Thoughts on Anna Nicole Smith: What is the Boundary to Self-Medication?
Right now, the headlines are filled with the autopsy results of Anna Nicole Smith. Her use of prescription medication to cope with her pain seems all too common a practice. I’ve met many individuals who have avoided street drugs or alcohol but who misused prescription drugs to a frightening extent.
I also just heard singer/songwriter/author Judy Collins speak about her experiences with therapists who actually prescribed alcohol as part of her treatment—this was back in the sixties. Since alcoholism was a common thread in her family, needless to say this was not great advice. You can explore her journey and her response to the tragic loss of her son from suicide in her book Sanity and Grace.
Substance abuse (or the more PC term “substance use disorder”) is a common thread in our illnesses. I’ve seen statistics indicating that as many as 60% of us misuse alcohol, prescription drugs or illegal drugs as a way to cope with our pain. To make matters worse, the health care system hasn’t made it easy for us to get help for both substance abuse and our mental illness. Although conditions are changing now, many of us have had to either get clean and sober before addressing our mental illness, or address our mental illness before working on our sobriety. Both illnesses have been viewed as separate conditions, with no communication between the health care providers for each.
This gets even more frustrating when we’re trying to access peer support. In the past, if you went to a traditional peer support group like DBSA or NAMI, you may not have found anyone willing to talk about substance abuse. If you went to an AA meeting, you may have been told that you shouldn’t take any medication for your mood disorder (i.e., depression or bipolar disorder). One helpful tool being used by many DBSA groups is the Double Trouble model, created specifically for those who live with mental illnesses and substance use disorders.
So, things are changing for the better.
On the other hand, many of us don’t like taking medication for our illness at all. We worry that it is addictive, that it will change our personality. We worry that we are overmedicated and will end up like the zombies in One Flew Over the Cuckoo’s Nest. Interestingly enough, studies show we are more likely to be under-medicated (that is, prescribed doses that are too low) than overmedicated.
So, how much medication is too much? When does it start to become misused? I don’t know what your answer is, but my solution to figure this out is as follows:
- I do my homework and look on the pharmaceutical company's Web site to figure out the “normal therapeutic dosage.” And then I talk to my doctor about it.
- I track my moods to pay attention to how I act when my medications change.
- I always ask which medication can be taken away whenever one is added.
- I work my wellness in talk therapy so that I’m facing my pain and not running from it.
- If I haven’t been happy with the openness of the conversation with my doctor or therapist, I‘ve changed doctors to find someone I can communicate with. One source for peer-to-peer doctor/therapist recommendations can be found on DBSA’s Web site.
Published On: April 11, 2007
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