New to Alabama VDAP

  1. Hi, I'm Ryan. I got caught with some morphine in my pocket a few months back and here I am. They are now also trying to get me on some charting errors "because I now gave them doubt". It was a first time thing, though I do take norco at home for a back injury from college (prescribed). It appears my own medical issues are only raising red flags here. Anyway, my biggest concern is if anyone has been able to do outpatient treatment here without any inpatient? It seems all the approved providers are linked to a center, which thanks to you guys, is just awesome *note the sarcasm*. I have two young kids at home, and yeah, I already feel bad enough about my behavior, but it would be nice to not have to go somewhere for who knows how long. Also, any other insight to how decent or awful this program is would be appreciated. Just committed today for the sake of the license.
  2. Visit StanleyJ profile page

    About StanleyJ

    Joined: Aug '18; Posts: 17; Likes: 14

    19 Comments

  3. by   meanmaryjean
    If that's your real name in your post/ screen name- you will want to change that STAT.
  4. by   StanleyJ
    It doesn't give me the option. Any idea how?
  5. by   sirI
    Hello,

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  6. by   StanleyJ
    Thank you!
  7. by   Eris Discordia BSN, RN
    Okay, so I wrote a novel. As an option to not read said novel, I'll give you the TL;DR version.

    **I was able to do outpatient treatment, but they made me do 7 months of it, stepping down after 4. I was cleared to work at month 4. I have 2 kids and a husband, and the whole thing is gonna be very hard on them, regardless. Finances were the most devastating aspect for me. Humiliation and anger rank #2 and #3. I found a job but compromises were made. Don't fight the process, follow the rules quietly, and stay off your case manager's radar. Never talk to them when you are angry. You will feel like quitting but you will surprise yourself with the amount of bull you can put up with and how creative you can get to make things work. Don't ever try to cheat the rules, not even a little. 10/10 you will regret it. If you ever are contemplating cheating the rules, come to this forum and dive in and read the stories of the disasters that follow. Monitoring isn't fair, and it's best to accept that quickly for your sanity...it's just something you have to get thru in exchange for your license. Venting is useful, but radical acceptance of your situation is the only way to stay sane and not drown in anger and bitterness. Practice radical acceptance daily. Ultimately, if you really want your license, yes...it is worth it in the end.**

    Now, the novel...

    I managed to get away with not needing inpatient treatment. However, the only assessor in my area was affiliated with an outpatient IOP and had no affiliation with inpatient or residential treatment...not even a detox, so I unknowingly lucked out there. She did recommend me for her program, of course, which was outpatient. Apparently, this outcome is pretty rare.

    But I wasn't accused of diversion, I was abusing (albeit, rather severely) a non-controlled med that is not really well known to be abusable...but I managed to abuse it. Because it's just so weird of a drug, I won't name the it because anyone associated with my program who reads this will automatically be able to identify me...and my goal in life is to stay of my program's radar. To put it in perspective, no one in my program or treatment team had ever worked with someone with my addiction before.

    Anyway, I had to do one week of PHP, which is a Monday thru Friday 9 to 4 program. After that, I was supposed to only have to do 8 weeks of IOP, which was 3 hours twice a week...so pretty light. Even though I had no issues with treatment, my program required me to do 4 months of IOP instead. I'm pretty sure they weren't pleased that I wasn't recommended for inpatient, but since there was literally no other program-approved assessors within 100 miles, they did not compel me to get a second opinion. To be fair, there are no inpatient programs within 100 miles either because I'm pretty rural and quite off the beaten path.

    Because I wasn't recommended inpatient, my program got their way in a backhanded way by requiring IOP for 4 months and then a half time IOP for an additional 3 months. (So, one day a week). I was not allowed to look for work until I was done with full time IOP. For the remainder of my contract I have to do a once a month mini IOP group, but I actually don't mind that group and find it decently helpful.

    I also have two kids, so yeah, it hit home hard, mainly financially as I am married. With me being unemployed for so long, plus the price of extended treatment plus testing at least weekly, we got utilities cut off on the regular, one car repossessed, and sued a few times for resulting medical bills we couldn't pay. Even though I've been back working for a year, I just got served papers for another lawsuit...over a stinking $900 credit card balance that went delinquent and was on the bottom of the repayment totem pole because we figured they would be the last to sue. Wrong. So yeah, even now, crap is still popping up.

    Really, the financial aspect has been the biggest hardship. Although my treatment wasn't intensive, it was lengthy and 7 months of some form of IOP is very expensive and it was non negotiable with my contract. On top of having to pay to COBRA my insurance to cover the treatment, drug screens, shrink appointments, mandated therapy, yada yada yada...we lived off food banks and went hungry often and used rain water to bathe when the water was cut. When the gas got cut, we cooked in the microwave and heated with the woodstove. I'm not trying to be a drama queen here, but never in my wildest imagination did I think it would get that bad. Plus, testing for my DOC is blood test only and pricey, and I do that on top of regular drug screens.

    If I knew how bad it was going to be at the start, I may not have done it. I almost quit several times. But my inability to find a job that paid more than minimum wage in my 4 months off pretty much painted me in a corner, so we had to make a decision to go bankrupt and starve in short term in exchange for getting my career back in the long term, and that career eventually would be able to reinstate us back into a comfortable living...eventually.

    My program informed me that if I didn't join or if I quit, I would lose my license and be turned into the OIG, so I would never be able to work in any facility that accepted Medicaid or Medicare, in any sort of position...not even as janitor. After 4 years as a pharmacy tech and 17 years in nursing, I was unemployable outside of OIG restricted facilities. Couldn't even become a dental hygienist or a drug counselor. So really, I didn't make the choice, the choice was made for me.

    My program is 5 years long and I am almost 2 years in. I just passed the one year mark working back in nursing. Our heads are finally just above water. Our credit is ruined, we've been garnished a few times, and we are considering bankruptcy...we may be able to get away with not filing if we are willing to go a little hungry again, which me might just be willing to do. Our utilities no longer get cut and we were able to finance another cheapo car to replace the repo.

    We are now able to make it paycheck to paycheck, but we have zero savings. We sold a lot of things to get by, my engagement ring, guitars, appliances, etc. We were able to learn to be levels of frugal that I didn't know we had in us. As upsetting as it all is, I'm actually damn proud of the survival skills we developed and how little we managed to survive on (my husband is a rural elementary teacher, so no good money there).

    So, I've listed a ton of serious negatives. Now, I need to tell you why it has been personally worth it for us. First off, it did force me to get clean. I would have rather have gotten clean a different way, but that wasn't in the cards, still...I'm a much better wife and mom than I was before. But I identify as an addict, and that's not you so, moot point there.

    I rediscovered that I really am passionate (on some level) about my vocation. I always considered myself a paycheck nurse prior with a pretty low level of work satisfaction...but let me tell you. I did not realize how much of my self esteem and personal identity was intertwined with being a nurse...until I was no longer a nurse. So, this program did let me save my career.

    Next, my specific program allowed me to keep my mishaps off the public record. I was granted a stay of discipline, so if I finish my 5 years, no one is the wiser. That's huge for me, because the investigation unearthed a whole mess of my really embarassing and dirty laundry. I had to sign a million releases for every provider for the past 7 years and because I have mental health issues, that was uncovered and it's all super personal and humiliating and I would basically do anything to keep that off the internet.

    Also, I was able to keep a career that can provide for my family. I was the main breadwinner before and while I did work a minimum wage job as a substitute teacher and a preschool teacher, had I quit monitoring, I would have been stuck within a few bucks of that paygrade for the rest of my life...and I made the personal choice that it was in my famiy's best interest for me to get back to our old income bracket eventually. Some people can get away living pretty decent with significantly less earnings if their partner out earns them, but that wasn't my situation.

    I mean, monitoring is intense and awful and I do not believe that anyone will say that they spent their time in monitoring feeling confortable. I'm not going to lie and say I am grateful and happy to be here. I'm royally pissed at myself for getting into this situation.

    But I cannot curse the program because I do not have the right to curse the program. I can make excuses...and my excuses are that I temporarily quit nursing prior to being reported because of my habit because I knew I wasn't safe and yeah, it doesn't feel fair that my doctor turned me in when I was was sick from complications and ready to get clean. That pisses me off and always will. I was admitted with sepsis and endocarditis, and I was asking for help...
    And I thought I was safe because I wasn't nursing...but my occupation was on file at the hospital, so they chose to report me regardless. So, yes, I am hell fire bitter on that point.

    But at the end of the day, I was an addict and I was everything they accused me of. And obviously I was pretty sick in my addiction if I had endocarditis and sepsis.

    I am rambling so hard now and I'm sorry. But I guess I will summarize below.

    Finances and family strain are gonna be difficult, at least initially. You will doubt your decision everytime you are forced away from your babies and everytime you have to pay for a drug test rather than groceries to feed them. There is a ton of anger...at the BON, at the program...and eventually, at yourself...even if you never used the morphine, you will likely kick yourself for carrying it in your pocket against policy at some point. Depending on your savings and finances, it's going to take a ton of sacrifice. You will have to have really uncomfortable conversations with providers, friends, family, future employers, etc. It's embarrassing.

    Job hunting is challenging, but it absolutely is not impossible if you are realistic with where you apply. I found my job in about a week, but I cast my net very wide distance wise and picked jobs that didn't appeal to me just based on my judgement regarding how how easy it would be to accommodate a narc restriction. I got a job very fast, but I also got a massive commute. The tradeoff was worth it for me.

    Life in monitoring is much easier if you don't fight with your team...you will lose if you try and just end up on their radar of who they deem to be trouble makers, no matter how righteous your indignation is. The faster you accept that they do not care about your finances or family, the easier it will be on you. That sounds harsh, but anyone on this board will tell you how hard the smack in the face in when you realize the BON and the monitoring programs give zero f**ks about your situation.

    If you act remorseful, follow the rules, and stay off the radar, they tend to leave you alone...which is a good thing. Staying off the radar has earned me fewer drug screenings, they dropped my appointment requirements across the board without me asking, they allowed me to transfer units without a fight, and they even let me not show up for a drug test on the day my father died... which all has resulted in less stress for me and more money in my pocket.

    Monitoring is to be survived. Almost 2 years in, things feel mostly routine now. I'm not angry all the time. I can provide for my family. I'm going back to school for my advanced degree as soon as finances allow. My little family has a routine and we are getting by now.

    Overall, I'm really glad I didn't quit. God, I wanted to...and almost did. I have 607 days clean. I'm in therapy that is mandated...but ironically, I primarily use the therapy as a way to process the trauma from my addiction and monitoring. If I could have eased into another career that I didn't hate and that would have supported my family, yeah...I would have quit. Still probably would. But that isn't my hand to play, so here I am.

    Honestly, this answer was really therapeutic for me so...thank you for listening.
  8. by   StanleyJ
    This was beyond helpful. Thank you so much. Your outlook is something I hope to gain. I am definitely in the anger and embarrassment stage.I'm hoping if they drop the discipline like I'm told will happen, that the investigation will also cease? I sure don't want everyone in my last being notified of my situation. Another big reason why I'm going this route. The crappy part for me is that I had taken Norcos for years and when this happened I completely stopped and have no problem with it, minus the pain that I'm hoping gets better. Do you mind me asking if the provider you used was a "board certified provider" or did you ask them to see someone else due to no one being close? Everything is far for me as well. Are you in AL? I'm horrified at what's coming. Scared that this will somehow come to backfire on me. I just have a thousand thoughts. Thankfully my spouse is being amazing and I even worked up the courage to tell my parents and they are being supportive as well.

    Thank you so much for taking the time to respond to me. I have a million and one questions about all of this. I almost want it to get going just to get it over sooner. I just don't want to be away from my kids.
  9. by   Eris Discordia BSN, RN
    Quote from StanleyJ
    This was beyond helpful. Thank you so much. Your outlook is something I hope to gain. I am definitely in the anger and embarrassment stage.I'm hoping if they drop the discipline like I'm told will happen, that the investigation will also cease? I sure don't want everyone in my last being notified of my situation. Another big reason why I'm going this route. The crappy part for me is that I had taken Norcos for years and when this happened I completely stopped and have no problem with it, minus the pain that I'm hoping gets better. Do you mind me asking if the provider you used was a "board certified provider" or did you ask them to see someone else due to no one being close? Everything is far for me as well. Are you in AL? I'm horrified at what's coming. Scared that this will somehow come to backfire on me. I just have a thousand thoughts. Thankfully my spouse is being amazing and I even worked up the courage to tell my parents and they are being supportive as well.

    Thank you so much for taking the time to respond to me. I have a million and one questions about all of this. I almost want it to get going just to get it over sooner. I just don't want to be away from my kids.
    To answer your questions

    1) The investigation will not stop regardless of your choice. The investigation has to be completed in case you fail or drop out of monitoring...because in that case, they will discipline you based off the findings of the initial investigation, plus they will add new findings if relapse or noncompliance is involved with your separation from monitoring. If you leave for non-practice related issues, such as finances or simply wanting to get out, that won't hurt you any worse, you will just face discipline off the initial investigation, but if you separate due to any form of non-compliance, they will add that to their "Findings of Facts" statement that is publically placed as part of your subsequent board order. There is nothing you can do to stop the investigation. The investigation will be completed even if you never pick up the phone and speak to the BON again. They will complete it regardless, and keep it on file until you finish monitoring...though, I'm not sure if it gets destroyed after monitoring, to be honest.

    2) My assessor was a Board pre-approved provider. She was only 45 minutes away, so I got lucky there. However, if she didn't exist, I would have been expected to travel to an approved assessor. There are many options in my state, so even if none had been close to me, I would have had no choice but to travel. It is a requirement of my program to use a pre-approved provider. That was a non-negotiable.

    3) I am not in Alabama. I choose to keep my state confidential because my investigator let it slip that they had searched my social media as a part of my investigation. She specifically mentioned Facebook and LinkedIn...I get LinkedIn, in case I had trouble with past employment and was trying to hide employers. Also, heads up, they called and interviewed every employer I've had in the past 5 years...even though I did not have work issues and wasn't in trouble for diversion. This was massively embarrassing and it got around town, despite me being promised some confidentiality. Apparently, the investigator cannot tell your former employers WHY they are calling and asking questions, but it's a pretty damn big hint as to why when the BON investigators are calling all your old employers, aka...the people you *had been* hoping to use as references. Yeah. Couldn't use those managers as references any more.

    Feel free to ask me any more questions. Anything I can to to help out, I'm more than happy to accomodate.
    Last edit by Eris Discordia BSN, RN on Aug 21
  10. by   StanleyJ
    I just looked up all the approved providers and only one is 100miles away, the others are 250-300 Miles. I can't bekieve this. I don't live in a rural area! Then what happens after the initial Hell where I have to do a year of one day a week outpatient treatment? I don't have the option of moving. This entire thing makes me sick. Did you case manager answer questions for you or were they rude etc? I fear I've made the wrong decision already. Thank you for all your help. I guess I should start checking out my options in case I need to surrender due to there not being anywhere close to me. I feel so sick.
  11. by   Eris Discordia BSN, RN
    Quote from StanleyJ
    I just looked up all the approved providers and only one is 100miles away, the others are 250-300 Miles. I can't bekieve this. I don't live in a rural area! Then what happens after the initial Hell where I have to do a year of one day a week outpatient treatment? I don't have the option of moving. This entire thing makes me sick. Did you case manager answer questions for you or were they rude etc? I fear I've made the wrong decision already. Thank you for all your help. I guess I should start checking out my options in case I need to surrender due to there not being anywhere close to me. I feel so sick.
    Deep breath. They will work with you on the actual location of treatment, particularly outpatient treatment...not so much inpatient treatment, but you won't be required to drive 100 miles for outpatient. That's absolutely not possible. You just have to travel for that first assessment. They want somebody who is familiar with the monitoring program and has been educated on what they look for. That's why they are picky on the assessment provider.

    Yes, if you are given inpatient, you may be required to go a hike away. But that's a one time shot, then done. Anything that is a maintenance sort of program they will work with what you have locally. My PHP wasn't a preapproved PHP, but they let it work because it needed to be in reasonable driving distance since it didn't include boarding.

    Don't panic about long term distance trekking. That won't happen. The IOP I was in for 7 months was only a 35 minute drive away...and that is super doable. Again, they will make you go to the moon for your assessment and any inpatient treatment, but never for outpatient treatment.

    You can do this. You got this.
  12. by   J.Adderton
    I am 2 years into Alabama's VDAP program. I self reported for alcohol abuse. If you self report, the board will give you a timeframe to complete a comprehensive eval with board approved provider. I went to Bradford, but have heard UAB has good program too. The eval consists of multiple interviews- Psychiatrist, psychologist, psychosocial, cognition and IQ tests. They will also complete bloodwork and hair sample to determine if substances present that have not been reported. After eval completed, the team will meet with you to discuss findings and recommendations. The board will require you comply with recommendations to maintain licensure. I stayed 10 weeks at Bradford ECP, followed by 2 weeks of IOP, then I signed monitoring contract. Although it was overwhelming at the time, my life is SOOOOO much better!
  13. by   J.Adderton
    P.S.- this is not my real name.
  14. by   StanleyJ
    Thank you for responding. You are one of the first Al people I've read. Which makes this incredibly overwhelming! 10 weeks, wow! Do you mind me asking how much your eval was? Did your insurance pay any of it? I read on a forum evals can be anywhere from 2-3k but it seems the majority of the people in here paid 500-1k. I'm glad everything is going well now. How long before you were cleared to return to work and was it bad trying to find a job? Sorry for the overload, still can't seem to wrap my head around where I am.

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