Drug Addiction Treatment, the inside story…

AdvanceAbilities
Jul 22, 2017 · 13 min read

During my too long period of ‘getting sober’, I visited every type and level of treatment facility in existence. I was convinced that, not only would I hear that magic something that would change my life and turn off my cravings for Cocaine, but I met some truly fascinating soles during my stays in treatment and aftercare. I’m not going to go through any who’s-who’s and recommend places according to their celebrity quotient, as there is an unwritten law of honor that I, for one, will not break for the sake of being cool. Nope — what I am writing about here is my experiences in treatment, and my hopes and fears about the new crush of treatment centers supported by the changing legislation that favors treatment and rehabilitation over jail time for drug offenders.

First, when someone like myself enters treatment, we are pretty beaten down and in no shape to be able to defend ourselves from much of anything. Sadly, there is a group of treatment programs that are designed to make their owner’s money and take advantage of the fact that their clients are not capable of much of anything but sleeping and eating. Luckily, there are also those that treat their clients humanely from the get go. My experience with a now defunct program called Alternatives, which billed itself as THE only treatment center that was really equipped to help gay men, is an example of just how inhumane a treatment center can be.( they expanded to include women as their popularity waned for revenue purposes)

Remembering that no one, including myself, is in their ‘right mind’ when they first enter treatment, especially if they haven’t been properly detoxed or are a matter of minutes to hours away from their last high. There was one treatment facility in southern San Diego county that had a long driveway to the reception area. More than a few of my fellow patients made sure to get in one last — whatever, before they surrendered their freedom. One guy I will never forget because of his pervasive stench downed two bottles of Vodka during his driveway trip. He didn’t surface for a couple of days after he arrived. By the time I got there, once again, I was done.

Back to Alternatives. I certainly wasn’t ever formally detoxed prior to my arrival. After a lot of back and forth, I finally gave in and agreed to let a friend take me to Alternatives’ in-patient unit at a local hospital. It was quite late at night, but they had called ahead, and I was admitted without having to go through the intake paperwork. I was instructed to go to bed for now, and they would worry about signing me in in the morning. I plopped on top of a bed in my shared room, not bothering to do much of anything but take my shirt off. A couple of hours later, my roommate woke me up when I felt his mouth on my penis. I was in my bodybuilding phase when I wasn’t using, so I was pretty strong and threw him on the floor, and ran out to the nurses’ station.

Before I could get a word out, ‘Mr. Chud, what are you doing out here without a shirt on?’ came at me from the nurse on duty. I apologized for that omission, and told the nurse that I wanted her to call the police because my roommate had just sexually assaulted me. She laughed, refused, and exclaimed, ‘Oh that Denny.’ She explained that he was harmless and prone to having poor boundaries. I wanted out — for several reasons including not wanting to be there in treatment and I didn’t feel safe. The incident ended with the sweet wonderful nurse telling me that I was in the last vacant bed, and that I could not sleep in the common room or anywhere outside my room. She would have to discharge me if I didn’t comply with her orders. As she had confiscated my cell phone, she told me that I was not allowed to use the payphones, since they weren’t turned on until after 10am. She further reminded me that if I left, it would be ‘AMA’- against medical advice, and Medicare would not pay for this or any subsequent visits. I went back to bed believing I could call my friend in the morning. I didn’t realize that I was banned from the phone for my first 3 days of treatment. I had never been held against my wishes before or since, and I just couldn’t understand why they would hold me and make me even more uncomfortable than I already was. I remember that I just didn’t stop thinking about why when I was there for help, they were turning it into a battle.

This was a psychiatric unit, NOT a rehab unit because the only way that they could get an insurance company or Medicare to pay for anything was for in-patient psychiatric treatment. In patient ‘rehab’ was not on the list back then. Here’s where it gets interesting. To ensure that they did in fact receive payment for a client, within 24 hours of entry, the unit psychiatrist and medical director would spend all of 5 minutes with you, tell you that you were really depressed/bi-polar/psychotic or whatever so that you now had a psyche diagnosis, and prescribe one or several psychiatric medications, usually including an anti-psychotic drug, and send you on your way. At the time, all I was thinking about was food and sleep. Those meds took care of the sleep part of things. As I have thought about my time in their care, and how dangerous it is to improperly prescribe psych meds to someone with a lot of other psychoactive drugs in their systems, I have gotten angrier and angrier at them.

This kind of threatening control was endemic to their program. To make matters worse, their nurses were such monsters, playing favorites and flat out lying about so many things, that I began to wonder if they were really registered nurses. I was on a boatload of medications for HIV, one of which was testosterone. All but one of them confronted me about my ‘being too big, not needing medications, questioned the validity of my HIV diagnosis, and based all of this on my physique, and their having treated a couple of people with HIV in the past and I was not at all like them. I don’t know where to start with this stuff. I could not believe that I was actually having to argue with them about my HIV status, and the meds that the doctors at the NIH had suggested I be on to do well. This whole situation was so outrageous to me, and was made even worse by this nurse one had to meet to feel the impact of her presentation. Imagine Nancy Reagan’s twin — as an avid smoker with more smoking wrinkles around her mouth than I have ever seen. Most of the time, she wore ancient faux Chanel Suits, that were just a little rough around the edges, and her mouth was frozen in a constant frown. I almost forgot to mention her make-up. She had almost invisibly thin lips, and she put her fuscia lipstick around her mouth as if there lips to put it on. Her eyeliner and other eye stuff was just over the top and always have cracked off by lunch time.

I don’t remember her name, but she professed to having been one of the original nurses at the Betty Ford Center, and claimed to have had a big part in designing their original program. I can’t tell you how many times she started something she was saying to me or the other patients with, ‘You know, I was one of the designers of Betty Ford’s program, so…’ Having been there as a patient several years prior to entering Alternatives, I took great joy in informing her that their current approach to treatment doesn’t resemble their original and flawed approach, and that one of the first lectures we received at the Ford Center went to great lengths to distance their program from the flawed approach of the past. She called me a liar. She was another one who professed to ‘know more about HIV/AIDS than I could possibly know.’ That one really floored me. She also had the brainstorm diagnosis of me, that she sold to the nurses and unit psychiatrist alike, I suffered from Munchausen by proxy. She took great joy in explaining not only what that meant, which she totally misunderstood, and how she reached that conclusion. I will do my best to recap that here:

She, like the other nurses thought I was making way too much about my HIV infection, which at that point had progressed to ‘full blown AIDS’. I visited their inpatient unit more times than I care to remember, and the last visit I made was after I had required 8 sinus surgeries, two of which involved peeling the upper half of my face off to access the underside of my braincase. I had a fungal sinus infection that was misdiagnosed for over a year by a truly awful doctor. I lived in San Diego during that time and moved to San Francisco for work in 1999. A month after my move, I visited my new HIV doc so that I could have a local resource and pick up my prescribed medications. He was surprised that I had the sinus malady so long and never had a scan or culture, and did both. Two days later at 9pm, my phone rang, and all I heard when I answered the phone was ‘Sweetie, we’re gonna get through this.’ I had no idea who it was and when it was all sorted, I was scheduled for 5 months of daily 4 hour infusion of a thick electric yellow fungicide called Amphotericin B. In the early days of AIDS, when you saw one of those bottles or bags hanging above a bed, the the person in the bed had 2 months to live — maximum.

I was 2 years sober when I was told that I would need this medication that required I receive up to 200mg of Demerol, IV at premedication so that I could tolerate the medication and not suffer ‘Rieger’s Syndrome’. After the first treatment, I called my doctor and told him that I simply could not do this regimen, as I wasn’t an opiate addict, but I could tell I would be one in no time. Plainly put, I had no option other than to let the fungus (Aspergillus) infect my brain and I would die. So I dutifully went to the hospital every morning for my treatment, and I managed to not go out and use street drugs for the first two months, and then I was a wreck.

Concurrent with my treatment, I had a total of 8 operations over about 6 months aimed at digging out the infected bone around my brain and right eye. I also have a scar that stretches from ear to ear across the top of my head. Over time after 2 surgeries, that seam stretched, and the doctor who followed me up at the hospital where Alternatives had its unit, cut out the scar and put my scalp together. I went into ‘the unit’, with staples still in my head, and he came in after I had been there a few days, and removed them. I asked when I could wash my hair, and he encouraged me to do so the same day — and assured me that I was healed up and would not have any problems. He was mistaken. After a few minutes in the shower, I lightly washed my head, and lots of blood and stuff came out of my hair, as expected. After the shower, however, when I looked at my head in the mirror, I almost fainted when I saw that my scalp had separated about 2 inches. I went to the nurses station and asked them to call my doctor and tell him what had happened. They responded ‘Now you don’t need to be bothering that doctor now, you’re fine.’ I looked down, so that the nurses could see the top of my head, and seeing what was going on, they looked at each other and then they all nodded in unison — Munchausen by Proxy. They told me to get to group, and that they would call him later. I told them I would not go anywhere other than bed so that I don’t risk any more damage to my head. That’s when the wise old nurse told me that I had purposely disobeyed doctors orders and washed my hair and pulled my scalp apart. Let’s just say that we were at an impasse. She would not allow anyone to bring me food at lunch time, knowing that my appetite would get me out of bed and she went so far as to put a sign on my door forbidding anyone for helping me.

She came in, and that is when I really pissed her off. I explained that Munchausen by proxy involves two people — hence the ‘by proxy’ thing. And, as anyone who has watched Mannix or Marcus Welby can tell you, that the typical etiology associated with her much adored Munchausen involved a mother who purposely makes a child ill by secretly giving them tiny, sub-lethal amounts of a poison, so that they were ill and totally under her power, and her illness would remain a great mystery. She laughed and laughed and laughed and left. When my doc finally came by the unit a little after 5pm, and saw my head, he exclaimed ‘why wasn’t I called?’ He escorted me into the treatment room, and sent my favorite nurse in search of a sterile stapler. As she was leaving, he muttered ‘ these damn psych nurses just don’t get it sometimes and they drive me nuts.’ He, of course knew that I wasn’t responsible for what happened and apologized. I had missed dinner, so he went out and got me some burgers, etc. because he knew how important it is to healing that one get proper nourishment. The re-stapling of my head was a comedy of sorts. He didn’t want to waste time taking me to the O.R., and without any Novocaine, he pinched my scalp together and instructed the nurse to hold it there and Bang! Bang Bang — 16 times he slapped those staples in much to my surprise. Blood was running down my forehead and every time he pulled that handle all I heard was the crunching of the staple going through my scalp. It didn’t really hurt, but it sure grossed me out.

I did tell him the whole Munchausen story and we both had a good laugh. He called the charge nurse in to the treatment room, and sternly admonished her for not contacting him when I asked her to. She started to defend and explain as he just walked by her saying I’ll be back with some food in a bit to me. Let me tell you, if I hadn’t already been on the nurses shit list, I certainly was now. Every time I asked for or told them anything, they would start their response with Mr Chud, You are not a doctor.’

Sadly, the abuse continued into their outpatient program and the non-medical aftercare program. They had a large house that could hold about 25 people in rooms of 4 people each in bunkbeds. The matron would conduct 2 groups a day, and basically browbeat and tell us how great she was, what she had overcome, and that if we didn’t complete the program, we would not stay sober. I later learned that this woman had not even attended college. If you completely towed the line and asked no questions, you did fine. There were tons of rules and control and it was awful. She freely handed out violations that would result in house confinement. She was a big user of the ‘you are not a doctor’ line. An example:

My roommates were complaining that I snored loudly. I knew that, and I had seen a specialist in sleep medicine and been diagnosed with severe sleep apnea — I still sleep with my bi-pap today, and couldn’t imagine life without it. Now Miss Cindy, the as-if apnea specialist, instructed me to get breathe right strips, and that they would take care of my problem. For some reason, I thought I could educate her about the fact that apnea is a condition of the soft pallet blocking ones airway when it relaxes and is not related to nasal airflow. Not only was I punished for crossing her, but I had to spend money on those things, knowing that they would not help. When they didn’t help, she accused me of not wearing them properly. You know, I just wanted to scream at her, but I resisted and made arrangements to transition out of the house and into a sober living house. I also agreed to continue in their intensive outpatient program. This is the situation that finally cured me of my dependance on Alternatives.

The outpatient group therapy was actually facilitated by a good, humane, therapist. After 3 weeks of daily groups — without an issue, I was taken out of group and brought into the program director’s office. Jan, that director, was so emblematic of what was wrong with that program, it was absurd. First, she was a serious food addict — morbidly obese, and used her largesse to scare people. I don’t scare like that. Her education level never included college, and her misuse of the English language was incredibly funny — to me.

We were required to take as many as 2 random urinalysis tests per week. It seems that my last one showed positive for opiates. Now, at that point — in the middle 90s, I had not taken any pain medication other than Ibuprofen, so I was shocked. My therapist and the clients all supported that my actions did not indicate any use, but Jan insisted that I leave treatment and their sober living because of the test. Not wanting to be on the streets, I got to the bottom of this quickly. I went to a terminal at the nearby public library, and good old Google showed me my answer. I entered ‘urinalysis opiate false positive’ as my search string, and much to my surprise, the first listing said that Levaquin would generate a false positive in 80% of the assays used by public health labs in the US. Guess whose doctor prescribed that medication, an antibiotic, yep it was the Alternatives doc for my sinus infection.

I returned to Jan’s office and brought her the printed out result of my search. Her reply was — How do I know that isn’t a fake? — I asked her — no told her to enter the search string herself on the screen right in front of her. She told me that she was busy and might get to it in a day or so. Two days later, no apology, no grace, just some crazy excuse that had to do with teaching me resourcefulness. I demanded a ‘completion discharge’, which after having to get their funders involved, they granted.

This is a very long story, I know, but the devil is in the details.

AdvanceAbilities

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My nonprofit dream to improve lives of disabled seniors & Accessibility4all. We interview,listen,learn & discover challenges. Then collaborate,innovate & solve.

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