What Has Surprised Me Most about Working in Long Term Drug Treatment

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It was unusual to say the least. There I was, a science nerd and sorority girl hybrid, who decided (seemingly out of nowhere) to spend part of my gap year between undergrad and medical school learning about (and living amidst) substance addiction. As a neuroscience major, I was relatively familiar with the biological motivations & consequences of substance addictions, but I was missing a major component- the humanistic side to the story. I wanted to understand why people (like a friend of mine from prep school) KNOWINGLY risked, and often lost, everything to chase a drug or alcohol induced high. Having been to my fair share of college parties, I knew that alcohol and drugs could be lots of fun, but people’s willingness to risk their job/family/friends/home to use them absolutely baffled me. It frustrated me. As a future physician, I wanted to be able to help those who are ill and substance addicted patients were going to be tricky ones. So to learn about addiction from the inside out, I launched into a 6 month internship at a long term drug treatment facility- The Gonzalez Recovery Residences.

We ate, watched tv, went swimming, cried, laughed, and sometimes disagreed with one another (the clients and I). Living in the same house with each of the patients in the GRR’s long term drug treatment program was a LEARNING experience to say the least.

When getting to know the clients, I was astounded by how many of them had abuse in their past (emotional, physical, or sexual). While few of the clients went so far as to blame the abuse for their ensuing addiction, the correlation was too strong to be ignored. The types of abuse ranged everywhere from early sexual assault to domestic violence later in life, but the feelings the abuse caused (outrage, despair, powerlessness, hatred, and loneliness) were shared. Additionally, it is interesting that many clients did not reveal the abuse until significantly progressed in their treatment. Programs that did not specialize in long term drug treatment might have missed the abuse entirely and the underlying issues from it might never be resolved, placing the individual at a much greater risk for relapse.

In addition to the high incidence of abuse among our long term drug treatment clients, I was astounded as to how difficult meaningful social interactions could be for them. Without their drug of choice lubricating the social situation, many of our exceptionally high functioning clients simply froze up or became uncharacteristically anxious. It had been decades since soberly socially interacting with others (for some of our clients) and the re-establishing of those skill sets takes time and practice. Re-learning the art of conversation and how to enjoy oneself soberly weren’t lessons I planned on helping clients with, but they turned out to be an exceptionally important part of long term drug treatment.

Blog Post To Be Continued & will include my take on the charade of the “functioning” addict/alcoholic!!

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