The End of My Addiction

saw and heard myself in all of them.
    As I have already said, the common threads in what I heard made me suspect that shared biological mechanisms must underlie all addictions and compulsions, and that a medical treatment for addiction must be possible. This thought never left my mind during my illness, but it receded into the background as the calming rehab routine took effect and I began to hope, once again, that I would achieve lasting abstinence through heightened self-awareness, improved coping skills, and AA.
     
    I saw lots of willpower and commitment to recovery in my fellow patients at Marworth, whether they were medical professionals or not, and I told myself that I too had enough of these qualities. We all hoped that we could leave our addictions behind, and we were encouraged in that hope by Marworth’s reputation. My best friend in the medical addicts rehab club, Daniel, another cardiologist, said, “This is the Harvard of rehab.” He was being sarcastic, but underneath that was a kernel of pride and hope that Marworth would help him.
    If Marworth was the Harvard of rehab, we all wanted to graduate with honors. Although there was nothing on paper, the scuttlebutt was that Marworth’s success rate was among the highest in the country, perhaps 66 percent or even 75 percent.
    You can search high and low, but no rehab center will ever state a specific success rate. Nor will they reveal the sad fact that the overwhelming majority of alcoholism rehab patients relapse within four years, even if they have been abstinent the entire time. The relapse percentages for other drugs of abuse are similar. 1
    Rather than admit these depressing statistics, rehab centers speak in vague positives, such as “Our patients have a higher abstinence rate one year after treatment than patients in an objectively matched comparison group.” The abstinence rate will almost certainly be based on nothing more than patients’ responses to a follow-up telephone call or questionnaire. And addiction patients commonly lie about how they are doing, because they have so much to lose—jobs, relationships, custody of their children—if they are not thought to be doing well and maintaining their abstinence without too much stress.
    That rehab centers can make such claims is part and parcel of the fact that there is no proven protocol for addiction treatment. In this context, relapse equals noncompliance on the part of the patient. After I recovered from alcoholism thanks to baclofen, I obtained my medical records from my stay at Marworth. My discharge report says, “[Olivier] has a history of not utilizing twelve step support, as seen by several relapses despite having a sponsor and home group.”
    This is doublespeak that could have come straight out of George Orwell’s 1984 . I went to AA regularly, I had a sponsor, and by all reasonable criteria I diligently utilized twelve-step support. But like the vast majority of AA members, I did not benefit enough from twelve-step support to be able to stop drinking for good.
    Outside rehab, I worked all day to abstain from drinking, and each day was as hard as, or harder than, the day before. Addicts struggle to abstain, they painfully accumulate days, weeks, months, and even years of sobriety, but they get no credit for that when craving overcomes them and their abstinence ends.
    Based on my own experience and my observation of fellow patients, I offer the following axioms for anyone undergoing, or delivering, treatment for addiction.
Relapse does not necessarily equal noncompliance.
Rehab does not equal cure.
Rehab equals respite.
    I was in dire need of a respite when I arrived at Marworth, and much as I resented being taken to Lenox Hill, I am grateful for my friends’ intervention, although the lies Tom told about me are another matter. In my intake interview at Marworth, a psychologist told me, “When you were admitted to Lenox Hill, your transaminase [liver enzyme] count was 300. As you know, that’s almost ten times normal. At this rate of drinking, you have at best five years of life left.” Transaminase levels that high often signal acute alcohol-related hepatitis, which can be a precursor to fatal liver cirrhosis, but Joan, Claudia, and Tom had stopped my binge in the nick of time.

    Like AA, a good rehab program teaches many valuable life lessons. One of those I learned at Marworth was to look in the mirror every morning and say something positive about myself.
    In an AA