It generally takes a couple of years for a drug or alcohol user to get to the point where they need drug treatment. People generally don’t just start out using heroin and then enter drug treatment the next week. They don’t have their first beer and then start drinking a couple of bottles of vodka the next day. Addiction is sneaky. It’s like a sneeze. You get that ominous tingle in your nose. You maybe rub your nostril, get a tissue, ignore the itch, whatever you can do, but you know that feeling won’t go away. You’re going to sneeze. Probably twice. Maybe three times. Each sneeze is the addict’s equivalent of a relapse.

So when clients come to us, they’ve already sneezed once. When they arrive from the detoxification center, we start assessing if this sneeze is a fluke or if it’s an oncoming cold. The first thing the clients do is stop in to see our nurse and/or psychiatrist. They assess the client’s wellbeing and prescribes medications as needed.

As it turns out, almost every client needs a sleeping medication. They also need an antidepressant. Sometimes they need two sleeping medications. Occasionally, they are prescribed an antibiotic. The ones who want to quit smoking are put on Chantix. Some of them are put on another medication like lithium for a pre-existing diagnosis of bipolar disorder. Some of them have pre-existing prescriptions. I’d estimate that on average, our clients take about five medications daily.

It’s confusing to me. These clients come to us because they’ve been self-medicating with drugs and alcohol for years. They’ve been incapable of coping with life or even being aware enough to realize what life should be like without the influence of some mind and body-altering chemicals. So we take them and get these “bad” chemicals out of their body and then we add more “good” chemicals.

Granted, these clients are going through tough times. They are likely experiencing Post-Acute Withdrawal Syndrome. It’s no surprise they’re having difficulty sleeping and they are depressed. They’re in a drug-rehabilitation facility, without their drug of choice, doing things and feeling things they haven’t felt in a long time. Even if they are in the contemplation stage of change, the approach of dealing with their past and current challenges without the use of drugs is probably a pretty radical concept.

I’m having a hard time watching these men take so many prescription medications for a few reasons. First, I view mental health like a set of scales. The goal is to have as balanced scales as possible with the client striving to obtain their own set of self-awareness about their natural balance. By adding prescription medications on the tail of drugs/alcohol, we’re basically creating another imbalance. The client cannot fathom their true zero.

Second, these medications all come with a host of side effects. The sleep medications often give clients Restless Legs Syndrome. As most of us know, antidepressants either produce a placebo effect 3 out of 4 times for a client, or provide a client with dry mouth, anxiety, decreased libido, nausea, insomnia, et cetera. A client already feels miserable and the medications we are giving to help often add to the misery.

Finally, it’s my opinion that the drugs become a source for denial. Clients claim to be drowsy and do not participate in group because they are not on the right dose of sleeping medication. They become less invested in therapy because they are “waiting on their antidepressant to kick in”. They sometimes express hesitance to leave the facility because they are unsure where they will be able to get their medications.

It’s frustrating because it’s an imperfect system, but I see why it is done. I’ve seen the benefits of clients who greatly improved in treatment from lithium or other needed medications. I’ve seen clients who are so grateful for a good night’s sleep in a warm bed. I’ve seen the clients get the medical care they’ve been missing.

I’ve also seen the ugly side of prescription medications. The side effects, the influence on our healthcare system, and the general acceptance that our lives would just be better if we could take a pill. I became a counselor because I believe that a pill is the equivalent of putting a band-aid on a stab wound. Sure, that band-aid might hold the edges for a couple of hours, maybe a day, but it’s not going to heal a wound so deep. The only thing that will heal something like that is an expert healer, the right interventions, and some time. Sometimes pills are the right interventions. I just wish the difference between right and easy was a little clearer for all of us.

Jennifer Bingaman is a counselor-in-training and freelance writer. She blogs about her experiences as a client and a counselor with a few life musings thrown into the mix at The Pursuit of Sassiness