Archives for Dual-Diagnosis

Alcoholism

A recovered alcoholic asks: If I take antidepressants, am I still sober?

I am a recovered alcoholic. I also have bipolar II, which can manifest in depression. I am what they call "dual-diagnosed" - or "twice blessed" as those of us in recovery often quip. I was about 7 years into my recovery when I slid into a deep depression and was diagnosed and put on medications. The decision to take antidepressants and a mood stabilizer posed a huge ethical and medical conundrum for me. I had heard from many fellow recovering alcoholics that WE DON'T TAKE MIND ALTERING MEDICATIONS! Obviously, antidepressants and mood stabilizers are - thank God - mood altering. Desperate - and with the encouragement of doctor friend who understands addiction - I took them. It took several months find the right dosages and for them to kick in but when they did, my life - and sobriety - completely changed. I'm not saying my life got better but my ability to deal with life got much, much better.
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Alcoholism

How private are a drug addict’s treatment records?

The confidentiality of alcohol and drug abuse patient records is under the government's microscope. The Substance Abuse and Mental Health Services Administration - SAMHSA - has filed notice of rule-making for such records. The proposed changes to 42 CFR Part 2- HIPPA - were published in Federal Register on Feb. 9. It's been 29 years since there have been any substantive updates to the Confidentiality of Alcohol and Drug Abuse Patient Records regulations. A lot has changed, especially the recent push for an integrated, continuum of care and the use of electronic medical records. I say changes are needed because you have a bunch of 20-something-year-old newly recovered addicts owning and operating some of the HIPPA-protected treatment programs, such as intensive outpatient programs, called IOPs. They, in turn, share a patient's health condition with their "clinical staff" - who are also newly recovered 20-something-year-old addicts who have little or no formal training and often no more than a high-school diploma.
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Alcoholism

4 reasons why addicts should not trust doctors

One Last month I went to the emergency room with tightness in my chest and shortness of breath. I answered a bunch of questions about my medical history, told them about my depression and bipolar, the meds I am on and made it clear that I am a recovered alcoholic/addict and that I do not want to be given any medications that might cause me to relapse. The doctor came, looked at my chart, looked at me and asked if I was in pain. I said no, just uncomfortable tightness and shortness of breath. . "Do you have any pain?" the doctor asked. "I'm going to give you some Ativan. It will help you relax," the doctor said. "No you're not," I said. "I'm a recovered alcoholic/addict and I don't take benzos." "Why?" the doctor asked.
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Alcoholism

Top 5 comebacks when asked why I don’t drink alcohol

For some reason, people want to know why I don't drink.

If you offered me Brussels sprouts and I said "no thanks" and you said, "are you sure I can't get you some Brussels sprouts?" and I said, "No thank you, I don't eat Brussels sprouts," would you ask, "How come you don't eat Brussel sprouts?"

Probably not. But when I say I don't drink alcohol, people what to know why.

Why is that? I haven't figured that out yet, but...
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Dual-Diagnosis

Addiction treatment: Here’s the prescription for relapse

I met yet another addict who is taking benzos prescribed by a doctor who knew this woman is an addict trying to stay clean.

WTH? (I would like to say WTF? but I'm a lady.)

This addict said the doctor who prescribed her Klonopin and Ativan knows she is in recovery. In fact, he's the doctor who treats clients in her intensive outpatient program. (Again, WTH?)

I have two problems with this common scenario:

Doctors who prescribe benzos to patients...
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Alcoholism

Drug treatment: How many times will you go to go to rehab before you realize it isn’t working?

This is going to make some people mad. I'm going to say it anyway. Why do addicts and alcoholics go to rehab over and over and over if it doesn't work for them? If you had cancer and you did 10 rounds of treatments and they weren't working, would you keep going? I know you are going to say relapse is part of the disease. But if you relapse over and over and over and over, why go back to the same treatment? At a certain point you have to stop blaming the disease for your relapse and realize the treatment you are doing for your disease simply isn't working. Stop going to rehab. Stop paying tens of thousands of dollars for a treatment protocol that isn't working for you. I'm not saying that rehabs don't work. They do - for some addicts and alcoholics. Treatment will work for the highly motivated addict or alcoholic who won't be distracted by the cushy, resort-like facilities that offer massages, tai chi, golf "therapy" and meditation on a Florida beach.
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Dual-Diagnosis

Why can’t we understand the link between teens, drugs and depression?

I just read an article that suggested teens with mental illnesses should be screened for substance abuse. To which my inner teen said, "D'uh!" The article also suggested that treatment for  SUD and MI in teens should be integrated and not on parallel tracks. "Double D'uh!" I can't believe that articles like this still are written. Did we learn nothing from Curt Cobain?
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Alcoholism

How my depression nearly killed my sobriety

This month I celebrate 17 years of sobriety. Let me say that again. This month I celebrate 17 years of sobriety. I can't believe I just said that because it seems so impossible and sounds so weird coming from my mouth. 17 years. How the heck did that happen? One day at a time. I also followed suggestions, especially from a doctor friend who told me about 12 years ago that I was in a major depression and needed antidepressants.
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Dual-Diagnosis

Why the religion of the Chattanooga shooter trumps his depression

Now we learn that Muhammad Abdulazeez, the gunman who fatally shot four Marines and a sailor at a recruiting office and naval reserve center in Chattanooga  last week, had depression and self-medicated with drugs an alcohol. Normally, this would spark the usual debate on whether depression can make someone homicidal. The media would tell us that yes, in very, very rare cases depression could cause homicidal thoughts but much more common are suicidal thughts. And the media would tell us that some anti-depressants can make depression worse and that Abdulazeez had taken anti-depressants. However, in this case the media is more focused on whether Abdulazeez was a Muslim terrorist whose alleged fanaticism was sparked by a lengthy trip to the Middle East last year. The media is throwing the word Isis into their coverage and voila! They've got a gazillion hits on social media.
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Alcoholism

Government scrubs substance-abuse data but doesn’t tell researchers

What if the government decided to withhold the data it gathers on an insidious mental illness that affects nearly one in ten Americans and did not bother to tell researchers it had done so? It happened. The data are collected by the Centers for Medicare and Medicaid Services. The mental illness - substance abuse. The New England Journal of Medicine exposed these shenanigans and explained the consequences in an article published in April: Protection or Harm? Suppressing Substance-Use Data, by Austin B. Frakt and Nicholas Bagley. According to the authors, the CMS began to withhold from its data sets, called the Research Identifiable Files, any Medicare or Medicaid claim with a substance abuse diagnosis. Why? Patient privacy concerns. Why didn't the CMS tell researchers? Good question.
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