A writer in Baltimore recently posted the following question on Avvo:
“If a rehab patient is misdiagnosed with alcohol dependency by a counselor is there any action he can take? Some one I know is in rehab for testing positive for marijuana on a urine screen. He was sent to rehab and although he said he never drank over a few beers every night he was diagnosed with alcohol dependency and now is forced to screen for alcohol also at work.”
Answering a question on Avvo presents certain challenges. Here, the writer did not disclose who he or she was. Was he the patient, a friend of the patient, a family member? This is important because I wanted to get my message across. Talking to someone who is personally suffering is different from talking to someone who has a different kind of pain from watching his friend suffer. I think of the people who are at least once removed from the actual problem as collaterally damaged by the problem. A primarily injured person may not hear my message unless the collaterally damaged person takes it to him. In addition, the collaterally injured person may have to reshape my reply in order to get the primarily injured person to consider, or act on, it. In effect, getting the message across often requires persuading more than one person that the message is worthwhile.
I also need to admit that when I answer a question on Avvo, I am also writing for myself. The writing process requires me to think deeply and try to hear what a writer is really saying — not just hear his words. Here, the writer seemed to be saying “there seems to be something wrong with a process that requires you to submit to treatment that may not be warranted.” That really was the root of the problem here. The person in rehab could not yet appreciate focusing on the entire substance abuse problem. The person asking the question, assuming it was someone other than the person being treated, wanted to help. When a person is in the midst of substance abuse, he is not ready to hear a message that urges treatment and sobriety. If I could answer the question effectively, I had an opportunity to empower the writer to help the patient during the transition from abuse to sobriety. This kind of opportunity gives my life meaning.
Answering Avvo questions also makes me mindful of the roles that people play in my own life. Life is not always pleasure. Sometimes, I have learned to listen to voices other than my own. The practice of thoughtful answering reminds me to thoughtfully listen.
Here is the full text of my answer on Avvo:
You have asked whether a person who is required to screen for alcohol at work has recourse if he has been “misdiagnosed with alcohol dependency.” This question may actually be an employment law question if the patient’s private employer is requiring the alcohol screening as a condition of employment. If that is the case, I’d urge you to post this question in the employment law forum.
Since your question sounds like the patient may be in rehab to fulfill a court requirement, such as a sentence imposed by a judge in a DUI or CDS case, I will go on to answer the question. The patient could retain an attorney for the purpose of seeking modification of the alcohol screening procedure. The decision whether to seek modification should only be made after answering honestly all questions asked by the attorney and waiving privacy rights to permit the attorney full access to medical records and doctors who have examined and treated the patient. In addition, if the attorney believes it is important for the patient to undergo testing by a privately retained medical professional in order to show that the alcohol diagnosis was made in error, the patient must follow the attorney’s advice. The attorney will most likely need a more qualified expert opinion to demonstrate that the original diagnosis is wrong.
Before assuming the burden of trying to show a misdiagnosis, however, I’d point out the obvious. The fact that the patient said he “never drank over a few beers every night,” taken alone, certainly does not show that the diagnosis is wrong. The patient’s admission actually supports the diagnosis.
It is quite common for persons who abuse alcohol to justify their use as “not unusual” compared to the general population or “no more than I can handle.” It is quite common for them to lie about how much they actually drink to others and to themselves. Alcohol abuse is insidious; it creeps up on a man. Very few people wake up one day and say to themselves, “I am going to start drinking in excess because I want to lose control of my life to alcohol and put my relationships and my job at risk.”
In the case you present, the patient actually admitted drinking a few beers every night. That statement supports a diagnosis of alcohol dependency and it would be reckless for an alcohol counselor to ignore it. The patient may have made the statement because, confronted with other indications of his abuse by the counselor he could not deny his alcohol use — but wanted to minimize it. It is also possible that finding himself getting the substance abuse treatment he knew he needed, he knew he needed to disclose his alcohol problem while he had the chance to meet that challenge at well. I do hope that this patient meets his substance abuse challenges and becomes all he is capable of becoming. Many people with substance abuse issues are actually extremely intelligent and capable of being very productive. That intelligence and productivity can be completely disempowered by substance abuse. Once they become sober, such patients can have the world open to them. I wish this patient well.
If you know someone who suffers from substance abuse, getting that person help is a challenge. Your immediate goal may be to get that person to listen when he is not yet ready to hear. In reality, that must be your longer range goal. Your immediate goal may be to get that person to hear. If you are now trying to meet that challenge, or if you’ve had some success with it, I am interested in hearing from you. Together we can begin to change life sentences of substance abuse to life sentences of recovery.
I wish you well.