Worried... something is different

Family
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My AH is in the VA hospital again. Without a doubt he has mental illness (non combat PTSD, drug impacted delusions/ SZ/ SOMETHING, etc) but he’s there bcz the psych ward is the gateway to rehab. He’s been turned down for rehab 3 times because he is too stable. Never gets meds while there, told delusional once or twice. Complete lack of insight.

Tonight is 72 hours since admission so I went to see him. I imagine it’s probably 75-80 hours since he last used. And when I say he’s a heavy user… he’s a heavy user. His DOC was opiates (yay VA) and we had to go outside the VA to get suboxone. He was successful in stopping using opiates but switched to cocaine… which has been so much worse for him. My point is, I know what opiate withdrawal looks like. I have no idea what cocaine withdrawal looks like.

He’s always in a bad mood there. And negative, and hates it. PTSD always triggered. Sometimes delusuons even increase. But tonight was different. He actually worried me. He said he is running out of options. It wasn’t in a sad way it was like deep anger and hopelessness. ANGER.

To get in, he told them he was suicidal… which he has told them before.( I think that’s one reason he uses heavily- he’s tried to OD before). But he also said, in this steely cold anger that he will be in a long time because it is different this time because he’s “suicidal” . Maybe sneering is the right word. I dont know if they are treating him differently since he’s been there so much? He even told another patient “oh, you have combat related PTSD and want rehab? You’ll have a place. Its people like me they dont help.” Which was awkward…

If they let him out without rehab or ptsd treatment, I honestly think the next binge is his last. The only possible mental health treatment he will get is around ptsd. I’m pretty confident if he gets that far in treatment he’ll get help for the SZ stuff. He did literally just call me and tell me he started amyltriptaline today “to help him sleep”. I haven’t even had time to Google it and I’m sure I spelled it wrong. I’m actually so glad… this is the first time he’s allowed any medication at all… but he also was resistant to allowing them to talk to me about his treatment.

For the addict side of my husband, I have not been calling social workers or trying to control things. For the mentally ill side, though, I think I really need to talk to his social worker. The VA is a very large organization that does very insane things. For instance, he was furious that he HAD and LOST a place in a rehab. A nonprofit, religious rehab. He was angry that it was religious and not the VA (his PTSD is due to abuse mixed with fundamentalist religion) but equally angry they used a very old phone number he no longer has to try to offer it to him… which I don’t get because they have been calling my number and I deliver all messages. I did confirm they used a 5 year old number. He seemed to be both angry that they gave the spot away and angry it is religious based.

I don’t think you can have someone you care about in the VA system without advocating like crazy. For ALL his health issues I have had to advocate. Control issue much? Absolutely. Necessary bcz the VA is ineffective and toxic? Yes. Last time he begged and begged to get in to rehab and they turned him down… he is very proud. He won’t beg again.

I don’t know what I am asking you all. First, I’ve never seen him act like this. Have any of your loved ones acted this way, especially the ones with dual diagnosis? It’s like he’s hopeless and furious at the same time. I hope since he has never acted like this and never got clean, maybe this is different.

How do I not control but advocate? The only thing I know to do is have a conversation with his treatment team and give them my perspective and then let what happens happen. Any other ideas?

I’m scared.

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By AH I mean addicted husband.

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Did he start to have worse problems when he went off suboxone?
I have selfish reasons for asking - my son was going downhill, but he quit suboxone cold turkey, didn’t get physically sick, but crashed mentally.

I wonder what would happen if you went to a teaching hospital with substance abuse/psychiatric ward?

I hear good things about the one here in Richmond (VCU Medical center, previously known as MCV), and I know they turn away people because of lack of insurance or ability to pay. And if you don’t have the funds to pay, they’ll write most if not all of it off if you can prove need.

I’m sure they have teaching hospitals in NC too?

But, unmedicated, my son might be angry like that at any given time, and the only reason he wouldn’t binge like your husband does is he doesn’t have access or contacts to get the drugs - or money to pay for it.

I think the drug use is part of the illness - not separate from it - for a lot of people. They do anything they can to make the symptoms go away, even if it’s just for a little while.

And, I thought it was incredibly hard to overdose on cocaine? maybe I have it mixed up with something else.

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He tapered down off suboxone years ago and had no problems at all with the taper itself or even withdrawing. He started using cocaine I think, because he never really was not an addict. I’m sure it was partially due to post acute withdrawal syndrome and needing something to feel energized and focused- so maybe due to the flatness the loss of suboxone caused. In addition, delusions started around that time. Whether due to opiate and then suboxone use, cocaine use, or whether he was coping with the delusions and “voices”-for lack of a better word-by using, I’ll never know. Cocaine is very very scary and truly evil. Its a whole different animal. I would not wish it on my worst enemy.

We have a teaching hospital but they don’t have inpatient services… they work with the VA lol. They have outpatient programs/iop but they throw people with mental illness in with people who have substance abuse issues. I don’t know which group my husband would attend (lol, little joke), but the needs of those groups in long term programs are different. And they don’t take people with SZ… bipolar and depression is what they do. Annoying! But I can look at surrounding hospitals. I hadn’t thought of that! Thank you!

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The anger and desperation sounds very familiar to me, back in the day when my son would use any drug he could find if he went without for a period of time and I was with him it would be the one time I would see so much anger and hostility and desperate talk. If I was having the issues you are having with the VA I might try to call or write the director of the VA and maybe even my state representative or senator, it can be done, and sometimes it works in your favor, I haven’t done it for a situation with my son but I have for other issues of concern…I may have mentioned this before but if your county has a mental health ombudsman…they are the best resource for help when you are in a bad situation, our mental health ombudsman got us (me and my son) on the right path here. One more resource that is good if you have it is an ADAMH Board (Alcohol, Drug and Mental Health Board) we have this in Ohio but not sure if it is available in other states…just thought I’d throw it out there in case. Hugs to you @Sadwife

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Well, if you check out MCV/VCU & they can do something for you guys, it’s not any further for you than Hampton.

And, the hospital does have a hotel-like thing they run for families. It’s an option if you guys get desperate.
I don’t know if they do what you need, but it’s an option.

Catherine does have a point. Maybe the anger is from not having his drugs?
I do know that cocaine is a mental addiction, not a physical one, and people have an awful time quitting.

Some people even get really angry like that if they try to quit smoking cold turkey.

And, I’m sure the frustration he feels with not being able to get the treatment he needs isn’t helping.

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One more thing I have learned about cocaine from reading is that since it is a stimulant, whatever underlying issues the user already has are usually “stimulated” and often made worse, so good reason to ultimately not use stimulants-I know I had to curtail even my sons coffee usage because if left to his own he would drink endless pots of coffee-triggering more paranoia, today he gets one over sized mug when he wakes up…that’s it…and it works okay for him. I know- big difference between coffee and cocaine…but I think you get my drift. :pensive:

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Makes so much sense… I hadn’t thought of it that way.

He sounds bad. Clearly depressed. They are moving him from the acute ward to the chronic ward. He takes that to mean he will be there a long time. I’m scared this has some impact on rehab. Can anyone she’d some light on this for me?

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Here’s my layperson thought: clear up the major symptoms of psychosis, then go to rehab when stable.

I had a friend who was an alcoholic and had to have an operation before he went to rehab. Whichever medical need is greater is taken care of first.

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I think what freaks me out is the move from acute to chronic…I just don’t know what that means. Would they send someone to a chronic ward whose only meds are low dose antidepressants (amitriptyline)? Something doesn’t make sense.

He sounds so bad. Told me not to come today. Not sure what the visiting hours will be in the new ward… what if there aren’t visiting hours? And he just sleeps. Yesterday I don’t think he’d brushed his hair at all. And I mean, just sleeps. Someone’s noticing this, right?

He doesn’t seem to have me on his medical release list. I’ll ask again but I’m panicked. Not as panicked as I would be if he was released, but getting there.

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I understand how anxious and panicked you feel as I feel that way almost all the time.

My goal is to just be in the moment and take the next step forward when it is time.

If there is something I don’t know that I can’t find out, that is beyond my control and I try to let it go.

You are doing everything you can and obviously care very much.

I hope everything goes well.

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@Sadwife I agree with Hereandhere you do care very much and you are trying to do all you can-so be good to yourself, As for acute and chronic explained…Acute means a sudden onset lasting for a less than a couple of weeks, and chronic means lasting longer than 3 months or persistent.

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It would explain things if they realize he is mentally ill now, I guess. The past 3 hospitalizations weren’t like this at all.

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@Sadwife So in a round about way maybe this is a good thing? so he can get the right treatment? I hope so for both of your sakes…