Fierce and Frail

Part One – A Fierce Storm

Today Rehab and Detox beds are nowhere to be found. Demand is higher than ever. Resources are more scarce. Staff are harder to hire and keep. Overdose deaths (CDC figures) rose 30% from 2019 to 2020 and another 15% from 2020 to 2021. The system has been broken for some time, but it all culminates into the lethal crisis that is worse than ever. Yet somehow this crisis flies under the radar of existential dread that everyone is experiencing with economic, ecological, and geo-political issues escalating.

It is not a perfect storm, but rather a perfect tsunami for people in crisis battling addictions. They suffer in silence. They too often die that way – silently, almost invisible to the community at large.

Shame is to Blame

Recently a friend slipped into an alcoholic bender for several days. He became overwhelmed by a number of legitimate challenges. And he stopped accepting help from friends who wanted to be of service. He opted for solitary confinement – a sometimes lethal sentence – in this case self-imposed. It was probably shame that dragged him away from people who love him. Shame tells us stories that we know aren’t fully true. Unfortunately, we only know that when we’re sober and can see clearly. Now, deemed unworthy by a drunken jury of one, his incoming texts will go unanswered. Calls go straight to voicemail without ringing. Voicemailbox is full, “please try your call later. Goodbye.” Eventually the phone goes uncharged.

Shame knows that it can only survive in silence and in secret. Like a cheetah isolating a single antelope from the safety of its herd, the prey has never been more vulnerable than now. On his own, the drink would quickly drag him into the murky blur of constant drinking – numbing the pain of childhood trauma, relationship problems exacerbated by a global pandemic, and a tragic disconnection from the authentic identity of this articulate, well-read, likable fellow.

A Broken and Frail System

After several days, he – in a fleeting moment of clarity – asked for help. He wanted to get help and was ready to go wherever he needed to go to get help without hesitation. That may sound like a great opportunity except for the fact that this system is desperately broken. If he’s going to get help, he needs to first find which facilities accept his insurance. May I say that if one is completely sober, that task is neither easily nor quickly accomplished. Next, make a list of the half-dozen facilities which accept your insurance. Call them every morning (at times that may vary by facility and day of the week.) Call daily, even though they told you yesterday that they have no beds and can’t predict when a bed might become available.

If that tedious task wasn’t disheartening and demeaning enough, remember that if you stop drinking too quickly, you may suffer debilitating withdrawal symptoms – even seizures or death. So drink enough crappy vodka (I mean the store brand $8.99 for a handle dreadful vodka) to keep from becoming ill. But don’t stop making your daily waitlist calls or they’ll drop you off the list! Hey, they have an impossibly long waitlist. What are they supposed to do – put up tents in the parking lot? Facilities know that waitlists aren’t the answer, but they’re doing what they need to do in order to survive, too. The bottom line is that addicted individuals need to keep using enough to stay medically safe, but stay sober enough to manage your list of daily calls.

Don’t have enough energy for meals? No problem. You have no appetite. Clothes starting to smell? You don’t care anymore. Sink full of swampy dishes? Who cares? You haven’t been to the kitchen in a week. You just lay on the bed and take sips of awful vodka trying to avoid painful withdrawal symptoms. At some point you fall asleep (aka pass out) because your aching body can only take so much abuse.

Periodically you stagger/crawl to and from the bathroom. Whatever’s in the fridge has been there for a week when you last opened it. That’s all… crawl, try not to fall, drink until it’s time to call. And you know they’re going to say, “no beds.” But if you don’t call every day, you get dropped off the waiting list and you don’t even get to pretend to believe that you’re going to get help.


A friend asked me to “plant-sit” his monstera while he went into rehab. The same day he finally got into treatment, his plant popped a new baby leaf.

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