The End of My Addiction

recovery will fail, and I’m being honest. I tell you I’ve never seen cocaine or heroin. And the only drug I have ever abused is alcohol. Do you believe me or not?”
    “Of course, we believe you. But we still have to check,” the case manager said.
    “My doctors regularly prescribe benzos for my anxiety and panic. My addiction specialist, Dr. Elizabeth Khuri, is a leading researcher in the field and associate professor of psychiatry at Rockefeller University, and she prescribes them.”
    “CPH protocol prohibits those drugs. They can be abused, they cause dependency, and you’re going to have to function without them. One more thing: you will have to urinate in front of a witness.”
    “Excuse me?”
    “Yes, some people try to do a switch.”
    I told Joan, “Look where I am now. I can’t go away even for a weekend, because I have to be available to give urine within hours of being paged, unless I inform them ahead of time and find an approved lab wherever I am going. I closed my practice to remove the possibility of my drinking affecting someone’s care, and now, at the sound of a beep, I have to go pee in front of a witness to check for drugs I have never seen in my life, much less used. On top of that, I am denied normal medication for anxiety. You’ve witnessed my panic attacks. They say they want me to stay sober and keep my license, but they are stacking the deck against me.”
    Besides urine monitoring, CPH mandated that I rejoin the alcoholism outpatient program at St. Luke’s–Roosevelt, and in addition see a CPH-affiliated psychologist twice a week. “You need to have a private session with me, which will cost one hundred fifty dollars,” the psychologist said, “and you need to join a group therapy session, which will cost eighty-five dollars.” My health insurance did not cover the $900 to $1,000 a month this would cost.
    I continued to consult Liz Khuri at Rockefeller, and she generously did not charge me because I was not working. I asked the CPH psychologist if my weekly appointment with Liz could replace a private session with him, and he fortunately agreed that it could.
    One day I had a panic attack in Liz’s office. She was very concerned and immediately wrote me a prescription for Valium.
    I got the prescription filled, but I didn’t touch it. I called the CPH psychologist and asked if I could take the Valium. He said, “Don’t take a single pill. If you have it in your urine, you will have to go straight back to rehab.”
    “But I have severe anxiety and panic attacks.”
    “Don’t take the Valium. The anxiety will subside.”
    The anxiety subsided, then quickly surged back up. It ebbed and flowed like the tides, but it never went away. And the panic did the same. I took the untouched Valium to the next CPH group therapy session and handed it to the psychologist in front of the whole group, physicians all.
    “Congratulations!” he said. “You are doing great.”
    “I am not doing great by any means; I am struggling desperately to save my life from alcoholism. But let me ask you something. You know my psychiatrist Dr. Elizabeth Khuri’s reputation as a physician-scientist working on addiction, don’t you?”
    “Oh, yes, of course I do. She is very well-known and respected in the field.”
    “In your professional opinion, is she right or wrong to prescribe Valium, when she sees me having a panic attack right in front of her and knows that I have a history of anxiety and panic that predates my drinking?”
    He would not answer. I said, “I know CPH forbids it and that is why I brought you all the pills. But in your own professional judgment, is Dr. Khuri right or wrong?”
    After a long pause, he said, “Well, medically she is right.”
    “So can I take the Valium?”
    “No, you have to follow the CPH protocol.”
    It was only a moral victory. But the looks on my fellow physicians’ faces suggested that they appreciated it as much as I did. From conversation I knew they also resented the charade of our forced therapy sessions. It was impossible to speak with complete honesty in these sessions, because the psychologist had informed us that some of their content would be reported to CPH. In such circumstances there could be no real patient confidentiality and no mutual trust, the two preconditions for therapeutic progress to occur.
    Programs like CPH—I believe every state has one—are important to protect the public from physicians practicing under the