Tuesday, January 11, 2011

The Rocky Road Of Rehabilitation

Two weeks after discharge, the heavy leg plaster cast came off and a new fibro-plaster cast was put on, and what a difference this made to Shane's, and ours I might add whole well being.   It had been a difficult, frustrating two weeks with the heavy, cumbersome cast on, especially keeping the leg elevated in bed at night, and also dry when showering.   However, after much thought and perseverance both these problems were solved within days of Shane being home.   We ended up having to elevate the end of the bed with big blocks of wood, and wrapping the cast in plastic for showers although it was a chore, proved to be semi successful.   I attended the hospital clinic appointment with Shane to view the leg wound when the old cast was removed.   I was amazed how well the surgeon had stitched the leg wound considering how swollen it must have been on the day.   Admittedly Shane would be left with a long, large scar down the front of his leg but, nevertheless, the stitching was beautiful work.

Shane was a good patient though and I enjoyed fussing over him.   He started getting good colour back in his face and having him straight, not out of it, was a real delight for us.   At week four Shane was weaned off the pain medication, but remained on the sleeping sedative and his doctor also prescribed anti-anxiety medication, to prepare him for Methadone withdrawal.   In those early weeks Shane appeared to be coping alright having the correct daily dose of Methadone, and he was talking positively about long term goals and plans, which was all very encouraging.    But it was early days and I feared getting to hopeful, knowing the real hard yards of rehabilitation were yet still to come, when Methadone withdrawal commenced.

Our first introductory meeting with Shane's new CADS caseworker was in early May, approximately two weeks after his discharge from hospital.   Shane's appointment was for one hour but my visit with him was brief.   It was just a 'getting to know you kind of meeting' and to discuss my authority for the Methadone, the reasons for it and how we would proceed with Shane's withdrawal and rehabilitation.

The caseworker was a nice, approachable young man, about Shane's age, whom appeared eager and enthusiastic to help Shane, and work with me to ahcieve a successful end result.   Although it wasn't spoken, I did detect at this meeting the caseworkers slight hesitation about my personal involvement, and felt perhaps he wasn't totally agreeable with me having authority over Shane's Methadone.   However, I was aware authority being granted for the Methadone was quite unique within Community Alcohol & Drug Services, so his reaction didn't surprise or perturb me.   I was very thankful though, at this point that Shane was still under Manukau City, when the request was made.

The Methadone withdrawal protocol required Shane to have regular visits with his caseworker.   These were weekly to begin with, extending to fortnightly, and his caseworker was prepared to travel to our home at Te Mata for some of these appointments.   Having regular contact with the caseworker I felt would certainly aid Shane's withdrawal and rehabilitation process, but only if some form of professional counselling was incorporated as well.   Of course, as with all counselling, trust and a general rapport must exist between both parties for the hope of a successful outcome.   Sometimes, to achieve this goal, qualifications work well, other times it maybe the benefit of the counsellor's personal or professional experience.   I was hoping Shane's caseworker, albiet that he was new to the service, therefore possibly inexperienced, was still a bloody good one because if he wasn't 'switched on', Shane would leave him sitting on the other side of the fence every session, especially if rehabilitation wasn't what Shane really wanted.

Like I've said, Shane's a really nice, pleasant, respectful guy.   However, he is a very clever manipulator and a bit of a dark horse!   He's been in the programme long enough to know what, when and how it all works.   He is also extremely knowledgable about addictions and addictive behaviour, so it takes an experienced person in addiction to successfully unravel him.   Over the years his manipulative, masterful approach has seen him very successfully manoeuvre his way out of many unpleasant situations.   And considering Shane applies these techniques while under the influence of drugs does vindicate just how skilful he is.

I'm not putting Shane down, or being unloving by saying these things.   Shane would agree with me, in fact these aren't bad qualities to have, I admire him for them.    I just hope, one day, he'll get the chance to use them all for the right reasons, other than for his drug addiction.

In the June Shane's fibro-plaster cast was removed.   Our weekly town days now became a tense time for us, wondering what Shane was up to, where he'd go and whom of the drug scene he may have seen.   He wasn't as mobile on crutches and never ventured very far, so town days over the last weeks hadn't been a concern.   At this point though Shane hadn't mentioned moving out, so again I assumed my rehabiliation plan was acceptable.

The six doses of Methadone that I picked up from the pharmacy on Thursdays were safely secured in my handbag while we were in town.   Upon arrival home the Methadone would, discreetly, be taken downstairs to the basement garage and locked away in my husband's gun ammunition cupboard.   If I was unable to do so immediately I would hide the bagged bottles of Methadone in my bedroom drawer until Shane was otherwise occupied.   Each day's dose of Methadone was labelled, dated and it was dispensed in small individual brown bottles.

One particular Thursday, towards the end of June, Shane didn't retreat immediately to the bedroom to rest his leg, as was normal, so I hid the bottles of Methadone in my drawer until I could lock them away.   To my bewilderment, there was only five little brown bottles in my drawer when I went to retrieve them, about half an hour later.   Now, my responsibility for this Methadone was taken very, very seriously, so you can only imagine the sheer panic that run through me at that moment.   I stood, for some seconds, just looking into the drawer at these bottles, hoping the missing bottle would suddenly materialize.   My first thought in those few seconds, was that maybe the pharmacy only gave me five doses, instead of the correct six.   Although, logically I knew the pharmacy would never have made a mistake like that, I was confused enough to consider it.   Funny, it didn't occur to me at all that one dose may have been pinched.  Foolish I know.   But honestly I was freaking out, thinking 'oh my god, I'm going to have to declare I'v lost a bottle of Methadone, I better tell Shane first.'

Normally I would respect Shane's privacy and knock before I entered his bedroom, but as the door was ajar I just barged in, all upset about my loss.   And, there he was, sitting on the bed, with a syringe in hand and the missing bottle of Methadone.   Until that moment, I thought everything was going so well, suddenly realizing that it wasn't, made me feel betrayed, stupid and so angry.   I think, seeing the syringe, was what shocked me.   I could've handled Shane pinching the Methadone to drink it, but to shoot it up, no way!   It was an awful moment and Shane never uttered a word.   He couldn't deny it, he just, silently, put the syringe down on the bed.   I picked up the syringe and the brown empty Methadone bottle, left the bedroom screaming abuse, and went straight to the lounge and threw them both on the fire.

Once calmed down, and in control, I re-entered Shane's bedroom to discuss the matter further.   He was visibly upset and apologetic for his actions, and was insistant he hadn't used the syringe.   I responded to his plea, saying;   "Well Shane, I didn't really care whether you'd used the syringe or not, actually seeing you with it was sickening enough, so tough, it's all gone in the fire now."   Shane was horrified, and stated I'd just burnt one of his doses of Methadone.   Still reeling with anger I sarcastically replied;   "Tell somebody who gives a shit, it's your muck up Shane not mine.   We're down one days dose of Methadone now,so you just let me know which day you're going without."   I left the room stating I was going to phone the caseworker and inform him of what's happened.   Shane's morale was pretty low by then, so I don't really think he cared what I done at that point.

I telephoned Shane's caseworker, and in a very upset, agitated state explained what Shane had done and how, by chance, he'd found the Methadone.   Ironically, the week prior to this slip-up, Shane's caseworker had made his first home visit and he'd checked the security of our Methadone lock-up downstairs.   Funny that though, CADS protocol obviously never required Shane's Methadone lock-up to be checked, because in all the years he was in charge, it wasn't.   I was a bit bemused by that requirement, wondering why my addict son was trusted more with the Methadone than myself.   Ok Diane, let's just move, don't dwell.   Of course, the caseworker wasn't emotionally involved like me, so this slip-up didn't affect him the same way.   I was advised that a minor slip-up like this wasn't to be seen as a complete failure, and that it would be discussed with Shane at his next appointment.   The conversation ended and I was left thinking  'Okay, that's all very well, I didn't see this slip-up as complete failure but I sure as hell did see it as possible failure.'   His comment insinuated I'd over reacted, which of course didn't ease my agitated state, so phoning the caseworker proved pointless and unhelpful.

Later that day though Shane and I did talk about the incident.   He admitted to knowing where I was putting the Methadone until it was locked up.   For two weeks he'd resisted the urge to act on his temptations.   This day, he wasn't strong enough to resist and temptation simply got the better of him.   He did it on the spur of the moment when the opportunity arose.   He was desperately trying to resist even after he'd put the Methadone into the syringe, and that's why he still hadn't injected it when I walked in.   Shane was aware of how disheartened and disappointed I felt and assured me it wouldn't happen again.

The issue of trust can be a major drawback when you're emotionally involved with an addicted person.   You want so much to trust them and believe their broken promises, but you never can.   Although I was trying to trust Shane, it was usually my gut instinct that I trusted the most.   My instincts only failed me that day because I'd become a little complacent, and maybe naive about Shane's rehabiliation, which had allowed this slip-up to occur.   However, you learn to move on quickly from upsets and problems when dealing with addiction, if you don't, disappointments can be to devastating and deflating.   Although this incident would soon be forgotten, the message behind it wouldn't, that there are consequences for every action.   Shane was reminded there is a fine line that separates advantage and disadvantage, and he certainly would be disadvantaged if my love and good intentions were continually going to be abused.  

My assumptions weren't wrong about Shane accepting my rehabiliation plan, he did declare his genuine desire to be clean and free of drugs.   But I think, he was also like myself, a bit fearful of the process that's all.   This was a mere bump in the road, and I'd be foolish to even contemplate it would be the last.

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