I am, at the least, a fourth-generation alcoholic. So, too, is my wife Deirdre. Our 22-year-old- daughter, Carrick, is a recovering heroin addict. Most members of our family have been successful professionally — Deirdre’s father was an attorney and judge; my side of the aisle brims with journalists who kept the proverbial pint flask in their desk drawers.

My great grandfather was run over by a trolley car while covering a story in 1904 — still reporting, probably inebriated, but certainly a broken man who was estranged from his family. Many of his progeny shared his taste not only for booze but also for the illusory camaraderie that goes with it in bars and binges.

Most of us got sober, but we’ve taken different routes to get there. I’ve learned along the way that there is a difference between not using a drug and being in recovery, which encompasses the way you lead your life, interact with other people and face your mortality.

To greater and lesser degrees, we functioned despite our illnesses, as many of you, or your loved ones, do today. More than 22 million of us above age 12 abuses or are dependent on alcohol or illegal drugs, according to 2004 government figures, and that’s not counting prescription drug misuse, a rising crisis. Sixty-three percent of Americans say that addiction — their own or another’s — has had an impact on their lives.

I first swore off booze as a 16-year-old who’d stop off in a saloon on the way home from high school for a few boilermakers — shots of bourbon chased by a beer. That period of sobriety lasted a few weeks; relapse is part of this disease.

I had my last drink two decades ago, when I was 32. My bottom came when I discovered the liquor cabinet was dry one evening. With my toddler tugging on my leg for attention, I felt physically compelled to buy a bottle of vodka, spiritually driven to stop letting alcohol control my life, and intellectually determined to end the cycle of waking up with a hangover, nipping at lunch to feel “normal,” imbibing in the evening to get blotto, and arising again with a hangover.

Few of my friends thought I had a problem; most drank as much as I did. My best buddy from those days, prone to depression and Seagram’s 7, blew his brains out 10 years ago, still drinking.

I did not seek treatment or help from a 12-Step program like Alcoholic Anonymous because I was not comfortable turning my life over to a “higher power.” Whenever someone asks me how to get sober, however, my first recommendation is to head to the nearest 12-Step meeting. Deirdre did, and the fellowship she found “in the rooms” was the cornerstone of her recovery 19 years ago — and counting. You’re always counting, because sobriety is, as the AA slogan goes, “one day at a time.” The reality is that I picked up a lot of the 12-Step philosophy by osmosis, and its precepts have helped not only the millions who join but countless others who are “sick and tired of being sick and tired.”

Every treatment philosophy has its zealots, from 12 Steppers to members of therapeutic communities such as Phoenix House that break you down in order to build you up. Any of them may work for you. Some will tell you that their way is the only way. That’s true only to the extent that it’s true for them. The bottom line is that many people overcome their addiction and flourish, but less than 10 percent of people who need intensive treatment at a substance abuse facility actually receive it in a given year, according to the federal Substance Abuse & Mental Health Services Administration.

Deirdre and I had our own ideas about what would work for our daughter Carrick, who first drank at 12, smoked marijuana at 13, dabbled in other recreational drugs by 15, became a heroin addict at 17 and met her bottom while speedballing — mixing heroin and cocaine — at 19. By that time, she had been through three emergency rooms, seven detoxes, three short-term residential programs, a four-month wilderness therapy program, several 12-step programs, four special schools, and had prematurely quit a long-term treatment community twice. She had talked to dozens of psychiatrists, psychologists, social workers, medical doctors and addiction counselors. The deeper her addiction took hold, the better she got at telling them all what they wanted to hear.

After she turned 16, Carrick was often away from home. When she’d visit our suburban New York State home, she recently recalled, “I would come home with a warm greeting, pillage the house, and leave with a warm farewell. It was not just stealing money, but time, sleep and sanity.”

We eventually told Carrick that we would no longer enable her in her addiction — including providing shelter and food — while she was using drugs, but we would do anything we humanly could to help her in her recovery. Some people feel that barring our daughter from our home was heartless. We knew her life was at risk every day she was on the streets of New York City, but she proved time and again that she would not face her recovery as long as we protected her from her bottom. Nor was it fair to our son, Duncan, five years younger. Or ourselves.

In the end, Carrick decided, on her own, to try methadone maintenance, a controversial treatment that critics contend “substitutes one drug for another.” It saved our daughter’s life. She is gradually reducing her dosage with the intent of quitting; others may need to stay on methadone all of their lives. Many become productive members of society, no longer scheming for the next fix.

“You’ve got to meet addicted individuals on their own terms rather than confront them on yours,” says Dr. Harris B. Stratyner, clinical division director of Addiction/Recovery Services for the Mount Sinai Medical Center in New York. “The goal is to get people to completely stop using, but not to say to them, ‘You’re using, therefore I’m not going to engage you in treatment.’ That’s not the way you motivate someone.”

Stratyner is a leading proponent of a “carefrontation” model of treatment, which holds that addicted individuals should not be held responsible for having their disease any more than diabetics are, but must take responsibility for their recoveries. So, too, must the family and friends who get caught in the vortex of lies and manipulations that swirl around an addicted person.

It’s human nature to want to believe a child or spouse who tells you “this is the last time,” no matter how often you’ve been burned already. At times, Deirdre and I enabled Carrick to continue using without facing repercussions – for example, by making excuses for her behavior to friends and teachers.

One day, I found a hypodermic needle and a card that allowed Carrick to exchange it for a clean one. My instinct was to break the needle and rip up the card. But what would that have accomplished? Dirty needles spread Hepatitis C, which Carrick has contracted, and HIV. Shuddering, I chose the lesser of two evils, a misunderstood concept known as “harm reduction,” and put the paraphernalia back.

Some say that it’s fruitless to force a person into treatment, particularly a teenager who is still enjoying the dopamine-induced good feelings that drugs undeniably provide. More than 80 percent of teens relapse within a year of treatment, according to one study. Carrick will tell you, however, that she took away one very powerful idea from the programs she attended and prematurely left: When she was ready, she could get better. And once she tried, we again did everything we could to help.

“Without trying to sound melodramatic, giving me another chance probably saved my life,” Carrick says. “The line between enabling and supporting sometimes requires you to take a risk and hold onto realistic hope.”

Call it paternalistic — in my case it literally was — but addicts frequently don’t know what’s best for them and interventions may be necessary. When Carrick was living on the streets, we prayed that she would be arrested and mandated to treatment by a judge. When she was finally nabbed for theft, however, she was sentenced to 30 days in jail. She celebrated her release by getting high.

Drug courts around the nation are beginning to substitute treatment for incarceration for nonviolent offenders. About 80 percent of the more than 2 million teens in the juvenile justice system have drug and alcohol problems, according to figures compiled by the Robert Wood Johnson Foundation, and a similar percentage have diagnosable mental illnesses.

Indeed, addicted individuals of all ages who suffer from illnesses such as bipolar disorder may use mind-altering drugs to self medicate. We once begged the admitting doctor at a psychiatric hospital to treat Carrick’s underlying depression. We were devastated when he not only gave us the party line that Carrick would first have to abstain from drugs, but also expressed his doubt, based on her record, that she’d be able to do so.

She has, though, and is attending college with the intention of becoming a fifth-generation journalist. An antidepressant stabilizes her mentally; she says she no longer “gets in a crummy mood for no apparent reason.”

In 1998, more than 10 years after she got sober, my wife Deirdre became so deeply depressed and suicidal that I marked her survival from hour to hour. She eventually signed herself into New York Hospital-Cornell Medical Center, a psychiatric hospital in White Plains, N.Y. Her life was saved by electro-convulsive therapy, antidepressants and talk therapy. She has gone on to become an accomplished substance abuse advocate and professional, working as an intake coordinator for Madison East, a unit within New York’s Mt. Sinai Medical Center. She’s a happy and productive wife, mother and citizen.

Fortunately, we’ve been able to afford treatment for her and Carrick over the years, but because New York State lacks a parity law for mental health and substance abuse, insurance coverage has been erratic and spotty. We’ve broken into retirement IRAs and refinanced our mortgage to pay medical bills.

What’s most unfortunate to many of us on the front line — addicts and family members — is that the War on Drugs has become a polarized battle between two camps: hardliners whose “zero tolerance” approach relies on interdiction and prisons for illegal drugs and laissez-faire libertarians and reformers who believe that supply, demand and individual choice should allow the market to reach its natural level.

The market for mind-altering drugs is a lucrative one, indeed. They are responsible for the livelihoods, legal and illegal, of millions of people worldwide — from drug lords to rapid detox clinicians, from bartenders to prison guards, from bureaucrats to copywriters. A recent study by researchers at the University of Connecticut confirmed that the more alcohol ads teens see, the more they drink. But the alcohol industry has the economic muscle to protect its interests: The beer industry in the United States alone spends $1.36 billion in measured advertising dollars annually, employs 1.78 million people, pays $54 billion in wages and benefits, and generates $30 billion in taxes.

The money for treatment is harder to come by. The Bush administration’s $12.7 billon drug control budget request for 2007 earmarks 65 percent for interdiction and law enforcement and barely 36 percent for treatment and prevention. A National Center on Addiction and Substance Abuse report found that of the $277 each American paid in state taxes to deal with substance abuse and addiction in 1998, only $10 went toward treatment and prevention.

There is an obvious common ground: People. If we were to focus our efforts on the family members, friends and neighbors whose brain chemistry has been altered by drugs and alcohol, and treat abuse and dependency as the public health scourge that it is, we’ll have declared a war on addiction. It’s a campaign that can be won, one life at a time. I’ve seen it happen.

(Thom Forbes is an author, blogger on addiction and recovery and former reporter for the New York Daily News.)
 

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