by David Sheff
My cell phone rings, and I know that Nic is calling. I search for a quiet place away from the crowd and find one near the brooding chicks in a cage inside Toby's barn.
I answer the phone, but no one is there.
I check for messages. There's one—from Nic. His voice is cocky, slurred.
"OK, OK ... sorry. Jesus, this is really hard. Sorry. I'm stopping. But part of crashing out, or whatever, and trying to get focused for work ... I've had to sleep a lot 'cause my body ain't that happy with me. I slept through Friday ... waking up on Saturday, not realizing I'd missed a whole day. So in regards to the rest, I don't know. I'm confused."
Then nothing.
Jasper, in a T-shirt and khaki shorts, runs up. "Can we buy some ginger cookies?"
He notices something and stops short.
"What?"
He looks at the phone in my hand with worried eyes and asks, "Is it Nic?"
A week or so later, Nic contacts his mother, asking for help. "Honestly you would be quite appalled at my lifestyle and I've got enough negative shit coming my way as it is," he writes in an email. "I'm in trouble. It has been a crazy couple months, ultimately resulting in my getting kicked out of the house. I had no money, nothing ... I'm banned unless I go back to rehab. This is not an option. I have that education already ... aa and a higher power don't work for me. They leave me just as horribly empty as ever—"
It cuts off, ends there.
Another email to Vicki. "I'm pretty screwed up physically and mentally, so forgive me if I'm less than perfectly eloquent," he writes. "I'm going to call you once it's late enough, but I wanted to get a few things down on paper just to lay it all out." He explains that he has stolen some checks from the mother of a friend. "I may have a warrant out for me and I need to pay them back or I'm just going to have to remain in hiding."
Vicki and I disagree about the best way to proceed. I understand her fright, but I'm disconcerted when she helps pay his debt. It's a natural and even laudable instinct, but I fear that her support while he's using will simply postpone the inevitable, allowing him to continue on his hazardous course. At least she has said that paying his debt is one thing, but she won't give him cash. Giving cash to a using addict is like handing a loaded gun to someone on the verge of suicide.
When I tell Karen about the emails and how incomprehensible it is for me that Nic would do something so abhorrent—so self-destructive—she reacts with anger.
"I'm so sick of all this."
"What am I supposed to do?"
"I'm just sick of it." She walks out of the room.
Nic disappears again, reappears again, keeping sporadic touch with his mother, not with me.
When old family friends from New York happen to be visiting San Francisco, Vicki arranges for Nic to meet them. She pleads with him to go to their hotel.
He does. Disheveled and obviously high, he's not allowed into the lobby until he persuades a security guard to call our friends.
When he, an ashen skeleton, twitchy and rambling, wobbles unsteadily into their room, they are horrified both by his debilitated condition and the track marks on his arms. They beg him to come to New York, where he can stay with them and detox.
Maybe his romance with the San Francisco streets has passed, maybe he is tired and frightened, or maybe it's just that relocating to New York City intrigues him. He agrees to go, but not before he flees one more time, scoring. His dealer gives him a going-away present, an obscene pile of meth, and Nic snorts it before boarding a cross-country flight.
In New York, our friends convince Nic to see a psychiatrist who specializes in addiction. The doctor prescribes sleeping pills and Nic sleeps for most of a week. He endures the physical withdrawal accompanied by the mental anguish—"remorse, shame, disbelief, wanting to use, wanting to die," as he says when he calls me.
Other than telling him that I love him and that I am sorry it is so difficult, I am unsure what else to say.
It's a week later. I answer the telephone. A representative of a bank I used to have an account with is calling. Someone wrote a check for five hundred dollars on the closed account.
Each new betrayal brings with it a new eruption of emotions, many of them clashing inside my skull. Being robbed is a visceral, traumatizing experience anyway. To have it be my son ... First Karen, now me.
After a month or so, when Nic calls, he sounds somewhat less desolate. Vicki helps him move into an apartment in Brooklyn, and he gets a job. After having concluded at one point that college was stupid, Nic has decided that working minimum-wage jobs is even stupider, and so he says that he plans to return to school. "This time I'll do it on my own," he says. "I've blown my chances before, but I won't blow this one."
Nic tells me that he can never again use crystal, he knows that, but, according to him, his doctor says that it's fine that he smokes pot or has a glass of wine; they help him "keep even." So once again I brace myself. I have reason to worry. A UCLA study has shown that an addict is twelve times more likely to relapse on meth if he smokes pot or drinks alcohol.
Nonetheless, I'm unprepared for the phone call at five on a Sunday morning. I leap up and my heart pounds. Karen lifts her head and looks at me. "What is it?"
I grab the phone and weakly say hello.
It's Nic's stepfather. Nic's stepfather? I have talked to him only a few times in twenty years. At this hour? He says that a doctor just called from Brooklyn. Nic is in a hospital emergency room after an overdose. "He is in critical condition and on life support."
I have been waiting for this telephone call, and yet it is no easier for having previewed it so often.
I hang up and tell Karen.
"Will he be all right?"
"I don't know."
I begin praying, pleading with a god I have never believed in.
"God, don't let him die. Please don't let him die."
I call the doctor, who explains that someone—one of the kids with Nic when it happened last night—called 911 because Nic went unconscious. An ambulance had been dispatched to Nic's apartment. When he saw the ambulance, Nic's landlord called Vicki, who is on Nic's lease. The doctor tells me that if the EMT team hadn't responded right away, Nic would have been dead already. Now there is a chance.
I have learned to live with tormenting contradictions, such as the knowledge that an addict may not be responsible for his condition and yet he is the only one responsible. I also have accepted that I have a problem for which there is no cure and there may be no resolution. I know that I must draw a line in the sand—what I will take, what I will do, what I can't take, what I can no longer do—and yet I must also be flexible enough to erase it and draw a new line. And now, with Nic in the hospital, I learn that I love him more, and more compassionately, than ever.
I make arrangements to fly to New York and throw some things in a suitcase.
The telephone rings again. It's the same doctor. He has a serious but empathetic voice. He tells me that Nic should pull through. His vital signs are returning to normal.
"He's a very, very lucky boy," the doctor says. "He'll have another chance."
My son will have another chance. For the first time since the early morning phone call, I breathe.
Jasper and Daisy are awake. They come in and see the state I'm in. Karen and I tell them. We say that we all just have to hope that Nic makes it.
I call the hospital and ask if I can speak to Nic. The doctor says no, Nic is asleep, I should try in a few hours. I pace. I walk in the garden. Vicki and I talk a few times, commiserate. Our child has nearly died. Jasper and Daisy again ask if Nic is going to be all right.
I call the hospital in an hour's time, and I'm put through to a telephone next to Nic's bed. He is hardly coherent enough to talk, but he sounds desperate. He asks to go into another program, says it is his only chance. I tell him that I'm on my way to New York.
In another hour, I leave for the airport. While driving, I call the hospital to see how he's doing.
&
nbsp; The on-duty nurse tells me that he has checked out.
"What do you mean he checked out?"
"He checked out against doctor's orders."
He pulled out the IVs and catheter, and he left.
I hang up and pull off the freeway. I know that if this overdose isn't enough to stop him, nothing will.
Shaking, I return home.
At night I lie in bed, smell the star jasmine through the open window, stare into the dark.
"Are you awake, Karen?"
"Are you?" she asks.
There is no sleeping for either of us.
I cannot comprehend what could have happened, but the most likely scenario is that withdrawal was too much for Nic, or the prospect of recovery was too much for him, or the pain was too much and he went out to score. Another known terror plays out in my brain. Nic, overwhelmed by the newest events and feeling physically as well as psychically defeated, has gone to kill himself.
No answer on his telephone, nothing.
He calls in the morning. He sounds groggy and deeply depressed.
"Nic..."
"Yeah, I know."
"Where are you?"
He tells me he's at his apartment.
"But what happened? Why did you leave the hospital?"
"I was freaked out. I don't know. I had to get out of there."
I imagine him in the basement apartment of the Brooklyn brownstone where I last visited him—devoid of decoration or furniture other than a mattress on the floor and a dresser that Nic found on the street, with shades drawn fast to keep daylight out. Except for throwing off the boots he had snatched from the closet in his hospital room, he has not troubled to undress. He still has the remnants of tape on his arms that had held the IVs in place. He had reached his apartment and made his way inside and fallen facedown on the mattress, as though diving headlong into a burial plot.
He asks if I'm coming. Will I come?
"What are you going to do?"
Without coercion this time, Nic chooses to return to rehab. He begs.
Is this what hitting bottom means? The experts all say that an addict hits bottom and then engages in recovery in a new way.
I fly to New York to help him check into Hazelden's Manhattan center. I take a taxi in the rain under a dusky lavender sky, and on my way into town I try to anticipate what I will feel when I see him. Overjoyed to see him alive. Furious because of how close he came to throwing away his life.
I wait for him in the lobby of my hotel, where we plan to meet.
Suddenly he's standing before me.
"Hey, Pop!"
It is always a dramatic moment when Nic arrives.
In spite of his attempt at putting on a brave facade, he looks like someone who survived a famine. His face is like crepe paper, ghost-white. He wears a torn sport coat over a T-shirt, torn jeans, and busted-up sneakers. We hug stiffly. My affection for him is tempered by my fear of him.
He stays in my hotel for the night. To kill time, we go see a movie, Punch-Drunk Love, and eat pasta in a café. He tries to explain what happened, but we're biding our time because this trip is about the morning, when he will check into rehab. Again.
After dinner, Nic and I watch TV. On one show, young men film one another doing ludicrous, humiliating things. Professional pitchers have been enlisted to hurl one-hundred-mile-per-hour fastballs at the crotches of greasy-haired boys. When the balls hit, the boys double over in pain. Why would someone put this on TV? Why are we watching?
We have two double beds with thick white comforters, and our heads rest on fat pillows. Letterman is on. In the middle of the show, Nic says that he has some business to attend to before he can go to Hazelden. I look at him as if he's out of his mind, which he is.
"Business? What kind of business?"
He says, "It's fine. I'll head out and be back soon."
"No," I say. "Any business you have to attend to now is trouble."
"I have to," he says. "I have to take care of a few things."
He pulls on his sneakers.
I'm unable to dissuade him, so I say, "I'll come."
I throw on my shoes and we go into the cold night. We take the subway to the East Village, stopping at seedy apartment buildings, buzzing buzzers that are (thankfully) not answered. We follow an Indian woman carrying groceries into a building and ascend five flights. I stand with Nic as he pounds on a door. He says that he has some money to retrieve.
Finally he gives up. I am relieved when, near two in the morning, a taxi finally drops us back at the hotel. Riding in the elevator, we stare up at the tiny television screen showing a Tweety and Sylvester cartoon.
In the morning, we walk around until his admission appointment at Hazelden, in a stately brownstone overlooking Stuyvesant Square Park. While he is interviewed, I wait in the park, sitting on a bench. I watch a group of boys huddled in a corner of the park near a metal gate. A drug deal goes down.
Hazelden is probably the nation's best-known drug and alcohol rehabilitation center. Its main location is in Minnesota, but there are programs in New York, Oregon, and Chicago. This is not a primary program. Nic has tried two of those. This one is an ongoing program of six months, perhaps longer, depending on how Nic does. Rather than a crash course of Rehab 101 fit into four weeks, patients are required to work or attend school. The idea is that they will learn to integrate recovery into their lives. There are regular meetings with a staff therapist, group therapy, and required AA meetings. There are chores. There is a long list of rules, but unlike the other programs, patients can come and go as they please, as long as they are present at dinner and required meetings and appointments, and return before curfew.
Nic signals me from the building's open door. It's time. I come upstairs, and we sit in the large foyer lined in cherry bookshelves. There's not much to say, but we sit there for a while on leather sofas. When an attendant calls Nic—says it's time for him to check in and say goodbye—we stand and look at each other.
We hug. His body feels brittle, as if it could break into pieces.
18
I watch the weeks and then months of his recovery from afar. Biding my time, I continue my research into meth, this time canvassing the nation's preeminent researchers and asking them what is to me the bottom-line question. What would you do if a family member were addicted to this drug?
They agree that the first step should be assessment. If an addict is in methamphetamine psychosis, sedatives and other medication should be administered. ("They sometimes are as crazy as a loon, and that needs to be dealt with," said UCLA's Dr. Ling.) Though meth addicts are three to four times more likely than others to have attendant psychiatric conditions in addition to addiction, the symptoms are difficult to distinguish from meth withdrawal. Some doctors would routinely treat addicts for depression. That is an expensive proposition, and some researchers suggest that patients should be off meth for at least a month before they are diagnosed and treated for secondary illnesses.
The experts are divided about whether inpatient or outpatient programs are more likely to work. The former are expensive, but they provide a safe and controlled environment where a patient can be closely monitored. However, it may be difficult to transfer rehab to the real world, and discharged patients often relapse. Outpatient programs integrate recovery work into an addict's life, but there are many opportunities to slip. The majority of experts said they would ideally choose as long an inpatient program as possible, to be followed by a gradual transition to a comprehensive outpatient program that would continue for a year or more. This would begin with four or five daily or evening sessions a week, then less frequent sessions, tapering off to once a week.
These experts agree that, whether in an inpatient or an outpatient setting, it makes little sense to start behavioral and cognitive therapies during the initial withdrawal period. Palliatives such as massage, acupuncture, and exercise programs, along with carefully monitored sedatives, may do as much as anything to help patients make it th
rough the worst stages of withdrawal. Addicts in outpatient programs seem to benefit when they get help making a schedule they can follow until their next session. Drug testing, with severe penalties for relapse, is, the experts claim, essential. Behavioral and cognitive therapies should be added slowly. When they are, they should be monitored so that they reflect an addict's ability to participate in them. Some doctors advocate psychotherapy, but many do not. "It probably has little effect," says Dr. Rawson at UCLA. "Talk just can't penetrate the wiring problems." Dr. Ling adds, "Understanding things will not change an addict's life. Doing things differently will." The doctors do prescribe psychotherapy and psychopharmacology when a dual diagnosis is apparent, such as depression, bipolar disorder, acute anxiety, or other conditions.
The first goal is to keep addicts in treatment long enough for them to participate in cognitive and behavioral therapies that train, or retrain, them. A range of these therapies has been implemented and tested at Matrix, the drug-rehabilitation centers founded by Rawson and his UCLA colleagues. The Matrix program, developed for cocaine addicts, has been adapted for methamphetamine. It includes therapies that teach addicts to avoid if possible, or "reframe" if not, situations that previously would have led to relapse. In theory, new behaviors eventually become habitual. At Matrix-based programs, addicts are trained to interrupt their normal reactions to anger, disappointment, and other emotions. They are taught about components of addiction such as priming and cueing, which often lead to relapse. Priming (as in priming a pump) is a mechanism that launches a single or incidental drug use into a full-blown relapse. Since addicts may slip at certain stages of their recovery, the program trains them to reframe the incident. Rather than responding to priming, an addict can stop the process at a "choice point." The moment can be viewed as an opportunity to try an alternate activity. Cueing leads to drug use when an addict encounters a trigger that starts a cycle of intense craving that often results in using. I came to understand the way a cue works when I thought about Nic's and my different reactions to the movie Requiem for a Dream. Nic loved Darren Aronofsky's relentlessly dismal story of a boy and his mother, a heroin addict and speed freak. I found it unbearable. Even the people I know who liked the movie were depressed by its bleakness and depravity, but Nic was thrilled by it. Nic later told me that the drug scenes, accompanied by throbbing music from the Kronos Quartet, which are cautionary, nearly unstomachable for most people, made him want to get high.
