Sober N Clean

Ten years ago, a small group of people frustrated by the rising cost of treating addiction decided to try to turn back the clock.

Managed care was eroding the Minnesota Model, the residential treatment programs that made the state the place to go to get sober. Hundreds of treatment centers around the country were closing as insurers tried to cut costs. The survivors, such as the famed Hazelden Foundation, were under pressure to show clinical results. They added medical staff, pushing prices beyond the reach of many.

The little group tried a different path.

They eschewed the clinical psychiatry and pharmaceuticals embraced by the rest of the industry, going back to the roots of the treatment movement: a full month's residence, surrender to a higher power and support from a community of former addicts.

"We went in a direction nobody was going -- simpler, more affordable," said John Curtiss, a longtime Hazelden executive who left to start the new venture.

They called it "The Retreat."

Now housed in a former nuns' retreat in Wayzata's Big Woods, it offers a one-month residential program for about $4,000, about one-seventh of what Hazelden charges. Its outcomes are comparable to that of other major centers, with 50 percent of those who come through abstaining from alcohol and drugs for 12 months afterward, Curtiss said.

Ten years after its inception, The Retreat hasn't exactly reversed the course of American addiction treatment, which continues to get more expensive. But it has thrived and spawned similar centers in Sioux Falls, S.D.; Auckland, New Zealand; and Hong Kong.

"The Retreat is a model for the nation of affordable treatment that works," said U.S. Rep. Jim Ramstad, a recovering alcoholic and longtime national advocate for better access to treatment. He is a regular volunteer at the Retreat.

Making access affordable

On a recent morning, two dozen women gather in a sun-filled room to study the "Big Book," the bible of Alcoholics Anonymous. Young and old, they bend over the volumes, pages heavily underlined.

Ralph C., a bearded, bow-tied volunteer, is talking about spiritual surrender.

"Is it possible that there is a power that has more horsepower out there?" asks Ralph C., who uses just his first name in line with AA's philosophy. "Am I beginning to suspect it's not another man who's going to fix this? Or a counselor or a drink?"

Quit trying to play God, he tells them.

They are among the few who have managed to get affordable help on the road to recovery. Many others never do. In 2006, 23.6 million people age 12 or older needed treatment for addiction, but only 2.5 million, or 10 percent, got it, according to the U.S. Department of Health and Human Services.

Cost is often a barrier -- with most programs charging $30,000 or more for a month-long stay. Not all insurance covers treatment, and not all centers accept insurance.

The Retreat draws half of its patients from Minnesota, the rest from as far away as India and Australia. The average age is 38 and most have college educations.

The program isn't for everyone. With no clinical staff, the typical client is medically stable and highly motivated. Eighty percent have been through previous treatments.

"We wanted to create a dignified, safe place to go, away from the burning house of addiction," Curtiss said.

If they're suicidal or otherwise need medical help, the Retreat refers them to Hazelden. Other centers in turn refer patients here.

"They have a niche," said Ron Hunsicker, president of the National Association of Addiction Treatment Providers. But the fact that the program hasn't been copied by many suggests its clientele may be limited, Hunsicker said. More addicts are showing up for treatment these days needing medical care.

But William Moyers, executive director of Hazelden's Center for Public Advocacy, differs. "I believe the Retreat is the future of recovery," he said. "It's crucial to replicate it." There is a need for cheaper alternatives for those who relapse, he said.

It was the Retreat, Moyers said, that inspired Hazelden to start its Lodge program in 2002, a nonclinical retreat on its Center City campus.

Letting go of insurance

Curtiss was a patient at Hazelden in the 1970s and returned as a counselor. He worked his way up to vice president of Hazelden's national operations, overseeing multibillion-dollar expansions into New York and Chicago.

In the early 1990s, health insurers, anxious to cut costs, were scrutinizing chemical dependency programs. As insurers insisted on medical diagnoses, addiction centers duly produced them.

"You want to see pathology? We'll show you lots of pathology," said Curtiss, describing the mood of the day. As centers hired more medical staff, costs went up further.

Others were uneasy.

"We were going down the wrong path, trying very hard to make alcoholism into a mental illness," said Dr. George Mann, former director of treatment at St. Mary's Hospital in Minneapolis, now part of Fairview Health Services.

Mann, Curtiss and others began meeting to discuss solutions. In 1998, with a grant from the Johnson Institute, they opened a facility with 20 beds in the old Pillsbury mansion in Minnetrista. Curtiss staffed and furnished it for the grand sum of $177,000.

The Retreat didn't register as a treatment center. Instead, it is regulated by the state Department of Health as "board and lodging." It has grown into an 80-bed campus in Wayzata and runs 54 sober living beds in St. Paul for program graduates.

Over the decade, about 3,500 clients have come through the monthlong program, a third of those with financial help provided by donations. The center doesn't have contracts with insurers.

Stoked by volunteers

In any month, 250 volunteers lead chapel services at The Retreat, drive patients or teach the "Big Book." They not only help keep costs down, they form a vital safety net of recovering addicts.

Alcoholism is "not a disease where people bake casseroles and come over," said Dee L., a volunteer wearing a business suit and pearls. A client three years ago, Dee now returns often to tell her story. She does it as much for herself as for them: "This is how I stay sober."

Even board members continue to work for free. The top executive, Curtiss, is paid $140,000 a year.

An early volunteer at The Retreat was Andrew Zimmern, host of the Travel Channel's "Bizarre Foods."

Zimmern left New York City and checked into Hazelden in 1992, in his words: "a homeless, alcohol- and drug-addled wreck." He credits Hazelden for saving his life. Luckily for Zimmern, his former business partner had continued to pay his health premiums, so insurance covered his treatment.

After he left, Zimmern became concerned that too many people couldn't afford the same. So he volunteers at the Retreat.

"We all know recovery works at its simplest," he said, "when one alcoholic talks to another."
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source: Minneapolis Star Tribune, http://www.startribune.com

The brain scientists who brought VH1 "Celebrity Rehab" are lobbying for a spinoff called "Sober Living."

The show, which would be a cross between "Surreal Life" and "The Real World," would put a number of "Celebrity Rehab" alumni together in a luxurious Beverly Hills mansion for 30 days while they try to rebuild their careers without drugs and alcohol.

Like "Celebrity Rehab," the new show would prominently feature Dr. Drew Pinsky ("Loveline"), who oversees the celebs during their stints in televised rehab.

Filming on the show could begin as early as next week, although VH1 has yet to give the project a thumbs up.

Among those approached by producers to appear on "Sober Living" allegedly have been members from the latest cast of "Rehab" residents, former Guns N' Roses drummer Steven Adler, model/actress Amber Smith and last season's resident, Seth "Shifty" Binzer the lead singer of the rock band, Crazytown.

Many drug rehab centers offer comprehensive care for patients after they leave treatment - ranging from 12-step programs to regular monitoring. "Celebrity Rehab" attempting to offer some kind of follow up for its patients is not a shock, although turning it into a TV show open only to those residents invited back by producers is a bit surprising.

The cast of the most current edition of "Celebrity Rehab" was released from their 21-day stint on the wagon last Saturday. The new season is slated to begin airing on Aug. 4.

On the show, washed-up stars check into a Pasadena, Calif. drug and alcohol clinic and are filmed participating in therapy and socializing with other troubled members of the cast.

Last season even featured former "Taxi" star Jeff Conaway going through detox.

A VH1 spokeswoman said that network does not comment on shows that may or may not be in development.
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source: New York Post

In 2006, 43,000 Californians sought publicly funded treatment for alcohol addiction, including vulnerable populations like seniors and youth. But, recent studies show that more than 2.2 million people in our state meet the criteria for alcohol dependence or abuse. Costs associated with alcohol abuse in California now reach $22.5 billion each year. In 2005, drunken driving caused 1,387 fatal accidents and 20,581 injury traffic accidents statewide. Alcohol abuse devastates families and communities. Treatment admissions in the state for alcohol dependence are second to methamphetamine. While drugs like methamphetamine make front-page news, alcohol addiction is the "elephant in the room."

Some individuals in California who abuse alcohol deny or refuse to discuss their alcohol problem, while others do not seek treatment out of fear, shame or lack of information. Alcoholics and their families and friends hide the addiction, and the stigma attached to alcoholism remains.

We need to remind the millions of Californians who are struggling with alcohol abuse of a simple message: treatment works and recovery happens. That is why it is important for us to recognize April as "Alcohol Awareness Month." This is a terrific forum in which to stimulate conversation about alcoholism, educate Californians about alcohol abuse and urge abusers to get help.

Science has proven that alcoholism is a brain disease -- a chronic condition that can be prevented and treated. Unlike an acute illness, say, appendicitis, we can't simply operate and make the person better. People who become addicted to alcohol will never be "cured," but they can get well and recover. We now recognize that those who abuse alcohol need both acute care and ongoing monitoring.

What makes me so sure that treatment works and recovery happens?

Thirty years ago, alcoholism nearly devastated my family and my life. The disease almost wrecked my marriage, took away my self-esteem and livelihood, and would have killed me had I not sought help. In treatment, I discovered that I was genetically predisposed to alcoholism. Moreover, I learned I didn't have to face the condition myself. With treatment and family support, I got help -- and I got better. I picked up the pieces of my life, marriage and career, and now, in a sweet bit of irony, I head the state's largest agency in the campaign against alcohol abuse.

source: Santa Cruz Sentinel

Reshaping of the DNA scaffolding that supports and controls the expression of genes in the brain may play a major role in the alcohol withdrawal symptoms, particularly anxiety, that make it so difficult for alcoholics to stop using alcohol.

The finding is reported by researchers at the University of Illinois at Chicago and the Jesse Brown VA Medical Center in the April 2 issue of the Journal of Neuroscience.

DNA can undergo changes in function without any changes in inheritance or coded sequence. These "epigenetic" changes are minor chemical modifications of chromatin -- dense bundles of DNA and proteins called histones.

"This is the first time anyone has looked for epigenetic changes related to chromatin remodeling in the brain during alcohol addiction," said Dr. Subhash C. Pandey, professor and director of neuroscience alcoholism research at the UIC College of Medicine and the Jesse Brown VA Medical Center in Chicago, the lead author of the study.

Chemical modification of histones can change the way DNA and histones are wound up together. Histone acetyltransferases (HATs) are enzymes that add acetyl groups to histones and loosen the packing, promoting gene expression. On the other hand, histone deacetylases (HDACs) remove acetyl groups from histones, causing them to wrap with DNA more tightly, decreasing gene expression.

The UIC researchers had previously shown in an animal model that levels of neuropeptide Y in the amygdala modulate anxiety and alcohol-drinking behavior. In the new study, they looked at the HDAC activity, acetylation of histones, and expression of the genes for NPY in the amygdala and the anxiety-like behaviors associated with withdrawal from chronic alcohol use.

Pandey and his colleagues found that acute exposure to alcohol decreases HDAC activity; increases the acetylation histones; increases levels of NPY -- and reduced anxiety in the animals.

Conversely, anxiety-like behaviors during withdrawal in animals with chronic alcohol exposure was associated with an increase in HDAC activity and decrease in histones acetylation and NPY levels.

Importantly, blocking the observed increase in HDAC activity using an HDAC inhibitor during alcohol withdrawal brought up histone acetylation and NPY expression levels in the amygdala and prevented the development of anxiety-like behaviors.

"Our findings suggest that HDAC inhibitors may have potential as therapeutic agents in treating alcoholism," Pandey said.

The researchers also found that levels of a protein known as CREB binding protein, which has HAT enzymatic activity, were increased by acute alcohol but were decreased during ethanol withdrawal.

They concluded that the enzymes that are involved in remodeling of chromatin play an important role in the anxiety that accompanies alcohol withdrawal as well as in the anti-anxiety effects of acute alcohol use.

"We need new strategies to treat alcoholism that are directed toward the prevention of withdrawal symptoms," Pandey said. "Anxiety associated with withdrawal from alcohol abuse is a key factor in the maintenance of alcohol addiction."

The research was supported by grants from the National Institute on Alcohol Abuse and Alcoholism and the Department of Veteran Affairs. Rajesh Ugale, Huaibo Zhang, Lei Tang and Anand Prakash of UIC and the Jesse Brown VA Medical Center also contributed to the study.

source: University of Illinois at Chicago

Joyce Walker's short hair is covered with bleach as she stuffs some last-second items into her bulging duffle bag. The rest go into a worn leather carry-on with a broken handle, and how appropriate is that?

One journey leads to another. A battered spirit is in need of repair. It's time to get sober again.

She grabs a paperback, but must leave her well-worn razor behind. No sharp objects allowed. A dainty diamond stud earring comes out of her right nostril, another no-no in rehab. Walker changes jeans twice and asks, "Do these make me look fat?"

A few drags on a cigarette calm her nerves, and there's a final snuggle for Taylor, an 11-year-old Peekapoo who doesn't judge her shortcomings.

"I love you, little man," she says. "Mommy has to go for a while, but I'll be back, better than ever."

A framed Seattle Times page leaning against her apartment wall proclaims Joyce Walker the state's greatest female high-school basketball player of the 20th century. But Walker, who won state championships at Garfield as a player and as a coach, feels anything but legendary. She is filled with shame, remorse and resolve as she readies for the road back that starts with the Recovery Centers of King County (RCKC).

After nearly 17 years of sobriety, one of Washington's best-known athletes had relapsed. It led to a journey the past year filled with alcohol, marijuana, cocaine and crack that emptied her bank account of at least $50,000 and left a trail of deception.

Now Walker has resurfaced after 26 days in rehab, recommitted to her recovery and dreaming of coaching the Garfield girls again. Some days, she feels back on top of the world. Other days, it's a struggle to get out of bed. Every day, the addiction gnaws at her.

"It's not like I don't think about it every day," she said of the temptation to use.

"I'd like to come home"

Starting over is nothing new for Walker. The 1980 Garfield grad and two-time All-American at Louisiana State played with a flamboyant style befitting one of the first female Harlem Globetrotters.

But the party lifestyle that accompanied her fame opened the door to alcohol, marijuana, cocaine and crack addictions that wiped out a six-figure income and sent her back home to Seattle.

"There's something about this damn town," Walker said, reflecting on now and then. "It's both a blessing and a curse."

Walker, who first smoked marijuana in high school, got clean and sober through Alcoholics Anonymous in April 1990 and became a drug and alcohol counselor who toured the country as an inspirational speaker. Her raw stories made fellow addicts laugh and cry.

She longed to give back to the game she loved and began training young basketball players. Coaching seemed the next logical step. Walker spent one-year stints as assistant girls coach at Ballard and Garfield, then took the head girls job at Rainier Beach for two seasons, 1994-96.

Eventually, she was drawn back to her old high school. The Garfield girls program she led to a state championship as a player was in disarray, and she cried as she sat in the bleachers watching one lopsided loss.

"If the job's open, I'd like to come home," Walker told Garfield administrators.

She was hired in 2000 and took the Bulldogs back to the top, winning a state title in 2005.

A year later, though, the unraveling began. Walker lost her father to prostate cancer, received a promotion to treatment director of the Milam Recovery Center in Renton that added to on-the-job pressure and opened her South Seattle home to two relatives.

One of them brought along crack cocaine.

"I hadn't had dope in my house for a long time," Walker said. "It opened up the craving for me."

She fought the urge, and focused on her basketball team and a growing desire to raise a child, her biological clock ticking at age 44. As last season's basketball season neared, she discussed options with her family doctor.

A routine physical ended with a sucker punch that Walker said ultimately sent her over the edge. Lung X-rays showed several spots, including one that her doctor said appeared suspicious, according to Walker. Three words echoed in her mind: I have cancer.

Trying to save face

The spots on her lung turned out to be benign, but Walker said the scare stirred her addiction.

"Everything toppled from that," she said. "It was just what I needed to justify."

Some in the Garfield community believed she made up the cancer story to at first cover up her relapse and later to excuse it.

When someone dropped a piece of crack on her living-room floor one day before Christmas 2006, Walker's foot instinctively slid to conceal it. Weeks later, she smoked it.

She says her cocaine use didn't escalate until after the basketball season. With crack in her home, she knew it was only a matter of time before the addiction roared back to life.

"I never dreamed I'd get loaded again," she said.

Walker also had started drinking again, and it began taking a toll. She missed practices and lost weight. Lies multiplied. Players noticed she lacked her normal fire.

"Her behavior during the season was pretty erratic, and we knew something was wrong for a long time," said Lily Ramseyer, now a senior.

Walker told the team in late January she had cancer. Rumors swirled in the community, but Walker publicly dodged questions about her health until talking to The Seattle Times in mid-February 2007.

Walker told The Times that three spots on her lungs were malignant. Her explanation now is that she used the wrong word and meant benign.

But Walker admits she was juggling her stories at the time.

"There was another factor going on," she said, referring to her addiction. "You can't save your face and your ass at the same time. You have to decide. At the time, I was trying to save my face."

Ramseyer said she never saw her coach drunk or high at practice or games. Walker insisted that's a line she would not allow herself to cross.

"There were some rules, some principles," Walker said, adding her conscience forced her to take a leave of absence from Milam in February. "I didn't come to practice high, but I was scattered at times."

"I wasn't done using"

Sometime in April, Walker said she went through an MRI exam that confirmed she did not have cancer. But her descent into drugs and alcohol was well under way.

"I had already opened Pandora's box again," Walker said, adding she knew she was in trouble when she quit talking about her addiction. "It's almost like I was running, I was running from myself."

Tricia Ross, Walker's partner and best friend, had been sober for nine years. She also started using again and joined Walker's downward spiral.

"It was a dangerous time," said Ross, who left her job as a pharmacy technician and still is trying to rebuild her life.

Walker called Garfield principal Ted Howard in early May to take a leave of absence from coaching. Players were told she needed time to get healthy. By then, though, they suspected Walker's issues were drug-related.

"Nobody really talked about it, but we all knew," Ramseyer said.

When Walker isolated herself from sober family and friends, her younger sister Shirley Wroten worried.

"I knew something was wrong when she stopped coming around," Wroten said. "We're a very close, tight family and she was just kind of distancing herself."

Wroten, a former track star at Garfield, demanded answers as rumors of a relapse swirled at the end of the basketball season.

"I went to her house and confronted her, but she denied it," she said.

Walker's appearance said what her words wouldn't: She was using. Sixty pounds had melted from Walker's 5-foot-9 frame. Even Walker didn't like the image in the mirror. Not just the tired eyes, but the emptiness inside.

Wroten spoke with Walker's AA sponsor, who said: "There's nothing you can do until she's ready to get help."

Walker wasn't ready. Mike Tretton, a longtime friend and her former assistant coach at Garfield, took her to two treatment centers in March and April. She walked away both times. Wroten coaxed her into detox July 4. Again, Walker fled.

"I wasn't done using," Walker explained. "It still had a hold on me. I wanted some more."

"A hazy time"

Walker sometimes spent $200 to $500 a day on her habit. Bills piled up. She sold her house in August. The cash helped feed her addiction.

"That has a hazy time," Walker said.

She took a road trip to Las Vegas in early November after blowing $24,000 on a new Chevy HHR. Walker totaled it in Eastern Oregon and later found out her insurance had lapsed.

Walker, with Ross and another friend as passengers, was driving eastbound on Interstate 84 near Ontario, Ore., in the early afternoon of Nov. 5 when she lost control. The SUV rolled three times, flipped over the median and landed in oncoming traffic.

Walker said she swerved to avoid a merging semi. No citations were issued, according to police, and, amazingly, injuries were minor.

"Obviously, God wasn't done with me," Walker said. "I paid this price for this journey, and I know that. Sometimes, a lot of things had to go so I could just stand alone in the presence of a power greater than myself."

That experience didn't stop her out-of-control downward spiral. She rented a car and continued to Las Vegas. A weeklong vacation turned into a month, as Walker hit the blackjack tables and slots, drinking and getting high.

Anything to escape. Anything to run away.

"I don't think it was about the gambling or getting high," Walker said. "It felt so excruciating, I didn't want to face any of it."

Walker spent a night in jail there. She was arrested for auto theft because the rental-car company claimed she hadn't returned the vehicle in time. Details are fuzzy, like many of the events in her life. But she didn't need a jail cell to make her feel trapped.

"I was in my own prison for about six months," she said. "I always knew I had the key, but I couldn't get it in the lock. Maybe I wasn't supposed to."

Walker's inner demons run deep, perhaps back to her childhood. The seventh of 10 children, she was born with spinal meningitis and needed more care than her mother and alcoholic father could provide. As a baby she was sent to live with her great aunt in Los Angeles. Walker was 7 years old when she returned to Seattle, but never outgrew the feeling she hadn't been good enough to live with the rest of her family.

As her recent crisis deepened, she felt drawn back to L.A., back to the now-ailing great aunt who raised her. It was time for some tough love.

"This is not you," her great aunt told her. "I know you're hurting, but you need to get back to your life."

Rock bottom came when Walker, longing for a high, nearly took the woman's life savings. She forced herself to put back all but $100.

The next day, four days before Christmas 2007, Walker flew home. It was time to get clean and sober.

"I was done before I got back here," Walker said, "and I was lucky. Most people don't get back here."

She still had a place to stay, an apartment in the Renton Highlands, but little else. Friends and family refused to lend more money, beyond a few dollars for cigarettes and food. Call when you get to treatment, they'd say, skeptical that day would come.

New clothes were returned for cash, some of which went for crack. She got high the night before going to rehab.

"Walking the sewer"

On Jan. 9, Walker learned a bed was available at the RCKC detox center. She called for a ride and hurriedly finished packing. A few quarters for the pay phone would be her only connection to the outside world.

"I know this is the only way," Walker said. "I want to rest. I want to get healthy again."

Her sponsors strongly advised against her publicizing her story so early in her recovery. But Walker decided to tell it anyway.

"It's hurtful to walk the way I just walked in broad daylight," she said. "Not everyone can do it. I didn't know if I could do it. But I felt it was the road to freedom. I know what society could say, but I know I had to walk it. When I found that inner freedom, it was the freedom of knowing there was something greater for me.

"But it was ugly at times."

Walker spent four days in detox before entering the treatment program at RCKC. The shakes from alcohol withdrawal were manageable compared to restless nights, when she dreamed of chasing drugs and woke up with the sweats. Her legs cramped, her arms went numb. Mood swings left her yelling one minute and crying the next.

"I went back to walking the sewer most people wouldn't walk through," she said a week into her recovery, "but I knew I wasn't staying. I stayed a couple of months longer than I wanted to, but I'm back and I'd pay any price to do it."

"A legend in the house"

Walker was released and awarded her certificate for completing treatment on Feb. 4, a week early. She slipped and injured her back, requiring treatment at Harborview.

Her thoughts immediately turned to Garfield. The next day she called Howard, the principal and her longtime ally, for a pass to that night's boys game at Eastlake in Sammamish. She couldn't wait to see her nephews, Tony Wroten and DeAndre Taylor, play for Garfield.

She headed for the gym at old Lincoln High School, where Garfield students are attending school until Garfield's renovation project is completed next fall.

"Get ready to get mobbed," Howard told her.

Lily Ramseyer is the first to see her, and her screams echo down the hall. Others follow.

"I love purple and white," Walker says, scanning the championship pictures on the window of an office that used to be hers. "I don't know anything else."

Walker shoots jumpers and shows off one of her Globetrotter tricks, spinning a ball on her index finger, then punching it up and through the net.

She scores a pair of purple and white sneakers and two practice jerseys bearing her number, 21, the one she has tattooed on her right biceps along with the words "Top Dog."

More confirmation and hugs come the next day, when the Garfield girls play at Eastlake. Walker knows she let players and parents down. She understands they all won't be forgiving.

"I've been mad at Joyce," says Judy Ramseyer, Lily's mother. "She made some bad decisions. But I love her, and I'm glad to see her back ... She was fighting her own demons."

But Lily has reservations.

"I guess I can forgive her, but I can't really forget it," she says.

"Shame is good for me"

Howard, wearing a Garfield jacket, is thrilled to see Walker in the crowd. He continues to be one of Walker's strongest advocates, as he has been since the day she schooled him on the basketball court when he was a Garfield freshman.

"Joyce means more to us than just a basketball player," the principal says. "She's part of the culture here. She's part of the kids, she's part of us. Every time the kids take the court, they're either dribbling like her or shooting like her. Her legend continues to live on."

Could she be back as Garfield coach? Howard won't say, but plans to talk with both her and Craig Jackson, the interim coach.

Walker believes she has a gift to give on the basketball court and already is back in the gym. Some days she has only enough energy to attend an AA meeting or study group. Ninety meetings in the first ninety days, that's the recommended regimen following treatment, and Walker says she attends one most days. She started an aftercare program Friday that includes weekly counseling.

The mood swings continue. One day, Walker is upbeat and excited about her future. Another, she feels sorry for herself. Depression lingers and humility is around every corner. She has no car, no job and, at the end of this month, no place to live. She hopes a school will take a chance on her again.

Walker tries not to worry about what people think.

"I'm not ashamed to let people see me go through difficult times," she says. "Shame is good for me. I messed up and did things wrong."

Step 9 in AA's 12-step program is making amends, face to face. Step 8 is making a list of those you have wronged.

"Hers is probably pretty long," Tretton says.

Some will never understand. Others will never forgive.

"There are those who don't understand it's a disease," says Tretton, who celebrated his 28th year of recovery Tuesday. "But once you know you have the disease, it is your responsibility to take care of it. From that standpoint, she has a responsibility. But once you start using again, you don't have a choice."

Walker knows her road back is only beginning.

"For some, there's no explanation necessary," she says. "For others, there's no explanation possible."

Joyce Walker makes no promises. Her addiction doesn't allow it. If she stays sober today, it's a good day.
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source: Seattle Times

Wednesday, 13 February 2008
Terence Blacker

Illegal drugs, we have learned this week, fall into two broad categories. Some turn their users into hopeless victims who, if they are lucky enough to recover, are to be welcomed and congratulated by society. Others, equally illegal, demonise their users for ever, whether they have recovered or not.

For the young, who are supposed to be taught about such things, it is a complex business of right and wrong, but the last few days have provided useful case studies in good bad drugs and bad bad drugs.

On Monday Amy Winehouse – "troubled Amy Winehouse" as she must now officially be called – was released from the rehabilitation clinic where she is currently living to sing her songs "Rehab" and "I'm No Good" before a small audience in London. Her performance was linked via satellite to the Grammy Awards in Los Angeles, and Amy was presented with five of the top prizes. She was "wonderful", said one of her main rivals, Beyoncé, while the Los Angeles Times praised her as "the most exciting performer of the evening".

There was a single discordant voice – the singer Natalie Cole suggested that rewarding someone "in the stupor of drugs" might just possibly set a bad example – but the general consensus was that troubled Amy may have turned the corner at last. Her mother announced to the press that she was on the road to recovery. It was all rather moving.

The other famous former druggie in the spotlight has been Dwain Chambers – "drugs cheat Dwain Chambers" as he should now officially be called – who was running in the 60 metres at an athletics meeting in Sheffield after serving a two-year ban for taking performance-enhancing substances.

Athletics specialises in goody-goody pundits, but not even the most bland and mild-mannered of them has had a good word to say for the drugs cheat. Colin Jackson could hardly bear to mention his name on TV. Steve Cram, normally the soul of dull diplomacy, gravely announced that Chambers should not be allowed to represent his country. The director of the London Marathon, David Bedford, suggested that fans should boo the drugs cheat as he ran.

They cheered him to the echo as he romped to victory, much to Bedford's rage. The true athletics fans, he explained a trifle desperately, were not there, having already "voted with their feet" because of the way athletics is run.

There is another explanation. Those applauding Dwain Chambers were confused. They thought that, because he had served his punishment, he was no longer a pariah. After all, Linford Christie still works in the sport; Christine Ohuruogu, having been banned for skipping three drugs test, was later welcomed back as a national hero.

Some of the fans might have been further bewildered by the media coverage of the Grammies and Amy Winehouse. If the great worry is about negative role models sending out those famous wrong messages, why is it just fine for the music industry to celebrate a famously addled singer, however talented, while the mere presence on a running track of an athlete who took drugs in the past causes trills of outrage from all right-thinking people?

Just possibly, it helps that Amy Winehouse is white and wasted; she looks like a recovering druggie should look. Dwain Chambers, by contrast, is strong, black and not about to burst into tears for anyone. No one has explained to him that the British like their victims to look the part. Only when he becomes "the troubled Dwain Chambers" will he stand a chance of forgiveness.

An unpleasant whiff of prejudice

Although it is not statistically proven, many English people believe the French are not only ruder than most other nationalities, but are particularly prone to wind.

Now these prejudices are to be passed on to the next generation. A new character in the TV series based on Roger Hargreaves's Mr Men series is to include a Monsieur Rude, who speaks with a French accent and invites children to pull his finger. When they do, he farts.

Never mind the complaints about political correctness, this is an outrageous, malodorous slur against our European neighbours. The racism tsar, Trevor Phillips, should have a word with M. Rude's creators.

* Good news for employees of the National Trust. They can stay home on 29 February. The Trust hopes that on what it calls Green Leap Year Day, staff and volunteers will use the time to think about the environment, possibly changing a light-bulb.

"If everybody gets involved, this means over 54,000 people could reduce their impact on the environment," says Dame Fiona Reynolds, the National Trust's director-general.

It is an attractive idea, staying at home and doing nothing in order to save the world, but the idea has certain flaws. Sitting around can be chilly at this time of the year: better turn up the heating. It gets boring after a minute or two: why not turn on the TV, with that high-energy plasma screen?

National Trust employees will be encouraged to write a report on what they have achieved. Doubtless, these will be printed out on – oh dear – paper. There are four more years to think this one through more carefully.

source: http://www.independent.co.uk

SEASIDE - Helping people clear the "cobwebs" 12 steps at a time.

That is the mission of Awakenings by the Sea, a rehabilitation facility that has opened its doors in Seaside.

The state of Oregon is ranked 47th in available addiction treatment in the country and ranked fourth in need for addiction treatment, according to Jim Arnold, chief executive officer of Awakenings by the Sea.

"Our goal is to help restore the physical, mental, emotional and spiritual health to these individuals, so they can be productive members of society," said Arnold. "Unfortunately, many of these people have more than one addiction," said Arnold. The programs are 30, 60 and 90 days with the first 30 days costing patients $7,500 and declining by $500 increments from there.

In defense of the cost, Arnold said a $21,000 price tag for a 90-day round of treatment in the Awakenings facility is what some facilities elsewhere charge for 30 days. In comparison, the Betty Ford Center charges $24,000 for a 30-day inpatient treatment program, according to the Web site.

"(For the cost) people are hopefully getting well," said Arnold. "What kind of price tag can you put on that. The cost also covers individual and group treatments, room and board, family visitations on Saturdays and aftercare. "There is also a discovery of the disease process and hopefully the tools to lead a happy, healthy, normal life."

Aftercare is for those patients who need additional support after completing the program.

"It's not unlike out-patient care. If they have issues with life on life's terms, they can come back for additional counseling," said Arnold.

He also said that initially the plan for the facility had been to provide care for "high-end" clients, working professionals, but realized that "we were kind of missing the point."

"White collar, blue collar, no collar, we're here to help," said Arnold. "We didn't expect to get rich off of this."

Arnold says that while Awakenings is a business, it is also a service to the community and that the facility has taken on eight patients in the last three months who could not pay for the care they received. Those patients who received care without being billed were locals referred to the facility by LifeWorks and individuals seeking treatment for their addiction.

According to LifeWorks Director Michel Meiffren, it would be "advantageous to the recovering community here" for Awakenings to be certified to receive clients who are without insurance. The uninsured would be covered by the Oregon Health Plan under indigent care. Awakenings is in the process of being OHP certified.

"We have referred four clients to Awakenings and they took one in," said Meiffren. "To their credit, they opened two beds for indigent care."

Meiffren says the most important part of the recovery and care process is to have a continuum of care that follows through from a 12-step program to inpatient care to detox to aftercare to the 12-steps again.

"The more that continuum of care is established, the better for the community, and Awakenings is part of that continuum," said Meiffren.

The facility is licensed to care for 15 patients in a residential treatment program, during which patients are allowed to have supervised walks and are escorted to two Alcoholics Anonymous meetings a week outside the facility.

"Individuals spend 98 percent of their time confined to the building," said Arnold.

Those in treatment are free to leave, if they wish, but for the duration of their stay in the facility, they must participate in group activities and are either supervised by staff or self-supervised in groups of no fewer than three patients.

Patients are examined by an "on-call physician" when they initially check in to the facility, undergoing a basic physical and an inspection of all medications they may be taking to ensure that "what's in the bottle matches what's on the label." The patient's state of addiction is measured by standards created by the American Psychiatric Association, thus placing that diagnosis in the hands of physicians and councilors rather than in the hands of family members, as would occur in a traditional treatment program.

Internally, Awakenings has round-the-clock care on hand for those in residence and also provides in-house counseling that is supervised by Kris Hansen.

Hansen used to be employed by LifeWorks and according to Meiffren, the staff at LifeWorks has "the highest regard for her."

Hansen says the program uses a combination of the Minnesota Model which, according to the National Institute on Drug Abuse, is "typically characterized by a thorough and ongoing assessment of all aspects of the client and of the multimodal therapeutic approaches," and is employed by Alcoholics Anonymous and other similar recovery programs.

Hansen says she has been working in recovery treatment since the early 1990s, including in- and out-patient treatments.

"I prefer the intensity of residential treatment programs," said Hansen. She said that she "had a career change sort of midlife" from business management to psychology.

"I realized I wanted to help people," said Hansen.

The level of addiction assessment also determines the length of stay for a patient.

In the long-term, Awakenings will be comprised of three facilities - the Seaside site, a site in Bend and a site in Portland. The proposed Bend and Portland facilities are still in the theoretical stages at this point.

The building housing Awakenings, at 1325 N. Holladay Dr., Seaside, is a renovated church but is far removed from its roots as such. It was purchased by other owners as a potential home and then purchased by Arnold and his investors. According to Arnold, the community as much as the building helped him make the decision to locate the facility here. Annually, Seaside plays host to conventions for those in recovery and that, says Arnold, was one of those important community factors.

"Clearly, the community here is supportive of people trying to better themselves and get well," he said.

Arnold said the venture was a first-time effort for him and that his group of investors are all private investors who are in recovery.

"This is an avenue to give back," said Arnold.

The facility is unique, according to Arnold, in the features provided by Awakenings. There are bedrooms that are two or three beds to a room, several bathrooms, two sets of stairways that connect each floor of the house and a feeling of a large home.

'Feeling of home'

"Every client here or that has come through, said we have given them the feeling of home," said Arnold. "One man said this facility had done in 30 days what another hadn't done in 90. That bodes well for the treatment modality."

Arnold praised local business owners and the neighborhood around Awakenings for being supportive and understanding the economic and social impacts of addiction upon a community.

"All the neighbors are elated that we've improved the look of the neighborhood and increased their property values," said Arnold. He said neighbors were most concerned about the possible increase in traffic through their neighborhood but said their fears were eased when it was explained that the facility encourages patients to be driven to the facility, rather than driving themselves.

"We are not a lock-down facility and we believe it's better not to have extra cars sitting around outside," said Arnold.

When a patient completes a treatment program, they are given a party of sorts that includes their fellow recoverers as well as their families.

"People are so grateful to get their loved ones back," said Arnold.

source: Daily Astorian

Among the many problems with Vancouver's failing Four Pillars approach to the grotesque addiction problems in the Downtown Eastside is that it has spawned the Not-in-Anybody's-Backyard movement.

It now seems impossible for municipalities like Richmond, Coquitlam, Gibsons, or Keremeos to even consider proposals for abstinence-based treatment centres without NIABY proponents raising red herrings such as Vancouver Mayor Sam Sullivan's support for providing free heroin to addicts or Senator Larry Campbell's support for reforming drug laws.

They even question the fact addiction is a disease, not a choice.

Small wonder.

The Four Pillars plan totters on only two -- harm reduction (which includes the safe injection site, the ever growing distribution of free needles, methadone and possibly free heroin) and the best enforcement Vancouver police can muster without completely abandoning the rest of the city.

It hasn't made a dent in the nightmarish scene at Main and Hastings or the lives of the hundreds of addicts who congregate there.

No one wants that replicated in their community.

However, that begs the issue of treatment.

As this week's series in The Vancouver Sun makes clear, alcoholism alone affects thousands of Canadians. It also makes it clear that tens of thousands of Canadians have recovered with treatment. And while the series focused on alcoholism, clinicians don't differentiate between them and drug addicts. They are unequivocal.

Addiction is a neurological disorder for which the only cure is abstinence and that means recovery is a process that takes years and often many attempts.

"There is no place for controlled substance abuse in addiction. Period," said Dr. Graeme Cunningham, associate clinical professor of psychiatry and director of the addiction division of an Ontario health centre.

For years, Dr. Douglas Coleman along with other board-certified addictions physicians have been saying the same thing in Vancouver. But they're rarely heard above the din of harm-reduction proponents and others who suggest drugs aren't addictive, rather a symptom of poor living conditions or some other disorder.

Medical experts like Coleman define addiction as a war between two parts of the brain. The forebrain, which controls our intellectual or rational understanding, is not able to keep the mid-brain, the emotional centre, in check.

Addicts are, in Coleman's words, people who continue to use drugs or alcohol despite knowing the consequences are episodes of loss of control and an ongoing preoccupation with getting that next drink or fix.

They drink or use drugs knowing full well it will impair their judgment.

That's what they want.

As Coleman says, "There's not a respectable addict in this country who would say, 'No, I think I've had enough.'"

Abstinence is the only proven cure, which is why Alcoholics Anonymous, Narcotics Anonymous and Turning Point, which is proposing a 32-bed facility in Richmond, insist on it.

Each week across Metro Vancouver, there are 700 Alcoholics Anonymous and Narcotics Anonymous meetings. That's 100 meetings a day in different neighbourhoods attended by doctors, lawyers, clerics, truck drivers, airline pilots, journalists, and every other kind of person you can imagine.

That's why it makes sense to not put recovery services in the midst of Vancouver's chaotic, drug market.

It's like holding Weight Watchers' meetings next door to a chocolate shop.

Harm-reducers have all but convinced us that some people can't be cured because there is too much wrong with them -- mental illness piled upon multiple addictions.
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So, who wants them in their neighbourhood?

But Coleman contends everyone has the potential to abstain and recover. To suggest harm recovery is the best we can do, he says, is a death sentence.

Even NIABYs don't oppose treatment. They simply want it far away from them, which has proved an attractive idea to urban politicians, especially Vancouver-Burrard MLA Lorne Mayencourt.

His non-profit, New Hope Recovery Society has taken over Baldy Hughes, an abandoned U.S. military base 35 km from Prince George. Based on the village model of San Patrignano, Italy, and the principle of abstinence, the first recovering addicts moved in earlier this month.

Last spring, The Sun's Jonathan Fowlie visited San Patrignano where addicts spend an average of three to four years recovering.

One resident told him that when she went home for a short visit, "It was strange. I felt like a Martian. I felt it was a world that wasn't mine anymore."

That's why addictions specialists refer to wilderness camps as "the Greyhound cure." It doesn't fully address the reasons addicts craved impairment in the first place.

So, what we're left with is this:

We can maintain the status quo, pouring millions of dollars into the Downtown Eastside and pretending that two pillars are four.

We can pack addicts off to the hinterlands and hope they don't come back as Martians.

Or, we can accept the medical evidence that recovery is a slow, hard process that's made easier if people get needed services in their own communities where, unimpaired, they can rebuild and resume their lives.

dbramham@png.canwest.com

source: Daphne Bramham, Vancouver Sun
Published: Friday, December 21, 2007
© The Vancouver Sun 2007

The way Joseph Carroll sees it, he has a second chance at life with his family.

'I'll take that,' Carroll, a 59-year-old Army veteran and father of four who brought back from Vietnam a propensity toward alcohol abuse.

Now, after a spell on the streets and a five-month stint at The Baltimore Station, a treatment center whose population is made up mostly of military veterans, Carroll plans to return to his wife in Portsmouth, Virginia, after Thanksgiving. 'If she don't change her mind,' he said, laughing.

'It's been an experience,' he said of his stay at the center, housed in an old fire station on West Street in South Baltimore. 'I'll never forget it. I needed a little structure in my life, which is happening. I got caught up in a situation which happened to bring me to homelessness. It's something that's new to me.'

Carroll and a few dozen of his fellow veterans gathered yesterday outside the treatment center to watch Gov. Martin O'Malley, Mayor Sheila Dixon, Rep. John P. Sarbanes, Sen. Benjamin L. Cardin and others break ground on a construction project that will double the size of the structure and enable it to house 100 residents, almost twice its current number.

'I can't think of a more appropriate place to be on this Veterans Day than here at The Baltimore Station,' Cardin said, noting that there are 25 million veterans living in America as well as 1.2 million active-duty members of the military, about 200,000 of whom are serving in Iraq and Afghanistan. Veterans, he said, have always been shortchanged.

'We haven't even done what we said we could do, and now we're trying to do the right thing,' he said, referring to The Baltimore Station's expansion, which, when completed, will increase the center's space to 16,225 square feet. Foundations, private citizens and the Department of Veterans Affairs contributed nearly $4 million for the expansion. The center operates a second treatment facility, also in a former firehouse, in Seton Hill, and the combined annual budget is $1.2 million.

O'Malley said that one-third of Baltimore's homeless are veterans, some of whom, he said, 'get their lives on a forward path' with the treatment center's help.

Donald Moaney, 72, who served in Korea as an Air Force mechanic and has been at The Baltimore Station since February recovering from an addiction to heroin, said that in the next few days he will start a new job, at the AFL-CIO's offices on Patapsco Avenue. In the treatment center, where he receives acupuncture therapy and takes part in group counseling, 'they just want you to sit still and get some guidance for your life,' he said.

Karen Hohlhoff, a retired nurse who has volunteered at The Baltimore Station for five years, said that most men in such programs 'don't feel respected.'

'You can't make an addict get better but you can support them,' said Hohlhoff, who acknowledged learning such things from being married to a drug addict. 'You can volunteer at a place like this and help them feel like valued human beings.'

It's apparently working for Jimi Fardan, also a Vietnam veteran, who has been at The Baltimore Station for a year and who recently set up a Web site, www.pencilmania.net, to display his art. The treatment program has been 'enormously helpful,' said Fardan, 61, his beaming face framed by dreadlocks. 'Every day we're getting a graduate class in addiction, and why we do what we do. For me, drugs at one point were the solution, and then they became the problem.'

After the ceremony, the center's program manager, Laura Poindexter, called out to the residents milling by the buffet table, reminding them that the center was on 'holiday schedule' and that they need not return until 10 p.m. 'And I want all your urine samples to be clean!' she warned with a smile.

Steven Wilson said he didn't need persuading. 'Now I feel I have direction and purpose,' said Wilson, 55, a former military policeman and computer programs analyst who is fighting addictive behavior in his third stint at the center. 'I couldn't maintain the professional appearance, the status. Thirty years went by just like that, and I have nothing to show for it. Now, I'm grounded. I finally landed.'

By Nick Madigan

Baltimore Sun