Too Many Doctors Still Get Addiction Wrong

By Anna David 04/04/13

When I was an active addict, my interactions with medical professionals harmed rather than helped me. Sadly, I'm far from alone.

Stumped? Psychiatrist via Shutterstock

The year before I got sober, I was in group therapy, snorting dangerous amounts of cocaine, suicidally depressed and seemingly without the ability to connect these facts. The therapy was only making me feel worse, so the solution, I decided, was anti-depressants. I asked my group therapist to recommend a psychiatrist, and she sent me to a guy with a fancy Beverly Hills office, a Southern accent and a pinkie ring.

For some reason, when I walked into his office and he asked me if I did any drugs, I decided to be honest and told him that I was regularly doing cocaine. Maybe I was sick of lying. Maybe I had faith that there was another way and believed he could help. Maybe I was just tired or coming down.

“While most medical professionals are great on the science, they're not so great on the art of establishing a therapeutic alliance with the patient," says Dr. Paul Hokemeyer.

“What?” he asked, clearly horrified; I made an instant decision never to be honest with a doctor again. “Does Arlene know?” he asked of my group leader. I shook my head. “Well then, you have to tell her,” he commanded. “Tell her or I will.”

I was terrified. I didn’t know the rules. The Internet existed but I was too wired and paranoid all the time to try to find out if his threat was legal or appropriate, and I felt judged and cornered and terrorized.

Until, that is, I saw an easy solution. The following week, during group, I made this confession: “I was doing a lot of coke for a while. But I’ve stopped.” They nodded. I think one of them picked at a hangnail. Group moved on; it was someone else’s turn to share. I called my coke dealer on the drive home.

While my situation was somewhat unusual, addicts receiving damaging responses from the medical profession—above and beyond the frequent failures to diagnose addiction—is sadly all too common. 

I continued to see my pinkie-ring psychiatrist for the next year or so, because he told me I had to if he was to keep prescribing me Paxil and Ambien—drugs I was convinced I needed. I thought he was a terrible psychiatrist and a worse person, and found the $250 half-hour sessions a serious financial strain. But he was a professional, and I was desperate and afraid.

Then one day he calmly explained that he couldn’t continue to see me, and I “must know why.” I theorized it had to do with my constantly telling him I’d gone out of town again and—would you believe it—had left my bottle of Ambien in Houston or Vegas (in reality I was barely leaving my apartment and taking roughly 10 times the amount he’d prescribed me). But I was too ashamed to say anything, so I only nodded.

He told me to find a new shrink, and that he wouldn’t give me any more Paxil; then he handed me a prescription for six months’ worth of Ambien. At no point did he mention AA, rehab, or even the words “addict” or “addiction.” I left his office hysterically crying, scrip in hand, feeling like he hoped I would kill myself.

Here’s what I'll say in his defense: Active addicts tend to be nightmarish patients. They often refuse to look at reality, lie whenever they can and would happily steal any doctor’s prescription pad if they didn’t think they’d get busted. I was all of those things and worse.

But does that excuse what he did? I didn’t think so. A year or so later, once I’d been to rehab and sobered up, I received a bill from his office and a note which claimed I’d never paid for my last visit. I sent him a reply detailing what I’ve just told you—adding that if he tried to contact me in future, I’d report him to the American Medical Association. I never heard from him again.

All that said, I have plenty of friends whose doctors have spoken to them directly and appropriately about their addictions, and it didn’t make a difference until they were ready to change. Tiffany, an LA-dwelling actress I went to high school with, told me that her general practitioner diagnosed her as a bipolar addict years before she got sober, adding that she couldn’t drink because “bipolar addicts don’t live long.” Her liver enzymes had shot through the roof, and she respected her doctor. But she hadn’t surrendered, so she did what anyone in the grips of alcoholism would: Quit long enough for her enzymes to normalize, got re-tested to get that doctor off her case and then went back to drinking.

After that, Tiffany’s luck with doctors ran out.

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Anna David is the New York Times-bestselling author of multiple books about overcoming difficulties and coming out on the other side: the novels Party Girl (HarperCollins, 2007) and Bought (HarperCollins, 2009), the non-fiction books Reality Matters (HarperCollins, 2010), Falling for Me (HarperCollins, 2011), By Some Miracle I Made It Out of There (Simon & Schuster, 2013) and True Tales of Lust and Love and the Kindle Singles Animal Attraction (Amazon, 2012) and They Like Me, They Really Like Me (Amazon, 2013). Find Anna on LinkedIn and Twitter.