I nside the addiction clinic, it's not always roses and rainbows. There are points when patients can become irate and aggressive. Sometimes you see it coming, sometimes you don't. It doesn't always happen because of something you deliberately say or do. Even the most mindful and considerate counselors can be caught by surprise when an innocuous word or phrase triggers a patient to anger. Once an escalation happens, how do we de-escalate? Let's discuss. Note: this article discusses de-escalation with patients who are not experiencing a mental health issue or crisis. The patient is angry and yelling. What do I do? The one thing you don't do, ever , is get angry and yell back at the patient. Never raise your voice. Never match their intensity. A sure sign of an unprofessional counselor is one who is unable to de-center themselves during live conflict. A professional counselor should always remember that unless you've said something deliberately disrespectful to th...
U rinalysis is the main laboratory testing vehicle Addiction Professionals utilize to determine whether or not a patient is using drugs and/or alcohol. To the uninitiated, an Addiction Professional only looks at a toxicology result through a binary lens: negative, or positive. True clinicians know that toxicology is much more complex than that. This article is just one example. Let's dig in: Let's suppose that a patient is suspected of having used cocaine recently because their urinalysis results showed positive for the substance. That's simple enough. However, their results also show them being positive for benzoylecgonine which is one of the 11 metabolites of cocaine. But how can that be? How can the patient be positive for both cocaine and a metabolite of cocaine at the same time? You look at the patient's toxicology history and see that this never happened with this patient before. This has to be some kind of false positive, right? And, after all, the metabolite i...