They started calling the numbers at noon. If I was lucky—if I had gotten there early enough that morning and held my ground against the tide of elderly Asian American women, all jostling to cut in line—I could be through the line and home by three, a fresh bottle of vodka from the liquor store by the bus stop tucked in my backpack for later in the afternoon. By the time I made it home, burdened with bags full of potatoes and cast-off matzo and expired prepacked salads, the first bottle of wine was gone and it was time to lie down. In the morning, I may have harbored delusions that I would wash the pile of dirty dishes, or take out the garbage that was attracting flies and giving off a sickly stench so strong that even my defective nose could sense it. By the afternoon, there was nothing to do but sink into the futon and read a few pages of the dense World War II history I’d been working on for a year, feel my head get heavy, and sleep the day away.
That was Saturday.
These food bank trips saved me a few bucks on groceries, but there was no way to balance the ledger. Making rent became an increasingly tenuous prospect. In Seattle, landlords could start eviction proceedings when your rent was just three days late, and every “three-day notice” went on your record, which could end up on your credit history. In 2014, I racked up so many three-day notices that when I showed up in person one month to pay my rent and late fees, the apartment manager pulled out a record of delinquency a half-inch thick. “Do you seriously keep all of those?” I asked her, in what I hoped sounded like indignation, not panic. “Every one,” she responded, her manicured nails clacking against the green metal of the filing cabinet. Well, I thought, I guess I can never move.
There’s another passage in AA’s Big Book that always spoke to me, in the chapter “To Wives,” which describes men at four different stages of alcoholism. The third type of husband reminded me of myself. “His friends have slipped away, his home is a near-wreck and he cannot hold a position. He admits he cannot drink like other people, but does not see why. He clings to the notion that he will yet find a way to do so. He may have come to the point where he desperately wants to stop but cannot.”
By the time I became desperate enough to even show up to AA in earnest (much less to show up sober), I had made more than my share of weary rounds and lost many more things that were precious to me than I had when I checked myself into that first detox in the hospital in northwest Seattle back in 2008. I had obliterated relationships, alienated friends, and nearly torched my career more than once. I had gotten myself into a nightmarish pit of medical and drinking debt so deep I couldn’t see sunlight. I had, as the Big Book also says, “all the desperation of a drowning man.” So I jumped.
Twenty-two
Far from Done
Six years after my first detox, I started going back to meetings—first to get Josh off my back, then, grudgingly, to half-listen, showing up fifteen minutes late and sitting in the back. I went to meetings all over town, but felt drawn to Cherry Hall, a run-down AA fellowship hall populated by unemployed men, ex-gang members, and women who’d joined “the program” to get their kids back decades earlier and decided to stick around. For the first time in a long time—probably since before drinking stopped being fun, when being a “regular” somewhere didn’t imply the sad taint of addiction—I felt like I was somewhere I belonged. Here, in this poorly lit room, with its torn secondhand chairs and fans that barely pushed the hot air around, I felt accepted even when the best I could manage was a three-days-dirty T-shirt and bleach-stained sweatpants. Half the time, I showed up drunk or well on the way—but I showed up. Years later, another member would tell me, laughing, that I had “rolled in looking like stir-fried shit,” and the distance between then and now is measured by the fact that I can laugh about that now. Still I didn’t get sober; still I snuck mini bottles into the bathroom and tossed the empties in the trash to be picked up by some alcoholic, ignoring the signs that clearly stated: NO ALCOHOL/NO DRUGS.
But it’s hard to sit in a meeting for an hour and absorb absolutely nothing, and the stories started seeping through. AA is a deceptively simple program—you go to meetings, you listen to people talk, you do some work, and you don’t drink—that works largely through repetition, something I absolutely hated when I first started going. One guy, who goes to the same lunchtime meeting every day, shared a story so similar from day to day that I can almost recite it word for word. “I started out broke down, beat up, wasn’t nothing to nobody, never had a father, dropped out of school, started drinking before I learned how to read,” it begins. What I started to realize around the tenth time I heard this man’s story of recovery—from sneaking beers at age six to becoming a “low-down, low-bottom drunk” by the time he dropped out of high school, to finding his way to this fellowship hall fifteen years ago and sitting in the same chair ever since—was that it was my story, too. If anybody was a low-down, low-bottom drunk, I was. Like a lot of people in the room, I had done inexcusable things to the people who loved me. As it said in the first step, which we read at every meeting, I was “powerless over alcohol,” and my life was unmanageable as fuck. I started to realize, dimly and with one eye sometimes literally closed, that this—for me—might be the beginning of a way out.
Here’s the thing. If you’re a person who needs to get sober—for health reasons or because your partner is about to leave you or because you’re consumed by self-loathing and on the verge of losing everything you love—there’s probably a path that will work for you, and only you will be able to figure out what it is. For a lot of people, the path might involve medication, or therapy, or religion. Mine happens to involve AA, and I have a theory about why that is. Most of the folks I know in AA are like me—Jekyll and Hyde drinkers, “always more or less insanely drunk.” AA and other abstinence-based programs are for the people who end up drowning in medical debt from ER visits, the men who learned to freebase in jail, the women who abandoned their babies at the hospital. I arrived at AA at my wit’s end—barely employed, living in a shitty apartment I never cleaned, and hanging on to Kevin by force of will—and everyone I know who ended up sticking around has a similar story. When you start going to meetings, they tell you all sorts of stuff that sounds like bullshit—things like, “Keep coming back,” and “More shall be revealed,” and “Don’t leave five minutes before the miracle happens.” I know, I know. It’s cheesy and clichéd and embarrassing even to say those things out loud. But the crazy thing is, if you stick around, all the stuff that sounds like bullshit at first starts to sound like wisdom, especially when it comes from someone who’s telling you about how she got her kids back after they’d spent five years in foster care, or how he finally got a housing voucher after living in a bedbug-infested shelter for seven months. “I almost gave up, but I didn’t, and then something amazing happened” sounds as sincere as an infomercial when you can’t get through a ninety-minute meeting without sneaking off to the bathroom or the store down the street for a nip, but something about all that relentless positivity starts seeping into your subconscious, and you begin thinking, How do I get some of that? Of course, my conscious mind was still able to tell me I was different—I would never abandon my own child, I sniffed as women told stories about doing exactly that, ignoring the fact that I had never been able to keep so much as a houseplant alive. But somewhere inside me, a seed had germinated. I saw people who loved their lives despite lacking material possessions and passport stamps, and I started to listen not for the differences but the similarities—the promises sincerely made and swiftly broken, the endless failed attempts to stop, the experience of surveying the wreckage, finding it insurmountable, but trying to surmount it anyway.
AA isn’t magic, nor is it monolithic. It isn’t the same everywhere, or even in every city. Some groups, and AA sponsors, require extremely rigid adherence to a specific way of doing things; others have a more laissez-faire, “take what works and ignore the rest” kind of attitude. Some meetings are dominated by guys who know what’s best fo
r everyone in the room, and some have rules about gender parity, requiring speakers to go in boy-girl-boy-girl order.
Some AA groups are superreligious; others are geared toward atheists and agnostics. Judging AA by going to one meeting or one group, historian William L. White wrote in his 1998 book Slaying the Dragon, is like “judging a country or city by one citizen encounter”—you have to meet lots of people, go to multiple meetings, before deciding what you think of the program as a whole.
Studies of AA, as well as other “mutual support groups” like Women for Sobriety and SMART Recovery, have largely validated its peer-counseling model. Although all studies of AA come with several obligatory caveats—it’s hard to do a scientifically rigorous study of a program that has “anonymous” right in the name; AA groups are all run differently; and each study has had a different measure of “success”—there is compelling evidence that, for some people, AA works better than other common treatments. In 1997, researchers published a well-designed study called Project MATCH, which randomly assigned more than nine hundred problem drinkers to one of three groups. The first group got cognitive behavioral therapy; the second, motivational enhancement therapy; and the third received 12-step facilitation therapy, in which a counselor helps a patient work the first few steps (admitting powerlessness, belief and faith in a higher power, and writing out a moral inventory) and encourages them to attend AA meetings. Twelve-step facilitation was just as effective as both other types of therapy in the short term, and follow-up surveys found that significantly more people in the 12-step group were sober after a year than those in the other groups. Another study found that people who attended AA at least twenty-seven times during their first year of sobriety, or about once every two weeks, were twice as likely to still be sober sixteen years later. Research suggests that AA works primarily by giving people struggling with alcoholism access to people and messages that support their recovery, by strengthening their sober social networks, and by teaching them skills to deal with risky or triggering situations. It also alleviates guilt, a major cause of the stress that leads people to drink, through the eighth and ninth steps, which require members to make amends to people they’ve harmed.
So . . . it sounds like AA works, right? Here’s the catch. Nothing really works all that well—not AA, not CBT, not anything. People who want to get sober (that is, people who find moderation doesn’t work for them and need a program of total abstinence) have a shockingly high attrition rate. And if you’re going to try AA, you have to be ready to jump into a program that requires you to believe that you’re powerless over your own addiction, confess your deepest personal failings, and apologize for your behavior to everyone you’ve harmed, including people you have good reason to dislike (there would be more of those, plenty more, by the time I actually started down that road). When I started going back to meetings, during that last chaotic year before I actually quit drinking, I wasn’t ready to quit. I looked at my past—a promising career sidelined by unproductive years of self-destruction—and my future, which promised more humiliation, failure, and loss, and I said: I want more of that. Of all the clichés you hear from people in recovery, this one, at least, is accurate: An alcoholic drinks until she’s done. And I was still far from done.
Twenty-three
Last Resort
Like everything else in the American medical system, there’s a class divide in addiction treatment—including, I was soon to discover, in detox. In the six years since my stay in the private hospital room in northwest Seattle, I had avoided checking myself into another detox facility, fearful of conceding defeat; instead, I detoxed in emergency rooms and ICUs. That summer, 2014, was unusually warm, and I couldn’t seem to stop sweating, even with my little desk fan pointed straight in my face. At night, I would pass out around ten and wake up a few hours later, kicking restlessly until sunlight started pouring through the cheap, half-broken mini blinds above my bed around 4:00 A.M. It was after one of these restless, heart-pounding, kick-sweating nights that I decided I needed to go back to detox—needed to return, that is, to the place in northwest Seattle, where I would have room service and TV and a door that closed. This time, though, I ended up at a place called Recovery Centers of King County, the publicly funded detox of last resort for the homeless, the indigent, and people like me who had run out of options.
Lack of access to detox is a huge barrier to treatment, and Seattle is typical in its shortage of detox options; everyplace I called told me they could put me on a waiting list or to call back in a couple of weeks. RCKC was the first place that had a bed. Could I be there in an hour? I could. I threw my ratty cloth purse over my shoulder and headed to the bus, gulping down the dregs of a few mostly empty bottles of white wine on my way out the door.
But when I got to the front desk, I almost turned around. The place was like something out of a prison movie—the scene at the beginning, when the inmates hand over their watches and shoelaces to the dead-eyed warden who seals it all up in paper bags marked “Possessions.” “No makeup, shoelaces, tweezers, prescriptions, or reading material; keep your wallets at your own risk,” the gruff intake counselor barked. I balked for a minute—no makeup, in a place with guys?—and then handed everything over. The woman showed me to my room, which already had two occupants, tossing and moaning on creaking metal beds. My bed was the one in the middle—a junkie sandwich. The room was windowless and stifling; a single overworked industrial fan roared just outside the open door, barely drowning out the shouts from the hall and the groans from inside my darkened room. After a brief intake, where I signed a sheaf of papers I didn’t bother reading and couldn’t have understood, a nurse handed me a cup and three pills, watched as I swallowed them, and sent me to bed, where the medication—a tranquilizer called phenobarbital and a double dose of generic Benadryl—knocked me out before I had time to look around.
A few hours later, I woke up in a sweat, sheets roped around my lower body. I was lying on a plastic-covered mattress, and under my head was the thinnest pillow I had ever seen. The room smelled sweaty, sour-sweet, and dank. A faint light filtered through the door from the hallway outside, and I could hear orderlies making the rounds down the hall, coming closer, closer, until a shadow appeared. “Vitals check!” the shadow bellowed, and I surrendered my arm to the blood-pressure cuff. Then I surrendered again to the sedatives that would keep me in a four-day haze.
There was no room-service fettucine Alfredo here, no kind-faced doctor welcoming me into his office to talk about relapse prevention plans. Instead, there were gluey burgers and spackle-textured oatmeal, provided by the same commissary that served the county jail; “outdoor time” in the tiny, smoke-choked courtyard that doubled as the center’s recreational area; and numerous defectors, including one of my roommates, who went back to her abusive drug-dealer boyfriend. The men’s hallway was separated from the women’s by the front desk and a tiny TV room, and setting a single toe past the threshold was grounds for reprimand, as I discovered when a guy wearing an ankle bracelet offered to give me his extra pillow. “Step back from the men’s hallway!” the front-desk lady barked, confiscating the pillow and ordering me to my room. “If you roll up a towel it’s kind of like a second pillow,” my other roommate, who had been silent until now, murmured from underneath her scratchy sheet. “You can also dip it in some water. Makes the heat a little more bearable.”
I toughed it out for four days, too scared of catching something to risk the showers, before I decided I didn’t belong there. I wasn’t like these people. I had options. I had a job, friends who cared about me, and a family who would be horrified to see me in this place (not that I would ever tell them). I had Josh waiting for me on the outside, still hopeful that detox—not rehab—would be enough. I had seen where addiction could take me. I would never let it get this bad again. And so, on a bright Monday morning, two days before the end of my recommended stay, I signed a piece of paper, stamped “AGAINST MEDICAL ADVICE” (AMA) and walk
ed straight to the liquor store.
I was right about two things. One, RCKC was unusually decrepit even for a public detox; it shut down, ostensibly due to unpaid wages, a few years after I stayed there. And two, I didn’t belong there—not because I didn’t need to be in detox, but because it was the only free detox in the county, meant for people with little or no insurance, and I was taking up space. In an ideal world, RCKC would have offered free, high-quality detox and treatment on demand to people who couldn’t afford to pay, and I would have had multiple places to choose from; in reality, the place was a holding pen with twenty-seven beds and a high rate of recidivism, and people like me ended up there because there simply weren’t enough options.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), Washington State had just twenty-two inpatient detox facilities in 2010, and nearly half a million residents with alcohol use disorder. Current law limits detox facilities to sixteen beds, and although creative medical directors have found ways to double that number, the math is irrefutable: There simply aren’t enough detox beds for everyone who needs them, and until there are, people will give up or get turned away, and some number of those will die before another “window of opportunity”—the moment when an addicted person decides to seek help—opens up.
Quitter Page 16
