By Christian Castaneda, LCSW, Program Director at Promises Malibu
Addiction recovery cannot be achieved through one method alone. Research has shown that a multidisciplinary approach is essential for both healing from the ravages of addiction and maintaining sobriety. The best drug rehabs address addiction on all levels and offer support for mind, body and spirit.
Whether you are a loyal UCLA Bruin or you spend your Saturdays cheering on the “cardinal and gold” of USC, game-day tradition calls for a booze-filled tailgate party outside the stadium. Stuffing oneself with food and alcohol pregame is a ritual that even marginal fans don’t want to miss. So just how does a fan in recovery navigate this danger zone? What options do they have to stay sober at tailgates and continue to work their relapse prevention program?
Addiction can take our lives down a difficult path and set us off in the wrong direction. We may struggle, and we may fail on the first attempts at sobriety. But it’s never too late to seek help and get a fresh start. Everyone deserves a do-over.
High-functioning addicts — a term attributed to people who have substance use disorders yet manage to maintain a job, support a family and sustain busy social lives — often perform well in the workplace while things start progressively spinning out of control in their personal lives.
According to the National Survey on Drug Use and Health, 9.5% of full-time workers aged 18 to 64 have abused alcohol or illicit drugs in the past year. This makes it likely that, at some point, you will work with someone who has a drug or drinking problem.
Certain Professions Make Addiction More Likely
Rates of addiction among the general population are estimated at 8% to 10%, while rates of addiction among physicians and other health care workers are somewhat higher. Medical professionals in clinical environments are at greater risk for addiction than others. For example, a 2014 study revealed that 10% to 14% of emergency department physicians will develop a problem with substance use at some point in their careers.
What accounts for the higher addiction rates among medical personnel? Typically a combination of high stress, high expectations, an attitude of self-reliance and invulnerability (i.e., “I know what I’m doing, so I can use this medication without becoming addicted to it”), and ready access to substances of abuse. Yet, these same characteristics are seen among professionals in other industries as well, particularly those with high levels of stress or trauma, such as law enforcement, first responders and the military.
Thrill-Seeking or Stress Management?
Many people who abuse substances, particularly professionals who hold positions of high authority or responsibility, aren’t typically thrill-seekers looking to get high. While some may be hoping to enhance their performance in high-pressure situations like the boardroom, surgery theatre or combat zone, many are simply overworked, overwhelmed and exhausted, and looking for some relief. A 2013 study conducted by researchers at the University of Florida’s Center for Addiction Research and Education found that nearly 70% of physicians who participated in their study cited stress and physical or emotional pain as their motivation for turning to prescription drugs.
Detecting Substance Abuse Early
Early detection of substance abuse is imperative in ensuring safety of work environments, of course, but early detection is also vital in ensuring that an addicted person receives treatment as soon as possible. If substance abuse continues unchecked, the rate or volume of abuse can escalate, making it more likely that the user will become functionally impaired, thus increasing safety risks at work.
Health care workers and those in other professions may continue abusing substances for long periods without detection because many work settings do not require random drug testing as a method of early detection. A lack of early detection measures can lead to escalation of drug use.
Signs of Substance Use Disorders
How can we recognize signs of addiction or substance abuse in work environments where there are no formal processes for early detection and intervention? It can be challenging to detect substance abuse in a high-functioning addict, particularly in a physician or other professional who knows how to hide the signs. It requires a bit more vigilance, but it is possible.
Eight ways to spot a high-functioning addict in a professional setting:
- Long sleeves. A tendency to wear long sleeves at work, even during warm seasons or where this formality is not required, may indicate a co-worker is trying to hide needle marks.
- Eye drops and breath fresheners. Use of eye drops before/during work hours (perhaps a special type that makes pupils appear normal), or use of breath mints and breath sprays at work may indicate that someone is trying to cover up on-the-job drinking or smoking of illicit drugs.
- Unexplained absences. It’s not unusual for people struggling with addiction to miss work, be late for appointments or meetings, or have more sick days. They may report multiple family “emergencies,” or a spouse or family member may call in sick for them. They may disappear unexpectedly during work hours or leave early for “meetings.”
- Alcohol overuse at social gatherings. Someone who is using prescription medications to relieve stress may also misuse alcohol for the same reason. At work-related parties or social functions with colleagues, a substance abuser may consume a high volume of drinks or may continue drinking long after everyone else has had enough.
- Changes in mood, behavior and/or appearance. Addiction to substances, whether to alcohol or a drug, can lead to changes in mood, attitude and behavior, as well as to physical changes and withdrawal symptoms. Has a colleague recently lost a lot of weight? Has their personality changed? A high-functioning addict may develop a bad attitude at work when they are hungover or have gone a few hours without using. If they have become psychologically or physically dependent on a substance, withdrawal symptoms may make them grouchy, short-tempered or more difficult to work with at certain times of day. Alternately, they may display hyperactive or manic behavior at certain times, and sluggish behavior at others.
- Medication shortages in a clinical setting. Like regular civilians who become addicted to medications, doctors, nurses, dentists, veterinarians and other health care professionals may obtain legitimate prescriptions for certain drugs, such as opioid painkillers. However, if/when they are unable to refill those prescriptions, they may begin accessing the medicine supply at the clinic or hospital. Be vigilant of medication supply shortages that occur despite recent order fulfillments.
- Distancing and isolation. If you notice that a colleague has disengaged or distanced themselves from the rest of the team at work, or that interactions have become strained, these can be signs that the addicted person’s problem has grown worse and they are having a hard time keeping things together.
- Inconsistent job performance. Take note if a worker who was previously a top performer or consistent producer starts making mistakes or displaying a more erratic job performance, with some good and bad days. These can be signs of escalating addiction.
Talking to a Colleague About Their Addiction
No one wants to get a friend or colleague into trouble or permanently damage their career. However, if you suspect a colleague of having a substance use disorder that is impacting their work (or patient safety), confronting them about it can be a good first step. An honest conversation lets them know their problem has become noticeable to others, and you are giving them a chance to seek professional help before a crisis occurs or they get reported to a higher authority.
Here are four things to consider when talking to a colleague about their addiction:
- A one-on-one, discreet approach may work best to avoid negative consequences. This is especially important if your colleague is a doctor and you work in a state that doesn’t have a state-run physician’s health program — currently, there are no active state PHPs in California, Nebraska and Wisconsin. Conduct some research before your one-on-one discussion so that you can inform your colleague of private treatment programs in the area that specialize in working with doctors and other high-level professionals. Some of these programs coordinate with licensing and regulatory boards to help mitigate disciplinary actions and ease re-entry to the workplace after treatment.
- Confrontation by a colleague may be the only way a professional in a high-ranking position is going to face their addiction and get help for it. High-functioning addicts rarely ask for help. Taking action to confront a colleague about their problem one-on-one — however daunting it may be — is like throwing them a lifeline. Your private intervention may be the one thing that leads them to treatment and recovery.
- Choose your timing. It is important to approach a colleague about their addiction at the appropriate time. In addition to speaking with them alone and in private, be sure to also approach them when they are not high, hungover or agitated. You want them to be able to focus on what you are saying and to synthesize the information when they are clear-headed. They may get defensive (denial and defensiveness go hand-in-hand with addiction) but, hopefully, they will respond with remorse over their behavior and see that they need professional help.
- Be calm and compassionate, yet firm. Make it clear that although it is up to them to recognize and admit that they have a problem, you can see that their addiction is impacting their work. Convey that you respect them and assure them you will keep things confidential, but they must get professional treatment. Don’t cave in to denials of a problem, negotiations for more time or alternative “self-help” treatment methods — all of these can result in delayed treatment, continued substance abuse and a crisis.
Approaching a colleague about their addiction can be daunting, but focus on the fact that your action may help them. If you can encourage them to enter addiction treatment, they will receive therapy and psychoeducational resources that help them manage the underlying issues that initially drove their addiction, such as stress, lack of support or healthy coping mechanisms, co-occurring mental health issues, and more.
Taking Steps to Help an Addicted Colleague
If an honest conversation with your colleague doesn’t go well or isn’t feasible, you may need to take the next step. In corporate work environments, employees who suspect a co-worker is using alcohol or other substances on the job can notify a manager or human resources director. The suspected employee will typically be summoned to a private meeting with their supervisor, who will discuss the problem and give them a warning about potential consequences. They may even encourage them to take a short leave of absence to undergo addiction treatment.
Employees in many work settings feel stymied by the thought of “snitching” on a colleague, because reporting the problem may cause them professional embarrassment or humiliation, and possibly, the loss of their job and livelihood. For professionals working in medical environments, things can be even more complex and the consequences more far-reaching.
Reporting a physician suspected of substance abuse could lead to the loss of their medical license. Thankfully, many state medical boards in the U.S. run addiction rehab programs just for physicians. Doctors in those states who are reported for substance abuse are diverted into these state-run rehab programs, or physician health programs (PCP). As long as they complete the state program and abide by the rules of the aftercare plan, they can usually avoid losing their medical license and suffering other punitive damages — though this is not always guaranteed. The good news is that many alumni of these programs return to work and achieve long-term remission of their addiction, with promising recovery rates of at least 78% for those who complete 60- to 90-day treatment and submit to post-treatment drug testing and monitoring.
Whatever intervention approach you choose, the best-case scenario is that you can avert a potential crisis and prompt your colleague to get proper treatment, enter recovery, retain their job, and return to work a healthier, happier person with new skills and support in place to help prevent relapse.
High-functioning addicts: Intervening before trouble hits. W Glauser. NCBI, NIH, March 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3883816/
When the addict is a doctor. The trend against punitive measures runs into resistance when the addict could cause medical errors. Steven Ross Johnson. Modern Healthcare, May 2016.
Drug Abuse Among Doctors: Easy, Tempting, and Not Uncommon. Shelly Reese. MedScape, January 2014. http://www.medscape.com/viewarticle/819223
Location, location, location! The three most important factors in choosing a property to buy can also factor into choosing a rehab center for alcohol or drug addiction treatment, especially if the location will enhance your overall recovery experience.
Thanks to several films and television shows featuring Malibu, California, this coastal community — a playground of the rich and famous — has become a popular destination for people seeking luxury rehab treatment at a premier Malibu rehab center.
Malibu Rehab: A Beautiful Destination Plus Excellent Results
When choosing an addiction treatment center for yourself or a loved one, does the destination make a difference? Of course! But location is not the most important factor. Whether you are considering a Malibu rehab or other options, the most important factor is a successful outcome — effective treatment and psychosocial training in the tools needed to sustain lasting recovery. A beautiful location just enhances and enriches the process.
You’ll want to make sure the Malibu rehab center you choose uses research-driven, evidence-based treatments, and is staffed with trained and experienced care providers who guide and support you through programs that get great results. You’ll also want to make sure the facility offers thorough clinical assessment, a range of therapies, recovery approaches and relapse-prevention strategies that can be customized to your individual needs to support your recovery. Will an addiction counselor work with you to develop an individualized aftercare plan for you to use post-treatment? Does the rehab center accept your insurance, and/or will they work with you on some different payment options (especially if your preferred location isn’t fully covered by insurance)?
Once you can confidently tick off those boxes, consider the rehab center’s location and the amenities and highlights it has to offer.
Why Malibu? Spending time in a serene hillside retreat overlooking the ocean minimizes the temptation to leave your program early and head home as soon as the going gets rough. Rehab is never easy, but you are more likely to stick it out if you’re soothed by daily views of the sun setting over the Pacific, refreshed by dips in the swimming pool or Jacuzzi and revived by the salt air in the ocean breeze.
Famous for originating the Malibu Model of treatment, which tailors treatment to match each unique individual, clients of residential programs at Promises Malibu rehab enjoy gourmet meals and therapeutic activities in a comfortable upscale home setting. Daily schedules are varied to suit a range of client needs, but typically include individual and group counseling, physical exercise, experiential therapies, and sessions on addiction-related issues like shame resilience and relapse prevention, among others. Staff also organize mountain hikes and beach walks, and plenty of breaks for clients to enjoy a game of tennis on the private court or some quiet reflection in the surrounding gardens, free from the stressors of daily life.
Clients at Promises Malibu rehab build recovery skills by meeting with alumni who have successfully completed the treatment program. These meetings are alternated with off-campus trips to community 12-step meetings for additional recovery networking and support. Weekly scheduling also includes evening social activities like game night, and family visitation weekends to facilitate healing in family relationships.
Rehab Far From Home Keeps You Committed, Provides a Fresh Outlook
Choosing an addiction rehab center in a beautiful, tranquil setting outside your local area is a great opportunity for you to escape the triggers of your home turf and get out of your natural element. Receiving addiction treatment in a scenic location can also be a great way for you to gain new perspective, focus on the recovery process, enjoy some “me time” and prepare yourself to make a fresh start into a sober lifestyle. Many alumni describe their Malibu rehab experience as transformative.
“It was a very wonderful, comfortable and luxurious treatment center,” reports one program alumna. “The food was great and the grounds were beautiful. I loved my group sessions and the recovery support meetings. I also appreciated the freedom we got. I was blown away by my whole experience. Thank You!”
You’ve made the important decision to enter inpatient rehab and understandably have questions and concerns. Addiction has been a long road full of angst, bouts of depression, health problems and a host of personal problems, but it’s familiar. For first-time clients, rehab represents uncharted territory, so it’s natural to feel some trepidation, not to mention all of the everyday matters you must attend to if you are employed and/or a parent. You’ve already toured the facility and talked to others who have been in rehab, but you still have questions. Below are practical tips including steps to take ahead of time (e.g. employment, childcare and financial issues) and what to bring to rehab.
Treatment for addiction saves lives. But there is still a lot of uncertainty about what rehab for substance abuse can or cannot accomplish. As a result, people have polarized views about inpatient addiction treatment, either idealizing it as a cure-all or cynically dismissing it as a recipe for failure.
Neither opinion is correct, but each is supported by myths that top rehab centers are doing their very best to refute. Here we will debunk some of the most damaging of these false beliefs, all of which could prevent people struggling with substance abuse from getting the expert medical assistance they desperately need.
By Jennifer Maguire, MA, MS, LPC, ACS, CCS
Clinical Director and Executive Director, Promises New Jersey
Failure to launch – the phenomenon of young adults being unable to leave home and support themselves in adult life – continues to grow, alongside the epidemic of opioid addiction among young adults. This is the population we specialize in treating at Promises New Jersey.
Recent research from a team of American scientists indicates that the presence of the hepatitis C virus is associated with a reduced level of success for people enrolled in some buprenorphine-based opioid treatment programs.
If you’re concerned that you may need treatment for drug or alcohol use, you likely do. According to Principles of Drug Addiction Treatment: A Research-Based Guide by the National Institute on Drug Abuse, people with substance use disorders typically require professional, long-term care in order to achieve sustained sobriety. The agency also asserts that addiction is a disease of the brain that necessitates treatment to address co-occurring mental health disorders as well as contributing psychological and social factors.
A steady increase in the number of doctors allowed to prescribe buprenorphine has led to a widespread rise in access to the opioid addiction medication.
New research into mental health may explain why the 12-step model for treatment first developed in the 1930s by Alcoholics Anonymous still helps many people find sobriety from drug and alcohol addiction. Studies show, after all, that recovering addicts in 12-step groups are significantly less likely to relapse: those who attend 12-step groups are twice as likely to stay abstinent from drugs, and higher rates of attendance accord with better prospects of long-term sobriety, for example. But such successes have not insulated AA and its 12-step treatment program from a round of bad press lately, as embodied in Gabrielle Glaser’s scathing cover story in The Atlantic this past spring.
Choosing the right rehab facility is crucially important to getting well if you struggle with a drug addiction. You have a lot of options, and knowing which type of treatment is right for you is not necessarily obvious. You need to understand your options, what they mean and what kind of person is best suited to each. As you sort through the choices, make sure you have someone you trust by your side to help you.
It’s not far into the new year, and if you’ve already botched your resolution to curb your drinking or quit altogether, it might be time to reconsider your approach. In the words of inventor Thomas Edison, “Many of life’s failures are people who did not realize how close they were to success when they gave up.” So try a little reinvention. Pull yourself up by the bootstraps, and give your resolution another shot. This one is worth it.