The End of My Addiction

I was becoming overexcited about the future, and with that nervous agitation came renewed anxiety about making my practice pay and about making the lifelong commitment to Joan that she wanted. In any case, for whatever reason, the binge was on, and despite my protests, Joan overreacted and called EMS. It was an understandable decision on her part, given the seizures I had experienced in acute withdrawal only three weeks before. When EMS arrived, I was furious, but too tired to argue, and soon found myself being detoxed in the ER at New York Hospital.
    Liz Khuri now advised that I should go straight from the ER into residential rehab. She thought of the Betty Ford Clinic in California, but it was full up. There was room at Clear Spring Hospital in the New York suburbs, so that was where I reluctantly agreed to go. I felt pushed into rehab, but more than that I felt bitterly disappointed in myself for drinking only days after a spiritual epiphany.
    At the same time, I hoped that rehab would be the answer I needed. In AA some people said it was helpful, and some said it was not.
    Joan drove me to Clear Spring. I arrived with only the clothes on my back and in a state of bleak depression. My credit cards were in my wallet in my apartment in New York, and the hospital required a $5,000 deposit before I could be admitted. Joan generously used her credit card for the deposit, trusting that I would immediately repay her when I was discharged, which I did.
    Clear Spring was the Ritz of rehab, a beautiful place with the amenities of a five-star resort. It drew affluent patients from the New York metropolitan area and across the country, and a number of celebrities and wealthy people were in residence, as I soon learned.
    We have all become used to seeing celebrities caught in the glare of the paparazzi’s flashbulbs as they go through the revolving door of rehab. After several extended stays of my own in rehab, I would suggest that this is not because celebrities are particularly lacking in willpower, spirituality, or positive attitude. The truth is that every addicted patient receives not as much rehab as he or she needs, but as much as he or she can afford. But perhaps that is getting ahead of the story a little too much.
    For the first couple of days at Clear Spring I was continuing to detox, and then I saw Dr. R. for an intake interview and assessment. To my surprise the interview did not involve a thorough discussion of my medical history and my drinking, and it was all over in ten minutes. Dr. R. prescribed Luvox (fluvoxamine), an SSRI, and naltrexone, an anticraving agent like acamprosate. Dr. R. said, “Luvox is good for compulsive behavior like alcoholism, and the naltrexone will get your cravings under control.” (I continued to take both medications for some time after I left Clear Spring, but they did nothing to alter my drinking.)
    A few days after our first meeting, Dr. R. saw me again briefly to ask how I was feeling on the medication. In a three-week stay at Clear Spring, these were my only contacts with an M.D. But I thought I was in expert hands at last and should trust the process. And my stay at Clear Spring was restful and restorative. In the absence of a proven treatment, the main benefit of rehab is that it provides an addicted patient with a much-needed respite from alcohol or another addictive substance or behavior.
    For alcoholics, the daily routine at Clear Spring began with taking turns reading from Living Sober and other AA-approved books. Later there were classes in coping skills such as how to refuse a drink, AA meetings, and a good deal of free time, in which I took walks, talked to fellow patients, and played a beautiful piano they had there. One of the people my piano playing attracted was a clarinetist for one of the country’s leading symphony orchestras, a very pleasant guy who was being treated for depression. We had many good conversations, but I imagined that he thought I was a low-life drinker, whereas he had been diagnosed with a respectable disease.
    In this regard I told Dr. R. and everyone else at Clear Spring, as I told all my caregivers, “My fundamental problem isn’t alcohol, it’s anxiety. If my anxiety is resolved, I won’t drink.”
    Dr. R. responded, as all my caregivers did, “If you stop drinking, you won’t be so anxious anymore.”
    After three weeks at Clear Spring, I was prepared to give her the benefit of the doubt on the subject. Thanks to the routine of