Before an addict can reach 12 steps, he or she has to get through the door.
Here in the detox center of Livengrin Foundation for Addiction Recovery in Bucks County, drug addicts thrash, jerk and sweat addiction out of their dilapidated bodies under medical supervision, with the worst cases taking drugs to get off drugs. Back muscles clamp into tight fists that force the body to spasm and kick (hence “kicking” the habit), sweat coats the skin in seasick tidal waves, bones ache, guts twist and skulls feel caved in.
You probably won’t die from withdrawal, “but you’ll hope someone comes up behind you and beats you to death with a bat,” says Vincent Ceraso, a professional interventionist who frequently escorts clients to Livengrin after convincing them to enter treatment during an intervention. He makes quick business of it, because wherewithal fades as withdrawal looms.
Once an addict decides—or begrudgingly agrees—to enter rehab, it’s wise to hustle them right to the chosen center before they change their mind. But they essentially hurry up to wait, sometimes for hours on end, as intake administrators sort out what level of treatment they need and whether or not the treatment will be covered by their health insurance.
The addict is already hunting for a way out. As they wait, he or she is likely telling him or herself that the problem isn’t really that bad, that everyone’s just being really hard on them. They’ll begin to wonder why the hell they’re agreeing to even go.
As the clock ticks, the tug of war between the disease and what Ceraso terms “the authentic self” buried beneath the disease escalates to a fever pitch. Literally.
Ceraso, who says professional interventionists send in the paperwork for clients ahead of time to facilitate the process, concedes the anxious wait “is like waiting for a baby to be born.”
Once the addict is admitted, the responsibility of getting him or her to stay falls on Jack Otto. Otto began working at Livengrin 25 years ago as a staff tech and worked his way up to Director of Detoxification Services. Between his own recovery and all those years of dealing with addicts and alcoholics, he’s explored all dimensions of the delusional, addicted mind. He’s a realist.
“The one thing you need to know about addicts is if you give them that much space,” he says, as he holds his fingers to show an inch, “they’ll wiggle through it.” Ceraso seconds that emotion. “You know how you tell when an addict is lying?” he asks. “His lips are moving.”
The addict’s tendency to lie or rationalize is a major problem at this point, because his or her honesty at intake, along with the quality of health insurance, determines the level of care the addict qualifies for—which, as a rule, is always less than they think they need, says Otto.
“If they meet the criteria for rehab, they’re going to want to do outpatient. If they meet for outpatient, they want to do AA. They always want to bump it down,” says Otto, “because the truth is they don’t want to be doing any of it.”
So how do you convince an addict (who probably doesn’t believe he or she is an addict) to face reality, and potentially withdrawal?
“I’m not above using a little guilt,” says Otto.
To that end, Ceraso helps out. Back in the early stages of the intervention process, Ceraso coached the addict’s family members to write letters that they read aloud during the confrontation. Through the letters, family members created a record of the addict’s life by itemizing specific instances of his or her out-of-control behavior. Ceraso turns over the letters to Otto .
So when the addict insists that everyone’s exaggerating the problem and swears everything’s just fine, Otto whips out the letters and reminds he or she of the consequences of bolting, whether that’s a spouse’s promise to move on, a boss’s threat or the loss of custody of a child.
“I can talk anyone into anything,” says Otto, friendly and smiling. “If I didn’t do this, I’d be selling Mercedes. And you’d be driving one today. Selling. That’s what we have to do to get better. I’m living proof. Look at AA, there’s millions.”
Otto points out that he’s not exactly getting rich pedaling his product of choice: quality of life.
“Addicts need to know how to deal with life,” he says. “Truthfully, when they come here, I don’t care how old they are, they haven’t done that yet. So any given day, we’re hanging around with a bunch of 50-year-old bodies in 12-year-old mental states. It doesn’t mean they can’t be president of a company. Addicts do it all the time.”
The sales pitch for recovery begins full force right away. Except for the patients who can’t get out of bed or are collapsing into seizures—a common, dangerous side effect when detoxing off alcohol—all patients are expected to attend three meetings a day. Keep ’em busy and re-focused, says Otto.
As the face of junkies continues to shift from unsavory characters scoring in the backrooms to teens nicking OxyContin and Vicodin and Percocet-popping moms, the role of the interventionist has become more proment. Meet Vincent Ceraso.
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