After almost 15 years as a model client in a Medication Assisted Treatment (MAT) program, I performed a medically supervised withdrawal from methadone maintenance therapy nine months ago. Although the “acute” phase of detoxifying from the drug was relatively easy and took a couple of weeks to accomplish, I was completely unprepared for what came next and has lasted through today. I was tormented by numerous challenges after completing MAT: Post-Acute Withdrawal Syndrome (PAWS), resurgence of long dormant Bipolar 2 symptoms, and a new and profound psychological and physical response to repetitive traumatic events that I had experienced.
While the United States ranks as the international leader in biomedical research, one doesn’t have to look far to find complaints about the quality of healthcare in the United States. From service users to the Institute of Medicine, a universal cry has gone out for more compassionate, person-centered care. In short, people want to be heard and understood by their providers. They want their visits to start out with the two simple questions posed by Mitch Kaminski: What are your goals for your care? How can I help you? However, these questions can’t be asked in a vacuum. They have to be asked within a continuous, healing relationship that focuses not just on disease and illness, but strengths and wellness.
I remember when I was first doing clinical training we had an advanced psychopathology course every Wednesday after rounds. When we started, we looked at the syllabus and there were a number of familiar texts: the DSM-IV-TR, and Adult Psychopathology and Diagnosis. But sprinkled throughout the texts were other readings: Nabokov, Dostoyevsky, Rilke. After we’d had a moment to look it over the teacher said, You will no doubt notice that there are a number of texts that you have not seen before. This is because I assume that your clinical training to be largely complete. Otherwise how would you get here? But now you have to learn what things actually look like. And, over the course of my career, I have found that anywhere a psychiatrist would go a great writer has been there before and has described it better.
As a person in long-term recovery from using opioids for more than three decades, including 16 years as a Medication Assisted Treatment client, I have been watching with great interest the progress of The Comprehensive Addiction and Recovery Act (CARA) of 2015 through the legislature. According to Faces and Voices of Recovery, “this is the most expansive federal, bipartisan legislation to date for addiction support services, designating between $40 million and $80 million toward advancing treatment and recovery support services in state and local communities across the country, which will help save the lives of countless people.”
