Dual Diagnosis help please
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Join Date: Aug 2021
Posts: 64
Dual Diagnosis help please
My alcoholic adult son has mental health issues--notably medication resistant depression and anxiety. He also has visual hallucinations that no one can diagnose. He knows they aren't real. They don't talk to him or tell him to do anything. They don't frighten him. They are just there. We've done it all---every drug you can think of, a lot of combinations, ruled out optical nerve issues, had the MRI and EEG, full blood panel, physical, etc. We've been doing this a looonnnggg time. No one understands it. My son is extremely high-functioning autistic. And here I need to say that he is undiagnosed but I am 100% positive. Because he is so high-functioning it was missed as a child (he met all his milestones) which is common. But interestingly enough, it has been suggested at points by professionals not in a position to officially diagnose it. I didn't put a lot into those subtle suggestions because I didn't know enough about it to understand how it impacted things. He is on disability due to his mental health issues so that you understand the severity.
So all that to ask for advice/opinions on finding a good dual diagnosis professional. He can't do it. I have to do it. What do I look for? What do I want to hear when I speak to them? What has worked and what hasn't? Same questions for a dual diagnosis inpatient facility. There is one in the vicinity of where we live but I have no clue how to evaluate it. Local would be great but if it isn't quality care then it is a waste of time.
He will drink again in my house. I know that. Is there a mother's hope left? Sure. But I know this. When that happens he will be invited to go to an inpatient facility. He will resist or just flat out refuse. He will be asked to live elsewhere. He will cry, apologize and tell me it will never happen again. I will probably cave and let him stay but tell him that the next time it happens, he can't live here. And the only good thing about that is the time he gets to consider inpatient again because that is how he operates---he needs time to process changes. And then I have to stand my ground. It will kill me but this is killing me too---and him.
In the absence of this, the only way I know to save his life is to legally have him deemed unfit to make these decisions for himself, get Power of Attorney, and force him into inpatient. I know that doesn't really work---they have to want it. However, I'm not entirely certain that it might not help him because of his mental illness and autism. I'm not entirely certain he can get there without some really intense situation where he is forced to focus on the problems. But I don't think that can work if he isn't focusing on ALL of the problems. What works for someone with just alcoholism isn't necessarily going to work for him because he processes information differently.
Please don't give me the three C's lecture. I understand it. What I'm trying to impart is that I have to do some things for him because he genuinely cannot do them. Do I do things I don't have to? Yes---all the time, I'm working on it and that is a whole lot harder when you have to evaluate each thing as necessary or codependency---but I'm working on it.
So all that to ask for advice/opinions on finding a good dual diagnosis professional. He can't do it. I have to do it. What do I look for? What do I want to hear when I speak to them? What has worked and what hasn't? Same questions for a dual diagnosis inpatient facility. There is one in the vicinity of where we live but I have no clue how to evaluate it. Local would be great but if it isn't quality care then it is a waste of time.
He will drink again in my house. I know that. Is there a mother's hope left? Sure. But I know this. When that happens he will be invited to go to an inpatient facility. He will resist or just flat out refuse. He will be asked to live elsewhere. He will cry, apologize and tell me it will never happen again. I will probably cave and let him stay but tell him that the next time it happens, he can't live here. And the only good thing about that is the time he gets to consider inpatient again because that is how he operates---he needs time to process changes. And then I have to stand my ground. It will kill me but this is killing me too---and him.
In the absence of this, the only way I know to save his life is to legally have him deemed unfit to make these decisions for himself, get Power of Attorney, and force him into inpatient. I know that doesn't really work---they have to want it. However, I'm not entirely certain that it might not help him because of his mental illness and autism. I'm not entirely certain he can get there without some really intense situation where he is forced to focus on the problems. But I don't think that can work if he isn't focusing on ALL of the problems. What works for someone with just alcoholism isn't necessarily going to work for him because he processes information differently.
Please don't give me the three C's lecture. I understand it. What I'm trying to impart is that I have to do some things for him because he genuinely cannot do them. Do I do things I don't have to? Yes---all the time, I'm working on it and that is a whole lot harder when you have to evaluate each thing as necessary or codependency---but I'm working on it.
Member
Join Date: Jan 2021
Posts: 259
I don't know where you live, but I can give a little info on what I went through with my AH. In MA, there are different ways to bring someone in against their will, but all can pose challenges due to red tape.
When my AH was binge drinking in a hotel, he was feeling extremely suicidal and told me multiple times during a phone call how badly he wanted to die. He sounded very unbalanced to me, had no sense of time, and refused to tell me his location. When I called the police for a check on him, they were able to ping his phone location without a warrant because: "... justified under the emergency aid exception to the warrant requirement, because the police had a ‘good faith, reasonable belief that there was a serious and imminent threat to human life’.
https://www.mass.gov/info-details/ma...phone-searches
At a later time, while he was hospitalized following his stand-off with the police, he had cooperated and consented to treatment. If he had not, he would likely have been temporarily admitted against his will using section 12.
https://malegislature.gov/Laws/Gener...r123/Section12
I listed those because they give you a bit of info on the laws allowing professionals to forcibly institutionalize someone in the event you have a medical emergency. For a family member to do so here would be section 35.
https://www.mass.gov/service-details...35-the-process
The short of it is only someone qualified (such as physician, police officer, spouse, blood relative, guardian, or court official) can file. Once you do, you have to go to the court and prove that the addict needs treatment (basically you need to prove they're an addict), is unwilling to commit to it themselves, and that they are at a risk of serious harm to themselves or someone else. It is a difficult thing to prove, and then gives the judge the power to decide what facility the person goes to.
From what I can see on reading about power of attorney for mental health, it gives you more power over someone's care, but isn't iron clad control. It looks to only activate when they are "incapacitated" as determined by a licensed psychiatrist, and must be drafted when the person is lucid and mentally stable. If he's drunk as often as you say, and you aren't already his power of attorney, that may be difficult to attain. I would definitely speak to a real attorney about that though, they would be able to give you much better info that's specific to your case.
https://info.legalzoom.com/article/p...mental-illness
Dial diagnoses seems relatively common for addicts, because so many begin their addiction with attempts to self medicate.
https://dualdiagnosis.org/dual-diagn...nt-statistics/
My AH for example was diagnosed with major depressive episodes during his visit to his first detox, and I suspect he is struggling with other issues as well that exacerbate his addiction. While I don't know about the facility near you that you mentioned focuses on dual diagnosis, I would be willing to bet many of the facilities around you are familiar with patients with multiple mental health issues. Questions I had asked when I called around, as well as ones I wish I'd asked are:
-Are you covered by my insurance? Can I get a list of all the fees someone staying with you could incur?
Seriously, this one is important. When we called and they checked our insurance, they said we were covered. Even after insurance, they cost up front was $7000 out of pocket. Then we got the bill from insurance later, and we still owed another $3000! Even after they claimed we had paid everything with the initial payment. Losing that much at once was devastating. I would work with your insurance provider ahead of time to make sure you really are pre-approved, and know exactly what costs you're about to incur.
- Do you offer support groups, therapy, or care for the families of the addicts?
This was actually a really nice part about that facility that cost us so much. They offered a weekly zoom meeting (it used to be in person but you know, covid) for the families of their patients. This was free of charge, and meant as a way for us to learn about addiction and how to support ourselves and our returning loved ones. A lot of places don't seem to include the families in this way, and it could be a good tool for you to get support outside of alanon.
- Do any of your staff specialize in or have experience with dual diagnosis or autism?
- Do you offer IOP (intensive outpatient) care for addicts once they leave the program?
- Do you have connections with sober houses or other housing options for patients who leave the program?
Those are what I can think of off the top of my head. Unfortunately it's difficult to evaluate these places, because we aren't the ones with addiction. The type of care we feel is needed might be different from what our loved ones feel works for them. If he is truly unwilling to listen or change, even the best place would be unable to help him. It's a tough road to forcibly institutionalize someone. I was not able to walk it for my AH, because I felt it wouldn't succeed and couldn't bring myself to do so. I hope the info I found helps you, and I hope he's able to accept help and reach out for his own recovery.
When my AH was binge drinking in a hotel, he was feeling extremely suicidal and told me multiple times during a phone call how badly he wanted to die. He sounded very unbalanced to me, had no sense of time, and refused to tell me his location. When I called the police for a check on him, they were able to ping his phone location without a warrant because: "... justified under the emergency aid exception to the warrant requirement, because the police had a ‘good faith, reasonable belief that there was a serious and imminent threat to human life’.
https://www.mass.gov/info-details/ma...phone-searches
At a later time, while he was hospitalized following his stand-off with the police, he had cooperated and consented to treatment. If he had not, he would likely have been temporarily admitted against his will using section 12.
https://malegislature.gov/Laws/Gener...r123/Section12
I listed those because they give you a bit of info on the laws allowing professionals to forcibly institutionalize someone in the event you have a medical emergency. For a family member to do so here would be section 35.
https://www.mass.gov/service-details...35-the-process
The short of it is only someone qualified (such as physician, police officer, spouse, blood relative, guardian, or court official) can file. Once you do, you have to go to the court and prove that the addict needs treatment (basically you need to prove they're an addict), is unwilling to commit to it themselves, and that they are at a risk of serious harm to themselves or someone else. It is a difficult thing to prove, and then gives the judge the power to decide what facility the person goes to.
From what I can see on reading about power of attorney for mental health, it gives you more power over someone's care, but isn't iron clad control. It looks to only activate when they are "incapacitated" as determined by a licensed psychiatrist, and must be drafted when the person is lucid and mentally stable. If he's drunk as often as you say, and you aren't already his power of attorney, that may be difficult to attain. I would definitely speak to a real attorney about that though, they would be able to give you much better info that's specific to your case.
https://info.legalzoom.com/article/p...mental-illness
Dial diagnoses seems relatively common for addicts, because so many begin their addiction with attempts to self medicate.
https://dualdiagnosis.org/dual-diagn...nt-statistics/
My AH for example was diagnosed with major depressive episodes during his visit to his first detox, and I suspect he is struggling with other issues as well that exacerbate his addiction. While I don't know about the facility near you that you mentioned focuses on dual diagnosis, I would be willing to bet many of the facilities around you are familiar with patients with multiple mental health issues. Questions I had asked when I called around, as well as ones I wish I'd asked are:
-Are you covered by my insurance? Can I get a list of all the fees someone staying with you could incur?
Seriously, this one is important. When we called and they checked our insurance, they said we were covered. Even after insurance, they cost up front was $7000 out of pocket. Then we got the bill from insurance later, and we still owed another $3000! Even after they claimed we had paid everything with the initial payment. Losing that much at once was devastating. I would work with your insurance provider ahead of time to make sure you really are pre-approved, and know exactly what costs you're about to incur.
- Do you offer support groups, therapy, or care for the families of the addicts?
This was actually a really nice part about that facility that cost us so much. They offered a weekly zoom meeting (it used to be in person but you know, covid) for the families of their patients. This was free of charge, and meant as a way for us to learn about addiction and how to support ourselves and our returning loved ones. A lot of places don't seem to include the families in this way, and it could be a good tool for you to get support outside of alanon.
- Do any of your staff specialize in or have experience with dual diagnosis or autism?
- Do you offer IOP (intensive outpatient) care for addicts once they leave the program?
- Do you have connections with sober houses or other housing options for patients who leave the program?
Those are what I can think of off the top of my head. Unfortunately it's difficult to evaluate these places, because we aren't the ones with addiction. The type of care we feel is needed might be different from what our loved ones feel works for them. If he is truly unwilling to listen or change, even the best place would be unable to help him. It's a tough road to forcibly institutionalize someone. I was not able to walk it for my AH, because I felt it wouldn't succeed and couldn't bring myself to do so. I hope the info I found helps you, and I hope he's able to accept help and reach out for his own recovery.
Member
Join Date: Oct 2013
Posts: 11,434
Removing media access is a pretty major consequence that typically gets the serious attention of the younger generations in particular. What about shutting off his internet, or making him get a job to pay for it himself as a consequence of failing to follow house rules?
Member
Join Date: Nov 2016
Posts: 8,648
Hi Lynn, I'm going guess these symptoms etc started before he started drinking? The thing is, if not, there is really no way to know and the fact that his medications have never appeared to work properly is an unknown too. Having him attend a facility is probably the only way you will ever know.
Does your Son have a psychiatrist? If so that is the person you might want to speak to about options, both for having him attend a facility and which facility might be the best in your area or elsewhere. You might find these articles interesting, written by Floyd P Garret MD:
.
Addiction, Lies and Relationships
.
"Addiction protects and augments itself by means of a bodyguard of lies, distortions and evasions that taken together amount to a full scale assault upon consensual reality. Because addiction involves irrational and unhealthy thinking and behavior, its presence results in cognitive dissonance both within the addict himself and in the intersubjective realm of ongoing personal relationships.
In order for the addiction to continue it requires an increasingly idiosyncratic private reality subject to the needs of the addictive process and indifferent or even actively hostile to the healthy needs of the addict and those around him. This encroachment of the fundamentally autistic, even insane private reality of the addict upon the reality of his family and close associates inevitably causes friction and churn as natural corrective feedback mechanisms come into usually futile play in an effort to restore the addict's increasingly deviant reality towards normal. Questions, discussions, presentations of facts, confrontations, pleas, threats, ultimatums and arguments are characteristic of this process, which in more fortunate and less severe cases of addiction may sometimes actually succeed in its aim of arresting the addiction. But in the more serious or advanced cases all such human counter-attacks upon the addiction, even, indeed especially when they come from those closest and dearest to the addict, fall upon deaf ears and a hardened heart. The addict's obsession-driven, monomaniacal private reality prevents him from being able to hear and assimilate anything that would if acknowledged pose a threat to the continuance of his addiction.
At this stage of addiction the addict is in fact functionally insane. It is usually quite impossible, even sometimes harmful to attempt to talk him out of his delusions regarding his addiction. This situation is similar to that encountered in other psychotic illnesses, schizophrenia for example, in which the individual is convinced of the truth of things that are manifestly untrue to everyone else. Someone who is deluded in the belief that he is the target of a worldwide conspiracy by some organization will always be able to answer any rational objection to his theory in a fashion that preserves the integrity of his belief system. Even when he is presented with hard and fast data that unequivocally disproves some of his allegations, he will easily find a way to sidestep the contradiction and persist in his false beliefs. (He can for example easily claim that the contradictory data is itself part of the conspiracy and is expressly fabricated for the purpose of making him look crazy! Anyone who has ever tried -uselessly- to reason with delusional patients knows the remarkable creativity and ingenuity that can be displayed in maintaining the viability, at least to the patient, of the most bizarre and obviously erroneous beliefs".)
Does your Son have a psychiatrist? If so that is the person you might want to speak to about options, both for having him attend a facility and which facility might be the best in your area or elsewhere. You might find these articles interesting, written by Floyd P Garret MD:
.
Addiction, Lies and Relationships
.
"Addiction protects and augments itself by means of a bodyguard of lies, distortions and evasions that taken together amount to a full scale assault upon consensual reality. Because addiction involves irrational and unhealthy thinking and behavior, its presence results in cognitive dissonance both within the addict himself and in the intersubjective realm of ongoing personal relationships.
In order for the addiction to continue it requires an increasingly idiosyncratic private reality subject to the needs of the addictive process and indifferent or even actively hostile to the healthy needs of the addict and those around him. This encroachment of the fundamentally autistic, even insane private reality of the addict upon the reality of his family and close associates inevitably causes friction and churn as natural corrective feedback mechanisms come into usually futile play in an effort to restore the addict's increasingly deviant reality towards normal. Questions, discussions, presentations of facts, confrontations, pleas, threats, ultimatums and arguments are characteristic of this process, which in more fortunate and less severe cases of addiction may sometimes actually succeed in its aim of arresting the addiction. But in the more serious or advanced cases all such human counter-attacks upon the addiction, even, indeed especially when they come from those closest and dearest to the addict, fall upon deaf ears and a hardened heart. The addict's obsession-driven, monomaniacal private reality prevents him from being able to hear and assimilate anything that would if acknowledged pose a threat to the continuance of his addiction.
At this stage of addiction the addict is in fact functionally insane. It is usually quite impossible, even sometimes harmful to attempt to talk him out of his delusions regarding his addiction. This situation is similar to that encountered in other psychotic illnesses, schizophrenia for example, in which the individual is convinced of the truth of things that are manifestly untrue to everyone else. Someone who is deluded in the belief that he is the target of a worldwide conspiracy by some organization will always be able to answer any rational objection to his theory in a fashion that preserves the integrity of his belief system. Even when he is presented with hard and fast data that unequivocally disproves some of his allegations, he will easily find a way to sidestep the contradiction and persist in his false beliefs. (He can for example easily claim that the contradictory data is itself part of the conspiracy and is expressly fabricated for the purpose of making him look crazy! Anyone who has ever tried -uselessly- to reason with delusional patients knows the remarkable creativity and ingenuity that can be displayed in maintaining the viability, at least to the patient, of the most bizarre and obviously erroneous beliefs".)
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Join Date: Aug 2011
Posts: 16,246
Lynn.......I sure do appreciate the complexity and challenges that you are facing. I can see that you haven't given up, and are open to getting help. That is so key.
Cookie has given you some good resources and info. for some specific situations, should you ever need them.
You are so right, in mu opinion---that you do need to be investigative and only deal with those who are exerienced and qualified to be of real help.
I am going to give you a couple of specific recources as potential Starting Points. I know that this is going to involve a lot of work for you. You are going to have to be tenacious and as determinded as a dog hanging on to a bone....lol. I call it "turning over stones".....
Tenacity will be your friend.
I do have some general familarity with autism, but, not enough to advise you in the ways that you need.
I suggest that you begin your search for help and advice on dual diagnosis with the following website. There, you will be able to participate in online forums, much like this one, for those who are dealing with autistic loved ones.....of every level and every age. You can find one specifically for adult children with autism.
There, you can ask the kinds of questions that you have and recieve experienced advice and information. They will know of the good resources and facilities and other support organizations and groups.
ANNE
The Asperger/Autism Network (look for the online discussion forums)
More in line with locating the proper kind of treatment facility....I suggest that you might begin your search at the following website...
www.recovery.org (look for "co-occuring-disorders).
Lynn....these are just my suggestions for starting points----you will find that there are lots of organizations and groups......for him...and for yourself, of course.
Please keep us appraised of how you get on......
Cookie has given you some good resources and info. for some specific situations, should you ever need them.
You are so right, in mu opinion---that you do need to be investigative and only deal with those who are exerienced and qualified to be of real help.
I am going to give you a couple of specific recources as potential Starting Points. I know that this is going to involve a lot of work for you. You are going to have to be tenacious and as determinded as a dog hanging on to a bone....lol. I call it "turning over stones".....
Tenacity will be your friend.
I do have some general familarity with autism, but, not enough to advise you in the ways that you need.
I suggest that you begin your search for help and advice on dual diagnosis with the following website. There, you will be able to participate in online forums, much like this one, for those who are dealing with autistic loved ones.....of every level and every age. You can find one specifically for adult children with autism.
There, you can ask the kinds of questions that you have and recieve experienced advice and information. They will know of the good resources and facilities and other support organizations and groups.
ANNE
The Asperger/Autism Network (look for the online discussion forums)
More in line with locating the proper kind of treatment facility....I suggest that you might begin your search at the following website...
www.recovery.org (look for "co-occuring-disorders).
Lynn....these are just my suggestions for starting points----you will find that there are lots of organizations and groups......for him...and for yourself, of course.
Please keep us appraised of how you get on......
Member
Thread Starter
Join Date: Aug 2021
Posts: 64
Originally Posted by trailmix 
Hi Lynn, I'm going guess these symptoms etc started before he started drinking? The thing is, if not, there is really no way to know and the fact that his medications have never appeared to work properly is an unknown too. Having him attend a facility is probably the only way you will ever know.
Does your Son have a psychiatrist? If so that is the person you might want to speak to about options, both for having him attend a facility and which facility might be the best in your area or elsewhere. You might find these articles interesting, written by Floyd P Garret MD:
.
Addiction, Lies and Relationships
.
"Addiction protects and augments itself by means of a bodyguard of lies, distortions and evasions that taken together amount to a full scale assault upon consensual reality. Because addiction involves irrational and unhealthy thinking and behavior, its presence results in cognitive dissonance both within the addict himself and in the intersubjective realm of ongoing personal relationships.
In order for the addiction to continue it requires an increasingly idiosyncratic private reality subject to the needs of the addictive process and indifferent or even actively hostile to the healthy needs of the addict and those around him. This encroachment of the fundamentally autistic, even insane private reality of the addict upon the reality of his family and close associates inevitably causes friction and churn as natural corrective feedback mechanisms come into usually futile play in an effort to restore the addict's increasingly deviant reality towards normal. Questions, discussions, presentations of facts, confrontations, pleas, threats, ultimatums and arguments are characteristic of this process, which in more fortunate and less severe cases of addiction may sometimes actually succeed in its aim of arresting the addiction. But in the more serious or advanced cases all such human counter-attacks upon the addiction, even, indeed especially when they come from those closest and dearest to the addict, fall upon deaf ears and a hardened heart. The addict's obsession-driven, monomaniacal private reality prevents him from being able to hear and assimilate anything that would if acknowledged pose a threat to the continuance of his addiction.
At this stage of addiction the addict is in fact functionally insane. It is usually quite impossible, even sometimes harmful to attempt to talk him out of his delusions regarding his addiction. This situation is similar to that encountered in other psychotic illnesses, schizophrenia for example, in which the individual is convinced of the truth of things that are manifestly untrue to everyone else. Someone who is deluded in the belief that he is the target of a worldwide conspiracy by some organization will always be able to answer any rational objection to his theory in a fashion that preserves the integrity of his belief system. Even when he is presented with hard and fast data that unequivocally disproves some of his allegations, he will easily find a way to sidestep the contradiction and persist in his false beliefs. (He can for example easily claim that the contradictory data is itself part of the conspiracy and is expressly fabricated for the purpose of making him look crazy! Anyone who has ever tried -uselessly- to reason with delusional patients knows the remarkable creativity and ingenuity that can be displayed in maintaining the viability, at least to the patient, of the most bizarre and obviously erroneous beliefs".)
Does your Son have a psychiatrist? If so that is the person you might want to speak to about options, both for having him attend a facility and which facility might be the best in your area or elsewhere. You might find these articles interesting, written by Floyd P Garret MD:
.
Addiction, Lies and Relationships
.
"Addiction protects and augments itself by means of a bodyguard of lies, distortions and evasions that taken together amount to a full scale assault upon consensual reality. Because addiction involves irrational and unhealthy thinking and behavior, its presence results in cognitive dissonance both within the addict himself and in the intersubjective realm of ongoing personal relationships.
In order for the addiction to continue it requires an increasingly idiosyncratic private reality subject to the needs of the addictive process and indifferent or even actively hostile to the healthy needs of the addict and those around him. This encroachment of the fundamentally autistic, even insane private reality of the addict upon the reality of his family and close associates inevitably causes friction and churn as natural corrective feedback mechanisms come into usually futile play in an effort to restore the addict's increasingly deviant reality towards normal. Questions, discussions, presentations of facts, confrontations, pleas, threats, ultimatums and arguments are characteristic of this process, which in more fortunate and less severe cases of addiction may sometimes actually succeed in its aim of arresting the addiction. But in the more serious or advanced cases all such human counter-attacks upon the addiction, even, indeed especially when they come from those closest and dearest to the addict, fall upon deaf ears and a hardened heart. The addict's obsession-driven, monomaniacal private reality prevents him from being able to hear and assimilate anything that would if acknowledged pose a threat to the continuance of his addiction.
At this stage of addiction the addict is in fact functionally insane. It is usually quite impossible, even sometimes harmful to attempt to talk him out of his delusions regarding his addiction. This situation is similar to that encountered in other psychotic illnesses, schizophrenia for example, in which the individual is convinced of the truth of things that are manifestly untrue to everyone else. Someone who is deluded in the belief that he is the target of a worldwide conspiracy by some organization will always be able to answer any rational objection to his theory in a fashion that preserves the integrity of his belief system. Even when he is presented with hard and fast data that unequivocally disproves some of his allegations, he will easily find a way to sidestep the contradiction and persist in his false beliefs. (He can for example easily claim that the contradictory data is itself part of the conspiracy and is expressly fabricated for the purpose of making him look crazy! Anyone who has ever tried -uselessly- to reason with delusional patients knows the remarkable creativity and ingenuity that can be displayed in maintaining the viability, at least to the patient, of the most bizarre and obviously erroneous beliefs".)
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Thread Starter
Join Date: Aug 2021
Posts: 64
Originally Posted by dandylion
Lynn.......I sure do appreciate the complexity and challenges that you are facing. I can see that you haven't given up, and are open to getting help. That is so key.
Cookie has given you some good resources and info. for some specific situations, should you ever need them.
You are so right, in mu opinion---that you do need to be investigative and only deal with those who are exerienced and qualified to be of real help.
I am going to give you a couple of specific recources as potential Starting Points. I know that this is going to involve a lot of work for you. You are going to have to be tenacious and as determinded as a dog hanging on to a bone....lol. I call it "turning over stones".....
Tenacity will be your friend.
I do have some general familarity with autism, but, not enough to advise you in the ways that you need.
I suggest that you begin your search for help and advice on dual diagnosis with the following website. There, you will be able to participate in online forums, much like this one, for those who are dealing with autistic loved ones.....of every level and every age. You can find one specifically for adult children with autism.
There, you can ask the kinds of questions that you have and recieve experienced advice and information. They will know of the good resources and facilities and other support organizations and groups.
ANNE
The Asperger/Autism Network (look for the online discussion forums)
More in line with locating the proper kind of treatment facility....I suggest that you might begin your search at the following website...
www.recovery.org (look for "co-occuring-disorders).
Lynn....these are just my suggestions for starting points----you will find that there are lots of organizations and groups......for him...and for yourself, of course.
Please keep us appraised of how you get on......
Cookie has given you some good resources and info. for some specific situations, should you ever need them.
You are so right, in mu opinion---that you do need to be investigative and only deal with those who are exerienced and qualified to be of real help.
I am going to give you a couple of specific recources as potential Starting Points. I know that this is going to involve a lot of work for you. You are going to have to be tenacious and as determinded as a dog hanging on to a bone....lol. I call it "turning over stones".....
Tenacity will be your friend.
I do have some general familarity with autism, but, not enough to advise you in the ways that you need.
I suggest that you begin your search for help and advice on dual diagnosis with the following website. There, you will be able to participate in online forums, much like this one, for those who are dealing with autistic loved ones.....of every level and every age. You can find one specifically for adult children with autism.
There, you can ask the kinds of questions that you have and recieve experienced advice and information. They will know of the good resources and facilities and other support organizations and groups.
ANNE
The Asperger/Autism Network (look for the online discussion forums)
More in line with locating the proper kind of treatment facility....I suggest that you might begin your search at the following website...
www.recovery.org (look for "co-occuring-disorders).
Lynn....these are just my suggestions for starting points----you will find that there are lots of organizations and groups......for him...and for yourself, of course.
Please keep us appraised of how you get on......
Member
Thread Starter
Join Date: Aug 2021
Posts: 64
Originally Posted by Cookie314
I don't know where you live, but I can give a little info on what I went through with my AH. In MA, there are different ways to bring someone in against their will, but all can pose challenges due to red tape.
When my AH was binge drinking in a hotel, he was feeling extremely suicidal and told me multiple times during a phone call how badly he wanted to die. He sounded very unbalanced to me, had no sense of time, and refused to tell me his location. When I called the police for a check on him, they were able to ping his phone location without a warrant because: "... justified under the emergency aid exception to the warrant requirement, because the police had a ‘good faith, reasonable belief that there was a serious and imminent threat to human life’.
https://www.mass.gov/info-details/massachusetts-law-about-cell-phone-searches
At a later time, while he was hospitalized following his stand-off with the police, he had cooperated and consented to treatment. If he had not, he would likely have been temporarily admitted against his will using section 12.
https://malegislature.gov/Laws/GeneralLaws/Parti/Titlexvii/Chapter123/Section12
I listed those because they give you a bit of info on the laws allowing professionals to forcibly institutionalize someone in the event you have a medical emergency. For a family member to do so here would be section 35.
https://www.mass.gov/service-details/section-35-the-process
The short of it is only someone qualified (such as physician, police officer, spouse, blood relative, guardian, or court official) can file. Once you do, you have to go to the court and prove that the addict needs treatment (basically you need to prove they're an addict), is unwilling to commit to it themselves, and that they are at a risk of serious harm to themselves or someone else. It is a difficult thing to prove, and then gives the judge the power to decide what facility the person goes to.
From what I can see on reading about power of attorney for mental health, it gives you more power over someone's care, but isn't iron clad control. It looks to only activate when they are "incapacitated" as determined by a licensed psychiatrist, and must be drafted when the person is lucid and mentally stable. If he's drunk as often as you say, and you aren't already his power of attorney, that may be difficult to attain. I would definitely speak to a real attorney about that though, they would be able to give you much better info that's specific to your case.
https://info.legalzoom.com/article/power-attorney-and-mental-illness
Dial diagnoses seems relatively common for addicts, because so many begin their addiction with attempts to self medicate.
https://dualdiagnosis.org/dual-diagnosis-treatment/important-statistics/
My AH for example was diagnosed with major depressive episodes during his visit to his first detox, and I suspect he is struggling with other issues as well that exacerbate his addiction. While I don't know about the facility near you that you mentioned focuses on dual diagnosis, I would be willing to bet many of the facilities around you are familiar with patients with multiple mental health issues. Questions I had asked when I called around, as well as ones I wish I'd asked are:
-Are you covered by my insurance? Can I get a list of all the fees someone staying with you could incur?
Seriously, this one is important. When we called and they checked our insurance, they said we were covered. Even after insurance, they cost up front was $7000 out of pocket. Then we got the bill from insurance later, and we still owed another $3000! Even after they claimed we had paid everything with the initial payment. Losing that much at once was devastating. I would work with your insurance provider ahead of time to make sure you really are pre-approved, and know exactly what costs you're about to incur.
- Do you offer support groups, therapy, or care for the families of the addicts?
This was actually a really nice part about that facility that cost us so much. They offered a weekly zoom meeting (it used to be in person but you know, covid) for the families of their patients. This was free of charge, and meant as a way for us to learn about addiction and how to support ourselves and our returning loved ones. A lot of places don't seem to include the families in this way, and it could be a good tool for you to get support outside of alanon.
- Do any of your staff specialize in or have experience with dual diagnosis or autism?
- Do you offer IOP (intensive outpatient) care for addicts once they leave the program?
- Do you have connections with sober houses or other housing options for patients who leave the program?
Those are what I can think of off the top of my head. Unfortunately it's difficult to evaluate these places, because we aren't the ones with addiction. The type of care we feel is needed might be different from what our loved ones feel works for them. If he is truly unwilling to listen or change, even the best place would be unable to help him. It's a tough road to forcibly institutionalize someone. I was not able to walk it for my AH, because I felt it wouldn't succeed and couldn't bring myself to do so. I hope the info I found helps you, and I hope he's able to accept help and reach out for his own recovery.
When my AH was binge drinking in a hotel, he was feeling extremely suicidal and told me multiple times during a phone call how badly he wanted to die. He sounded very unbalanced to me, had no sense of time, and refused to tell me his location. When I called the police for a check on him, they were able to ping his phone location without a warrant because: "... justified under the emergency aid exception to the warrant requirement, because the police had a ‘good faith, reasonable belief that there was a serious and imminent threat to human life’.
https://www.mass.gov/info-details/massachusetts-law-about-cell-phone-searches
At a later time, while he was hospitalized following his stand-off with the police, he had cooperated and consented to treatment. If he had not, he would likely have been temporarily admitted against his will using section 12.
https://malegislature.gov/Laws/GeneralLaws/Parti/Titlexvii/Chapter123/Section12
I listed those because they give you a bit of info on the laws allowing professionals to forcibly institutionalize someone in the event you have a medical emergency. For a family member to do so here would be section 35.
https://www.mass.gov/service-details/section-35-the-process
The short of it is only someone qualified (such as physician, police officer, spouse, blood relative, guardian, or court official) can file. Once you do, you have to go to the court and prove that the addict needs treatment (basically you need to prove they're an addict), is unwilling to commit to it themselves, and that they are at a risk of serious harm to themselves or someone else. It is a difficult thing to prove, and then gives the judge the power to decide what facility the person goes to.
From what I can see on reading about power of attorney for mental health, it gives you more power over someone's care, but isn't iron clad control. It looks to only activate when they are "incapacitated" as determined by a licensed psychiatrist, and must be drafted when the person is lucid and mentally stable. If he's drunk as often as you say, and you aren't already his power of attorney, that may be difficult to attain. I would definitely speak to a real attorney about that though, they would be able to give you much better info that's specific to your case.
https://info.legalzoom.com/article/power-attorney-and-mental-illness
Dial diagnoses seems relatively common for addicts, because so many begin their addiction with attempts to self medicate.
https://dualdiagnosis.org/dual-diagnosis-treatment/important-statistics/
My AH for example was diagnosed with major depressive episodes during his visit to his first detox, and I suspect he is struggling with other issues as well that exacerbate his addiction. While I don't know about the facility near you that you mentioned focuses on dual diagnosis, I would be willing to bet many of the facilities around you are familiar with patients with multiple mental health issues. Questions I had asked when I called around, as well as ones I wish I'd asked are:
-Are you covered by my insurance? Can I get a list of all the fees someone staying with you could incur?
Seriously, this one is important. When we called and they checked our insurance, they said we were covered. Even after insurance, they cost up front was $7000 out of pocket. Then we got the bill from insurance later, and we still owed another $3000! Even after they claimed we had paid everything with the initial payment. Losing that much at once was devastating. I would work with your insurance provider ahead of time to make sure you really are pre-approved, and know exactly what costs you're about to incur.
- Do you offer support groups, therapy, or care for the families of the addicts?
This was actually a really nice part about that facility that cost us so much. They offered a weekly zoom meeting (it used to be in person but you know, covid) for the families of their patients. This was free of charge, and meant as a way for us to learn about addiction and how to support ourselves and our returning loved ones. A lot of places don't seem to include the families in this way, and it could be a good tool for you to get support outside of alanon.
- Do any of your staff specialize in or have experience with dual diagnosis or autism?
- Do you offer IOP (intensive outpatient) care for addicts once they leave the program?
- Do you have connections with sober houses or other housing options for patients who leave the program?
Those are what I can think of off the top of my head. Unfortunately it's difficult to evaluate these places, because we aren't the ones with addiction. The type of care we feel is needed might be different from what our loved ones feel works for them. If he is truly unwilling to listen or change, even the best place would be unable to help him. It's a tough road to forcibly institutionalize someone. I was not able to walk it for my AH, because I felt it wouldn't succeed and couldn't bring myself to do so. I hope the info I found helps you, and I hope he's able to accept help and reach out for his own recovery.
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Join Date: Jan 2021
Posts: 259
😊 I hope it helps. I can keep looking for info if you'd like, but you'll need to consult with professionals to get any that's personalized and accurate to your situation.
Unfortunately even if you are able to institutionalize someone, it usually isn't for the long term. A group mate of mine in that support group I mentioned actually did file section 35 for his wife. Even with all the info he'd accrued and her self destructive life style, it wasn't enough to convince the court. Putting someone through the systems like that essentially makes them a ward of the state for a time, and you know how much states love to spend money on people or their health. I think the amount of time someone is institutionalized is also up to some discretion. The section 35 page I linked mentions it lasting about 3 months, whereas my group mate said it would only have been 1 month for his wife. Like I said, you'll need to talk to several local professionals to get the most accurate info.
Unfortunately even if you are able to institutionalize someone, it usually isn't for the long term. A group mate of mine in that support group I mentioned actually did file section 35 for his wife. Even with all the info he'd accrued and her self destructive life style, it wasn't enough to convince the court. Putting someone through the systems like that essentially makes them a ward of the state for a time, and you know how much states love to spend money on people or their health. I think the amount of time someone is institutionalized is also up to some discretion. The section 35 page I linked mentions it lasting about 3 months, whereas my group mate said it would only have been 1 month for his wife. Like I said, you'll need to talk to several local professionals to get the most accurate info.
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Thread Starter
Join Date: Aug 2021
Posts: 64
Just wanted to give you a quick update Cookie. I found a place I think would be good for him to go for residential treatment (they define inpatient more of emergency and residential more of what I was looking for). They have a robust program for family. They have two steps of intensive outpatient (one where you go 5 days a week all day and the other where you go 3-4 times per week for 2-4 hours) and typical outpatient care as well. They accept his insurance. It is even nearby (about 30 miles away). I didn't even know it existed--because why would I until I needed to know. I also investigated the laws in my state and they are similar to yours. He has been trying to transition to a new psychiatrist (one at his recovery center) as during the pandemic he started seeing one through telehealth and she is not in-state (his psychiatrist at the time was not working out due to a medication issue that she wouldn't address). From my research, I need a psychiatrist on my side for this and he has his appointment in 2 weeks. So I'm going to continue to arm myself with information and await this appointment. Since he just lapsed (it is typically for a day when it happens--not that it is better just defining because for many it is longer), there is a strong chance that he will not before that time (we'll see). Whenever he does (and I know it will happen), I will present this option. I have no expectation of him going willingly and I already see that it is going to be a real battle to get him there if he isn't willing. I'm going to have to make the hardest decision of my life to give him an ultimatum---residential treatment or live elsewhere. He will not understand (at least for a very long time) but it's the only viable option to save his life and ours (my other son and me). The waiting game is going to be hard but it always is and in some sick way I guess I'm accustomed to the stress of waiting for it to happen. I can do it one more time. I want to be in a place where I can have a psychiatrist back it up. Obviously, I'm counting on that piece and it may not happen, but I feel like it will. Thank you again for all of your help and the information. You made an awful situation easier and I appreciate it more than I can express.
Member
Join Date: Mar 2021
Posts: 336
I’m sorry for whatever you’re about to have to do, it sounds like it’s going to exhausting and very hard on the heart and soul.
But I’m really glad it sounds like you have prepared as many resources in the meantime as possible.
But I’m really glad it sounds like you have prepared as many resources in the meantime as possible.
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