Dr. Johnson and Dr. Berkley, who previously met with Alexandra to evaluate her back pain, join the conversation. Dr. Phil asks Alexandra, "Do you have any questions for them?"
She asks the doctors for the results of her MRI.
"We looked at the initial MRI scan and the follow up. Really, there was no significant change," Dr. Johnson says. "There's not something there that would cause an ongoing pain problem, but it certainly would in the beginning. There's not something there that we can see that needs some further intervention."
Alexandra was in a car accident two years ago, and Dr. Johnson says that a broken bone takes six or eight weeks to heal, and by two years, it should be resolved.
Dr. Phil tells the doctors that Alexandra is taking prescription drugs to help manage the pain she still suffers.
"The problem is that these medications, narcotic pain medications, or opiate medications, are really intended for short-term use, at the most, three to six months," Dr. Berkley explains. "It's not intended for long-term maintenance use. There should be really no reason for taking the high doses of pain medication that Alexandra has been taking and for this long of a period."
[AD]"You said that these medications can actually exacerbate the pain," Dr. Phil says. "How is that, and what do you mean by that?"
"There are a number of ways in which pain medications can bring on more pain," he says, explaining that some theories say the brain cells are turned on and can produce more pain. "The pain receptors become desensitized so that your threshold for pain drops to the basement, so the slightest ache or pain that you have may be magnified, and you interpret it as a horrible, significant discomfort, where, in fact, it might just be a simple ache that we all experience from day to day."
Dr. Phil calls out Alexandra for her previous behavior. "You have called us before and said you are on the floor, you are cold, you are shaking, it's like the flu 10 times over," he says.
"I don't recall that," she replies.
"Maybe you don't remember, because it sounded like withdrawal at that point," Dr. Phil says. Alexandra blows off the comment.
Dr. Johnson asks Alexandra, "What's the endpoint? Where do you envision yourself, and why are you here?"
[AD]"I didn't come here to talk about the amount of pain pills that I use," she says. "I came here to ask for help so I can get into school, so I can make my life better for my children."
"I think your goal is very admirable," Dr. Berkley says. "But I think that one of the major steps you have to take for that, really, is to get off of these medications. Because we know that the longer you take these medications, they won't have the same effect on you. You're going to have to need higher, and higher and higher doses. That's where we say where is this going to end? That's what our concern is."
"No," she replies.
"So, you just don't think they know what they're talking about?" Dr. Phil presses.
"I think that each doctor has their own opinion," she says.
[AD]"You know that's totally non-credible, right?" he asks. "It's really the only thing you can say right now, because you have no intention of changing what you're doing. So the only thing you can do is take that position. I understand that. It's completely non-credible, and nobody believes it. You don't believe it." He adds that Alexandra is probably taking the opinion of her doctor in Florida because he is telling her what she wants to hear. "You want the drugs, and he's giving you the drugs."
Alexandra laughs it off.
"When you talk about additional opinions, there are probably some addiction specialists, people who are really engaged in the detox world," Dr. Johnson says. He asks Alexandra, "Have you seen anybody like that?"
"Yes, I've spoken with somebody who specializes in detox," she says, noting the person works at her county health department.
"Do they think your meds were appropriate?" Dr. Phil asks her.
"Yeah," she replies.
[AD]"That's interesting to me, because I think it's absolutely ludicrous, and I don't believe that anybody with a full history of what's going on would believe that," Dr. Phil tells her.
Dr. Berkley addresses Alexandra. "You have a choice and an option here," he says. "We can only just show you the way, but if you make a decision not to do that, it's going to be a problem for you later in life."
"We've offered her every possible help and assistance, and she doesn't want it," Dr. Phil says.
Alexandra rolls her eyes.