A few of the responses I’ve heard over the years, from patients who were discovered attempting to smuggle drugs into rehab for their own (secret) use:
Numero Uno, by a wide margin: “You found that in my suitcase? I can’t imagine how it got there! Although now I remember, my little brother used that same bag on his trip to Jamaica last summer, the scamp…” And variations on the theme.
When somebody did ‘fess up, they invariably cited fear of being undermedicated as a motive.
“I was in detox last year, sick the whole time, begging for more medication, and they just wouldn’t give it to me…” and that could be true, or it could be an exaggeration. I would reassure the newbie that our docs followed the latest recommended detox protocols (which they did) but this would be greeted with deep skepticism, as they watched me carry their precious contraband away for destruction.
Nobody said it was a perfect system, just efficient.
On occasion, I’d run into an organized, carefully planned effort to subvert the goals of detoxification. Perhaps the most memorable involved a rock band prepping for their first European tour. Their manager had warned them that procuring drugs while on the road in a foreign land was very risky, and therefore they could only bring a limited supply of dope along with them — far less than they were accustomed to consuming at home.
Worried, they had decided as a group to make use of the hospital detox unit to “get our habits down“ to a more manageable level prior to the trip. They reasoned that this would greatly reduce their drug cravings, and any lingering withdrawal symptoms could be self-medicated, they believed, with good ol’ booze.
As it turned out, one band member decided that he needed to bring extra drugs along, just in case. I didn’t find his special stash on the initial search, but a couple of days later there he was, nodding off in the day room from the combined impact of his drugs on top of the medication the nurse had already given him.
The head RN wanted to discharge him, but he signed himself out first. As in, “you can’t fire me, I quit!”
The remaining musicians stuck it out to the end and on their last day, as they were preparing to leave, the leader took me aside and explained their plan, admitting they never intended to remain drug-free, and in fact would probably celebrate with drugs that every evening. I did warn them that overdose risk was now higher since they’d finished detoxing.
I doubt they paid much attention.
No word on how the tour went. But the experience served as a reminder for me that a patient’s goals for treatment can easily diverge from, or even directly contradict, the goals of the professionals who treat them.
