Brotherly Love

Strange behavior a sign of substance abuse.

Unsure why it happened, Jackie* felt helpless as she watched her younger brother Stephan* deteriorate before her eyes. He went from a happy, energetic man who loved to build furniture and go dancing to a moody, lethargic person with no interest in woodworking or social activities. She thought he was depressed and would eventually snap out of it.

Photo by Jordan Pysz.

Christian Sicignano, RN

“But he didn’t snap out of it,” Jackie recalls. “Instead, he got worse. Stephan went for days without showering or shaving, and he started staying up all night. He stopped eating well and lost twenty pounds. But he was drinking excessively.

“Stephan gave excuses to avoid attending family functions and refused to allow anyone into his home. He started neglecting his job and was officially reprimanded. And the only time he spoke to his friends was to ask them for money.”

Jackie became so concerned about her brother that she went to a counselor to ask for advice on how to help him. She was surprised by what the counselor told her: The signs Stephan was showing were those of substance abuse.

“There are two major categories of signs exhibited by people who are actively abusing substances,” Christian Sicignano, RN, Director of Nursing at Riverside Recovery of Tampa, observes. “There are physical signs and behavioral signs.

“One of the physical signs is lethargy, especially if people are actively using. Substance abusers may have a chronic runny nose or loss of physical coordination. They may totally neglect their personal hygiene or activities of daily living. They may experience appetite changes, weight changes or tremors. They may smell of alcohol and have irregular sleep patterns, which are common with addiction.”

Christian goes on to describe some of the behavioral signs that a person who is currently struggling with substance abuse may exhibit.

“Substance abusers may engage in secretive behavior,” he adds. “Family and friends may notice deceit or dishonesty in their interactions with them. Substance abusers may neglect their responsibilities and begin to exhibit poor performance at work or school. They may start missing work or school.

“In addition, substance abusers may run into financial problems. They often don’t have enough money to keep up with their monthly bills and start asking people to borrow money. There are often changes in the substance abuser’s habits. They stop doing things they used to enjoy.
“But the biggest thing we see with substance abusers is isolation. They begin to separate themselves from their friends and family, which is a concern because that’s their support system.”

For friends and family members who notice some of these signs of active substance abuse in a loved one, there are a few steps they can take to help the substance abuser. The first thing they can do is reach out to substance abuse resources within the community. These resources can provide direction on how to proceed in finding their loved ones the care they need.

“Concerned individuals should share their concerns about the substance abuser with other friends and family members,” Christian relates. “They can then work together to encourage the substance abuser to attend counseling or a therapy session. If the condition is severe, the family members can speak with an interventionist, who can help them take appropriate action.

“An interventionist can tell the family which level of treatment the substance abuser may need, such as detoxification or a residential treatment program, if their substance of choice doesn’t meet the criteria for detox. At Riverside Recovery of Tampa, a comprehensive recovery center, patients with substance abuse can enter detox, residential or day treatment, whichever is appropriate for their substance of choice and individual needs.”

Continuum of Care

The recovery process at Riverside Recovery of Tampa is a continuum of care that begins with the Medical Detoxification Program and moves to the Residential Program, Christian describes. From there, clients transition into the Day/Night Program, a day program during which clients return to Riverside Recovery from 8:00 a.m. to 4:30 p.m.

A common denominator throughout this continuum of care is the Riverside Recovery of Tampa nursing staff. During the medical detox phase of treatment, there’s a nurse on site 24/7, as well as nursing support staff, including behavioral health techs. The nursing staff care for clients during this difficult stage of their treatment.

“Riverside Recovery offers detox for benzodiazepines, opiates and alcohol,” Christian notes. “The nursing staff closely monitor clients during the detox stage. Depending on the substance they’re detoxing from, clients may be given medication. The behavioral health techs check on clients in detox every thirty minutes.”

Nurses in the Residential Program schedule and administer medications. Sometimes, clients experience symptoms of post-acute withdrawal during this stage of recovery. When that occurs, the nurses meet with the clients’ providers, and together, they address the
clients’ symptoms.

“There’s a nursing group every week as part of the Residential Program,” Christian adds. “During group, we educate clients on anti-craving medications and post-acute withdrawal symptoms. We explain what to look for with post-acute withdrawal and what is normal. We also educate clients about HIV and AIDS, as well as sexually transmitted diseases, from a nursing standpoint.”

After clients complete the Residential Program, the next level of care in the continuum is the Day/Night Program, formerly known as the Partial Hospitalization Program, or PHP. The Day/Night Program runs six days a week for eight hours a day at Riverside Recovery of Tampa.

“Clients continue to receive nursing care while they’re in day/night programming. They meet with a nurse if they are taking medication and if any new symptoms occur,” Christian explains. “After the Day/Night Program, clients transition into the Intensive Outpatient Program, or IOP, which is three days a week for three hours each session. IOP consists of therapy primarily. Nursing care is not typically needed at this outpatient level, unless there’s an emergency.

“Riverside Recovery’s nurses are integral members of the patient care team throughout their stay in the recovery center.”

Creature Comforts

One of the factors that set Riverside Recovery of Tampa apart from other treatment centers is its strong emphasis on comfort during the recovery process. The staff at Riverside Recovery work to be as cooperative as possible to make the process comfortable, yet productive.

“We understand life doesn’t stop when a client enters treatment, so we try to accommodate them, within reason, so they can keep up with their responsibilities while in detox,” Christian states. “We allow clients to bring in their personal electronics so they can take care of business or do homework if they’re in school.

“We allow clients to focus on getting better and still take care of the outside world, as long as they attend their group sessions during the day.”

Substance abusers often have triggers that initiate their substance abuse. Some say, I drink because of my job, I drink because of school or I use this substance because of financial hardships.

“Clients face these triggers while in recovery, but they don’t snowball until they leave treatment and have to deal with all of their stressors,” Christian informs. “With our approach, clients deal with many of their stressors while they’re in treatment. They don’t get hit with them all at once when they leave treatment.”

When clients complete detox and move to the Residential Program, they’re able to recognize their triggers and stressors, and with their therapists, they can pinpoint where those stressors come from.

“With their therapists’ help, clients learn new coping mechanisms that are healthy,” Christian explains, “as opposed to abusing their substance of choice.”

Jackie heard about Riverside Recovery of Tampa from a coworker and told the rest of her family. They agreed it was the best place for Stephan. He initially resisted the family’s pleas to enter recovery, denying he had a substance abuse problem. But eventually, Stephan broke down and entered the Medical Detox Program. Jackie felt relieved.

“I’m happy Stephan is finally facing his drinking demons,” she says. “And I know he’s in good hands at Riverside Recovery of Tampa.”

*Names withheld at their request.
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