Post acute withdrawal syndrome can mimic schizophrenia, bipolar, PTSD, explosive d/o and others. This is why it's not recommended for addictionologists to stamp any new diagnoses on patients until they're finished wit PAWS. It can last anywhere from 2mos to 2yrs. Addiction is a disease, just like cancer. What do we do with a cancer patient who breaks his leg in an accident? We tend to place them in the unit where the most acute need determines where they go. This is the same with addictions at the psychiatric campus where I work. It's not fair to place addicts in a locked ward with people hallucinating, etc. Actually we had to learn this. A patient pursued this the legal route (when we did detox in a locked unit with psych) and the findings were--this was, in fact unreasonable and unjust to lock detox with acute psych (who can get violent), so no more detox patients into the locked units where I am (unless mental illness is the primary need). This is how triage, care, anything works (squeaky diagnosis gets oiled first) :) ha ha!
Regarding the previous comments above: "The rest of them I couldn't care less what happens to them. They are generally, from my exp, ungrateful, needy, selfish, and just aholes?":madface: Whoa Nelly! Did I just read an professional RN calling a diagnosis group aholes ???
If you read no further; three letters E.A.P.!
I don't feel it's remotely appropriate, or acceptable to name-call any diagnosis group. I had to do a double-take. If a patient is doing something where I feel I'm going to react emotionally, or negatively, I've completely lost my ability to help that person (and I need to move out of that area to a different specialty ASAP). My self actualization, nor does my career depend on patient gratitude (they're not on our units to please US)! My job is focused on saving lives from a continuous, progressive and fatal disease. It's not a moral character disorder where patients are (enter negative name here). Again, it's an AMA AANP ASAM diagnosed disease. Has anyone called diabetics idiots, or aholes because they did xyz to further their illness, became obese, cheated, etc. I take care of them, because they come to me asking (asking) for help. Withdrawals (acute and post-acute) make patients insane. Some are more difficult than others (psychiatry 101 for anger, manipulative redirection, anger management, safe handling, etc). It's my job to come to them armed with all this information, so they understand what's happening to them. I always tell them, "Although you feel like you're completely losing your mind, YOU"RE NOT." When they act manipulative, panic, angry, etc. I calmly let them know "It will get better, trust me, it will."
In nearly all cases, once in recovery after PAWS, many can decrease or stop psych meds (obviously supervised, but these are the outcomes of recovery). It's nice to see the majority of professionals here taking it upon themselves to learn the most they can, ask legitimate questions and enjoy learning about a rapidly progressing specialty. Wouldn't it be great if we had staff who liked working with the most challenging patients, as well? I love my "druggies and drunks." The more manipulative, the better (because we have something to talk about, and I have an inroad to help them). I don't need any thank you's (my ego isn't fragile, and I already get paid as a thank you; never mind I'd do it for free).
Last of my soap box chat...patients and other staff see, and react to body language, facial expressions and word choices that exude the feelings one harbors against addiction, races, religion, orientation, etc. People can see, feel and sense that, whereby the practitioner becomes therapeutically ineffective (and creates a toxic environment of the unit, as this behavior can be contagious).
