Mr. Campbell, again, I appreciate you being open and honest with me, but I can definitely tell you at this point based on the information that we have so far, you definitely meet criteria for what's called an opioid use disorder. Okay? So what does that mean? Yeah, I know it's hard to hear disorder, that word, but it basically means that you've lost control and you definitely don't want to be doing the things that you're doing, and as a result of the opiod use, you're not functioning at a place where you need to. How am I supposed to manage my back pain without having some pain medication? Yeah. No, I hear you and again, I'm here to help. So I'm on your side and I can only imagine how frustrating it is. One of the things that we can do is talk about some medications that not only will work for your back pain but also for you losing control as a result of this is opiod use disorder. Okay? Some other pain medications? Again, these medications can be used for pain but they're also used when people are losing control as a result of their opioid use. So for you, it would be really good because it can treat your chronic pain and also the loss of control that you've been having with getting the opioids, okay? Got it. At this point though it's important for me to really understand what your risks are in terms of your opioid use. So have you ever heard of the medication called Naloxone or the more common name might be Narcan? I've heard of Narcan. Okay. All right. Do you have access to that medication? I don't have it. No. Okay. So we definitely want to make sure that you have access to a Narcan kit. It has the medication called Naloxone so that if you accidentally use too much of the opioids, we can make sure that that's available. You can't use it on yourself, but we want to make sure we get that education just so you know how you can teach others around you. Yeah. Okay. There's many different forms that it can come in. The one that we have here and it's easiest to use is the intranasal kit. So we'll make sure that you get that and also we'll make sure that you work with one of our health technicians so we can go through the education of how to use that. So I have to carry this thing around me all the time? It'll be important for you to have because we don't want you to die accidentally from overdose. But what we'll also focus on is like you said, you getting treated for the pain and also for you losing control with the Opiod use so that we're not putting you at risk for accidental overdose deaths from opioids. Other things that I like to know in terms of where you're getting the non-prescribed Oxycodone from. Are you buying it from the same person each time? I pretty much always get it from the same guy. Yeah. Okay. So that's another thing just to make sure you know what you're getting and your not switching where you're buying it from. We mentioned the way that you're using, so the pattern of use. How much of the Oxycodone are you using now? I know you started out, you said around 60-80, but where are you at now in terms of this? A hundred and twenty milligrams. A hundred and twenty milligrams. Has it always been that or did you go up over time? Well, the highest it ever was, was 160. Okay. Then you cut back on your own or? Yeah. Really, since that work episode in New York, that's when I decided to stop the heroine, and I figured it would be easier to taper myself down if I was on something like a pill like Naloxone. Yeah, got you. Mr. Campbell, when did you first start using opioids? Ever in your life, not even when it first became the problem, but just when did you first start using? Ever? Yeah. In college, recreationally, once in a while. When did you start out of use in the college, do you remember? Yeah. It was Oxycodone, Vicodin, Xanax. Got you. Just experimentally. When did you notice that it became a problem for you? A problem? Well, in terms of feeling like you need it to use it more or have to go and buy it? Was that? Well, that was while my back had blown out and I couldn't get it prescribed by the doctor anymore. I have serious back pain and I know I need it for that and I probably always will. Okay. In terms of treatment, so have you ever been treated for the opioid use? Never went to any AA or NA meetings or anything like that? I just got to say it, I'm not an addict. I'm just trying to manage a situation with my back, it's chronic. Yeah, and I hear you Mr. Campbell. I don't see you as an addict at all, I actually think that's a very stigmatizing word. It's just important for me to understand what the full picture is so I know the best way to help you. I know I said I did it recreationally in college, but I don't do this for recreation, I'm not trying to get high, I'm just trying to function. Yeah, I got you. We already went over the effects of your substance use, the problems with lying to your wife, the problems at work, things like that, concentrating, sleeping, anything else that I'm missing in terms of what you're seeing in terms of using the opioids, any physical or emotional effects of that? Well, I don't like the way I treat my wife sometimes. I guess I'm mean. I talk mean to her and I feel bad about that afterwards. She's pretty patient and understanding, but I really don't like that. Okay. In terms of periods of abstinence, you mentioned when you were in New York and you didn't have the heroine for a couple of days, have there been other times where you're able to go for any particular period of time without the opioids? No, that was pretty much the only time. Okay. That was pretty much the only time that I was without. In terms of relapse, you went for those two days and then you went right back to the non-prescribed Oxycodone use, is that accurate? After that business trip to New York, yes. Yeah. So that helps me understand the opioid use in terms of any other types of substances, first time using like alcohol or tobacco, anything else that you use? First time in my life? High school, everybody smoked pot and that's when I started smoking grass. Is that a problem for you now? The pot or do you use that now? Yeah. I do use it. I enjoy smoking it a couple of time in a week. It helps me sleep. I don't feel so like that's a problem. My wife knows about that. She even smokes sometimes with me. Yeah, we drank in high school, we drank in college, drank plenty in college. Do you feel like with the drinking, the alcohol use that you ever drink so much where you blacked out or something like that happened? Back in college, yeah. I know I had more than a couple of binges like that, but that's decades ago. I drink beer now. Yeah. A couple of beers during the week and maybe a few on the weekends when I'm watching a game or something. But in terms of the substances that you're using now between the cannabis or the pot and the alcohol and the opioids you seem, which one do you think is really affecting your ability to function the most? Well, I don't think drinking some beer and pot is affecting me at all. Okay. Anything else? Cigarettes, tobacco, anything else, anything like that? No, I've never smoked cigarettes. Okay. Good. That's one of the best things you can do. No cigarette use, good for you for that. I want to go through just a few more histories and we'll be done with this section, but it's important for me to understand your past psychiatric history. So have you ever gone to a psychiatrist or a mental health professional? No. Ever dealt with any mood problems like depression or anything like that? I've never seen anybody for it, but I just think as time has gone on, managing this situation, I know I'm just not happy with the way things are. Right. I feel down a lot and I don't have energy, and it's frustrating. Am I depressed? Yeah, I probably am. Yeah. But never spent any time in like a mental health hospital? No. See things that don't exist, hear things nothing like that? No. Okay. All right. Good. Then in terms of your past medical history, I definitely have a good understanding of the chronic back pain, any other medical problems that I should know? No, I don't think so. Okay. Any surgeries that you had that I should know about? No, I haven't had any surgeries. Okay. Then finally in terms of past family history, have your parents ever dealt with any substance use issues or anything like that? Well, my mother and her brother were very heavy drinkers, I guess you'd call them alcoholics. Okay. Are they still alive? No. Okay. Do you know what's your mother or your father died from? Heart attack. Okay. What about siblings? Any brothers or sisters that dealt with any mental health or substance use disorders or anything like that? No. I'm the only child. Okay. All right. So at this point, we really have gone through a very comprehensive assessment and I can appreciate again Mr. Campbell that you are uncomfortable, so I want to move along.
