On October 9, 2010, I had the privilege of sitting down with Dennis McCarty, PhD to discuss drug and alcohol addiction treatment in the US. I have the great fortune of working with Dennis, mostly by turning his printouts into PDFs and booking the conference room for him, and I’ve always been fascinated and heartened by the work he and his team does; I’ve secretly always thought of him as a bit of an unsung superhero – out there fighting the good fight. After reading some posts about drugs, addictions, and treatment here on TNB in recent months, I asked Dennis to share his thoughts on all of it from the angle of policy. Here’s what he had to say.

 

I met Jen in rehab in 1995. She was trying to kick a methadone habit and I was in an ugly battle with the bottle. She’d been in treatment a few weeks before I arrived. And when I did arrive I was running on a two-week binge that had me buckled over and racked with blurred vision. I could hardly move except for my hands that wouldn’t stop rattling. I showed up at their door with a duffle bag full of clothes and a couple of books. One of them being Camus’ Exile and the Kingdom.

They immediately put me in detox. In the bed next to me was this young dude who was hooked on speed. On the other side of me was a middle-aged man whose drug of choice (DOC) was morphine.

“I got addicted after a car accident,” he told me, his eyes pale and gone. He lost two fingers in the accident. “That was the first time I tried morphine. In a hospital of all places.”

When I was in the clear they put me through an assessment and found that I was highly depressed, was loaded with anxiety, suffered from sleeping disorders, and had a problem with alcohol.

I was a walking time bomb.

I was lethal.

I already knew this.

One of the first things they tell you when you enter rehab is that it’s not a place to find romance. Don’t look for a boyfriend or a girlfriend in rehab. That’s not what you’re there for. You’re there to rewire your brain. You’re there to get clean. You’re there to fix yourself. You’re not there to get fucked. You’re already fucked. That’s why you’re in rehab.

But when I met Jen there was an instant attraction between us. She was pretty, had beautiful green eyes, fair skin, and short brown hair. Over the next week I’d see her around the facility. We’d stop and chat, talk about our treatment and whatnot. Small talk. But there was something else going on. One night after a group session I was walking out to my car and she stopped me.

“So, what are you doing tonight, Reno?”

“Try not to walk into a bar and get shellacked,” I said, laughing.

“Sounds like a good plan. How about some coffee? Want to join me?”

That night over coffee and her burning cigarettes we told each other’s story. She came from a wealthy family, was born and raised in Miami. Two brothers, one sister. Mom was a materialistic pill-popping bitch and dad was a functioning drunk who owned a Budweiser distribution center that allowed him to fill up his houses with kitschy shit and wrap his neck and fingers in diamonds and gold. Her brothers were alcoholics and her sister, who owned a successful talent agency, was addicted to everything. Coke, booze, opiates. She was a professional addict who never missed a day of work, never lost control, never went to rehab.

“She has her addictions under control,” Jen said. “If there’s even such a thing.”

Jen worked as a graphic designer and was heavy in the Miami art scene. That’s where she was introduced to methadone. Like many addicts, she experimented with all kinds of drugs including alcohol. But it was methadone that did her in. Her story was the typical drug tale: at first her using was recreational, a weekend thing. And then quietly and suddenly she was in the throes of full-blown addiction: methadone was running her life, waking her up, putting her to bed, and calling all the shots in between.

She avoided friends and family. Her work started to suffer and then disappeared all together. She lost self-respect, her dignity. And then she didn’t care. Didn’t care what happened to her. She packed up and drove across the states to Vegas not remembering much of the drive. I knew the story all too well. I lost my fiancé over alcohol. I disconnected from friends, family, and eventually myself. I told her that when my addiction was at its worse I knew damn well I was killing myself but didn’t care. The pleading voices over the phone didn’t mean a fucking thing. The concerned faces of those who loved me were featureless, blank, nothing.

The bottle won and was eating me alive.

We started to see each other a lot. We’d go to the movies, have dinner. We’d jog the Vegas Strip, hike Mount Charleston. We flew to California and sipped lemonade on the Santa Monica Pier. We watched the sunset and held each other. We couldn’t change the past. What the future held in store for us was a mystery. There were no guarantees—our promises just fragile utterances that could be snapped by the deceitful, cunning, and destructive voice of the addictive mind. But we were sober today. That was our mantra.

Today.

Today.

Today.

On the night that it happened we were walking in Sunset Park and I reached for her hand. We walked for quite a while without saying a word. But there really wasn’t much to say. Our hands weaved together said all there was to say.

“Want to go to my place?” she asked.

We sat at her kitchen table listening to Derek and the Dominos and talked long into the night. We wondered and worried if we were ever going to kick our habits. We knew we were in trouble, that our addictions had a stranglehold on us. We knew that if we continued to use then the end result would be the grave. There was no doubt about it. Two months before I lost a dear friend to heroin. A year before that another friend lost his fight with alcohol. One dead at forty-one, the other at twenty-seven. Good men. Funny, intelligent, gentle. But sick and damaged beyond repair. I was right behind them. So was Jen.

We knew we were in control of this.

We knew we were out of control.

“Reno, I know you don’t love me,” Jen said, looking through me. “But will you make love to me?”

My ex-girlfriend’s face flashed in front of me. Her telling me to wait, to not sleep with anyone, love anyone, that it will only complicate matters, not yet, get clean, please, I’ll wait. I shut off my picture-making machine, pushed away her words, and followed Jen to her bedroom as the opening lead to “Layla” slurred behind us.

Let’s make the best of the situation/Before I finally go insane/Please don’t say we’ll never find a way/And tell me all my love’s in vain

I woke up to Jen sitting on the bed Indian-style reading a book of poems I bought her. She looked beautiful, peaceful, her green eyes bright and clear.

“Hey,” she said, in a soft voice.

“Good morning.”

We stared at each other, examining each other’s face looking for something. I finally sat up, held her face in my hands, and kissed her. Tears rushed down her face. And then I started crying. We crossed over. We broke the rules of rehab. We cared for each other now. We wanted each other to get well, to be happy. We wanted the best for one another. We wanted each other to be clean and sober. We held each other thinking the same thing: please don’t use, don’t drink.

* * *

After three months we completed the program. Jen finished before me, but continued her treatment at another facility. We continued to see each other, but as time passed we saw less and less of each other. We were in love, but knew that because of our addictions a serious long-term relationship would be a precarious situation. We were dangerous for each other and didn’t want to bring the other down if our addictions surfaced again. The statistics said there was a high probability they would. This terrified us and eventually broke us up. We cared for each other too much to take the chance.

I remember our last phone call which would be the last time I’d hear her voice. We thanked each other, wished each other good luck, said that we’ll always love one another, but that it just couldn’t be. It was devastating. I hung up the phone empty, crying, lost, but sober. To this day I can still hear her voice coming over the wire.

“We’ll be all right, Reno. We’ll be O.K.”