Rebuilding a life
The Florida Recovery Center is helping people recover from substance abuse and get their lives back.
By Laura Mize
Michele Markant is a healthy-looking mother of six and a registered nurse — not the kind of person most would suspect of a drug addiction.
But, as they say, looks can be deceiving.
In 2009, authorities arrested Markant at her attorney’s office for forging prescriptions, each instance a felony, to feed her addiction to painkillers.
“I had been writing and calling in my own prescriptions for opiates for about two years,” Markant says.
Her addiction goes back 11 or 12 years, she says, and stems from a shoulder injury she sustained at work that led a doctor to prescribe painkillers. After a while, Markant couldn’t get enough of the pills, and she developed an addiction that escaped the notice of her friends, family and colleagues.
“I was using in my lawyer’s bathroom when the police were outside waiting to put me in handcuffs,” she says. “That’s how crazy it was.”
Markant spent a few hours in the Alachua County Jail, then went with her attorney to check into the Florida Recovery Center. The center is a UF College of Medicine treatment facility focused on substance abuse, pain management, eating disorders and obsessive-compulsive disorder. Her attorney negotiated a deal with the prosecutor’s office, allowing her to forego a trial and extended jail time in exchange for community service, probation and enrollment in treatment. She also received a $1,200 fine from the Florida Board of Nursing.
In-patient detoxification at the Florida Recovery Center lasted six days for Markant, and she lived away from home for two months. Even after her arrest and the start of treatment, Markant says she resisted help.
“It was kind of hard to come in to a place and have people tell you what to do and how to do it and when to do it — when you were going to get up, that you were going to do things a certain way,” she says. “The first month or so, I struggled with that. Finally, it was almost like an epiphany. I thought ‘OK. I’ll just try it their way.’”
Her decision to cooperate, she says, made all the difference.
“It was just another huge weight lifted off me when I realized I did not have to do this alone, and they made it much, much easier.”
Treatment included eight hours of classes and local Alcoholics Anonymous or Narcotics Anonymous meetings every day. After 101 total days of treatment, Markant completed the program. Today, she has been sober for more than two years.
“It was not an easy process,” she says. “The steps that you follow are very simple, but it’s not easy. But it is well, well worth it.”
Unfortunately, Markant’s struggle with substance abuse is an all too common one.
Nearly 9 percent of Americans age 12 and older suffer from substance abuse or dependence, according to the Substance Abuse and Mental Health Services Administration.
The 2010 National Survey on Drug Use and Health, published by the administration, reports an estimated 22 million people in this demographic had struggled with addiction to alcohol or drugs in the year before they were surveyed. Seven million had used prescription drugs illicitly in the past month.
Health-care providers are not exempt.
Ten to 15 percent of physicians will develop substance abuse problems during their careers, according to a 2003 review of literature on the topic, written by Roger S. Cicala, M.D., then an assistant medical director for the Tennessee Physicians Health Network.
Mark Gold, M.D., chair of UF’s department of psychiatry, says health professionals in general are more likely than the general population to abuse prescription medications. Rates of alcohol abuse and non-prescription opiate use among health-care providers are similar to those in the general population, he says. But Gold notes that data on the subject may not tell the whole story.
“Being a physician is a drug-free occupation, so survey data has been questioned,” he says.
Gold says health-care workers’ elevated rates of prescription drug misuse are due in part to their greater access to medications. Demanding, high-stress lifestyles prevalent among health-care providers, especially physicians, also can play a role.
“There are other factors, which have to do with life and balance, or imbalance,” he says. “Having a healthy diet, sleep and exercise is not something that’s always taught as part of medical school.”
But some providers, just like non-providers, are vulnerable because of genetics or a personal or family history of substance abuse. And anyone who uses addictive substances can become addicted, regardless of their profession. Gold says some people seem to think otherwise.
“I think sometimes physicians and health-care providers think that they’re immune to the neurobiological realities of substance use and dependence.”
Markant says she knew she needed help before her arrest. But, as is often the case, something stopped her from asking for it. She says being a nurse made it tough to admit her problem.
“I think drug addicts have that tendency to resist,” she says. “And being a health-care professional, I think it makes it that much harder, because we think we know everything. We’re professionals. We tell other people how to get better.”
Colleagues and patients of health-care workers hooked on drugs or alcohol are often the last people to know, says Gold. He also noted that he thinks providers are more reluctant to admit substance abuse than the general population. Those factors combined mean many hit rock bottom before they get help.
“The data for impaired health professionals around the United States (shows) that physicians lose everything before they lose the respect of their colleagues and before they ever have a patient complain,” Gold says.
“They wait a very long time (to seek help). It may be easier in some workplaces to identify a problem,” Gold says. “Physicians in a medical group practice might have more autonomy than a person who had an assembly line position, or if you were a pilot you would be drug tested. There would be a lot of ways that you could get detected earlier. Physicians worry about loss of their license.”
While some health-care providers do lose their licenses over substance abuse, there are alternatives. Organizations across the country offer help to providers caught up in substance abuse.
Though she ultimately lost the job she had when she was arrested, Markant has retained her nursing license because of her cooperation with the Intervention Project for Nurses. The project helps Florida nurses struggling with substance misuse or with mental or physical health problems. The Florida Professionals Resource Network offers the same services for other health professionals, such as physicians, dentists and even veterinarians.
Both organizations were created in accordance with state statutes and are charged first with protecting people from impaired health-care providers. They also seek to help providers maintain recovery and salvage their careers. When a provider breaks a condition of his or her contract, the supervising organization may contact the appropriate licensing board, opening the door for more serious consequences.
After completing her treatment at the Florida Recovery Center, Markant signed a five-year contract with the Intervention Project for Nurses, which detailed the steps she must take to keep her license. She must attend three Alcoholics Anonymous or Narcotics Anonymous meetings and one IPN meeting per week, submit to random drug testing and attend counseling. In addition, Markant’s employer sends evaluations of her work to IPN once a quarter and, though she hasn’t worked with patients since her arrest, she was prohibited from administering narcotics in practice during her first year after treatment.
So far, Markant has stayed on track with her recovery, says Scott Teitelbaum, M.D., one of the physicians who treated her. Teitelbaum is the medical director at the Florida Recovery Center and an associate professor of psychiatry in the College of Medicine. He credits Markant’s continued recovery to her persistence pursuing a healthy life.
“She’s in solid recovery,” he says. “She continues to do the things that got her well, and that’s the reason she’s doing well.”
Since Markant finished treatment she has gone through a divorce, lived apart from her children for several months and moved in with her mother. But there have been good times, too. Since October 2009, she has worked as a research coordinator for the College of Medicine’s department of anesthesiology. Because of her past, she currently has no contact with patients, though Markant says she hopes one day to return to patient care. Her children are living with her again, and Markant purchased and moved into her own home several months ago.
Life is better than it used to be, she says, and treatment has helped her learn to live without drugs, even when things are tough.
“When I came in to FRC, I thought there would never be a day that I would wake up and my first thought would not be about obtaining drugs,” she says. “Now, I have the tools to deal with life on life’s terms. I am amazed, now, because the things that I’ve been through since I left treatment were so much more horrendous than what I was going through when I was in treatment and before treatment, when I thought I couldn’t get off the drugs.”