holiday trip ahead, daughter melting down, please help

It's 2 days before Christmas, I'm supposed to be working hard so I can leave to go with my family (daughter, 28yo son, husband, me) to see relatives 600 miles away for holidays. But our daughter, mid-twenties, is melting down, and I don't know what to do, can hardly think. She lives with us because her anxiety and substance use issues make it not possible for her to live independently right now. Was using klonopin this summer (not for the first time) for anxiety, but over-used it, went crazy, finally said she wanted to detox from it. We didnt' know what kind of place was available, and neither did our sh rink, and there didn't seem to be anywhere  good. She went to a place where they kept her for 4 days and discharged her.

After that she tried for a while to go to AA every night but said she got overwhelmed. Went to a new shrink who said the 4-day detox was like medical malpractice but wouldn't prescribe klon because she had abused it--put her on seroquel, which was not good. Then tried another doc because that one got angry with her, and he put her on remeron. She was already on lyrica and luvox.

She got out of that detox place in late September and sometime since then she started taking klonopin along with adderall, both  that she bought on the street.  She just told me she had been taking 8-12 mg klon a day (ran out of that adderall 3 days ago). Seems so stressed, crying, saying she can't go.

I don't know what to do about the trip. I wouldn't have a problem canceling it except it's my mother who is 91, who keeps saying how much she wants us to be there--all of us. I'm sure she thinks each Christmas will be her last, and she never sees her granddaughter. But I don't see how we can go. And it wouldn't be a good visit between my mother and daughter if daughter is bouncing off walls, which my mother would absolutely not understand. There is no place daughter can go, and how could i just park her somewhere and just leave anway? I asked my husband to go with son (who really wants to go) but husband refuses, and daughter refuses to stay home with just him (he pops off at her when she pops off at him). Daughter thinks she would be in bad shape if she got less than 8 mg a day (which we would have to get somehow). Neither our family shrink or another one who MIGHT be helpful with a taper is in town. I think the trip itself and being with the relatives would be so stressful for (and thus for us), altho she could stay in the hotel room we're getting rather than grandmother's house.

Not only do I not know what to do about the trip, I don't know what to do after. I think we are going to go back to our family shrink, who is a decent guy who has agreed to help with a taper. But how does she even taper off? She has had several tries in the last couple of years to just take a maintenance dose of klon and she hasn't been able to take it even as prescribed, not tapering.

If anybody has time to read this during these busy days and give me a clue, I would so appreciate it.

8-12 mg klonopin a day is [glow=red,2,300]toxic[/glow] and your daughter is physically ill because of it. Maybe you can have her see a psychiatrist who is also an addictionologist? The most important thing now is her getting stable or on the way to stable. 

8mg of klonopin is equal to 160mg of Valium!

I'm sorry you find yourself in this sad situation, and my heart goes out to you.  That said, your daughter is an addict, and out of control from the sound of it, and trying to take her on a trip like this would be very ill-advised, in my opinion.  Is your 91 year old mother capable of understanding the situation you're in?  Hopefully she is, but even if she is not---(if it were me) I'd tell her that although you can't visit for Christmas, you'll come as soon as you can (early next year if possible).  After all, it won't do her any good if your whole family is melting down at her house.  That's not going to create Christmas memories.

So sorry this is happening,

Megan

Dear Gem,

  My heart goes out to you and your daughter. Watching our children suffer is a mothers nightmare. I am sorry.

  I can not begin to understand the cocktail of drugs she is on. All I can do is respond to her delicate condition combined with the stress of holiday travel. Speaking from my own experience with withdrawal traveling is out of the question when I am at my worst. It would not only be difficult for her but you as well. She needs a quiet predictable environment right now. When I am in my most challenging state it is difficult to leave the house. Activities need to be dialed down as an over sensitized nervous system has trouble processing stimulation.

  I hope my simple post helps you feel more confident making the decision. I am not an expert....just an accidental addict whose world has changed drastically because of benzodiazepines.

  Please take heart in the fact this is all reversible. Brains heal given time. My thoughts to you as you face this difficult time.

Carita

I'm so sorry you are all having to deal with this. I agree with other posts. Do what you can to get your daughter stable. This will pass. It just takes time...a long time. Be prepared for a long haul on getting her through this. Once you can accept that time is the only way to get past getting of of benzos, it will make the journey more acceptable. I was in the hospital over Thanksgiving last year. This year I was able to be home with family, I'm not done tapering and I'm not healed but far from where I was last year.

There are threads on this site to help you come up with a taper plan for your daughter. The main rule of thumb is a 10% cut every 14 days. You can see my taper plan on my signature. Have you read the Ashton Manual? Folks suggest printing it out and bring to doctors appt to help with coming up with a taper plan. I brought so much in for my doctor to help with my taper plan.

Lots of love,

BT

thanks everybody, for your replies. I thought going on a trip with her like this would be bad too.

How do we help her stabilize? Hospital--they will just put her on benzos and other bad stuff. Residential places--the same. I don't see any place mentioned on the list of providers that are good (well, one is mentioned but later i think they say bad things about it). Our experience with rehabs has not been very good. How does someone who is addicted even do a taper program?

And there have been years of this--her anxiety, drinking, abusing adderall, rehabs, having her at home and trying to function by taking pills---her dad and I are exhausted.

Need to address some blunt questions here. Is your daughter a drug addict taking these to get high, or did she have prior mental condition that led to taking psych meds? If she had no problems prior these drugs klonopin can certainly cause plenty.

Sounds like she needs to make up her mind if she really wants off or not. This is hard work. Requires planning and discipline. It is not impossible, but it is certainly unpleasant. I've read stories of people who tapered off in hospitals over many, many months. Many more do so in the comfort of their own home. Sounds like someone would have to lock up the meds and provide the doses for her. There was one person recently who went into rehab and they took him off in about 2 weeks from a fairly high dose, but that is usually brutal and most folks require a lengthy period of very, very, VERY difficult recovery.

Most important is to get her a doctor who will provide a consistent supply of medication and formulate a plan to taper off from there. A good doctor will be very helpful, might take some searching. I will be gone for awhile today and not able to respond but many of the buddies here can help and I'll try to check back in later. As for the trip she's probably not in a very good spot for that. Please take care, everyone here can help with ideas to get your daughter on the path to healing if she wants to travel it!

Hi:

I am so sorry to hear about your bad situation. Seems like you're at your wits end, and I don't blame you. My heart goes out to your and your family.

I, like the others here, agree that taking a 600 mile trip with your daughter is not a good idea. She's quite unstable and it will cause much stress and problems for her, her grandmom, and you and your hubby and son. Just a bad situation. Putting her in hotel room alone is bad. She obviously needs supervision. The best thing to do is get her on a stable amount of K, that will take a bit of time, and keep her there until she sees her doctor. I'd make an appointment ASAP.

Her doctor should be able to taper her off the drug. And hopefully she'll stay away from the cocktail of meds she's on and avoid the alcohol at all costs. Uing the Ashton Manual, like others said, in conjunction with her doctor, seems to be the best choice.

I would not send her away again. You're gonna have to keep her meds locked up, and throw away the alcohol from your house. Mixing alcohol with 8-12 mg of k can be lethal. She's an addict and can outsmart you, so you have to be vigilant. Addicts are the perfect manipulators. She'll beg and cry and talk slick, in order to avoid the withdrawal effects by taking more K. She'll want more of it.

C/T off of that much of K, especially since she's not even stable, is not an option IMO. C/T will just send her back to reinstate. Once again getting the drugs form the streets. She has got to really WANT to get off the drugs she's on and get better. 12 mg of K is a toxic level. I can speak from experience. My pdoc put me on 10 mg of K and frankly, while I am stable because I took as directed (didn't know it was addictive til I found BB) I am functioning OK, but could be a lot better.

At least I am not a mess and can function from day to day. Since I dropped 4 mg so far, I'm feeling more like myself and better able to deal with life from day to day. And I didn't take other meds or used alcohol. To his day I wish I have never even met my doctor. I told her I didn't want to be on any addictive meds and she said OK, I won't. But then she did, So she lied to me. I hate her for it and what it's done to ruin my life. Can't wait to get off the rest of it.

But enough about me. I'd bag the trip, despite your mother being so old and may not be around, and see what happens when she sees her doctor. Your daughter's health situation has to be first and foremost. She must lay it on the line and not lie about her drug/alcohol abuse. You should be with her when she sees her pdoc. Seems like the whole family needs to be involved in her recovery. She obviously can't go it alone. It will take lots of time to get her off the K, but I CAN be done, with help and supervision. Never say no.

Sorry your Christmas won't  be a nice one. But the New Year is ahead and once she starts tapering, you'll feel a lot better, and eventually, so will she. Keep us posted and up to date. I'll be here over Christmas, so feel free to PM me at any time. Hugs, Betsy

How do we help her stabilize? Hospital--they will just put her on benzos and other bad stuff. Residential places--the same.

Actually, if your daughter is addicted to Klonopin, only Klonopin or another benzo can help stabilize her, in my opinion.  Most of us posting here are or were dependent upon our benzos as prescribed by our doctors.  However, the same principles apply to someone who has been self-medicating who is addicted.  The idea is to take the lowest possible daily dose of the benzo, (every single day --- the same dose), to allow the person to stabilize.  After hopefully stabilizing, (and the time it takes to stabilize can vary from person to person and can take anywhere from 14 days or possibly longer), hopefully the person has begun to feel better and more like themselves. 

Then from that starting point, the taper is begun by slowly reducing the medication usually at a 5-10% rate.  Some people aren't quite so fortunate though especially after abruptly starting and stopping benzos a number of times, and they aren't able to stabilize prior to starting to taper. 

A taper can take a very long time for a person who is dependent upon the high doses of Klonopin that your daughter has been taking.  I took Xanax for insomnia for many years and became dependent.  When I started my taper I was taking 3mg of Xanax.  This is equivalent to 3mgs of Klonopin.  My taper took 9-months.  Many people aren't able to taper as quickly as I did, so I was very lucky that my body cooperated.

How does someone who is addicted even do a taper program?

When dependent or addicted to a benzo, a taper can be extremely challenging.  As we reduce our dose, the body goes into withdrawal and many of us feel quite ill both physically and mentally.  In order to get through this process, the person tapering has to want to do this more than almost anything else in the world.

Recovering from a benzo dependency/addiction generally takes quite a long time.  Also, after the last bit of pill is taken at the end of a taper, we generally begin an acute withdrawal phase that can last as long as 3-4 months where the withdrawal symptoms can be quite severe and debilitating.  The idea is to taper slowly enough so that when the last pill is taken that the acute phase won't be as severe or won't occur at all, (which is what happened in my case).  After the last pill we move into a stage we call recovery.  During this period of time some of us continue to experience withdrawal symptoms for many months and for some of us it can take years.  Benzo withdrawal and recovery is 'sometimes', (but not always), a multi-year commitment. 

 

And there have been years of this--her anxiety, drinking, abusing adderall, rehabs, having her at home and trying to function by taking pills---her dad and I are exhausted.

I'm so sorry to have to say this but sometimes we must hit rock bottom before we can start crawling back out of our hole.  Your daughter has to want to do this, if this is going to work for her.  Rehabs and detox centers can work quite well for some drugs, as well as alcohol, but for benzos, these types of facilities can cause the situation to become worse due to the level of the severe withdrawal symptoms that can happen with a rapid taper or cold turkey off of the benzo.  Recovery may take a whole lot longer for a person who has rapid tapered or cold turkeyed too.  This is why a slow taper is recommended.  About the only way that I know to accomplish this is at home with a doctor willing to provide a continuous supply of the medication and a person dedicated to tapering off slowly. 

If she could make a 1 to 1 connection that the pills and the boozing are what is making her life so hellish, I believe that she'd start coming around.  I'm so sorry that you've been dealing with this situation.  So very sorry.

Here are a few links that may be helpful to you:

What is happening in your Brain, by Parker

Family Members & Partners Support Thread 

Gem,

Others have given you very good advise.  To add to what Juliea said about tapering, in no way does your daughter sound like she is capable of doing a proper taper.  You would have to manage her medication under lock and key.  First get her stable on the exact same amount of medication daily.  This will take 2-3 weeks.  Create a written taper plan that you may have to adjust in the future.  (Slower/smaller cuts).

Understand that benzodiazepine withdrawal can be extremely painful even when doing a slow taper.  Expect that you will have to weigh/titrate her medication.  It can become complicated and I doubt she will be able to do it.  As Innadaze said, this is hard work and takes an inordinate amount of dedication and resolve. 

You will need to change the way you view benzodiazepine dependence.  You can start by reading the Ashton manual.  You absolutely must be educated in withdrawal if you want your daughter to succeed. Tapering and withdrawal can last years!  I'm sorry, but it's quite possible you may have to become her full-time caregiver.

I don't wish to be blunt; I just want you to understand the severity of the situation.  You sound like a wonderful, caring mother and I wish you all the best.  Many thousands of people have had successful tapers and your daughter can have one too.

Gem, hello. I'm so sorry u are going through such a gut renching time. I have to say though that unless your daughter seriously wants to get clean, then nothing u do will help her. Nothing.

  This is the most difficult journey I have ever experienced . If I wasn't committed to getting off benzos ,I would have given in. So please , find out first , if she wants to get off them. U could save yourself a lot of heart ache.

    In no way have I meant to be discouraging to u.        I send u a big hug. My heart is breaking for u and your family.      Pinkee

theres not a easy answer for your initial question, but if you all want to make the trip, she could score some K from "somewhere" and do whatever dose that makes her stable throughout the trip, then try to start a stable taper after ya'll return............if shes in any shape to do that, shes gotta reinstate anyway, regardless of the trip......

or hospitalize her, (where she will have to stay put), do your trip, and deal with it when you get back...

This is a sad situation.  For what it's worth, I would guess your daughter is not dependent on 6mg clonazepam (which is roughly equivalent to 120mg diazepam).  6mg is probably a dose which makes her feel comfortable but it may not be necessary for her to take as much as that. 

As an example, look at this poster's situation where he is concerned that he needs a very high dose of diazepam to be stable.  It turned out he was able to be stable on only 30mg diazepam.  http://www.benzobuddies.org/forum/index.php?topic=91906.msg1178680#msg1178680

In your daughter's case this may be further complicated if she is using benzos to counteract the recreational Adderall she takes or she may take one to terminate the experience of the other.