Suboxone, Alcohol, Withdrawal, Schizophrenia

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Angelus Says:


My brother has been suffering from paranoia and delusions for about six months. He has has been a heavy drinker for several years now. And he also had an addiction of some kind which compelled him to go to a suboxone clinic to manage his life with the hopes of tapering off. Unfortunately, he never tapered off and seemed to use his strips several days if not more than a week before his next prescription.

I'm not sure what happened, but eventually he started talking about people bugging his apartment, car, phone, etcetera. He also claimed that people were talking about or to him on the television or radio. Sometimes I'll get up and he will have taken the batteries out of devices and unplugged electronics because he thinks people are spying on him through them or mysteriously talking to him somehow.

So, he's been living with me and I have encouraged him to stop drinking and taking suboxone. He no longer has legal access to suboxone either. Now, it has been very tough for him to quit these vices, and he has had relapses as expected when trying to kick such strong addictions.

The problem is I don't know whether his paranoia is due to withdrawal or if he has schizophrenia. I have read that it is common to have bouts of paranoia and delusions when going through withdrawal, but sometimes it becomes so fantastical that I am getting concerned. I believe he has depression as well and years ago he barely survived because of the hold it had on him.

Tonight he got a hold of beer (maybe something else too) and is going off on wild and impracticable tangents about the apocalypse and making no sense whatsoever. He thinks that his coworkers from his last job are out to get him too. He doesn't always talk about these things, probably because he is embarrassed. But he has said when he is sober that he has those thoughts all the time. But again, he's been trying to quite his vices for months.

He can't sleep either. He gets up every 20-30 minutes and goes outside to smoke. That is another thing. He was taking cannabis for a while. But I don't know how much and if he has been having that again either.

I cannot reason with him and I understand he is in a bad state of mind. I just try to calm him down and let him know that I'm here to help him.

He has been angrily talking to himself and me tonight. I heard him telling "someone" to stop messing with him and playing games.

So the question is this: for those of you that have experienced withdrawal either personally or vicariously as a loved one, have you experienced symptoms to this degree?

I know that you can't diagnose someone until they are clean. But he is adamant that he will not get help for his problem. I don't know if he is embarrassed or doesn't trust people. He doesn't fully trust me or anyone else and even made the statement that if he got professional help (rehab, etcetera) and no longer thought the world was out to get him, that he would assume it was all orchestrated by me and our family to get him to stop drinking.

If you could help me I'd be very grateful. I'm just trying to understand what I'm dealing with. Thanks for your help and God bless.



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Shaymus Says:

Hello,

I am sorry you are having to go through this. I have seen this very scenario in others and recently experienced a bout of alcohol induced mania. I am correct in assuming that your brother is not sleeping well or eating regularly? Key vitamin and mineral deficiencies are very common in alcoholics. A quality multivitamin supplement is essential, especially B-complex vitamins. The suboxone is an opiate analgesic most often prescribed for opiate addiction maintenance therapy.

What kind of alcohol does your brother consume? For example large quantities of beer can flush some of the medication out prematurely and lessen the therapeutic effect. Does your brother have severe alcohol withdrawal or "DTs" ? Hallucinations are part and parcel with alcohol withdrawal and should be managed medically especially if he is 40+ years old. There is a medication called Baclofen that will help a great deal with alcohol DT symtoms, but must be used under observation as a relapse in drinking combined with this medication could be dangerous as it is a CNS depressant. If he is having hallucinations not due to DTs he is likely having alcoholic dementia. Alcoholics can get so severely malnourished their brains literally start disintegrating from lack of fatty acids and protein. Also, sleep disturbances and sleep apnea are very common. Make sure he is not using any stimulant drugs as this will likely send him in to full blown psychosis. Get him to eat eggs regularly and meals regularly, take a high quality brand B-complex and e-mergen-C powder packets regularly. Try to get him to switch to a lower potency form of alcohol like lite beer at first. Try benadryl at night to see if that will help with sleep. Also, get distilled water and bubbly mineral water and drink alternating. Magnesium and calcium are also VERY important for alcoholics. If he is to the point you are describing, do not try going cold turkey, it wont work. Fruit juice and carbonated water will help start to get some hydration going, then allow him some nutrition and sleep so he can get his wits back enough to even evaluate the situation from a semi-sound mind. I cant stress nourishment enough.

When the paranoia has subsided a little, get him to a physician for some pharmaceutical intervention as when its gotten to this point its necessary. Trazadone might be in order for a short period to help with sleep as alcohol dramatically diminishes sleep quality.

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Angelus Says:

Hello,

Thank you so much for your replay. You have provided me with a great deal of good information that I will implement as soon as possible. My brother is not sleeping well at all, sometimes hardly more than an hour or two a time. But he is also a heavy smoker and tends to get up to smoke a lot, which I assume has been compounded by the anxiety and symptoms of withdrawal. I did encourage him to talk niacin because I read it can help in his situation. I also read somewhere else about a multi-vitamin, but now I am going to make sure he takes one every day.

As far as his diet, he eats fairly well, howbeit mostly junk and processed food. But he does eat home-cooked meals, too. I’ve not seen any DTs in the way of shaking, but as mentioned, hallucinations are common, and he claims that he is always paranoid about people out to get him even when he is sober. But I assume that it is due to the changes in his body and brain. He’s in his early thirties, but I’ll still keep all that in mind.

As of right now, he refuses to get professional help for his problem. I might be able to talk him into seeing a physician, but as of now he is adamant that he will not go to rehab or a clinic. And he does have relapses. He recently went two weeks without a drink, then went to a friend’s house and relapsed. After that he would drink anywhere from 1-6 a day for a week. He usually drinks beer, but I have seen him with liquor – and those days are bad. He’s said he won’t drink it again though and so far I haven’t see him drink in person.

I’ll have to have a big talk with him about stimulants. I know that he has broken down and bought Suboxone, and he mentioned some medication he took a couple of weeks ago, but right now he is at home all the time and trying to fight it. I think I’m going to try to get him out more, because he stays in fighting this addiction all the time, and I believe he may be getting restless.

He takes Benadryl and melatonin – sometimes far too much. I usually put them up if I see him grabbing too many pills close together. They don’t seem to help much though.

He’s been trying cold turkey for a month and a half, and it hasn’t worked. But he did get down to 1-6 beers a day, so I think he can go without beer for now. Should I ask him to let me know if he gets desperate? I don’t want to enable him, but I don’t want to put him I harm either and I haven’t seen any sign of TDs.

Again, thanks for the great information. I appreciate your help and God bless.

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David Says:

Dear Angelus,

Sorry to hear about your brother's challenges. Personally I think it would be a wonderful thing if he's able to cooperate with you in so far as letting you know whenever he gets desperate for more medication/drinks/etc. That way it may be easier to monitor and adjust his intake intermittently. If he truly wants to overcome these obstacles that he's created for himself, then I believe finding ways to gain his trust from a non-judgmental point of view (and of course reminding him that you're blood related) might be the quickest path to helping him implement further changes down the road. Once you know that you have his trust to at least some degree - that alone should eventually dissolve phycological barriers that people are "out to get him" and may enable him to overcome other mental disillusions in the process. At the end of the day though, sometimes we just have to face the reality that changing someone else isn't always within our control and as hard as it is to witness a loved one suffering, they may have to fall down on their own and get back up on their own in order to truly learn from their mistakes. I pray that everything turns out for the best and hope the both of you are able to find peace of mind in the process of it all.

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Angelus Says:

Hello,

First I wanted to thank everyone for their help and support. I wanted to give an update and ask for any other advice someone may have. Since I posted my brother's situation there has been a drastic change in him for the better.

The very next day after the incident above, he apologized profusely and began making concerted efforts to refrain from alcohol and suboxone. I'm thrilled to say that he has been sober and drug-free for three months now. He's happier, healthier, and has even started to quit smoking.

The problem that remains is his paranoia. I don't know if this is suboxone induced or something psychological. It seems like I read that some people have paranoia issues up to a year after getting off suboxone. He still believes that terrorists are watching him and after him. He says that they send him messages through television shows and the internet, et cetera.

I cannot reason with him. And I've read that it's more or less impossible to reason with someone with delusions. But he gets frustrated with everyone and claims that we just won't listen to him. He's adamant that he does not need medical treatment.

I know that I cannot force him to get help. And I know that it could be unrelated to his abuse of suboxone. But I though that I would ask those who have more insight and experience in that matter.

Could this be the effects of suboxone withdrawal?

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Ruth Says:

sounds like schizophrenia my 19 yr old daughter has it and she does the exact same thing they hullucinate,hear voices talk to the voices think people they dont even know are out to get them there basically detached from reality i would get some activated charcoal and began detoxing him and some niacin 3 which is a b vitamin no caffiene diet no sugar and a healthy diet smoothies with almonds walnuts blueberries and maybe some vitamin d tablet and a daily vitamin just give the vitamins at a different time then the activated charcoal you'll notice a difference it detoxing up to 60 percent of toxin out of the body at a time the niacin curve the shizophrenia hemp seeds good also those are yr omega 369 which the body needs as well anything to help boost his immune system

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