Problems in late stage alcoholism treatment: Part 1
Late stage alcoholism goes under diagnosed
People with alcoholism that is more advanced are almost always under-diagnosed in the treatment system in my home state of Wyoming – it’s something that is a leftover from the past. It’s just the way things have been done, and programs don’t exist for these patients. These are people that often develop true long-term damage from their drinking, but with the lack of recognition of this condition they are not told what to expect and very often I know that they fail to recover without a correct diagnosis. These shortcomings in treatment are evident in the following account about a long time friend of my family who died while hopelessly mired in some serious problems this sort of system helped create for her while she was trying to recover from alcoholism.
Different stages of alcoholism require different types of treatment
Public and private programs here use simple behavioral ideas for treatment, and the system is blind when it comes to dealing with cases where recovery takes a very long time just to get started because of the type of damage that is present. Advanced problems are very different from more average problems. For a person to reach this stage is actually fairly uncommon amongst the total number of alcoholics of different ages and personality types, etc. – there are many different types of drinking problems. Partly because most people never reach this stage advanced cases are easily overlooked in our system, and everyone is placed in the same basic programs that are strongly tied to the legal system. Some things have changed in treatment since this happened, but the philosophy behind what happens in the programs basically hasn’t changed for people with true long term damage due to this different type of alcoholism.
This may seem only to be a personal story that lacks credibility, but my feeling has always been it is important for me to try to advance this argument that the diminished quality of treatment due to elimination of programs in the past has been the cause of many poor outcomes for patients who are the worst afflicted from this sort of illness-stage alcoholism. I see no reason to believe that anything has changed here, and it’s very likely Wyoming is not alone in this.
My friends name was Janet. We both went through some of the same treatment programs at first, and we both ended up in the same program for alcohol at the state mental hospital in Wyoming (I went through four programs before I quit drinking, and we were both sent to this program because of our inability to recover in any of the regular treatment we had). I was there within a few months prior to the time she arrived so that I knew firsthand what this program was all about, and as a friend of her family I knew some of the details of what she was going through when she went there. This is based on what she said about her problems while she was going through the state’s program and it is also based on my own knowledge of treatment and the experiences I had recovering from the same type of alcoholism. I’m convinced we both had the same advanced level of progression with true long term damage from our drinking, and I think my experience with this subject allows me to tell what really happened to her in the treatment programs before she died. I believe that I can say the lack of a diagnosis led to the extreme problems she had in treatment.
Beginning around 2000 Janet had extensive problems throughout the treatment she had. She was misdiagnosed in the programs she had gone to, and essentially she was permanently ejected from treatment a short time later after going through the punitive type of substance abuse program at the Wyoming State Hospital in Evanston. I had the same level of alcohol damage that I believe she had, and in the treatment programs I went to I was never told that my level of alcoholism was at a very advanced stage. I believe I was deliberately under-diagnosed, and as a result I didn’t know that my advanced condition was the real reason why I continued to fail in one treatment program after another (the programs just blamed me and I blamed myself). I was a willing participant during the treatment I had, and I think Janet was trying to find a solution for her situation in the programs she went to because of the type of damage she had also. But at that time treatment was still very limited after several decades of neglect with addictions issues in the state, and as a result punitive programs were used with people who were too sick to recover quickly in the short amount of time that was allowed in the programs.
to be continued…