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Re: The Controlled Substance Catch-22 » fachad

Posted by alan on April 19, 2002, at 22:23:38

In reply to The Controlled Substance Catch-22 - My Worst Fear » Elizabeth, posted by fachad on April 19, 2002, at 9:57:21

> Drug Seeking. Dose Escalation. Doctor Shopping.
>
> Those are some of the most pejorative words ever used in medicine and in behavioral health care. In so many ways both medicine and mental health has tried to get away from pejorative language and pejorative concepts, but when it comes to controlled substances, they sometimes become self-appointed judge, jury and executioner in a trial that is rigged with a built-in bulletproof Catch-22.
> But I have thought it thru, comprehended the vastness of the dilemma from a theoretical standpoint, and tried to work out rational solution scenarios.
>
> (BTW, this activity in itself would meet DSM IV Criteria 5 for Substance Dependence: "a great deal of time is spent in activities necessary to obtain the substance...” I had to interject that because I know how much you love DSM-IV. And it just further shows that this Catch-22 is all encompassing and bulletproof.)
>
> I think any rational person, and most pdocs are rational, intuitively understands a Catch-22 situation. Besides, if you are not hiding anything, there is no reason to doubt your sincerity.
>
> Please post some follow-ups for us, and let us know how it is going, and how it worked out, because the only thing standing between any one of us taking a CS and this awful situation is blind luck.
>
> -fachad
*****************************************
All superb points fachad! I know because I've LIVED them - you've just enunciated them so clearly and plainly.

The beauty though is finding a doctor that understands and sees beyond the double bind in all of it's complexity. It took me years to find one that did and I'd now know how to go about doing it again if I had to: copying your post and taking it in to the doc as a theoretical case study to see if they GET it!

Alan


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