Friday, July 24, 2009

The Importance of Aftercare

I first met Maureen last fall. She was 19,bright and beautiful. She came in with her mother and they shared a warm rapport. Plenty of laughing, inside jokes and warmth.

Maureen, with her mom’s help, had managed to detox off heroin. She had heard about The Coleman Institute and wanted a naltrexone implant to assure her continued sobriety. We talked at length about follow up counseling and options. We discussed how the brain takes at least a year to heal and restore neurotransmitters to their normal functioning, which is why we are so convinced of the importance of a year of naltrexone therapy. They were a bit dismissive, but took the information.

Several months went by and we didn’t hear from Maureen….until last week.

I went into the exam room to start our new patient’s heroin detox. It was Maureen, but I barely recognized her. The first thing I noticed were her huge green eyes-once sparkling—now dull and bloodshot. Then I saw the scars on her arms and a huge poorly healing abscess at her antecubital vein. Her face was blotchy. She was pale and very thin. She looked 10 years older. What she had to do to get enough money for her heroin had left her in a state of self-loathing.

Her detox proceeded smoothly and she is back on naltrexone. She and her mother had several discussions with our aftercare coordinator about residential treatment, outpatient counseling and other resources. They listened, but who knows if they will follow through?

We know we can do an effective, gentle detox from opiates, benzos and alcohol. We also know it is just the tip of the iceberg. The rest of life must continue to unfold from this chance to start over fresh. Be assured if you come to The Coleman Institute you will be well coached in resources for follow up. I hate to say it, but I have my doubts about Maureen’s quality of life if she doesn’t embrace some kind of aftercare.

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