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Changing Times, Changing Challenges for Couples posted Dec 29, 2017

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As if establishing and maintaining a good, solid marriage relationship wasn’t a big challenge all on it’s own, unexpected turns of events from outside can strain even the most resilient of couples. For example, there is a couple from Alaska that I have

seen online via Skype for nearly a year now, who have been challenged by significant external events. Here is their story:

Hanna and Jason (not their real names), a couple in their early forties, have two late teen-age kids. Hanna works at a software development company, and Jason is a line supervisor for the local electrical power company.

The couple has had it’s ups and downs but for the most part they say that they have worked on their many of their differences on issues like money and budgeting, parenting practices, and dealing with expectations from in-laws, quite successfully. They and their family were doing quite well over all.

It all changed when Hanna got a phone call from the power company head office informing Hanna that Jason had experienced a work accident, a fall from a scaffold, and had been rushed to hospital by ambulance.

Hanna immediately left her office and proceeded to the emergency room. When she finally got some information from the emergency staff, she was told that Jason had severely injured his shoulder, but that there were no broken bones. They wanted to keep him in hospital for a few days, and then he could go home.

Hanna was relieved and she found a thankful Jason when they talked, both saying how the consequences of a serious fall could have been much worse.

The problem was, that the shoulder injury left Jason with some very severe ongoing pain. His doctor prescribed some type of opioid medication temporarily, as well as attendance at a physiotherapy clinic.

Jason was off work for several months, as his injury disqualified him from working for a while. It wasn’t long before Jason was back to his doctor complaining that the pain medication wasn’t working all that well and that he was suffering. The doctor responded by increasing the dosage of the pain medication.

As the weeks passed, Hanna says that Jason was becoming depressed and moody, impatient with the kids, and, in her words “kind of a bear to live with.”

Then, she found out that Jason was double dosing himself and running out of pills before he was due for his next doctor visits. She asked him about this and Jason’s response was a cranky “I’m in pain, and I can’t help it if I need more.”

Worse yet, Jason started to buy pills on the black market. Hanna was beside herself with worry. She explained to Jason how dangerous a practice this was and that you never know for sure what you might be buying or if these drugs might hurt or even kill him!

Eventually, Hanna sought a meeting with the doctor for the couple and they had a frank discussion with him. The doctor explained how he himself felt in a bind with his pain patients. Many of them were suffering terrible pain, opiates often have the best pain reduction properties, but he knew well that they were addictive.

He agreed to meet with Jason regularly and put him on a program of corticosteroids, anti-inflammatory drugs and some anti-depressant medication. The plan was to gradually have Jason stop the opioids.

This approach worked to some degree, though Jason cheated a few times by getting some pills on the black market again. As much as Hanna tried to be patient and understanding, their marriage was strained and they were not feeling as close. Jason was trying but struggling.

Around the time all this was going on for the couple, the laws regarding medical and recreational marijuana availability were changing in Alaska. Hanna did some on-line research and decided that the couple should meet with a doctor who specialized in the use of marijuana for pain management. She didn’t feel that Jason was fully handling his stopping of the opioids all that well.

They saw the ‘marijuana’ doctor and she prescribed some so called CBD oil. This is cannabidiol, which comes from the marijuana plant but doesn’t create a high or any form of intoxication. She thought that this might help Jason with his pain management, or at minimum reduce inflammation for him.

Jason ran this plan past his regular doctor and he was on board.

In one of our online sessions, Hanna reported a significant change in Jason. She was quite excited and pleased that he had gotten right off the opioids and was relying on the CBD oil and continuing some of the medications that his doctor had been using with him.

Things seemed to be returning to normal, when a call came from Hanna asking for an urgent session.

When they came on the Skype screen, Jason looked dejected and Hanna looked angry. She explained that she had come home from work one day and found Jason in the garage in what she called “a stinky cloud of smoke.” Jason explained that although he was winning the battle against the pills, he was still feeling a bit depressed.

He said that he had gone to a marijuana store and bought some regular, non-medicinal type of marijuana, that he started smoking while Hanna was at work. It made him feel better in terms of his mood.

“Fine,” said Hanna, “but it also makes you withdrawn. You are not there for me and the family when you are high, and I don’t appreciate it.”

I asked Jason how often he was smoking, and he said he was doing it every day. I also asked him if he could see how getting high, though it may improve his mood, removed him from the family and into himself.

He agreed.

Then Hanna got upset. “Jason, I have walked the path with you through your injury, your prescription drug abuse, and now you want to be able to get high and check out whenever you want? I’m not sure I’m up for this.”

Jason asked: “What are you saying, that you would leave me?”

Hanna: “I don’t know. I get stressed too you know. Smoking dope is not something that I want to set as an example for our kids as a way to handle problems.”

I asked Jason what he could say to Hanna to make sure he understood her feelings.

“I get it Hanna. You are right. You’ve been with me all the way and I know it hasn’t been easy. Just go with me on this a bit longer, and I’ll do everything I can to be the husband and father I used to be. I’m trying like hell to change. Please stay with me,

I’m almost there.”

Hanna said she would try.

I asked the couple if they could agree on a scheduled frequency, where Jason could smoke if he wished, but only in a limited way.

Jason said that if he could smoke on his own one evening per week, he would assure Hanna that he would keep that agreement and make every effort to be present for her and the family the rest of the time.

I also asked the couple if they could provide some education about this whole matter to their children since they surely will wonder why dad has gone to the garage some evenings, about marijuana use, and about issues like depression.

Hanna was not fully thrilled about this compromise arrangement, but because Jason had been doing so well staying off the pills, and because of his pledge to return to the family, she would give it a try.

On three and six month follow-up, the couple reports many improvements. Jason is back at work, his pain is nearly gone, and his marijuana smoking has become more occasional. Hanna reports that Jason is back “in” with her and the family and she is glad to have him back.

I commended this brave couple and have stopped the counseling. We will have a check in six months from now.

The times are really changing, aren’t they?

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