I hear the rain’s footsteps on the roof.
Every few minutes our living room couch’s wooden frame that opens up to a futon creaks under his weight. The sound of my husband tossing and turning. Thursday he said yes to rehab, Friday he slept, ate cereal, and walked the dog, and today he detoxes. So here I am again searching and researching rehabs. It is different this time, I think. Because he actually agreed to rehab. In the past it was always “yes” to outpatient, “yes” to therapy, “yes” to meetings, and a firm “HELL NO” to rehab. He never really gave any of those other programs a shot. Actually, no, I don’t think it was that much of a choice. It’s that he really never was ready to give them a chance, because he never really stopped using. His using brain, with it’s biological defects, never let him be open to the recovery process in meetings, therapy, etc..
A few months ago he willingly went into an inpatient dual diagnosis unit.
Before he went in he said to me: “I am waving my white flag”. That was after I found a bag of heroin in the car. Just sitting there nonchalantly on the floor below the steering wheel, I had never seen heroin in real life before. HOLY SHIT HE’S USING HEROIN. As if that is any better than oxy…boy am I brainwashed. But I digress, so he went into the psych unit for 5 days. He detoxed, got 1:1 therapy, and went to every group they offered. It was STRUCTURED. What I mean is, there was no opportunity for relapse, no dealer on the street corner, no stress from work, no cash in his hands, no wife, and he was operating with a sober brain. When they released him, the nurses and social workers told me how he had taken advantage of every therapeutic opportunity, they had high hopes for him, he showed so much promise. I told them I didn’t think he was ready for release into the community. I told them he has been battling this for 12+ years with a few years of sobriety. I almost pleaded: he needs therapy to address the trauma, he needs more clean time, he needs coping skills, he needs a firm diagnosis and appropriate meds, he needs relapse prevention. He needs the STRUCTURE of a rehab. But instead they released him with a referral to IOP (Intensive Outpatient Program) and a naltrexone script. They are the medical professionals, I thought feeling hopeful and skeptical…yeah never again.
So back to the rehab search (big sigh).
A couple of things, I am in a state where the opioid epidemic crisis in one of the worst, we are ranked #5 in the overall highest heroin fatalities in the nation. The death toll keeps rising, now with overdoses linked to this Fentanyl-laced killer product that is circulating. People are dropping in staggering numbers; in stores, parking lots, walking into clinics to seek help. Remember the video that just emerged on the news of the mother overdosing in Family Dollar, her toddler attempting to wake her? Yeah we are not far from there. So any-hoo, what I am saying is there is a lot of competition for resources in my tiny state. What I CAN FIND for my husband right now: 3-5 days detox/medical stabilization (oftentimes with suboxone, which was a massive roller coaster, see-sawing failure for him in the past), outpatient treatment (but he needs STRUCTURE and CLEAN TIME OFF THE STREET), a sober halfway house (he is not homeless), places that only take MassHealth (we have a PPO-and those places it turns out, have wait lists anyway), very expensive self-pay options (I freakin’ wish). What he needs is a long term intensive inpatient rehabilitation facility that takes our private BCBS-MA PPO insurance plan. This does limit my options. So far this is what I have got:
- One place in Connecticut: They can check benefits Monday morning since I am BCBS of Massachusetts. They will give me a call then. They have a bed open. They will need to do a phone screen/interview with him to make sure he is a good clinical fit. Until Monday…
- One place in Massachusetts: I need to fax a self referral packet (which I completed to the best of my ability). They will need to do a thorough phone interview with him in order to make sure he meets criteria for the program (um, yes he has a drug problem and PTSD, and depression, but okay). They have a wait list, they will put us on it after they receive the referral packet, check benefits, and do the phone interview. No one from admissions is there until Monday. Oh and, try to keep him from using before he comes in, the woman told me. Um, okay I’ll do my best…
- Another place in Massachusetts: they need to do a phone intake with him, make sure he is a fit. If he is admitted to the 30 day program, he has to make a commitment to complete it (“of course!” I told the woman on the phone). They can’t guarantee that our insurance will cover the entire 30 days, which means I will need to give them a credit card for secondary self payment options if need be. Um…okay let me think, which credit card is not maxed out, and how much is that per day? The amount took my breath away. Okay, okay, that is another option…
- A facility in New Hampshire: No beds available right now, but that changes daily. I should call and check every day. Same as Connecticut, they can check benefits Monday morning since I am BCBS of Massachusetts. They will give me a call then. They will need to do a phone screen with him to make sure he is a good clinical fit. Hopefully he passes. Until Monday…
So that’s it. Did I mention I have to go to work on Monday?
Now here is what is going through my head: where are the places that the people on Intervention get whisked away to?? They don’t seem to be doing any phone interviews or screening patient intakes. I mean we are in crisis right now, correct? And what about cost, insurance can just stop paying any time…my head is spinning. OR— I could take him to the ER now, get him admitted to inpatient where he can’t use, then hope they don’t release him with a referral to IOP. Oh and I need to get him off the couch. At least I know he is safe RIGHT NOW.
The truth is I feel like a failure.
I mean I have accomplished a lot in my life, so why can’t I do this? Maybe I am not searching correctly, maybe I am not saying the right things on the phone, maybe I am not trying hard enough to access resources, I am not finding the right resources. And then there’s this: why do I blame myself? One of my issues in codependency is that I have never believed I deserved much. But that is not true, I deserve better, my husband deserves better, we all deserve better from the healthcare system. I pay taxes, work my ass off, and pay for (part of) my health insurance. I am a human of worth. We are just people, prone to human error, imperfect, yes we deserve more. Okay up next is the part where I blame my husband, the addict, the junkie. He should be doing the work, making an effort, being proactive in his recovery. This, though, feels innately wrong. I am not saying he is completely powerless. I am not saying he doesn’t have a choice. But if wanting to get sober was enough for him, just making the choice to, well he would have done it already. Blaming, jailing, labeling, stigmatizing, and punishing the addict are the defective policies that exacerbate, rather than alleviate, the issues of our drug crisis. So I am left with this: could it be that it is a systemic problem? A system that puts up barriers, that cares more about profit than care, that imprisons instead of rehabilitates. A system that makes it difficult to get medical treatment for addiction. On a personal level, I am digging deep, really deep, to find strength in a time of turmoil, find stamina amidst the exhaustion, when part of me just wants to hide, to rest, to run, to even stay in this downward cycle (because sometimes it feels easier than getting him into rehab). And then there’s my husband—well—I mean the addiction part is hard enough, the deciding to get help, the surrender to assistance, the detox, the therapy, and later the recovery. Isn’t that enough work? Yes I am convinced we deserve better, getting into a treatment facility should be the easy part because the rest of it is hard enough. A quote comes to me from Johann Hari’s book ‘Chasing the Scream: The First and Last Days of the War on Drugs’, reminding me of how broken our system is:
“The opposite of addiction isn’t sobriety. It’s connection. It’s all I can offer. It’s all that will help in the end. If you are alone, you cannot escape addiction. If you are loved, you have a chance. For a hundred years we have been singing war songs about addicts. All along, we should have been singing love songs to them.”
That’s right I am giving my husband a chance. I am not giving up without a fight. A very loving fight.