Thursday, May 20, 2010

Watching patients change at Williamsville Wellness

For the last three months I have had the pleasure of being the Medical Director at an inpatient rehab program called Williamsville Wellness. It is a fabulous program in a beautiful setting out in Hanover County. What has been the best experience for me has been seeing the changes that the patients make over the 4 weeks that they are there…

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Four weeks is such a short time of course, but the changes I have seen have usually been dramatic. Patients come in at a point in their lives that things are going horribly wrong. They are hurt and angry and usually very afraid. They are confused. They don’t really know what they need to change; they just know that things are not going well.

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They usually have a lot of denial. Often this takes the form of minimizing their problems and believing that their problems are really not too bad. The denial often shows up as blaming others or blaming the system. Frequently they are there because of pressure from others around them: family, friends or the court system. It is easy for people to see themselves as the victim instead of taking full responsibility for their problems.

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During the first week, the patients start to wake up and start the inevitable process of questioning their old beliefs to see if they really make sense and if those old beliefs really work well. The therapists at Williamsville Wellness are fantastic at helping patients with this process. There is some group therapy, but a large part of the program is individual therapy. Each of the therapists has a slightly different style, each of which complements the others. There is cognitive behavioral therapy, hypnosis, neuro-linguistic programming, experiential therapy, substance abuse therapy and family therapy. In addition, the patients get exercise therapy, art therapy and yoga. The staff also spends a lot of time helping the patients deal with the immediate wreckage of their past so they can relax and move on with their therapy. There is even a professional chef on site cooking gourmet meals, so their nutritional needs are well taken care of!

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Over the course of the four weeks, the patients start to move into acceptance. They start to really internalize the belief that they have this addiction problem and that it is their responsibility to deal with it. They come to understand that they are not alone and that there is a lot of help available. They start to also be able to identify what issues they will need to continue to work on after discharge. By the time they leave they have usually developed a comprehensive discharge plan and have committed to following it.

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It is wonderful for me to watch this growth unfolding in such a short time. The changes are dramatic, and I know that, if the patients continue on this path, the joy they will experience and the joy they will bring to those around them will be profound.

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Of course one of the truths of substance abuse recovery is that while these changes are powerful and very meaningful, they truly are only the first steps at the start of a long journey.

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Dr Peter Coleman

1 comment:

  1. It was so interesting that this was your topic. Earlier this week a friend forwarded this article. An incredible example of how people can perceive that their problem really isn't that bad. Thanks, Dr. C...

    May 20, 2010, 3:48 pm
    An Addiction Expert Reveals a Drug Habit
    By TARA PARKER-POPE

    In this week’s “A Piece of My Mind” column in The Journal of the American Medical Association, a specialist in addiction offers a riveting tale of his own tragic drug habit.

    Clinton B. McCracken of Baltimore is a biomedical scientist who built a career exploring the neuroscience of addiction. He writes that his experience serves as a cautionary tale for highly educated professionals, particularly health care workers, who may “intellectualize their drug use.” As he explains, their own intelligence and expertise about addiction leads them to overestimate their ability to stay in control of a drug habit.

    Dr. McCracken confesses to a daily, decade-long marijuana habit and three years of abusing opioids injected intravenously. But because of his extensive knowledge of addiction, he was able to convince himself that his drug use was not a risk. He continued to function at a high level at work and in his personal life.

    But then tragedy struck. His fiancée lost her life after injecting a contaminated drug, which resulted in a severe allergic reaction.

    While waiting for the paramedics to arrive I tried unsuccessfully to resuscitate her. Despite heroic efforts, neither the paramedics nor the emergency department physicians were able to revive her. As a consequence of her death, our house was searched by police, who then discovered the ongoing marijuana cultivation. I was immediately arrested, jailed, and charged with a number of felonies; then, in the space of a few days, my employment as a postdoctoral fellow was summarily terminated and I was evicted from my residence.

    In addition to losing the woman he loved, Dr. McCracken faced jail time and an uncertain future.

    Reputation is critical in my field, and mine is likely to be damaged for the foreseeable future….I have now been convicted of a felony, which will undoubtedly have a severely negative effect on any future job prospects and international travel. Finally, as a Canadian citizen, my ability to live in, work in, and even visit the United States, my home for the last ten years, is also compromised; I face imminent deportation with almost no hope of reentry in the future.

    The transition from my drug use having no apparent negative consequences, to both my personal and professional life being damaged possibly beyond repair, was so fast as to be instantaneous, highlighting the fact that when it comes to drug use, the perception of control is really nothing more than illusion.

    The essay, “Intellectualization of Drug Abuse,” is at The Journal of the American Medical Association Web site, although the full article requires a subscription.

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