Anatomy of a relapse part 3: healthcare barriers

On September 6, 2014, I made a choice that could have cost me my life. In this six part series, we’re journeying back to analyze how I slipped into a DXM relapse and what I did to self-stabilize and avert catastrophe.

This is part three of six in a series. For part one (Losing Grip), click here. Or here for part two (Onset).


The morning of September 8. Thirty-nine or so hours after my personal ground zero.

As planned, my mother arrived between 9:00 and 10:00am to drive me to the hospital.

Sparrow Hospital.

One of the major healthcare facilities in Lansing, Michigan.

A reputable facility. Part of the Mayo Clinic Care Network.

I know people who have received outstanding treatment at Sparrow.

As I write this, my aunt is in Sparrow’s care, recovering from a pulmonary embolism. The practitioners there surely saved her life. That’s incredible.

The doctors, surgeons, nurses, receptionists, janitors, administration and all the rest have collaborated to save and positively change more lives than I can readily fathom. Lansing is fortunate to have access to such a competent resource.

Shortly, I will raise some concerns and frustrations I had when seeking treatment at Sparrow for substance misuse and mental imbalance.

The spirit of these complaints will not be spiteful or vindictive. I simply see room for improvement, and will propose some suggestions. At least one of which would be nearly effortless for Sparrow to implement, and with clear benefits.

Throughout 2014 my alcohol misuse was so frequent, abrasive, and detrimental to my life, that I researched inpatient treatment options. The Substance Abuse Inpatient Unit at Sparrow seemed like my best bet.

It was my intended destination on the morn of September 8.

Their website states:

“Sparrow’s substance abuse inpatient unit is a 14-bed unit that treats individuals 18 and older with an alcohol or drug problem that impairs biological, social, family or occupational functioning.”

The remainder of the page’s text is brief. Please read it.

Now, imagine that you are losing control of your life. Alcohol and drugs dominate your thoughts. And suicide. You are absent of hope, at wit’s end.

In desperate need of help, would you find solace in the words on that webpage?

Would those words represent a light at the end of the tunnel? An actual and obtainable hope?

For me, they did.

But I felt amiss after a few hours conversing with various professionals at Sparrow. Detected they were not buying into the gravity of my situation.

Had slept a full night beforehand, to be alert, present, and engaged at the hospital.

If I’d gone before resting, I’d have looked like a rambling shell of a man.

For perspective:

In 2008, after a bizarre sequence of events, I ended up in an emergency room against my will. Fully loaded with DXM, of course.

The attending staff came across as insulting, patronizing, condescending.

Some joked about my condition with each other, as if I wasn’t even there. They did not listen to a word I said, which to their credit is understandable. I spouted off about the craziest things.

Still, underneath all the crazy I was a person. Even though those emergency room attendants did not see me, I was in there. Aware and human.

Andrew Hicks, full of thoughts and emotions and life.

Who knows? Maybe they thought I wouldn’t remember any of it anyway.

But I did, and I do.

And it hurt to feel looked down upon. As less than me.

That night in 2008 concluded with my involuntary admission to an inpatient facility.

Over six years later, on September 8, I hoped to initiate a similar chain of events but this time on a voluntarily basis.

Did not want to feel like a joke, like in 2008. Hoped a cooperative attitude and clear(ish) mind on my part would be just what the doctor ordered.

But it wasn’t.

Composed and articulate, I politely explained my situation and requested inpatient treatment for substance misuse.

I informed the nurse I had relapsed on a drug that I had not taken in over five years. That I would continue using it without intervention.

Also explained that if I continued using it, my life would be in jeopardy. That before my DXM relapse, my drinking problem had already escalated to a point of utter dysfunction. I needed help or I couldn’t stop.

But was I suicidal in that moment?

No, of course not, I was in “getting help” mode. It is not very easy to want to kill yourself while you\’re scheming to save yourself, is it?

Did I want to hurt anyone else?

No, why would I want to do that? It’s called self-destruction, not others-destruction.

Was I having withdrawal symptoms?

Yes, indeed I was. But my symptoms weren’t noticeably killing me, and I looked fairly regular on the outside.

But they don’t have a means for testing for DXM.

I didn’t have any alcohol in my blood. I was clean of opiates, and all the rest they tested for.

The truth about DXM

Here is a list of DXM side effects (most are withdrawal symptoms).

They are all real. I have experienced the gamut, and probably some more.

Recovering from using DXM is the most arduous challenge my body and mind have faced.

Alcohol, for all its rapacious toxicity, pales in comparison to DXM in terms of depth of impact on mind and body.

Yet at the hospital, the practitioners’ questions revolved around my alcohol use, and they sparsely glossed over DXM, hardly mentioning it.

This is not a pissing match between DXM and alcohol, or DXM vs. any drug.

DXM misuse is relatively uncommon, but common enough for helping professionals to prioritize being informed of its properties and repercussions.

It is common enough to take seriously.

No one should buy into the illusion that because it isn’t heroine or cocaine, it isn’t serious.

Dextromethorphan happens to be a cough suppressant, easily purchasable in over-the-counter medicine.

Understandably, its availability and format could lead to misunderstandings about its potency and validity as a psychoactive drug.

After all, we don’t buy LSD or cocaine over-the-counter.

I have done ecstasy a lifetime total of twice.

I’ve used DXM hundreds of times.

Why did I use DXM without abandon while leaving ecstasy in the past without hesitation? Because DXM compelled, allured and seduced me in ways no other drug I’ve tried.

Why is it do you think, that people are willing to drink entire bottles, even multiple bottles of Robitussin?

Cough medicine is among the most repugnant liquids on the planet. No one likes the taste (well, maybe someone does, but most don’t).

Even after protracted use, the taste never gets better. It gets worse. Eventually, I mixed Robitussin with orange juice to disguise the flavor. It did not help much.

And after several years of use, I switched to gel caps, did my best to avoid syrup altogether.

Because it is nasty.

So, please ask yourself: why? Why do people do that to themselves? Tell me what you think in the comments below.

So, back at Sparrow…

Eventually, a therapist came in to see me. The resident expert on substance use disorders. Giver of my verdict.

I let him know I’d fantasized about suicide a few times over the previous week, in vivid and serious ways. I expressed that if my drug use persisted, I believed suicide an inevitability.

He, in turn, let me know that he Substance Abuse Inpatient Unit was reserved for patients suffering from potentially lethal withdrawal symptoms or who were an immediate threat to themselves or others.

“Are you listening to me?” I said. “I just told you I fantasized about killing myself more than once, very recently.”

He corrected me, told me that’s not what I actually said.

He pointed out the distinction between suicidal thoughts and suicide attempts, and told me to come back if my condition worsened.

So, come back after I kill myself? I thought.

But I didn’t say it. Didn’t want to spend another minute talking to that guy.

Most of my college background is in human services.

As in social work, unrelated to human resources (a common misunderstanding).

I am well-educated of the limitations of the medical field, so I left Sparrow with the sad sense that I should have seen this all coming a mile away.

Mental health concerns and substance misuse are difficult to find immediate professional remedy for when not suicidal, homicidal, or crazy out of your gorge.

A rational understanding of a genuine need for help, a preemptive attempt to avoid imminent catastrophe? Not enough.

Even though my initial thought was I should have known better, I recently reviewed the information on the Substance Abuse Inpatient Unit\’s website. It is clear that my expectations were not baseless.

Again:

“Sparrow’s substance abuse inpatient unit is a 14-bed unit that treats individuals 18 and older with an alcohol or drug problem that impairs biological, social, family or occupational functioning.”

Was my alcohol and DXM use impairing my biological, social, family, and occupational functioning?

Absolutely. Without a doubt on all accounts.

I have a straightforward request for Sparrow: please fix this, right now.

Align the website with reality (the easy way) or align reality with the website (trickier, but wouldn’t it be awesome?).

It was not easy or natural to work up the bizarre combination of courage and humility to research treatment options. To follow through all the way to the emergency room. To request inpatient care.

After all the built-up gall, the result was disheartening to say the least.

Self-determination

Self-determination is an individual’s competence in knowing what they need, knowing what is best for them at a given time.

I had self-determined that I required intervention to avert imminent calamity in my life. That determination could not be accommodated by protocol.

However, had I been forced into the ER by the police, as a drooling mess incapable of determining anything, the hospital staff surely would have carted me off to inpatient care.

Looking at it this way, it seems medical policy is focused on making decisions for those rendered unable to make decisions for themselves.

Those in dire trouble but capable of making conscious decisions are left in the cold until it is too late.

I truly respect hospitals and all who work in them. Sparrow included.

I rationally comprehend that limiting policies exist for a plethora of reasons.

Some reasons, I am too much a layperson to even know of.

So, I propose we generate respectful discourse to expand understanding and search for solutions.

Help me see details I’m missing.

Let us discuss stigma, misconceptions, preconceptions, barriers.

Obliterate myths, establish stable common ground.

Let’s talk more. Listen more. Do more.

People are slowly dying, suffering unimaginably, isolated, addicted to what’s destroying them, unable to get the help they need. Lacking information, resources.

It is up to us to combine our creative resources to solve these problems. To transform the system, create a bold and vivid future.

After spending most of my Monday in the hospital, I was released to my own devices.

The therapist I’d met with suggested an appointment for Intensive Outpatient services, and a talk with the National Council on Alcoholism about possible residential treatment.

But these things take time. My mind was already trekking through a minefield.

The process of getting help often inherently involves bouts of waiting.

Confusing paperwork and impossibly rigid questions, especially when my brain is snap, crackling, and popping in an addiction haze.

My appointment with NCA was three days out. Plenty of time to get myself in trouble.

One day later, after spending some downtime with my mother, I felt restless, frightened.

Honestly, pretty much screwed.

At the final strained, frayed thread of my rope.

What do you think I did next?

I’ll tell you what I did: Went home. Did another excessive round of DXM.

Duh.

Part four (Bad Trip)


Originally published at Andrew L. Hicks.