Where Can He Go After Rehab?
hayleskp wonders if having her Loved One live with her after rehab is the best option. The last time around, he OD’d a few weeks after moving back. He has grown bored with hearing the same things at multiple rehabs. With mental health issues on top of addiction, he really needs something more.
I have so many questions and the confusion is going around and around in my head. My 30 year old son is currently in rehab for the 4th time in 2 years. This time is following an OD which resulted in him coding 3 time and led to him being on life support for 5 days. He is very depressed even though he is on antidepressants and is bored of hearing the same meeting material over and over. Because of his many rehab stays he feels he is getting nothing new. Individual therapy is lacking and what I feel he desperately needs. He has experienced so much trauma in his life that anxiety (PTSD) is a very serious issue that is at the center of his addiction.
He leaves rehab in a little over a week. He has been angry with me and although not physically violent he is difficult to be around. He is angry and depressed.
The Rehab center is recommending a very strict sober living home. I doubt he will go or stay if he did go. Prior to coming to stay with me from several States away he had been living in sober living for a year. He was able to use the legal substance kratom the entire time and the sober living was of no benefit to his sobriety. Just seems to have exposed himself to a lot of other’s sickness. He had a serious illness in which he felt living in sober living proved to be dangerous for his physical recovery. He was only with me 3 weeks when he OD’d.
It seems best if he could stay in this area and continue recovery with IOP and additionally see a therapist. This would be difficult for me but seems to be the only option in which he might continue to get help. If he wants to stay with me I just can’t wrap my head or heart around turning him away. I have my own anxiety issues that are triggered by others anger so his anger is a problem for me. But, I just can’t turn my back on him if he requests to stay with me to continue recovery. There is no other family member that can or will provide him a place to live. There just does not seem to be a better option.
Thank you for your thoughts and/or advise.
Housing is such a difficult question for families. We have written about it from various angles (see topics tab Home/ Homeless on the right hand margin of this page).
My first reaction is that your son is vulnerable to relapse and should be on a medication assisted treatment (MAT: Methadone, Buprenorphine or Naltrexone, see our article in the Resource Supplement). You didn’t mention this piece in your comment… Is this something that is being recommended, or that he’s used in the past? It’s an important factor to consider in setting up a strong array of supports as a Loved One transitions out of rehab. We’ve written about MAT as well in a number of other posts.
I don’t think you should be asked to live with someone who is at such risk. You must also think about your own well-being. Taking him back out of a sense of guilt or obligation can be a slippery slope. This set-up is based on a sort of emotional manipulation – even if it’s played out internally. We encourage members to be aware of these feelings and be aware of when we are acting on them, instead of from a more neutral, centered place. This really ends up being for benefit of both parties involved.
You say the sober house he lived in for a year didn’t help with his recovery. Is this because of the kratom? Did he successfully reduce or stop his use of opiates during that year?
Getting off of drugs is a process. Your son has accepted help repeatedly. This is very hopeful. The opiates are very very strong. If he came home and was clean from opiates for three weeks and then overdosed, it could be because he misjudged the dose to take. His tolerance would be low from being drug free for those 3 weeks, and many people make the mistake of taking the same dose they were previously used to taking. It is one of the main reasons for overdose. The MAT isn’t fool-proof but it does help prevent overdose.
Your son is angry and hard to be around, and you struggle with your own anxiety. Are you prepared to manage this in your own home? It’s understandable to feel you can’t “turn your back” on him in terms of housing. But perhaps your help with an alternative set-up would do more to preserve and strengthen your relationship – as well as your own precious sanity and well-being – than agreeing to something that you’re not comfortable with.
With all the unknowns, it’s hard not to be afraid about what comes next. But you can work on reigning yourself in when these feelings are at the forefront (see Learning Module 7), and looking at things from a different place. Embracing a compassionate stance – towards yourself as well as your son – can help you find a new way to feel grounded and strong as you make decisions based on your needs as well. It can also help you find peace in “not doing”. Being supportive and encouraging doesn’t always mean jumping in to help. It sounds like you are ready to be supportive in different ways. A lot of this comes from being dedicated to caring for yourself as well.
As you pore over the Learning Modules, you’ll see there is a lot to practice. We often suggest a family member give themselves a few months to implement the changes that CRAFT recommends before assessing things again. Your situation requires that you make a decision right now, though. The level of attention you’d need to work with him in this vulnerable situation sounds like it might just be too much to take on single-handedly at home, at this point. But you can still apply the CRAFT principles in each of your interactions with him. You can remain supportive, encouraging, compassionate and open. Your love remains constant, and as you embrace these practices, he will have opportunities to feel that even as you seek to support him in different ways along his journey.
Would your son agree to go to a strict sober house if he knew you weren’t inviting him back home? Has the rehab identified the sober house? Are they putting together a community-based plan for treatment and self-help in addition to the sober house? Please make sure to ask the rehab for this regardless of where your son goes to live.
For your own peace of mind, and to help things move along in upcoming conversations with your son, I’d push yourself to explore more options. What other housing options could you consider besides the strict sober living and your home? What is available in that area to support him with the PTSD, anxiety, and depression? Could you help your son with rent for a couple months for a room somewhere? This would give him a few months to find work and start paying rent on his own after coming through this time of transition.
Intensive outpatient programs (IOPs) typically last 3-5 weeks and will likely be a repeat of what he is already bored listening to. Yes, therapy is important but so is a community of concern, whether it be NA or another self-help group (see self-help resources for your Loved One in our Resource Supplement). Either way, helping connect him with a broad array of resources is something positive you can do, that also helps you to see that you aren’t all he has. This can be empowering to you as you seek to detach with love, nudging him towards safer territory as best you can.
Housing can be so confusing for the family to work out. There are so many factors to consider. You are right to question all of this. We recommend you think equally about yourself if you can. If he does come home to your house could it be only when not high, and then he gets a daybed in some common space in the house. We’ve written about the daybed and locker set-up in previous posts. These can really change the game in terms of how we approach the housing question.
I’m afraid I am raising more questions than answers. But you have a little more time before your son leaves rehab. There’s a lot to think over in this post. Can you write back and let me know some more? Let me know your thoughts on the questions I’ve raised here. This conversation should be helpful to tease out what guiding principles need to be at the forefront for you in this decision. Please write in again… we are all here for you.
I thought it best to answer questions with the telling of his story. These are the highlights but still I apologize for the length.
My son went through cancer treatment at the age of 12. He incurred many traumatic events during those years and was freely prescribed opioids for pain. We did not realize he was addicted until he graduated high school He went to rehab and was successfully sober for 7 years. He learned of kratom in a smoke shop. He was told it was “natural” and not addictive. Over the next couple of years he increased usage. As his usage increased he began to drink heavily and was “given” illegal drugs of all sorts when out with friends. Kratom was his mainstay.
Three years ago he called me to say he was in trouble. I repeatedly told him to go to rehab. He did not want to go and felt he could do it on his own. 2 years ago he called to say he wanted to go to detox and asked if I could take him. I did. He did not stay in the rehab that followed (for good reason) but refused to go to another one. Several months later he called to say he was severely depressed and wanted to go to rehab. The night before he goes in his long time girlfriend broke up with him. The entire time he was there he was only thinking of the breakup and began using kratom the day he got out. It was in rehab that he learned of an over the counter medication that if taken in high enough doses (60 plus pills) can be a high similar to heroine. After rehab he moved into a sober living home using both the over the counter medication and kratom while he attended IOP. During this time period he breaks his foot and has to have surgery. (More pain meds prescribed). After IOP he moves out of state to another sober living home. There he says he cleaned up for several months. He stopped taking his antidepressant and immediately spiraled and began using the two legal substances. He struggled to get clean and found a church with a strong men’s fellowship and a sober community. In Feb of this year he says he cleaned up. Beginning of March he spent practically the entire month in the ICU with pneumonia where they were giving him large doses of opioids. I went to him out of state while he was in ICU. Things were pretty grave. When he was released he asked if he could come back with me to heal physically. I agreed but with the stipulation that he must be kind and that he was not to use drugs not prescribed or alcohol. He wanted to attend IOP while staying with me and also get foot surgery once again. My thought even then was to set up the bed and foot locker living conditions since I do not have but my bedroom downstairs.
He filed for medical insurance coverage through the Market Place on April 12. While waiting for coverage to become effective May 1st specialist doctors were identified for required referrals once an ins ID was secured and addiction rehab resources (IOP and therapist) were located to get help as soon as insurance was activated May 1st. As he waited for coverage his addiction overcame him and on May 2nd he OD’d on the over the counter medication.
He coded 3 time and was on full life support for 5 days. Coming out of the medically induced coma he was very psychotic and lots of craziness ensued. Finally he agreed to go to rehab once he left the hospital. The trauma to all his organs was great and they have only started to function more healthily in the past 2 weeks. He has not only been mentally drained but physically drained for most of his rehab stay.
The day he left the hospital he went to a psychiatrist that prescribed him Suboxone. The rehab would not let him take it there. Since being in rehab he has asked me to to dispose of it.
The rehab has recommended sober living homes but I do not have that information. I have racked my brain for other living options but to no avail. The rehab has onsite PHP, IOP and AA meeting to help build a sober living community when they are discharged. He was required to get a sponsor early in his stay but last I heard the sponsor has not been responsive. If he is willing to stay in the program and live in the area for a year I would gladly help set him up in an apartment. However, Isolation is a concern.
He has been very difficult to talk to because of his anger. He has cut off communication in the past several days so I do not know his current state of mind. I’m sure he must feel he has tried so many time to get clean and keeps getting derailed even with his best efforts. I pray he has not given up.
I apologize for the length but I hope this answers your questions and adds more clarity to the situation. I no longer know what questions I have because I can not see a solution anywhere.
Your son’s story brought tears to my eyes. So sad, all that he’s been through. How could he not be depressed?
It’s so great to have AIR to provide this wonderful advice and support. My heart says that this man needs some emotional support. Maybe much more than you can give him.
Has he had any CBT type of therapy? This has been helpful to me.
I agree with SoCal that depression might should be a welcomed stage. How many of us have tried to focus on an LO sleeping too much when the problem was the SUD? Roger Federer sleeps 12 hours a day and has more money than most podunk cities and is a humanitarian and good citizen to boot. Same goes for Lebron James, sleeps 12 hours a day.
Through CRAFT I have learned to pick one thing at a time, the most important thing, to be a resource for my LO in our relationship. It must be relevant to the stage of recovery and my own attunement to my LO in order that they not sink into desperation yet trust coming to me.
This means when its “over my head”, meaning my opinion is not accepted by them, then I pray with them for our HP to help them imagine a solution appropriate for the LO. This also means to focus on morale and ignore their desperate relapses into self reliance or their old stinking thinking and ways. Progress happens yet I can’t resent the method of recovery and relapse can be a method as well as lurching progress and perhaps lifelong MAT or other things my own thinking finds repugnant (just say to myself “its over my head” let go and let G-d – don’t resent method of recovery).
Your son has tried repeatedly to stop using drugs. He has been to a number of detoxes, rehabs, and sober living houses only to find himself once again at the same crossroad. What is the next move?
I see that you are not in Massachusetts but I want everyone to know that Sober houses in Massachusetts cannot deny someone medication assisted treatment (Suboxone in your case) IF the house runs AT ALL on state funding.
The first thing to do is to help your son get back on Suboxone when he leaves rehab. Despite your son’s best intentions, he may use again and the drugs he takes are very dangerous. The Suboxone will reduce his cravings. It will also put him in front of someone, on a regular basis, who is drug testing and managing the opiates, regardless of where he is living. This can be considered support on a few levels. We know he needs all the support he can get.
Read Dominique Simon-Levine’s full response to hayleskp here: https://alliesinrecovery.net/discussion_blog-his-rehab-didnt-allow-suboxone