Here is my story of being hospitalized for a drinking problem
Dear Dr. Peele,
In February, I drank too much vodka — about one pint — and blacked out. In the black out I wandered out to the living room and said something to my husband and son about the clonazepam being gone. I have had a prescription for clonazepam for about five years, and never take as much as is prescribed — it's more a safety net for panic attacks. They looked, and found the empty bottle, which should have had about twenty tablets left. They assumed I had taken it and took me to the emergency room. I don't remember this, but the ER doctor apparently asked me why I had taken the meds, and I am reported to have told him that I just wanted to go to sleep, and described some of the stressors in my life. He "decided" I had tried to commit suicide and slapped a do not release order on me.
My blood work came back saying I had a 0.137 BAC, and there was no trace of anything else. I may have flushed the pills down the toilet, I have no idea, but I certainly did not take them. The first thing I was aware of was being in the CCU, being questioned by a psychiatrist I had never met. She decreed that if I did not sign myself into "treatment" she would get a court order to put me there. She described a facility about one hundred miles away, in north Texas: Red River Hospital in Wichita Falls. She said that they would use a dual approach with me to treat my depression as well as my alcohol abuse. She said I would be there a week to ten days. I was assured my insurance would cover this. I did not want to become involved with the court system, and my husband and personal physician seemed to want me to go to treatment, so I signed myself in.
I was taken there in a hospital vehicle — was not allowed to ride with my husband, who followed in our car. When I arrived at this lock down facility, forms were filled out and I was taken to my "floor." There, I was strip searched, told I could not keep any of my reading material, and given extremely poorly printed facility literature. This place was, of course, 12-step oriented. When I asked the nurse (I assume she was a nurse; no one wore any ID telling you what they were) how long I would be there, she said something to the effect that it depended on what my insurance would bear. I stayed there a week, and it was only through my persistence that I was able to leave then; they, of course, said I was doomed if I didn't stay the 28 days my insurance covered.
While I was there I had virtually no one-on-one counseling of any kind. I saw a psychiatrist three times: once for an intake type interview that lasted about thirty minutes, and twice for brief meetings that covered nothing of importance. I saw a woman who was working on her LPC licensure three times. The first time was to complete paperwork. The second time was when my husband, son, and granddaughter came to visit. The third time was just before I left, to go over "work" I had turned in (12-step stuff). I also saw the program director, when he tried to talk me out of leaving after one week. The group sessions I attended were usually late in starting because of all the time spent on smoking breaks. Some were cancelled. I was billed for all of them. The facility was overcrowded to the point that they ran out of pillows, blanket, and beds.
When I left, I filled out the paperwork to get my medical records, and the psychiatrist who had "treated" me signed to release the records. But the facility refused. My personal physician has requested them, also; so far, nothing has arrived.
This facility charged $750 per day.
Needless to say, I do have problems with alcohol abuse. But the 12 steps are not the answer for me. I am currently moderating successfully, with lots of abstinent days. If I go off the rails again, I will try abstinence. Either way, I have the support of my doctor, my therapist, and my family. I get a lot of support, insight, and strength from the MM list serve, and also from the affirmations of the Women for Sobriety website.
Until we deal with issues of informed consent, patient choice, individualized treatment, second opinions, and other issues that are standard in genuine medical treatment, we will never professionalize substance abuse treatment.