Narcolepsy or Addicted to Pain Meds?

Reader’s Question

My mother is 61 years old, and I consider her to be a hypochondriac. She is completely focused on mysterious health problems and sees numerous specialists for complaints that most of us believe don’t really exist. As a result, she takes a number of medications, including some very strong pain meds. My sister and I think she’s addicted to these pain meds. In the past few years, we think these pain meds have led her to have problems sleeping. She is now a textbook example of narcolepsy. The biggest problem is that she even falls asleep while driving. But she is in complete denial about this: if I offer to drive or mention that she looks tired she gets very annoyed.

I brought my two young children to visit recently (we live out of state) but avoided driving with her. This meant I didn’t do as many activities with her as we usually do. Instead we spent a lot of time with my sister (who agrees with me 100% on this issue). I probably should have confronted my mom, but she has a very strong personality, and I did not want to cause a major fight when we only visit once a year. Toward the end of the trip she confronted me, saying that she knew I had some issue with her driving and that she was really mad that we spent almost no time with her during our visit. When I got home I called her and left a message. She never returned my call. A few weeks later I emailed to tell her that I missed her and wanted to put this behind us. She never replied.

Before this trip, she called me several times a day. Now it’s been two months without contact. She hasn’t spoken to my sister either.

Part of me is almost glad not to get her constant phone calls about her medical ailments. I just don’t know what to do.

Our Clinical Psychologist’s Reply

At some point, you will need to confront the important issues with your mom. However, the “confrontation” need not be either hostile or indicting. You can clearly express your concern for your mother’s health and well being and honestly and benignly indicate that you are concerned about the possibility of her falling asleep at the wheel.

Confronting you mother about what you suspect might be a prescription drug addiction might prove even more delicate. You might want to broach that topic by discussing the actions of the various drugs she’s taking as well as their side effects in a matter-of-fact manner and suggest that you’d be willing to accompany her to her next doctor’s visit to share your concerns.

The definition of narcolepsy has been expanded in recent years to include many of the sleep irregularities you cite as well as frequent sleeping during the day. At one time, narcolepsy was primarily defined by the phenomenon of cataplexy, which is a sudden muscular weakness typically brought on by strong emotions (although it can occur without an emotional trigger). Narcoloeptics experience deficiencies in deep sleep, and most especially REM sleep during the night. Indeed, many medications can interfere with regular sleeping patterns.

If your mother has a relatively strong personality, it will probably not be all that easy to confront all the necessary issues with her. It will be very important for you to let her know that it’s not your intent to take away her autonomy or to chastise and disrespect her, but only to let her know how much you care for her and want her and the rest of your family to be safe, healthy, and happy.