Twelve Step 101: Part One

Posted by: HSP Woman on: April 13, 2007

• In: anxiety | benzodiazepine withdrawal | depression | detox | Effexor | Klonopin | mental health | Phenobarbital | rehab | Xanax
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Literally, within hours of my psychiatrist appointment (and unbeknownst to him), I was voluntarily standing in front of a very stoic nurse as she dumped my purse contents on top of the table. Welcome to detox! She immediately confiscated my cell phone so I wouldn’t be tempted to call my dealer.

“I don’t have a dealer,” I half-heartedly told her squinting through swollen, red eyes.

Note to self: Wait! Is my psychiatrist, then, my dealer?

“I still need to take it” she replied incredulously as she fished out my cute, miniature Swiss Army knife from the rubble on the table. I immediately peeked at her clipboard and saw she had recorded “six blade weapon.”

You’re kidding? A weapon? This was 1999. A weapon back then was obvious, or so I thought, unlike now when bottles of breast milk are considered potentially dangerous. So how could a little one-inch Swiss Army knife, you know with the little plastic toothpick? How could this be considered a weapon? I was speechless.

Maybe I was really an addict? And, a dangerous one at that.

After stripping me of most of my few personal effects (she left with me a little photo of my kitties, thank God), she sent me off to the next interrogator nurse.

Nurse #2 handed me a little paper cup of multi-colored pills.

“Take these.”
“What are they for?” I said as I closed my eyes and concentrated so I could remember to look them up later.
Still no answer.
“What are the names of these meds?” I asked her sincerely.
“Honey, there’s no need to know the names.” She said with complete condescension, patting me on the head like an ignorant and not-so-innocent puppy.

Finally, she took my vitals, drew some blood, and snapped a very unflattering Polaroid of me pressed up against the wall. I started obsessing about this photo. I just knew it’d end up on the internet if I ever became famous or ran for President. Nick Nolte, anyone?

News from the Lab: I wasn’t feeling well. I had started to get light-headed and woozy. So when yet another staff person approached me soon after I arrived, I was nearly floored (literally) by her accusation. She was interested to know why I had conveniently forgotten to mention I was an abuser of barbiturates. First, what are barbiturates? Second, I told them everything I had ever taken. Everything. Why? I felt I had to sell myself, you know, make my case for being there. This particular Chemical Dependency Center wasn’t keen on admitting “psych patients.” Because of my diagnoses (panic attacks and depression) they hesitated. They preferred hard-core addicts, I guess. The more drama the better, I found. And, initially at least, I wasn’t an addict, but rather only “dependent.” How could she not know I would confess if I was taking yet another med? My case for admittance would have been that much stronger.

Then she hits me with another bombshell: I tested negative for benzodiazepines.

Huh??

Now, for sure I’d be sent home, deemed “Not Addict Enough.” Or worse, I’d be sent to the 5th Floor. I hadn’t been there two hours, and already I kept hearing whispered rumors about so-and-so who had been sent to the 5th Floor. I soon found out that was the Psych Ward. No. Never. Not on your life! If I had (have) one worst-case scenario, it’s being locked up and forgotten about in a mental hospital. I’ve never seen a real psychiatric care facility, so my imagination sees one like in the movies — the bad movie-of-the-week movies.

Billowing white curtains, windows ajar, bars across the opening. A rocking chair with me in it. Rocking ceaselessly. Rocking back and forth, alone, white hair, glazed, unblinking eyes …

The Verdict: Even before my mental horror show could fade away, I was told I “qualified” for being there (translation: my insurance authorized treatment). Never mind my blood levels of benzos weren’t detectable. This still surprises me. I was taking the equivalent of about 120 mg of Valium each day. This is a pretty large amount of benzodiazepine to not show up in a blood test. Very strange. Maybe the nurse was right? Maybe the lab made a mistake. But, instead of repeating the test, they showed me to my room.

Oh, wait! Remember those little pretty-colored pills they gave me soon after arrival? Guess what? One of those pills was phenobarbital — a barbiturate. Not so amazing anymore that I tested positive for barbiturate use, no? Many detox centers use phenobarbital as a drug to help lessen the blow of CT (cold turkey) benzodiazepine withdrawal. Today, many countries have banned the practice of administering phenobarbital during detox. Take a look at what Dr. Ashton says about it:

Q: My doctor has asked me to switch to a drug called “PHENOBARBITAL” for detoxification. Is this a good idea?
A: No. Although this method of “detoxification” is commonly practised in the USA, it has long been abandoned in the UK and is even regarded by some authorities as barbaric. It is best avoided.

First mistake: I should have run at this first major sign of incompetence. But, I stayed. I wanted to stop taking these prescription meds immediately, and “now” wasn’t soon enough.

What was I thinking? I wasn’t, I guess: Second mistake: Silly me had quit smoking two days before rehab. In all the rush to get checked in ASAP, I had no clothes, toiletries, or nicotine patches. Big mistake. I wrongly assumed, being a hospital supposedly all about health, that this place would have nicotine patches readily available. I even thought I’d get a gold-star for having quit. Ha! I told numerous nurses I needed some help, and they all promised to get me patches “right now.” Unfortunately, as I waited for hours for “right now,” I became transfixed on the other patients (for lack of a better word) who were outside on the little square patio smoking like the world would end before they could finish. You know, totally hot-boxing their ciggies. Finally, I caved. I bummed a cigarette off another woman, promising her I would give her 5 in return. I lit it and sunk down in the plastic patio chair for support. This isn’t so bad, I thought. Actually, the phenobarb and whatever else they gave me had made me a little too relaxed. I even felt kind of high, like life wasn’t so bad after all. It was easy.

Third mistake: Thinking even for a moment that it’d be easy.

The First Night: I’ve never been so sick in my life. I had taken my little meds-in-a cup like a good patient. I was a good patient like I was a good student, a good daughter, a good citizen, a good everything. Being good was one of my highest priorities. I expended most of my food energy on trying to be “good” — no questions, no assertiveness, no conflict. Just good. However, taking those meds without a single question ended up being very “not good.” I conked out within minutes after taking my night meds, not even concerned for the moment about the uncomfortableness of the narrow hospital bed. I felt like I was having those “fever dreams,” but that I was still awake. I felt paralyzed, helpless, but not sure if I even cared. Then, a few hours later, I was startled by two nurses literally drawing my blood as I was flat on my back, half-conscious.

Suddenly I felt nauseated. It crescendoed as the simultaneous urge to lose my bowels overcame me. The two nurses managed to help me to the toilet, although I don’t remember getting there. But, once there I was having the most terrible bout of IBS at the same time I was vomiting all over the little square-tiled floor. I wanted to get up and get some towels. I felt bad for making a mess. I was humiliated for having experienced such loss of control in front of two complete strangers. But, getting off the toilet would be impossible if the room continued spinning like that. I must have fainted or blacked-out. In fact, I think I lost consciousness more than once while being propped up there on the toilet.

As soon as I had just finished the last dry heave and final spray of diarrhea, one of the nurses reassured me, “Don’t worry. This happens to most everyone when they first get here.” Okay, I thought, then I do belong here. “This is what happens when people who are addicted to drugs get clean,” she continued. Hmm…

Flunking Twelve-Step 101:

“Addicted”? “Get clean”? Later, I realized I had never thought of my problem in terms being an addict. I was prescribed these meds by medical doctors. I wasn’t getting them illegally, popping them in dark alleys. More importantly, I wasn’t taking more than prescribed. This was, in hindsight, my fourth mistake: I had wanted to end my dependence on psychotropic medications so badly that I allowed myself to be brainwashed by the Detox staff. I started to believe the rhetoric they shoved in my face: I was an addict, nothing more, and I was powerless over the drug.

I know this approach works for many people in recovery, but, personally, it wasn’t for me. I failed twelve-step 101. I resisted it with all my heart, while at the same time, trying desperately to embrace it. But, I just couldn’t get past the first step if I was being honest with myself. It didn’t resonate with me, although I played the game. Maybe I was wrong, I thought. Maybe this approach would be the key to me getting off the meds, ending my panic, and to never being depressed again. Despite my inner conflict, the foundation had been laid for a very challenging and painful seven more days.

Day Two: Fifth mistake: I saw the resident doctor the next morning. I have no memory of this meeting except for one thing. He asked me if I wanted to quit my antidepressant, too. That I might as well as I am here to get clean.

There’s that “get clean” expression again.

I thought, why not? So that was the first day I went cold turkey off Effexor, making my grand total of meds quit THREE: Xanax, Klonopin, and Effexor. Well, make that FOUR. I had yet another rude awakening that morning when I went for some coffee. NO caffeinated coffee or drinks allowed. To go from four or five Starbucks lattes a day to NONE? You can imagine why I started panicking… It just added insult to injury, as they say. Why hadn’t anyone warned me?

Smoking Break:

I had some time before the one of the countless mandatory meetings, so I moved ever so slowly to the front nurses’ station. Once there, I had to ask (nicely) for my allotment of smokes (two) and my lighter. How damn insulting, having to ask for my two cigarettes like I was a little child? My husband had brought me a couple of packs with some clothes the night before. He didn’t protest too much about me starting to smoke again. But, I know it was hard for him to bring them as he hated seeing me slowly killing myself by smoking. I’m grateful he did. I had already discovered cigarettes were great bartering tools, but they also gave me some twisted sense of comfort during the storm that was going on in my brain slowing rendering my body weak and useless.

This time, however, the word “easy” never crossed my mind…