What to expect during assessment for TPAPN

[Recovering_RN]

I entered TPAPN a couple weeks ago and am scheduled for my assessment by a psychologist next week. I self referred after having a positive drug test at work and being terminated. I admit I diverted while at work, I've started the NA meetings.

I used dilaudid that I diverted at work a couple times a week for about two months. It started as simple curiosity: what is it about dilaudid that all the patients seem to love? So I tried it. I honestly don't think I'm an addict, I stopped once I got caught without any problem (other than the shame and embarrassment of course), no withdrawals etc. I never used it at work. It was recreational use, it was a nice feeling, so I did it again, and again, once or twice a week, depending on how often I was able to get a 1/2 dose from work. I never got to the point where I had cravings, I never had to increase the amount I used. I know it was stupid and would've been the beginning of an increasing level of use...but I didn't get that far. From everything I've read and what I hear at the NA meetings, I feel like I will be treated as an addict no matter what I say. I'm worried about going into this assessment and having the doctor twist everything I say to justify an addiction.

i know they'll just view me as being in denial, refusing to admit I have a problem. But I truly don't think I do! Yes I was stupid, but I never got to the point of being addicted. I'm afraid I'll go to this assessment and they'll make me go to 8 weeks of "therapy" for my "addiction". I was under no stress when I started diverting, I wasn't trying to use drugs to cope with any problems in my life, nothing like that. It was a simple, stupid case of curiousity and then kept up just because it was a nice high.

I self reported to TPAPN strictly because I knew I'd have to go eventually once my employer reports me to the board.

So I guess I want to know what to expect during the assessment and if there's any point in trying to convince anyone I wasn't addicted?

[TXRNC]

They will do interview just be honest and your right if you keep saying I don't have a problem they will say your in denial, then most places do a ASI It ask you lots of questions but a lot of them are the same ask another way these questions are about what you think is right or wrong what's a problem or not, what's too much or "normal" Just answer what you really think if you try to play games or beat the test you just hurt yourself.Try to avoid clinics that only offer inpatient or that's what they will recommend you probably won't be able to avoid the min. 6 week Outpt. Good luck.

[LibertyTX]

If you aren't an addict, then you won't be eligible for TPAPN. The Texas BON has a program called the Extended Evaluation Program (EEP) for non-addicts. It involves one year of random drug screens. It is what I was referred to after a chemical dependency evaluation determined that I have no substance abuse problem. You might want to ask your TPAPN rep about it. EEP is run by TPAPN.

[Recovering_RN]

My case manager said that I wouldn't be eligible for the EEP if there were any practice violations and diverting is a practice violation. I would LOVE to qualify for the EEP! But I was under the impression I wasn't eligible because of diverting.

[odaat]

I'm trying to wrap my head around the idea of a "non-addict" diverting dilaudid just for the heck of it the first time and then continuing on after that. The cornerstone of my addiction was insanity and I gotta say, that sounds pretty insane. When I finally started diverting it was out of dope sick desperation and was truly the beginning of the end for me. It brought me to my knees and broke me so bad that either I was going to finally get clean or i was going to kill myself. I'm only speaking of my experience so to explain why I find yours so mind boggling, to go from 0 to 100 like that and not be an addict.

I believe you're going to have a real tough time getting them to believe you're not an addict after all this. I'm not saying you are one, only you know that, I'm just saying with the actions you took saying you're not an addict is gonna be a hard sell. As the board tends to err on the side of extreme caution anyway I would say you're more than likely going to end up with the whole shebang of monitoring (treatment, 12 steps, UAs, etc) addict or not. Hopefully you won't also face a felony for the diversion as I did once the board informed the police of my self-reported actions. Good luck with everything!!

[Recovering_RN]

odaat, glad I could offer you some mind boggling! Yeah, I never claimed to be smart, obviously! I did something really stupid. I never did Vicodin like some people do, because I'd taken that before after surgeries and I already knew how that felt. Been there, done that, wasn't interested in trying it again. I did some "dabbling" in drugs in college, but whatever I tried was just one time, just to see what it was like. Never got hooked on anything, I was just curious. And this time around I did try morphine too, just to see what it was like. So yeah, I was an idiot playing around with something that I shouldn't have been doing.

Not to cause an uproar here, hope I don't offend anyone, but I see a parallel in my situation to infidelity. Some people would never ever consider it, because it's morally wrong or they're simply not interested. Their minds just don't go there. But for people that do, they know it's wrong but they do it cuz they want to try it, it feels good, and they don't think they'll get caught. The longer they go without getting caught the more likely they'll think they're invincible and they do it again. Doesn't mean they're addicted, just that they're stupid and selfish. (Like I was with the dilaudid).

[dirtyhippiegirl, BSN, RN]

My case manager said that I wouldn't be eligible for the EEP if there were any practice violations and diverting is a practice violation. I would LOVE to qualify for the EEP! But I was under the impression I wasn't eligible because of diverting.

If you aren't eligible for EEP because of the diversion and you aren't eligible for TPAPN because you're "not an addict" -- than it seems like your last recourse is going to be a public hearing with a possible license suspension/revocation? The monitoring programs are built on the premise that addiction is a treatable disease. At this point I would be more worried about being labeled as someone who is at a minimum very immature with very, very poor judgment than an addict because there isn't a program to fix that.

[TXRNC]

Someone who repeatedly tries substances "to see how they feel" is heading down a very dangerous road and does not think that's a problem well sounds a little like for want of a better word an addict in training but that's my opinion.

[Omaapecm, ASN, RN]

Well said. So confused by this post

[Psychcns]

OP, at the very least you showed poor judgement stealing the dilaudid from work. You stole it to get high. This is what addicts do. I think at your interview the more you can admit you have a problem and need help, the easier the interview will be. Otherwise it will seem you are in denial. Best wishes

[CryssieD]

RecoveringRN--I think you're confused by the label of "addict" because you have an image in your head of some strung-out junkie living on the street; because you don't fit the "classic" description of an addict, you must not have a problem, right?

Wrong. There is nothing normal or OK about "experimenting" with morphine and Dilaudid just to see what they feel like. These are hardcore drugs, and you, as a nurse, know that perfectly well. None of this sounds like "experimentation" at all--I think you know exactly what you're doing. Your drug abuse--and yes, taking powerful opiates just for funsies is definitely drug abuse--tells me you have a serious need to escape your own life. I know it's normal to want to get away from harsh reality once in a while--that's why many people have a social drink now and then--but morphine and Dilaudid are not drugs someone does socially, unless that someone is hanging out with heroin addicts. Actions speak louder than words, and your actions bespeak a serious problem brewing.

Believe me, I've been where you are--minimizing, excusing, denying; we all try jumping on the denial train, only to find out that it doesn't go anywhere. Ever. Take a deep breath and jump off. Forget about fighting the label, it's wasted breath. If you want to keep your nursing license intact and your hind parts out of jail, you're going to have to go through the whole recovery thing, whether you think it's appropriate or not. Incidentally, the doctor who did my addiction evaluation told me that even if I wasn't an addict--and I am--I would still find many useful things in recovery. She was so right.

I sincerely hope that you embrace this opportunity, because that's what it is. Your post could have been written by me--I didn't fit the label either, if you asked me; the problem is, I didn't know what I was talking about. I know better now. I hope you learn all I have and more. Mostly, I hope you let this episode be the beginning of a whole new chapter in your life--and the best one, too.

Good luck. Much love. :) Keep us posted, OK?

[LibertyTX]

I didn't know that a practice violation makes you ineligible for EEP, but that makes sense.