Help my friend detox

May 8, 2011 11:09 AM

How can I help my friend detox from heroin in NYC?

Posting for a friend:
I'm going to take my best friend for heroin detox in the NYC area.

I have two options: Option 1: Sending her to a 6-month inpatient treatment center called Daytop in Far Rockaway. Option 2: Staying in a cabin the woods for 7-10 days, cold turkey with me babysitting her.

Her biggest concern is that other people (friends, work, etc.) will find out about her habit. At this point she's kept it all very quiet, and only I and 1 other friend know for sure what she's been going through. So her thoughts are: If we can pretend to take a week- 10-day vacation, she can return to her routine with a minimum of disruption and not risk losing her job and her life.

I understand it's going to be a nightmare, exorcist-style. I need any suggestions or experience anyone might have on how this is all going to go down. Right now she's willing and open to going cold turkey, and we'd both prefer to keep her off of other addictive substances (i.e. supoxin, etc.) She's been daily dosing for over a year, but has been trying to taper down her intake.

Further complications: her S.O. is also a user, but not every day like her. Unclear at this stage whether or not he'll be joining her in this detox adventure.

6-month rehab is free (awesome!) no drugs (awesome) but long (yuck) and welfare-supported, so I'm worried about what kinds of people she'll be exposed to, and how this will affect her long-term recovery.

I understand the nightmare that I'm getting ready to experience. I don't need to have that explained to me. What I need are anecdotes, experiences, tips, and advice, other inpatient/outpatient rehab centers, to help me help her conquer this.

Thanks for any and all info and advice. I'll relay all this to the friend I'm posting for.

posted by alight to Health & Fitness (21 answers total)

I vote overwhelmingly for the 6 month rehab. Part of the recovery process is being exposed to the damage that addiction has wrought on others' lives, and also being in the presence of trained professionals who can observe and protect her.

Also I think that the S.O. needs to pursue his own treatment options. People make endless compromises in their own progress in order to accommodate the needs of their loved ones, especially if they've used together.
posted by hermitosis at 11:16 AM on May 8, 2011 [6 favorites]

Stop watching Trainspotting, take a minute, and think about the consequences of screwing this up. It could be life-threatening for her. You can't just put her in a locked room with a bucket. Aside from all the other reasons that this is a terrible idea, if her SO is still using, her "detox adventure" would likely last exactly 7-10 days.

Worrying about "what kinds of people she'll be exposed to" at a public rehab is... distasteful, at the best. They will be addicts. So is she. Also, poverty isn't contagious.
posted by charmcityblues at 11:17 AM on May 8, 2011 [23 favorites]

Ibogaine has a reputation as a helper with addiction issues . Illegal in the US, clinics in Vancouver and Tijuana.
posted by hortense at 11:25 AM on May 8, 2011

If you can do the real rehab, do it.

In the 90s, I helped a friend out like this and it was intense and dangerous. For both of us.

I mean really, really dangerous. I felt like an extra in The Exorcist. And we were in a small town with medical people available. I couldn't imagine doing it out in the woods in a cabin.

Also: If she doesn't break up with S.O. or they don't deal with this as a team she is going to be using again soon.
posted by Tchad at 11:32 AM on May 8, 2011 [4 favorites]

Please don't try to help your friend through detox alone in a cabin without medical support. This is really just too dangerous. Even detox and rehab programs sometimes need to send people to the ER due to complications. Seriously, don't do this. It isn't safe.
posted by dchrssyr at 11:36 AM on May 8, 2011 [3 favorites]

It is admirable that you want to help, but alarming how you repeat how you know what sort of a nightmare you are in for. This is one of those things that is really, really not supposed to be about you. Taking a chemically dependent person into the woods far from civilization is not at all a good idea! What if she has a seizure? What if she chokes on her own vomit in her sleep, when you are dozed off? What if she has a psychotic break or turns violent against you?

What makes you think you are in any way prepared? Have you experienced it yourself? I have never gone through drug detox, nor seen anybody experience it, but there is a reason that the people that help others through it are professionally trained. It might go fine, but hardly worth the risk. The psychological trauma of a rough experience seems like the least of your potential worries. Your friend needs professional help.
posted by pazazygeek at 11:36 AM on May 8, 2011 [3 favorites]

Sorry but I have to come back and ask if you're ready to deal with the responsibility and guilt if she dies during detox while alone with you in a cabin? It is a possibility and I think you should consider the costs to yourself.
posted by dchrssyr at 11:50 AM on May 8, 2011 [4 favorites]

welfare-supported, so I'm worried about what kinds of people she'll be exposed to

She'll be exposed to fellow heroin addicts, and maybe that's a deglamorization step she needs.
posted by availablelight at 11:58 AM on May 8, 2011 [15 favorites]

A few things:

1) The program is better. There is more support, an exposure to a wider range of experiences (other junkies, social workers who won't see her as the star of her own narrative, etc), and you are more likely to keep your friendship. Plus, junkies are also usually drama-addicts, and going out into the woods to detox sounds like the most dramatic drama in the history of drama to me.

2) If her SO is not also getting clean, she needs to break up with him. Completely, like "never see again," and before she goes into detox. Like moving out, splitting everything up, the whole 9 yards. Heroin does not appreciate half measures.

3) She is also going to have to do this with pretty much every aspect of her life -- if she shot up somewhere, she can't go back, probably for years, if ever. This probably means avoiding all the places she used to go, if she's like any of the junkies I have known.

It is possible to get clean; I have known people who have managed it, but it is hard, and she is probably not going to be able to keep it secret, especially to people she has been actively lying to.

Here's the thing for you to keep in mind. You cannot really help her. This is all her thing. You can provide some material support, but, really, she has to do all of the heavy lifting on her own.

Here's another thing: at the moment, she is a rock shackled to your leg, and you need to be prepared to cut through that shackle and let her sink on her own. Because, if you try and take any of her burden, a) she won't make it and b) neither will you. (This goes doubly for her and her SO, but that is not your problem.) It may seem very callous to you, but, when dealing with junkies, you need to look to your own physical, emotional, and fiscal safety first, because you will always be (at least) second place in the junky's mind. You are not being evil or disloyal; you are being sane. This is another good reason to leave her to the program.

Here's the other thing: if she's willing to do the heavy lifting? She can get through this. Her life will be different, but she will be alive and things can go on from there. And so can you. You can be friends, but it may be a little like going through a breakup with someone who you get to be friends with a few years later. Not the same, but OK and even good.

If you want to memail me, I'd be glad to talk more.
posted by GenjiandProust at 12:04 PM on May 8, 2011 [10 favorites]

I think she could probably detox in ten days in the woods, but there's a lot more to rehab than detox.

She's a junkie who's been using daily for over a year and her current significant other is apparently going to continue to use. I get the impulse to try to avoid disrupting her career and life right now, and I don't know what I would do, but it's worth keeping in mind that one's life can last a long time and a six-month disruption is a lot shorter than the possible disruption if this doesn't work.
posted by J. Wilson at 12:16 PM on May 8, 2011 [1 favorite]

Response by poster: Follow up from my friend:

I don't think I am prepared at all and I don't know what to do. That's why I am asking for suggestions. I just confronted this with her and thus have just started trying to figure out what the options are. I would love to be able to facilitate her going somewhere to get better. So I guess the question should be does anyone have experience with a program that has financial assistance. Don't get me wrong I know it's not about me. I know I can't get her clean but I am right now completely ready to give her all the support and love I can for the initial detox. Then continue to do my best to be emotional support from there on out. I just need real suggestions: a link, or a solid idea of what to do right now in this moment to help her help herself while she is still open and wanting to quit after confronting her yesterday.

Thanks to everyone so far for the advice. I just need a little more concrete idea of how to help.
posted by alight at 12:48 PM on May 8, 2011

I think that this is the kind of medical situation in which help from the internet is no help at all. She has a physical dependency, a condition that could kill her. If she had a tumor, we on metafilter would advise you to take her to a hospital, to real professionals who can offer real help. It would be unwise for you to try to treat this like anything but a true medical emergency. Take her to the program.
posted by pickypicky at 1:06 PM on May 8, 2011 [1 favorite]

I suggest you give Narcotics Anonymous a call -- I'm sure they have experience with people coming off heroin.
posted by elmay at 1:10 PM on May 8, 2011 [3 favorites]

Does she have a job where she can take advantage of the Family & Medical Leave Act? That would give her a month with her job guaranteed, and her boss and co-workers don't have to know what kind of medical condition she has. If she has any kind of medical short or long-term disability leave, she could then use that. I think she would just need a note from her doctor -- I don't think they have to say what it's for.
posted by la petite marie at 1:10 PM on May 8, 2011 [1 favorite]

Alight, my dear you sound positively overwhelmed. I want to second what everyone has said about this being dangerous.

The most likely time a heroin addict will overdose is after they have detoxed and go back to it at the dose they were previousely used to.

If you get her off heroin and she doesn't die, which is a possibility to begin with: She will be dumped right back with her bf who will have heroin accessible.

SHE WILL GO BACK TO IT. Even with will of steel you can't stick a junkie who kicked for ten days in a room with someone who can get her access to heroine. She will hop right back on that train and what's more, she will be at risk of dying.

PLEASE DON'T DO THIS CABIN IDEA!

If you need someone to talk to about this you can memail me any time. I've cared for heroin user family members, and worked in a harm reduction based outreach program for homeless. The program. Get her in, and then process all the emotions you're dealing with. You sound totally overwhelmed!!! (I understand that feeling well!)
posted by xarnop at 2:13 PM on May 8, 2011 [3 favorites]

To add an additional note to elmay's answer: don't forget to take care of yourself! Take a look at Nar Anon or Al Anon. I personally have some issues with the 12-step-program, but going to the meetings and reading some of their literature helped me a lot. And it's good to be aware of how you as a friend might be affected by her addiction and how you can help her while also taking care of yourself.
posted by Bearded Dave at 3:17 PM on May 8, 2011 [1 favorite]

Right now she's willing and open to going cold turkey, and we'd both prefer to keep her off of other addictive substances (i.e. supoxin, etc.) She's been daily dosing for over a year, but has been trying to taper down her intake.

Are you a doctor with knowledge of addiction medicine? Because if not, frankly it is incredibly irresponsible for you to be putting yourself in charge of your friend's recovery plan. If your friend has a specific way she'd prefer to quit, that's something she should discuss with a qualified physician.
posted by !Jim at 8:10 PM on May 8, 2011

The part where the addicted SO remains the SO makes me think you might be dealing with somebody interested in a little spot of teh dramaz with you along for the ride, not somebody genuinely interested in getting clean. I find it hard to believe that anybody could believe that, that they'd stay off heroin with a partner on it.
posted by kmennie at 8:31 PM on May 8, 2011 [1 favorite]

Others have already weighed in with sound (No Cabin!) advice, but I thought I would drop in to address some of the things you mention in your op which are kind of concerning.

"Her biggest concern is that other people (friends, work, etc.) will find out about her habit. At this point she's kept it all very quiet, and only I and 1 other friend know for sure what she's been going through. So her thoughts are: If we can pretend to take a week- 10-day vacation, she can return to her routine with a minimum of disruption and not risk losing her job and her life. "

Well, tough. You know what your friend is? She is a heroin addict. So is my brother, for the record. But this type of thinking, that you can keep it a secret and fix it quick before people notice, it is totally antithetical to the recovery process. If she is a daily user, then heroin is her life. She needs structured, out-in-the-open support to address her addiction, period. Like charmcityblues said, this isn't Trainspotting. Recovering from addiction isn't a matter of detoxing and willpower, it means completely restructuring every aspect of your life--learning to live all over again.

Also this "6-month rehab is free (awesome!) no drugs (awesome) but long (yuck) and welfare-supported"shows an unrealistic attitude towards what recovery is. Recovery means staying clean, you know, for the rest of your life. Six months in a structured program is small change, and it will certainly go a long way in preparing your friend for the inevitable shock of living a life without using.

Anyway, all this is just to say that you are a very caring, awesome friend for confronting her about her addiction. So, having done this personally, I would recommend offering to drive your friend to the rehab facility, and visit her during visiting hours, which will probably only be an hour or two, once a week. She may have to go to the hospital to detox first, but you should let the rehab facility make that assessment. She may not want to use suboxone or methadone, but again, that decision can be made with professionals, at the facility. Understand that she may leave the treatment program early and go back to using or may graduate from the program and relapse. It happens, a lot. If it does, offer to drive her back to the facility. If she refuses, let her know that the offer still stands, and then leave. Getting into a tug-of-war with an addict is never productive and generally heartbreaking. Find yourself some NA meetings to attend, and don't forget to breathe. Best of luck with this.
posted by ailouros08 at 6:29 AM on May 9, 2011 [4 favorites]

I have a friend who went through this. Here is what she says:

"Suggest a 30 day detox - why is the only option 6 months? I went to a hospital first, detoxed for 5 days, then went into a 30 day program.

7 days in the woods is not then end...it's just the beginning.

Her symptoms will be sweating, irritability, uncontrolled bowel movements, vomiting, chills, intense physical pain, restlessness, sleeplessness, intense physical cravings in any combination. Being in a facility with people who are trained with this is the best recommendation.

Does she have insurance? Use it."

She recommends this center: Long Island Center for Recovery

Even if you don't use that center, I'm sure you could call them to discuss options in the NYC area.

Phone: [phone]
Crisis Helpline: 800-344-LICR (5427)
posted by valeries at 8:33 AM on May 9, 2011 [1 favorite]

For the record, your friend is a good friend for wanting to help. Actually executing the cabin-in-the-woods plan would be news, and stepping aside in favor of professionals is not only loyal but smart.
posted by wenestvedt at 11:49 AM on May 9, 2011