How have you been treated by the medical establishment in your attempts at recovery?

[Jabberwocky]

This post I wrote go me thinking. Despite our thread where you can post your specific experiences with specific treatment centers, I'm curious to hear what my fellow BLers have experience when it comes to the medical profession. On the one hand, medical professionals and modern medicine has literally saved my life (particularly as regarding pharmacological treatments like methadone and buprenoprhine for ORT, antidepressants like trazadone and bupropion, and medicines like gabapentin, clonidine and diazepam for detoxing). However, when it comes to more behavioral modalities, such as your standard abstinence focused rehab or treatment program (that yes, even MMT falls into at many clinics), I have had nothing but negative experience after negative experience.

It wasn't till I'd been around the block with the recovery industrial complex that I began to figure out how things work, before I was able to realize - hey, this shit is taking me away from achieve my goals, and that shit isn't - did I finally understand the absolute necessity of educating myself to what effective treatment actually looks like in this day and age and act for myself, as opposed to just following the orders dolled out by, most often, poorly trained "experts" and so-called "professionals." Only after suffering some truly horrific experiences from relying on the advice of experts and professionals did I begin to realize that, "hey, these mother fuckers have no idea what my needs even are, let alone how to meet them!"

The below generally reflects my views on this subject.

It is always amazing to me that the last thing an addict thinks of is to consult with their doctor.

This is beyond trite and insulting. Addicts don't not think to rely on doctors, they have less access and support doing so than any other class of patient. It's like living in the ghetto of professional medicine. When you find someone who is willing to treat you, much more often than not they're in it primarily for the money, relying on outdated, age old method of treatment that have proven time and time again to benefit less than 1/10. Personally, thanks to my insurance and my family's support, I have had access to "the best" modern medicine has to provide in American since the very start of my journey in recovery, and that for the longest time I did nothing BUT rely on advice of experts in the field.

And what have I got?

I have learned a healthy mistrust of medical professionals in the states. 9/10 times my interactions with the medical establishment has be little more than a paternalistic "we know what's best" kind of attitude. I don't even want to go into the harms that medical professionals have caused me in my attempts at recovery. People who use substances and/or struggle with substance use are routinely given the lowest priority when it comes to medical treatment - and when they are given priority, it is generally to backwards treatments that are treated like their best shot, despite having nothing in common with the standards of any other form of modern medicine.

Anyhoo, what have your experiences with treatment and medical professionals looked like? What gets me the most is that treatment professions, the counselors, directors, etc, who staff rehabs across America, are given the powers that medical professionals are given when it comes to the treatment of their "patients" (a more accurate word is "clients" - not patients). No where else in modern medicine is this kind of thing acceptable. Yet, when it comes to substance users, former and current, this kind of sub-par treatment is accepted as the status-quo.

Kinda makes me feel like someone out there doesn't consider us junkies as as human as the rest of the population...

---

I feel like I should also add, that the biggest problem faced by people seeking sobriety or recovery in dealing with medical professionals and the recovery industry isn't even the poor quality of treatment, it is the serious lack of funding for the treatment of the most effective (and cheapest) forms of treatment along with the extortionate costs of the most established forms of inpatient or even outpatient treatment. What I'm say is, at the end of the day it isn't even about quality of care, it is about access - particularly the lack there of - that bothers me the most.

But I'm still interested in hearing what your experience in dealing with the medical and treatment establishments have been like...

 

[Erikmen]

I belive that happens not only with doctors with other professionals too, some of those not even from medical or health issues' areas.

 

[Jabberwocky]

No doubt. I just see it as an issue running rampant in the treatment field in America, especially considering the vast sums of money to be made. It encourages bad actors. Considering that the field itself seems to attract bad actors to begin with, or at least those without the highest of qualifications or level of professionalism I see in take to be the normal in nearly every other field of medicine in my country, it is like a worst case scenario, encouraging bad medicine geared primarily towards profit maximization, not patient success.

What have your experience been with substance use treatment Erik, or how you have been treated by your country's medical establishment (assuming they knew you were current/former substance user)?

 

[2dark2see]

I almost feel like I should take a beta blocker before I reply to this bc this topic can really get me going lol!

The experience I'd like to share has to do with how mental health patients are perceived in general by the medical community. I've struggled with depression and anorexia for many years, well before I even had an opiate addiction. I'm sharing this bc addiction is recognized as an illness.... anyway I'm going to try and make a very long story short....

When I was 34 I had a stroke in the middle of the night while I was sleeping. I woke up unable to move my entire right side and could barely speak. At the ER they saw my mental health history in their system and instead of doing the normal testing they do when stroke patients arrive, they called in a psych consult and told me they thought that either a: this was just anxiety, or that b: I was making the whole thing up entirely.

Thankfully I had a nurse call a friend of mine, she came to the ER and long story short got them to admit me overnight for "observation" instead of just discharging me. Mind you at this time I still could not move my right side but apparently that didn't matter due to my mental health history they clearly thought this was a mental health thing. Fast forward to early the next morning when they finally did an MRI and saw that not only had I had a stroke but that it was due to 3 torn arteries (a clot from one of those arteries had caused the stroke). Well now everyone was much "nicer" and treated me entirely differently than when I was just a mental patient who was only there overnight due to a technicality.....

I ended up transferring to a larger and better hospital bc of the rarity of my condition and need for surgery. A few months after I was feeling better I did go back and made an appt to talk with the Medical Director of that hospital about how I was treated and the horrible stereotypes that I experienced while in their hospital. It felt very good to have that meeting.

I know this isn't directly related to addiction treatment but I feel pretty certain that their awful treatment would have remained the same if they had, instead of seeing my depression history in their system, seen a history of opiate addiction. Addicts and mental health patients aren't treated well at all... it's almost like we've got to prove there is really something wrong before anyone will even begin to take us seriously.

 

[simco]

I have had two experiences that I think are relevant to this thread.

1. About a year ago, I spent ~6 months working with a local suboxone clinic. It wasn't terrible, but it was far from ideal. All of the patients I knew there shared the sense that the main motive behind their treatment decisions was money. The clinic was required to provide us with 'counseling' which was laughably phoned in and useless. Visits with the doctor were microscopic, lasting little longer than it took for him to fill out a script. So over all, my experience with this clinic was bad, in the sense that the care was of low quality. But I will admit that I never had trouble with them belittling or harassing me...honestly, they didn't care enough to do either of those things.

2. Since September of this year I have been involved with an outpatient rehab that is administered by a local hospital. The "intensive outpatient" part of the program ended about a month ago for me, and I am continuing to work with them in their "after care" program--this means that I have periodic one-on-one sessions with a counselor and once-weekly meetings with a counselor and other graduates of the IOP. My experience with this rehab has been really complicated and conflicted. The actual sessions of the IOP were at best rote and one-size-fits all (all the materials were from Hazelden, and the counselors were all firmly entrenched 12-steppers), and at worst truly awful (one counselor publicly shamed the hell out of a poor woman who had chosen methadone therapy). I almost left the program soon after starting. But the truth is, in the end I found it to be a net good in my life. I got pretty close with some of the other patients. And although some of the counselors were awful, I did find two whom I have a real connection with. Also, the medical staff there is always good and helpful. Basically my feeling about this program is that once I learned to push back against the occasional bullying and bullshit, there was a lot of good to be found. But I do have to work hard to find the good stuff.

 

[Stargazer]

My experience was.ok and then really great.

I was on methadone for about 5yrs. and it was shitty. I was sick everyday by 4pm. I told my counselor(who was ridiculous. We talked about his crush on the guy that worked in the lab rather thymy struggles lol) I had a blood test one day, and I wasnt well - in a cold-sweat, etc. when the results came back my methadone level was so low they asked me if I was really swallowing it. Wth. Indeed I was. Turned out Im an abberrent(sp?) metabolizer. I should've been split dosing. No shit.

My next experience was when I was court-ordered into rehab-straight from jail after being locked up for 6 and a half months. I was sent to a chronic pain program that teaches alternative ways other than meds- or at least less meds. One girl came in w 3 100mcg fentanyl patches on-and she was on a crap ton of other stuff. She ended up being my roomate and is one of my best friends to this day.

That experience was the best thing that ever happened to me. I was treated w nothing but respect and kindness there. It felt awesome to be around people that understand the nuances, depth and complexity of chronic pain. And the complexity of chronic pain and addiction issues. I felt a deep bond to the people in my group as well as the staff. I believe it was that great ecause I was open to learning something. In fact I called my counselor from there and told her about my. recent relaspe- she made my admission prioritized. Unfortunately my insurance only covered some of it. I have military insurance too but they don't accept it. I wouldve been there already. So yeah- this experience was good.

 

[cj]

My experiences at doctors and hospitals have been mostly shit. Doctors who don't understand how to do a taper. Condescending psychiatrists. Overhearing nurses bitch about me wasting there time. Rehabs have been worse. They where all one sized fits all. to make matters worse they relied on group therapy with the groups consisting of 10-15 people. That's not very helpful to me. They also failed to address any of my co occurring disorders or past trauma. But the question is how much can they do when your insurance will only cover 30 days? 30 days to fix a lifetime of problems? Considering your going to be dope sick at least the first week I can understand why there relapse rates are abysmal.

Ive pretty much given up on the whole rehab thing. Ill play the methadone clinic psychiatrist game for my drugs here on out.

 

[2dark2see]

Thanks for your help TPD.... you saved me from having to take a beta blocker

 

[Burnt Offerings]

Only ever "confessed" to one "medical professional", a psychiatrist who was working at the university I was attending (as part of free mental health counseling).

Once I mentioned that I was an opiate user, and heroin in particular, the tone of the conversation changed somewhat dramatically. The tone became noticeably more cold and grave. She asked me if I had ever injected it, and when I replied affirmatively quickly wrote a note in her notebook.

This will probably be looked upon as a disagreeable statement, because people want to access outside sources for help when it comes to treating substance abuse (and rightfully so), but I'm not sure if it has ever been a good idea to let people know that I was/am a user of illegal drugs, on the level I went to. I'm loathe to ever admit it to ANY authorities, be they medical or legal or anyone else. I've regretted telling anyone in my (non-drug related) personal life about what I've done...it never leads to good things. You are truly on the bottom rung as an injection drug user.

When I want to get sober nowadays I usually will try to find resources from people who did the same kinds of stuff I did (and achieved sobriety). Communities like this, for example. I already know what the medical establishment will tell me...either 1) don't do those drugs, do these drugs we'll give you to substitute, or 2) stop doing drugs, complete abstinence, AA/NA-style mantra.