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December 2008 Archives

December 5, 2008

Cliches for the Week...

I hope you all enjoyed the week off from my "musings," I know I can overburden people with my monologues. But I'm back. And I'm back with a half-full glass and a half-empty glass. The half-full glass contains the saving of my paid internship until I graduate. I am told I will be working in the World Trade Center Program for those who worked on the clean-up after 9/11. I'll continue to do the policy piece of my internship as well which involves 4 or 5 interesting programs in varying capacities. The half-empty glass is the fact that this is a temp job and again when the internship ends so will my employment. But I'm one of those Pollyannaish believers that when one door closes another one opens. Whether there's horror or happiness behind it is another question but at least it opens.

None-the-less it has been quite difficult going to work without feeling defeated, depressed and anxious. I try to do some self-talk on the way up in the elevator like "the patient's still need you, you need to at least try and put out some positive enthusiasm for their sake." As I expressed in an earlier blog, I found that was impossible during the first week. I felt like I was in a state of shock. People would talk to me and I had no idea what they were saying. The following week I got angry and now I've accepted the inevitable with some positive hope for the future. I think I skipped a few Kubler-Ross stages but no mater how you slice it, our unique program for those with co-occurring disorders won't be there for those who need it most.

Some say everything happens for a reason. I believe that as well. But I also believe the reason is something we discover as we go through it or at some point down the road as opposed to being predetermined and imposed by some outside force. If we seek meaning we usually find it.

Deirdre

December 6, 2008

It's Not a Moral Failing: $5.00 heroin, Drug policy savings, 6 mos. Bupe dosing, etc...

If heroin costs $5.00 a hit and oxy is selling at $10 to $80 a tab (about $1 a milligram) it can’t be hard to imagine that we’ve got:
More suburban teen-age heroin addiction
Hartford Courant - United States
By Rick Green on December 2, 2008

http://blogs.courant.com/rick_green/2008/12/response-to-teen-age-heroin-addicts-in-the-suburbs.html


5 Million People a Year Use Self-Help Addiction Programs
U.S. News & World Report - Washington,DC,USA
MONDAY, Nov. 24 (HealthDay News) -- An estimated five million Americans
over the age of 12 participate in self-help groups for alcohol and drug
abuse each ...
http://health.usnews.com/articles/health/healthday/2008/11/24/5-million-people-a-year-use-self-help-addiction.html

My first thought was imagining people trying to cut out the rod from their body because it was keeping them from getting high. I’d love comments if people have any other thoughts on this new dosing. I’m not sure how I feel.
Bupe in 6 mos. doses
Probuphine, which is currently in development for the treatment of opioid addiction, is a small solid rod made from a mixture of ethylene-vinyl acetate (EVA) and buprenorphine that is designed to provide continuous, non-fluctuating, long-term therapeutic levels of the drug buprenorphine for six months after a single administration.
http://pharmalive.com/news/index.cfm?articleID=586569&categoryid=48&newsletter=1


New Tack on Drug Policy could save State Billions
Recent DOC figures show the slight reforms made to the Rockefeller Drug Laws in 2004 and 2005 saved the state at least $90 million. That doesn't include additional savings from related parole reforms. Meanwhile, crime in the state has gone down.
Conservative estimates of savings from Rockefeller Drug Law repeal are around half-a-billion dollars much higher once court and policing costs are factored in
Earlier this year, the six Assembly committees held historic joint hearings to begin outlining a public health approach to drug policy. Experts explained New York had the required programs and services largely in place only appropriate funding is needed.
The rest of the story:
http://www.syracuse.com/opinion/index.ssf?/base/opinion-5/1227952516173270.xml&coll=1


New Report Indicates that Integrating Mental Health and Physical Health Care Services can Benefit Patients with Depression
A new report released by the Agency for Healthcare Research and Quality (AHRQ) of the Department of Health and Human Services’ (HHS) found evidence that people treated for depression in primary care clinics that provide a coordinated set of mental and physical health do better and have fewer symptoms than patients who are treated at sites that just provide health services.
Here is the web address for the report:
http://www.ahrq.gov/downloads/pub/evidence/pdf/mhsapc/mhsapc.pdf

Deirdre

--
There are many paths to recovery, ask me about the one I walk.


December 14, 2008

Bio-psycho therapy and the bogs of quicksand

I walked into my massage therapist's office with a smile on my face. When Dawn, the therapist asked how I felt I said something like, "believe it or not I actually feel pretty good." She said I looked much brighter than when I'd walked in the last few times.

I met Dawn back in October. My stress was expressing itself somatically with miserable neck muscle and head aches. I couldn't relax because the pain was always there. Once before when I was feeling this badly I tried a chiropractor. I had a number of visits but I never felt better. I had recently been to my family physician who suggested I try out the new massage therapist down the street.
So when I finally couldn't take the pain anymore I decided to walk by just to see if I could get the name, hours and contact info. Turned out she was open and could take me for a 1/2 hour treatment. While I didn't feel enormously different when she was done. The next morning I did. She was called upon to make the same magic happen about 2 weeks later when the pain came back. After that I decided to try and keep a monthly schedule in order to keep the nasty, mood altering, work inhibiting, pain, away. No doubt psychotherapy relieves stress and anxiety over time but there's nothing like massage therapy to kick it off or boost the affect.

So what caused the change since last I visited Dawn? Certainly the relief of knowing my internship and at least temporary employment had been set in place helped. But also, complete were my final papers, a power point presentation for my policy internship and the 3 hour CASAC exam I'd been waiting (while working) 4 years to take. Tune back in, in six weeks, to see if I passed. Maybe now you can imagine, my angst at having to wait another 3 years after May to sit for another qualifying exam. Hopefully with all the hard work the LMSW Coalition is putting into it, the "C" issues will have been resolved in our favor and the 3 year road ahead won't seem like it's filled with bogs of quicksand.

December 21, 2008

The last day

Friday, the 19th, was my last day of work. After almost 4 years I ran my last group for the outpatient AOD (Alcohol and other drugs) clinic. 19 chairs with their backs against the institutional yellow walls were squeezed into the square space which usually held 12 to 15 at most. Since joining the staff, almost 4 years ago, we had hoped money would be found allowing for the purchase of new stacking chairs. Chairs which would be made of some material resistant to stains. As it was, most who used the chairs tried not to look before sitting down.

Shortly before the group was to start I was handed my yearly evaluation form to sign off on. I didn't bother to read it. I knew it was not going to be positive, though last year's was glowing. I know my performance was disappointing since learning they were closing the unit and I'd be out of a job/internship. I was disappointed they were unable to see the situation from my perspective. I was disappointed I was met with anger rather than empathy. I said I was sorry a number of times, for disappointing them with my behavior. The only defense I could give was my humanity. I also said I thought it unfair to judge all my work over the year based on the past number of weeks when I didn't perform my job above and beyond what was asked of me. They never said I didn't do my job, just that I didn't do it in the style they'd become accustomed to.

But needless to say, this interaction right before the last group was to begin, caused me to become somewhat emotional and tearful. So I grabbed the box of tissues from my desk and headed down the hall to the "group room," soon to be some mucky mucks new office space. I threw the box in the middle of the floor. I learned this protocol from my first supervisor. The clients defensively laughed and asked "Who's that for?" And I replied, "Me." I'd been through a scene like this once before. I had cried more than anyone in the place, I explained. I thought it was because I was new to the field back then; I really loved where I'd been working and the closing of the agency was quick and unexpected. Well I learned Friday (the 19th) that didn't have anything to do with it. I'm pretty certain I won the title for most tears once again. I hated the idea that a sorely needed outpatient program was closing down. I hated the idea that the clients had formed such strong alliances with those of us who worked there as well as their peers, that this was going to be very difficult for them and that it would be highly unusual if at least a few didn't wind up relapsing because of it. Though I pray that doesn't come to pass.

After the group I had to see my field supervisor to go over the 1/2 year evaluation for field learning. I wasn't looking forward to that, fearful it would be much the same about being disappointing. But we did manage to talk things out as I hoped we could and while I still think we have difficulty walking in each other's shoes, I'm grateful for the support she was able to give me.

Then I returned to my office, not realizing how bad the weather had become. I called an administrator to see if I could borrow a hand cart after hours if the gentlemen who were to help with the move had to leave at 5. I discovered they had left quite sometime before due to the weather conditions. So I thought why should I rush to pack if no one was moving into my office on Monday anyway, and decided I'd better just try to get home in one piece after the day I had and the weather outside, and so I did.

Oh I can be Pollyannaish here and acknowledge that endings are simply the start of something new and perhaps exciting and enlightening. But the fact that it was such a difficult ending saddens me. The fact that no one from upper management came and spoke to the outpatients. Oh, they were set up with other agencies to go to, but anyone who has ever had a therapist knows its not easy for whatever reason to change them when you're not expecting to.

I have two weeks off now. Thank god I didn't have to be at the job until the very bitter end (Dec. 31st). I have to practice a lot of self-care as well as a lot of housekeeping that hasn't been touched in a couple of years, thanks to school. My husband has been overgenerous with his help but there are certain things only I can do. I'll keep all those outpatient clients with me--I've internalized each one. I'm forever grateful for having had the honor to witness their recovery and have them in my life.

I waited a week to publish this blog. I wanted to be sure I wasn't saying anything i didn't really want to say in public. I'm satisfied it's ok.

So have a happy New Year everyone. 2009 should prove to be interesting.

About December 2008

This page contains all entries posted to Midlife Musings and my Second Career in December 2008. They are listed from oldest to newest.

November 2008 is the previous archive.

January 2009 is the next archive.

Many more can be found on the main index page or by looking through the archives.