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Tuesday, May 10, 2016

Your Dying Spouse 153 - Self-Medicating

We're linked to Messy Marriage's Wedded Wednesday; please visit for some great marriage resources.

What do you do, as a caregiver, when you realize that your terminally ill husband or wife is self-medicating?

Self-medicating can take many forms; what they have in common is that they address the combination of physical pain and discomfort along with the emotion burden that dying places on the soul - the fear, disconnection, and loneliness.

Understanding where it's coming from is the first step in dealing with the issue...and as a caregiver, you have to find a way to deal with it. You can't turn away.

The process usually begins when a patient feels that he or she is being 'let down' by medicine, that the prescribed treatments either aren't effective enough, or cause side effects that are hard to tolerate.

"I now how I feel...I can do a better job."

Well, no. Unless one's well-trained and well-educated, and can work with an almost superhuman detachment from oneself, one can't. I mean, would you take out your own appendix? That's an extreme example, but not completely hyperbolic, because self-medication can and sometimes is fatal (consider Prince and heath Ledger).

There's also a sense of entitlement, as in, "I don't have long, and I deserve to feel better in my last days."

Sure, you deserve to feel better. But as Mick Jagger said, You Can't Always Get What You Want, and sometimes, to continue to function as part of a family and part of a community, you simply have to bear the pain, and face the sadness.

Self-medicating can take many forms, such as -

  • Finding a tame doctor who'll over-prescribe pain meds (harder now, but still possible)
  • Alcohol
  • Marijuana use
  • Street drugs
  • Shopping (especially online)
I separated out marijuana from 'street drugs' because there is some social tolerance for it, and therefore often more reluctance in confronting someone who's using it to self-medicate.

What should you, as a caregiver do, when you realize that self-medication is happening on your watch, so to speak?

First, talk to a counselor to get your own bearings.You should be doing this anyway, if possible; caregiving takes an enormous toll.

Next, try to determine the extent of the problem...and stay involved. There are some levels of self-medication that aren't worth a confrontation. If your husband goes to the house of the old hippie dude down the street to share a marijuana cigarette or two once or twice a week, you may find that it's simply better to keep your own counsel, and keep an eye on the situation, especially if death is close.

Creating an emotional rift at the end of days can make for damage that's hard to repair.

Likewise, shopping. If you can afford the 'feel-better' purchases, you may choose to let it go.

But sometimes, it's past tolerating, and you have to take action. Prepare for it.

Talk to your spouse's medical care team. Don't make it about 'you'; but do make them aware of what's happening.

Talk to your pastor. You'll need prayer, and all the spiritual support you can get, because I promise you this...

When you confront, it's going to be ugly.

Your spouse is going to get defensive, guaranteed, and when he or she realizes that you've called in outside parties, feelings of being ambushed will arise.

Be firm in your commitment to the health of your relationship. Don't make it a power-play; someone who's dying is losing influence steadily, and raming this as a matter of exerting control will make things really horrible, and can kill the good times you may have left.

Be supportive in every way you can. If your husband or wife is having problems with medication dosage or effects, listen attentively, and if possible, go with them on doctor visits to lend your support. Make the system work.

Don't take the abuse that may be hurled your way personally.  While part of it is personal, and intended to hurt, a larger part comes from feelings of guilt and shame. Your spouse may, on being confronted, say that he or she hates you; but the amount of self-hatred is even greater.

Don't expect a quick 'healing' if you have to confront. Bad habits can be hard to break, and quitting cold-turkey can cause some pretty nasty physical and psychological problems. It's going to take time to mend.

And it will take time to mend your relationship. From both sides; you'll have to be watchful, and untrusting for awhile, and that builds distance. Your spouse will feel, at best, 'on probation', and something less than an equal partner in your marriage.

Finally, pray...a lot.

If you can, please do leave a comment. I am trying to answer all, and I am failing, but please know this - I read and treasure each one.

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  1. Andrew, you are a giver of wisdom and encouragement. My prayer today is that God will send those in need of a blessing to your site.

    1. Lara, thank you so much, and the prayer you offer is just perfect!

      Thank you for being here. Your presence matters to me.

  2. Gosh, man, you're getting wiser by the minute! There's a fine line here and real discernment is needed.

    Until you've walked a few miles in my shoes ... well, who knows what any of us would do.

    1. Thanks, Linda!

      It is a fine line to walk, and very hard, sometimes, to make the right call. Prayer and counseling - for the caregiver - are absolutely necessary!

  3. I have a suspicion that if a caretaker is making this a bone of contention in the relationship that it is more of a distraction strategy. Maybe even a way to engage in a way that makes them hurt less because they are so angry with their dying spouse for self-medicating. Just my thoughts which may be way off base. But I'm so grateful that you've written this, Andrew. So much wisdom from your perspective that we all can benefit on. The end of our lives is a path that not many of us are walking--that we know of anyway. So I'm grateful for your insight shared with all of us!

    1. Interesting thought, Beth, and I think there's a lot of truth in that. Self-medication does engender bitterness and hurt on the part of the caregiver...it's almost a slap in the face, saying, I'm going to handle this MY way, and what YOU think is secondary.

      Terminally ill or not, one is still part of a team, and has relational responsibilities.

      Thank you so much for your kind words, and for being here, my friend!

  4. Probably all the things I would do are the things you list DON'T DO. Can't believe you have the presence of mind to be writing all of this for us. xo Bark Bark

    1. Susan, this is hard to write some days...just tough to get my head physically around the words, not to mention being able to type them. But it does give purpose.

      XOXO WagWagWag WOOF!

  5. Andrew - very needed and very well done. See, God's still using you!

    1. Paul, thanks so much! Yeah...He ain't done with me yet.