By Deborah Rasso, LMHC, CAP, ICADC, LPC, NCC, QS, CH
It was a typical sunny, warm, Mid-April day when Matt (his name and some details have been changed to protect his privacy per HIPPA laws) landed in West Palm Beach, Florida. He wasn’t here for the fun, sun, and surf. Matt was here to save his life. At only 24-years-old, Matt’s life had been slowly crumbling due to his active addiction to heroin. Just over two weeks prior, Matt had been arrested for the second time. He was charged with DWAI (Driving While Ability Impaired) and was caught with heroin during the arrest which added two possession charges. Matt’s life had taken a turn for the worse.
With encouragement from his family, Matt entered a hospital near his home in Westchester, NY on March 29, two days after his arrest. He admitted that he has been snorting a bundle of heroin, smoking a gram of marijuana, and drinking six beers daily. He also shared that he was using cocaine several times a week and was taking up to 4 mg of Xanax when he could find it.
Matt had tried unsuccessfully to quit in the past. He attended an intensive outpatient treatment near his home a few months earlier. He shared, with the hospital staff, that he had used heroin the entire time he was in the program. He admitted that he faked the urine screenings by bringing a small bottle of his sober friend’s urine in to use the evenings he was drug tested. He shared he was selling drugs on the side with a friend and never stopped hanging out with his drug-using friends and co-workers. He told them he was motivated to quit when he started the program, but drugs were still a part of his daily life whether he was at work or simply driving around his home town.
Matt was tired of the game. Tired of waking up every day trying to figure out how, when, and where he would get his next fix. Tired of lying, cheating and worrying about money. Tired of losing jobs, friends, and his freedom all for a little bit of powder. The staff at the hospital stabilized and detoxed Matt. Matt’s father had a friend at work who had gone to The Palm Beach Institute, a small boutique treatment center in South Florida that has been in business for 47 years. The co-worker had returned clean and sober. His friend credited the treatment center for his ability to return to his former life, re-earn his family’s love and support, and return to his job.
He encouraged Matt’s father to consider the program for Matt. At this point, Matt’s father was tired of Matt’s failed attempts at sobriety. He and the staff at the hospital decided that it would be in Matt’s best interest to transfer to The Palm Beach Institute. His parent’s understood that if Matt stayed with them, in his hometown surrounded by old triggers and temptations, the odds of getting clean and sober were lower. Matt bid farewell to his friends and his family and got on that plane headed to Palm Beach on April 14.
Arrival At The Palm Beach Institute
Matt entered residential treatment. At this level of care, Matt had nursing supervision available 24 hours a day. He attended group sessions daily and most days there were five to seven hours of groups. This helped Matt learn more about why he was doing the things he had been doing. The groups gave him the support and encouragement he needed when he was feeling anxious and homesick. He also attended an in-house Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) meeting in the evening.
Matt’s first week of treatment was a busy one. He met with the nursing staff daily and was given a complete physical by the medical director. He had blood work completed to make sure he did not have any medical issues as a result of his drug use. He met with the psychiatrist for a full assessment. The psychiatrist diagnosed him with several disorders: Opiate Use Disorder, Severe; Cocaine Use Disorder, Severe; and Sedative Use Disorder, Moderate.
The psychiatrist determined that he would benefit from some medications to help with his sleep issues, a common post-acute withdrawal symptom from opiates. Matt struggled to get more than a couple of hours of rest. This, in turn, increased his anxiety. He was prescribed non-narcotic medications to give him some comfort.
He met with the case manager who wrote the letter to his attorney so that his court date for the possession and DWAI could be delayed while he got the help he so desperately needed. He quickly became acquainted with his therapist and gave her a full life history (officially called a “Bio-Psych-Social Assessment”) including all the relevant events from birth to present, biological, psychological, and social.
Matt is from an upper middle-class family in Westchester, NY. Matt shared that he lost his mother to cancer when he was only seven years old which was devastating for him. He and his older brother and younger sister were raised by his father alone until his father remarried, bringing two younger step siblings into his life. He successfully completed high school and went on to attain his college degree in political science. He had been diagnosed with attention deficit disorder at the age of 14 and medicated with Adderall. He didn’t start to use recreational drugs or abuse alcohol until he was 18 and in college. Six years later, he found himself hopelessly addicted to Heroin. When asked why he came to treatment he shared, “Because I can’t keep doing this, but I also can’t stop.”
Treatment And The Beginning Of Recovery
For the next several weeks, Matt attended group therapy every day. He learned about the disease of addiction and why it is so hard to break the pattern of using, due to the chemistry of the brain. He learned about grief and loss, anger management, triggers, coping skills, AA and NA, relapse prevention, mindfulness, cognitive behavior therapy to change his thoughts, family systems, spirituality, anxiety, depression, ego, guilt, shame, and emotional intelligence. He read the Big Book and he started to write out the first through third steps to prepare for the future when he will do it with a sponsor again. Matt learned how to express himself using music, art, and writing and learned how to communicate better while gaining new life skills. It was like he was in college again, majoring in sobriety.
Matt became closely acquainted with his therapist, whom he saw every day. He met with her at least once a week for individual sessions and daily in a small process group. He finally took the necessary steps to accept and process the loss of his mother at such a young age. He shared that she was the higher power he used in times of trouble. He learned ways to identify when his thinking was irrational. He identified his triggers and the people, places, and things he was going to need to avoid. He continued to see the psychiatrist and the medical doctor once a week to monitor his progress, both mental and physical.
Old And New Struggles
As much as he was learning new skills, he was still struggling. Intrusive thoughts of using kept returning. He was having strong cravings to return to his drug of choice, heroin. Sometimes in group, he would stare out the window, daydreaming about the good feelings he had when he was high. Conveniently forgetting all the consequences and suffering that brought him to treatment. He was encouraged to talk about it and not “stay stuck in his head.” And he did. But the feelings didn’t always go away. That is how insidious this disease is.
But through his struggles, Matt was never alone. He was joined in treatment by about 20 other addicts and alcoholics with whom he became close. Most of them were from other states as well. Their families also hoped a change of venue would be the key to continued sobriety. Matt and his new peers came together to help each other through cravings, homesickness, divorce, grief, and many other issues. They shared a common bond. They all knew, first hand, the pleasure and the pain of addiction and learned that the most powerful treatment for addiction was found in the strength of the union with other suffering addicts. Matt shared every day in group. He talked about his cravings and the irrational thought that “maybe he can drink again.” His peers and counselors would remind him “one is too many and a thousand is never enough.”
Besides his peers, Matt always was under the watchful eye of staff. Behavioral Health Technicians (BHT) were there around the clock, trained to look for any changes in the client’s mood, appearance, or behaviors. They, too, were happy to lend a kind ear and help Matt to understand that there are solutions and a way out of the life he had been leading.
Progress And New Challenges
After a few weeks of his treatment, it was determined that he was ready for a lower level of care. The clinical team agreed and he was moved to the Partial Hospitalization Program. This meant that Matt was able to go out to AA and NA meetings daily with his peers. He had to attend five hours of treatment per weekday. The program included “community housing” which meant he continued living with his peers and he continued to be supervised by BHT 24 hours per day.
This step down is a normal and required part of the recovery and treatment process. Now that Matt had more freedom and contact with the outside world, the random drug tests (urinalysis) several times a week kept him accountable to remain sober. He knew that most drugs are detectable in the urine for about three days., and since he was being tested randomly, he knew he had to remain sober, despite the continued cravings, and often obsession, to return to use.
Addiction Is A Family Disease
The next step in Matt’s recovery process was to involve his family more. Addiction is a family disease and it is imperative that the family understand how to be a part of the recovery. His father was encouraged to come to the three-day Family Program. This program invites family members to spend time together learning about the disease of addiction, and how to be supportive while not enabling their loved ones. The family learns about spirituality, the 12 steps, codependency, communication skills, relapse prevention, and how to protect their own sanity while loving someone with an addiction. Each afternoon, Matt joined his father for intensive family therapy. Matt’s dad was of vital importance to Matt’s recovery.
Matt had a girlfriend when he came into treatment. He was hoping that when he discharged from the treatment he would go live with her. His girlfriend couldn’t attend the family program due to a work commitment but she did come down for two sessions with the therapist and Matt. During these sessions, she was able to express her concerns about how his addiction had affected her life. She was able to admit that she enabled him and she told him she wasn’t sure she could continue to be a part of his “chaos.” One month later, she ended the relationship.
This was a bit of a setback for Matt and he responded by restricting his food intake to lose weight. Then he began showing interest in female peers. The staff stepped in and began to redirect his irrational behavior. He was confronted about looking outside of himself for something to make him feel better instead of focusing on his recovery.
On one hand, Matt wanted the distraction and numbness that drugs and girls offered. On the other hand, he wanted to change his life. He was willing to follow the suggestions. With urging from his counselor and other staff members, Matt found a sponsor about two months into treatment. His sponsor was an alumnus of The Palm Beach Institute. He had come in to speak to the clients at one of Alumni meetings that Matt attended.
Matt felt a connection to this speaker and asked him to be his sponsor. To help him find the solution. Matt started calling his sponsor daily and meeting with him weekly during his Sunday visitation. Things were starting to look better for Matt.
But those pesky cravings were occasionally rearing their ugly head and a part of Matt thought, “maybe I can just drink beer again”. The battle for recovery was waging war in his brain. He wanted sobriety, but he also wanted an escape. So, Matt was taking one day at a time, sometimes one moment or second at a time.
Then it started to get easier. Each day the cravings were less and less and his motivation to recover was growing. Matt had decided that it would not be a good idea to go back to live with his family. He realized that there were too many triggers and using friends there for him to be able to continue his progress. He knew that he needed to stay where he is and keep working on himself. He knew that if he went to Westchester, he would only have a few AA meetings every day available to him. He knew that if he stayed in South Florida, he would have a few AA meetings every hour available to him. This is the place where he can find sober support and recovery. He decided he can always return to New York, but for now, he needs to stay in “the recovery capital” so that he has an all access, 24/7, pass to recovery.
Matt’s legal issues were still looming. The courts delayed his hearing, but the day came that Matt needed to make that trip to New York. For the first time in more than two months, Matt had to get on an airplane by himself and make the journey home. Matt’s therapist coached his father on setting strong boundaries for Matt’s return. The case manager helped his father make sure the trip was as short as possible. In and out in less than 48 hours. Matt was nervous. He wasn’t sure he could trust himself. But Matt was determined. He had come so far and he wasn’t going to let all of the people who had helped him down.
On June 28, he boarded the plane and made the trip home, drug and alcohol-free. The judge saw his commitment and determination for recovery. Matt had 90 days of treatment working in his favor. The judge dropped the possession charges and gave Matt permission to return to The Palm Beach Institute to continue his recovery work.
Intensive Outpatient Treatment
Next, he would step down to the next level of care: intensive outpatient. At this level, Matt would attend treatment three times a week for three-hour groups. He could process the issues that arise as he goes back to work, or school. He would continue to have the accountability of drug testing and the support of counseling.
They say “it takes a village to raise a child.” It also “takes a village to save an addict”. Matt had so many people help him get to the court hearing sober. Nurses, doctors, case managers, therapists, the executive director, the clinical director, his attorney, his family, his sponsor, and his peers, all played an important role in making it possible.
On June 30, as the wheels of the plane touched back down in Palm Beach, Matt realized that he was safely back in the South Florida, the place that changed the course of his life and gave him the promise of a future.
Matt’s story isn’t over. He’s still in treatment, and, beyond that, recovery never really ends. Cravings and irrational thoughts may continue to creep into his mind. However, the hope for Matt, and for all those in recovery, is that they will continue to learn and grow so he can master those cravings. Matt’s story will be continued as it continues to unfold.
Are You Or Your Loved One Seeking Addiction Treatment?
The facilities at Delphi Behavioral Health Group offer various treatment, detox, and residential programs in California and South Florida. Our professionals are ready to handle any medical and behavioral challenges linked to addiction, and we strive to provide our clients with the tools they need to begin their life in recovery. Click here to learn more about our programs and treatment centers.