We expect that all health conditions be continuously evaluated by our health care providers. No responsible healer would ever assume that a chronic cardiac condition, diabetes or even asthma is in check. Monitoring and identifying change ensures healthy maintenance and constitutes best practice. In the case of alcohol and drug addiction however, this practice is conspicuously absent.
With regard to addiction treatment, we tend to provide only acute medical treatment for what we know to be a chronic condition. After abstinence is achieved, health professionals often mistakenly assume that it will continue. Anyone who understands addiction knows that recovery requires a lifetime of attention. Only amongst natural supports (AA, NA, families, friends and others) is this approach evident. Those who are paid to provide care are limited by managed care and by our own understanding, prejudices, and biases.
Certainly there are bench marks. We achieve periods of time in which our loved ones gain confidence and peace of mind. We know however that we must remain vigilant. The disease preys on complacency and wants us to believe that we are out of the woods.
Subtle changes in our health are tell tale signs for relapse and continued use. Changes in blood pressure, heart rate, and/or skin color should be seen as red flags in monitoring our health. If we did lasting damage to our organs while active, we expect that they will be monitored. Yet, as an addictions counselor, my experience is that physicians tend not inquire about ongoing sobriety?
A PCP who notes their patient has a significant period of sobriety might fear offending us. If this occurs, it would constitute an exception to the rule. It’s not as if it’s a topic we can separate from our holistic health. Most of us are both happy and proud to tell you we continue to maintain and grow in our recovery.
Psychiatrists and others who monitor psychiatric medication have an important role to play as well. Please ask about our history of addiction and check our medical records. Please weigh heavily the need to prescribe controlled substances and consider non addictive meds whenever possible. You may be dispensing our next addiction.
Please understand that our concerns regarding a host of mental health symptoms and conditions should bear scrutiny. As we progress in the first year of recovery, our presentation on any given day can meet any number of diagnoses. Please know that feelings and experiences of depression and anxiety are a natural byproduct of getting sober and dealing with life on life’s terms.
For those who treat we who are dually diagnosed. Please put our sobriety first. Except in the case of conditions that significantly undermine our stability and health, sobriety must take precedent! Our capacity to learn, remember, and integrate are always impaired as long as we continue to use.
For all health providers: Please educate yourselves and come to grips with powerlessness. One of the most difficult ways in which a person can feel ineffective is when they care for a person who remains active in addiction. Too often we cover such experiences with anger and develop prejudices.
Please familiarize yourself with resources within your local communities! It’s great that you recommend programs and groups. There is a world of difference, however between saying, “You might want to check out an AA meeting” as opposed to saying, “You know, Friday night at the Congregational church on Elm street, there are a pretty diverse group of folks in helping each other stay sober!”