Groundhog Day in Rehab
One addict's journey through more than a dozen rehabs has taught him more than he needs to know about those shaky first days of treatment.
I'm 28 years old. In my short career as an abuser of substances, I've visited 13 rehabs. That adds up to an immodest 960 days, or around 32 months, two and a half years, and enough tepid coffee and nondairy creamer to power a metropolitan police force. You might say that I am a hearty supporter of the substance abuse treatment industry, and that I've put my money where my problem is. I've been treated by both Dr. Drew and his on-screen sidekick, addiction counselor Bob Forrest, though at separate locations. I've shared rooms (and meds) with the rich and famous. Yet no matter how much experience I've had in treatment with tens of thousands of fellow patients, I've never gotten used to the first day at a rehab. It's disorienting, terrifying, sometimes sickening, sometimes shameful.
It was always a debacle, each time a different sort of mess. Like the time I insisted on drinking a fifth of vodka on the drive to rehab; my fed-up roommate literally pushed me out of his car when we pulled up. There were the times I checked in shaking and shivering, with used syringes stuffed into my socks. Sometimes, a body search would reveal paraphernalia I didn't even know was on me (or in me). The scenario and environment changed, but the feeling was generally the same: utter defeat and fear for tomorrow—a day without substances.
To compound the unease of those first hours, I would notice the other patients seemed to have known each other for years; I felt like the transfer student from another school. So I would respond by either hanging in my room reading or try and sabotage the new social strata. Sometimes I was the clown, sometimes the convict, sometimes the guy taking it all very seriously—but I was never myself, and I was never honest. My attitude on day one was often indicative of how I approached the immediate treatment as well as recovery afterwards.
In one therapeutic community, the rules on Day One were the “Five F’s”: no flirting, fucking, fighting, fixing, or fruiting. The last “F” was in reference to the orange trees in the yard; clients would have dealers stuff drugs inside oranges and lob them over the walls.
I often sculpted my background to suit the atmosphere. If the rehab was state-run (read: low-rent), I would play up my time in jail—talking about my crimes and how I beat people for drugs. If the rehab catered to the super wealthy, I’d slip in that Robert DeNiro and Robin Williams have vacationed at “my” villa in the Caribbean (which is my parents', not mine). Whether I was speaking to a 1%er or a wino straight off the street, it really didn't make a difference. We both talked and neither of us listened; this is a trait of early recovery.
My first rehab was called Sierra Tucson, a posh place in the barren landscape of Arizona. My dad cried in the parking lot when we arrived; I had never seen that before. I remember feeling sorry for him. “What is he so upset about?” I wondered. He left to fly home and I made a beeline for the smoking pit. There I met my new friends, none of whose names I recollect. We spent the day—and the ensuing weeks—trading war stories. It was of utmost importance to me that I establish myself as the "worst" addict there. It made me feel better to let everyone know that I was worse. At least I excel at something. If rehab consisted of the all-stars of using, my ambition was to be voted MVP.
Later that day, I read the Twelve Steps for the first time. They pissed me off. “$50,000 for treatment and this is the solution? Where is the pill? Where is the fix?” Honestly, my intention was to stop using drugs and alcohol; I just didn't like the remedy they were offering. So I read the steps again. Twenty minutes later I said to myself, “I got this.” I was wrong.
Fast-forward a year to another first day. Little in my life had changed—except that I was facing six felony charges, for assaulting police officers, causing "great bodily harm" on a police officer, and robbery. While blacked-out in the middle of the day, I had robbed a veterinarian for drugs. To say I resisted arrest would be an understatement—a police helicopter was summoned to monitor the spectacle.
I was released from jail on a very large bond. It was my fourth rehab, but it was the first that was court ordered. Per the judge’s instruction I wouldn't be spending my time on bail at a luxury resort with group therapy. No more shiatsu massages, EMDR, equine therapy, or ropes courses. My placement was at a "therapeutic community," a spartan place with state beds and a contingent of ex-cons—I suppose I was one of them.
I came straight from jail, and was wearing my jail issue slippers during intake; the state of California had retained my shoes as evidence. Even though my parents had given me new shoes, I thought checking in with my county jail kicks would be a nice touch. It worked. Evidence of my recent incarceration garnered acceptance with my peers. I puffed a cigarette proudly in the smoking section, happy with the way things were headed. Never mind how fucked up my life is—these guys think I’m cool! My new friends had copious amounts of ink on their skin. I was part of the in-crowd.
Life in a therapeutic community is different than in a run-of-the-mill rehab. The first order of day one was to learn the rules, or the “Five F’s”: no flirting, fucking, fighting, fixing, or fruiting. The last “F” was in reference to the orange trees in the yard; clients had dealers stuff drugs inside oranges and lob them over the walls. Consequently, residents were forbidden from picking up the fruit on the ground.
Three times a day a bell would ring roll call. We would congregate for “maintenance.” Everybody would get assigned a task, which usually consisted of cleaning things that were already clean. I remember mopping a clean floor on day one and thinking, “Maybe these other hooligans need to mop a floor to get clean and sober, but I certainly don't.” I’d humor the fools to avoid going to prison.
But the most resonant memory from that “day one” was the stench of my bedroom. Four people were packed into a cell-sized room with a communal bathroom. It was a recipe for disaster. The symphony of snoring and farting was amplified by the fact that most residents were opiate addicts whose bowels were loosening up for the first time in weeks. It was beyond annoying: It was funny.
Fast-forward yet again. After another year, I was still a teenager and the consensus was that I wasn't an addict, I was crazy. I remember my attorney telling me with absolute conviction that there was no way someone would do what I did without a serious mental disorder. Constantly running away from rehab while out on bail and facing decades in prison were not the actions of a sane person. It was sound logic, I suppose. The rehab du jour was essentially a psych ward for people with a serious dual-diagnosis. I hoped this was the answer. Getting lots of medication jived with my mental state. The more pills the merrier.
My earliest memory this time around was certainly not day one. It was close to a week before the benzodiazepine haze lifted (I was known to wash handfuls of Xanax down with vodka). What I recall, with perfect recall, is this: the med line, and it was straight out of Cuckoo's Nest. Instead of “maintenance,” it was medication (we met four times per day instead of three). The metal window would roll up and we would line up to receive our Dixie cup full of pills. Depending on the line, the process could take upwards of an hour. An eclectic mash of personalities met to receive their daily dosages. There was the guy who was always first and stood patiently waiting for the window to open. He rarely spoke, stared at his feet, and kept his hands in his pockets. Then there was the woman who always disappointed. Her prescription was always wrong. Something was always missing. There were those who were restless and couldn't bear to wait. They seemed to find each other and would spend the duration of the med line asking each other, “How could they take so long?” And then there was the rowdy bunch. This became my crew. We’d spend the time loudly reminiscing and fooling around. To the outsider, our demeanor would have closely resembled friends knocking back shots at a bar.
Towards the end of my stay I was prescribed a large dose of an anti-psychotic. The psychiatrist mentioned it was available as a pill or an injection. I opted for the injection. He told me that in his twenty years of service he’d never had a patient ask for the injection. This angered the other clients. Now when it was my turn during the med line the nurse had to lock up the window and retire to the bathroom to inject medicine into my butt-cheek. At one point she remarked that my ass looked like a pin-cushion.
I finally had the solution I desperately wanted back when I first read the Twelve Steps: the pill, the shot, the fix. Of course, my faith was misplaced; these new legal substances didn't cure my ailment. What they got me was six months of the worst depression I’ve known and a fifty-pound spare tire around my midsection. I could barely make it up the stairs without gasping for air.
Fast-forward four more years, many more treatment centers, jail sentences, and overdoses. It was rehab number thirteen. My final stay. Three of us were admitted that day. I remember because my intake took twice as long as the other two clients combined. I had amassed a considerable treatment history, which they always insist upon poring over. I remember at one point the admissions woman asked if I was a heroin addict to which I replied “no.” Then I mentioned that I shot heroin everyday. She laughed and told me that I was heroin addict. Oh yeah. Right.
Once admitted, I was brought the lobby and introduced to a young man who had been a patient for some time. She told me he’d give me a tour and show me to my room. I thanked her and turned around to find that my escort had vanished. I stood there clueless and alone. I shivered as the Suboxone left my system.
Eventually, after an hour or so I found a hot shower and a Robin Cook book. He is an excellent “rehab author”: a light and easy read that brought me out of myself. As I settled in to do my usual bid I sensed something was amiss. For a fraction of a second, the notion surfaced that I had no fucking clue what I was doing with my life. I snuffed that scary thought out quickly, but it lingered just long enough to have a profound effect. I decided that just this once I was going to be honest. For the first time in my life, I felt tired.
Over the following days, people pointed to the overwhelming evidence of my life’s unmanageability. It was the same unmanageability people had been pointing at for a decade, but I was committed to honesty now. There was no retort. My life was in shambles because I’d been running the show. I became willing to listen to others; I became willing to not listen to myself.
I listened. This was the crucial lesson that I learned at my final treatment center. It wasn't the yoga, meditation, the jail, the humiliation or even the Twelve Steps—although all of these things keep my sober today. I listened. Again, this was the key that opened the door to my recovery.
A wise man once told me that if a treatment center is open it is working for someone. Although there was a wide spectrum in quality among the places I attended, I firmly believe I could have gotten clean and sober at any of them had I only listened. Another wise man broke it down further for me. He said the journey one needs for effective treatment is a matter of four words: “ Oh, Shit!” to “Oh Boy!”
Christopher O’Connor is a freelance addiction writer. He works for Family Healing Strategies providing counsel to families of those in treatment.