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Penny Rayas, MFT
Penny Rayas, MFT, Therapist
Category: Mental Health
Satisfied Customers: 395
Experience:  I have 20 years experience in the mental health field
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My son is in a drug/ alcoh rehab. He has only been in there

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My son is in a drug/ alcoh rehab. He has only been in there a little over a month.This is the very first time he has been in a rehab facility to detox or go without drinking. He was drinking about a gal. of Captain Morgan a day.He is 22 years old. He has been drinking very heavily for the past two yrs. He started off experimentally with kids trying drugs, partying etc.He never had any exposure to drugs or alcohol growing up. As he got into his last year of highschool, he got around kids that exposed him to drugs/alch. This facility has a Psychiatrist, not a Psychologist. During his detox, he was being given Librium or Ativan and Trazodone. He hallucinated. (Trazodone causes hallucinations, as well as detoxing can cause it. After 7 days of detox,he entered the 27 day rehab. As you know, when a person is detoxing, they display a slew of symptoms, such as anxiety, depression etc. I might add, that this trip to rehab was an intervention by me. Eventually he completed the rehab part of the program, but relapsed. He went back into the program and into detox. He hallucinated again while on Trazodone, and whatever other drugs the Psych was giving him. He called me and told me he hallucinated, and couldnt stop twitching his mouth, and his arm was numb. He never hallucinated before he entered rehab. He has no history of illness or hallucinations, nor does anyone in our family.( He did admit to some cutting, because someone told him it increased the high when someone drinks) he also throws up a lot, presumably because his stomach is inflamed from drinking so much for so long, he cant keep food down.) I asked him what he was being given, and he said Trazodone, I called in to ask the nurse about it and the nurse told me that the Psych. was looking into it. THE NEXT DAY, I got a call from my son, asking me to make a co-pay at the pharmacy that is near the rehab, which is where the rehab gets its prescripts. The doctor ordered Risperdal, and Neurontin (Gabapentin). I asked the pharmacist what the medicine was, and she said Risperdal was an antipsychotic drug. Neurontin is a mood stablizer. I was in shock. I did not pay the copay, and instead chose to call and question this doctor about the medicine he had prescribed. He immediately became defensive, and did not like being questioned. He said that he was trying to rule out bipolar disorder. He said that the leading cause of suicide was undiagnosed bipolar disorder, and no one wants to be responsible for that happening.After talking a few minutes, he told me that he was the Medical Director at the facility and he was pretty satisfied with his diagnosis. So it went from "ruling out bipolar disorder", to "satisfied with his diagnosis". This doctor barely knows my son, has never talked to us, his parents, and has no idea why my son ended up with a drinking problem, he has barely spent any time with him. My son relapsed, and if he is not in a seriously structured recovery program, he will drink, without question. So, for a Psychiatrist to experimentally try serious drugs on him, in less than a month and a half of rehab, blows my mind. RISPERDAL is serious medicine, with terrible side effects, and possible long term injury. NEURONTIN is a mood stablizer that can cause suicidal thoughts or actions, and anxiety. Both of those drugs are dangerous if the arent taken properly, and or stopped after taking, which can cause serious siezures, withdraws and worse. So, It seems to me that to diagnose my son with bipolar disorder because he had hallucinations during detox, in rehab, simply because he doesn't want to overlook a disorder, is ludicrous. The risk of an accidental overdose, or stopping the meds is higher in someone who is drinking seriously, and isn't paying attention, let alone the side effects -suicidal tendencies. The fear that my son is taking drugs unneccesarily is very real- and on top of everything else, it introduces another habit that he was not having a problem with, pills. Now he is ready to transition to a long term rehab, and the Psyche Eval by this psychiatrist will go along in his paperwork. The next psychiatrist will look at what this doctor is diagnosing, and because of the general fear doctors seem to have these days about underdiagnosing bipolar disorder, will probably continue this horrible mistake. I mean, what brave psychiatrist wants to be the one to risk reversing a bipolar diagnosis, and risking that they are wrong?The egotistical reaction that I recieved from the doctor during our phone call leads me to believe that if I confront him at the rehab center to discuss this, that he will dig his heels in to prove he is right, rather than consider his possible jump to a conclusion. My son was evaluated by a psychologist for a custody evaluation, as our whole family was, and there was never a question about his mental health. This is a nightmare, and I am ready to go to the director of the facility because this is a terrible mistake. What can we do?
Submitted: 3 years ago.
Category: Mental Health
Expert:  Penny Rayas, MFT replied 3 years ago.

Hello there and I am sorry about all the problems that your son is facing. I have worked as an addiction specialist for about 21 years. I have worked with many people in detox and have been the director of a dual diagnosis program. It is my opinion that your son does not have bi-polar because I believe that most of the symptoms are alcohol detox related. Have you thought of moving your son to a different detox program. Your son sounds to be like he has alcohol withdrawl symptoms called delirium tremors. Those can be life threatning but treatable. Some of my clients had those symptoms while they were in pscychiatric detox and the symptoms lasted for over a month. Those are also called wet brain syndrom in AA. Some of my client's who had deliriun tremors have been treated with Respiradol for a short period of time but not diagnosed with any disorder other than Alcoholism. The diagnosis of bi-polar is hard to make, when someone is drinking.

Did your son have any symptoms of mania such as talking very fast, not sleeping for more than 5 days, flight of ideas,(meaning he talked about one thing after another, and did not make sense, or did he think he had special powers. You have the right to ask for you son to be transfered to a different detox program. Or since he is an adult he has the right to ask to be tranfered to a different program.


Here is some information on delirium tremers

Symptoms most often occur within 72 hours after the last drink. However, they may occur up to 7 - 10 days after the last drink. I seen people who drink more and longer having them for almost a month.

Symptoms may get worse quickly, and can include:

  • Body tremors

  • Changes in mental function

    • Agitation, irritability

    • Confusion, disorientation

    • Decreased attention span

    • Deep sleep that lasts for a day or longer

    • Delirium

    • Excitement

    • Fear

    • Hallucinations (seeing or feeling things that are not really there)

    • Increased activity

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