The Monster of Addiction (and the Frustration of the Mental Health System)

This has been the day from Hell. I have written about my alcohol abuse and potential for relapse. I have been dry for 4 years and 4 months, tomorrow. I continue to have cravings and my cravings have really come to a head recently.

I had mentally relapsed already--fantasizing about drinking and even going as far as trying to figure out how to beat the system with my drug screens. This weekend I had taken it a step further and went to the ABC store. It was almost a dissociative state move and it felt as though my body was on auto pilot and I was checked out. It was Thursday night and I was off the next few days; so, the plan was to wake up at 4 am and check in to see if I was to be drug tested on Friday; if not, have a drink of vodka and tea. I normally like a drink called a Sea Breeze, which has grapefruit juice; cranberry juice; and vodka. I did not have cranberry and grapefruit juice on hand, so a favorite tea would have to do. I woke up a little late at closer to 5:30 am and checked in. No test. Perfect. I was rather sleepy yet still wanted a drink; I knew if I did not drink then, there would be no way to beat the test as an ethyl G urine drug screen can detect alcohol up to 80 hours, sometimes even 5 days in rare cases.

I did not want to relapse, but I wanted a drink. I have not drank in almost 4 years and 4 months and it is an accomplishment for me; but the cravings and desire are still there. I just laid there thinking of what I had accomplished both personally and professionally--I had a great job that I love; I had my own house; and I was satisfied with life. I also reminded myself that I had an appointment with a psychiatrist for medications to help my cravings in a few days and if I could just hold on a little longer, everything would be okay. I was so close.

In addition, I was tired and I was reminded of time back during my drinking days when I waited until my parents were asleep; went downstairs, and poured me a red solo cup full of whiskey and drank it straight. I was sleepy after and went back to bed. I woke up laying in vomit. I have been sleeping in my guest bedroom, which my mom had bought the bedroom set for me as a housewarming gift. I could not imagine destroying it with vomit.

I decided to go back to sleep and to just smoke when I woke up in place of the drinking. Smoking does not alleviate my cravings for alcohol by any means; however, it has helped my anxiety dramatically.

When I woke up, I felt proud of myself that I was able to work through my near relapse and even shared my victory with a close co-worker of mine. My co-worker sent me back a 'good girl'. It helps to have a support system and I have a few co-workers in recovery that their support has been priceless.

I ended up going through this whole staving off relapse on Saturday, as well.

Flash forward to today. I had an appointment with a psychiatrist this morning. I showed up only to find out the appointment was cancelled due to insurance reasons.  This office is within network and there should not have been a problem. The receptionist seems to have no understanding the difference between insurance and a health savings account or understanding of being within network, a co-pay and submitting the claim to insurance. I was supposed to come back at the end of the day; and between the morning and end of the day, get everything sorted out with insurance. My insurance re-affirmed what my understanding of everything is and I tried to explain that to the receptionist. The receptionist told me I was getting irritated and that she did not think I would be a good fit for their business and to go elsewhere.

Here I am back at square one with alcohol cravings, no medication for the cravings, and no appointment to get medication lined up. Unfortunately, I have moments where I almost think relapsing/letting go and taking my chances with HPMP and the Virginia Board of Nursing may be easier than to keep fighting/hanging on. What happens next, I have no idea.

Easing Anxiety: The Decision to Smoke

I have always been an incredibly anxious person. This anxiety led to so much irritability and unhappiness. I have a long history of attempts to treat my psychiatric issues to no avail at this point; this includes taking medication. I have taken a medication called Buspar, in the past, for anxiety. I did not feel like it helped. I felt like externally, I looked cool, calm, and collective; however, on the inside, I felt like a trainwreck. I have never been prescribed any benzodiazepine due to substance abuse. It ended up being for the best because being in HPMP, I cannot taken any controlled medication and still actively work as a nurse. So, my anxiety continued and I was left with my poor coping skills.

I started to entertain the idea of smoking cigarettes. I never thought I would be a smoker. However, I got to the point where I was craving alcohol so bad (physical cravings and missing the relaxation and peace it gave me) I really thought I would relapse. I have 13 months left out of a 60 month contract with HPMP. I have spent so much money on therapy appointments, drug screens, intake assessments, etc. I initially contacted the Virginia Board of Nursing with hopes I could appeal to the Board to get out of HPMP early (HPMP had already said no themselves), so I could go back to drinking. I did not tell the Board staff that, by the way; that was just my reasoning behind trying to get out early. After I found out the only way 'to get out of HPMP early' was to resign and go before the Board (and most likely get my nursing license suspended); I decided it was not worth it.

That is when I decided that I would start smoking. I have not smoked long at all, but I have found that my usual amount of smoking is around a 1/2 pack to 3/4 pack a day. Smoking has eased my anxiety in ways Buspar and counseling never could. Plus, my appetite has decreased drastically and I am slowly losing weight.

I am still working on finding a psychiatrist to be able to get medication for depression and the alcohol cravings. I made a couple calls today, so I will wait and see what happens. I want to try Campral for the alcohol cravings. I originally planned to just smoke for 13 months until I was done with HPMP, but I truly find smoking helpful and most likely won't quit after HPMP.

Relapse Potential

My co-worker was holding her Reflections group last night as usual before the patients headed to their rooms for bed. The discussion topic was focused on the bad outcomes of their using and drinking. My co-worker mentioned to the patients about her history of drinking and the most embarrassing thing she had done while drunk.

                                      'This is the person I need to talk to.' I thought.

I have been struggling with thoughts of drinking--I have had them since I have been in the Health Practitioners' Monitoring Program; however, lately, it is getting worse.

               '"...Can I get your phone number before you leave tonight?"' I asked my co-worker.
                                         '"Sure...Did I do something wrong?"' she asked.

Our patients had went to their rooms and aside from one other co-worker of ours, we were alone. I quietly explained my situation and that I really feel like I am going to relapse soon.

               '"I am dry, not sober. I am literally counting down the days until I am out of HPMP,
                                                      so I can drink again."' I explained.
                                    ""Mentally, you have already relapsed."' she told me.

I went on to tell her that AA meetings are not for me due to being focused on a higher power and gratitude and if a person works the steps, then the desire to drink goes away. I have an amazing life--I have family that I am close to; I have my own house, clothes on my back, food on the table, and three sweet cats that adore me; and I have a career that I absolutely love. I do not want for anything and I am grateful beyond belief; yet I still want to drink.

            '"I physiologically crave alcohol. I have not drank in 4 years and I still crave alcohol.
                                                   Is that even possible?"' I ask.
                                                           '"Yes."' she replied.

In addition to the physical craving of alcohol years after, we discussed my fears. As my time in HPMP comes closer to an end, I become more excited; however, I can walk by the ABC store now and talk myself down by thinking of my nursing license and how all it takes is getting drug screened the next day or after the weekend to put my nursing license in jeopardy (although I have tried to calculate the number of hours from if I drank to I would have to test when I was getting a particularly strong craving for alcohol. Alcohol can be detected in blood for up to 24 hours; up to 72 hours in a urine drug screen). Once I am out of HPMP, I do not know if I will be able to do that because I will not have to do any more drug screens. I can drink as much alcohol as I would like and as long as I do not show up to work intoxicated, no one will know. I hate that mentality because I have a fear that with that mentality I am going to eventually get a DUI or do something that will hurt myself or someone else but I want to drink again. I said it, I want to drink again. Between that and the mouth watering I get when thinking about alcohol, the relapse potential is strong.

I also discussed my fear/feeling of being destined for jail, homelessness, or suicide. I have a fear of all of it, even the latter. Since my dad passed it is harder to get rid of suicidal thoughts; between my love of alcohol and the longing to see my dad again, suicide would be too easy with alcohol. My co-worker understood; she used to get those feelings, too.

We came up with a plan. She taught me to write down a bad decision I am contemplating and next to it, write all the possible bad outcomes from the decision. We are also going to keep in touch outside of work and she is going to take me to some of the meetings at her home group. I asked her to be my sponsor, she agreed.

I hope I can come up with a workable solution before I relapse, whether it be solely counseling and AA meetings/sponsorship or if I have to get medications, in addition.