Sunday, October 10, 2010

Soapbox Ramblings

have been thinking a lot lately about treatment. I guess these thoughts have been prompted by comments, and also other blogs. I feel like I may be back on the treatment soapbox a little here, but let's face it...addiction treatment has a lot of holes in it.

I left a rather long, and ranting response to Erin about treatment, and my wheels have started turning on the subject again. And then there is No2Methadone, who I believe also has some really great ideas about reform for the methadone program. So, once again, I am going to get back on this soapbox about treatment. Here, with a little more background information about me....

I have stated before that the methadone program is good in theory, but falls short in practice. I also have put up my seal of approval for suboxone. And furthermore, I now acknowledge that I personally had to be opiate free to really begin to release and beat my demons of addiction. I am not here to argue or defend any one point of treatment over the other. I think they all have their place. But, I do think things could always be better...

Two years ago, when my son was just starting to show through all the baby fat I had eventually regained in my clean time I started looking towards the future. And taking a serious look this time, for the first time in many, many years. Since I started the journey of recovery, I tried several different career paths. I had lots of half hearted and half serious ideas about what I wanted to do when I grew up. This child growing inside of me had made me realize that I needed to re-evaluate some things...and I needed to get serious thinking about my future.

Up to this point, I was still just floating by, almost flying by the whims from the seat of my pants. Even in recovery, I still had so many ideas about what I was going to do with the rest of my life. My writing had taken a bit of a back seat in the early days of my recovery. I felt like I just never had enough time, as I filled my life up with all sorts of activities to keep me busy. And then, there was the question of what to write about. Writing had always been a strong piece of my past, my history. I may have abandoned a lot of things in my addiction, but I never abandoned my writing. I carried a tattered and blood splattered journal where I would scrawl down all the decrepit ideas that sometimes where vomit ted from the depths of my mind. I read voraciously in my using days. I did not watch tv, and I surrounded myself with other addicted artists. I was tragic. I was the tragic writer addict who would someday publish his works of addiction...I would really get started once i could afford a laptop, and finally start organizing some of these tattered and torn notes.

But, in my early recovery, I put down the notebooks for a while. Let me transgress a jail, I wrote all the time, again all the feelings and revelations from the bottom(jail really was my bottom)...came spilling out. My heart and soul bleed out on that paper in jail, splattering it with reality and ideas for a new future. When I first got out of jail, I was writing lots of letters. I shared my revelations for the future, and God's hand that was guiding me to those I had befriended in jail. But, just as quickly as the blood flow had begun, I abandoned my craft once more.

I cannot really explain why. Part of it was that I had taken on a whole new series of activities. I was also hurting from the terrible heartache that comes with divorce. And then, I think there was some subtle piece of me that was associating my writing with the past. Also, I experienced a writer's block, after all I had always written about my experience with drugs, and when i was trying not to focus on all that, I just did not have much that I was so passionate enough about to just get lost in the words. I stared at a blank paper.

I delved into the restaurant business. For those of you who do not know, food is also one of my passions. I have always worked in the restaurant business, and much of my life that was not consumed with drugs was consumed with food (and drink...) and often, this lifestyle went hand in hand with the service and hospitality industry. I think we all know that the restaurant business always is worked by those who have a tendency to party. It is the hours, it is the high pace, and it is the flexible attitudes of so many in the business.

Anyway, in my early recovery, I focused on my desire to excel in this restaurant business. It was the only way to make money I had ever known besides stripping...waiting tables and bartending. I was well aware that I could not work in bar any longer, so I chose to dive into food. I ended up waiting tables in a really nice steakhouse, and I decided I also wanted to work in the kitchen, in hopes to maybe go to culinary school.

I wormed my way into the kitchen, and excelled at a rate that even surprised me. I really loved it. I wanted to cook for the rest of my life. I wanted my own restaurant. I wanted to stay just inside the gas flames that ignite the burners in every kitchen. I made a plan to move back to Charlotte, and go to college at Johnson and Wales.

Then, Lucien comes unexpectedly along. At first, it did not really sink in. Some women report that they became a mother the moment they realized they were pregnant. Well, it wasn't like that for me. It took a while to sink in. The ramifications of how my life would change are still sinking in sometimes. At first, I thought since I was already on a good path, this would not change anything. I really thought I could just take a couple weeks off from work to have the baby and then just get right back into the grind. I really thought I could start Johnson and Wales, have a baby, and not miss a beat.

As Lucien grew inside of me, and the realities began to sink in with the tiny feet prodding at my ribs while I waited tables, always walking around on my feet. (I am a hard worker, and I did not slow the pace while pregnant...I even waited tables on a double on my due date. ) As Lucien began growing inside of me, protruding for the world to see, I realized that I needed to rethink my plan. I had been contemplating other options for a while, and it became a reality as my son became more obvious to both me and the rest of the world.

One of the things I really considered was substance abuse counseling. I am passionate about treatment, and I am recovered now. I think I have a lot of insight to offer addicts who are struggling to find their way. I think the best counselors I ever had were former addicts. The only methadone program I was on that I would agrgue was a good program, was run and staffed by former addicts. These truly are the best people to be involved in treatment programs. People who know what it is like can better help those struggling. At least, that is what I think.

I wanted to open my own treatment center...that worked. I had this heroin treatment utopia facility in my head. I think the methadone program is a good program, in theory. I also think that as an addict in search of treatment, this was the only option I really considered. At least in the beginning. I was not about to go cold turkey again, and I had already tried that several times and it never worked. If not for methadone in the beginning, I might not be clean today. At the point that you have been using for seven years, it is just too scary to consider the fact that you may never, ever use again.

That was what was hard about treatment in the beginning. When it got bad enough that I sought treatment, I was not ready to give it up completely, which is what many treatment programs require. It was just too scary tom think about not ever getting high again. And then the agony associated with withdrawal. Hell no. Oh, and the agony after the initial "physical" withdrawal is over. Yeah, you might just be sick for three or four days, but after that part of the sickness, is when the mental anguish comes crushing down on you. Racking and reeling your brain, pounding it with thoughts of ony dope. And the exhaustion. You just can't seem to walk more than the pace of a snail. You feel like you have been through the ringer, and you just feel like crap. It is those weeks after the initial kick that are the real agony of lethargy and depression, riddled with the anxious spinning and turning from your brain and its obsession. It is hell, and I knew I could not do it. Methadone was my only option at this point.

Now, this was almost ten years ago that I started to seek treatment for the first times. Suboxone was unheard of at this time. It was about three years later before I began to hear of the treatment called buprenorphine. It wasn't even Suboxone or Subutex when i first heard about it, it was just buprenorphine in those days. I wonder what could have been different if my first inquiry into methadone had been treated differently.

Let me fill you in...the first time I ever called a methadone clinic was before I left New Orleans. I had been using for six months or so. Well, I had been using every day for about six months. It was still in my earlier experiences of the agony of withdrawal. I had experienced this agony on occasion when I waiting for the dope man. If I did not call soon enough, and then I had to wait a couple of was miserable. I was still snorting the drug at the time. My dealer got busted, and there was a couple of days when i could not get much. I had to call in for over a week. I would eventually find a little something after about two days of pain, and then another two days of agony passed before I found another little something. I did not have any back up sources in those days, I was relatively new to the game, and my guy was reliable.

Well, in those days of agony I did call a methadone clinic. I was not ready to "recover", but I did not want to take this sickness any longer. One of the first questions they asked me over the phone was "How long have you been using?". When I responded, six months...I was immediately shut down. Nope, there was nothing a clinic could do for me. You had to be using for at least a year to get on methadone. I could have just gone down there and lied about how long I had been using, but in a few days the dope man was released and things went back to normal for at least a couple of months.

I think about how that crucial call, six months into the addiction game could have been handled differently. This is one idea that fed my idea of this treatment utopia. With buprenorhine, you are not required to be addicted for a year. I think that clinics should be able to prescribe both buprenorhine and methadone, and they should be able to evaluate the patient and mutually decide the best treatment. For instance, when a caller says they have only been addicted for 6 months, then the clinic explains that buprenorhine could be used but not methadone. Instead, when I made that call, I was basically told to keep using for another six months and then call them back.

What if there had been some intervention from the clinic I reached out to? What if they scheduled me an appointment, and offered me some other program, some other sense of relief. Maybe if I had been given buprenorphine and proper counseling then, I would have never gone on to the next stages. And maybe I would have simply rejected it, or just returned to using once my source returned. No one can say. (In defense of the clinic, buprenorhine was not out back then, and I am glad they do not put people who have been using less than a year on methadone.)

Also, I wanted to start a clinic that provided good counseling, and that it was mandatory. I wanted to start a clinic that gave financial discounts with an extended amount of clean time. The methadone clinic I attended in Middletown, Rhode Island was a nearly ideal program, and it gave me some ideas. This program was run by a recovered addict, who knew the score. They were not lenient, and you had to follow the rules. They required counseling, and they provided both group and individual sessions that were also covered by insurance. They had an incredibly high success rate, I think out of the hundred or so people on the clinic, only about 15 would test dirty. Most of the people on the program here really had gotten their lives together, and there was not much drug talk here. They were strict about the rules, and if you did not follow could not dose. Most clinics merely want your money, and do not care to provide any service beyond that.

So, I wanted to open a methadone/buprenorhine facility that worked. I wanted to help addicts with counseling, and I wanted to make a difference in live's and still make a buck doing it. I do think that these programs need a lot of fixing, and i want to commend those who realize the programs are worth fixing, but they are definitely broken.

Anyway, my ideas of getting into substance abuse counseling began to fade after Lucien was born. I realized a lot of things that I did not know before becoming a mother. And I had to make a stable living for my child. As things began to get ugly with Lucien's father, I realized i had to get my degree, and get on with my life. I had only a year left for my mass media communication degree, and then the writing started to spill out once again, and I realized I had to pursue my god given talent. The stories started to pour out of me, and the blog was born. The book was started, and school is now well underway. So, I have abandoned the ideas of opening a clinic and becoming a counselor to help others. I hope i can helf them through my writing.

Now, I feel I have come full circle. I have come back to my writing, and it is getting more and more polished. I write every day. And I am getting a lot of good work done. I am getting a lot of good responses. I think I have come abk to this path I was destined for, in a different light. But, I really hope that someone else decides to open a utopia clinic, and I hope that the system for treatment does eventually get fixed. And although I can stand on my soapbox, I really do not know what is best. And although, I have all these ideas of improvements, I still am not doing anything about it. It is just not my fight anymore. I may talk about it. I may think about it, but my focus is now my writing, and my family. All the rest will have to be taken on by someone else...

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