he is in the hospital. This might be only the time you can talk with him while he is sober and you have the support of staff. It may be possible to set up a plan of care meeting with his doctor, a case worker or social worker and his brothers to discuss the need to quit drinking and get help.

Without insurance, the treatment options may be rather limited but there are often publically/grant funded treatment centers and/or charity beds at private hospitals.

As the others said, PM is going to be hard to get with the level of drinking going on, so alcohol treatment really is the first step. If he can start it immediately after discharge from the hospital, while he is already detoxed, that would be ideal.

Thanks for being such a good friend. Just remember to take care of you too. I hope your friend finds relief and healing soon,

im sorry your freind is in a screwed position. 20 years of sobriety and getting RSD put me in instant suspicion category, under medicated, tortured. Reduced to such hopelessness I drank. Then I did something really stupid I was honest about it. There are actually pm places who help people with pain conditions who have addiction issues too. Few and far between. The isolation was a natural result of being unable to do things as in the past, family thinking you're just being overdramatic, not being believed etc. suicidal ideation soon follows. Recommend this place so he can educate himself and have some socialization. The drink will have to go. It won't take long before he realizes his pain will increase the more he drinks and he won't like the cost with RSD. I would recommend blocks or infusions instead of opiates. He could use oral ketamine troches for pain without killing himself drinking on it. Low dose naltrexone would block the brain payoff of opiate use. There are options. A freind is the first thing he needs. If you can get him on line and give him a place to safely share and reach out when in dispair that would be a good place to start.