Intervention Part II: Detox

Before an addict can reach 12 steps, he or she has to get through the door.

By Tara Murtha
Add Comment Add Comment | Comments: 9 | Posted Nov. 10, 2009

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Power clean: Jack Otto, Director of Detoxification Services at Livengrin, designs programs to keep addicts in treatment.

This is Part 2 in the series. Read Part 1 of this series here. Read Part 3 here.

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.

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Comments 1 - 9 of 9
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1. Anonymous said... on Nov 11, 2009 at 09:27AM

“Good Stuff! My only comment is - you most certainly can die from withdrawal, and that fact should never be downplayed. This is why well-equipped detox facilities are so important. I like how Otto points out that addicts can be anybody - so many people do not realize this! If more realized how prevasive addiction is, I think there wouldn't be nearly as large of a stigma as there is now, and there would be much more done to help addicts and their families.”

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2. Anonymous said... on Nov 11, 2009 at 11:14AM

“from the article: "You PROBABLY won’t die from withdrawal"”

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3. Anonymous said... on Nov 11, 2009 at 02:31PM

“I know, I read it correctly. I just thought that it downplayed the seriousness of withdrawal, that's all.”

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4. Anonymous said... on Nov 11, 2009 at 03:07PM

“Livengrin saved my son's life. Enough said.”

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5. been there said... on Nov 11, 2009 at 03:16PM

“I hope that people who need help or have someone needing help will see past all the uncalled-for "dramatic writing" to the real message of the article. This reporter made the place sound like a bad TV show, with people in pain writhing on the floor surrounded by disdainful therapists with smirking remarks. It doesn't happen, Livengrin did OK by me. It's been around for a long time, the people are great. Going through detox, while a very painful thing, is not like it was portrayed and it's very important to the recovery process. Here's an ad for Livengrin - they really help.”

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6. Anonymous said... on Nov 11, 2009 at 03:54PM

“I don't really think this is dramatic writing. In fact, this article actually gave me a sense of detoxes being supportive and helping. I reread it and still feel the same way. However, unlike "been there said..." I haven't been through the process. Maybe it's just what YOU read into it”

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7. Amy said... on Nov 12, 2009 at 07:39PM

“They tried to make me go to rehab but I said no, no, no____________
Yes I've been black but when I come back you'll know, know know___________
I don't got the time____________
And if my daddy thinks I'm fine_____________
You tried to make me go to rehab but I won't go, go, go”

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8. Anonymous said... on Nov 18, 2009 at 08:16PM

““You know how you tell when an addict is lying?” he asks. “His lips are moving.”

You gotta be kidding me. Look, if an addict is lying to you it's because of 2 things: 1) He's desperate for something and you haven't built enough trust for him to be honest or 2) You've been working with him and should have some trust by now but you're a dick and don't deserve his respect.

Livingrin is great, especially compared to some of the other places CBH might send you. But this Ceraso guy has got to get over himself. Interventions don't work for most people because they're all about guilt and that is all about other people. Sure, maybe we'll go to rehab, but if you're not doing it for yourself it's not gonna stick.”

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9. Anonymous said... on Nov 18, 2009 at 11:31PM

“You know..."This Ceraso guy" is the best there is. He helped me get sober, I'm in my third year and couldn't have done it without him, period. He's helped SOOOO many go straight. Get over your addiction and you'll see that he doesn't need to "get over himself"...he just needs to open your eyes, and he does.”


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