Part One of Two
When my son, Sam, (no one’s real name is used here) boarded a plane to his first rehab, I wanted to kneel down and kiss the tarmac.
I had navigated the powers that be to pluck a sick and broke addict that I loved from certain death. He was safely on his way to Florida and forever sobriety.
Talk about innocent. I was so the rehab newbie Mom.
Rehab did accomplish something important: Sam inhabited a temporary space to quell the bedlam that addiction brings. At my house, Sam was in withdrawal. It was like watching childbirth, only in reverse. He curled into a giant comma of fetal vulnerability and could only whisper and vomit a bit. He was disappearing instead of coming toward life.
He was clearly leaving.
In between frantic phone calls to find help, (and I called everyone I could find on the Internet, I called hospitals and help lines and rehabs directly) I gave him Tylenol. Then soup. Then more Tylenol. That’s what I did whenever he was sick before. Heroin withdrawal was not anywhere in my book of Mom cures.
But the plane ride was, and so was insurance verification for 30 days of treatment. I couldn’t get him to Newark Airport fast enough.
I didn’t think he would score there. I thought his happiness was a result of the epiphany of getting sober, but he was able to find someone at the airport who sold him heroin. I realized it then, and so did airport security.
He was denied passage until the next flight. We sat in Newark Airport for five hours, and he did board that plane.
I’m not sure you have ever entered that particular circle of parenting hell until you spend five hours with a child who is jonesing for his next heroin hit in an airport where he could disappear at any moment. I learned that afternoon that what I previously thought was anxiety was merely bumpy nonchalance.
Sam finally boarded and went for his 30 days and seemed to be making progress. Two weeks in, the director told me they wanted him to stay 60 more days and then reside in a halfway house.
“Great, “ I said. “I’ll help him however I can.”
“Ummmm,” the director said, “we’ll talk again next week.”
Maybe he had another call, I told myself. But the director’s tone had been not promising. Not at all.
Next week, the director called.
The problem? Sam’s dad wanted him back and had already sent a dated return ticket. Sam was 19, of legal age. Nothing could keep him.
Sam used the first night back at Dad’s house. His friends posted pictures on social media of them all getting high. I saw Sam, passed out on the sofa. I knew it was heroin.
I was crushed.
Why hadn’t rehab worked? Was Sam hopeless? I began a crash course on addiction and rehabs and the toxic cycles that control it all. Everything fit in a kind of slow blackening of hope: codependence, enabling, denial. All of it.
Rehabs did not seem to be the answer I had thought. I had seen them as quasi-hospitals, as places where you could take your loved one to and get prescriptions or casts or salves and make them whole again, make them well.
What I found was nothing like that. They are far from hospitals; they are not even regulated. Many do not “believe” in the latest practices for addiction medicine or don’t have staff trained in them.
In the United States, national accreditation standards for addiction treatment do not exist. There is no accountability for any treatment center. The staff is free to pick and choose elements of their programs without adhering to any accepted methods of success or proven medical practices. They can also change their program requirements without any type of supervisory oversight.
Still, there are good people in rehabs who want to help. I met them so I must say that here. But for how long does the addict have contact with them?
The standard thirty days for drug rehabs is not based on the disease itself; it is based on the insurance model and what they are willing to pay. Some rehabs are predatory and charge desperate families thousands of dollars by promising their loved one will be sober at the end. The families pay out of pocket, hearing what they need to hear about recovery.
Except addicts come home. They shouldn’t: they should spend time away from the people, places and things associated with their addiction. They should move. They should start over with financial and emotional supports in place. It isn’t a luxury to do this; it’s life or death.
The idea that you can live in a controlled environment for so many days and leave with a changed mindset is a compelling one, an easy fix. It’s also false.
Thirty days in a rehab can plant seeds and teach some good practices, but substance abuse is a chronic condition. Maintenance is required to combat the disease, just like it is required for other chronic conditions like diabetes or hypertension.
Then there is the issue of the staff. Many states require only a high school diploma to work in a drug facility with patients. People without training in dealing with the trauma or mental illness that is prevalent with addiction can do more harm than good.
And rehabs are expensive. Sure, insurance will pay for a month, but you want to keep your family member safe forever, so many families will pay out-of-pocket for additional time. The rates are often outrageous. Patients frequently return home before completing the program. Less than half of all non-court mandated patients complete rehab.
If they leave, the rehab can charge admission fees again and reap yet more financial gain.
As I learned more about addiction medicine and rehabs, I called Sam’s second one in Galloway, New Jersey and spoke to the director. She was friendly until she realized I was the same “Anne” who was an Addictions Editor for an online magazine she had read (yes, I learned that much). I was asking questions that made her uncomfortable.
The next morning, the director sent me an email that stated I was one of Sam’s triggers and she had verified this with his dad. As a newly identified trigger, the staff had decided it was in Sam’s best interest if he had no contact with me whatsoever.
She allowed Dad to visit him freely, the same Dad who had used with Sam when he was fourteen.
He didn’t ask any questions.