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CASE STUDY 1 : OPIATE DEPENDENCY

Bringing control to an eight year Codeine dependency in six one hour sessions. 

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“Thank you so much for your help, we are starting to see a real difference in our lives since your input.”

 Clients wife 2019 

 

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The client received one consultation which was attended with his wife and provided the basic information to assess and evaluate treatment potential. What followed was a six week intensively focused addiction resolution therapy program.  

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Due to holidays, the full time was ten weeks from beginning to end. Seven hours of discussions/sessions including consultation were delivered, one per week. The client was free to go about his business, to attend work and live his regular life whilst attending. 

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The days between sessions are for implementation and reflection on the issues and directives discussed. At the end of the period the client was reporting disgust at the idea of using codeine, experiencing a visceral gut reaction of revulsion on passing a chemist, his usual anticipated stop off to acquire supply. The clients’ wife administered random drug tests but was also witness to the changes unfolding in her husbands’ demeanor and behavior. Initial sessions were attended as a couple and provided the ground to build and establish a working ‘team’ mentality and establish the frame for treatment.

 

Later sessions were attended individually and focused on deepening the process, examining causation and working through key historical issues toward integration and emotional fluency. This involved helping the client move from emotional suppression (self medicating pain with codeine) to emotional expression, openness and normalisation of communicating feelings. This combats the initial presenting position of needing to suppress pain via repression by a drug. Therefore countering relapse potential, as the need is replaced with new skills and self competency through communication and dialogue. This further has the benefit of rebuilding trust and capacity in the primary relationship. 

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The client is instructed on progress milestones as part of the educative element of the process and encouraged to implement these as necessities at the chosen end of treatment. Further work/therapy is available if required and the client is assured support is ongoing if needed. 

 

This process has been successfully implemented with use in cocaine, alcohol, and poly substance use cases delivering similar outcomes. 

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“It all started in 2010 when my father passed away – it was a sudden death and unexpected which hit me hard. The following year I suffered a football injury and that was very painful and was given codeine phosphate (30mg) for the pain. I never thought in a million years that I would become an addict, and for a long time I didn’t consider myself an addict, especially to a prescription drug like codeine. But it was not until I tried to get off that I realised I had become reliant upon it.  Yes, the tablets did help with the physical pain of the football injury but I also found that they helped with the emotional pain I was still feeling from my dad passing away so suddenly. I thought it would be fine to continue taking them as they were prescribed pain killers under a doctor’s supervision. However, I also discovered that when I took them, they made me happy and I felt better in myself. 

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After two surgeries on my knee I no longer required the codeine for the injury but I continued to take them for the emotional and psychological benefits thinking that this was ok as they were legal and prescribed.  I thought I had it all under control, but as time progressed I discovered I needed to take more and more to achieve the same effect.  My body had begun to become tolerant. I began to take more than the advised dose and also supplement with Nurofen Plus. At this point I still felt in control, but I wasn’t in control, I never had been, I was delusional.  

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The addiction began to take over my life. Emotionally I was shutting down as the codeine began to make me numb. My wife was beginning to notice that I was changing, she would frequently ask me what was wrong which is when the lies began. In order to keep her from finding out the truth, that I was addicted to codeine, I lied about everything. I had to hide the truth to avoid a potential showdown. So the lies just kept tripping off my tongue. Upon looking back now, I feel nothing but shame and guilt for what I did.

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As the time progressed I began to feel and look physically ill. I was taking up to thirty two Nurofen Plus a day. People were beginning to say to my wife that I looked ill and ask what was wrong. Family holidays were affected, ruined by me as I went through withdrawals every holiday as I couldn’t obtain Nurofen Plus overseas. I had a slew of symptoms associated to opiate with drawl. I wouldn’t be able to sleep, would have restless legs syndrome, diarrhoea etc. The stress had been building between my wife and I for some years. I recognised that I had to come clean about the addiction I now knew I had, otherwise I feared she would find out and leave me anyway, or much worse, I was going to die. Throughout the years I had secretly made many attempts to stop taking codeine but it was a disaster every time. I realise now you can’t get off codeine secretly, you need the full support of your family.  

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In August/September of 2018 I decided to come fully clean about how bad the problem was. I was surprised to find she was fully supportive. Yes, she was angry at the lies I told and the way I had kept it hidden from her, she was angry at how I had made her feel over the years, being secretive, lying about where my money was going but finally she had the truth. It was not a pretty truth, it was damned awful, the feelings of mistrust almost destroyed our family, the thing that I love most. After talking it over with her she decided to buy a testing kit and test me to determine whether I was still using codeine or not. This in itself did not work, quite often I would test positive and shamefully I would come up with an excuse as to why. We both came to realise I was not going to be able to do it without professional help and that help came in the form of Edward Conn.  

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We made an appointment for a consultation. I was a little reluctant to go but my wife was eager and virtually dragged me there. Prior to consulting Edward I had tried hypnotherapy which had had no effect.  

Upon consultation Edward informed us of the symptoms of opiate addiction.  He described what opiates do to a person, how it changes them and how they withdraw and how their behavior can change to someone unrecognisable. He also took time to discuss how this goes on to effect the wider family. Everything he talked about and described reflected mine and my situation at home.  It made me sit up and listen. It was a difficult wake up call in the words that Edward offered. However, my wife and I took the opportunity, as we both felt that if this did not work then there was likely no hope for our future as husband and wife.  

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During this first meeting Edward was frank with his observations. I basically got the naked truth, brutal, empathic, harrowing, emotional....its overall effect was powerful.  It allowed me to fully understand what I had been through, what my wife had been through, and unknown to them, what my children had been through as we tried our best to keep this addiction hidden.  

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Initially Edward was a little hesitant to take the case due to the fact it was an opiate addiction. He wasn’t’ sure I would be able to complete the course. I assured him I wanted to get rid of this curse, I wanted to get better for my sake and particularly for the sake of my wife, she had been through enough and to my surprise was still ready to support me. 

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The initial three sessions involved discussions with myself and my wife together. She was policing any codeine abuse during the process via the testing kits. On reflection this was very helpful...the combination of therapy with Edward and the governance of my wife helped to keep me focused, it was the best combination I could have asked for. I quickly overcame the physical withdrawals that come with stopping usage of an opiate.  I’m sure those of you with opiate addictions know what I’m talking about. That was the easy part.  The hard part is dealing with the anxiety afterwards, the need for the opiate to take all your feelings away.  

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The following three sessions was with Edward alone. He helped me to deal with the anxiety. At one point I took a Valium to help as a short term fix and we discussed this. It had caused problems at home. I did not want to tell him at first, as I felt a failure but he was very helpful and non-judgemental in his approach. We discussed a strategy with this.  He guided me to come to my own outcomes in various issues in my life and sometimes did make suggestions of how to proceed, he was my guide and encouraged me to come to my own conclusions. I learned that coming to your own decisions helps you understand the problem and how to solve it without actually being told. 

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I learned a great deal about myself, my insecurities, my inability to talk openly with my wife and how badly my father’s death in 2010 actually affected me. By the last session I had been codeine free for 10 weeks, with no desire to return to my previous behaviour. The thought of taking codeine now disgusts me and it’s all down to Edward’s patient approach and skilled guidance, allowing me to think about my problems and come to my own conclusions with my own solutions. This gave me a deep insight into how I had been behaving, the huge effect on myself and others which the years of addiction had caused. 

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I thank Edward for his knowledge and skilled intervention which has assisted me to quit this opiate habit, something I had been unable to successfully do previously despite many attempts. I would not hesitate in recommending Edward as his input has changed my family life immensely. I am unsure whether I would be here now writing this if it were not for him. So a big thank you Edward for helping me with my addiction, likely saving my marriage and possibly saving my life. THANK YOU!!” 

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