I have bipolar disorder, fibromyalgia, severe insomnia and social anxiety. I'm on several medications to deal with some of these and lately I've begun to feel like I'm having a problem.

I started taking Ambien five years (? perhaps a little longer or a little less, it's hard to remember) ago. In the last year it started to be less effective. I went to my dr and asked him if there was something else I could try or if we could add something that would help it get back on track. He refused to discuss any possibility. He told me that insomnia does not really exist and if I were controlling my other conditions properly it would go away. He told me that using long term sleep aids was not going to be a solution to my problems which are not really insomnia and that eventually anything I take will fail me, so I ought to fix the other things instead. I didn't know what to say so I went home and gave up on addressing it as an issue. I focused on other things.

But I still wasn't sleeping well. Inability to fall asleep, inability to stay asleep, waking up every 15 minutes to go to the bathroom...I wasn't getting any rest. So when it got bad I tried taking two Ambien to see if it would knock me out. It did, but ultimately I think this was a serious mistake.

Around this time for reasons I don't understand the same doctor changed my norco prescription. Originally my rheumatologist had prescribed me 1 -2 5/325mg norco every four to six hours as needed for pain. By the time I was given this prescription I had had a dx for fibro for ten years. I tried all of the standard drugs (gabapenten, lyrica) but had really bad reactions to them - severe confusion for example. I liked this system because it allowed me to take less on a good day and more on a bad day. I had requested norco as a opposed to Vicodin because I wanted to have a lower Tylenol dose in the med.

What happened was that the pharmacy decided they had to call my primary doctor for my refills instead of my specialist. After a month or so of this, without warning, my primary doctor changed the prescription to 1 10/325mg every four to six hours as needed for pain. I didn't like this as much. It felt like I had less control. Oh, I could break a pill if I wanted to take less but it makes me really nervous to do so. I'm always worried that I'll loose half or drop it and not be able to find it...there is a toddler in my house, a dog, several cats...I don't want to expose any of them to a dangerous medication. I tried asking my doctor the next time I saw him to change it back but he wouldn't. He just told me to break the pills if I wanted to take less. I tried to explain why the other system was better for me but he wouldn't change it back. Fibromyalgia is a chronic pain condition. I never expect my painkillers to completely address the pain, just hep me manage it.

By this point I was taking 2 ambien on a more regular basis. I was sleeping better, which by result made my pain level somewhat more manageable. Of course it also left me short of meds. I got early refills a couple of times. My doctor reacted to this by doubling my painkillers... I didn't understand why. I hadn't seen him, the prescription was just changed one day when I went to the pharmacy. I probably should have just taken them the way I had been but I decided to try the prescribed dose. It really, really helped.

But by this time I was having a real problem controlling my sleeping meds. I was always short, always out, always trying to figure out how to get an early refill. My doctor reacted to this by saying that I was overusing my ambien and my painkillers. He insisted I go to a pain management clinic. I agreed to go because, well, pain management is a good thing.

When I got there they focused on my norco use, not my pain level or how to manage it. I had to sign a contract stipulating how I would deal with the prescription, including never getting an early refill for it and never ordering a refill on a weekend - as well as never allowing another doctor, even in the ER to give me norco. There was no mention of the sleep aid. I brought it up, said that I knew I wasn't using it properly. I asked these doctors if I could try something else or add something to help it. They told me the sleep aid wasn't their territory; they were there to deal with how I use opiates.

After a while the pain management doctor cut the norco prescription back down to what it had been before, without warning. I thought I'd be ok with it but I guess I had gotten used to the higher dose because now I'm having a much harder time. I'm on a two-week supply rotation. Not because I've messed up with the pills, but because I miss appointments. I have anxiety attacks and I can't seem to get past them to go to the doctor. It feels like a hostile environment to me. The pain management doctor added tramadol to my regular prescriptions. At first it was a good thing; it helped.

Then a weekend came when I had ordered a norco refill that Thursday, knowing I'd be out Saturday. The doctor didn't verify the refill order until Tuesday morning. By that point I was in trouble. I had run out of norco and when I started to feel just absolutely terrible, I used extra tramadol. A lot of extra tramadol.

So now I feel like I'm on a roller-coaster. I'm using to much ambien when I have it and then going without it for very long stretches. The incident of the untimely refill has not been an isolated one. It's led me to overuse my tramadol more than once, which in turn leads me to overuse the norco (back to the dose I was on before they cut it down) when I run out of tramadol.

I know I have a problem. I feel like the biggest problem is with my ambien use because it has become a constant issue and I've had a couple of times where I have seriously overdosed - taken a month's worth in three days. But I'm also concerned about the way I'm handling my painkillers. I can't simply quit; the pain can be hideous. Without treatment sometimes I can barely walk to the bathroom or brush my hair because of it. I don't know what to do. I have a goal of trying to get level again - using each medication exactly as prescribed, but I don't think I can do that without some kind of support structure. I don't feel like I can discuss problems with my doctors at all. I'm always terrified that if I bring up an issue they will simply cut off my medications.

I guess I gotta just keep trying to make it work...