Guinevere Gets Sober

Recovery news, reviews and stories, by Jennifer Matesa.

Tag: relapse (page 1 of 3)

Could Proper Standards of Care Have Saved Robin Williams?

Cross-posted with Recovery.org.

Robin Williams fish

Why does addiction care still, too often, lag behind the care you’d receive for other illnesses? I asked three addiction doctors how we can reimagine treatment as an ongoing collaboration.

When I first heard that Robin Williams died, of course I thought, Another overdose. But when I read “suicide due to asphyxia,” I remembered a 2013 statement from his publicist, which the media is now repeating into an echo chamber: Williams last year checked into rehab to “fine-tune” his sobriety.

What does fine-tuning your sobriety mean?

That the vagueness of this statement was accepted without question in the major media illustrates not only the media’s lack of knowledge about addiction but also the vast gray area in which addiction treatment operates. As a person recovering from addiction, I have the only life-threatening illness I know of in which I’m expected essentially to diagnose myself and oversee my own treatment and recovery.

Would we expect someone with cancer to diagnose herself? Hell, no. Does anyone with cancer check into the hospital to “fine-tune” her treatment? Well, in fact, maybe—if, for example, she were experiencing new symptoms that indicated a complication in her standard system of care. The physician might then use a physical exam and tests to retool the treatment accordingly.

And this is how some physicians are beginning to imagine addiction treatment: an ongoing collaboration between patient and doctor to carefully oversee lifelong recovery.

“I imagine people in recovery regularly seeing an addiction medicine physician,” Kevin McCauleyM.D., medical director of New Roads Treatment Center in Sandy, Utah, tells me. With his background as a Marine pilot and flight surgeon, and with eight years in recovery from painkiller addiction, McCauley talks about taking newly sober people through a system of recovery, in the way soldiers returning from war with injuries are led through recovery practices.

“The team assesses the condition, assigns names to the injuries, and takes the individual stepwise through exercises and therapies to get them where they can, for example, grasp a cup, and then walk again,” he says. “We would regularly see an addiction medicine physician. As I pass through my recovery through the rest of my life, I need to be in that collaborative relationship with a professional.”

But such a collaboration requires standards of care, which are sorely inconsistent—or even nonexistent—in addiction treatment.

Robin_Williams_fork

What is the Standard of Care for Addiction Treatment?

“I don’t think there is a standard of care—I think that’s evolving,” says Michael V. GenoveseM.D.J.D., the incoming medical director of Sierra Tucson in Tucson, Arizona. “It’s just becoming apparent to people that addiction is a disease. So that’s the first step, and now there will be a medical model that surrounds it.”

I don’t think there is a standard of care—I think that’s evolving…It’s just becoming apparent to people that addiction is a disease. So that’s the first step, and now there will be a medical model that surrounds it.—MICHAEL V. GENOVESE, M.D., incoming director of Sierra Tucson treatment center

Many people, especially some in 12-step abstinence-based recovery—which emphasizes humility—think that celebrities shouldn’t be given any more attention than any other recovering person, and there’s some truth to this. But when Philip Seymour Hoffman died, I wept. He was just a couple years younger than me, and what further choked me and so many others was the abbreviation of his artistic contribution.

McCauley blames the lack of a standard of care for such deaths. “It’s a terrible idea to leave detox and go home,” he says of Hoffman’s situation. Hoffman had relapsed after 23 years of abstinent recovery; he had apparently gone into rehab, been given Suboxone and gone home.

“If the standard of care had been [to give him] naltrexone for at least a year, and in that time get [his] rather considerable and proven recovery skills back up to snuff, that man would have lived,” McCauley says. Both Genovese and Harry HaroutunianM.D., medical director of the Betty Ford Center in Rancho Mirage, California, agree. Betty Ford is now a part of the Minnesota-based network of Hazelden, through which Williams sought to “fine-tune” his recovery.

Opinions differ on the kind of practitioner that might best oversee the process of recovery. “An addiction medicine physician also needs to be thought of as an addiction recovery physician,” says Haroutunian, who is himself a recovering alcoholic. “Certainly addiction physicians who are themselves in recovery and have good recovery may be best suited to help observe and guide someone who’s on that path from the dangers—everything from identifying other addictions such as workaholism, to relationship problems such as codependency, to excessive exercise or eating habits and nutritional deficiencies.”

“I understand [Haroutunian’s] point,” says Genovese, a board-certified addiction psychiatrist who is not in recovery, “but I think some of the best oncologists may never have had cancer. The best cardiologists don’t necessarily have cardiovascular disease.” He doesn’t think that the practitioner overseeing care needs to be a psychiatrist: “It could be an internist, an addictionologist, any practitioner with additional training in addiction.”

Many are saying that it was depression that killed Williams. People said the same thing about the author David Foster Wallace, who hanged himself at 48 after a lifetime of struggling with both addiction and mental illness. But you only have to look at the clips of Williams’ performances on YouTube to know that he had been a hard-core alcoholic and addict and that he negotiated sobriety on a daily basis. (Likewise, you only have to read Wallace’s writings—Infinite Jest, for example, or his essay, “This Is Water”—to find his struggle with addiction and his understanding of recovery.)

Robin-Williams-robin-williams-23183287-1600-1200

Williams’ cocaine clip has 2.5 million views, and his bit about alcohol and weed has almost 6 million. Some of my favorite bits—inexplicably, because I never copped on the street—are of Williams “doing” drug dealers. In a Thanksgiving appearance on Craig Ferguson’s show he does a “turkey-dealer” selling tryptophan; he and Ferguson (another recovering alcoholic) riff about knocking back heroin and Jack Daniels to get through the holidays and take turns making each other laugh their asses off.

Williams had been sober 20-odd years before he started drinking again in 2006. Nobody seems to know whether he carried on and that’s what necessitated the “fine-tuning” trip to Hazelden, or whether he’d climbed back on the wagon. But whatever happened, addiction was a major part of the mix, and like most of us in recovery who wake up and want to either bang our favorite drug or suck on our exhaust pipes, he wasn’t getting enough help.

Eventually, that help might look like the kind of support patients get when they have cancer, diabetes, cardiovascular disease, even near-sightedness—any chronic health problem that requires regular follow-up visits with medical specialists who operate according to scientifically backed protocols, measurable outcomes and standards of care. According to McCauley, “That’s what recovery oversight ought to look like.”

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Robin Williams, Alone.

Robin Williams

This morning I read a transcript of the coroner’s press conference about the scene of Robin Williams’s suicide. (I came across it on Facebook, where it was posted by Salon’s social media person with the strange warning, “Proceed with caution.” Badly done, Salon. Linking to a gruesome description of someone’s hanging body with a note that sounds flippant is at the very least mean.)

I read the transcript three times. I read it the second time because, the first time around, I couldn’t understand how his body was positioned. I still can’t. Frankly the first thing I thought of was that scene in season 2 of “The Wire” when D’Angelo is strangled to death by Stringer’s guy, but Dee’s body is left to look as if he’d hanged himself by a belt suspended from a door. It doesn’t work: there’s not enough gravitation to cut off the airway.

But I read the transcript a third time because I couldn’t understand how Williams could have been left alone for so long. In other words, how he could have been found so many hours after he had died.

He was living in a house in Tiburon, on San Francisco Bay, with his wife of three years. The report said she’d last seen her husband at 10:30 p.m. Sunday night, when she went to bed. Or, as the report said,

when she retired for the evening in a room of the home. 

By herself, is the tacit qualification here. I mean, if she’d been sleeping in the same room, to say nothing of the same bed, as her husband, it would have been more likely that she’d have noticed him getting out of bed in the middle of the night and scurrying off down the hall to loop a belt around his neck, shove the other end between the door and the jamb, and somehow—I don’t understand how, probably because I don’t really want to understand—suspend his body to hang himself.

So they were probably sleeping in separate rooms.

And here’s the thing. He wasn’t found by his wife. He was found by his personal assistant. The employee knocked on the door at 11:45 a.m., more than 12 hours after Williams’s wife had last seen her husband, and couldn’t raise his boss. So the assistant went into the room, the assistant found the body.

Robin Williams and Matt Damon

I’m thinking about this report in this way because I think a lot these days about the commonalities of people who are suffering for various reasons. If Williams died in this supremely lonely way, then you can bet there are hundreds, thousands of others who have died this way: sneaking off to loop belts around their necks, suck on exhaust pipes, take too many pills, shoot too much dope. Stick guns in their mouths. Jump off bridges.

I’m also thinking about the fact that Williams went back to drinking after having quit for more than 20 years. One of my friends, who has several more years sober than I do, wrote on Facebook yesterday afternoon:

It’s hard to describe the agoraphobic, upside-down sensation that strikes me when I read the words “falling off the wagon after 20 years of sobriety.”

That’s what the press kept saying about Williams: he’d fallen off the wagon after 20 years.

(They also kept saying he went into rehab last year to “fine-tune” his sobriety. Which doesn’t mean a damn thing. The fact that this statement by his publicist was accepted without question is proof of the huge gray area in which addiction treatment is allowed to operate.)

But most of all I’m thinking that stories like this one—which are emblematic of the untold stories of ordinary people who die similar deaths, who wade through similar struggles to stay sober, do their work, love their kids, pay their bills, survive divorces, and just be human—make me grateful for a quiet, ordinary life. Famous people can’t go anywhere without people recognizing them and wanting a piece of them. While this may not generally be something to pity them for, it puts real restrictions on recovery practices. Eminem, for example, doesn’t go to meetings, because when he does, people want shit from him all the time. This is true of most famous people. When Williams went to rehab last year he clearly couldn’t even buy an ice cream cone without the dipper asking him to pose for a picture and without some fucking journalist (we pain in the ass journalists, oh man) writing a bit about it.

Robin Williams Dairy Queen Minnesota

When I was using I used to think that no amount of fame or money would be enough to make me safe and prove I was worth the space that my feet take up on the planet. I used to lie in bed, eyes riveted open by hunger and whacked out diurnal cycles and fear, wondering what was the amount that would make me safe—$1 million? $5 million?

Any amount is too much, and no amount is enough.

Of course on the other side of this statement is the quiet little whispering voice that Williams himself called “the lower power,” the voice that whispers You can have just one little bottle of Jack Daniels or You can steal those Vicodin and be OK. Or: $5 million, I think about $5 million would do it. Which is exactly the reason I go to meetings, because none of those options are possible. Even if I had $5 million, which I don’t, $5 million would be way too much and not nearly enough to solve the problem of the kind of sickness Williams had. That I have.

Williams (Winehouse, Houston, Ledger, Jackson, Hoffman) had big houses, cars, fans, millions of Twitter followers, check-mark-verified social media accounts. They had personal assistants or private physicians or physical trainers who shot them up with drugs (in Jackson’s case) and knocked on their doors in the morning, couldn’t rouse them, called the cops (or strangely enough, in Ledger’s case, called either Mary Kate or Ashley Olsen—I can’t remember which. As if it matters).

They had all that stuff. But they didn’t have the component of life that, in Stephen King’s words, “stills the demons.”

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The Treatment that Might Have Saved Phil Hoffman.

Cross-posted with AfterParty Chat.

Philip-Seymour-Hoffman

Late last week it was suggested that a cultural stigma against maintenance medications such as methadone and Suboxone helped kill Philip Seymour Hoffman.

This doesn’t make much sense to me given the fact that, shortly after he died, it was reported that buprenorphine was found in Hoffman’s Bethune Street apartment. Buprenorphine is a long-acting opioid the FDA approved in 2002 for opioid detox and maintenance. It’s used mostly for maintenance: it’s the New Methadone, but it’s much easier to get, because while methadone is approved for addiction-treatment only in a clinic setting, buprenorphine can be dispensed in a doctor’s office. Refills can be called in or faxed to pharmacies.

So how did Hoffman get his bupe? Either he was being prescribed buprenorphine for his opioid habit, i.e. he was “on maintenance”—as so many opioid addicts are: buprenorphine maintenance is a booming business in this country. Or else, as many heroin users do, he obtained his buprenorphine on the street.

Poor heroin users often cop street “bupe” to tide them over between fixes. But Hoffman was far from poor. So it’s speculation, of course, but I think it’s more likely he got his buprenorphine from a doctor. That’s what doctors do these days with opioid addicts: When we get honest about our addictions inside the exam room (and because Hoffman had spent 23 years sober and abstinent via 12-step fellowships, it may be fair to say he had practice in being rigorously honest) the doctors’ fear kicks in and they boot us into Suboxone clinics, where we’re prescribed upwards of 16mg of this very strongly-binding, fat-soluble drug that stays in our bodies for days before it’s excreted. In painkilling power it’s weaker than morphine or oxycodone, but in binding power—in its ability to stick to the body’s opiate receptors—it’s the second-strongest out there.

The strongest is fentanyl, the drug that’s been cut into heroin and has killed nearly two dozen in my region alone.

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812

Some publications are wont to report that opioid addicts—like Hoffman, like me—wreck our brains’ opioid receptors forever through drug-use. (This proves they don’t understand how the body’s painkilling system works: a great portion of the body’s opioid receptors actually reside in the gut. Which is why we get that lovely warm feeling throughout our bellies when we use painkillers or shoot heroin.) But there’s at least as much scientific and anecdotal support for the idea of neuroplasticity in recovery—the fact (it’s not just an idea anymore, it’s a fact) that the central nervous system is far more adaptable than we ever before believed and is evolved to use this resilience to recover from major traumas and illnesses, including addiction—especially if we help it by taking care of our bodies in basic ways, with exercise, good nutrition, and relaxation.

So the “old-school” idea is not 12-step programs, as these pieces suggest. “Old-school” is what I was taught as a kid: that once you lose brain cells, you never get them back, that our nervous systems cannot heal.

Still, these publications are putting the idea out there—and it is not a fact, it is just an idea—that if “most opioid addicts” don’t take maintenance medications forever to “correct” the “permanent damage” we’ve done through drug-use, we’re doomed to relapse.

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Philip Seymour Hoffman just four or five years before he got sober, in his 1985 high-school senior-year portrait.

Philip Seymour Hoffman just four or five years before he got sober, in his 1985 high-school senior-year portrait.

The clearest example that this isn’t the solution exists in our states’ physician health programs (PHPs)—systems of recovery designed to help addicted and alcoholic physicians keep their licenses to practice. These programs vary from state to state but generally provide five years of continuous care and oversight. Success rates for PHPs are extraordinarily high—upwards of 80 percent of physicians finish five years of treatment and are able to keep practicing.

These programs ought to be considered models for our citizenry. But they remain off the radar because they’re rigorous, expensive and intensive—five years, as opposed to a 28-day rehab, or even a ten-day or three-day detox.

Also, studies of PHPs show that linking recovery to one’s work is one of the strongest incentives you can give an addict to take responsibility for healing. Addiction thrives in situations of un- and under-employment not because the poor are somehow more susceptible to addiction, but because the people affected don’t have enough, or any, productive work.

It’s sometimes said that PHPs are effective for “highly motivated” addicts. Which leads me to my last point. I find it astonishingly patronizing that some are suggesting that public prejudice against maintenance killed Hoffman. Hoffman was an extraordinarily intelligent, articulate, “highly motivated” man and consummate professional whose work, he said, required him to be extremely introspective and emotionally present. I find it hard to believe he would be so easily swayed by public opinion about his choices.

I can more easily see him protecting his ability to work.

To act with the depth of feeling and nuance that he managed required full use of his entire internal emotional range. And opioid medications—including buprenorphine—necessarily dull one’s range of feeling.

I think it’s more reasonable to suggest that Hoffman tried bupe and found that, while taking it, he couldn’t access his feelings to the degree to which he’d become accustomed.

To be sure, he likely felt a great deal of shame during his relapse. One of the more damaging aspects of some 12-step groups, in my opinion, is their focus on “sober-time”: to “come back” from a relapse after a sober period of 23 years—half one’s life—would have been not only extremely embarrassing for anyone but also physically difficult, given that the heroin available these days is wicked strong.

But no way could Hoffman have wrecked his neurology permanently by using heroin for less than a year. I think it’s likely he did what so many who use heroin do: he chipped heroin, then switched to bupe, thinking it might remove his cravings. In fact, buprenorphine reliably does this for many opioid addicts who take it.

But craving is a feeling, and you can’t numb feelings selectively. My bet is that, feeling not-high but not-normal—after all, he’d been sober for 23 years: he knew what His Normal felt like; he knew what it took for him to do his job with the precision and quality with which he was used to doing it—he said what so many of us say when we’re caught between a rock and a hard place.

Fuck it.

What he needed was not more drugs. What he needed was a better form of treatment, perhaps the best evidence-based addiction treatment system we have going: the time-consuming, attentive one we give to doctors, the people we trust to protect other people’s lives.

But because Hoffman was “just” an artist, he followed the cheap, easy, brief trajectory that ordinary people in this country follow.

Pills. Then heroin. Then Suboxone. Then heroin again. Then death.

Hoffman in perhaps the last photo ever taken of him, a tintype made by Victoria Will two weeks before his death.

Hoffman in perhaps the last photo ever taken of him, a tintype made by Victoria Will two weeks before his death.

Suboxone: Addiction, Recovery, And Self-Confidence.

Hi folks, good to be with you again.

I miss writing on this blog. I used to file two or three blogs per week. That was before I got a job—several jobs, actually. I need to earn my daily bread, and I need to take care of my kid, who the other day flipped over head-first, fell on his head and shoulders, and was back-boarded off the soccer field (he’s OK but yes—shocking to watch the trainer test him for paralysis and hear her say, “We have to call an ambulance”). So sometimes the blogging goes by the boards. I’ve been filing a lot on my Facebook page, but you have to be my friend to see it. So, won’t you be my neighbor?

Been teaching writing to university students. An interesting experience: the last time I taught was four months before I got sober. The other day I was sitting in a meeting next to an acquaintance in recovery, a woman sober about two years who just got tenure at one of the universities in town, and I told her I was teaching again. “Teaching sober is AWESOME!” she said. This is someone who does not usually include the word “awesome” in her lexicon.

“I know!!!” I said. I am someone who usually does not speak with multiple exclamation points.

Teaching sober is, in fact, awesome. The best thing about it is that, having practiced Step 10 on a regular basis for four years, I now have a much better sense of what’s my responsibility and what’s not. Which enables me to relate to the kids (they’re kids: they’re just three or four years older than my kid) on a much clearer basis than when my head was wrapped up in films of fentanyl.

In other words, I have more confidence.

The root of the word “confidence” is the Latin fidere: fidelity, trust.

Sober, I can trust myself. At any rate, much more than I could when I was taking drugs.

It is 3 a.m. and I’m writing this because I got up to pee, checked my phone, and this email came in overnight. She is taking drugs to feel self-confident. She wants help.

The drug she is taking is Suboxone. She was using heroin for five months—“five long, brutal months,” she writes, “and even though that’s a short period of time compared to most people, I was really addicted”—and her doctor put her on Suboxone. Her doctor told her taking it for three months would lead to a lower “success rate” than taking it for at least eight. (I’d like to see the data behind the claim, and I’d like to know who financed the studies.) So she took it for a year—along with two antidepressants and a long-acting benzodiazepine.

No idea what kind of doctor she went to, but in fact family doctors and internists, who are generally ignorant about addiction and recovery, can prescribe Suboxone, a long-acting fat-soluble opioid that’s more powerful, milligram for milligram, than heroin. Just as family doctors and internists, who are generally ignorant about mental illness, can prescribe antidepressants—drugs that also change the brain, usually not for the better, according to Robert Whitaker, who wrote a comprehensive and almost universally acclaimed book on the subject of psych meds and mental illness. Any time-frame over six weeks is considered “long-term” treatment by most physicians and researchers, and lots of folks wind up on these drugs indefinitely.

My reader writes,

I have been living with the knowledge for about 18 months that Suboxone is this wonder drug. It turns out I didn’t know too much about it. I kept a couple of the film strips in case I felt like I was going to relapse. One day I took the Suboxone after about three months of being off of it and I felt so high that it scared me… so I tried it again after.

Of course she tried it again. She’s an addict, and she has drugs in her stash.

This person has a job, too. She’s a college student, like my students. She’s studying to be a doctor, “so I could go help people with the problems I had,” she writes. And since starting school in August, she’s been on “a Suboxone binge,” she says.

Not to get high, but because it gives me my confidence back.

She needs confidence. She has to make friends, she writes. “I became socially awkward after my addiction”—as though her addiction is “over”—“and I felt like I needed it to talk to people.” So now she’s back to taking it every day.

Just little, tiny pieces, probably like 1/9th of a pill a day, but I don’t want to take it anymore, and I want my confidence and ability to talk to people back… can you please help me?

I have news for whoever is reading this who thinks that one-ninth of a Suboxone pill isn’t a lot. If it’s one-ninth of an 8mg pill, then that’s almost 1mg of buprenorphine, and that’s roughly equivalent to 30mg morphine. Which ain’t nothin to sneeze at.

This 18-year-old girl (she is 18: she told me) is taking drugs simply because she wants to trust herself. She has a drug that gives her that fleeting feeling of self-trust. She knows it won’t last.

These emails I get from readers feel like silk threads that bind me to folks around the world who are desperate for help with their drug problems. It’s like each of these people is Spider-Man, firing out webs that reach around the world and go straight inside me and attach themselves there. And they pull.

To my reader: your addiction is not “over.” If indeed you were “addicted” to heroin, then you are an addict. Being an addict doesn’t mean you’re a low-life. It means you have an illness, and like anyone who is ill you need to learn to take care of yourself. To do this you must ask for help In Real Life. However scary it might seem.

On the other side of that reality of needing to ask for help is this problem my reader will most likely run into: she may go to her doctor and tell him that she stashed her films and she’s been using again. You know what may happen? He’ll decide she’s a “chronic relapser” and put her back on Suboxone, perhaps at a higher dose, perhaps for a longer time. She is 18. Her brain and central nervous system aren’t really even out of childhood.

She writes, in a voice that is perhaps not self-confident but certainly reaching toward self-awareness,

I don’t want to take it anymore.

“I don’t want to take it anymore.”

The famous scene with Peter Finch from the film, “Network.”

I’m mad as hell and I’m not gonna take it anymore.

Reader, there are two ways I might be able to help you. One is to suggest you call Alcoholics Anonymous or Narcotics Anonymous and get help from real people who have been through this (and worse). Don’t Take It Anymore.

The second is something I think I need to do for all the folks who write in, to me and to forums for drug addicts, saying they can’t quit Suboxone. And that is to write about Suboxone.

If you have a story you want to tell about how Suboxone either helped you or kicked your ass, please email me at guinevere (at) guineveregetssober (dot) com.

In Real Life: Meeting Allgood.

Have you ever met anyone online who means a whole lot to you—you’d take their middle-of-the-night calls, you’d give them food or shelter, you love them, but you’ve never seen their face?

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A couple weeks ago I get this Facebook message:

Hey, so I’ll be driving through your state next week. I’ll be on I-80 heading east… could we meet for lunch? I would like that. Let me know. Love

It is “Allgood” writing.

Mid-30s, Mark Wahlberg-ish accent, former heroin addict, one of my mainstays when I was first getting sober. “Allgood” is his screen name.

Stoked to try to work this out. End of school year; teaching, writing, driving the boy around; schedule has been impossible. But this dude was one of the first and most dependable folks I met when I started looking for sober people online. He tells it like it is. He was so honest and direct that he freaked me out. He’s kind, and he’s no-bullshit: two qualities I admire in anyone. (Sometimes the no-bullshit comes before the kindness; sometimes vice-versa, as with anyone, right?)

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I met Allgood on Opiate Detox Recovery, the place where I became Guinevere, when I was in detox in 2008. Allgood is a former East Coast stocks trader and IV addict who has been sober since spring 2008. Just before I detoxed, he was Getting It after many, many, many tries. He had been looking at jail time. He picked sobriety instead.

How he stays sober: he helps other people. He has written almost 5,000 posts to people (including myself) trying to kick drugs of one kind or another. He is busy changing his work and moving across the country so he can help more people.

And the people online who helped him?—they were telling him their stories, they were giving him their numbers, they were offering to take his dog while he went to rehab, for chrissake. The help just goes around and around.

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It’s in the back of my mind: Allgood will be here in a couple days, he’s coming in north of my town and this is a bridge-and-tunnel city, I never venture into the suburbs, so I kind of wait for some burst of inspiration about a meeting place till I’m sitting at a soccer match last week and my phone lights up with a text:

Is our gathering happening, G?

Yes, dammit. It is. I sit there at dusk in the dewy skeeter-ridden grass and watch my kid score a goal, then I use an app to nail down a place. I text him the address so in case he has GPS he can plug it in. He writes:

Sweet! Can’t wait!!! See u there

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It’s 85 degrees at 5 p.m. in the shady parking lot of this restaurant, and I am on the phone with a 20-something woman in the program when I see him open his car door. He has already warned me he’s in “super-duper driving-cross-country casual dress” and I see that he’s wearing three or four days’ growth of black beard and black flip-flops. He tells me to take my time with this girl and my conversation winds down, and then Allgood is standing in front of me, and I put my arms around him, and it was like the time my son and I hugged one of the redwoods in Marin County. We just leaned in.

In Marin County with my boy, four months out of detox.

Marin County and the redwoods—that was three years ago, March 2009.

Allgood was steady.

When I relapsed in January 2010, I told my friends on the forum. A lot of people were surprised and some expressed shock, disappointment, and even feeling “doomed” if Someone Like G could relapse (for godsake). Because I can talk a good talk, I sounded most of the time as though I were doing real well. (I’m still learning how to apply the principle of rigorous honesty to my relationship with myself, and also how to ask for help and then to accept it.)

Allgood’s boat wasn’t rocked. Allgood had tried to quit and had relapsed many times himself. Here’s what he wrote (in Post No. 999 on my thread) to the people who were disappointed and to me:

We are never “cured” from this disease of alcoholism and drug addiction. What we have is a daily reprieve contingent on our spiritual condition.

Sure, this is disappointing to hear. Am I surprised? Certainly not…

G—what was missing in your program this time? Are we willing to move forward and seek more this time? I’m hand in hand with you my friend. Much love

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“So, in my family we just kind of order, and share everything,” Allgood told me as we looked at the dinner menu. “Is that cool with you?”

I’m, like, hardly ever really hungry. I didn’t care much about the food. I wanted to see him smile. (It’s impossible to see someone smiling while writing to them over the Internet.) He told me some of his story I hadn’t heard before. I was having a very, very tough week last week, and he listened with deep attention and asked me questions about my experience.

I’d spoken to Allgood over the phone before and his years out West had taken the edge off his Marky-Mark accent. I ordered a crab cake on salad and he had scallops and salmon and at the end we split a funnel cake with cream on top, and we shared stories, and it was all good.

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I’ve met other sober people In Real Life who I’d first met online. Two in particular mean a lot to me, and they both live in New York. There are one or two on Long Island I’d like to meet. There’s another one in Jersey who I’ve never met but for whom I’ve made some art, and another in New Hampshire I want to make a date with in July. (These two have helped save my life.) There’s a guy in Iowa I wish I could connect with, a former fentanyl addict whose every post I read for several years before I even logged on as Guinevere. There’s one in L.A., one in San Diego, and one in Washington, D.C.

Have you ever met a sober person in real life who has helped you online? Are there sober people you know only online who are part of your sober community? Would you be willing to tell us about them?

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