Previously I wrote of two brothers with very similar diagnoses who took two very different paths. Both with classic Generalized Anxiety Disorder and intermittently affected by panic attacks the twenty one year old fell into using prescription opioids he bought off the street to self-medicate. The younger 18 year old chose a different path and after some long and hard thinking decided to go with a prescription antidepressant from me.
Last week they coincidentally came into the office within a day of each other. I say "coincidentally" because they are no long speaking to each other. The older's drug use has created a rift in the family. So where is each of these brothers at with their diagnoses?
The younger brother was doing quite well on his SSRI. Panic attacks still occasionally plagued him, but they were much more manageable. His worries not quite so debilitating. In fact he was doing so well he decided he wanted to stop his medication thinking he had this thing licked. Despite my concerns about a quick relapse, I think he will wean himself over the next month and see how things go.
The elder decided his $100+ a day oxycodone habit wasn't sustainable and he wasn't the person he wanted to be. A few days earlier he enrolled in the closest methadone maintenance program and now drives 30 miles every morning to get his medication. Far from feeling as if this were a burden, he has come to enjoy the peacefulness of an early commute to get there when the clinic first opens.
While he has progressed, I could tell he still hadn't really accepted his addiction when he said, "Some people might call me a drug addict, but that's only because I got hooked on them."