Addressing Dependence on Stinose: A Guide for Families - Psychiatry

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The issue of addiction to Stinose sleeping pills!


Hello Doctor: My mother has long-term insomnia issues and is very dependent on Stynox.
The dosage has been increasing, and when she doesn't take it, she becomes noisy and agitated.
In the past six months, she has even been taking it during the day.
Due to a previous issue with tongue inflammation, she has been taking Stynox for tongue pain as well.
After taking Stynox, she becomes disoriented and incoherent, and sometimes she doesn't even recognize us.
As her children, we have to work during the day, and we are very worried about her having an accident or potentially developing a mental illness.
We want to take her to see a psychiatrist and switch to another sleeping medication, but she refuses, believing that Stynox is effective, which is a typical sign of drug dependence.
We are from Nantou County, and the clinic doctor suggested that we take my mother to your hospital for inpatient drug withdrawal treatment.
I would like to ask: which department should we consult at your hospital? How long does the inpatient treatment usually last? Do family members need to accompany her daily (note: we have to work during the day and our financial situation is not good)? Is there coverage under health insurance? What are the estimated costs? If my mother is resistant to inpatient treatment, will it be effective if we force her to go for treatment? Thank you for your response.
Daughter from Nantou.

Nantou Nü'er, 30~39 year old female. Ask Date: 2010/05/01

Dr. Wu Peijun reply Psychiatry


Thank you for your letter.
I believe that you and your family have had a difficult time over the past six months due to this issue.
Insomnia is a common problem in modern society, and there are many causes for it.
Typically, identifying the underlying cause is necessary for effective treatment.
Our hospital currently offers a "Sleep Disorder Specialty Clinic" that can provide relevant consultations and treatments for insomnia.

Regarding the treatment for dependence and withdrawal from Stilnox (Zolpidem), due to national health insurance regulations, treatments for drug and alcohol addiction are not covered, so this part of the treatment may need to be self-funded.
Our hospital does have an Addiction Psychiatry Clinic that can provide relevant assistance.

Generally speaking, successful treatment for substance dependence requires the individual to have the motivation to change and a willingness to accept treatment.
The initial consultation for addiction treatment typically costs around NT$2,000 (which is relatively expensive), while follow-up visits are about NT$1,000.
The cost for inpatient treatment varies depending on the condition and the medications used, ranging from approximately NT$3,000 to NT$5,000 per day.
In principle, family members do not need to accompany the patient.
However, unless absolutely necessary, we recommend that Stilnox withdrawal treatment be conducted primarily on an outpatient basis.
Thank you! This response was assisted by Dr.
Chen Hou-Liang from our hospital.

Reply Date: 2010/05/01

More Info


Addressing dependence on medications like Stinose, particularly in the context of insomnia, can be a complex and sensitive issue, especially when it involves a family member. It’s commendable that you are seeking help for your mother, as her reliance on this medication appears to be escalating, leading to concerning side effects and behavioral changes. Here’s a comprehensive guide on how to approach this situation.


Understanding Medication Dependence
Stinose, which is often used for treating insomnia, can lead to dependence if used over an extended period. Patients may find it increasingly difficult to sleep without the medication, leading to a cycle of increased dosage and reliance. The symptoms you describe—confusion, disorientation, and even aggression when the medication is not available—are indicative of potential withdrawal or dependence issues.


Steps to Address the Issue
1. Consult a Healthcare Professional: The first step is to have a thorough evaluation by a healthcare professional, preferably a psychiatrist or a physician specializing in addiction medicine. They can assess your mother’s condition, the extent of her dependence, and recommend a suitable treatment plan.

2. Consider Inpatient Treatment: If your mother’s dependence is severe, inpatient treatment may be necessary. This typically involves a medically supervised detoxification process, where she can safely withdraw from the medication under professional care. The duration of inpatient treatment can vary but often lasts from a few days to several weeks, depending on the severity of the dependence and her overall health.

3. Choosing the Right Facility: When looking for a treatment facility, you would typically want to consult a psychiatric hospital or a specialized addiction treatment center. In your case, you may want to inquire about the specific department that handles substance dependence or addiction treatment.

4. Insurance and Costs: In Taiwan, the National Health Insurance (NHI) may cover certain aspects of inpatient treatment, but it’s essential to check with the specific facility regarding coverage details. Costs can vary widely based on the facility and the level of care required, so it’s advisable to discuss this upfront with the hospital’s admissions office.

5. Family Involvement: While family support is crucial in the recovery process, it’s understandable that your work commitments may limit your ability to be present daily. Many facilities offer family counseling sessions, which can be beneficial for both your mother and your family dynamics. You may not need to be there every day, but regular visits can help her feel supported.

6. Handling Resistance to Treatment: If your mother is resistant to the idea of hospitalization, it may be helpful to approach the conversation with empathy. Discuss her concerns and fears about treatment, and try to involve her in the decision-making process. Sometimes, presenting the idea of treatment as a way to regain control over her life rather than as a punishment can help.

7. Alternative Therapies: In addition to medication management, consider exploring alternative therapies for insomnia, such as cognitive-behavioral therapy for insomnia (CBT-I), mindfulness practices, or lifestyle changes that promote better sleep hygiene.


Conclusion
Addressing dependence on Stinose requires a multifaceted approach that includes medical intervention, family support, and possibly a change in lifestyle. It’s crucial to act promptly, as prolonged dependence can lead to more severe health issues. By seeking professional help and considering inpatient treatment, you can provide your mother with the best chance for recovery and a return to a healthier, more balanced life. Remember, the journey may be challenging, but with the right support and resources, improvement is possible.

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