Family and Caregiver Schizophrenia Discussion Forum

At wit's end...son needs rehab asap

Need advice on how to get 24 year old SZA son with drug abuse habit into rehab. He cannot hold a job and is completely financially dependent on me and husband. He lives with us, has plenty of food, clothing etc. but we cannot give him any cash - he will buy drugs or alcohol. Kicked him out of house a while back due to his refusal to take home drug test/not use drugs or alcohol. He came back 24 hours later and agreed to drug test. It’s become obvious, he has continued to “play” us - he lies, steals, sells things from house. He asked to go to hospital 2 months ago due to psychosis. Stayed 9 days to stabilize - admitted to taking meth for a few weeks previously. Less than 2 weeks later, another psychotic crisis, he was willing to go to hospital. I tried to check him into a rehab but due to issues, did not work out. Later that day, he was involuntarily admitted to hospital after assessment. Social workers said he needed to be hospitalized but he wanted to do outpatient - which led to involuntarily admittance. I thought he would be there for a month - not to be released till was better, but within 72 hours he was able get a court hearing where he was released. Our system for mental illness and addiction does not work well for the patient who cannot recognize a problem or agree to get treatment. He needs long term rehab asap. How do I get him there? Live in TX and has to be danger to self or others to be involuntarily committed. Not sure he meets that definition - he’s not threatening anyone or hurting anyone physically - just stressing us out and playing Russian roulette with drugs.

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Check with your county to see what it takes to have your son picked up under the Marchman Act - which is related to substance abuse. I know CSUs see a lot of people with dual diagnoses so they might be able to address both issues initially.

I’d also call your state mental hospital and ask to speak to someone in admissions. Ask if they handle (if sent by the court) SZA and drug abuse in their facility. I actually toured our state facility BEFORE I had my son sent there. Call your state rep and anyone else who will listen.

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I gave my sz alcoholic son an ultimatum rehab or out. I researched facilities that had psychiatrists and stated they had dual diagnosis care. The first time he stayed 90 days most covered by insurance. The second time 60 days - different place due to covid. It can be a blessing as straight mental health programs are expensive and not as transparent

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Thanks for info. I’ve heard of Baker Act but not Marchman Act. When I researched CSU found a hospital nearby that treats co-occurring - a teaching hospital no less. Had not heard of it before. I am very thankful to the people on this forum. When you don’t know where to turn, I can always come here and read or post. THANK YOU

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We’re hoping to not have to kick him out. I hate that sometimes that’s the only option to get their cooperation. We should not have to resort to this to get our adult children treatment - it’s just ridiculous. Seat belts are mandated, helmets for motorcycles, speed limits etc. My son has two brain diseases - he is not in control of himself. He is a gentle soul and not violent or threatening. He is the one that feels threatened by the voices. One 2 occasions recently, he spent the night walking around the house with all lights all, carrying a steak knife because “something was about to happen.” I can only imagine the terror I would feel if in his shoes. They need help whether they realize it or not and we have a responsibility to help them. Stepping down from soap box now. THANK YOU. I appreciate you and your post.

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I wish you and your son the best! :palm_tree:

My brother (with bipolar disorder) has recently committed to alcohol rehab in principal, although it takes significantly more time for it to actually happen than you might think at least in the US. There’s back and forth about medicals and insurance and interviews to try to see if patients are truly committed and even seems to be review boards with cross functional teams including patients that approve intakes. Not sure about court-appointed situations, but I remember some time ago when he was in alcohol related legal trouble, the mental health resources said he wasn’t really ready for it yet.

I believe chances of success and reviticism are very poor for people who go to rehab for people without being committed to the process, so in order to save time money and precious bed resources they are very careful to ensure the rehab will “take”. I had a work buddy confide in me that he went to a rehab for drugs and alcohol that was seemingly easy to get into, but the vast majority of fellow patients were court-appointed and he was a novelty for having checked himself in. The rehab didn’t “take” for long and his opinion was it was set up as a revolving door money-making scam for insurance money. As with inpatient psychiatric care, my understanding is the quality of care varies widely from state to state, county to county or city to city.

As far as getting him to accept that he needed treatment, my siblings and I had been angling in on it for months as he deteriorated, and he began to have money and other troubles because it was an expensive habit and there were consequences to actions taken when drunk that he couldn’t ignore. So it was combination of removing enabling factors, incentives toward treatment, tag team negotiations of all the siblings working different angles, but we couldn’t seem to get him to commit. Then miraculously an old friend of his who has similar issues visited him and was able to take him over the threshold of calling the rehab facilities himself— which was part of all of their processes— and offer to buddy with him during his recovery and so on. My brother was better able to “hear” what he was saying than from family members most of whom have not had significant alcohol issues, yet far more skeptical and jaded about the possibility of this working. I suppose you could call him his “sponsor” although I don’t believer this is an AA/NA recovery framework. We are still skeptical, but have far more hope than before. I think the secret ingredient was someone he would listen to showing that he cared, and remaining positive that the process might work. I know these sorts of friends aren’t ready-made or always hiding in the woodwork, but most users and abusers don’t use alone, so you may be able to find a friend like that in his past or present if you scratch hard enough.

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Thanks for your input. I value your experience and viewpoint. Son has effectively run off the few friends that he had. There is one I have been in contact with that is still hopeful he will recover one day and has encouraged son to get professional help to no avail. I wish son could turn his stubborness toward getting clean instead of digging in and cutting off his nose to spite his face. His Dad, my husband, no longer cares. Sister wants nothing to do with him. I really do not want to kick him to the streets to make him agree to go - he still may not - and as you said it probably won’t be effective if he’s not motivated to get clean. It fells like an impossible situation.

I just had my husband invol committed in TX last week becuz he was so bizarre, even tho he never threatened me or himself. Its called a White Warrant. They held him for 72 hrs then he went before a judge while in the hospital and they extended it another 2 weeks. Thats as long as they can extend it. I actually wrote a letter to the judge, stating why I thought my husband should be in there the full 14 days and the judge sent me an email, telling me I should write the attorney that was representing my husband a little something, as that might help also. So I wrote just a paragraph. And that did help, as the judge decided to keep him the full 14 days. My husband is not happy but I am his voice when he has no voice. I love my husband very much and need him healthy and if it takes 14 days to allow the meds to work better, then yeah. I understand that they may not be working to their full potential, but it’s better than 3 days. It’s now been a week and he seems to be better than when he went in

He understands that he needs to stay on them, he’s feeling better than when he went in last week. He asked me to shop for healthy foods as he understands that weight gain is a side effect and he doesn’t want to “get fat”. So it sounds like he’s planning on staying on them. He’s planning on attending AA (he starting drinking to self medicating to drown out the voices) and going to therapy. He’s also wanting to go back to work, which I’m thinking its too soon but he’s insistent and it may be good for him to keep busy. I’m happy with his progress.

We had a 3 way phone call with his psych and I on Fri and possibly after his Depakote level (he’s on Depakote and Risperidone) is back on Mon or Tues he can come home before his full 2 weeks is over. I feel safe to say that he may be ready. And I was scared of him 2 weeks ago. So, while yes, its easier to get him committed if he threatens ur life, he doesn’t have to in TX. U can get a White Warrant. U can go to Justice of the Peace and state ur scared of him from his actions (my husband threatened to “kick the neighbors ass if they “looked his wife”” )

Good luck to u!

Marci

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Can I be ask what state you live? I can’t find any dual diagnosis residential treatment centers for my son. We live in MA. He had been clean for a year then used in January and ended up in the hospital.

We live in the state of Texas

i live in pa and he has been in rehab in md and pa. happy to give you names as well

My grandson with SZA was a heroun addict. Fought for 2 years to get him on Clozapine. It saved his life. He was back to his old self in 5 days. He has been clean for 6 years and has a life. He has a great job working a city with great benefits there is hope

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Glad your grandson was able to turn around. My son takes meds for SZA but the illegal drugs really mess with his meds/brain. He needs rehab but he refuses to go. Says the voices would make life worse for him if he went to rehab - they would not respect him. Found out in Jan of this year - he has used meth for about a month - that’s how he wound up in the hospital where he did not participate in couseling/classes. He tested positive for meth and pot last weekend with a home drug test. I don’t know how to convince him to go. Unless he is a harm to himself or others, he will not be involuntarily committed. Until he can be convinced to willingly go to rehab, I see no solution.

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The system is completely dysfunctional. When doctors want to keep a patient against his/her wishes the patient has to go before a judge. It’s very easy to learn the answers to the questions that will allow release. Do you have a place to live? Do you have food? Are you feeling suicidal? etc. And my daughter usually adds “if you keep me here I will sue the hospital” . That always get her out.
Also there are so few psych beds available in many states that should the person be kept involuntarily there might be no bed available. Then the court order would expire anyway.
It’s a complete mess.

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What state are you in? I’m navigating my partner’s first involuntary hold and was so hopeful this was the start to help. It’s day 3 now and he called me mad at the system saying he shouldn’t be there. If they let him out today I’m certain he won’t continue whatever meds he says they are “shoving down his throat” and he sounded overall suspicious of everyone, I guess I was hoping they would be successful in helping him understand that accepting treatment can help make things easier for him and he would start to understand the fears he has of being in danger and the many people/voices that contact him through his mind are thoughts that can be managed. He feels imprisoned and that he has no problems or need to be there. I have no clue if they plan to hold him another 14 days or if he is to be released today then we are back to square one or possibly a few steps backwards now bc of his distrust

I live in TX. Good luck to you. Hope your partner is able to stay long enough for the meds to work. Take care.

@Jane16 - How’re things going? :palm_tree:

@Pookey52 Thanks for asking… hes started risperidone (as well as paxil and a couple anti alcohol meds).
The fact that he is taking risperidone is pretty miraculous bc he is adamant there is no sz/delusions, but he calls it his anti-irritability meds and seems to want to take them. So kudos to whatever doctor helped convince him to work them in. He even suggested he may want to up his dose. The hard part is he has a lot of stomach pain.

He had a drinking relapse after almost 3 weeks out, which led to all the other old things (verbal abuse, talking about people going after him) and that lasted a weekend. He was pretty torn up physically from that and the blow up it caused with me, and then let me come over and take care of him after-- thats when i got more involved and he finally allowed me to know what specific meds he took plus get in contact with his psychiatrist to get another appt for more refills as he admitted he stopped taking them the day before his binge and at one point said he didnt have any left (but was able to produce them later on).

This incident seemed to stem from going to his first follow up appt, he doesnt like the invasion of his privacy. After that appt he started bringing up the “bad people” for the first time since release and his binge/relapse followed two days later. After we got him to the second appt, the next week, he admitted to me he hadnt taken his meds again the night before due to the stomach pain (and blood in stool was frequent). He doesn’t want to go to his regular doctor though.

Within two days of that (and me gently asking him to at least continue his anti depression and anti irritability meds) he had another more tolerable outburst where we had a great day, i left for work, and that night he started blowing up my phone with the insults and accusations i was so used to. I was really shocked and so angry and ignored him, and got an apology the next day but it was heartbreaking. That was a few days ago and then a couple days later he was back to calling me a wh*re, same thing basically a busy work day where i couldnt spend time with him all day.

I stayed calm the third time around but told him its not fair to me and our child to keep dealing with the disrespect and that for my own safety, wellbeing, and self respect i cant keep coming around him with this happening out of nowhere. He called me in tears saying he doesnt deserve me and that he needs me to stay away cuz the “ones out to get him” are who put all the doubts in his head about me and theyre just gonna try to ruin me and he doesnt want me hurt. He wouldnt talk on the phone much to say anything else just that he loved me. I again asked him if he was back on his meds, pointing out that he was doing well until his couple “hiccups” where he stopped, and it seemed that they were really helping him deal with the stress of those “bad guys”.

He didnt answer that message except to tell me again he loved me and last night he turned his phone off no doubt to ensure he didnt allow himself to berate my phone with the mean stuff again. Like he’s containing a werewolf from a full moon.

So i dont know, if the meds are not working, if hes taking them and the “hiccups” are bc of missed doses, or if he just stopped taking them now. I know ive caught him lying about them and he can be manipulative in his responses so anything is possible. I want so badly to go in and fix things and do the requirements for him. He decided he doesnt trust his psych bc she sent mail to his house and also a mobile response unit showed up at his house and he was embarassed to be outted by these two things. He says she broke his trust since he told her not to let those things happen but they did anyway. Originally, after his binge weekend he agreed that i could go with him to his appt to help him navigate and so we both know how to manage his meds and i could meet her, as it was one of my requirements if he wanted me to stick around, but the day of we got in an argument and he said he didnt trust me to be there either as he was afraid i would say something i shouldnt. I was upset at first but realize i cant force the trust and he at least let me take him to it.

In retrospect each of the three outbursts that weve experienced in the month since his release seemed to be lesser and improved in comparison to prehospital/pre-meds. So maybe thats a small victory. But as i write this its also possible he snuck back onto the alcohol again and that is where he really turns to worse. Its frustrating and im usually weighing thoughts and feeling torn-- do i stay away bc i am soon to have to raise a daughter and i shouldnt be dealing with his immaturity and (what can feel like are) games, or do i stick it out and keep learning and going through the trial and errors and hopefully we continue to see progress. I love him and part of me thinks he is taking some advantage of his situation but part of me feels it is out of his control and he needs the support and some forgiveness to have any hope.

Thanks for letting me vent, how have things been for you???

@Jane16 : This week has been relatively quiet BUT my 88 year old Mom had to have hip replacement surgery so my son’s been on his own a lot. I hide money around the house (usually a single $5 bill in each place) and he has to call me from the house phone to ask if there’s any more money. Since he has no cell phone, its kind of my way of seeing that he’s checking in and $5 won’t go very far, knowing that he won’t save any of it from one time to the next. My Mom called the house one day when I was en route and he actually answered the phone, telling her that he hoped she got better soon. Doesn’t sound like much but that was MAJOR!

I had to go to the dentist today and one of the women in the office has a son with SZ, a year younger than my son and she was a month older than me. We spent time comparing notes, venting about the lack of resources in our area and how we find ourselves at our wits end. I told her about this site so maybe she’ll pop up on here one day!

“…but realize i cant force the trust and he at least let me take him to it.” I think shows a lot of insight on your part. I hope he stays away from the alcohol but I know that my son will, maybe once a month, have a beer. In his case, it seems to calm him down but I don’t want it to be the start of a bigger problem with alcohol. So, I mention it, tell him that I’m not good with it and drop it.

I hope things get better and that you’ll have less to worry about. Take care of yourself! :palm_tree: