What Was Your Rehab Experience Like in the First 24 Hours
September 2, 2010 9:21 PM Subscribe
After many years of struggling with alcoholism we finally talked my mom into going into rehab a couple of days ago. We checked her in at 2am and she was already trying to leave at 3pm the next day. She ended up not even fully discharging and walked out with only her pillow and hitched a ride to her house at 11pm that night. My question is more an inquiry about rehab.
I'm curious about the first 24 hours of rehab, what it's like, especially broken down, how helpful people were or if you were left on your own. My mom claims no one helped her at all, she was very isolated and no one was nice to her. She missed lunch and afternoon meds because she didn't realize that's what the knock on her door meant. I think what we are trying to find out is if her stay was normal for rehab or if she really was in a facility that mishandled her care, at least in an emotional sense, no one to guide her or help her in the first 24 hours at least to get used to where things are and how to follow the schedule. I'm trying to ascertain if it's even worth trying to find her another rehab or if the same thing will happen again, if this is just how it is in rehab.
If you went to rehab and you could share your experiences in the first 24 hours, what help or guidance you were given, feelings of isolation, staff being unfriendly, long lines to ask questions, humiliation, that sort of thing that would be very useful to me. I've been having trouble locating anything to do with negative rehab experiences. Of course, positive experiences would be helpful too if this is not how things are supposed to be. I just kind of feel like maybe if she had some guidance and help at least in the first 24 hours instead of just abandoning her to figure things out on her own maybe she wouldn't have walked out so quickly. She never met with a counselor, never met her roommate or was assigned a "buddy" as mentioned on their website. She was completely on her own. Thank you for your help.
I'm curious about the first 24 hours of rehab, what it's like, especially broken down, how helpful people were or if you were left on your own. My mom claims no one helped her at all, she was very isolated and no one was nice to her. She missed lunch and afternoon meds because she didn't realize that's what the knock on her door meant. I think what we are trying to find out is if her stay was normal for rehab or if she really was in a facility that mishandled her care, at least in an emotional sense, no one to guide her or help her in the first 24 hours at least to get used to where things are and how to follow the schedule. I'm trying to ascertain if it's even worth trying to find her another rehab or if the same thing will happen again, if this is just how it is in rehab.
If you went to rehab and you could share your experiences in the first 24 hours, what help or guidance you were given, feelings of isolation, staff being unfriendly, long lines to ask questions, humiliation, that sort of thing that would be very useful to me. I've been having trouble locating anything to do with negative rehab experiences. Of course, positive experiences would be helpful too if this is not how things are supposed to be. I just kind of feel like maybe if she had some guidance and help at least in the first 24 hours instead of just abandoning her to figure things out on her own maybe she wouldn't have walked out so quickly. She never met with a counselor, never met her roommate or was assigned a "buddy" as mentioned on their website. She was completely on her own. Thank you for your help.
I've had 2 ex-boyfriends with repeated rehab stays, and a biological father with one rehab stay.
None of them reported having no assistance at all. One of them complained that he was never left by himself, to think it through.
My gut instinct is that your mother just didn't want to be there.
I'm sorry, but some people just don't want the help they're offered.
Good luck, and stay strong.
posted by malibustacey9999 at 10:11 PM on September 2, 2010
None of them reported having no assistance at all. One of them complained that he was never left by himself, to think it through.
My gut instinct is that your mother just didn't want to be there.
I'm sorry, but some people just don't want the help they're offered.
Good luck, and stay strong.
posted by malibustacey9999 at 10:11 PM on September 2, 2010
--we finally talked my mom into going
--We checked her in at 2am and she was already trying to leave at 3pm
--walked out with only her pillow and hitched a ride to her house at 11pm
Sounds like *you* are ready for her to get sober. Maybe when *she* is ready, she'll have better luck.
If she ever gets ready. Alcoholism is a bitch.
The time in a rehab and/or detox is totally different, depending upon the individual in question. Many -- most? -- need detox to clear not just their body but also their head. Though fact is that it takes many a long, long time to clear out distorted thinking -- alcoholism, it's pretty powerful.
I think that the body can clear alcohol -- detox -- in 72 hours; I'm sure we'll hear from people who know. A week, max, outside. (I think.) If she has other issues ie pills, more detox time than that, esp if it's benzodiazepenes ie valium xanax etc. But even without that, alcoholics are often very, very shaky for a long time.
Many of them don't even remember their first days clean/sober, it's all a big swirl of ... something. It's a big swirl. It's a confusing time. They're lost.
Get off your chair, walk across the room. Now, do it with the walls and floors whirling up and down, everyone acting totally nuts, you yourself feeling totally nuts, every little thing rubbing your heart raw, maybe crying jags, maybe fits of rage, whatever. That's probably about how it feels for an alcoholic to be sober, there at the first, and many of them aren't real interested in that. Some of them even leave rehabs AMA. Happens every day.
This will be a good thing for your mother, in the long term. She's now beginning to get a sense of the road ahead, that her family isn't going to put up with this, that she's going to have to face down this illness.
It's not her fault that she's got alcoholism. You know this, but I think it bears repeating. The AA text talks about how no one ever blames a person with cancer, but many seem to think that alcoholism is a moral issue, and then they act accordingly, and treat the suffering person as if it's their fault. It's just so confusing. Plz be there for her, with her. Early milestones are huge -- thirty days without a drink is longer than you can possibly imagine. And I am not kidding. It's forever.
I wish you and your family good luck.
posted by dancestoblue at 10:15 PM on September 2, 2010 [3 favorites]
--We checked her in at 2am and she was already trying to leave at 3pm
--walked out with only her pillow and hitched a ride to her house at 11pm
Sounds like *you* are ready for her to get sober. Maybe when *she* is ready, she'll have better luck.
If she ever gets ready. Alcoholism is a bitch.
The time in a rehab and/or detox is totally different, depending upon the individual in question. Many -- most? -- need detox to clear not just their body but also their head. Though fact is that it takes many a long, long time to clear out distorted thinking -- alcoholism, it's pretty powerful.
I think that the body can clear alcohol -- detox -- in 72 hours; I'm sure we'll hear from people who know. A week, max, outside. (I think.) If she has other issues ie pills, more detox time than that, esp if it's benzodiazepenes ie valium xanax etc. But even without that, alcoholics are often very, very shaky for a long time.
Many of them don't even remember their first days clean/sober, it's all a big swirl of ... something. It's a big swirl. It's a confusing time. They're lost.
Get off your chair, walk across the room. Now, do it with the walls and floors whirling up and down, everyone acting totally nuts, you yourself feeling totally nuts, every little thing rubbing your heart raw, maybe crying jags, maybe fits of rage, whatever. That's probably about how it feels for an alcoholic to be sober, there at the first, and many of them aren't real interested in that. Some of them even leave rehabs AMA. Happens every day.
This will be a good thing for your mother, in the long term. She's now beginning to get a sense of the road ahead, that her family isn't going to put up with this, that she's going to have to face down this illness.
It's not her fault that she's got alcoholism. You know this, but I think it bears repeating. The AA text talks about how no one ever blames a person with cancer, but many seem to think that alcoholism is a moral issue, and then they act accordingly, and treat the suffering person as if it's their fault. It's just so confusing. Plz be there for her, with her. Early milestones are huge -- thirty days without a drink is longer than you can possibly imagine. And I am not kidding. It's forever.
I wish you and your family good luck.
posted by dancestoblue at 10:15 PM on September 2, 2010 [3 favorites]
This will sound harsh, but because your mother is an alcoholic, you should take everything she says with a grain of salt. Every single word. Are you completely sure that the picture she painted of this rehab is 100% accurate? Why don't you call the rehab in question and get their side of the story and their description of the policies and procedures there?
As a side note, ask yourself and other family members and friends if you are enabling her alcoholism in any way. If you are, you have to stop, right now. IANAD, but I've seen enough episodes of Intervention to see this principle in action (if you haven't seen the show, I highly recommend it for you and your family).
posted by zardoz at 10:29 PM on September 2, 2010 [1 favorite]
As a side note, ask yourself and other family members and friends if you are enabling her alcoholism in any way. If you are, you have to stop, right now. IANAD, but I've seen enough episodes of Intervention to see this principle in action (if you haven't seen the show, I highly recommend it for you and your family).
posted by zardoz at 10:29 PM on September 2, 2010 [1 favorite]
Different rehabs have different policies with regard to sedatives/tranquilizers during the first few days. Some consider them essential as preventative treatment for the DTs as well as helping people settle in, some go for a no drugs at all policy. It can make a major difference in terms of whether people make it through the first 2-3 days, and you should check with the center to see what their policy was and whether it was implemented.
Also, what other people said about "she has to be ready."
posted by Ahab at 10:53 PM on September 2, 2010
Also, what other people said about "she has to be ready."
posted by Ahab at 10:53 PM on September 2, 2010
This is scary stuff.
My Mother finally admitted to being an alcoholic for around 18 years - most of my life, after being sent to the emergency room, with enough alcohol to kill my 200lb+ father. It was a major turning point in everything, but even then, she still never really came to terms with it, never really thought the treatment and support groups (AA and NA) were needed and relapsed - one time enough to just kill her.
It was very very sad.
This whole, "needs to be ready" thing - yeah... how fragile is your Mother? If she's too fragile, maybe they're not in the best state to realize how close to death they've gotten themselves, and maybe - just maybe, it's for their own good to force them into some not so nice situations. This sounds horrible to even type, but if it's a choice between, forcing them into rehab for a few days, or them killing themselves from drinking, please consider that first option.
I wish you the best of luck - for you and your Mother.
posted by alex_skazat at 11:22 PM on September 2, 2010 [1 favorite]
My Mother finally admitted to being an alcoholic for around 18 years - most of my life, after being sent to the emergency room, with enough alcohol to kill my 200lb+ father. It was a major turning point in everything, but even then, she still never really came to terms with it, never really thought the treatment and support groups (AA and NA) were needed and relapsed - one time enough to just kill her.
It was very very sad.
This whole, "needs to be ready" thing - yeah... how fragile is your Mother? If she's too fragile, maybe they're not in the best state to realize how close to death they've gotten themselves, and maybe - just maybe, it's for their own good to force them into some not so nice situations. This sounds horrible to even type, but if it's a choice between, forcing them into rehab for a few days, or them killing themselves from drinking, please consider that first option.
I wish you the best of luck - for you and your Mother.
posted by alex_skazat at 11:22 PM on September 2, 2010 [1 favorite]
I've worked in several rehab facilities - one really terrible one, two others pretty good. You didn't mention whether your mother was inebriated when she checked in or not, but usually when people go to rehab, they are still drunk or high.
When someone comes in to rehab, there is an extensive round of paperwork that needs to be done (usually by the admitting nurse), including admission orders by a doctor, orders for medications if necessary, discussion with the patient. Even if the patient is uncooperative, some questions must be answered. Since your mom arrived on the night shift, it is possible some of the more detailed questions were deferred until morning.
An alcoholic patient is monitored every hour on the hour, if not more, depending on their history. Many patients are given orders for meds to control for DTs, seizures, high blood pressure, nausea and vomiting. Alcoholics can be frightening patients for the nursing staff because of the complex medical issues and potential for seizures, etc., and even more so if valium/xanax/other benzos or cocaine are also involved.
Every rehab I've ever worked in required accounting for each patient every hour - hourly checks. It is very unlikely that she missed meals or afternoon meds. Even in the one less-than-optimal facility where I worked, patients were tracked down for meds by nursing staff, meals were brought to those who were unable to leave there rooms, and all patients were oriented to the unit rules and facilities.
It is not unusual for a patient to leave within in 24 hours. Heck, oftentimes someone admitted at 2 a.m. is out by 9 a.m. when she awakes a little more sober and realizes she doesn't want to be there. Even if she was admitted on a weekend, she still should have met with medical staff and nursing staff, and there are usually groups every day. If she walked out without a full discharge, she went home AMA (against medical advice). It sounds like she was on an unlocked unit. In terms of no one being nice to her - people in detox are generally ornery and bad-tempered, as they're trying to deal with the bottom falling out of their lives. But there are always people nicer than others, both patients and staff.
I tend to think your mother has constructed her own reality about what happened. It sounds like she's not ready yet for rehab.
posted by la ninya at 11:46 PM on September 2, 2010 [14 favorites]
When someone comes in to rehab, there is an extensive round of paperwork that needs to be done (usually by the admitting nurse), including admission orders by a doctor, orders for medications if necessary, discussion with the patient. Even if the patient is uncooperative, some questions must be answered. Since your mom arrived on the night shift, it is possible some of the more detailed questions were deferred until morning.
An alcoholic patient is monitored every hour on the hour, if not more, depending on their history. Many patients are given orders for meds to control for DTs, seizures, high blood pressure, nausea and vomiting. Alcoholics can be frightening patients for the nursing staff because of the complex medical issues and potential for seizures, etc., and even more so if valium/xanax/other benzos or cocaine are also involved.
Every rehab I've ever worked in required accounting for each patient every hour - hourly checks. It is very unlikely that she missed meals or afternoon meds. Even in the one less-than-optimal facility where I worked, patients were tracked down for meds by nursing staff, meals were brought to those who were unable to leave there rooms, and all patients were oriented to the unit rules and facilities.
It is not unusual for a patient to leave within in 24 hours. Heck, oftentimes someone admitted at 2 a.m. is out by 9 a.m. when she awakes a little more sober and realizes she doesn't want to be there. Even if she was admitted on a weekend, she still should have met with medical staff and nursing staff, and there are usually groups every day. If she walked out without a full discharge, she went home AMA (against medical advice). It sounds like she was on an unlocked unit. In terms of no one being nice to her - people in detox are generally ornery and bad-tempered, as they're trying to deal with the bottom falling out of their lives. But there are always people nicer than others, both patients and staff.
I tend to think your mother has constructed her own reality about what happened. It sounds like she's not ready yet for rehab.
posted by la ninya at 11:46 PM on September 2, 2010 [14 favorites]
Something else. Who you end up in a room with on your first night can easily be a deal breaker.
If you get bunked with someone who's only there to try and avoid the legal consequences of running a dog fighting ring, it's an entirely different experience to sharing a room with a gentle old professor who's just got to the stage where he can't remember his students' names.
If her leaving was a product of something like the first scenario, trying again may well be the way to go.
In a more general sense, trying again (and again, and again) is the approach needed for some addicts. You can't let your intervention become an enabling pattern in itself (eg they think "I can keep drinking/using because my relatives will always bail me out by packing me off to rehab for a day or two") but sometimes it is possible for an addict to pick up a little bit of wisdom from each of many repeated attempts to stop, and get there in the end.
posted by Ahab at 12:00 AM on September 3, 2010
If you get bunked with someone who's only there to try and avoid the legal consequences of running a dog fighting ring, it's an entirely different experience to sharing a room with a gentle old professor who's just got to the stage where he can't remember his students' names.
If her leaving was a product of something like the first scenario, trying again may well be the way to go.
In a more general sense, trying again (and again, and again) is the approach needed for some addicts. You can't let your intervention become an enabling pattern in itself (eg they think "I can keep drinking/using because my relatives will always bail me out by packing me off to rehab for a day or two") but sometimes it is possible for an addict to pick up a little bit of wisdom from each of many repeated attempts to stop, and get there in the end.
posted by Ahab at 12:00 AM on September 3, 2010
Sounds a bit weird and typical of institutionalized facilities. She'd probably do better in a more personalized, smaller-scaled setting geared towards women her age.
posted by watercarrier at 12:42 AM on September 3, 2010
posted by watercarrier at 12:42 AM on September 3, 2010
I don't have direct experience with rehab, but this --
She missed lunch and afternoon meds because she didn't realize that's what the knock on her door meant
-- doesn't make any sense. Obviously a knock at the door means you answer the door and see what it's about.
posted by jon1270 at 2:58 AM on September 3, 2010 [2 favorites]
She missed lunch and afternoon meds because she didn't realize that's what the knock on her door meant
-- doesn't make any sense. Obviously a knock at the door means you answer the door and see what it's about.
posted by jon1270 at 2:58 AM on September 3, 2010 [2 favorites]
I have no firsthand or secondhand experience with rehab, but alcoholism - like depression, eating disorders, and many other mental illnesses and addictions - does everything it can to keep itself alive. It's very possible your mother is lying through her teeth about her experience, and it's possible she shut herself off from the staff and other patients because she didn't want to be there. And she's probably not totally lying - she almost certainly felt lousy during her stay, but it's probably at least partly from her own attitude and actions while she was there. Addictions aren't afraid to lie and hide and be mean, because they don't need friends, in fact they flourish without them. Doesn't mean your mom, the person, doesn't need friends, and it doesn't mean she's bad or fundamentally untrustworthy.
It's worth trying again. Before you take her, arrange to take a tour of the facility where she'll be staying. Talk to the staff about her previous experience - how she felt isolated, ignored knocks at her door, felt so unwelcome that she left the same day. Ask them what the first 48 hours are like, what their procedure is. You have a better idea of what she needs in her first days of rehab, so use that to your advantage.
This is an incredibly difficult situation to be in. I wish you both luck and health.
posted by Metroid Baby at 4:31 AM on September 3, 2010 [3 favorites]
It's worth trying again. Before you take her, arrange to take a tour of the facility where she'll be staying. Talk to the staff about her previous experience - how she felt isolated, ignored knocks at her door, felt so unwelcome that she left the same day. Ask them what the first 48 hours are like, what their procedure is. You have a better idea of what she needs in her first days of rehab, so use that to your advantage.
This is an incredibly difficult situation to be in. I wish you both luck and health.
posted by Metroid Baby at 4:31 AM on September 3, 2010 [3 favorites]
The first 24 hours were filled with such searing sickness that I felt like I had the plague. I was bunked in a detox room with about 6 other sick dopefiends with nothing other than a rubber pillow and a plastic wrapped twin bed. Every now and then I hobbled down the hall to the day room where I sat on a busted couch and mewled. The only service provision I really cared about was getting my Subutex and Catapres to relieve withdrawal. I came in with a massive infection I had left untreated for months so I thought I was dying and almost signed myself out to go to the emergency room but stuck it out.
It depends on the place, but detox/rehab can be rugged from the perspective of services provided and physical conditions and early withdrawal heightens the sense of generalized misery. Your mother can try again with a different place but she should know that every time she does this -- signing yourself out before completing treatment is called leaving "against medical advice" -- her insurance provider is making a note of it in her records and they may be less likely to fund her for future treatment attempts, or might be willing to approve less in terms of services because they aren't convinced she's going to complete whatever program they recommend, which costs them money and makes her look like a less attractive funding candidate.
posted by The Straightener at 5:47 AM on September 3, 2010 [7 favorites]
It depends on the place, but detox/rehab can be rugged from the perspective of services provided and physical conditions and early withdrawal heightens the sense of generalized misery. Your mother can try again with a different place but she should know that every time she does this -- signing yourself out before completing treatment is called leaving "against medical advice" -- her insurance provider is making a note of it in her records and they may be less likely to fund her for future treatment attempts, or might be willing to approve less in terms of services because they aren't convinced she's going to complete whatever program they recommend, which costs them money and makes her look like a less attractive funding candidate.
posted by The Straightener at 5:47 AM on September 3, 2010 [7 favorites]
My sister left rehab early. Her story was much the same as your mother's. I can't speak for your mom, but I have a feeling that what my sister told us was 90% conniving, 10% reality. Rehab is what you make of it. If you WANT to get clean, you do. If you want to make a break, you do.
posted by julthumbscrew at 6:00 AM on September 3, 2010 [2 favorites]
posted by julthumbscrew at 6:00 AM on September 3, 2010 [2 favorites]
If she got there at 2am, is it possible that she was allowed to sleep later in the morning than the other patients? Would a facility let her do that on the first day? Would they knock quietly to see if she was awake then go away and let her sleep, or would they wake her up anyway and get her into the routine?
I don't know anything about rehab, but the late hour makes me wonder about the rules regarding sleep. Maybe someone knowledgeable could answer this?
posted by CathyG at 6:06 AM on September 3, 2010
I don't know anything about rehab, but the late hour makes me wonder about the rules regarding sleep. Maybe someone knowledgeable could answer this?
posted by CathyG at 6:06 AM on September 3, 2010
Response by poster: My mother fell asleep and woke up with her dress on fire, she had dropped her cigarette. That's when she decided she wanted to go to rehab. And then she immediately started stalling. Two days later she missed a very important doctor's appointment and my brother went over and found her yelling at people in the backyard who weren't there. This isn't the first time she's hallucinated. Then she lit a cigarette and dropped it and got confused and lighted another one. My brother picked up the dropped cigarette before it burned the rug. She agreed that night to go to rehab in a couple of days. The next day he called about her missed appointment and called her psychiatrist to have him tell her to go. Her psychiatrist didn't even know she was an alcoholic. He did tell her to go to rehab and I don't know, something about my brother spending the day with her (he had to miss work at his new very important job) and the special way he has with her that I don't seem to have. She agreed to go that night. We had to wait so late because part of her conditions was to talk to the neighbor that she trusts to watch the house and her dog. He didn't get home until 8pm. Then it was showering and makeup and packing and I need another cigarette, another drink, etc. It felt like stalling, I admit it. I even asked my brother what are we waiting for, let's go. It was 11pm when we arrived and yes, she was very drunk and her evening cocktail of antidepressants/anxiety meds were kicking in. The first thing she did was start removing her pants saying she peed her pants. We found her a bathroom, luckily she didn't pee her pants. It took until 2 am to get her checked in, all those things mentioned above, paperwork, doctor's orders, etc, my brother helped her with her paperwork and questions. Finally at 2am they loaded up her stuff on a cart and took her to the back. I'm positively sure she woke up and didn't remember anything and didn't know where she was. It would have been helpful to have someone ready for that maybe and not make her wait in a line to ask questions. The knock on the door is what they do to everyone down the hall. The walk down the hall and knock once and continue on. My mom's naturally a confused person and naturally not the nicest person in the world. I think she really needed some handholding and major gritting of teeth by the staff. I guess I thought that's how it would be. There's very little information, we are certainly naive, not having dealt with this before. It's supposed to be a good place, recommended by people we know so we trusted the system maybe more than we should. We called to get a tour and they refused because of anonymity of guests. We followed what was available on the website but really felt they are a rehab, certainly my mom's not a one in a million case, I guess I assumed everyone was like her and they knew how to handle their patients in an individual nature. Certainly a marine who is staying there can get up and find a chart and figure out when and where breakfast is but my mom isn't like that. I'm surprised she knows her way around her own house. I don't know exactly what happened, I've been trying for two days to talk to someone about her stay and no one will call me back. I can't tell you how frustrating this is. Was she ready? No. Is she a danger to herself? Very much so. How do we reconcile the two when she has to commit herself to rehab. Since she's been home she's been very destructive and aggressive. Last night she parked her car in the garage (at the back of the house) where she stores a lot of furniture. She just plowed through the furniture with her car to get it in there. Then she called the police and said my brother stole her car among other things. The neighbor that she trusted is actually renting her garage apartment and when he refused to buy her alcohol she told him he had 30 days to get out. My brother now wants to have her committed. We are trying to figure out how to do that today. Detox has little information and I guess I assumed it was a hospital type environment. Someone would bring her food, she'd have a nurses button, and she'd spend the first couple of days throwing up or sedated or whatever until she was sober. Instead she treated just like the guy who's been there for 20 days, I guess, I don't know really because no one will call me back.
posted by flarbuse at 8:35 AM on September 3, 2010
posted by flarbuse at 8:35 AM on September 3, 2010
After many years of struggling with alcoholism
I can only assume this to mean that your mother had been on a drinking jag for quite some time leading up to the point in which you convinced her to check herself into a rehab. The first 3-7 days are spent detoxing from alcohol, depending on how long you had been drinking for. I spent 3.5 days, and finally couldn't take it for the boredom, and volunteered to be put into groups early with extra monitoring. They will let you sleep as much as you want, but will wake you for meds to prevent DTs if you're in bad shape. After that time it's a regimen of groups and therapy and such, but usually not until your head and body are clear enough to make sense of what's being told, and you can hold some food down.
A simple suggestion: I was intervened. I was unwilling, uncooperative, and resentful of being there. I went not to stop drinking, but to shut my family up. Recovery is about willingness, and I had none. My family spoke with professionals and sent me out of state. I hated them at the time, but I am glad they did. There are reasons many families' send their loved ones out of state for rehab, and one of them is that when it comes down to acting on the desire to leave, it is very difficult when you are in an unfamiliar area. Especially if your credit cards have been held for "safekeeping" by your family (or cancelled), and you don't have any large sums of money. You are free to leave, but where would you go with 3 suitcases and 10 bucks in an unfamliar city?
I spent the first month of rehab trying to come up with ways on how to go home. Pretending I was doing AWESOME!!!, lying, pretending I was crazy, whining, crying to my family. No one would take me back, I had nowhere to go, and no one wanted me to come home. So I stayed. And I am eternally grateful that I did... I didn't find my permanent solution in rehab, for I drank again several times after, but it opened my eyes to the possibility of sobriety. It showed me that I could go for several months without drinking, and that my happiness wasn't directly contingent on the availability of liquor. Most importantly, it exposed me to the miracle that I consider AA to be.
posted by Debaser626 at 8:55 AM on September 3, 2010 [2 favorites]
I can only assume this to mean that your mother had been on a drinking jag for quite some time leading up to the point in which you convinced her to check herself into a rehab. The first 3-7 days are spent detoxing from alcohol, depending on how long you had been drinking for. I spent 3.5 days, and finally couldn't take it for the boredom, and volunteered to be put into groups early with extra monitoring. They will let you sleep as much as you want, but will wake you for meds to prevent DTs if you're in bad shape. After that time it's a regimen of groups and therapy and such, but usually not until your head and body are clear enough to make sense of what's being told, and you can hold some food down.
A simple suggestion: I was intervened. I was unwilling, uncooperative, and resentful of being there. I went not to stop drinking, but to shut my family up. Recovery is about willingness, and I had none. My family spoke with professionals and sent me out of state. I hated them at the time, but I am glad they did. There are reasons many families' send their loved ones out of state for rehab, and one of them is that when it comes down to acting on the desire to leave, it is very difficult when you are in an unfamiliar area. Especially if your credit cards have been held for "safekeeping" by your family (or cancelled), and you don't have any large sums of money. You are free to leave, but where would you go with 3 suitcases and 10 bucks in an unfamliar city?
I spent the first month of rehab trying to come up with ways on how to go home. Pretending I was doing AWESOME!!!, lying, pretending I was crazy, whining, crying to my family. No one would take me back, I had nowhere to go, and no one wanted me to come home. So I stayed. And I am eternally grateful that I did... I didn't find my permanent solution in rehab, for I drank again several times after, but it opened my eyes to the possibility of sobriety. It showed me that I could go for several months without drinking, and that my happiness wasn't directly contingent on the availability of liquor. Most importantly, it exposed me to the miracle that I consider AA to be.
posted by Debaser626 at 8:55 AM on September 3, 2010 [2 favorites]
I think she really needed some handholding and major gritting of teeth by the staff.
I can only assume that what you and your family have been doing, as that is what mine did for many years. The duality of addiction is that it sickens the person using the substances as well as the people that love them. The only handholding she needs in the beginning is to be in a place which will medically take care of her until she is out of danger, provide her food and temporary shelter, while not letting her indulge in her addiction. I sincerely doubt she would have starved to death, but you have listed two experiences in which she could have burned herself severely or injured herself in a car accident.
I feel for your pain, and I know what it's like to be so involved in removing myself from pain of the desire of a substance that it crowds out all rational thought to stay alive. Your mother will be in my thoughts and prayers, and I wish you and her serenity in the days to come.
posted by Debaser626 at 9:37 AM on September 3, 2010
I can only assume that what you and your family have been doing, as that is what mine did for many years. The duality of addiction is that it sickens the person using the substances as well as the people that love them. The only handholding she needs in the beginning is to be in a place which will medically take care of her until she is out of danger, provide her food and temporary shelter, while not letting her indulge in her addiction. I sincerely doubt she would have starved to death, but you have listed two experiences in which she could have burned herself severely or injured herself in a car accident.
I feel for your pain, and I know what it's like to be so involved in removing myself from pain of the desire of a substance that it crowds out all rational thought to stay alive. Your mother will be in my thoughts and prayers, and I wish you and her serenity in the days to come.
posted by Debaser626 at 9:37 AM on September 3, 2010
The person I know best who eventually had a successful rehabilitation at a private clinic, went to two other facilities previously and checked himself out of those two claiming that they were treating him poorly and all that. He had all sorts of explanations for why the first two places were unacceptable. Eventually he got into a third place and for whatever reason it worked for him and he's been sober for three years now. I'll never really know if it was because he was finally ready or if the third place really was all that much better. (It certainly cost more!). I hope your mom finds something that works for her when she's ready. It sounds like an awful situation for you.
posted by otherwordlyglow at 9:44 AM on September 3, 2010
posted by otherwordlyglow at 9:44 AM on September 3, 2010
I've been in rehab 3 times and a county detox/drunk tank a few too over the past 10 years. Now sober for 3+ and doing well.
My experience (in general at all places):
I was always drunk when I checked in. Once I was so drunk they got the wheelchair out for me. The first 24-48 hours they didn't expect much of me except to detox safely and not die.
The way it works in my state is that for the first 24-72 hours, you're under general inpatient medical care that bares little difference to being admitted to a hospital or something like that. Once the medical staff is reasonably certain that you're out of the woods as far as seizures, DTs, sudden onset of death or whatever then I was considered a regular rehab patient.
Once place had a separate medical wing for detox and then from there someone (a patient) who is your "buddy" shows up to get you from detox, take you to your more permanent room, show you around, etc.
I've never had a "bad" rehab experience - as in never was treated poorly. But all rehabs are different.
+1 to what others have said about your mother possibly not being truthful.
Feel free to shoot a pm. I'm happy to give you my email addy and answer whatever questions I can.
posted by thatguyjeff at 10:29 AM on September 3, 2010
My experience (in general at all places):
I was always drunk when I checked in. Once I was so drunk they got the wheelchair out for me. The first 24-48 hours they didn't expect much of me except to detox safely and not die.
The way it works in my state is that for the first 24-72 hours, you're under general inpatient medical care that bares little difference to being admitted to a hospital or something like that. Once the medical staff is reasonably certain that you're out of the woods as far as seizures, DTs, sudden onset of death or whatever then I was considered a regular rehab patient.
Once place had a separate medical wing for detox and then from there someone (a patient) who is your "buddy" shows up to get you from detox, take you to your more permanent room, show you around, etc.
I've never had a "bad" rehab experience - as in never was treated poorly. But all rehabs are different.
+1 to what others have said about your mother possibly not being truthful.
Feel free to shoot a pm. I'm happy to give you my email addy and answer whatever questions I can.
posted by thatguyjeff at 10:29 AM on September 3, 2010
I was going to add - in a nutshell rehab was always a two part deal for me. First part - acute medical care for the detox part (24-72 hours), second part - chronic rehabilitation for the remaining 28 days or however long.
First part and second part are very different. The "rehab" doesn't start until part 2.
posted by thatguyjeff at 10:34 AM on September 3, 2010
First part and second part are very different. The "rehab" doesn't start until part 2.
posted by thatguyjeff at 10:34 AM on September 3, 2010
A lot depends on the place, but the first 2 days aren't a stay at a resort.
Coming in under the influence, there's not much they can do until that's slept-off. Being on booze booze and pills, it's no wonder her head isn't screwed-on tight. Wanting to leave after about 12 hours, yeah, she'll be feeling withdrawal and wanting to go back to using.
Part of the problem is if she's not not completely honest about how much, how long, and what she's been using and especially in combination. With alcoholics and addicts (yes, alcohol is a drug), there's often a desire to not be entirely honest with those who are trying to help. But without that information, it can be difficult to know what and how much medication is needed to properly manage the withdrawal. Once what was in here system when she came in is out of her system and the withdrawal symptoms and severity can be gauged, then they can start treating her. It helps if she's honest in this regard too. Nausea? Thirst? Headache? Usually one of the nurses can give something to help.
As far as hunger and missed meals, it's common to not want to, or be able to, eat for the first couple of days. After that, it's usually a fixed time, and if you don't get out of bed to where meals are served, or answer the door if they bring it around, you don't eat. It serves a few purposes, practicality for preparing and cleaning-up meals, getting the body used to eating at proper intervals again since it's not usually the highest priority when loaded, and knowing that the patient may not want to eat due to nausea or just preferring to gain some healing sleep.
It would be unusual for them not to check in on her very regularly at the start. Alcohol withdrawal can and does kill. One of the things they should be doing frequently is checking both for degree of shakiness and blood pressure. Because alcohol is a depressant, the body compensates in areas such as the central nervous system and blood pressure. When you suddenly take the alcohol away, the body doesn't adjust back to normal right away. She could have a seizure or worse.
Staff and generally busy and under-appreciated by the clients. When one first goes in, it's often confusing not knowing the routine, where things are, what you're not allowed to do or not allowed to go (for your own safety), when to get medication and monitoring, etc. In other words, new patients can be clingy and interfere with getting responsibilities done. As long as it's nothing life threatening or extremely uncomfortable, they by necessity will either brush aside too many questions or give an increased dose of medication to keep the patient 'resting comfortably' until they're more adjusted physically and mentally after the first 2 or 3 days.
As far as monitoring and need for assistance, it can be any combination of video, call bells, regularly giving a quick knock before ducking their head in the door to make sure the patient is sleeping, whatever. Usually though there's a call bell to push if you need something, even if it takes them a short while if they're busy or the bell is abused.
There is some degree of humiliation, especially with going to the washroom and washing-up with a nurse watching. It's a safety thing. During withdrawal you can be very shaky and unsteady resulting in a fall or other injury, or a seizure or something.
During detox, you're not all there usually. There isn't much point in a councilor or buddy. Once sobered-up and mentally alert after anywhere from 3 days to 2 weeks, then comes recovery where the real problem gets addressed. Alcohol and drugs are only a symptom. The disease is upstairs. If in doubt, note the use of smoking, anti-depressants, and anti-anxiety medications. I wouldn't be surprised if she has a problem with anxiety attacks. Self-medication isn't the answer. The problem is fears gone awry. In recovery, programs like the 12-steps practiced by AA and other fellowships help people to better understand themselves, their fears, and the reasons why the answer was sought in the bottom of a bottle. But it's not there, it's inside. Without addressing the cause, and working at it constantly, she's almost guaranteed to continually relapse again and again after detoxing until she dies which may not be long.
It would be very good to get a thorough check of her liver. It's not just the alcohol usage, but the combination with pills can be very bad. When it goes, it takes other organs down with it. Combine that with withdrawal during the stay in ICU which is deadly on its own. For the liver, many places won't even consider transplants if the patient hasn't been clean for at least a year.
This is getting long. Anyway, to make it successfully through detox and recovery, some things like willingness, honesty, humility, and courage have to be in place. Even so, it's not easy, but it's worth the effort, even if she doesn't realize it at the moment since she's probably forgotten what it's like to live clean and sober.
posted by hungrysquirrels at 12:07 PM on September 3, 2010 [1 favorite]
Coming in under the influence, there's not much they can do until that's slept-off. Being on booze booze and pills, it's no wonder her head isn't screwed-on tight. Wanting to leave after about 12 hours, yeah, she'll be feeling withdrawal and wanting to go back to using.
Part of the problem is if she's not not completely honest about how much, how long, and what she's been using and especially in combination. With alcoholics and addicts (yes, alcohol is a drug), there's often a desire to not be entirely honest with those who are trying to help. But without that information, it can be difficult to know what and how much medication is needed to properly manage the withdrawal. Once what was in here system when she came in is out of her system and the withdrawal symptoms and severity can be gauged, then they can start treating her. It helps if she's honest in this regard too. Nausea? Thirst? Headache? Usually one of the nurses can give something to help.
As far as hunger and missed meals, it's common to not want to, or be able to, eat for the first couple of days. After that, it's usually a fixed time, and if you don't get out of bed to where meals are served, or answer the door if they bring it around, you don't eat. It serves a few purposes, practicality for preparing and cleaning-up meals, getting the body used to eating at proper intervals again since it's not usually the highest priority when loaded, and knowing that the patient may not want to eat due to nausea or just preferring to gain some healing sleep.
It would be unusual for them not to check in on her very regularly at the start. Alcohol withdrawal can and does kill. One of the things they should be doing frequently is checking both for degree of shakiness and blood pressure. Because alcohol is a depressant, the body compensates in areas such as the central nervous system and blood pressure. When you suddenly take the alcohol away, the body doesn't adjust back to normal right away. She could have a seizure or worse.
Staff and generally busy and under-appreciated by the clients. When one first goes in, it's often confusing not knowing the routine, where things are, what you're not allowed to do or not allowed to go (for your own safety), when to get medication and monitoring, etc. In other words, new patients can be clingy and interfere with getting responsibilities done. As long as it's nothing life threatening or extremely uncomfortable, they by necessity will either brush aside too many questions or give an increased dose of medication to keep the patient 'resting comfortably' until they're more adjusted physically and mentally after the first 2 or 3 days.
As far as monitoring and need for assistance, it can be any combination of video, call bells, regularly giving a quick knock before ducking their head in the door to make sure the patient is sleeping, whatever. Usually though there's a call bell to push if you need something, even if it takes them a short while if they're busy or the bell is abused.
There is some degree of humiliation, especially with going to the washroom and washing-up with a nurse watching. It's a safety thing. During withdrawal you can be very shaky and unsteady resulting in a fall or other injury, or a seizure or something.
During detox, you're not all there usually. There isn't much point in a councilor or buddy. Once sobered-up and mentally alert after anywhere from 3 days to 2 weeks, then comes recovery where the real problem gets addressed. Alcohol and drugs are only a symptom. The disease is upstairs. If in doubt, note the use of smoking, anti-depressants, and anti-anxiety medications. I wouldn't be surprised if she has a problem with anxiety attacks. Self-medication isn't the answer. The problem is fears gone awry. In recovery, programs like the 12-steps practiced by AA and other fellowships help people to better understand themselves, their fears, and the reasons why the answer was sought in the bottom of a bottle. But it's not there, it's inside. Without addressing the cause, and working at it constantly, she's almost guaranteed to continually relapse again and again after detoxing until she dies which may not be long.
It would be very good to get a thorough check of her liver. It's not just the alcohol usage, but the combination with pills can be very bad. When it goes, it takes other organs down with it. Combine that with withdrawal during the stay in ICU which is deadly on its own. For the liver, many places won't even consider transplants if the patient hasn't been clean for at least a year.
This is getting long. Anyway, to make it successfully through detox and recovery, some things like willingness, honesty, humility, and courage have to be in place. Even so, it's not easy, but it's worth the effort, even if she doesn't realize it at the moment since she's probably forgotten what it's like to live clean and sober.
posted by hungrysquirrels at 12:07 PM on September 3, 2010 [1 favorite]
I'm sorry for your frustration with not getting any answers from the facility; it's a catch 22, because you need some information from them to find out if she's lying, as well as some real guidance on just what the heck to do next. Unfortunately, they are bound by law not to tell you much of anything--I remember once trying to get hold of my loved one in a facility, and they wouldn't even tell me whether he had checked into the place. There's a good reason for this confidentiality--going to rehab can wreak havoc on your employment opportunities, for example--but it doesn't help you. Have you contacted a social worker? They can often help you through these confusing mazes.
Another frustration is that as we have all said already, she has to want to get well, and unless she does, the facilities won't hold her for any length of time--in most states, they can't. It used to be that people could be committed involuntarily, for months at a time à la those 1960s institutions you read about. In the 80s, my loved one's insurance would have covered him for 30 days of detox. When he used it, in the mid 90s, it only covered three days. It's getting harder, not easier, for people to get treatment; but again, in the end, it all just comes down to whether she is truly committed to rehab or not. Best of luck to you.
posted by Melismata at 12:32 PM on September 3, 2010
Another frustration is that as we have all said already, she has to want to get well, and unless she does, the facilities won't hold her for any length of time--in most states, they can't. It used to be that people could be committed involuntarily, for months at a time à la those 1960s institutions you read about. In the 80s, my loved one's insurance would have covered him for 30 days of detox. When he used it, in the mid 90s, it only covered three days. It's getting harder, not easier, for people to get treatment; but again, in the end, it all just comes down to whether she is truly committed to rehab or not. Best of luck to you.
posted by Melismata at 12:32 PM on September 3, 2010
Is it possible that someone did speak to her about meals and general information and she just doesn't remember? If she was as messed up as you say, with a boatload of alcohol, anti-depressants and anti-anxiety medications in her system, she may have had several conversations without remembering one of them.
That being said, the lack of communication from the facility is troubling. Was this a private rehab facility? Maybe you can work with her psychiatrist to get her first into a mental health facility and then get her over to rehab.
posted by The Light Fantastic at 12:38 PM on September 3, 2010
That being said, the lack of communication from the facility is troubling. Was this a private rehab facility? Maybe you can work with her psychiatrist to get her first into a mental health facility and then get her over to rehab.
posted by The Light Fantastic at 12:38 PM on September 3, 2010
In the US, federal law bars substance abuse treatment facilities and providers from acknowledging that any particular person was previously, or is currently, receiving treatment (Substance Abuse Confidentiality Regulations, administered by the Substance Abuse & Mental Health Services Administration under HHS). Substance-related confidentiality is much stricter than general HIPAA requirements, and even some practitioners don't realize that the feds have given nearly absolute confidentiality to people undergoing treatment, except for the people to whom the client has explicitly, and in writing, granted release of information.
OP, if your mother did not sign a release form permitting the facility to talk to you, they are prohibited from doing so.
posted by catlet at 3:11 PM on September 3, 2010
OP, if your mother did not sign a release form permitting the facility to talk to you, they are prohibited from doing so.
posted by catlet at 3:11 PM on September 3, 2010
I'm so sorry you're going through this.
Detoxes vary greatly, and there really is no uniform experience. Check your memail for more detailed personal experience.
posted by thankyouforyourconsideration at 10:18 AM on September 4, 2010
Detoxes vary greatly, and there really is no uniform experience. Check your memail for more detailed personal experience.
posted by thankyouforyourconsideration at 10:18 AM on September 4, 2010
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posted by Melismata at 9:29 PM on September 2, 2010 [9 favorites]