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When
Your Child Drinks-Reader's Digest, November
1986 |
Magazine
and Newspaper Articles |
| Magazine
and Newspaper Articles |
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L I F E S T Y L E
The Long Road Back
‘After-care’ for drug and alcohol abusers
At
the Betty Ford Center in Rancho Mirage, Calif., patients
are prohibited from receiving phone calls for their first
five days of treatment, cannot keep any medications they
might have-not even vitamins or mouthwash-and are assigned
chores: Elizabeth Taylor hauled garbage and hosed down the
patio. At the Smithers Center for Alcoholism and Drug Treatment
in New York City, where New York Mets pitching ace Dwight
Gooden spent the last four weeks, residents trying to kick
the habit go through a program that harkens back to grammar
school: they meticulously copy out statements, such as a
list of definitions of sobriety, and attend lectures. But
when patients complete the standard one month of in-house
treatment at a rehabilitation clinic, they are only beginning
what may be the most critical part of their recovery: after-care.
Even doctors and psychologists who debate the merits of
various treatment programs agree on one thing: a few days
or weeks spent in an alcohol-or drug treatment center is
not enough to wean patients from their dependency. Some
80 percent of addicts, be they drinkers or drug abusers,
fall off the wagon at least once, says Dr. Thomas Kosten
of the Substance Abuse Treatment Unit at Yale University.
And short “detox programs” have, he says “a
failure rate of 90 to 100 percent within a couple of months.”
For that reason, every reputable rehab center provides its
patients with an aftercare program to follow after release.
Though the requirements vary, they generally include weekly
follow-up visits to the clinic for meetings to talk about
learning to live sober.
But a primary goal of many after-care programs is to get
patients into Alcoholics Anonymous or a similar support
group that uses AA’s 12 steps. “Meetings are
your lifeline,” says Betty Ford. The clinics urge
patients to attend 90 AA meetings in their first 90 days
back home and, after that, to attend regularly or whenever
they feel the need-for the rest of their lives. Sometimes,
just going to a meeting to help others will keep an addict
on the wagon. Mrs. Ford, for instance, regularly works with
patients.
One relapse-prevention strategy recognizes that old environments
can trigger old habits. Ex-patients encounter “cues”
that can prompt them to reach for the bottle or the white
powder once again. The cue might be a friend who uses cocaine
or a party at which many people are drinking. Clinics therefore
teach patients to identify such cues and deal with them-to
quickly leave the party, for instance, or find new, non-coke-snorting
friends.
Most centers have patients return for counseling after release.
Graduates of Smithers usually return two or three times
a week at first, then once a week for about two years, says
associate director Dr. Allan Lans. Gooden, who tested positive
for cocaine use late in spring training, is expected to
receive psychiatric counseling up to three times a week.
One reason for mandated follow-ups is that patients who’ve
grown accustomed to leading disciplined lives at the treatment
centers are more likely to suffer a relapse when they have
all day to themselves. Sports stars whose youth and huge
financial resources make it extra hard for them to recover
might especially benefit from the continued scrutiny. Some
clinics also offer after-care sessions for family members
of patients, partly because domestic problems that may have
triggered a coke habit will not necessarily have disappeared
during the patient’s stay.
Minor Slips: Despite the best after-care,
some relapses are bound to occur. The riskiest period is
the first 90 days after discharge. But after-care can keep
a minor slip from becoming a renewed addiction. The Veterans
Hospital in Seattle found that 70 percent of patients who
completed its nine-month after-care program maintained complete
abstinence or had only an isolated relapse during that period;
80 percent of those who dropped out of after-care had serious
relapses. Certainly there is no sure-fire cure for the estimated
17.9 million alcohol abusers and 5.8 million cocaine users
in the United States. But after-care seems to be the best
way to keep them on the road to recovery.
Sharon
Begley with Mark Miller in Washington, Michael Reese in Los
Angeles and Karen Springen in New York
(Source:
Newsweek, May 11, 1987)
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