What kind of treatment is necessary for a relapse?

Nurses Recovery

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Should I get an evaluation for alcoholism or just go straight into an IOP? 

For reference, this is my backstory: https://allnurses.com/I-dilute-urine-t755646/

I've been given a new contract that includes dual diagnosis and told by my case manager to go into treatment. 

I asked to see one of the BON approved evaluators, but my case manager said if they recommend treatment I'd have to go immediately (I will be abroad until mid-December). If I do not get an evaluation, then I can wait until I return. 

I was looking at the ASAM criteria because he was vague about what treatment meant. I don't think I arise to the level of needing IOP. Granted I'll do whatever the board wants, but I was just wondering if I should first go to a counselor and determine the level of treatment required in my case. 

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Specializes in Psychiatry.

I would skip all of this if I were you since you don't want to be a nurse. Your family would have to try to find out you had action against your license and even if they did you could explain.  But if you insist on going through with it. I'd try to escape the penalty.  5 years of this prison is a long time.  Call a lawyer and see if they can recommend a lawyer who may decide you don't have a sud. Give up a vacation to save yourself 5 years if possible.  Imagine having to check in daily to see if you have to test and if you do, kiss your plans for those hours goodbye every time you test. It's difficult to make plans around the tests. You have to give up hours for AA.meetings, hours for appointments with their providers.  You miss one detail and 5 years becomes longer. If you have a hope of avoiding it,take the chance. There will be more vacays in the future. 

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Healer555 said:

I would skip all of this if I were you since you don't want to be a nurse. Your family would have to try to find out you had action against your license and even if they did you could explain.  But if you insist on going through with it. I'd try to escape the penalty.  5 years of this prison is a long time.  Call a lawyer and see if they can recommend a lawyer who may decide you don't have a sud. Give up a vacation to save yourself 5 years if possible.  Imagine having to check in daily to see if you have to test and if you do, kiss your plans for those hours goodbye every time you test. It's difficult to make plans around the tests. You have to give up hours for AA.meetings, hours for appointments with their providers.  You miss one detail and 5 years becomes longer. If you have a hope of avoiding it,take the chance. There will be more vacays in the future. 

I'm already in a 5 year contract. The way I see it is I'm only in this position because there was something wrong. If I wasn't 100% guilty, then yeah I'd feel indignant about being compelled to participate. However, I definitely had depression that was not being addressed properly beforehand. The only real difference now is that I have to go to AA. However, I wrote the op because I don't think I arise to the level of needing an IOP (after reviewing the ASAM criteria).

I do think I was at risk for alcoholism because I have depression, was unemployed and living in a toxic environment. Yet, I made the decision to move to a place that was healthier for me until I got a new position and could afford to live on my own. I am also in therapy again (I had a gap of two weeks when I was binge drinking) and that helped me to correct course. I did this of my own volition before I notified the board of my binge drinking.

That's partly why I'd like to get a diagnosis first. These nuances don't get taken into consideration with AtD programs, which I get makes it easier to administer but also makes it sort of emotionally taxing for me. As much as I loved the trauma-based IOP I did before, it was....a lot for me to get through it. So, I'd like to at least get some idea of what I'd need for my own well being and present that to my case manager. He may very well say that I still have to do another IOP but it doesn't make a difference for me time wise (4 weeks, virtual, evenings) to at least present that for him.

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Specializes in Psychiatry.

For a substance use disorder you are looking at frequent drug tests. Do what you need to to make this easier on yourself is my advice  Good luck 

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In my state and monitoring agency, everyone has to go to residential rehab anywhere from 6-12 weeks.  Hardly anyone gets just IOP - usually it's someone who had a DUI that was dropped and they were nowhere near work hours. 

They will look at the DSM criteria for SUD and adjust that to meet more of the bullet points.  In their minds, since we are in the medical field, we should have known better NOT to test positive even after we were told of the consequences.  (even if this means we only drank on Friday evenings, not at work and didn't have to work all weekend).

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Universe93B said:

In my state and monitoring agency, everyone has to go to residential rehab anywhere from 6-12 weeks.  Hardly anyone gets just IOP - usually it's someone who had a DUI that was dropped and they were nowhere near work hours. 

They will look at the DSM criteria for SUD and adjust that to meet more of the bullet points.  In their minds, since we are in the medical field, we should have known better NOT to test positive even after we were told of the consequences.  (even if this means we only drank on Friday evenings, not at work and didn't have to work all weekend).

Wait so they had to go to rehab over a positive screen? I agree about how the board looks at it, which makes sense bc they aren't invested in whether nurses can successfully complete the program. I just want a neutral third party to evaluate me according to same tools/standards used by the board to determine tx. LOL I feel so conflicted because I naturally want to advocate for myself but worry it may but me in the *** somehow. 

I was originally on mental health contract after diverting and attempting suicide. But I didn't have to go to any inpatient treatment probably because it was 2 months later that the board reached out. This positive drug screen was two months ago too so fingers crossed no rehab for me!

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Sam_0896 said:

Wait so they had to go to rehab over a positive screen? I agree about how the board looks at it, which makes sense bc they aren't invested in whether nurses can successfully complete the program. I just want a neutral third party to evaluate me according to same tools/standards used by the board to determine tx. LOL I feel so conflicted because I naturally want to advocate for myself but worry it may but me in the *** somehow. 

I was originally on mental health contract after diverting and attempting suicide. But I didn't have to go to any inpatient treatment probably because it was 2 months later that the board reached out. This positive drug screen was two months ago too so fingers crossed no rehab for me!

I had three positives (back to back) for alcohol and I went into an IOP. My case manager didn't specify the treatment either, just that I had to go to a facility. As long as your subsequent drug screens are negative (and you're completely honest about the positives), I don't see why they would insist on rehab. There are nurses in my program who cannot go to rehab, but have been allowed to do less intensive therapy. I don't think any state board really cares if you have a documented diagnosis or not. They would rather err on the side of caution, and all that matters is the drug screens to prove you're in recovery. 

I am not an alcoholic but I have the risk factors for addiction. I did shop around for a suitable IOP that wouldn't interfere with my work. If you can afford it, I would look for something that works for you. 

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