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Wednesday, September 17, 2014
Addiction and Substance Abuse
Hi, my stbx spouse is a psychiatric nurse practitioner with prescriptive authortiy, hence he has access to writting prescriptions and many drug samples. He had been self-medicating for at least 7 years. I could always tell when he would be experiementing with medication dosages or withdrawing from anti depressants my his symptoms. My concern and or question is can you become addicted to psychiatric medications? I questioned his practice many times and he adamantly states you can not abuse or be addicted to psychiatric meds. Right now I know he is taking effexor 75mg twice a day abilify 5mg he takes ativan prn provigil in the am and uses lunesta, ambien at night. Occasionaly he throws in depokote and or topomax in the mix. He at one time had his family Dr. write scripts for the effexor and ativan but he soon grew tired of having to be under a Dr. care and began again just taking samples from work and bringing them home to medicate himself. When he moved out I cleaned out the medicine closet and this is what I threw away; seroquel, paxil, effexor, geodon,lunesta, ambien, topomax, depokote, levitra, zoloft,lexapro cymbalta. All of these were drug samples that he would bring and self medicate with. He would change around try something for awhile then go to something else, mix this with that etc. etc. He is sopose to be "an expert" in medication adjustments etc. It is hard for me to believe these drug combinations he would use are safe or appropriate. I have concerns about his safety around my son with all the chemical altering medications and at times he mixes large quantities of alcohol in there. Since he self medicates and is not under a Dr. care I am not sure where to turn to. Can toxicology screens be used to determine abuse here, and is he correct in stating you can not "abuse" psychiatric medications? I have suggested he get professional help over the years but he stongly states, there is no one "qualified" in his opinion that he could see.
Some psychiatric medications are controlled substances and thus have the POTENTIAL for abuse. Whether there is any abuse going on is unknown. Some of these medications have the potential for a discontinuation syndrome but this does not constitute abuse.
I would never recommend anyone self prescribing psychiatric medications because this is generally not good practice, particulary when multiple medications are involved. I would always encourage a psychiatrist to be involved with this type of case.
Nicholas A Votolato, RPh BCPP
Assistant Professor of Pharmacy
College of Pharmacy
Assistant Professor of Psychiatry, Emeritus
College of Medicine
The Ohio State University