En route to breakfast each morning, patients stop into the rehab facilities’ little medical command center known as the nursing station. Rehab nurses are their own breed. They defy your schema of a typical detail oriented, well adjusted hospital nurse. A couple of them here have packs of Marlboro Lights peeking over the edges of their scrubs’ pockets. A couple have tattoos, and a couple of them don’t seem to mind when the male patients flirt with them, even though a place like this represents a gene pool only slightly better than prison. Men wait in a row of chairs as one of the nurses goes by with an automatic blood pressure cuff, making a note of their vitals with a ballpoint pen on a yellow legal pad.
“One-fifteen over seventy-five and pulse fifty-nine — that’s good,” the nurse tells me. I get up and try to sneak out of the room before the other nurse has a chance to give me the standard issue super-B complex vitamin — a yellow pill that smells like dog food and looks like a drug an equine vet might give to a horse. With half a foot out the door, I’ve almost escaped the dreaded horse pill. “Kirk! Where are you going?” “To breakfast,” I say, trying to pretend I don’t know the routine. She hands me a thimble-size paper cup and a dixie cup of cold water. Drawing on respiratory skills from my days as a swimmer and saxophonist, I inhale, take in the water, and slowly exhale through my nose as I slip the disgusting yellow submarine through my lips and swiftly swallow it. The only enjoyment anyone gets from it is seeing their urine turn neon-green a couple hours later. But in all seriousness, the pill is a common prophylaxis for the potential neurological complications of alcoholism, which may include Wernicke–Korsakoff syndrome and peripheral neuropathy. “It’s good for your brain,” the nurses tell the patients when they protest.
The medication room occasionally becomes a hostile place when new patients find out that the staff psychiatrist has suspended the myriad of controlled substances they turn in when they arrive. They get angry as their Vicodin, Ambien, Lorazepam, or Adderall wears off. “My doctor at home prescribed that!,” they protest. “You can’t take that from me.”
Thus they have begun the all so predictable first step in recovery — they face anger and resentment at the institution revoking their addictive drugs, the things that landed them here in the first place. The medication room is a minefield for the pill addicts, because unlike a person whose brain prefers alcohols, their “good stuff” is just a turn of a key away. And some patients do get to keep taking the good stuff. When the ones who don’t get to keep their meds hear that out of the context of their overall medical situation, they get even more upset. As is typical with addicted persons, they jump to the conclusion that either the doctor doesn’t know what he’s talking about, or is flat out trying to spite them. This paranoia that “the man” is out to get them is an insidious denial mechanism that is both obvious and perplexing to the outside observer.
This is often a multi-year process that brings with it layers upon layers of revelations and insight and confounds friends and loved ones. “Why don’t they just stop?” the loved ones ask. As I look back on the past few years, I can remember exactly when I was at the asking-for-a-quick-fix stage of denial. In 2008, I was already making homemade vodka pasta sauce — without boiling off the alcohol. Around the same time, a psychiatric nurse practitioner informed me that 500 mL of vodka a day, 7 days a week was “kind of a lot.” She suggested I set up a meeting with a chemical dependency counselor, otherwise known as a “CD Consult.” I was mortified at the idea. Surely I could do something about it myself, and keep it quiet. But things must happen for a reason. If it weren’t for my alcohol-induced idea to earn a degree in medical journalism, the values and courage to write about this publicly never would have been instilled in me.
So when the psychiatrist today asked me what I feel should be the role of medication in my treatment, I scored major brownie points by knowing the right answer: I see a gradually reduced need for them as I continue to improve my social and coping skills. In the meantime, you get to keep reading about my nutty adventures, and hopefully glean some gratitude for having a much less complicated life.
Editor’s Note: The following post was handwritten by Kirk Klocke at Keystone Treatment Center in Canton, S.D. and transcribed, edited, and published by Cassie Rodenberg, an independent journalist in New York City who covers addiction, poverty, and other dark things happening in rough urban neighborhoods. Ms. Rodenberg publishes “The White Noise,” a Scientific American blog that focuses on the scientific, medical and social implications of addiction. Follow her: @cassierodenberg