For years, I had worked as a detox nurse at a inpatient facility. In the beginning it all made sense: People who drank too much or used other substances came to us. We would medically supervise their detox, administering limited medications to offset the symptoms of withdrawal. The process took 2-4 days. Then they would transfer to a Rehab unit and begin a ‘28 day program’. There they would be educated about their disease, learn new coping skills and be plugged into a support system before they left treatment. The philosophy was simple: “Of course you can be substance free, and we can help you.”
Almost overnight, we went from treating mainly functional alcoholics to people with poly-substance addictions. Many were dysfunctional people with little or no coping skills, and medically compromised. They came from inner city streets, hospitals and jails. They came with their street bravado, their anger and their wounded spirits.
Our doors became revolving doors, in one side and out the other…callers begging for admission and then discharging themselves within a few days.
Insurance providers made cuts again. Straight addiction was not necessarily enough to warrant an admission; care was then based on addiction with psychiatric diagnosis or, ‘duel diagnosis’ as it was called. Our facility went from open units to locked units; from an open nurses station to ones with plexi-glass barriers and sliding, locked windows. No longer were patients free to walk the perimeters of the property and enjoy the pond view. Free time was spent in fenced in patio areas.
Our medications now included Methadone and Darvon, along with a generous selection of comfort medications. Then came maintenance programs including Suboxone and Methadone.
The philosophy changed as well, when a new approach to addiction spread across the nation called ‘Harm Reduction’. This was expressed in the statement, ”We’ll show you how to function safely until you can become drug free”. This was demonstrated in needle exchange programs and the use of maintenance drugs.
With the addicts came the stories they told.
One regular resident comes to mind, a girl in her early twenties. Though she didn’t remember me, she had been in the Sunday school class I taught. I knew her mother from church.
Initially, it was alcohol and pot, but with each admission her drugs grew. I watched her go from an attractive young woman to a bloated, sore ridden, old lady. Her last admission came after she had left treatment with a peer to get high. He had beaten her and left her unconscious in a motel room. She returned to treatment. This time she managed to complete the Program and went to a Halfway House. Word reached us that she had suddenly died in that place, due to injuries sustained in that beating. She left her mother with her young daughter, and the knowledge that she had died drug free.
The story another young, female patient told me was sadder still. She had been on the unit several days, and was very non-compliant. Her attitude made it difficult to reach out to her. This evening, she returned to the unit from a meeting very agitated, demanding to talk to a counselor. I suspected she wanted to sign papers to discharge. While she waited she was verbally abusive to anyone who got near her. When she finally had someone to address her need, her voice could be heard behind the closed door. Soon, she left the counselor’s office still yelling, pushing past me and slammed the door to her room.
I check with her counselor to find out what was going on and was informed the girl was ‘acting out’ because she had received word that a family member was dead. We decided to give her some space and time to regain control of herself.
Later in the shift, she came to the station window. Wanting to apologize for her outburst, she offered this explanation: “I found out today that my 16 year old cousin has died of a overdose. They found her with a needle still in her arm, feeding a bottle to her 6 week old baby.”
I was left, absorbing this information, as she went into the lounge with her peers who were returning from the meeting.
Dear God, I thought I had heard it all…surely this bondage comes straight from the pit of hell. Only Jesus can break chains such as these and set the captives free.
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