Intervention!

December 12, 2008 9:42 AM

I live in Chicago and need to help a friend get into a drug rehab program. I have no idea where to start. Please help!

First, he wants to go, but doesn't have the presence of mind to do it all on his own. I've never known anyone who has done this before, so I feel overwhelmed.

How do you select a place? He's about 50 years old, gay, HIV positive and severly depressed. Do these factors need to be considered when picking a place? Does it matter what drugs he's on? Are certain places better for some addictions than others? If it matters, he's using coke, crystal meth, crack, and pot (that I know of).

How does he tell his employer? He applied for short term disability or the family medical leave because of a recent MRSA infection, but I don't think he's been approved yet. Will going into rehab mean he's going to lose his job?

What sort of information do I need about/from his insurance company (Blue Cross Blue Shield)? I have other friends that work for the same employer and have the same coverage, so if the friend can't get the information, I'm sure someone else can.

Do I ask for his family's help? He's fairly close to his family (brothers, cousins, but no children, spouse or SO), but has fallen away in the recent months due to his addictions. I don't know how much they know about what he's been doing.

I know he's practicing reckless sexual behavior. Is this something that a rehab program can help address?

Also, he went through the 12-step AA program 10+ years ago and never wants to go back to a 12-step program. Do non-12-step rehab facilities exist? Should I ignore is dislike for the 12-step program (he thinks of AA as a cult) just to get him help?

I feel like this is really scattered, but I don't know how else to put it. I saw him last night and he was so tweaked out that I came to the realization that he is going to die from this. I just want to cry......

posted by youngergirl44 to health & fitness (12 answers total)

The good people at CAP may be able to help. I think they deal mainly with heroin abuse, but they can probably steer you in the right direction.

Good luck to you and your friend.
posted by chillmost at 10:07 AM on December 12, 2008

Perhaps the folks at Howard Brown can help or give you some suggestions.
posted by penchant at 10:13 AM on December 12, 2008

You are a good friend. There is a lot to do here...

There are different options to explore:

The City of Chicago, the county, or the state of Illinois will probably have public detox and 28 day rehab programs available. The first thing you should do is call Health/ Human/ Social services or visit their website. I have personal experience with publicly funded rehabs- they work if your friend is not going to be fussy about amenities and the company he is with. If he can't afford a private rehab and he is really serious about cleaning up- this is the way to go. You will need to ask for more specific HIV related care- and I expect they will have systems in place for that.

There are many, many private rehab facilities as well- some of the best are out of state. I have personal experience as a client at one called Hazelden in Minnesota. It's incredibly expensive, but I was able to obtain a partial scholarship, insurance coverage, and outside help from my parents. You haven't mentioned what your friend's financial status is. This will be important to know, as well as his insurance coverage info.

You can also attend a local al-anon meeting and get a great, great deal of information there. Also call the National Institute on Drug Addicition (NIDA) and visit the SAMSHA addiction facility locator.

Yes, non 12-step facilities exist. My opinion, however, is that your friend is throwing the baby out with the bathwater when it comes to 12 step programs. Yes, one will encounter cultish, dogmatic AA members and rigid 12-step programs that don't leave room for questioning. I think these people and places are not properly teaching, applying, and practicing the essentially healthy and beneficial principles of the 12-steps.

The private programs that I am familiar with do address sex addiction, self-destrutive behavior, and other co-occuring disorders like depression, anxiety, bipolar, etc...

Your friend should also see a private doctor who specializes in addiction diseases- these are hard to find. Research a drug called Buprenorphine- and it's successes in treating opiate addiction. I don't know enough about it's availability to say whether or not a private physician will prescribe it without a rehab program in place. Maybe someone else can comment on that...

His family: If they are loving, supportive, and understanding- invite their help. Invite them to join you at an Al-anon meeting to gather info about facilities. They will need to learn more about addiction. It is often a familiy disease, so I would not be suprised if there at least some alcoholic family members. If his family members are toxic, even if well meaning, I'd say leave them out of it for now.

Good luck. Email me if you need support. Please let us know how it goes.
posted by hellboundforcheddar at 11:22 AM on December 12, 2008 [1 favorite]

And, no- it does not matter what drugs he is long as long as the facility incorporates and/ or treatment includes, either on, or off-site a de-tox to help him with withdrawal.
posted by hellboundforcheddar at 11:25 AM on December 12, 2008

rather, "drugs he is on, as long as..."

typing/ thinking too fast..
posted by hellboundforcheddar at 11:29 AM on December 12, 2008

hellboundforcheddar's advice is excellent.

Another potential resource: Does his employer have an EAP? If so, they will help him to make the arrangements and find the right place. They specialize in substance abuse so if his company has one, he should definitely look for help there.

Do you have an EAP at your company? If so, you can get confidential help from them - they won't help him, but if you say that this is someone close to you, they should give you some pointers, resources, and advice about local facilities.
posted by madamjujujive at 11:29 AM on December 12, 2008 [2 favorites]

Ask his doctor. If you don't know who his doctor is, try asking Howard Brown for suggestions.

My reasoning: My partner is gay, and HIV+, and 50. If we were facing the same problem, we'd definitely start by asking for a referral from someone identified as gay or gay-friendly. It's important that whoever helps him understand who he is and where he's coming from, and more than that, that he can feel confident that they do. If he's in the same demographic as my partner, he probably has a doctor he trusts and who he talks with openly. That's a great place to start.
posted by Robert Angelo at 12:08 PM on December 12, 2008 [1 favorite]

He could look at the Pride Institute in Minnesota. I know a 50-something, gay, HIV+ man who recently went there. The program at Hazelden is also good.

The thing about Minnesota is that it has about a million treatment centers and a very large and active community of people in recovery. Minneapolis is also a gay-friendly city, so your friend could find lots of support. Chicago is also a good place for these things, should he decide he wants to stay there.

I also would really like to emphasize what hellboundforcheddar said:

Yes, non 12-step facilities exist. My opinion, however, is that your friend is throwing the baby out with the bathwater when it comes to 12 step programs. Yes, one will encounter cultish, dogmatic AA members and rigid 12-step programs that don't leave room for questioning. I think these people and places are not properly teaching, applying, and practicing the essentially healthy and beneficial principles of the 12-steps.

I hope your friend would be willing to give AA another try. There are indeed many cultish type meetings out there which I really believe do more harm than good. There are also quite a lot of pretty laid-back, normal meetings as well which do so much good in so many people's lives.

If you or your friend want to know more about recovery and gays in Minnesota, memail me. I know a lot about both!
posted by triggerfinger at 12:44 PM on December 12, 2008

Thanks so much for all of the comments so far. I really appreciate it. Please keep them coming! I'm starting to feel less crazy about the whole thing.
posted by youngergirl44 at 12:57 PM on December 12, 2008

hellboundforcheddar said: Research a drug called Buprenorphine- and it's successes in treating opiate addiction. I don't know enough about it's availability to say whether or not a private physician will prescribe it without a rehab program in place. Maybe someone else can comment on that...

I'm not a (anything) related, but I do have a couple of friends that are currently on Buprenorphine (aka Suboxone) for opioid withdrawals, so I can tell you a little bit about it.

Apparently it's still pretty highly regulated by the the government, so few doctors are qualified and able to prescribe it, and those that are have a finite limit on the number of patients they can prescribe it to at a time (the two doctors my friends are using have a 50 and 100 patient limit, respectively). They're expected to be on Suboxone for at least 12 months (although I believe the amount will decrease as time progresses). Both state that it has helped tremendously with their withdrawal symptoms and cravings.

That said, unless your friend really wants help and seriously wants to make a commitment to change, I doubt even a long-stint at an inpatient rehab facility will produce long-lasting results. I know several people that have been in multiple facilities around the country and while they were able to stay clean for a short period of time afterwards, they would always relapse in a matter of months until they finally decided they'd had enough and really wanted to quit for good. Rehab (whether inpatient or an intensive outpatient program) is one of those things that you get out of it what you put into it, and it's pretty easy to go through the motions and get released.
posted by Ufez Jones at 2:57 PM on December 12, 2008

I'm 2nding the suggestion of checking into whether his employer has an Employee Assistance Program (EAP). They're often the ones that deal with getting employees mental health assistance and substance abuse resources.
I'm not an HR person, but he may be able to use FMLA time for his time in rehab if he works for a covered employer/meets the other requirements.
This page talks about using FMLA for substance abuse treatment.
posted by fructose at 3:56 PM on December 12, 2008

Not experienced, just a guess-advice.

Do all the research for him if you can, find gay friendly recommendations, get to the point that all he has to do is email or call the number, and say he wants it.
Then email him, and print out a couple of copies of those details, and let him do it.
Don't pressure him to do it, just have all that info sitting there.

At any given point, he probably won't 'get round to it'. At other times, when he hits really low points, he'll want to do it, but won't have the information he needs to do anything. If he has it there, and knows the next step, you've slightly upped the chances that he'll be able to take that step himself. Just choosing to do it himself might up the chances of success.
If he doesn't within a few weeks, you might still need to sit down with him and help talk him through it.

When you say 'reckless sexual behavior' - is he endangering the health of anyone else? Or just himself? Because either way, not cool. But if the former? He is being a danger to others, no less than if he was being violent and aggressive.
posted by Elysum at 2:13 AM on December 13, 2008