Saturday, February 15, 2014

Finding appropriate treatment

I recently was reading more about Phillip Seymour Hoffman and the question of whether he received appropriate treatment was brought up. I think the 23 year factor of sobriety and then relapse has shaken a lot of people. So now we set out to figure out why? What happened? My friend Mary would say its because addicts are only clean and sober one day at a time and the "sword of Damocles" is always hanging over their head, our head. I believe she is right. 

What is appropriate treatment? Is appropriate treatment a necessity to getting well from addiction? I don't know....but I thought I would write out some of my questions and thoughts here. This is just a rambling...not really anything cohesive or productive. lol

I will start with what I believe...."appropriate" treatment should be available to everyone. How much money you have or don't have should not be a factor. Every life is worth saving. You can't put a price on health and finding your way to wholeness. I think that treatment has become big business, big money in today's society. Treatment centers are the dichotomy of drug dealers....but both are taking a drug addicts (and their families if we still contribute to that sort of thing) financial resources. Both have different reasons for bleeding people dry, but they both do it.

Ok, so enough with the topic of money....add in the dual diagnosis dynamic, which I believe most if not all addicts have some sort of dual dx issues going on. I mean really, what happy and content person sticks a needle in their arm "recreationally?" Even a glass of wine each night is a solution to a stressful day, is a way to relax. Its solving something. Medicating something inside. The numbing effects of drugs and alcohol are a solution, a means to an end...not a long term or healthy solution of course, but a momentary respite from whatever is ailing us.

There are spa like centers to recover in, Ibogaine treatment centers in other countries, wilderness programs, scared straight programs, there are rehabs with ratty twin beds lined up... unmatched bedding abounds, everyone does chores and contributes to the cooking, there are harm reduction clinics that will prescribe and pass out Suboxone (or clean needles if you choose,) there are expensive dr's that will prescribe Suboxone or the Vivitrol shot, there are giant HMO's who will run a treatment program like a machine...protocols, unbreakable rules, medical record numbers, strict parameters for how to handle a crisis, a phone maze to find your way through.....but hang on, don't shoot this number, got a voice mail? Call back in an hour, they must be at lunch. And then there are 12 step meetings.....for any sort of thing that ails you. Food, drugs, alcohol, "helping" others, sex, being raised by an addict....the list goes on. There is outpatient, inpatient, massage therapists, group therapy, individual therapy, psychotropic meds....and any combination of all of the above. There are people who just decide they are done and stop. No 12 steps, no "treatment." Voila! They just stop and move on.

What if.....getting clean and sober is just about being ready to be done? I think any of the above can and should be used as tools (and we have used and are currently using many of them) but I think the biggest factor could be, possibly, if our addict is sick of being sick. What if they went into treatment and did what they were told to do? I know, believe me when I say this....I KNOW that its far more complicated than that. The head stuff that goes on is a constant jerking around in the very core of our kids. Does that mean that my girl hasn't gotten appropriate treatment? I don't know.....I can't stand our giant HMO that she has gone through, but its what we had available to us.

The question for me and the stark raving fear for me has always been how do we keep them alive long enough to get them to that point of being sick of being sick, with the least amount of permanent damage being done? That is what I have carried with me for the past 10-12 years.

So I guess my question really is "what is appropriate treatment?" Is there such a thing and if so where do you find it? P.S.H had any form of treatment available to him and was intelligent enough to figure out what he needed and where to go. Maybe, and I can't stand the thought of this, but maybe sometimes they want the relief of the drugs more?



notmyboy said...

Couple things that jumped out at me from this post (which is terrific, by the way)

*If an addict can just stop and move on, changing nothing else about himself, he was not really an addict. It doesn't happen like that with a real addict.

*My son has/had no co-occurring disorders. He just loved to get high. The depression that often followed detox came from the realization that he did really bad bad things.

*I believe talk therapy is great. It will not, however, lead to recovery long term. The addict has to take right action day after day after day. PSH stopped doing that. I would bet my bottom dollar on that.

*Addition/alcoholism is a spiritual disease. It must have a spiritual treatment. If the treatment center your addict chooses does not have a spiritual core, go somewhere else. You are likely wasting your time and money.

If you have an hour, listen to this speaker. Well worth your time!!!!

Birdie said...

The cost of treatment centres frustrates me. When my brother went into treatment 25 years ago it was $10,000 for a 30 day program. Thankfully he has been sober for 25 years but his saving grace is A.A. He goes to meetings, a lot of them. Sometimes more, sometimes less but he is aware that the only way he can stay sober is going to A.A.
I know there are other programs out there but I think why I like 12-step programs so much is they keep us accountable. In my opinion, we never recover we just learn to live with our disease. If we stop learning to live with our disease it has a greater chance of taking over our lives.
But really, I don't know. I just know what works for me.

My mom died on September 27, 2011. She was 65 and had ovarian cancer. I too cared for her until she went into palliative care. I miss her everyday. She was not only my best friend but a member of Al Anon and was always there to listen. She had about 20 years in Al Anon and made a lot of friends in the program.

Annette said...

Great comments here....thank you.
Notmyboy....first of all I miss your blog. Big time. ;o) Secondly....YES! A spiritual malady! You hit the nail on the head. I love that part in the big book. I also so agree that PSH probably stopped diligently guarding his sobriety, stopped taking "right action." Yes, it takes daily maintenance and care to continue to be a healthy person making healthy choices. (Thus the thought that we are never really "recovered" but always walking out our recovery day by day.) I am planning on listening to your video later today. Thanks for sharing it with me.
Birdie, awwww your mom was so young. I am so sorry. My mom was in her 80's and died from kidney disease. I miss her a lot.
I love the 12 steps and the Alanon groups that I am a part of. They met a need somewhere deep inside me that nothing else ever did. I believe that God directed me there and then sat down and waited for me to walk through the door so He could meet me in those rooms.

Signe said...

Such a good question, Annette. What is appropriate treatment? I do think you are so right in saying that the person has to finally be sick of being sick. I don't think listening to someone else's story is effective until someone really needs to listen. Really wants to heal. I am so angry at the system of rehabs. I think a lot of places treat the persons with addictions as less than human. I think they can be cruel and hurtful. Maybe having a lot of money can buy a more professional attitude, but if you are just one of us regular folk, that can be difficult. Maybe appropriate treatment is an individual thing. I've heard some people just get tired of being high or drunk and just dump it all out and work on their sobriety. Some people need to be with a group. I seems to be an individual process. I don't know. Thanks for sharing.

Syd said...

I don't know the answer, other than I get comfort knowing that I am not alone and that in the rooms of Al-Anon, I can share honestly and openly without feeling ashamed. I was so willing to get help and not feel FINE anymore. Sick and tired of being sick and tired.

For the addict/alcoholic, I read what the Big Book says and know what I have heard in meetings. Alcoholism is a disease of body, mind and spirit. And it is a symptom too of trying to block out the pain of some other illness,such as depression, ADD, bipolar, etc. Complicated and yet so many have found a solution. Maybe by being of service to others, one will stay sober.

Thought provoking topic.