Originally Posted by Cirque
If she was in a program under lock and key sooner, she would not have been in the car and trying to jump out.
Has anyone considered doing it the old fashioned way and just locking her in a padded room for as long as takes so she can get it out of her system? Yeah its painful, yeah it sucks, and sure there is always the temptation to go back to the drug later (but thats always there).. but perhaps the memory of the experience would make an impression. She would have to "work" through it instead of going to sleep and waking up after a "rapid detox".
Perhaps I am just not feeling very understanding today or I do not fully understand herion (more likely), but I have seen people lie and use others so I suppose that has jaded me some. For me it comes down to actions not just words and "intent". Oh well, I am still wishing all the best for her and you two for trying to take care of her.
The other problem is that especially with heroin addicts and alcoholics, forced detox almost never works, which is why no psychiatrist, therapist or social worker trained in addiction problems recommends it. The user has to be committed to quitting.
It's easy to look at the situation and think we've been soft or functioning as "enablers." I certainly thought less of Gary's mom when I judged her as being "an enabler" when she was in a similar situation with Gary's sister. On the other hand, being in the situation now, as a parent, and functioning on the advice of trained professionals, I see it quite differently. We certainly provide(d) the space for Naomi to use heroin, but the other choice was to say "stop using or get out" - and that was not the commitment we wanted to make. The whole point of having her move in with us (apart from the fact that we're adopting her and already feel about her and think of her as our daughter) was to help provide the resources for her to get clean (when she was ready, which she supposedly was, though we knew that may not have been the case), to provide a motivation to get clean (some kind of life, like college) which she'd never had before - and to have her be healthy and safe, so she wasn't sleeping on the streets of NYC, and so she wasn't in a situation where she could be raped and assaulted again. (Part of the problem with heroin is that when addicted, people are willing to put themselves in positions where they can get raped or assaulted). We had no idea if she was actually ready to quit using heroin or not, and it didn't really matter. Even if she never wanted to quit, she was welcome to live here in safety.
However, if we ever suspected she is/was dangerous to herself or others, we could have an ambulance take her to the hospital where she would be evaluated - but if she was determined to have psychiatric problems, then she would be committed by the State, and no one other than the hospital staff would have any say about what happens to her. She could then be committed for as long as they want her to be, which is what essentially has happened.
Naomi did not have a correct understanding of the program she just committed to. The counselor never called last night, but did call this morning. She did enter herself into the program, but it is a combined detox/rehab program, and because she showed up with heroin in her possession, despite the fact that she entered the program voluntarily, because she was just in court for a possession charge and the "sentence" was detox and community service, showing up at this detox with heroin in her possession she's in violation of the case dismissal agreement, and her leaving the program is no longer voluntary.
Fortunately this program does include psychiatric evaluation and treatment. She hasn't been diagnosed yet, but we've talked to her psychiatist out here, and she said from what we communicated that Naomi will likely be diagnosed as a paranoid schitzophrenic - we already knew about the manic depression. So the staff will determine if she leaves the detox program after five or seven days, and then she's moved into rehab for anywhere from 28 days to nine months, at their discretion. She's on 20mls of Methadone (at her level of heroin use, an equivalent dose of methadone would be 80mls), and that will be scaled down to 15 while in detox, then from 15 to 0 over 28 days in rehab. How long after that they'll keep her, we have no idea. But it could be anywhere up to another eight months.
There is no visiting during detox; there is visiting three times a week in rehab, though we don't know which facility they'll transfer her to for rehab yet.
So while we didn't force her into a padded room and lock the door, Naomi took the step herself. She knew she was committing to the detox and one month of rehab. She didn't know that because of the circumstances they'd be able to keep her up to nine months. But either way she's got a fighting chance now of staying clean after she gets out of the program. We'd discussed her probable need for an in-patient rehab program, which she's never been interested in before (I mean before us - and we looked for "known" facilities at the recommendation of friends and doctors, and of course they're full with waiting lists...). So it would appear that this psychological break she just experienced provided the final motivation she apparently needed.
Gary's on his way to the Bronx now, dropping off some clothes and books, as she didn't leave prepared to be gone for a month (or more). She called shortly after Gary left, and I talked with her for a while. She sounded pretty good, actually. Certainly much better than yesterday. More importantly, she's really happy with the decision she made, and she feels like it's really important she be in an in-patient program so that's she's with other people going through it, she can get the therapy she needs and work to get her dosage levels right (whether it's lithium or paxil or whatever) while in a monitored environment, and she can vent any range of emotions and not worry about how anybody's going to feel. I agreed with her 100%, and told her how proud I am of her for doing this on her own. Which I also think is important.