My sister is almost 36 and has RA. She has tried almost every medication out there, and seems to be going downhill. She has a 7 year old son, and can not (or will not?) get out of bed other than to make him lunch and TV dinners. She hasn't driven in a year and 1/2, and barely leaves her front porch. She has tried Enbrel and Humira (sp?) and has gone in to anaphalytic(sp) shock with both of them. She is scared to try Remicade, as she is told it is from the same family of medications. I am concerned that she is addicted to all the other medications (morphine, etc.) that she uses to control the pain, and am concerned for my nephew. She is now on long-term disability, and trying for social security disablility, and I am not too sure that she has not given up in trying to find a way to help herself other than pain medication...My mom and I are exhausted from doing everything to help w/ her and my nephew, and don't know which way to turn - any suggestions would be helpful....

How long has she had the symptoms of RA and how long has she been on pain medications, what type and how is it dosed? Is she seeing a pain management doctor?
It's really hard to say one way or another unless knowing the entire situation.

First of all those with true chronic pain rarely become addicted to pain medications, they do not take it to get high, they take it to stop the pain, there really is a huge difference in the side effects if you will. Also most who abuse the medication take more than is prescribed. Most people who are abusing pain medications and are addicted to them often doctor shop, going to more than one doctor and they will always run out of pain medication very early.

So I guess what I am saying here is you need to ask yourself:
does she see more than one doctor at a time ?
does she frequently run out of pain medication quickly ?
does she make excuses to get more pain medication?
when she takes the medication is she suddenly out of bed and running around doing things particulary the first week or two after seeing a pain doctor?
Is there any real reason to believe she is addicted such as a past history of addiction?

Most of those are clear signs of addiction. Our bodies however, can become dependant on medication and if you suddenly stop taking it you will go through withdrawals. When dependance sets in often times the medication is not as effective as it was say a year previous and a change of dosage or medication is often used to resolve the problem.
A good PM will also be able to realize signs of abuse and those generally are: is the patient constantly loosing medications, patient constantly asking for medication increases without giving current medications a worthy try and many other key clues. Of course you probably can't answer those questions but should she be doing those things a little flag should go up in the doctors mind.

Something you may be overlooking is the obvious. She may actually be in that much pain, it happens, I've been to that point as well with both my osteoarthritis and herniated spine. Her medications could be making her very tired or run down, morphine does that it's one of the side effects that cause most people to stop taking it.
She might be very depressed especially if this took an acute onset. It's hard to be normal one day and then the next you are dibilitated.

Before you jump to any conclusions I would suggest you talk to your sister, find out what kind of pain she is having, which you probably already have. Suggest that she seek out counseling for depression. And one thing you can do for her is get her some help at home. She may actualy need it. You don't need to be 65 with RA to get help or to be completely disabled, some people don't realize that. More and more there are people who are disabled for life at a very young age with arthritis it isn't a disease for just senoirs anymore. There are many helping hand type programs out there if you live in the US that are free and because she is on disability then chances are she will be eligable. She can get someone to come in the home and help her with her son and help do small chores and the like, it can make a difference in her life. You didn't mention, but does she have a spouse?

Depression is all too common in those who have chronic pain regardless of its origin. She may need to see a counselor to help her deal with the pain and possibly put her on medications if she isn't already. If she is on medications it might be the time to adjust them they can loose their effectiveness over time. Because she won't leave her house is an indication of severe depression and pain. And when you are depressed you hurt more, and when you hurt more you become more depressed. It is a huge cycle that the average no CP person may not understand.

There are pain management classes she can take to also help her cope with the pain. If her pain is valid and she isn't abusing then your family too should take a class and learn more about chronic pain and how you can help her out without enabling her or making her dependant on you and your family.
Drop by the pain management board here and browse some of the various messages, you are going to see how chronic pain can impact our lives on a daily basis and how some do struggle just to get out of bed in the morning.

If she is addicted then it is your responsibility to get help for her son in whatever means you can. A child should not be subjected to an addicted environment.
But again before you determine that she is an addict you really need to understand or know if her pain is valid and she's having a tough time coping with it.

I wish I could be of more assistance but being I don't know the situation personally I can only look at it as a global whole from both sides of the fence.
I wish you luck and if you have any questions feel free to ask. We will try to help you out.