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Addiction out of the box

Despite being an aspiring singer-songwriter, a lifetime of chronic addition and seeking behaviours led Jane* into a potentially life-threatening situation that compromised the very organs she relied upon to sing.

A client of Ruah’s Individualised Community Living Strategy (ICLS) program, the 34-year-old was admitted to hospital five times in a year and she found it increasingly difficult to attend to her basic daily needs such as showering, teeth brushing and maintaining her home.

Facing potential institutionalisation, the hospital examined Jane’s physical and mental health and observed a close link between Jane’s mental health stability and her nicotine use, which could reach up to 100 cigarettes in a 24-hour period.

Hospital staff determined that creative case management would be needed to improve Jane’s health and her quality of life – and that case management would need to begin before she left the structure and ‘safety’ of the hospital.

Ruah’s ICLS team re-engaged with Jane while she was in her hospital bed. The team met with her weekly to consider how the skills she was developing in hospital could be transferred to her life in the community.

As her discharge date came closer, our contact frequency increased, as did discussions about the lifestyle Jane wanted when she got home.

After expressing a love of boxing, as it provided both structure and increase the control in her life, Ruah helped Jane engage a boxing coach.

The next step was to find a solution to better manage Jane’s nicotine intake. That required a bolder and more creative solution. Together, Ruah and Jane agreed to implement a timed locked-box solution to help slow the pace of her cigarette intake without completely removing her control. The cigarettes would be locked in the box and Jane could only access them at timed intervals, minimising her nicotine intake and related impact on her mental health.

This ‘out-of-box’ solution has helped Jane make great progress in the community. She said this solution “is the best idea ever”, citing reduced anxiety about running out of smokes as one of the things she likes most.

Jane continues to meet weekly with Ruah’s ICLS team and is pursuing her love for singing by working with support from a Ruah team member to develop her own EP.

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