Can we ever get a handle on the opiate crisis and other forms of addiction as long as the doctors continue to believe that treatment means medication? I hear one too many psychiatrists say things like, “They’ve never had treatment” when what they mean is: The patient has never been on antidepressants or psychiatric medications. Therein lies a large missing piece of the puzzle and helps explain the reason why millions of people who may need recovery never find recovery because the medical community fails time and again to point people in the right direction. If doctors don’t understand addiction, how can they help you?
The answer is they can’t help, and most times, they don’t. Alcoholism and drug addiction can show up in anyone. In Raising The Bottom, I wrote about doctors such as Caro, a surgeon, who when she got home from work found herself pouring wine, yet again. She decided then and there she had a problem and went back to the hospital to tell her partners that she wanted to get help for her drinking problem. “I knew I had a problem for two or three years before I addressed the problem,” Caro said. “I didn’t have a last drunk. I worked as chief of surgery. My colleagues often talked about the hospital sponsored wellness program for employees. I started to pay attention. Perhaps the wellness program was an option for me. The final day came. I had several surgeries that day. I came home, had a glass of wine, made dinner, and went back to the hospital. I was done living the lie. I wanted to come clean. I talked to the VP of staff and told him I had a drinking problem. He and another physician first asked if I was overreacting. Then they asked if I thought I was an alcoholic. I said, “I know I am.” They looked incredulous, like it couldn’t be true!
Those surgeons’ reactions showed a stunning, yet predictable mindset—alcoholism is for other people, but not us. Their reaction made it clear to Caro, that alcoholism is not supposed to happen within their ranks—but there’s more; when emergency room physician Fiona, who had been practicing for over twenty-five years at the time admitted that even though she dealt with alcoholics coming into the ER, she really didn’t know a thing about addiction: “As a physician, you would think I’d know a little something about alcoholism, but the truth is, I knew nothing about the disease. I was oblivious to alcoholism, so much so that when the time came to pick a specialty, I jumped on emergency medicine. Not because I wanted to save all these lives, but because I felt that working in the ER would allow me the most freedom to drink. Yet, at this point, I wasn’t a daily drinker, but already alcohol was calling the shots. I was on top of it though. Every six months, I checked on my liver enzymes. Normal people do that, right? I guess I started to realize that the three bottles of wine a night that I drank could do some harm. My enzymes were always normal. I figured that meant I was a superior drinker! I was meant to drink all that wine.”
Those are just parts of the stories from the doctors that agreed to share their stories so that I could share them with you, and the world, in Raising the Bottom. These doctors came to understand that addiction has no demographics, but only after it happened to them. Most doctors practicing in the world today have a scant clue about alcoholism or addiction, yet, they prescribe medication as if they know exactly what they’re doing.
Another physician I spoke with, Dr. James, had had twenty years of sobriety until he quit treating his disease and relapsed. “I relapsed after twenty years of sobriety because “I quit being honest about how fucked-up my life was.” He went on to say that “There I was, doing all sorts of noble things. I was the primary caregiver for my wife, I was chief of staff.” And just like that after two decades of sobriety, he forgot where he came from and he forgot that he was an alcoholic and an addict. He also forgot what most of us in recovery have come to understand—that titles and good intentions mean nothing, and that dishonesty is the kiss of death to sobriety.
I was grateful that he was willing to be vulnerable, and truthful—the disease of addiction does not discriminate.
The doctors I talked with are all in recovery and all still practice. I can tell you that in twenty-five years as working as a nurse I can count on one hand the number of physicians I’ve encountered who seemed to have a grasp on what addiction is and how to treat the disease. The rest—incompetent at best, yet, people continue to flock to hospitals and their doctors to seek help with their anxiety, depression and addiction issues. I believe people would be much better off if they sought out recovering friends to connect them to rehabs or professionals who understand addiction, and that anxiety is often the result of untreated addiction: is there an active addict or alcoholic out there who doesn’t try to control the uncontrollable? When someone is serious about reaching out for help, it’s imperative that they get connected with the right kind of help.
Most doctors will never admit how uninformed they are when it comes to the disease of addiction.
What’s even more disturbing about healthcare workers is that many nurses, therapists, respiratory therapists, x-ray technicians, housekeepers—name a position—there’s not a discipline in the hospital that doesn’t have at least a few workers in need of substance abuse help of their own. The reality is that the hospital is full of people who need rehab, but most hospitals refuse to acknowledge the ubiquitous problem within their own ranks. The only times I’ve ever seen it addressed was, indirectly, when someone was caught diverting drugs or got canned for poor attendance.
I can talk to any nurse friend or any doctor on any given day, and all the staff knows that when it comes to addiction, healthcare as a whole, is a joke. We all know that the modality of treatment for addicts most times is inadequate; the overprescribing is ineffective and often causes more harm than good, but the beat goes on; nothing is done to correct the problems that everyone knows are there. What happens instead is that the staff all send up collective shrugs and sighs, and accept defeat. “Oh well,” they say. “That’s the way it is. There’s nothing we can do about it.”
I talked to a nurse friend the other day who rounds in a large the hospital to assess patients who were brought into the hospital, for perhaps an overdose (OD) or some other drug or alcohol-related admission. She said, “We have patients that overdose in the ICU!” Yes, family members and drug dealers bring the drugs to the hospital during visiting hours. Patients on medical units, telemetry units, and psych units have OD’d while in the hospital.
Visitors passing patients illegal drugs is nothing new, it’s just that it used to be joints or pills of some sort, now it’s heroin and the lethality has skyrocketed due to the fentanyl.
It’s a jungle out there, but the hospital administration continues to bury their heads in the sand and refuse to talk openly about the problems. As Dr. James further pointed out: “The attitudes of doctors toward addicts has changed marginally. Nothing is taught in medical school. Money pours into treating the symptoms. Instead, we need the money to be put into treating the addiction.”
People need to know the truth. It’s like when you’re on an airplane and the flight attendant instructs, “Put your own oxygen mask on first.” How can our healthcare system help people if they can’t or won’t acknowledge they have problems within their own ranks that they need to deal with first?
Do your homework. Ask your doctor questions and see what they believe about addiction. If their first response is, “Well, I could write you a prescription for X, and you can try that and see how you feel,” Run, don’t walk out the door—run. The desire to get sober waxes and wanes. When someone is teetering between the should I or shouldn’t I’s, it’s helpful to have a decisive doctor who can steer you in the right direction. After all, your life depends on it and you never know when that last drunk can be the end of your life or someone else’s life.
Lisa is the author of the multi-award winning book, Raising the Bottom: Mindful Choices in a Drinking Culture. After short stints where she trained polo horses, worked as a flight attendant, hairdresser, and bartender, she revamped her life and settled in as a registered nurse. For the past twenty-nine years has worked with hundreds of women to overcome alcoholism, live better lives and become better parents. She was prompted to write Raising the Bottom when she realized after twenty plus years of working in hospitals, that doctors and traditional healthcare offer few solutions to women with addiction issues. You can start reading for free on Amazon. Follow her on Twitter @LBoucherAuthor and Instagram