State of Play

Do you have any idea how hard it is to deal with addiction and get treatment in America? I have gold plated insurance, am comfortably middle class, and I have been going through sheer hell trying to get into a facility. It’s almost like you have to show up with a syringe full of heroin dangling from your arm and a crack pipe in your mouth to get anyone to take you seriously.

A while back, I went to my general practitioner and tried to get into a rehab facility. He was caught off guard and sent me to some place which was basically a level 4 detox facility (this meant nothing to me when I was first told it). Regardless, I had made the plans, packed my bags, gone to go be admitted, and the doctor there told me there was no way in hell he was admitting me because this was a place for court ordered detox of people who were in a far different place than me, criminal, and basically the people drinking MD under a bridge for 30 years or smoking crack rock and holding people up at gas stations. Basically, he told me that under no circumstances was this the place for me. I’d set aside the time for work. Showed up, got rejected.

Spent another couple months trying to get a place that was right, covered by insurance, and amenable to my time schedule. Found a place in Ft. Myers, Florida, and was getting ready to go, but then they flaked out on me and would never send me proof that my insurance would cover it. I’m not jumping into that kind of scam, especially in Rick Scott’s Florida. Not to mention, I sweat in a meat locker, and Ft. Myers in July sounds like my own personal hell.

So then I just said fuck it. I’m just going with the VA, even though I have private insurance. It’s close, veterans (who bitch more than anyone on the planet) consistently rate their care at the VA higher than civilians rate their hospital experiences, plus there would be a comfort level there because I was around folks I understand. Spent a couple days making arrangements with people at the VA in Pitt, they told me what to bring, packed everything up, and went, thinking I was making a big step.

Guess what. In 2003, under our favorite President, for whom I voted twice, they changed the rules of eligibility. Because I am comfortably middle class and have a retirement account, even though I am a veteran with a combat patch, I am not eligible because I have too much money. At this point, I’m just like, you have to be fucking shitting me.

Get home, called the local hospitals. None of them have facilities for rehab, or if they do, they are all outpatient and they basically give you aspirin for headaches from withdrawal. Called a number of places, and it was all the same.

Finally, I called a hospital which accepts my insurance, and I can’t even set up a rehab appointment, I have to go through their emergency room, and then they will refer me to the clinic. So that is the plan this weekend.

Why is this so fucking hard? Am I just incompetent or is it this fucking bad everywhere? You’d think they would make it much easier for people to voluntarily check in to rehab. I mean, after all, I’m a drunk. A high functioning one, but a drunk nonetheless. Sometimes I cut myself while slicing tomatoes or doing basic everyday things because… I’m fucking drunk. Why is it that getting into rehab requires a fucking PhD in bullshit and the equivalent of a tax attorney’s knowledge of procedure? Isn’t getting clean tough enough? Jeebus.

I’m winding down now. Was really psyched to start today and get shit done, and got home dejected and have just been keyed up and pissed off all night. Not to mention the bullshit of the day we discussed earlier.

Weird fucking world we live in.

149 replies
  1. 1
    Mary G says:

    Sounds like Kafka. Poor Cole. I’m guessing it’s driven by insurance company bullshit. They may technically cover something but have so many nitpicking loopholes that make it hard for the facilities to be sure they’ll actually see any cash.

  2. 2
    John Revolta says:

    All this shit is just gonna strengthen your resolve. Don’t let the bastards wear you down, goddammit.

    You’re gonna do this.

  3. 3
    patrick II says:

    Guess what. In 2003, under our favorite President, for whom I voted twice, they changed the rules of eligibility.

    One of the things I hate the most about Bush/Cheney is this. While they were extolling the heroism of our warriors in war they were cutting their medical care at home. They pretended to love our soldiers when they went to war, but they are not as important as tax cuts when they get home.

    My own mother is the widow of a WWII vet (a marine who fought at Iwo Jima) and is 91 years old now. She could really use the VA benefits she was supposed to have to live in assisted living. Instead she lives alone in her house because she does want to spend down what money she has paying for assisted living herself until she is dirt poor enough for the VA to provide the aid that was once promised.

    Joining the military has been made a sucker’s game by the Republican party.

  4. 4
    Jewish Steel says:

    Damn, what a rigamarole!

  5. 5
    John Revolta says:

    BTW Cole, you can start on your own, by not drinking tonight. ;-)

  6. 6
    Sir Laffs-a-Lot says:

    Best in the USA this side of Betty Ford Clinic:

  7. 7
    Omnes Omnibus (the first of his name) says:

    Why is the process so hard? Because people have worked to make it so. Don’t fucking let them win.

  8. 8
    mtiffany says:

    As soon as the Church of the Flying Spaghetti Monster sends me a certificate of ordination, you can come spend your thirty days with me…
    No prayers, no ‘higher powers’, just “Jesus, you smell like sour milk and diarrhea again?!?!? Take another fucking shower!”

  9. 9
    David Koch says:

    is rehab part of insurance plans?

    I ask cuz I don’t know anyone who has gone through it.

    also too, I broke my hand once and it was like pulling teeth to my carrier to approve more than 6 out paitent physical therapy treatments, which makes me think trying to get them to pay 28 days of room and board and treatment would be a nightmare.

  10. 10
    BillinGlendaleCA says:

    @Omnes Omnibus (the first of his name):

    Why is the process so hard? Because people have worked to make it so.

    My guess is someone is making money and the added value of shaming addicts. Getting over an addiction is hard enough, you’re right Cole it shouldn’t be so difficult.

  11. 11
    ninerdave says:

    @John Revolta:

    Actually alcohol withdrawl is the only withdrawl that can kill you, and should be medically supervised. Most rehabs recommend you continue drinking until you check in so they can bring you down with benzos.

    Also there’s the small issue that if he could just quit, he wouldn’t need rehab.

  12. 12
    Ruckus says:

    John, 40 yrs ago I was a mental health counselor in a local clinic. We saw people on an ability to pay basis, honor system. We also spent time manning the hotline(suicide among other things) phone. So while my experience is decades old I will say that it wasn’t any better then. The concept of a 72 hr hold had just changed and what that meant was that people who obviously should have been given assistance, could not be unless they posed a risk of serious harm. Mental health/kicking addiction, those things have been the antithesis of a nation of strong willed, raging individualist, go forth and conquer, win the west people, you know, morons. Is it worse today? I don’t see how it can be but it sure isn’t any better. And there are fewer mental health facilities, but that may not be all bad, some of them were absolutely horrible.
    And yes I like the VA but then I’m in your position except for the money and insurance. But the VA, because of money issues has limited space and ability to help as well. Only so many ways to put 25 lbs in a 5 lb pot. Hence the LA Times just ran an article about the homeless situation here and how a rather large percent of the people are vets with issues. Many of them seem to have so little ability to tolerate bureaucracy that I doubt they would be able to get help even though they qualify. The VA is a waiting game. Not quite like the military’s hurry up and wait but you do wait a lot. If you can’t play in that game the VA would be intolerable. The people are great, there just isn’t enough of them. Money.

    Anyway please keep as positive attitude as you can, places do exist to help.

  13. 13
    mtiffany says:


    Also there’s the small issue that if he could just quit, he wouldn’t need rehab.

    You can lead a horse to water…

    No one quits until they’re ready.

  14. 14
    lahke says:

    Because there are no beds, that’s why. New mental health/ substance abuse facilities don’t get funded, existing public ones get their budgets cut, private hospitals can make more money on the med/surg beds. Boston is the city with more hospital beds than any other place on the planet, and even we don’t have enough mh/sa beds. The result is that there’s only room for the most severe cases.

    Now don’t take that as encouragement to hit bottom, John. Hang in there. And then vote for funding for more mental health services and getting full MH/SA parity with other medical conditions.

  15. 15
    Gvg says:

    It is so hard because there aren’t enough space. Nationwide there is a shortage in treatment facilities. for all levels of addiction and functioning as far as I can tell. If you get a space several someone else’s don’t. there is no solution except gradually increasing the number of facilities everywhere and training staff. Around here the affordable place is basically a joke that ought to be out of business but that would make things worse and leave the courts nowhere to send people.
    they are probably not trying to run you around, they just don’t have anywhere to put you. I gather we could build more places easier than we could staff them. We have been resisting recognizing that so many of us need treatment for a long time. war on drugs put them in jail at a profit has not helped but is not the whole story. also I don’t know the whole story, just picked some info up as a relative of a doctor.

  16. 16
    Ruckus says:


    Also there’s the small issue that if he could just quit, he wouldn’t need rehab.

    For some(most?) it is not a task they can do alone. Hence the saying, “If it was easy, anyone could do it.” It ain’t easy. It’s both a mental and physical thing.

  17. 17
    BillinGlendaleCA says:

    @ninerdave: John’s already taken the first step, he’s admitted that he has a problem.

  18. 18
    Steeplejack says:


    Mental health/kicking addiction, those things have been the antithesis of a nation of strong willed, raging individualist, go forth and conquer, win the west people, you know, morons.

    LOL and QFT.

  19. 19
    hans says:

    Give Mayo – Rochester, MN – a call

  20. 20
    James E. Powell says:

    An old and wily politician once told me “Everything you think is a problem is how somebody else makes his living.”

    If things are such that ordinary people have a hard time getting into the right rehab in a timely manner, it is because somebody is making money off the way thing are.

  21. 21
    Tiny Tim says:

    @John Revolta: I don’t know everything about John’s situation, but choosing (trying) to go to rehab is doing it on your own as much as much as trying to stop drinking with support of friends of family is doing it on your own. No one’s forcing him to do this. He’s taking heroic steps to get treatment which is sadly hard to get it. Maybe he needs medical help with withdrawal. Maybe he needs some instruction/therapy. Maybe some combination and more. I don’t know.

    Without going too deep into it, and it certainly has something – but not everything – to do with fucking insurance companies, there is a whole narrative of “hitting rock bottom” within the addiction community. You shouldn’t have to be found in the gutter covered in your own vomit, or arrested for beating your spouse, to get treatment. Yet, there it is.

  22. 22
    another Holocene human says:

    This is what drives mental health patients to claim they are suicidal. I’m sure inventing suicidal fantasies and abjectly begging for care doesn’t impose its own cost. ….

  23. 23
    another Holocene human says:

    @Tiny Tim: I wonder what is required in Canada because under their labor law if you’re caught with dirty pee and admit you have an addiction problem you go off work for a while and get treated under their last chance provisions.

    If you refuse to admit you have a problem, you’re done.

  24. 24
    dianne says:

    The Seventh Day Adventists run a facility in Napa Valley, Ca with a really good reputation. I know someone who went there a few years ago. He had tried to dry out ahead of entering and seized out in the lobby as he was being admitted. Do NOT do that. It will kill you.You don’t have to drink a lot but you do need to drink a little until you are under medical supervision. It sounds counterintuitive but its true.

  25. 25

    I went through this with my ex-partner 22 years ago in northern lower Michigan, a place that breeds addiction like rabbits. He hit rock bottom on a weekend and no amount of pleading could get the rehab center 50 miles away to take him in until Monday morning and only then with an appointment. We spent a harrowing weekend and finally got him in; he was practically comatose. Oh, and forget about insurance; back then BC/BS wouldn’t touch it.

    I hold you in the Light, John.

  26. 26
    another Holocene human says:

    @Ruckus: It takes up to a decade to rewire those synapses, hence the relapses one or two years in.

    The Jeremiahs who rant about how you never change are wrong, though–Science! has proven that.

  27. 27
    Rhoda says:

    Wow. I am so sorry it’s so hard, it’s not just you. Here in VA we saw how impossible it can be with Creigh Deeds’ son and his mental health horror story.

    Good luck and keep the faith; hopefully you’ll find a good place soon.

  28. 28
    rando2000 says:

    This country gives no shits about people with mental health issues. Our society should feel so embarrassed about how we treat those who are actually trying to get better–because we basically throw them to the wolves.

    i have a suicidal and bipolar friend whose psychiatrist went on vacation for 3 months and did not leave any notice or backup care. Her meds stopped working. She went through every single psychiatrist that the insurance said she could go to. Dozens said they were booked; two returned her calls. Of those two, one tried to shame her (‘you must have made so much trouble for your parents when you were a kid’) and another prescribed SSRIs, which are a no-no for bipolar people because they make things worse. She ended up in the hospital.

    By the time everything was done, her psychiatrist was off vacation. One would like to get her to an alternate psychiatrist, but having gone through literally all of the ones on her insurance in SF/East Bay, it seems like she just has to hope the current one sucks less.

    Other countries are not this cruel to people with addiction and mental health issues.

  29. 29
    another Holocene human says:


    It totally kills me how as a country we don’t take care of our own and we don’t think everyone is worth saving–ever noticed that?

    It’s shocking to watch British reality tv and see how much the community pulls together to save one person. But they live in comically small houses. Americans could never live in such tiny living quarters. Clearly our way is superior.

  30. 30
    Schlemizel says:

    Yes and mental health coverage is very similar. Even the best plans I have ever had only cover a limited amount of treatment. The payments they make are minimal so many doctors will only see a small number of insured patients because of the adverse affects on their income. So when you feel like your situation is hopeless and there is no way out you have to call dozens of doctors and hear that each one is not taking any new, covered, patients.

    Its as if they want you to fail. Stay strong JC and fight for what you know is best for you

  31. 31
    RosiesDad says:

    Hang in, John. You are going to get through this and you are going to get help.

    Fcking system sucks.

  32. 32
    raven says:

    Have you watched Gridlock’d with Tupac and Tim Roth? Killer fucking movie

    Set in Detroit, Gridlock’d centers around heroin addicts Spoon (Tupac Shakur), Stretch (Tim Roth) and Cookie (Thandie Newton). They are all in a band together in the spoken word genre. They go by the name of Eight Mile Road, with Cookie on the vocals, Spoon on the bass guitar (plus secondary vocals), and Stretch on the piano. Spoon and Stretch decide to kick their habit after Cookie overdoses on her first hit. Throughout a disastrous day, the two addicts dodge police and local criminals while struggling with an apathetic government bureaucracy that thwarts their entrance into a rehabilitation program.

    The scene where Howard Hessman as a blind Nam vet going bonkers in a post office is incredible.

  33. 33
    Botsplainer says:

    In the mid-90s, I sent a surgeon with license troubles over her drinking to a place in Rochester MN, but forget the name of it.

    She was a well-functioning drunk, very able in the operating suite and never drunk in that setting, but in the evenings she just got blistered.

  34. 34
    Patricia Kayden says:

    Hang in there, John. Hope you get the help you need ASAP. It really shouldn’t be so dang hard to get into rehab — especially for a former soldier.

  35. 35
    OzarkHillbilly says:

    Sucks to be you John. Keep strong and don’t let the bastards beat you down.

  36. 36
    another Holocene human says:

    @patrick II: The 1%’s game: spending down assets for thee, intergenerational wealth transfer for me

    The 1% ers are probably already very concerned about slight medicaid changes that don’t require lower middle class households to reduce themselves to penury, the ungrateful peasants, in ACA.

  37. 37
    Amir Khalid says:

    Mayo, right?

  38. 38
    Schlemizel says:

    Are you sure it was Rochester? The famous place is Hazelden in Center City MN. Elvis even went there.

  39. 39
    BillinGlendaleCA says:

    @Amir Khalid: No mayo on my burger, yuck. Happy belated B-day Amir.

  40. 40
    BillinGlendaleCA says:


    Elvis even went there.

    Well that worked out well.

  41. 41
    raven says:

    In order to ensure the availability of quality and timely health care to Veterans with service connected conditions, special authority based on military service, low income, and those with special health care needs, in January 2003 VA made the difficult decision to stop enrolling new Priority Group 8 (high income) Veterans whose income exceeded VA Income Thresholds.

  42. 42
    SixStringFanatic says:

    @John Revolta: The only people in the world more obtuse than those who have had the good fortune to not have to deal with addictive issues are Republican congresscritters.

  43. 43
    geg6 says:

    Did you try Gateway Rehab here, John? They have a pretty good rep, I have former students who work there and a friend who successfully went through their program. I can contact our psych program dept. head to see if he can pull some strings. Email me if you want me to try.

  44. 44
    OzarkHillbilly says:

    Rehab in America

    After years and years of twists and turns with everything from coke to meth to alcohol my ex finally got the help she needed, free of cost (to her), no insurance needed. The catch?

    She is doing 7 years in Chillicothe.

    Seems if you really need help in this country, you have to almost kill 2 people.

  45. 45
    raven says:

    @geg6: When I hit the wall I was lucky, I was in a doc program and was able to get free counseling at the university health center for two years. Granted, their position was that I was not an alcoholic but I got the help I needed to help me start and, up to now, successful sobriety.

  46. 46
    Matt McIrvin says:

    This is fucked up, John. Here’s hoping you can figure out a way through.

  47. 47
    Nicole says:

    This post makes me cry with frustration. My uncle died last year at the ripe old age of 60 after a lifetime of alcohol abuse and my dad has spent the last few years in and out of hospitals- he drinks and doesn’t eat, gets weak from lack of food, ends up in the hospital, can’t drink there, so he heals up enough to go home, and the cycle starts again. I’m so glad you’re ready to get sober for yourself and so angry the system is screwing you. Alcoholism takes a huge toll not only on the drinker but on the people who love him, and this is a great gift you’re giving to your family. And it makes me furious our health care system isn’t providing, you know, care.

    On a brighter note, another uncle dried out at age 40, temporarily, or so he planned. He started drinking at 20, got sober at 40, and intended to stay sober until 60, at which point he intended to resume drinking until he died. As he tells it, he hit 60 and thought, “Eh, maybe I’ll see how this sobriety thing turns out.”

    Rooting for you. My uncle dried out in the mid-80s but I’ll ask him what his process was for getting into the drunk tank, as he called it, and if there’s anything helpful I’ll let you know.

  48. 48
    Botsplainer says:


    It may have been. That is ringing a bell.

    Now that I remember, she got really pissed at us for coming up with a solution that involved any kind of assessment. According to her, she was just a social drinker who was the target of a vendetta by her dry drunk ex, jealous doctors and the dry drunk running the licensing board’s substance abuse arm. The plan was to go there, get assessed, and immediately zip back home with a clean bill of health.

    Our failure, according to her, was in not instructing her to lie about how much she was drinking. She honestly self-reported, the staff did a collective gasp, and told her in no uncertain terms she needed a full course of inpatient therapy. The woman barely broke 110 lbs, and the amount she reported drinking would be hard for me to handle; she did that on a daily basis.

    She checked out after about a week, fired us, and went on to lose everything.

  49. 49
    OzarkHillbilly says:

    @raven: Raise taxes to get more vets who need it in? Naaaaahhhhhhh…. That would make sense!

  50. 50
    George says:

    Best of luck to you, John.

    Personally, I was able to get into treatment when I had a mild stroke followed by a mid-life crisis, attempting to drink myself to death, finally calling my sister who drove 200 miles to try to get me in but turned away with a blood pressure reading that was over 600/300 (my memory of what they told me and I was drunk as shit at the time…), went to the emergency room for a week with nitro under my tongue, another week in a hospital 70 miles away and then damn near begging the state assistance person for a spot in the local facility. Thank the FSM that my sister is better with paperwork than I ever could be.

    But, through it all I made it for another 5 years and counting…

  51. 51
    BillinGlendaleCA says:

    @raven: I was in the hospital for about a week and then couldn’t walk for several months. By the time I could walk, I wasn’t stopping by the licker store. The week in the hospital and being told by folk with MD after their name that if I started drinking again; I either be back or in the morgue.

  52. 52
    enplaned says:

    All that drug enforcement money should fund rehab instead…

  53. 53
    Chuck says:


    While you’re waiting, check out this site.

    It may not be the answer for you, but at least you’ll have someone to talk to.

  54. 54
    Delk says:

    Went to Hazelden here in Chicago before they merged with Betty Ford. Did Intensive Out-Patient. Five days a week from 9am to 1pm with an AA meeting afterwards. My insurance covered everything but $2000 originaly. However, about 4 months later they refunded me about $1000 back.

    I’ll be 52 in September and August 4th will be my one year anniversary. I was ready mentally to quit but the withdrawals were so bad I ended up in the ER and put into a drug induced coma.

    It has been the best thing I have ever done for myself.

    Good luck John.

  55. 55
    Botsplainer says:


    On further reflection, I realized I hadn’t thought about her for several years and googled her up. Looks like she spent more than a couple of years in the wilderness, then got her shit straight and reinstated.

    Her main problem, as I think about it, was in her refusal to acknowledge a problem, and was abetted by the fact that she was, at the time I dealt with her, cohabiting with an active drunk who was a layabout and happy to have a housemate with surgeon pay. He’d sit with her at meetings and reconfirm that she didn’t have a problem, that everyone was out to get her.

    One particularly galling aspect – at some point, her ex expressed concern over her continually taking their grade school daughter to a restaurant that was really a lounge with a nice hors d’oeuvre menu. Middling upscale, but definitely adult. Because she usually paid by credit card, he was able to subpoena some of her order tickets, and over the sample period of 3 weeks, there were more than a couple “three double scotch” nights for her (I think her new beau was a gin guy). The tipsy couple’s response to the concern was along the lines of “she loves it there. She has favorite menu items, everybody loves her and the staff makes a big deal out of her. We are really upset that the ex wants to deprive her of that”.

    What the staff at rehab hashed out was the pregaming and nightcap supplements to the heavy pour 3 double scotch tickets for a woman that was in the 100-110 pound range on a nightly basis. Of course, there’s also the bit about a girl seeing mom shitfaced every single night.

  56. 56
    SammyV says:

    Hey John,
    A friend of mine recently went through something pretty similar. He was in worse shape than you but still had a hard time. He finally got in and the change is amazing. Glad to hear how you’re keeping at it. Good luck again.

  57. 57
    El Caganer says:

    Take a look at SMART Recovery, Mr. Cole. It’s not a substitute for rehab, but it can help get your head together, especially if you’re getting frustrated waiting around. It’s worked for me (I was a drunk for 40+ years) where other plans didn’t. If nothing else, it will give you some useful exercises to do.

  58. 58
    Botsplainer says:

    A query for the recovered (particularly for the newly minted coin holders): do you find it difficult to listen to these stories, or do you draw some strength from them, glad you’re no longer in that spot?

  59. 59

    @Sir Laffs-a-Lot: Yes, I helped a friend get into Hazelden and they have people there who figure out your benefits and (if needed) fight with the insurance company on your behalf.

  60. 60
    PurpleGirl says:

    John, I’m sorry you’re having problems getting the help you want and need. It does seem that you need go through an ER to be seen by any other unit in a hospital. In NYC, I had go through the ER to be referred to the Adult Primary Care Clinic because I didn’t/don’t have insurance. I hope everything settles down this weekend for you.

    In the family story file: My sister’s husband was always a drinker. But when he worked for Railway Express as a box handler it didn’t much matter if he went into work under the influence. Time comes though when RE closes up shop and he needs to find another job. Somehow how he passes the tests to joint the MTA and is trained as a subway conductor. (He’s in his 40s at this point and it’s his last chance at a good job.) He has his first vacation from the MTA and he goes on a bender to end all benders. He wakes up and realizes he can’t in any way, shape or form, go to work. Luckily for him, the MTA has an Employee Assistance Program and has programs involving alcohol addiction. He calls them and they help him arrange for detox and hospitalization and all that.

  61. 61
    Johannes says:

    Hazelden is the gold standard, according to my AA friends who used rehab. Graymoor in Garrison NY is very well thought of. John, might I suggest trying a few AA meetings, and seeing is any of the folks there can help? I’m 17 years sober as of June, and I couldn’t have done it without AA.

    All best; you’re in my thoughts and prayers.

  62. 62
    Chuck says:

    @El Caganer:

    HAMS takes a lot of principles from SMART recovery.

    John, if you’re thinking of going to a Hazelden-type facility, I wish you would consider reading A Million Little Pieces. Yes, some things in the book were fabricated or exaggerated, but the important issues and details were dead on.

    Yes, AA and 12-step methodology help some people, but John, you don’t seem like that type of person. Better for you to question it now than to follow it blindly for a decade or whatever and then suddenly realize it’s bullshit.

  63. 63
    raven says:

    @Chuck: Some?

  64. 64
    raven says:


    From Amazon reviews:

    I have worked with alcoholics and addicts for many, many years, and I worked for the Hazelden Foundation, the treatment program the author indicates he attended. His description of the events in treatment never could have happened. All treatment centers are strictly regulated by a licensing board called the Joint Commission as well by state laws. What James Frey describes is in gross violation of these strict standards of accreditation. The treatment center would have been severely disciplined or shut down. Hazelden is one of the finest treatment centers in the world and is the pioneer of treatment as we know it today. Their treatment program is centered on respecting the dignity of each patient and preserving the safety of all who are admitted.

    James Frey would not have been admitted into treatment in such terrible medical condition without first being sent to a hospital for care and then admitted only after the hospital staff granted medical clearance. He wouldn’t have been given stitches in his face at the treatment center, because treatment centers aren’t licensed to give that level of medical care. Yes, recovering people can use anesthetic. Anesthetic is not an addictive drug, so no one needs to endure painful dental work or stitches or surgery without masking the pain. Pain medications (which are addictive) are used when necessary, such as after major surgery.

    There are no men in white coats with syringes tackling people who misbehave. People in treatment don’t behave in ways the author describes. People are mostly kind, caring and thoughtful. Disagreements are generally mild in nature, and mood-swings are usually the worst we must contend with. When someone behaves in an unacceptable manner, they are asked to change their behavior or be discharged. Treatment romances are never tolerated because they are a precursor to relapse and disrupt the entire unit. Physical violence always results in discharge, as does destruction of property. A patient would be asked to leave immediately if he destroyed a room full of furniture, for example. (Accomplishing this feat, by the way, would be extremely difficult because the furniture is made of heavy wood, built for endurance.)

    The author’s assertion that a doctor left the ER without treating him and then drove him to an airport is equally astonishing. Putting a patient on an airplane, where he cannot access emergency medical care while suffering from severe head injuries is unthinkable. That the airlines allowed James Frey on the plane is impossible to believe. These things simply aren’t allowed to happen for very obvious and good reasons.

    It goes without saying that counselors don’t drive patients to crack houses-or anywhere else-while they are in treatment. Doing so would result in immediate dismissal. Never have I heard people screaming in detox, nor would someone be left lying on a floor overnight. Patients are well monitored and vitals are checked on a regular basis to be certain that blood pressure isn’t dangerously high due to the body coming off alcohol and/or drugs. Without close monitoring, we would risk strokes or heart attacks. It is also surprising that almost everyone the author went through treatment with has died or disappeared in rather unorthodox ways. I’ve never know of this to happen and none of my colleagues, whom I’ve asked, have ever heard of this either. We sometimes hear that one individual out of a treatment group dies, but even that is fairly rare. People do relapse after treatment, but that happens primarily because people don’t follow their aftercare plan.

    I hope if you read this book, you will keep in mind that this description of treatment is fiction. No one who is thinking of going into treatment to seek help should be afraid, thinking they will experience things similar to what the author has described. All reputable treatment centers offer caring support, preserve patients’ dignity and will not allow one person’s behavior jeopardize the wellbeing of all others. As for the author’s assertion that he has stayed sober without the help of AA or other 12 step groups, that may be true, but only about 2% of addicted people find this method successful. And of that 2%, most continue to behave in much the same way they did when they were drinking or using drugs, only without the alcohol or drugs in their systems. Sometimes they are so unhappy and angry being “dry” because, without a recovery program, they haven’t learned to find contentment in sobriety, and their behavior becomes more intolerable than before. The main purpose of AA isn’t just to quit drinking or taking drugs, but to become a better person in recovery.

  65. 65
    Haroldo says:

    I became sober at Talbott Recovery Center in Atlanta about 6 years ago. Varied demographics – initially it was established to help drunk MDs. It seems to have undergone quite the change in professional staff over the past couple of years, so its complexion may have also changed. Strongly AA based, though very holistic in its approach.

  66. 66
    JasperL says:


    do you find it difficult to listen to these stories, or do you draw some strength from them, glad you’re no longer in that spot?

    Both. It’s hard to hear about because you understand what the person’s going through – the end of a life really, and unsure about how the new life sober will work out. I know now that life on the other side is better than I could ever have imagined, but there isn’t any way to know that going in, and getting there is tough.

    But, sure, newcomers provide a lot of inspiration and strength. And I’m glad I’m not having to start over, but more than anything what I hope is people starting the journey find the peace that so many have found living sober.

  67. 67
    raven says:

    @JasperL: I agree. I’ve kept quiet since John announced he was quitting (quiet about John, not sobriety issues). I’ve wondered how he was doing and cringed when people make their cutesy little drinking comments to him. I also do not personally ascribe to the “recovery” perspective but if it helps some people then more power to them.

  68. 68
    JasperL says:


    Yes, AA and 12-step methodology help some people, but John, you don’t seem like that type of person. Better for you to question it now than to follow it blindly for a decade or whatever and then suddenly realize it’s bullshit.

    There are as many ways to use AA as there are people. One AA group will be completely different than the next. You can read the Big Book every day, and follow the 12×12 like it’s handed down from on high, or barely skim them, and just be part of a sober and supportive community. So there is no one “it” to be bullshit.

  69. 69
    Chuck says:

    Well, that didn’t take long. One of the telltale signs of a cult is how quickly its members rush up to defend it.

    I concede the fabrications and exaggerations in Frey’s book. My point is he recognized the futility of following a process when you don’t believe in it and finding an alternate path. Our dear Mr. Cole somehow made his way out of being a Republican. I would hate for him to be sucked into another rabbit hole.

  70. 70
    rikyrah says:

    Keep on it, Cole. It’s wonderful that you’re going to help.

  71. 71
    AMinNC says:

    Access to mental health services is abysmal in the U.S.; worse for inpatient care; worse still for children/teen services. I know three families who have children with mental health issues, and they have gone through hell trying to find appropriate help for their children.

    These are upper middle class families with good insurance, and the problem is that there are no available inpatient beds open anywhere. This is in North Carolina and Colorado, so it is not simply one state, or one region of the country.

    I have one friend whose 13 y.o. son was talking about suicide, and she couldn’t even find an outpatient psychiatrist who would see him sooner than 3 months out. Their advice while putting this kid off? “If it’s an emergency, send him to the E.R.” Now I live in a place that has world-class medical care from multiple medical centers and the attendant doctors’ groups that cluster around these centers, not the middle of nowhere, and yet, the only option for this kid is the ER and to be checked into a hospital psych ward that is not equipped to handle teens?

    Because my friends have friends who are doctors, somebody made a few calls and got this kid seen outpatient. But the kid’s mom and I were both aghast at the thought that if this process was almost impossible for someone with all of the resources they have at their disposal, what on earth are parents who don’t have good insurance, high incomes, and doctor friends doing for care? They love their children as much as we do – I shudder to think of the decisions they have to make (do I go to work today because we have to eat, or am I too afraid to leave my child unattended because she has been harming herself?) with no help from anyone.

    Another real-world catastrophe brought to you by Reaganism and the idiotic magical belief that individuals can solve all of their own problems, and public investments in public services are Satan’s handiwork.

    Heartless and stupid. Not a good combo.

  72. 72
    raven says:

    @Chuck: Who defended it?

  73. 73
    raven says:

    @Chuck: Who defended it?

  74. 74
    WereBear says:

    Best wishes to you John!

    Yes, he is struggling in yet another web… that of the way our “go it alone” society is currently structured.

    Tormenting people with problems – not letting them get help with their problems – draining their resources while they try to cope with their problems – REPEAT

    Fortunately John has some support; it’s so vital. Any time.

  75. 75
    Miki says:

    Here’s how I did it back on ’99: Called a local hospital-related chem eval office and made appointment. Went to appointment @3 hours later. Evaluator called around for available bed for detox. Drove myself (after passing Breathalyzer) to different hospital for detox (Wed – Sat: librium drip until I could hold my hand out and stick my tongue out without shaking). Evaluator called around for a place in an out-patient program on Monday – this is where things got tough. At first I was told nothing was available for 2 weeks. I knew I couldn’t make it two weeks without support so I kept pushing until they found me a spot at the same local hospital I went to for the chem eval. Started outpatient on Tuesday night: 3 hrs/night for 6 weeks (included after care), plus AA weekly during and after treatment. Learned a lot.

    Weekly AA was key for me – “Step” meetings with a really diverse group of drunks. [Note: I’m a raging atheist but I figured out a way around all the god-stuff.] [Note 2: Took some time to find a group that fit. It’s easy to get discouraged, but was worth it to keep trying.] [Note 3: Get a sponsor, sooner rather than later.]

    Hang in there, John – if you want it bad enough (which you obviously do), you’ll make it happen. xoxoxoxoxoxoxox

  76. 76
    Roger Bacon says:

    Addiction treatment is an underfunded, fragmented system that can be crazy to navigate. Plus enormous state to state differences. I agree with the recommendations for Hazelden. They have a good rep. If the VA doesn’t work out, you also might check out Valley Hope. Facilities in Colorado, Kansas, and other states. A solid program that really helped my mother get sober.

  77. 77
    Applejinx says:


    I’m finding it difficult to listen to these stories because (as an addict) what jumps out for me is the ferocity of the people insisting ‘you have to keep drinking until you get into the right rehab! then you have to blow off those creepy 12 step people and all their talk about powerlessness, and do something that acknowledges you’re a Smart Person who probably can handle drinking some of the time if you just figure out how to do it responsibly!’

    Ain’t my advice that’s gonna kill the man. Going to a meeting of a bunch of god-botherers and saying you have a problem and are out of control does not kill anybody. I always marvel at how IRATE people get.

    If that makes you mad you’re really gonna hate surrendering, just sayin’.

    Everybody that I’ve seen really dig into the ‘I am better than these assholes, I will go find a sobriety that fits MY life and needs and I will get control of my life!’ has gone down in flames. I concede that I haven’t physically seen everybody on Balloon Juice arguing this way and that. Mind you, I might get some nice flames and explosions of incoherent rage by suggesting that some of you guys are fucking John Cole over for ego reasons and clinging to your rationalizations of how the world—and recovery—works.

    John, go forth and start looking. Here are my only tips: out of everyone trying to help you, try to identify which ones act and feel like glibertarians and which ones act and feel like, say, Lily.

    This isn’t a thing to think your way out of: your thinker’s busted. You may never be able to rely on it again for CERTAIN things. It’s okay: you can use it for lots of stuff, and even use your crazed alky obsessiveness and intensity for really valuable things (see: this blog. Your blog got me to volunteer and go out and physically work for Obama’s re-election campaign. We could’ve had Romney, and YOU created the community that made me get involved)

    Get some doctor opinion on whether you really are going to croak from DTs alone. If not, or if it’s a chance you can take, go to a meeting and find some shaky drunk bastard to HELP even if it’s just telling them you know just how they feel.

    You KNOW how to give. You know how to care. Don’t let your blog (a reflection of all sides of you!) con you that recovery is about getting the help you deserve. You might just have to hang on to sobriety through finding ways for you to help others. It’s that, not the godbothering, that kept AA alive. That’s the secret.

  78. 78
    El Caganer says:

    Also keep in mind that there’s no one-size-fits-all, which some of the other commenters here have already noted. I’ve known people who just woke up one day and said “Fuck it,” and that was the end of their drinking (I did that 20 years ago with my 3-pack/day cigarette habit; couldn’t do it with alcohol). Some people do well with AA, some need an institutionalized rehab…..don’t get discouraged if you try something and it doesn’t work. The fact that you do want to do something about the problem is at least as important as what you actually do. As I mentioned above, SMART has worked for me – that doesn’t mean it works for everybody, it doesn’t mean that it’s the ‘best’ road to recovery, it just means….it worked for me. For what that’s worth.

  79. 79
    JasperL says:


    Well, that didn’t take long. One of the telltale signs of a cult is how quickly its members rush up to defend it.

    I concede the fabrications and exaggerations in Frey’s book. My point is he recognized the futility of following a process when you don’t believe in it and finding an alternate path. Our dear Mr. Cole somehow made his way out of being a Republican. I would hate for him to be sucked into another rabbit hole.

    Not defending the “cult” of AA. I was just pointing out the fact that there is no one AA experience. What it is, at its core, is a meeting of people trying to get and stay sober. It could be 50 people or 6. Please tell us all how you know what a meeting of 6 people on Friday at 8pm is going to be like?

    There is no Dear Leader to enforce AA dogma, require everyone swear to the Bible of the Big Book, and punish groups that step out of line. If you quit showing up, no one comes to get you. You’re not required to donate even a penny. If it didn’t work for you, the group you joined didn’t help, that’s fine, and I’m happy you found another way that DID work for you.

    But you have no idea what anyone else’s group is like, what their experience will be, who they’ll meet and whether meetings will help or not. And it’s arrogant to presume to know what will work for anyone else. The anti-AA crusaders who had a bad experience then spend their time running down ALL AA groups are just a cult of a different flavor than the AA true believers.

  80. 80
    Paul in KY says:

    @Chuck: Mr. Frey realized how to write a lucrative book of fiction.

  81. 81
    JasonF says:

    I’m sorry you’re going through this, John. It really sucks. Hang in there.

  82. 82
    lawguy says:

    Having been through that myself. I’m sure that there are NA or AA meetings around. Start going to those. Intensive outpatient rehabs seem to work well if one is motivated, I was. The only other issue is if you do need to detox and for that you should be able to do it within about a week or so. After the drugs are out of you system and you learn a little about the illness I’m not sure inpatient is that important.

    There are a couple of very good places in Michigan. One in Battle Creek, I think, that is or was connected to the Kellogg cereal people. One called Dawn Farm 734-485-8725 or 743-669-8265. I think they have a web page also My wife knows the people who run the Farm place quite well.

  83. 83
    Glocksman says:

    Detox is hard enough to get into unless you show up rip roaring drunk or shaking worse than a Subaru stuck in a farmer’s field from the DT’s.

    Even then, sometimes they’ll send you to a hospital (raises hand and waves) if they have no beds available.
    If you’re an alcoholic and wind up detoxing in a hospital, watch out for what the ER doc prescribes on discharge.

    Years ago during a really bad withdrawal/DT episode (blood pressure of 220/160, sweats, shakes, etc.) I was admitted for a 4 day stay and on discharge while going over my meds, I found that the Doc had prescribed Restoril for insomnia.

    Really? Giving an admitted alcoholic a 90 day supply of a powerful benzodiazepine tranquilizer?
    Just what I needed was an addiction to Restoril to go along with the alcohol.

    I tore the scrip up and the discharge nurse said that I did the right thing.

    Long term inpatient rehab is even harder to get into locally, as the nearest facilities are 200 miles away with waiting lists as long as my arm.

    AA can work, but I still have trouble with the whole ‘higher power’ thing.
    Though I do think what helped me the most is the listing of defects of character.
    Until I did that, I never realized just how much repressed anger and resentment I had, and a problem realized is a problem on the way to being dealt with.

  84. 84
    Paul in KY says:

    John, you have to take care of John. I think you are doing the right thing (by wanting to go to rehab). You are familiar with bureaucracy. Don’t let it get you down. Just navigate it (as you sure can) & you will get into a good treatment place. Best wishes.

  85. 85
    Glocksman says:


    For me, they’re a welcome reminder of where I came from and a warning of what would happen if I started drinking again.
    When I looked in the mirror while I drank, I didn’t like the person I saw and the shame and guilt merely served to depress me further, thus driving me to deliberately drink to the point of blackout.

    At my worst I was drinking a pint of vodka a day just to avoid the shakes, and on weekends it was a quart or more a day.

  86. 86
    Glocksman says:


    I almost died during a withdrawal.
    I went to see my sister at her job while undergoing a bad case of the shakes after a weekend of heavy drinking.
    I was later told during my 5 day stay in the ICU that a second after I walked in the door, I collapsed to the floor and started having seizures.

    If that episode had happened either 5 minutes earlier or 5 minutes later, I would have been driving a car in highway traffic and probably have died in the resulting wreck.

    After that I asked my doc about a scrip for Antabuse and he flat out refused, saying that Antabuse would literally kill me, given my history of heart disease and artificial heart valve (incidentally put in by former teabagger favorite Larry Buschon R-IN08)

  87. 87
    Glocksman says:

    A final word of advice for any alcoholics/addicts out there is that if you’re employed and need treatment/detox, don’t be afraid to use FMLA.
    By law, the reasons for any FMLA leaves are confidential and cannot be divulged to anyone outside of the HR people who deal with leave requests.

    When I used FMLA for detox all anyone on the plant floor knew is that I was on a leave of absence.
    They didn’t know why at the time (they do now because I’ve admitted it to anyone who asks as part of my recovery), and using FMLA instead of attendance hours has saved my job more than once.

    And if you do use FMLA and somehow your confidence is violated and word leaks out, see a lawyer about filing a suit.

  88. 88
    Howard Beale IV says:

    There’s also the Sinclair Method, which uses medication to blunt the euphoric affects to alcohol (naltrexone, acamprostate, topiramamte, baclofen).

  89. 89
    JasperL says:


    Been there with the withdrawal seizures, only not as severe. Which is why any approach to getting sober should absolutely be medically supervised, and in a facility or with a friend or loved one nearby for the first few days.

    The other important thing that illustrates is alcohol abuse causes a real chemical imbalance, a physical illness, and especially early on the cravings are your body screaming at you to get brain chemicals back to a non life-threatening state. And the physical, chemical imbalance persists for quite a long time after quitting. The best book I found to explain that part and ways to ease the transition was Seven Weeks to Sobriety, by Larson.

  90. 90
    Chuck says:

    @Paul in KY:

    I really should know better then to try to play in your coffee, cigarettte, Oreo, and old man urine stinking sandbox, but here’s one last Gaza volley:

    I think “raven” only read the negative Amazon review and didn’t read the book. If “raven” is a woman, lucky for her she didn’t get 13th-stepped.

    I’m really looking out for Mr. Cole’s welfare.

  91. 91
    El Caganer says:

    @Howard Beale IV: I was part of a naltrexone study a number of years ago – very weird stuff. While I was on it, I lost the ability to imagine what food tasted and smelled like; could taste and smell just fine while I was eating, but couldn’t picture it in the abstract. As a result, sometimes it would take me hours to decide what I wanted for dinner.

  92. 92
    CaseyL says:

    John, you probably don’t want to travel this far, but Seattle has Schick Shadel. It’s a very expensive, very effective 10-day program that uses aversion therapy.

    Here is a diary from someone who went through the treatment:

    A friend of mine went through the treatment and it worked like a charm.

    The downside is I think there are only two facilities in the whole country, Seattle and Texas, though one in Florida is supposed to open this month. If you come to Seattle, there are local BJers who would be happy to see you and offer morale support.

  93. 93
    El Caganer says:

    @JasperL: Fortunately I never had seizures from withdrawal (unlike when I was given Paxil for depression). The only time I had a physical problem when trying to get away from booze, I got a case of the DTs and had the sensation and hallucination of black spiders crawling all over me. Went out for a drink posthaste. Didn’t have that problem this last time around, thank goodness.

  94. 94
    Paul in KY says:

    @Chuck: I was speaking of the ‘memoir’, A Thousand Little Pieces by James Frey.

  95. 95
    El Caganer says:

    @Chuck: It’s hard to tell who would or wouldn’t benefit from a 12-step program. I did AA for about 8 months, several different meetings a day, and wound up with a very negative view of it and just as much a drunk as I was before. Flip side of that, I work with a guy who turned his whole life around with it. I’m confident Mr. Cole will find his way.

  96. 96
    feebog says:

    I’m going to second what Applejinx said, and then add my own story. Yesterday my oldest grandson turned twenty. He has been using drugs and alcohol since he was thirteen. When he was fourteen, he came to live with my wife and I because he was no longer welcome in his house. That lasted 9 months, until the night we had to physically restrain him from breaking up all the furniture in the house. He returned home, dropped out of school, and eventually was kicked out of the house again. He went into a long term detox center for children in Spokane WA. He was almost through the program when he started using again. He went to another program, dropped out again. Finally, he got sober for a few months and got into job corps. Went over a year and then started using again just before he graduated from Job Corps (beginning to see a pattern here?). For the next year he was homeless and using drugs. Finally, he got a job and a room he could afford to rent. Problem was, the guy living in the house with him was dealing dope. He got kicked out of the house because he could not afford to pay the rent, all of it was going for dope. He then did something that is typical of addicts and alcoholics, he did a geographic. That means simply leaving, thinking that it your environment, rather than you, who is the problem. Bottom, line, he showed up at our house, no plan, no job, just going to live with someone who he used to hang with when he was down here. Someone who he used to drink with. He had enough money to rent a room from this kid’s father for a month, so that is what he did. And he continued to use. One night, when the month was almost up, I get a call to come and get him. I refused. The next morning, my grandson came over, and we had it out. I finally had the opportunity to confront him about his drug use. He said he was leaving, and I said fine, go, But he didn’t leave. He called me the next day and asked me if I knew where any AA meetings were held. A couple of days later we went to an NA meeting together. He has now been sober a month. Gets his 30 day chip tonight. He is in a sober living home that requires him to attend a meeting every night. He has a sponsor, a great guy who is still working on his first year of sobriety. For the first time in his life he is sober because he wants to be, not because someone else wants him to be.

    The bottom line John, is this. Maybe you need to go into detox to begin your sobriety, or maybe you don’t. I don’t know. But I do know that there is an AA meeting within driving distance of you sometime today. And there is nothing to prevent you from going. There is one tomorrow, and there is nothing preventing you from going to that one either. Maybe it’s what you need, maybe not. Both my brothers and my sister quit cold turkey, never attended a meeting. But you don’t need to wait for a bed at a treatment center to open to stop drinking. Go to a meeting, talk to someone about it. You have a great family who will no doubt be completely supportive. Go to a meeting.

  97. 97
    Paul in KY says:

    @El Caganer: Bet that was a very strange experience.

  98. 98
    The Pale Scot says:

    @ninerdave: Very, very true.

    Gots to go to detox, then rehab.

  99. 99
    El Caganer says:

    @Paul in KY: Yeah, never had anything quite like it. Too bad it didn’t get me to stop drinking.

  100. 100
    The Pale Scot says:

    One thing I’d like to mention John is there are different paths for sobriety, most facilities go the AA route, and it works for some people. But the “give up your will to higher power” is going to be annoying to (physical) materialist misanthropes like me, and I think you. I dismissed “higher powers” in the second grade at Lady of the Seven Bleeding Sores and haven’t looked back.

    There’s a therapy course called “rational reality” you might find better suited to yourself.

    Albert Ellis did not belief that Alcoholics Anonymous (or indeed any of the 12 Step programs) was the perfect solution for this type of self-destructive behavior. He did not believe that such an approach could work for everyone – particularly those individuals who are not spiritually inclined. His main concern was that such approaches encouraged the individual to feel powerless.

    I not recommending it, just pointing out an option. It doesn’t seem to be an institutional approach, more like a tool you use yourself. A relative (who is actually a practicing RC) found it better suited for himself than going to AA and being around people he wasn’t interested in interacting with.

  101. 101
    Paul in KY says:

    @El Caganer: How are you doing now vis a vis the drinking?

  102. 102
    gene108 says:

    @patrick II:

    Joining the military has been made a sucker’s game by the Republican party.

    Working for the government is a suckers game, thanks to Republicans and aided by many Democrats. The job security and pensions folks were promised, in lieu of larger private sector salaries seems to be a thing of the past in the government sector.

    Gutting pensions are where both Democrats and Republicans go to balance budgets without raising taxes.

    It is sad.

  103. 103
    kindness says:

    Gosh John, my heart goes out to you. You are Yoda. No try, DO. Perseverance will pay off. I wonder why some folk can play hard and not get addicted and others don’t even have to be in it all that deep and do. Functional addicts. Which is what you are even in your worst days. You still take care of the kids & business.

    Energy goin’ out to you big guy.

  104. 104
    El Caganer says:

    @Paul in KY: I’m completely dry. SMART really worked for me; the most interesting part is that unlike my previous (and unsuccessful) attempts to quit, I’m not experiencing any cravings. Am most certainly not going to question why that is, just will continue keeping on keeping on. Timing was good, too – out of the blue I got diagnosed with pulmonary embolisms and have to take blood thinners, which most emphatically do NOT mix with alcohol.

  105. 105
    Chuck says:

    @Paul in KY:

    Did you actually read the book? The concept overrode the fabricated details. Shame on him for that, but bless him for trying to break a stranglehold on the recovery industry that hurts more people than it helps.

    Have you ever heard of George Valiant’s famous study on AA? It proved it was no more successful than self-directed remission. In fact, studies have resulted in AA’s success rate at being less than 5%.

    Again, I’m looking out for John Cole’s welfare. No need for hm to replace one “addictive” habit with another one.

    I dare you to show up to the HAMS chatroom, you cultists.

  106. 106
    JasperL says:


    Here’s the thing, Chuck. AA works for some people. It doesn’t work at all for others. You do not know what will work or not for someone else, and you shouldn’t presume to say you do.

    If you were looking out for anyone’s welfare, what you’d suggest is he or she investigate many options. Read books – I read at least a dozen my first year of sobriety, and learned something from them all. Talk to recovering alcoholics and get their insights, try AA meetings in your area, and if one or more are a good fit, and help you, go back often. If not, if AA turns you off and doesn’t help, find other people to support you on your journey. Etc.

  107. 107
    Diana says:

    Good luck, John. I have little experience with this (for which I’m very grateful) but I agree that as long as you are the one who wants to change, as opposed to someone else wanting you to change, you can probably do it on your own.

    Look on the bright side: your job does not involve insuring Malaysia Airlines.

  108. 108
    Chuck says:


    Okay, fine.


    The Orange Papers
    Charles Bufe
    Ken Ragge
    Stanton Peele
    Any woman who was 13th stepped

    I got the impression John Cole was smarter that to submit himself to a cult, since he evolved himself out of the Republican Party.

  109. 109
    JustRuss says:


    the MTA has an Employee Assistance Program and has programs involving alcohol addiction. He calls them and they help him arrange for detox and hospitalization and all that.

    It’s almost as if the MTA realizes that spending a little coin to get their employees straightened out and flying right is a good investment. Maybe we as a society could take a look at that model and scale it up so that people with mental health issues who are barely functioning could become productive members of society. but what do I know, I’m just a crazy liberal.

  110. 110
    Matt Smith says:

    Hey. I mostly lurk, but was so frustrated by this I wanted to pipe up. Solidarity.

  111. 111
    Ruckus says:

    Blasphemy I say! Productive members of society! We can’t make enough money off of productive members of society!
    Oh wait, you mean if we took care of people’s real needs and helped them with education and a hand up when shit hits the whirllies and health care including mental, dental and vision, and retirement, life would be more pleasant for all but a few wealthy assholes who already have far, far more than enough for anything and it would cost far less in the long run? That kind of liberal? I can see that. Count me in.

  112. 112
    Paul in KY says:

    @El Caganer: Very glad you are in a good place. Just keep on keeping on!

  113. 113

    First, my entire sympathies. Yes, the treatment of mental illness in the USA stinks.

    Second, here’s a Google search on AA for atheists. Yes, that is a thing. Lacking anything better, I suggest that thing. Of those links, I like this article, “An Atheist’s Guide to 12-Step Recovery.” The whole blog looks interesting.

  114. 114
    Mnemosyne says:

    @El Caganer:

    It’s hard to tell who would or wouldn’t benefit from a 12-step program.

    That’s a huge part of the problem with our current addiction treatment: one layperson in the 1930s stumbled across a process that works really well for a specific subset of addicts and our society basically decided, Yeah, let’s go with that.

    As I said in Richard’s thread, there’s no one magic treatment that works for depression, bipolar, or schizophrenia, so it makes sense that there would need to be multiple different possible courses of treatment for addicts. I suspect the issue is that we still don’t really consider addiction to be a mental illness, so everyone gets shuffled into 12-step programs even if they aren’t good candidates for it.

  115. 115
    Mnemosyne says:


    So does the fact that Prozac doesn’t work for everyone with depression prove that depression treatment is a total scam and never works for anyone so no one should ever try Prozac?

  116. 116
    Optical Inch says:

    I went to Caron in PA to get my shit together (alcoholic – 10 years sober). I also had a Cadillac plan, but still had to have my folks put down a portion in case Cigna decided to drop coverage after a week or two. Was there for a little over 30 days, although, like most of the more boutique level rehabs, once they find out that you can pay, they start pushing you towards doing an extended, 90+ day tour at some ranch or in one of their extended stay facilities somewhere. I had a good network in place at home, so didn’t need all that.

    Not sure what your situation is, but go to some meetings in the meantime.

  117. 117
    Lizzy L says:

    Keeping you in my thoughts & prayers, John. Yay you for recognizing a problem and looking for help. I’ve got no advice, except to ask you to remember: You are loved.

  118. 118
    Ruckus says:

    @Optical Inch:
    Some of us are open and don’t really give two shits if strangers aren’t immediately our best friends with beaming approval, others can’t abide by this at all. How does one just walk into AA type meetings/group therapy if they fall into the second group?

  119. 119
    Optical Inch says:

    @Ruckus: I was a mix of those two types of people: someone who acted like I didn’t give a shit, but really did; a misanthrope expecting to be loved. Bottom line, I was so desperate to stop drinking that I ended up doing things that we’re out of my comfort zone.

  120. 120
    Ruckus says:

    @Optical Inch:
    Glad it worked for you.
    Comfort zones. Lucky me, my comfort zones all have to do with physical limits, don’t ride too fast, fall out of airplanes or sides of buildings, etc, etc. People? Words? Sideways glances? Not so much, unless they want to kill me. Not in favor of that.

    ETA Or if they want to convert me to any religion. Now that bullshit pisses me off.

  121. 121
    Quaker in a Basement says:

    Nevermind the quarrel going on upthread. If you haven’t checked out AA, find a meeting and go. Can’t hurt.

  122. 122
    JasperL says:


    I have investigated. Read Cult or Cure, spent hours with the Orange Papers, and have read Peele’s work from time to time. I’ve read many more books on addiction – 20 at least. I mentioned a book that looks at addiction as a physical disease and suggests non-AA ways to deal with that. Many other medical professionals agree that the chemical imbalances are overlooked by many treatment programs, and obviously AA cannot and does not treat physical disease. Many of those same medical professionals recommend AA because it’s an effective support group for some addicts and alcoholics.

    So I’ve investigated and know opinions on AA by treatment professionals and medical doctors who deal with alcoholics vary from “Must do” to “avoid at all costs” and everything in between. The only person here suggesting they know the right approach for anyone else is YOU.

  123. 123
    Miki says:

    @The Raven on the Hill: Thanks for the links.

  124. 124
    Nate Dawg says:

    The startling ignorance about alcohol addiction that some on this thread have displayed is dismaying.

    John *is* taking responsibility. He *needs* to be under supervised care. To “just quit” is dangerous and ill-advised.

    Seen someone in a similar situation, and there are few treatment options for the alcoholic who manages himself.

    I’d suggest out-patient at this point, John, if you’re there. I’ve seen it work twice. They will knock you out silly with benzos, but when you wake up, you’ll be off the alcohol.

  125. 125
    Chuck says:

    @JasperL: @JasperL:

    I DON’T know the right approach. I’m taking an intuitive guess based on Mr. Cole’s evolution away from the Republican Party and suggesting I know the WRONG one. The one which the treatment-industrial complex has this country by the short hairs.

    Again, I shouldn’t be playing in your smelly sandbox. I saw my link to Peele’s commentary on Frey’s book got moderated out for some reason so I’m trying again:

  126. 126
    El Caganer says:

    @Chuck: It’s both premature and a bit presumptuous to tell Mr. Cole what treatment plans he should or shouldn’t investigate. He’s tried the by-his-own-bootstraps, keep-a-tight-asshole approach; he advises that this went down in flames. My own experience with AA was extremely negative. As far as I’m concerned, AA sucks limp dick. Nevertheless, some people, including ones I know personally, are helped by it (and the success rate I’ve heard is 3%, not 5%). If he wants to go to some meetings or read the Big Book or whatever, why shouldn’t he? Let him make up his own mind. Hell, there’s a link upthread to a program that sounds like the fucking Ludovico Technique; if he wants to take a shot at that, it’s his business.

    If you’ve personally had a shitty experience with AA, I empathize – welcome to the club. But your repeated denunciations of people who are often merely suggesting that Mr. Cole try a meeting or two come off as a bit unhinged. Or libertarian. But I repeat myself.

  127. 127
    kc says:

    Sorry you’re going through that, John. Hang in there.

  128. 128
    ninerdave says:


    I DON’T know the right approach. I’m taking an intuitive guess based on Mr. Cole’s evolution away from the Republican Party and suggesting I know the WRONG one.

    I got sober about a year ago, in rehab AA was presented as an option, but not mandated. However I went about once a week, mostly to get out of the facility and eat cookies and drink coffee, also to hear the speakers.

    When I got out I continued to attend meetings, did the 90 in 90 and actually tried working the program. Just wasn’t for me, but I still enjoyed the speakers and loved hearing the stories to remind me where I don’t want to be again and more importantly I got to be around people who were going through the same thing as me as I’m the only one I know who’s been through rehab and it can feel sort of lonely at times.

    All this is a long winded way of saying, AA can be helpful for people even if they don’t follow the program.

    There are alternatives, SMART, LifeRing but if you are lucky enough to have a meeting near you, you’ll find they are pretty sparsely attended. AA meetings are easy to find and well attended.

  129. 129
    Applejinx says:

    @Ruckus: Dunno.
    My experience was, I’m more a straight-up addict. I didn’t have much of the drinker’s camaraderie and self-delusion, I was just getting high at all costs however I could. I did notice that the 12 step meetings weren’t allowed to keep me out no matter how bad of a person I was, and took special note of that.

    I took even more note when one AA group ended up meeting together to try to figure out if there was a way they could get me/ask me not to come (pro tip: there wasn’t). One ballsy lady told me about this and said it was because they figured I wasn’t recovering (because of my doom-laden self-hating diatribes: I was heading toward homelessness at a good clip, at the time).

    I begged her to tell me what to do, then. She had no answer other than to listen to my sponsor, and to keep coming. I went to my sponsor, amazing mellow hippie biker dude, and told him what had happened. He’d made an actual decision not to give me advice but just to listen for a while because I so needed to vent. That was my cue to basically grab the guy’s throat and demand ‘GIVE ME THE ADVICES NAO!’.

    First advice: go back to meetings (maybe not that one) and shut up and listen. I did that, and basically shat myself that suddenly people were saying TOTALLY DIFFERENT things that blew my mind. I’m not at all sure it was just my POV, either, something freaky happened.

    I still go to meetings (more NA though) more than twenty years later, and part of the reason is that I can do better than that group back then which just wanted to be comfortable, just wanted to tell themselves how awesome they were in comfort. I’m not scared by fucked-up people. I am/was/still kinda am one.

    It’s not about the fellowship for me: I remain an outsider in some ways but I also am living proof that whoever you are, you can reach out and help others and freakin’ save lives. And this is worth doing.

    And there are a lot of people who don’t want to bother with anyone too twisted, or struggling, or angry. But I don’t have to be FYIGM. And whenever I manage to reach some poor bugger who just CANNOT get the message, it’s worthwhile.

    And the message is not ‘fuck you I got mine’, and it’s not ‘my way or the highway’. It’s pretty much tapping into the Lily inside you, opening up, and letting yourself connect with and care for others as they are without having to always do it on your own terms. Because if you set foot in ‘the rooms’ and sit in the seat that’s been saved (and always will be saved) for you, you never have to use again. Then it’s a matter of what you intend to do with the rest of your life…

    …and a lot of people can’t get past the bad attitude they came in the door with.

    Again, ask yourself who’s acting like Lily, and who’s acting like what glibertarians would do if they had to make up a recovery program. Just because it makes sense to you doesn’t make it the right thing, if your alcoholic brain isn’t great at sense right now. It might be worth trying to trust. And this is the guy who had an AA meeting trying to keep him away, saying that. If I can say that, maybe it means something, because I stayed.

  130. 130
    Johannes says:

    @Applejinx: This. Well said!

  131. 131
    LT says:

    Ah, goddamnit it, Joh, DO NOT LET THE BASTARDS GET YOU DOWN. Do not.

    Fuck, this is fucked up.

    Don’t let winding down get you down. Go ahead and wind down. One dude’s opinion – that’s not going to stop you. You’ve come too far.

  132. 132
    Ruckus says:

    Thanks for the reply!
    Glad that something worked for you. Everyone should have the opportunity if needed.
    I think you may have misunderstood my question. I wasn’t asking for myself as I was able to just stop my moderate drinking and my drug use years before that. For me it was relatively easy. For most it is not. I just stopped. I don’t miss the highs and for sure don’t miss the lows. 30 yrs in March off drugs, alcohol mostly stopped about 10 yrs ago. I was lucky. Very lucky. From my training I was able to see the signs and I stopped before the shit consumed me. Very, very lucky.
    My question was more directed at the people saying just go to meetings. As we all take substances for different reasons and we all take different paths to get off of them and the gossip of how effective meetings are(that means I don’t know and don’t know what not being effective means) I wonder how does an introverted person cope with meetings. I’ve been in situations with others, many of whom didn’t want to be there and participation was minimal at best. Maybe meetings will still help. That really was my question.

  133. 133
    Mnemosyne says:

    @El Caganer:

    He’s tried the by-his-own-bootstraps, keep-a-tight-asshole approach; he advises that this went down in flames.

    Note to any lurkers: 99 percent of the time, a by-your-own-bootstraps approach to a mental health issue will go down in flames. Heck, a by-your-own-bootstraps approach to any lifestyle change will usually go down in flames. As they say in my Weight Watchers meetings, if it was easy to lose weight on your own, no one would be fat. Now multiply that exponentially for addictive substances like alcohol or narcotics.

    Some people can do a major lifestyle change on their own — my husband lost 60+ pounds by not eating junk food and going to the gym, and he’s kept most of it off. But he’s a very far outlier.

  134. 134
    Ruckus says:


    I went to my sponsor, amazing mellow hippie biker dude, and told him what had happened. He’d made an actual decision not to give me advice but just to listen for a while because I so needed to vent.

    I did this with my sister once. BTW we were both very grown adults at the time. She was giving me shit and I gave her some back. But she went on kind of a marathon attack at that point and I just let her go. No replies, no comebacks. When she was done I just sat there and listened for about another 10 minutes. She finally spoke up very quietly and asked if I had anything to say. Asked if she was done. Her answer was that no one had ever let her get to the end before. She was stunned that someone would let her have the last word. Neither of us ever said another word about it. She passed away a couple of years later. This is both a sad and fond memory of her for me. She was a real character.

  135. 135
    Johannes says:

    I’m in moderation for chiming in to identify with Applejinx? Ah, well. Many more 24.

  136. 136
    Chuck says:

    This whole thread, and my first two-mile swim in nearly a year, reminded me today why I quit Facebook and need to stay offline as much as possible. Excuse me, you moles, I’m going back outside.

  137. 137
    Louis says:

    @ninerdave: Benzo withdrawl is also very dangerous.

  138. 138
    Louis says:

    But the above was a response to someone else. I work and worked in the field. Looking for help is hard, getting it is hard, each state is different and within states too. In Illinois, there is Gateway, which can be long term (90 days) and for people with little or no money but they may be happy to take you too. Getting medical supervision may be necessary for you, but how can I know from here. In the ER I work in in Evanston Illinois (the religious connected hospital) we watch over people in the ER and the MDs admit if it looks necessary. The more important work takes place after on a daily basis. AA helps some but not all. Having freinds and associates who are compasionate, warm and tell you when you are wrong is great, if you can listen. There are ups and downs and no simple answers, except wanting help and asking for help will get you help. Especially if you tell yourself you are worth what you are asking for. Treat yourself with kindness, but do what you need to do to stop. I have family who did not and died as a result. Fisteen years later it still angers me. Don’t be like him. You are worth stopping. Be well, take care.

  139. 139
    Louis says:

    I’m not a Social Worker if I don’t provide the resource. NOT an endsement, just a link.

  140. 140

    Why do you think you need residential rehab. If you had done our research you would know that outpatient treatment is equally effective at a fraction of the cost. You need to read Anne Fletcher’s book Inside Rehab.

  141. 141
    El Caganer says:

    @Chuck: Yep, libertarian, all right. Most likely an Objectivist.

  142. 142
    eric nny says:

    Always late. If you really need to get into rehab, go to any emergency room and tell them you’ve been thinking about suicide. You will then be evaluated by psychiatric. They typically want to observe you for 3ish days. This is when they’ll ask you to voluntarily check yourself in to a mental health unit. From there, the psychiatrist will have a better chance to get you into rehab. Or so “a friend” tells me…

  143. 143
    eric nny says:

    @Kenneth Anderson:

    My experience with outpatient was a joke. I needed to be locked away for awhile.

  144. 144
    InternetDragons says:

    30 years clean and sober here. Worked in addiction treatment for quite a few years, then finished grad school and worked after that in HIV prevention/treatment research, with a hefty dose of substance abuse work along with it, since the two are often linked.

    A couple of tips, if you are open to them: Don’t listen to anyone else’s opinions about A.A. because those other opinions don’t matter. It may or may not work for you. It does work, but it doesn’t work for everyone. You can say that about any form of substance abuse treatment or intervention.

    However, if you can’t get into treatment right now, it is very much worth going and sitting in a meeting and just LISTENING to other folks’ stories. That’s it. No need to analyze whether you like anything else about it. If you can’t get into rehab right now, hit a few meetings and simply listen to others who have been there. It’s powerful stuff.

    Try Hazelden. Try Betty Ford. Ask a few of the old-timers in A.A. which rehabs they’d recommend. Not all of them will have gone to rehab, but some will know which programs are good ones. Look up local physicians or therapists with a substance abuse specialty and ask which rehabs they would recommend. As you already learned, never ask a GP or any health provider who does NOT have a substance abuse specialty for advice. They’re clueless; they haven’t had the training needed or the experience to go with it.

    I’m sorry you have had to go through this; honestly if some of us had known you were trying we could have given you a heads-up and maybe eased the path a bit, but you will get there and you will be OK.

    You can do this. And it so incredibly worth it.

  145. 145
    patty \ says:

    we just went through this two weeks ago with my sister. she was completely strung out and no one would take her. we finally found a facility to take her overnight. and she’s poor as a church mouse so the problem isn’t that you are middle class, the problem is that the medical care in this country is little better than third world. i’m really sorry that you can’t find help and my sister can’t find help.

  146. 146
    Gemina13 says:

    John, I’m sorry. I had a feeling what was going on with your first post.

    I’ve lived with alcoholics. Mom used to drink “socially” until the mother of all hangovers made her stop. My first boyfriend drank like a fish. My brothers are functional alcoholics. And I’ve had to fight the urge to drown my sorrows with a few glasses a night, if only because all the sugar in the booze would cause my diabetes to go thermonuclear on my ass.

    My oldest brother has managed to hide his drinking behind a facade of (first) upper-middle-class living and then a “return” to our so-called redneck roots (that he’d mocked most of his life). My second brother fought for decades to quit, and was even ordered to rehab twice for DUIs. Neither time worked. He had insurance, and for a while was making good money as a contractor; yet he couldn’t get help outside of a courtroom, and he already knew what court-ordered rehab would do. He hit a point where he told himself he was either going to get sober or kill himself. Thankfully, he’s been sober ever since, but when he told me how many times his doctors would lecture him about his drinking and then recommend AA, I wanted to scream. Useless, all of them, fucking useless.

    If you wanted to quit smoking, doctors would be happy to refer you to programs to help you kick the habit. They’d remind you during your quarterly physicals that smoking cuts years off your life, can be a root cause for strokes, cancer, and heart disease, and will do damage to your teeth and eyesight as well. And every one of us who’s even 10 pounds overweight has had nosy-ass doctors insisting we get more exercise, take a ton of statins, and otherwise get rid of that unhealthy flab before we die prematurely. (I told the doctor who said that to me that, unless I got lung cancer like my father or Alzheimer’s like my mother, death would be premature anyway.) But if you want to stop drinking or stop using drugs, suddenly medicine doesn’t get involved. You’re not trying to get healthy; you’re fighting a moral failing. You loser, you. You expect medical science to help you? Don’t you know that’s only for deserving little kids with horrible diseases?

    The attitude in this country that you can beat addiction on your own isn’t helped by the assumption that the twelve-step program is all you need. (Brother #2 tried AA, the granddaddy of all twelve-step programs. It failed him utterly.) People don’t really understand how addiction works unless they’ve seen it at work among their own loved ones, and even that’s not enough enlightenment. I have no idea if schools still include addiction in health education classes, but most of what I learned in high school was the twice-chewed DARE cud, leavened with an explanation of how drugs were classified, what their effects were, and what research at that point told us about the damage they could do. Scientists have uncovered a lot more knowledge since then, most of which could be used to treat, if not totally cure, addictive behavior. But because we’re still run by the crowd that thought DARE was edgy and cool, it may take us another two decades to formulate a program that would work here and now.

    I hope you’ll get help. I hope you will be able to do this. Don’t be afraid to call on people here for help, and don’t be afraid to just lose your shit at times. Do what you need to do to get away from the urge.

  147. 147
    serena1313 says:

    I did not read through the comments as Iam short on time, however, John you might try going to an AA meeting.

    Rehab is the same as AA except you cannot leave rehab. The 12-step programme is the core of their philosophy.

    People who are in rehab are required to go to AA meetings anyhow. And they are required to work the steps. After rehab, the choice is yours, but it is highly recommended as part of the programme to keep sober.

    So before you commit to spending time and money at a rehab, I would suggest attending an AA meeting first. Who knows, it might be exactly what you need. If not, at least you’ll have an idea of what you will be getting yourself into.

    John, ask the people at AA for assistance. Surely they have the information you need to get into a rehab or direct you to someone who can help you.

    AA is free. It has helped a lot of folks including my sister, who after years in and out of rehab, stay sober and clean.

    While that was decades ago, Iam presuming the same 12 step programme applies today.

    John, it is important to understand, too, that Rehab is not for everyone and not everyone succeeds, but that is something that you and only you can decide.

    No path is set in stone. There is no time stamp. Nor is there a right or wrong path. There is an infinite number of paths to choose from.

    If you do not like one path, then change it and change it again until you do. It is all about choices.

    So don’t worry about what others think. This is your life. Live it as you so choose.

    Lastly I just want to add that you will find the answers you seek. First you need to find the right questions to ask. Once you do, you’ll realize you already had the answers — they were there within you, inside you, all along.

    Focus on the positive. And therein begins the first step of the journey toward healing of your own volition and pace. It is a process not an end to itself. Enjoy it. Be happy.

    And John … always, always, always be kind to yourself.

  148. 148
    Tabitha King says:

    John, I want to get you into Hazeldon. Send me an e-mail.

  149. 149
    Al Anderson says:

    John, I wish you the very best. I was in a real bad spot when I finally asked for help. 6 weeks of outpatient treatment and 26 years of AA have kept me sober and sane. As an atheist, AA has not always been an easy fit for me, but the wonderful people, some are still friends after 26 years, have been the best thing that ever happened to me. I just use the tools that I can work with and enjoy the good people at meetings. There may be other routes for you to take to sobriety, but never give up. May you succeed in spite of the pot holes in your road to recovery!

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