Addiction

Effect of Addiction on Mothers, A Personal Story

Addiction takes a massive toll on families, accessing services and knowing what road to travel is daunting by any measure. Medication assisted recovery comes with its own set of challenges and side effects and not just from the medications themselves. Here a mom shares a bit of her struggle trying to find the right help for her son and negotiate the wild, wild world of methadone. Is there a better way?

Cunning, baffling, and powerful…even for Moms

My son has struggled with a substance use disorder for about 10 years.  He was diagnosed with a bi-polar disorder and ADHD when he was 15 years old.  He has gone to too many in-patient programs to remember but what I do remember well is that he has been told over and over again that his issues were all related to his drug use.  He doesn’t know that his behavior is anything other than normal because it is his normal. 

Years of overdoses and relapses has taken their toll on our entire family and especially him.  He violated probation soon after starting for positive drug tests so he decided to try Methadone.  As an advocate, I’ve always supported medication assisted therapy but I have to admit, when he made the choice I had some real concerns.  It’s not the medication itself but what I was being told by people I have worked with who were or had been in programs.  I still believe that MAT can be a life saver for someone who has had a difficult time with the abstinence model.  I also believe many providers are doing a disservice to individuals like my son who need to be stabilized while they work on the underlying mental health issues with a psychiatrist and mental health counselor.  

A supervisor at a clinic told me my son was “no angel”.  No kidding!  Did they really think I didn’t know that?  It’s not that he doesn’t except help or won’t go to treatment because he has never refused to go for help.  The problem is that he has been given the same treatment over and over again and it has failed over and over again.  Only one program asked me to complete a questionnaire on his family, medical, mental health and drug use history.  He did well there because they could work on the underlying issues right from the start.  They prescribed medication for a bi-polar disorder and he told me it was the first time in his life he could think clearly.  Unfortunately, like many prescribed psychiatric medications, as soon as he felt good he stopped.  He didn’t like the idea of a mental health diagnosis.  Somehow an addict was more acceptable.

I supported my son’s choice to try Methadone because I felt comfortable with his plan to stabilize and begin psychiatric medication so that he could titrate off of Methadone as the other medication and treatment began to help him.  It would make sense if anyone with a history of chronic relapses and overdoses has a psychiatric evaluation.  The clinic never scheduled him which seems to be the norm.

One of the biggest barriers when involved in MAT is that it is often not patient friendly.  Many people have told me they are treated like criminals and there is no compassion for what is going on in their lives and the challenges of being on a Methadone program. One day we got caught in traffic and ended up getting their ONE MINUTE late and they refused to give him his dose which included 2 additional doses for a holiday.  We called from the road to let them know and they didn’t care.  

The hours are difficult for patients who work early and if you travel out of the area it’s impossible.  My son quit his job temporarily and thought he would be able to start again after he was stabilized but after 5 months he was still not able to get take home medications and even though he asked to begin titrating off it was never ordered.  After 9 months he became extremely frustrated and just wanted off no matter what that meant.  He signed an agreement to detox from 90 mg. to 0 in 17 days.  I knew that he was being set up for failure.  The pain was horrific and the mental anxiety made it 100 times worse. During the detox period he never saw a counselor and his vitals were checked one time.   At the end of the 17 days he was in a full blown relapse and no one knew or seemed to care.  

I contacted another provider and explained what happened.  They suggested that my son go to their clinic to stabilize him and then detox him safely.  They started him at 30 mg. because of the liability which meant that he was still very sick and used anything he could to feel better.  The plan was that he would have a psychiatric evaluation to work on the mental health diagnosis so he could titrate off.  The psychiatric evaluation was scheduled more than two months from his initial intake which was very frustrating.

A couple of months after starting at the new clinic we learned of a new recovery house in another area that would allow him to be on medication and gave him work opportunities that he did not have in our area.  Living at home has never been good for his recovery and he felt that the move would be good for all of us.  We went to see the house and stopped by the local clinic to find out how to transfer there.  He got paperwork from the clinic to give to his counselor and planned on moving the following week.  He misunderstood the process but they were willing to treat him like a visitor until the paperwork was all sent.   All they needed was paperwork to begin.

The new clinic did not receive his records for the temporary doses or transfer and because of the way it was done he was unable to get his dose in either clinic.  He went from 70 mg. to 0 in ONE day.  After two weeks the new clinic told us to go to the original clinic that had his records and demand a meeting.  He signed a release for me to be in the meeting so I could hear why they were not sending the records.  At the meeting we were told that they had cancelled his psychiatric evaluation which he had been calling about for a week and no one would give him information.  Once they became uncomfortable with my questions the entire conversation became an attack on him.  Now I understand why someone is uncomfortable signing releases.  

The meeting was less than positive and it was clear that the supervisor did not understand how the system works.  She refused to be held accountable for the medical records and suggested I contact his probation officer to force him to go to in-patient.  A violation would’ve sent him to jail where they do not give medication even if you are on a program.  She had no idea that he could not get into a detox in our state because of the level of Methadone he had been on.  I mentioned the bi-polar diagnosis and his counselor told me that everything made sense once he knew that but the supervisor said that my son (who doesn’t believe in the diagnosis) was accountable for giving the that information.  No mention of the psychiatric evaluation being cancelled.

The records were finally sent a week later, the Friday before Christmas Eve, so there was no chance for him to be scheduled for an intake.  He had to leave the recovery house and came back home where he detoxed himself illegally off of Methadone for a week in order to go to a detox for heroin.  Once he got in he told them what had happened and they kept him three weeks to try and help with the Methadone withdrawal symptoms.

MAT can be very affective and I still believe could’ve worked for my son if it was done right.  Treatment providers are not held accountable so it is easy to blame everything on the “difficult”, “non-compliant” patients and release them no matter how sick they will be.  Patients are replaced immediately and most won’t place a complaint because they are sick.  When a family member or advocate does place a complaint most of the time nothing is done.  I’ve suggested allowing recovery coaches to be present during discussions about treatment plans and to be a support for an individual and I get some very angry responses.  Could it be that coaches might hold them accountable as well as the patient.

If we want people to be successful using MAT programs we need to start having discussions about the barriers and discrimination.  It’s time we hold treatment providers as accountable as we hold patients.

Author: Tonia Ahern