My Day Working At A Women’s Residential (Addictions) Facility: Observations And Thoughts

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Yesterday I was blessed to be able to go and work with a group of women in a women’s residential facility. All of these women varied in age from barely twenty to the elderly, yet they all battle some form of substance abuse.

None of them looked like “typical addicts” and they were all extraordinary women.

Many of them were mothers or wives and of course daughters who had lost nearly everything due to their alcohol, cocaine, crack-cocaine, prescription pills, meth or heroin addiction.

One older lady had battled addiction for most of her life and at one point became homeless before finally making up her mind to try to get sober and clean. She has seven months sobriety.

Another woman who looked like she couldn’t have been a day over twenty, but had a five year old child, had been clean for four years before an old dealer of hers found her on Facebook and seduced her into using again.

And another older female had been pretty much a functioning alcoholic for the past five years and then one night out of the blue had an alcohol related gran mal seizure that landed her in the hospital for five days and she was court-ordered to rehab from there.

A lot of the women had tragic stories, including a very young girl who I don’t think was even twenty and was in rehab for the first time after being court ordered into treatment.

She was adopted, her birth mother was a drug addicted, her birth father was in prison and when her adopted father died two years ago she started using any drug she could get her hands on to numb the pain she felt.

Working with these women yesterday in group and individual settings I took a lot away from not only what it meant to become and remain substance free, but also what it meant to accomplish any major goal.

Having a good support system of course is important.

The women who had a supportive family, a supportive group of people such as Alcoholics or Narcotics Anonymous, supportive healthy friendships, supportive professionals or a supportive sponsor all seemed to be doing better than those who did not.

Having a belief in and a relationship with a Higher Power also seemed to help.

Not that there weren’t many women there who weren’t religious, but it was obvious that those who had some type of relationship with God, the universe, or whatever, seemed to be doing better in recovery compared to does who didn’t.

Also, those who were honest with themselves and in touch with reality seemed to be doing better than those who seemed to be a bit oblivious to reality.

The one thing that bothered me most about a lot of the women in the facility were that a lot of them were lying to themselves as we all do from time to time, especially when trying to stop a bad habit.

Many of the women still had “addict behaviors” not only in the fact that they were lying to themselves, but they were also lying and being sneaky to others.

For instance, this was a smoke-free facility where these women are prohibited from smoking, yet a number of the women sneak out and smoke.

That may seem relatively harmless in comparison to their bigger addictions, but that type of sneaky, dishonest behavior sets the stage for future relapse.

Relapse is not something that usually just happens, but develops overtime in the way a person thinks, feels, and acts.

A sober, clean person may start feeling agitated, lying, sneaking off to do things they know they shouldn’t, etc., days, weeks or months before actually relapsing.

They start lying to themselves, saying things like, “I can just have one drink” or “I can just take one hit and walk away, I know how to control it now”.

Before you know it, they are back in the thick of their addiction, driving under the influence to get more alcohol or selling whatever they can get their hands on to get more drugs.

Most of these women displayed some of those signs of a future relapse, from sneaking off to smoke, to being angry and irritable, to the woman who had the seizure asking me:

“How much do you think I’ll have to drink for that to happen to me again, because it scared the hell out of me. I don’t want to drink any more, but I just want to know if I have one drink, or two drinks, how many would it take before that happened again?”

Although she’s telling me she doesn’t want to drink again, she is lying to herself. It is obvious that in her conscious or unconscious mind, she is trying to figure out if she can get away with drinking “just a little”, but she is an alcoholic, and knows that there is no drinking “just a little” for her.

The women sneaking off to smoke, will be the same women sneaking off to drink or get high once they are out of rehab. That is “addict behavior” at it’s best.

Just like in trying to quite anything from smoking to losing weight, people generally relapse and it takes a few tries before they get it right. Relapse at some point is usually expected which is why there is often a focus on relapse prevention.

One of the biggest things to know about relapse is that if you mess up, if you have a drink, or a hit, or a donut, it doesn’t mean you just give up and give in. You can still back away at that point and start over before the addiction truly regains a hold of you.

All the women in this facility are at different points in their recovery and no doubt, for many of them, this will not be their last time in treatment, but hopefully one day they will get it right.

Teens, Marijuana and Nutella

The other day during a group therapy session, one of my teenage clients told me she had been tempted to use marijuana for the very first time.

I questioned her about why she was tempted to smoke marijuana and she informed me that she wasn’t going to smoke it, she was going to eat it. She had been offered some marijuana sprinkled on a cracker covered with Nutella.

This was the first time I had ever heard of teens eating marijuana on a cracker with Nutella, but that’s not the point of this post. Most teens believe marijuana is harmless, and I spend a lot of my time trying to convince them that it’s not.

From my experience, working in the field of substance abuse, I tell them that in a lot of cases, marijuana zaps motivation. Teens I work with who use marijuana usually start failing classes, missing school and eventually dropping out or getting kicked out of school.

Also, there is growing evidence supporting a correlation between marijuana use and schizophrenia.

Marijuana doesn’t cause schizophrenia, but it does seem to activate schizophrenia and other mental illnesses in individuals with a predisposition to mental illnesses, especially schizophrenia.

In the book The Center Cannot Hold: My Journey Through Madness by Elyn Saks she shares intimately about her battle with schizophrenia that all started after her first experience with marijuana.

She thought the hallucinations and thoughts that came and stayed for days were all normal and so she didn’t tell her parents out of fear of being punished for having smoked marijuana.

I’ve worked with a handful of schizophrenic patients who had their first schizophrenic experience after smoking marijuana and initially thought that their experience was typical until much later when the hallucinations and delusions didn’t go away for days, weeks or never.

These people all had a predisposition to schizophrenia which seemed to be activated after they started smoking marijuana. If they hadn’t started smoking marijuana, that doesn’t mean some other life event wouldn’t have activated the gene, but who knows.

Teens argue with me that marijuana is not addicting, but it is. Marijuana is psychologically addicting, why else do people who are regular marijuana users do the some of the same things people addicted to harder drugs do when they are addicted?

Some of the signs of being addicted to anything is when that thing starts to interfere with and effect your life negatively.

Teens I’ve worked with who claim not to be addicted to marijuana have:

  • Missed numerous days of school to stay home and smoke mariuana
  • Come to school high and thus got expelled
  • Got caught smoking marijuana at school and thus got expelled
  • Got pulled over while driving and smoking marijuana
  • Have violated their probation for smoking marijuana after being on probation for marijuana in the first place
  • Have lost jobs for smoking marijuana on their lunch break
  • Have stolen from family and friends to support their marijuana use
  • Have damaged relationships with family and friends over their marijuana use
  • Can’t get jobs because they can’t refrain from marijuana long enough to pass a drug test

These are all signs of addiction. These are all the same things people with cocaine, crack, heroin, alcohol and crystal meth addictions do. Yet these teens still think they aren’t and can’t be addicted to marijuana.

Then they argue that marijuana should just be legal. I’m not going to argue that point here, but even if marijuana was legal it still wouldn’t be available to people under 18 and most likely, not to people under 21.

Even then, employers would probably put in place rules where you couldn’t either test positive for marijuana or at the least, not come to work high. Same goes for places of higher education, the department of motor vehicles and such.

So while teens think legalizing marijuana will mean a free pass to smoke at will, it actuality won’t.

Marijuana use also leads to a higher risk of experimenting with other drugs and I’ve seen enough teens using hard drugs that started with marijuana to know that this is indeed true.

No teen I know who smokes weed can imagine smoking crack, but most people I know who smoke crack started off by smoking weed and didn’t see the day coming when they would be smoking crack or shooting heroin.

I’m not saying marijuana is all bad or trying to bash people who use it, but I do know one think for certain, and that’s that no teenager should be smoking or experimenting with marijuana, especially as their brains are still developing and they have enough trouble making good decision when they aren’t influenced by substances as it is.

Looking at the Five Stages of Grief in Our Daily Lives

Elizabeth Kubler-Ross developed the five stages of grief theory after her work with terminally ill patients. It is a widely used theory used to explain what happens when people are coping with dying and now is even used outside of death to include any experience of loss including divorce, separation and bereavement.  The five stages are:

  1. Denial- “I am fine”
  2. Anger- “Why me! It’s not fair!”
  3. Bargaining- “I’ll do anything for a few more years!” “I promise to go to church everyday!”
  4. Depression- “I’m dying, what’s the point of trying to be happy?”
  5. Acceptance- “I can’t fight it. It’s happening. I might as well be prepared for it the best way I can.”

People often go through these stages in different orders and sometimes from one to the other and back again. For example, someone can be in acceptance and go back to bargaining, or go from denial to depression while skipping anger and bargaining. While this theory has most widely been studied and accepted in dealing with the dying and grieving, in my experience, I’ve notice that it seems to apply outside of these populations.

The Five Stages of Grief Outside of The Grieving Population

  • Substance Abuse

In working with substance abuse users, they often times also experience the five stages of grief. There is a period of denial that there is a problem, anger that there may be a problem, pleading with themselves or a higher power to take away the problem, a period of depression as the reality of the problem starts to set in and then acceptance eventually sets in, more so in those seeking treatment compared to those who do not seek help and seem to remain in the denial stage. Even family members of substance abusers tend to go through the stages of grief in dealing with the family member who is abusing substances.

  • Loss of a Relationship/Affair
Often times the unseen or unwanted end of a relationship sends someone through the five stages of grief. The same sometimes happens when an affair is discovered or sensed. The person first is in denial and then as further evidence is discovered, the person becomes angry and then bargains with themselves, the other person, the universe or whoever for this not to be happening, and then they usually fall into a depression and then eventually acceptance which allows them to try to deal with the reality of the situation in a healthy way.
  • Sexual Abuse
 In cases of sexual abuse, families often go through the five stages of grief. Sometimes it’s a mother who goes through the stages when confronted with evidence or suspicion that one of her kids is being molested by a new boyfriend. Recently I started working with a young girl who was sexually abused by her uncle, who had recently gotten out of prison for sexually assaulting a minor,  but still no one in her family believed her until a year later when her younger sister became pregnant with her uncle’s baby. That tragedy could have been avoided if the family would have not stayed in the denial stage for so long in realizing that her uncle was a sexual predator.
  • Mental Illness
I wrote in a previous post about parents denial of their child’s mental illness. From my experience, parents often go through the five stages of grief when it comes to facing the fact that their child has certain challenges such as ADHD, anxiety or mood disorders or even more severe issues. Mentally ill individuals also sometimes go through the fives stages of grief, not wanting to admit or accept that they may have a depressive disorder, an anger problem, or whatever it may be. This is what usually keeps them from seeking help for years until they finally reach the acceptance stage.
  • Everyday Life
I know there are many other times and situations in which the five stages of grief can be applied, but the ones I named above are the ones I seem to deal with the most. How have the five stages of grief showed up in your life? Have you been diagnosed with an illness and went through a period of denial, anger, bargaining, depression and finally acceptance? I know when I was diagnosed with type II diabetes I went through the five stages of grief and it was only when I reached the acceptance stage that I was able to actively take control of my life.