Addiction: Why Can't They Just Stop?: New Knowledge, New Treatments, New Hope - Hardcover

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John Hoffman--Vice President of HBO Original Programming, has spent the past eleven years creating, producing, and supervising documentary programming for HBO, including the ADDICTION project, Hacking Democracy, the Emmy-nominated Last Letters Home: Voices of American Troops from the Battlefields of Iraq, and In Memoriam, New York City, 9/11/01. Before coming to HBO, Hoffman produced and created the children's television series Allegra's Window and served as executive director of AIDSFILMS, where he produced six multi-award-winning films, including AIDS: Changing the Rules.

Susan Froemke has more than twenty-seven nonfiction films to her credit, including the 1976 classic Grey Gardens and the 2001 Academy Award-nominated Lalee's Kin, an HBO film that was also honored at the Sundance Film Festival. A four-time Emmy Award winner, Froemke won a 2001 Grammy for her work as director and producer of Recording the Producers: A Musical Romp with Mel Brooks. Before starting her own company in 2003, Froemke was the principal filmmaker at Maysles Films, Inc.

Susan Cheever is the bestselling author of twelve books, including five novels, the memoirs Note Found in a Bottle and Home Before Dark, My Name is Bill, a biography of Bill Wilson, the co-founder of Alcoholics Anonymous, and most recently, American Bloomsbury. She is a director of the Corporation of Yaddo, a member of the Authors Guild Council, and teaches in the Bennington College MFA program and at the New School.

Sheila Nevins, president of HBO Documentary Films, is responsible for overseeing the development and production of all documentaries and family programming for HBO, Cinemax, and their multiplex channels. During her tenure at HBO, she has received seventeen Primetime Emmy Awards, twenty-four News and Documentary Emmys, and twenty-five Peabody Awards. Nevins has also been honored with a Personal Peabody in 2001 and an Emmy Lifetime Achievement Award in 2005 for her contributions to the art of the documentary.

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Why Can't They Just Stop?

It was like a hard-hitting reality--"I am an alcoholic." I am one of those people I see on TV. I am one of those people I used to criticize, thinking, How can they be so weak?

JULIE, RECOVERING ALCOHOLIC

It was December, a peaceful evening, the sidewalks covered in fallen leaves. Along with a few colleagues, Timothy* ducked out of his office. The 42-year-old engineer wore a new blazer and gray wool slacks underneath a gray overcoat, which he pulled tighter when he felt the cold night.

Timothy, tall with hazel eyes and dark hair parted on the side, ran a small, elite R&D division at a software company. He was a popular boss. He loved his job, though not the required seasonal office parties like the one he was walking to that evening.

En route, Timothy held back from his colleagues for a moment. Retrieving his cell phone from underneath his coat, he dialed home. Lara*, his wife, answered on the first ring. Their 14-month-old was singing in the background and banging on a toy drum.

After asking about the kids and Lara's day, Timothy promised, "I'll be home in a couple of hours. I'll escape as quickly as humanly possible." When Lara told him to have fun, he half groaned. "You know what these things are like," he said. "I'll pay my respects and be home soon. I love you."

"I love you."

The restaurant was decorated for the holidays with twinkling white lights, a flocked Christmas tree, and red-leafed poinsettias on white-clothed tables. A jazz combo, set up in a corner of the room under mistletoe, played a vaguely recognizable version of "O Holy Night."

Timothy's colleagues dispersed, making their way toward other early arrivals, and meanwhile a waiter approached him and asked what he would like to drink. Without giving it a second thought, he asked for a sparkling water. In recovery for three years, he had made sparkling water a habit. At AA meetings, he joked that it had become his drug of choice--having replaced the drugs that previously had vied for that title: cocaine, methamphetamine, and prescription pills such as Valium and Vicodin. It was those drugs, when mixed and combined with a new Toyota Prius, that landed him in a hospital emergency room. The car was totaled but he was fine. Miraculously. The greatest miracle, however, was that he had driven his car into a tree and not an oncoming car. Afterward, he dwelled on this detail. A head-on collision probably would have been fatal, but that wasn't the worst scenario. Much worse, Timothy knew, would have been to have survived the accident but harmed someone. Or killed someone. He could not have lived with that. It was a sobering realization. Figuratively and literally.

Timothy claimed that even if not for the DUI and threatened criminal charges, he would have checked into rehab. It was his second time. In the initial rehab three years earlier, he learned that there's a myth that addicts and alcoholics have to hit bottom--whatever that is--before they become sober, but the reality is that everyone is different--there is no predicting what will impel someone to seek treatment. That first time, he had been in wretched shape. His wife had threatened to leave him if he didn't get help. But the accident was the clarion call of the variety that many addicts speak about in twelve-step meetings. "I got it," he would say when he told his story. "Only by the grace of God was I still here. That was that. I checked myself into treatment." For the second time. He promised his wife--he vowed--there would not be a third time.

Since then, he and Lara had another child, a beautiful daughter with large brown eyes and a serene smile. His career, which had floundered while he used, was back on track. He was committed to recovery, a regular attendee at Alcoholics Anonymous meetings. He had a full life, a happy life.

At the Christmas party, soon after his call home and after he ordered the sparkling water, something caught Timothy's eye. Later, he describes it. "It sat there on an isolated table," he says. "The rest of the room--the people, the sounds, the light--it all faded away. I sort of laughed it off. Like God was testing me. You can't fool me, I thought." A glass of Scotch, abandoned, set by a poinsettia on a white table, illuminated as if by a spotlight. He walked over, picked it up, and sniffed it. "A billon thoughts went through my mind," he explains afterward. "A billion thoughts and no thoughts." He spoke wistfully. "The glistening amber liquid. The intoxicating smell. Wood smoke. Euphoria."

Maybe, in that moment, he could have made a different decision--or maybe that moment was too late. "My mind simultaneously raced and froze," he says. "I thought, After three years a sip won't hurt. I am so bored. What a waste of good liquor. I deserve it. I hate parties. It's a night of celebration. Christmastime. I am impervious. I am one of the lucky ones. My gorgeous children. My family. Three years sober and a sip. A sip. Half thoughts like those and no thought at all."

He says it was almost like watching someone else--someone in a movie. Like he left his body. He felt a sense of horror, he says. Horror and also, incongruously, reckless delight. He sipped the Scotch. He breathed it. The taste was "heaven." He sipped again. "Glorious." He drained the glass. The reaction inside his head was instantaneous and intense. "I was filled with electric warmth," he recalls. "A smoldering fire was rekindled. I felt enlivened. The taste was . . . and I felt so . . ." He could not find the exact words. "I was horrified and felt perfect, both, but perfect won."

He said the required goodbyes and left the party. Again wrapped in his overcoat, walking to his car, he thought, See? They say that I can't have one drink. I can and I did. A glass of Scotch. One glass. I am in recovery. Three years. My judgment isn't impaired. It's sharper than ever.

Driving, he thought, One drink. I missed the taste. The faint buzz. No problem. I've licked my addiction. Maybe "they"--"they" in the rehab programs, "they" in AA meetings--can't have just one, but I am not like them. I never have been. I talked the talk and walked the walk. I played along. But I'm not like them. He laughed. Aloud.

He drove home, had every intention of driving home. His car came to the same intersection he drove through every morning and every evening before and after work. The car turned. By itself. Left instead of right. He smiled. Nervous now. The car had a mind of its own. Right would have led home. Left led to . . .

Peter*.

For a little holiday cheer, he told himself. I deserve it after three years. Everything is in my life is great. Celebration. I am not like them. One line.

Some addicts think it's okay to drink or smoke--"Just a little pot," "One beer"--as long as they don't use whatever was their drug of choice. However, according to Richard Rawson, PhD, associate director of UCLA's Integrated Substance Abuse Programs, an addict is far more likely to relapse on hard drugs if they drink or smoke marijuana.

Driving this familiar route, Timothy felt what he later describes as "a secret thrill. It filled my body." Driving itself, the car wound down a quiet suburban street--he chuckled as he always did when he turned on the road because it was called High Street--and pulled over in front of a cheery house. Peter. His friend. His buddy. The house dressed brightly for the holidays with a wreath on the front door.

Inside, after a bear hug from Peter, he noticed a clock. It was 7:30. Early. Plenty of time. At nine o'clock, he ignored his chiming cell phone. It rang again at 9:12. Then again. At 9:30, after the incessant ringing, he shuddered and turned off the phone. At dawn, he thought, I am making up for lost time. I'm flying. How I have missed this in my life. Who have I been kidding? Later he...