5 Surprising Realities of Working in a Drug Rehab Program
The first step toward recovery is admitting you have a problem. But then you actually have to do something about it. That's theoretically what detoxification programs are for -- they're safe, clean, welcoming environments where people can escape whatever bullshit caused them to hit rock bottom, sober up, and start up a long-term recovery plan that works for them.
But programs need money to survive, and without it, you'd stand a better chance at recovery by binge-watching The Flintstones Kids -- Just Say No video until it's literally the only thing running through your brain. I know this because I spent two years working at a state-run detox that the state had completely given up on because there were other, more important things to spend its money on. It had already fallen apart by the time I got there, and it only got worse. It was so bad that spending years toiling in convenience stores actually became a better action plan for my life.
So what happens when a recovery program goes to Hell? Well ...
Only the Simple Bare Necessities Remain (and That Isn't Enough)
When your detox has no money and no way to get money, one of two things must happen: either the bosses take pay cuts to fund the thing, or the thing gets whittled away to virtually nothing. You'll never guess, in a hundred trillion years, which option my company chose.
Give up? So did the company. The few scraps of state funding that didn't go into management's pockets were allocated to keeping the detox program alive, but only in the strictest "persistent vegetative state" kind of way. The patients had hard beds that we probably only had because the local prison was overstocked, scratchy pajamas that at least guaranteed nobody tried to take them home, plastic chairs that made for only slightly better seating arrangements than the milk crates they replaced, and ... that's it. The rec room had a whiteboard. Our break room had white bread and peanut butter for the workers. And pens. Sometimes.
Choosy moms choose Jif. Choosy cheapwads choose store brand on clearance.
Forget about recovering and working on your future in a comfortable, supportive, well-lit, pleasant-smelling environment. Shit, forget about spending your recovery time somewhere with carpets, wallpaper, and more than one window. At best, the place looked like a barless medium-security prison. At its worst, it was one murderous clown shy of being Arkham Asylum.
At least that place had laughter.
This hardtack-and-tap-water approach took its toll on the workers as well, because as it turns out, we don't like depressing surroundings either. Nobody enjoyed their job or found any meaning in it, as evidenced by the one former user who abruptly quit to go back on the streets and use, the one old guy who openly admitted he did the job because it was easy and nobody expected him to do anything, and the one kid who suffered a nervous breakdown, took medical leave to recover, never returned, and was me.
Everyone Abuses the System (and Nobody Cares)
Those who truly needed help and wanted to recover clearly had no faith in a neglected, unfunded detox system, because they almost never showed up. In their place were hordes of people who weren't quitting, had absolutely no desire to quit, and who snipped and snapped at us if we even suggested quitting. So why were they there? Because free jail bed, that's why.
Now with 50 percent less jail!
Good luck getting funds-slashing politicians elected for their ability to verbally masturbate themselves in public to admit this, but just about everybody who came in crying about wanting to turn their lives around actually loved their lives, and merely desired a quick break from hustling, chugging, snorting, and shooting up. They'd come in, "admit" they had a problem, get their three free meals plus free snacks, lounge on their free bed, and chill in the free rec room with people they knew from the streets and almost certainly drugged with every day. Depending on their mood, they'd either finish detoxing and go right back to using, or leave early against medical advice and go right back to using.
"This is all the medicine you'll ever need. Until tomorrow."
Their abuse of the system could not have been more blatant if they had announced it to our faces ... and several did, not that I could do anything about it. If I told management, they would simply shrug it off, arguing that these people might actually want help next time and we didn't want to lose their trust. That's awfully noble, but it was pretty clear we never had their trust to begin with. Or their respect. We were mere Kindergarten gym class obstacles in their way of free everything.
The worst punishment anyone ever got was a disappointed look from a kid rapidly realizing what a mistake he'd made not majoring in Ancient Greek Sexuality. Even when somebody did something so egregious that we had to kick them out for safety's sake, they didn't actually get banned, and would often come right back first chance they got. And if there was a bed available, we always gave it to them. Just in case. Of course, "just in case" almost never happened, but as long as the bosses got just enough dollars to cover their salaries and keep us rolling in white bread, they remained conveniently optimistic.
"Man, what are you doing here?"
And speaking of those whose rebel yell has been replaced with a rebel slur ...
You Become a Glorified Babysitter (for Terrible Children)
At the end of my second day, I went to my car and noticed some clown had broken in and made off with all my CDs, presumably as punishment for being old and creaky and still listening to CDs. This really should have tipped me off as to what I was getting into, and would have cut my misery down by about 728 days.
At least all evidence that I ever owned a Sugar Ray album is gone forever. No one must know.
When you work in a program where just about every patient openly games the system and turns it into an extension of their druggie/drinky lifestyle, you quickly become far less a psychologist or counselor and way more an ineffective babysitter forced to handle the worst kids in the neighborhood, night after night. They would sneak in nips, deal and use drugs in the bathroom, prostitute one another despite an entire 20 feet of apathetic nurses separating the men and women, and throw angry tantrums laced with violent threats if we refused their requests to go outside and smoke any time they wanted, day or night, with no workers around to make sure they didn't bolt to the other side of town and Giles Corey themselves with a giant bag of rocks.
It's the only way to associate crack with "more weight."
Regarding the in-house drugs -- their way of covering up what they were doing involved gathering in the bathroom and shaving each others' heads, every day. Naturally, they used razor heads, because it's awful hard to chop your breakfast on a mirror afterwards with a Gillette Mach 3. We knew full well what they were really up to, and would constantly attempt to break up the head-shaving party, but unless we literally caught them using the razors to snort something (which we rarely did), we couldn't do much other than ask that they disperse and find something else to do, pretty please with booger sugar on top. And even when we did catch them, like kids denying they hit the kid they just hit, they would plead innocence from the moment we told them to leave to the second security shoved them out the door.
But don't think fruitless attempts at minimal control of the situation were all we did. Not that any other part of our job had anything to do with recovery, but at least they offered variety. Pointless, pointless variety ...
Busywork Becomes Your Best Friend (and Progress the Enemy)
The detox hired me as a clinician, which sounds more impressive than it actually was, since I did nothing clinical aside from go clinically insane. Their version of clinicianing involved me finding someone who had come in overnight, taking them to some random room with a desk that was my office until someone else needed it, and asking who they were and why they were there. I'd then jot down their answers in a folder, bring it to the nurses, mourn the day not being over, and repeat until everybody stopped drugging forever.
Or until I stopped giving a shit forever. Whichever came first.
This was fine when somebody truly new came in, or if somebody who hadn't been there in a while fell off the wagon. That's when we needed the new info. But even with people who had been there dozens of times, we had to follow the same exact steps, entering a land of make-believe where we'd never seen them before. I'd ask someone their name, address, date of birth, and drug of choice one week, and ask them their name, address, date of birth, and drug of choice all over again the next week. And the week after that. It was so Groundhog Day, I suspect half our skeletal funding went toward paying Bill Murray royalties.
After a year of dull, repetitive paperwork causing my brain to feel neglected and threaten divorce, I tried to do something about it. I identified all the people who saw us as a free, subpar Motel 6 and started typing their information into a lonely Word doc on my office computer. That way, I could boot it up whenever someone familiar came in, ask them if anything had changed in the past week or so, fill out the folder faster than a speedballing bullet, and then focus on formulating plans and goals for their recovery. You know -- why I was fucking hired.
"Congratulations on being literally the only person on Earth to want this job." What a whip my boss was!
Sadly, my poor spreadsheet lived maybe a week before boss man murdered it in cold blood. According to him, slapping patients' information into Word was an invasion of their privacy, despite our network being so strongly firewalled that I could roast marshmallows over the hard drive. My suggestion to print them out and store them in my office for future use was also shot down, as was the entire conversation, because the goal wasn't actually protecting privacy -- it was making sure I always had enough pointless busy work to justify my hourly pay. Go ask about birthdays again, White Coat!
"Don't forget to bake them a cake and watch them eat it all without offering you any. It's in your contract."
AA/NA Meetings Become Forced, Rote, and Meaningless
Alcoholics / Narcotics Anonymous doesn't work for everyone, but aside from breathing, very few things in life do. If you feel it can work for you, and do all you can to make it work, then it will probably work for you.
If, on the other hand, bored and tired nurses who are more wretched than Ratched rudely awaken you from a long winter's nap to attend these meetings against your will, then they'll be about as effective as arguing back and forth with Bugs Bunny. So of course, that's exactly what we did. In lieu of personalized recovery plans, one-on-one counseling, or anything better to do, we herded everyone into the rec room on the daily to discuss why drugs are bad, m'kay. Unless someone was actively dying, attendance was mandatory -- if nobody ever faked an overdose just to get out of discussing the negatives of their one true love, I'd be fucking floored.
It's the leading cause of that disease where the victim can't stop winking and nudging when doctors ask what's wrong.
As you might imagine, I despised these meetings and dreaded my turns to run them. A successful meeting was one where I wasn't mocked and swore at by angry patients who decided it was bullshit for someone who hadn't ever used drugs to talk about why using drugs was a bad idea. Of course, they barely listened to those of us who had used before, largely treating the meetings as an excuse to trade wacky anecdotes about the hard knock drug life.
Since we had an hour to kill, and not enough people wanted to fill it by taking the damn thing seriously, we often had to get creative. This resulted in us (me, especially) concocting just the dumbest and stretchiest angles to make "stop poisoning yourself" seem like a unique and novel idea that maybe the patients just hadn't considered yet. My all-time favorite was when I whipped out a whiteboard and asked people to give me song lyrics, movie and TV show lines, or famous people quotes that reminded them of the recovery process. Because that helps (me get through the day). Suffice to say, the guy who contributed "I'm gonna kick tomorrow" from "Jane Says" did not, in fact, kick the next day. Or any day after that.
He was a fucking master at stuffing dinner into his pockets, however.
Why didn't they bring in actual motivational speakers and life coaches who knew how to run a meeting and inspire sick people to rise up and take control of their fucked-up life, you ask? Same reason they skimped on anything else that could've helped the program thrive, not to mention helped anyone who legitimately needed it in order to not fucking die alone in a trashcan one day: because that would've cost money.
For more from Jason, check out 4 Valuable Life Lessons (That We Never Follow) and 4 Children's Books That Will Unintentionally Scar Your Kids.
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