The Hidden Deaths Of The COVID Pandemic

BROOMFIELD, Colo. — Sara Wittner had seemingly gotten her life back under control. After a December relapse in her battle with drug addiction, the 32-year-old completed a 30-day detox program and started taking a monthly injection to block her cravings for opioids. She was engaged to be married, working for a local health association and counseling others about drug addiction.Then the COVID-19 pandemic hit.The virus knocked down all the supports she had carefully built around her: no more in-person Narcotics Anonymous meetings, no talks over coffee with a trusted friend or her addiction recovery sponsor. As the virus stressed hospitals and clinics, her appointment to get the next monthly shot of medication was moved back from 30 days to 45 days.As best her family could reconstruct from the messages on her phone, Wittner started using again on April 12, Easter Sunday, more than a week after her originally scheduled appointment, when she should have gotten her next injection. She couldn’t stave off the cravings any longer as she waited for her appointment that coming Friday. She used again that Tuesday and Wednesday.“We kind of know her thought process was that ‘I can make it. I’ll go get my shot tomorrow,’” said her father, Leon Wittner. “‘I’ve just got to get through this one more day and then I’ll be OK.’”But on Thursday morning, the day before her appointment, her sister Grace Sekera found her curled up in bed at her parents’ home in this Denver suburb, blood pooling on the right side of her body, foam on her lips, still clutching a syringe. Her father suspects she died of a fentanyl overdose.However, he said, what really killed her was the coronavirus.“Anybody that is struggling with a substance abuse disorder, anybody that has an alcohol issue and anybody with mental health issues, all of a sudden, whatever safety nets they had for the most part are gone,” he said. “And those are people that are living right on the edge of that razor.”Sara Wittner’s death is just one example of how complicated it is to track the full impact of the coronavirus pandemic — and even what should be counted. Some people who get COVID-19 die of COVID-19. Some people who have COVID die of something else. And then there are people who die because of disruptions created by the pandemic.While public health officials are trying to gather data on how many people test positive for the coronavirus and how many people die from the infection, the pandemic has left an untold number dying in the shadows, not directly because of the virus but still because of it. They are unaccounted for in the official tally, which, as of June 21, has topped 119,000 in the U.S.But the lack of immediate clarity on the numbers of people actually dying from COVID-19 has some onlookers, ranging from conspiracy theorists on Twitter all the way to President Donald Trump, claiming the tallies are exaggerated — even before they include deaths like Wittner’s. That has undermined confidence in the accuracy of the death toll and made it harder for public health officials to implement infection prevention measures.Yet experts are certain that a lack of widespread testing, variations in how the cause of death is recorded, and the economic and social disruption the virus has caused are hiding the full extent of its death toll.How To CountIn the U.S., COVID-19 is a “notifiable disease” — doctors, coroners, hospitals and nursing homes must report when encountering someone who tests positive for the infection, and when a person who is known to have the virus dies. That provides a nearly real-time surveillance system for health officials to gauge where and to what extent outbreaks are happening. But it’s a system designed for speed over accuracy; it will invariably include deaths not caused by the virus as well as miss deaths that were.For example, a person diagnosed with COVID-19 who dies in a car accident could be included in the data. But someone who dies of COVID-19 at home might be missed if they were never tested. Nonetheless, the numbers are close enough to serve as an early-warning system.“They’re really meant to be simple,” Colorado state epidemiologist Dr. Rachel Herlihy said. “They apply these black-and-white criteria to often gray situations. But they are a way for us to systematically collect this data in a simple and rapid fashion.”For that reason, she said, the numbers don’t always align with death certificate data, which takes much more time to review and classify. And even those can be subjective. Death certificates are usually completed by a doctor who was treating that person at the time of death or by medical examiners or coroners when patients die outside of a health care facility. Centers for Disease Control and Prevention guidelines allow for doctors to attribute a death to a “presumed” or “probable” COVID infection in the absence of a positive test if the patient’s symptoms or circumstances warrant it. Those completing the forms apply their individual medical judgment, though, which can lead to variations from state to state or even county to county in whether a death is attributed to COVID-19.Furthermore, it can take weeks, if not months, for the death certificate data to move up the ladder from county to state to federal agencies, with reviews for accuracy at each level, creating a lag in those more official numbers. And they may still miss many COVID-19 deaths of people who were never tested.That’s why the two methods of counting deaths can yield different tallies, leading some to conclude that officials are fouling up the numbers. And neither approach would capture the number of people who died because they didn’t seek care — and certainly will miss indirect deaths like Wittner’s where care was disrupted by the pandemic.“All those things, unfortunately, are not going to be determined by the death record,” says Oscar Alleyne, chief of programs and services for the National Association of City and County Health Officials.Using Historical Data To Understand Today’s TollThat’s why researchers track what are known as “excess” deaths. The public health system has been cataloging all deaths on a county-by-county basis for more than a century, providing a good sense of how many deaths can be expected every year. The number of deaths above that baseline in 2020 could tell the extent of the pandemic.For example, from March 11 to May 2, New York City recorded 32,107 deaths. Laboratories confirmed 13,831 of those were COVID-19 deaths and doctors categorized another 5,048 of them as probable COVID-19 cases. That’s far more deaths than what historically occurred in the city. From 2014 through 2019, the city averaged just 7,935 deaths during that time of year. Yet when taking into account the historical deaths to assume what might occur normally, plus the COVID cases, that still leaves 5,293 deaths not explained in this year’s death toll. Experts believe that most of those deaths could be either directly or indirectly caused by the pandemic.City health officials reported about 200 at-home deaths per day during the height of the pandemic, compared with a daily average 35 between 2013 and 2017. Again, experts believe that excess is presumably caused either directly or indirectly by the pandemic.And nationally, a recent analysis of obituaries by the Health Care Cost Institute found that, for April, the number of deaths in the U.S. was running about 12% higher than the average from 2014 through 2019.“The excess mortality tells the story,” said Dr. Jeremy Faust, an emergency medicine physician at Brigham and Women’s Hospital in Boston. “We can see that COVID is having a historic effect on the number of deaths in our community.”These multiple approaches, however, have many skeptics crying foul, accusing health officials of cooking the books to make the pandemic seem worse than it is. In Montana, for example, a Flathead County health board member cast doubt over official COVID-19 death tolls, and Fox News pundit Tucker Carlson questioned the death rate during an April broadcast. That has sowed seeds of doubt. Some social media posts claim that a family member or friend died at home of a heart attack but that the cause of death was inaccurately listed as COVID-19, leading some to question the need for lockdowns or other precautions.“For every one of those cases that might be as that person said, there must be dozens of cases where the death was caused by coronavirus and the person wouldn’t have died of that heart attack — or wouldn’t have died until years later,” Faust said. “At the moment, those anecdotes are the exceptions, not the rule.”At the same time, the excess deaths tally would also capture cases like Wittner’s, where the usual access to health care was disrupted.A recent analysis from Well Being Trust, a national public health foundation, predicted as many as 75,000 people might die from suicide, overdose or alcohol abuse, triggered by the uncertainty and unemployment caused by the pandemic.“People lose their jobs and they lose their sense of purpose and become despondent, and you sometimes see them lose their lives,” said Benjamin Miller, Well Being’s chief strategy officer, citing a 2017 study that found that for every percentage point increase in unemployment, opioid overdose deaths increased 3.6%.Meanwhile, hospitals across the nation have seen a drop-off in non-COVID patients, including those with symptoms of heart attacks or strokes, suggesting many people aren’t seeking care for life-threatening conditions and may be dying at home. Denver cardiologist Dr. Payal Kohli calls that phenomenon “coronaphobia.”Kohli expects a new wave of deaths over the next year from all the chronic illnesses that aren’t being treated during the pandemic.“You’re not necessarily going to see the direct effect of poor diabetes management now, but when you start having kidney dysfunction and other problems in 12 to 18 months, that’s the direct result of the pandemic,” Kohli said. “As we’re flattening the curve of the pandemic, we’re actually steepening all these other curves.”Lessons From Hurricane Maria’s Shifting Death TollThat’s what happened when Hurricane Maria pummeled Puerto Rico in 2017, disrupting normal life and undermining the island’s health system. Initially, the death toll from the storm was set at 64 people. But more than a year later, the official toll was updated to 2,975, based on an analysis from George Washington University that factored in the indirect deaths caused by the storm’s disruptions. Even so, a Harvard study calculated the excess deaths caused by the hurricane were likely far higher, topping 4,600.The numbers became a political hot potato, as critics blasted the Trump administration over its response to the hurricane. That prompted the Federal Emergency Management Agency to ask the National Academy of Sciences to study how best to calculate the full death toll from a natural disaster. That report is due in July, and those who wrote it are now considering how their recommendations apply to the current pandemic — and how to avoid the same politicization that befell the Hurricane Maria death toll.“You have some stakeholders who want to downplay things and make it sound like we’ve had a wonderful response, it all worked beautifully,” said Dr. Matthew Wynia, director of the University of Colorado Center for Bioethics and Humanities and a member of the study committee. “And you’ve got others who say, ‘No, no, no. Look at all the people who were harmed.’”Calculations for the ongoing pandemic will be even more complicated than for a point-in-time event like a hurricane or wildfire. The indirect impact of COVID-19 might last for months, if not years, after the virus stops spreading and the economy improves.But Wittner’s family knows they already want her death to be counted.Throughout her high school years, Sekera dreaded entering the house before her parents came home for fear of finding her sister dead. When the pandemic forced them all indoors together, that fear turned to reality.“No little sister should have to go through that. No parent should have to go through that,” she said. “There should be ample resources, especially at a time like this when they’re cut off from the world.”

Legacy Healing Center

Legacy Healing Center, which has locations in Pompano Beach, Delray Beach, and Margate, Florida, is an addiction treatment and behavioral health center that offers Detox, PHP (Partial Hospitalization Program), IOP (Intensive Outpatient Program), Outpatient, and a Family Program. The program is client-centered, holistic, and designed to provide a safe and encouraging space in which people can “relax and feel positive about themselves” while they build a foundation for sustained recovery.Legacy alumni who took our survey describe a wide variety of circumstances that led them to treatment; for example, one alum “struggled with opioids and amphetamine addiction for over 13 years,” while others were there to treat heroin or alcohol dependence. One person checked in because it was clear they needed “to go through detox with medical oversight.” Length of stay also varied from several weeks to several months. Many clients step down through levels of care as their treatment progresses. Each client’s situation is considered individually and their treatment modified as needed.Alumni describe “A wide diversity of residents," coming from throughout the U.S. and abroad, “some young, some older. Some with careers, families, nice backgrounds & some that were homeless with nothing at all, and some in between.” One alum felt that everyone was “Pretty cool for the most part,” while another described some of his younger peers as “young punks.” Another appreciated the diversity: “I got to interact with people that I generally would not have hung out with.” The majority of people who came to Legacy “truly wanted to change their lives for the better.”The gender-specific luxury accommodations all have flat screen televisions and swimming pools. “Legacy was by far the nicest Detox + PHP + IOP I've been to,” said one alum. Nearly all clients are assigned roommates. Residents are required to make their beds and keep their rooms and common areas clean, although there is also housekeeping service.Meals at Legacy vary depending on which program you are in. While in Detox and PHP, a personal chef does the cooking. In Detox, meals are served cafeteria-style. Once in IOP, residents submit grocery lists to staff and prepare most of their own meals. All levels of care have a weekly pizza night, which is very popular.  Clients praised the chef-prepared meals, which provide “a healthy variety and alternative options based on client preferences.” A couple of favorites were chicken tenders, fish, and steak night. Specific dietary restrictions are always accommodated. Most alumni thought the meals were “great!” while one wished for more variety on the Detox menu. For snacks, “Coffee and juices are provided and a fully stocked/ open snack bar was available daily.” Some alumni were not happy that coffee is only available until 10 am.Daily life in PHP consists of six hours of clinical groups, one-on-one therapy, and a daily 12-step meeting outside of the treatment center. Clients also have access to yoga classes, massages, chiropractor, acupuncture, and haircuts. On Sundays, there is an offsite activity such as getting a manicure, going to a movie, or having a picnic. “They took us to offsite meetings, as well as day trips to the beach. During free time I enjoyed hanging out by the pool.” There are other onsite activities and amenities for residents to enjoy during their free time, such as equestrian therapy and personal training. “We had a personal trainer come once a week, we were allowed to go to the gym 3x a week.” As part of reintegrating into life outside of treatment, IOP clients are required to find employment at some point during their residency. When it comes to rules and structure, one alum felt “There was a healthy amount of rules,” which “all made sense aside from the phone calls in detox" (phone use is limited while in Detox). Clients differed in whether they thought Legacy provided tough love or was more permissive. One alum appreciated the strict structure, commenting “That’s what I needed at the time and they knew it.” A couple former clients said there was variation between staff members, with some more permissive than others. One person chalked it up to perception: “I am a bit older and knew the ropes. I did not require tough love, but rather a place to clear my head and get sober.... so for me, it was more permissive.”When rules are broken, staff are “fair” and “professional” in meting out consequences, which always depend on the particular infraction. One alum who broke curfew got a verbal warning the first time. “But the next time, my curfew would be changed to an even earlier time.” For the most part, people followed the rules. Some clients mentioned that when one of their peers relapsed in IOP, “The staff was confidential and handled the situation well.”Residents are allowed to watch TV anytime during non-treatment hours. Phone use is more restricted: Clients, generally, do not have access to their cell phones unless prior arrangements have been made. For example, one client who was a working professional was given permission to use their cell phone and laptop, “2-3 hours a day for business purposes.” Otherwise, clients’ phone use is dependent on their level of treatment. After Detox, clients can make brief calls to people on their approved contact list with staff present. Then, after two or three weeks, clients “earn” their phone and may use it for one hour a day. The next stage is being allowed to use the phone while at the house until 10 pm. No internet is allowed unless absolutely necessary and approved by staff. Medical staff were described as “Very helpful” and “awesome, qualified doctors” who “took the time to understand any concerns that I had.” There are no doctors in residence at the houses but clients can see them daily or when requested. Most former clients were happy with medical staff, and a few said they particularly appreciated the attention to medication details and dosage. One alum, however, felt medication was pushed that was “not always necessary.”The treatment model at Legacy incorporates the 12-step recovery program and the “spiritual rather than religious” philosophy that goes with it. However, 12-step is definitely “not pushed,” and instead offered as part of a balanced approach. Clients are allowed to choose their own outside meetings, including non-12-step recovery meetings.When asked about the most memorable part of treatment, some alumni focused on staff: “It wasn't the amenities that made my experience, it was the way the staff cared about clients and the dedication they had to their work.” Others were impacted by “The friendships I was able to establish with other clients that I continue to stay in contact with.” One client was grateful for the life-changing EMDR sessions: “It was a weight of trauma lifted off of my shoulders. I suffer from PTSD and do not have nightmares anymore, and I can sleep through the night.”After clients leave Legacy, their relationships with staff and other alumni often continue, with check-ins, follow-up calls, and meetings. “We have a Legacy Group chat that consists of many people I attended Legacy with. We check in with each other, share our struggles, our good times, and sobriety anniversaries.” Most of the clients who took our survey have remained sober since leaving treatment, crediting Legacy with giving them the tools they need to continue on their recovery path: “Legacy provided me with the foundation that I was able to build and grow in my recovery.” Many are thankful for the comprehensive treatment they received, with one alum praising Legacy’s “transparency, authenticity and professionalism.” Overall, gratitude was a common refrain: “I am grateful to be alive, grateful to have my life and family back...as well as my career. I definitely have Legacy to thank for this.”

California Behavioral Health

California Behavioral Health (CBH), located just outside of Palm Springs, offers residential treatment for clients who want to address their substance use disorder. Their website describes a “comprehensive range of treatment services” within a “flexible therapy framework” in a comfortable setting. The goal is to empower individuals to overcome addiction and live a joyful and fulfilling life. Their program includes support for dual diagnosis and non-12-step treatment.Surveyed alumni gave various reasons for choosing CBH, including location, privacy, and accommodations. Clients live in units that they share with two or three housemates. Each has a private room with a television and there is a shared bathroom. There are no assigned chores although everyone is expected to keep their room and common areas tidy. Quality of treatment ranked highest as a deciding factor. “I liked that there were only master’s level or higher clinicians.”Alumni described their fellow residents as “diverse” and “quite a cross-section of male and female” who ranged in age from “mid-20’s to late 50’s” (although they tended to skew over 30). One younger alum remarked: “I liked how the older residents were able to take me under their wing and share some personal experiences with me,” while an older resident observed that the younger ones “tend to be louder.” Clients came from “different parts of the country...and appeared to be employed with decent jobs.” Clients varied in the particular substances they were struggling with and the length of time they were in treatment. Most stays were 30-45 days. One who was there for “Alcohol and opiate addiction” stayed for just over 60 days, while another client who struggled with alcohol “to the point that I felt like I would probably end up killing myself with it” was at CBH for around 90 days.When it comes to food, CBH provides “Satisfying meals prepared by caring chefs.” There is a wide variety of choices which residents described as “wonderful,” “Healthy and delicious,” and “varied and wholesome.” Salmon, burgers, and barbecue were mentioned as favorites. For those with dietary restrictions or food allergies, the chefs will prepare alternate meals, as one alum mentioned “a gluten allergy that they were able to accommodate.” Between meals, “Healthy snacks are available, sweets when we bought them.” Coffee is available until noon. Daily life at CBH was described as “Structured but as fun as life in treatment can be.” Clients are treated with a combination of “evidence-based” therapies such as cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and eye movement desensitization and reprocessing (EMDR) tailored to their individual needs. In non-treatment hours, residents may hike, swim, work out at the gym, or attend yoga classes.Many clients chose CBH because it is not a 12-step program: “It felt as if the program was really tailor made for my needs. 12 step is offered but not mandatory which I really liked.” Treatment is client-driven: “I was really encouraged to take the lead in my recovery.” Underlying issues are addressed, as one alum explained: “It's about 'core' issues not just stopping. Everyone cares and everyone is treated with respect and dignity.” Clients also appreciated the secular nature of treatment, although every client’s faith is respected.According to the residents who took our survey, rules at CBH were rarely broken because everyone was “focused on getting better.” Clients are encouraged to communicate with each other in a positive way in the event someone is not pulling their weight (not cleaning up after themselves in common areas, for example), “to set boundaries and stand up for ourselves.” When infractions occurred, “Staff was always fair and worked with individuals who were experiencing a setback.” “There are consequences for actions and this was fully explained.” The emphasis is on “Safety, caring and respectful treatment, everyone is empowered and is treated as an adult.”Clients are allowed to watch TV, make phone calls from house phones, and use one of the facility’s desktop computers “As needed, but within reason.” “There weren't a ton of restrictions for us...but the focus on treatment was always first.” Clients’ cell phones are kept in a safe. They are allowed to access their phones outside of group/class times if there is a good reason. Additionally, each resident is given an MP3 player with music which they can listen to whenever they are not in group.Alumni had high praise for medical and non-medical staff who were described as “Very kind” and “amazing!” “Caring staff from the maintenance staff to the Nurses to the Therapist to the Owners.” CBH provides 24/7 care with licensed registered nurses and certified nursing assistants, who are described as “very helpful, I really felt like a family member when there, as cheesy as it sounds” and accessible: “I love the nurses, they are always there to talk to and really care.” One alum appreciated that their meds were “finally figured out and I was able to get myself balanced.”When asked about the most memorable aspect of treatment at CBH, some alumni mentioned the level of compassion of the staff: “The team treated me like a human being - I felt seen and heard. You can feel how much they care.” Others appreciated the focus on the underlying issues of their substance use disorder: “They go into the why of my drinking and I got to really learn about my emotions, how to express them and ways to cope.” One was especially grateful for the group: “It truly was the other residents that helped me to embrace a willingness to open up and accept treatment.”The clients who were surveyed report that they are maintaining their sobriety, with some finding it more difficult than others. “It's not easy being away from such a caring facility, trying to find the right outpatient center has been challenging; however; being able to reach out to CBH during this period continues to help me stay sober,” said one. Another reports: “I am 160 days sober and feel like I have a new chance at life.”In general, alumni credit CBH for providing them with the tools to get and stay sober: “It had been a long time since I felt like someone cared. I know this is a life long journey and I now know that I have the skills that it takes.”

Intervention

The following is an excerpt from The Heart and Other Monsters by Rose Andersen.I cannot remember my sister’s body. Her smell is gone to me. I do not recall the last time I touched her. I think I can almost pinpoint it: the day I asked her to leave my home after I figured out she had stopped detoxing and started shooting up again, all the while trying to sell my things to her drug dealer as I slept. When she left, she asked me for $20, and I told her that I would give it to her if she sent me a picture of a receipt to show me she spent the money on something other than drugs. “Thanks a lot,” she said, sarcastically. I hugged her, maybe. So much hinges on that maybe, the haunting maybe of our last touch.The last time I saw my sister was at an intervention at a shitty hotel in Small Town. Our family friend Debbie flew my stepmother and me there in her three-seater plane. The intervention was put together hastily by Sarah’s friend Noelle, who called us a few days beforehand, asking us to come. There were little resources or time to stage it properly—we couldn’t afford a trained interventionist to come. Noelle told us she was afraid Sarah was going to die. I agreed to fly with Debbie and Sharon because Small Town was far away from home and I didn’t want to drive.Debbie sat in the pilot’s seat, and I sat next to her. My stepmother was tucked in the third seat, directly behind us. It wasn’t until takeoff that I realized with my body what a terrible decision it was to fly. I am terrified of heights and extremely prone to motion sickness. I was not prepared for what it meant to be in a small plane.I could feel the outside while inside the plane. The vibration of chilly wind permeated through the tiny door and gripped my lungs, heart, head. It would have taken very little effort to open the door and fall, an endless horrifying fall to most-certain death. From the first swoop into the air, my stomach twisted into a mean, malicious fist that punched at my bowels and throat. For the next hour I sat trembling, my eyes shut tight. Through every dip, bounce, and shake, I held back bile and silently cried.When we landed, I lurched off the plane and threw up. I do not remember what color it was. My stepmom handed me a bottle of water and half a Xanax, and I sat, legs splayed on the runway, until I thought I could stand again.My sister vomited when she died. She shit. She bled. How much is required to leave our body before we are properly, truly, thoroughly dead? I dreamed one night that I sat with my sister’s dead body and tried to scoop all her bodily fluids back inside her. Everything wet was warm, but her body was ice-cold. I knew that if I could return this warmth to her, she would come back to life. My hands were dripping with her blood and excrement, and while begging her insides to return to her, I cried a great flood of mucus and tears. This I remember, while our last touch still evades me.<#>My sister was late to her intervention. Many hours late. Seven of us, all women, five of us in sobriety, sat in that hot hotel room, repeatedly texting and calling Sarah’s boyfriend, Jack, to bring her to us. I realized later that he probably told her they were going to the hotel to get drugs.The hotel room was also where Sharon, Debbie, and I would be sleeping that night. It held two queen-size beds, our small amount of luggage, and four chairs we had discreetly borrowed from the hotel’s conference room. I sat on one of the beds, perched on the edge anxiously, trying not to make eye contact with anyone else. I didn’t know many of the other people there.When I told my mom about the intervention days before, I had immediately followed with “But you don’t need to come.” There were so many reasons. She has goats and donkeys, cats and dogs who needed to be taken care of. She didn’t have a vehicle that could make the drive. She could write a letter, I said, and I would give it to Sarah. The truth was, I didn’t feel like managing her now-acrimonious relationship with Sharon. I didn’t want to have to take care of my mom, on top of managing Sarah’s state of being. It occurred to me, sitting in this crowded, strange room, that I might have been wrong.Sitting diagonally across from me was Sarah’s close friend Noelle, who had organized everything. Sarah and Noelle had met in recovery, lived together at Ryan’s family home, and become close friends. They had remained friends even when Sarah started using again. Helen, a fair-haired middle-aged woman who was not one of the people Sarah knew from recovery but rather the mother of one of Sarah’s boyfriends, sat on the other bed. Sarah’s last sponsor, Lynn, sat near me. I had to stop myself from telling her how Sarah had used her name on her phone. Sitting in one of the chairs was the woman who was going to run the intervention. I cannot remember her name now, even though I can easily recall the sound of her loud, grating voice.The interventionist had worked at Shining Light Recovery, the rehab Sarah had been kicked out of about a year and a half before, and was the only person Noelle could find on short notice. She had run her fair share of interventions, she told us, but she made it clear that because she hadn’t had the time to work with us beforehand, this wouldn’t run like a proper intervention. She smelled like musty clothes and showed too many teeth when she laughed. She talked about when she used to drink, with a tone that sounded more like longing than regret. When she started to disclose private information about my sister’s time in rehab, I clenched my hands into a fist.“I’m the one that threw her out,” the woman said. “I mean, she’s a good kid, but once I caught her in the showers with that other girl, she had to go.” Someone else said something, but I couldn’t hear anyone else in the room. “No sexual conduct,” she continued. “The rules are there for a reason.” She chuckled and took a swig from her generic-brand cola. I felt hot and ill, my insides still a mess from the plane ride. We waited two more hours, listening to the interventionist talk, until Jack texted to say they had just pulled up.When my sister arrived, she walked into the room and announced loudly, “Oh fuck, here we go.” Then she sat, thin, resentful, and sneering, her hands stuffed into the front pocket of her sweatshirt. Oh fuck, here we go, I thought. The interventionist didn’t say much, in sharp contrast to her chattiness while we were waiting. She briefly explained the process; we would each have a chance to speak, and then Sarah could decide if she wanted to go to a detox center that night.We went in turns, speaking to Sarah directly or reading from a letter. Everyone had a different story, a different memory to start what they had to say, but everyone ended the same way: “Please get help. We are afraid you are going to die.” Sarah was stone-faced but crying silently. This was unusual. When Sarah cried, she was a wailer; we called it her monkey howl.When we were younger, we watched the movie Little Women again and again. We would often fast-forward through Beth’s death, but sometimes we would let the scene play out. We would curl up on our maroon couch and cry as Jo realized her younger sister had died. For a moment I wished for the two of us to be alone, watching Little Women for the hundredth time. I could almost feel her small head on my shoulder as she wailed, “Why did Beth have to die? It’s not fair.” She sat across the room and wouldn’t make eye contact with me.I addressed Sarah first with my mom’s letter. I started, “My dear little fawn, I know that things have gone wrong and that you have lost your way.” My voice cracked and I found I couldn’t continue, so I passed it to Noelle to read instead. It felt wrong to hear my mother’s words come out of Noelle’s mouth. Sarah was crying. She needs her mom, I thought frantically.When it came time to speak to her myself, my mind was blank. I was angry. I was angry that I had to fly in a shitty small plane and be in this shitty small room to convince my sister to care one-tenth as much about her life as we did. I was furious that she still had a smirk, even while crying, while we spoke to her. Mostly, I was angry because I knew nothing I could say could make her leave this terrible town I had driven her to years before, and come home. That somewhere in her story there was a mountain of my own mistakes that had helped lead us to this moment.“Sarah, I know you are angry and think that we are all here to make you feel bad. But we are here because we love you and are worried you might die. I don’t know what I would do if you died.” My sister sat quietly and listened. “I believe you can have any life you want.” I paused. “And I have to believe that I still know you enough to know that this isn’t the life you want.” The more I talked, the further away she seemed, until I trailed off and nodded to the next person to talk.After we had all spoken, Sarah rejected our help. She told us she had a plan to stop using on her own. “I have a guy I can buy methadone from, and I am going to do it by myself.” Methadone was used to treat opioid addicts; the drug reduced the physical effects of withdrawal, decreased cravings, and, if taken regularly, could block the effects of opioids. It can itself be addictive—it’s also an opioid. By law it can only be dispensed by an opioid treatment program, and the recommended length of treatment is a minimum of twelve months.“I have a guy I can buy five pills from,” Sarah insisted, as if that was comparable to a licensed methadone center, as if what she was suggesting wasn’t its own kind of dangerous.“But honey,” my stepmother said gently, “we are offering you help right now. You can go to a detox center tonight.”“Absolutely not. I am not going to go cold turkey.” Sarah was perceptibly shaking as she said this, the trauma of her past withdrawals palpable in her body. “I don’t know if I can trust you guys.”She gestured to my stepmom and me. “I felt really betrayed by what happened.” The heroin in her wallet, the confrontation at Sharon’s, Motel 6, breaking into her phone. “You guys don’t understand. Every other time I’ve done this, I’ve done this for you, for my family.” She sat up a little straighter. “For once in my life, it’s time for me to be selfish.”It was all I could do not to slap her across the face. I wanted desperately to feel my hand sting from the contact, to see her cheek bloom pink, to see if anything could hurt her. She wasn’t going to use methadone to get clean. She just wanted us to leave her alone. I made an excuse about needing to buy earplugs to sleep that night and walked out. I did not hug her or look at her. I did not know I would not see her again. I did not know I would not remember our last touch. I did not know that the next time I held her body, it would be chips of bone and gritty ash in a small cardboard box. THE HEART AND OTHER MONSTERS (Bloomsbury; hardcover; 9781635575149; $24.00; 224 pages; July 7, 2020) by Rose Andersen is an intimate exploration of the opioid crisis as well as the American family, with all its flaws, affections, and challenges. Reminiscent of Alex Marzano-Lesnevich's The Fact of a Body, Maggie Nelson's Jane: A Murder, and Lacy M. Johnson's The Other Side, Andersen's debut is a potent, profoundly original journey into and out of loss. Available now. 

Drinking Surged During The Pandemic. Do You Know The Signs Of Addiction?

Despite the lack of dine-in customers for nearly 2½ long months during the coronavirus shutdown, Darrell Loo of Waldo Thai stayed busy.Loo is the bar manager for the popular restaurant in Kansas City, Missouri, and he credits increased drinking and looser liquor laws during the pandemic for his brisk business. Alcohol also seemed to help his customers deal with all the uncertainty and fear.“Drinking definitely was a way of coping with it,” said Loo. “People did drink a lot more when it happened. I, myself, did drink a lot more.”Many state laws seemed to be waived overnight as stay-at-home orders were put into place, and drinkers embraced trends such as liquor delivery, virtual happy hours and online wine tasting. Curbside cocktails in 12- and 16-ounce bottles particularly helped Waldo Thai make up for its lost revenue from dine-in customers.Retail alcohol sales jumped by 55% nationally during the third week of March, when many stay-at-home orders were put in place, according to Nielsen data, and online sales skyrocketed.Many of these trends remained for weeks. Nielsen also notes that the selling of to-go alcohol has helped sustain businesses.But the consumption of all this alcohol can be problematic for individuals, even those who haven’t had trouble with drinking in the past.Dr. Sarah Johnson, medical director of Landmark Recovery, an addiction treatment program based in Louisville, Kentucky, with locations in the Midwest said that, virtual events aside, the pandemic has nearly put an end to social drinking.“It’s not as much going out and incorporating alcohol into a dinner or time spent with family or friends,” Johnson said. “Lots of people are sitting home drinking alone now and, historically, that’s been viewed as more of a high-risk drinking behavior.”There are some objective measures of problematic drinking. The Centers for Disease Control and Prevention defines heavy drinking as 15 or more drinks a week for a man or eight or more for a woman.But Johnson said that more important clues come from changes in behavior. She explains that, for some people, a bit of extra drinking now and then isn’t a big deal.“If they are still meeting all of their life obligations, like they are still getting up and making their Zoom meetings on time, and they’re not feeling so bad from drinking that they can’t do things, and taking care of their children and not having life problems, then it’s not a problem,” Johnson said. “It’s when people start to have problems in other areas of their life, then it would be a signal that they are drinking too much and that it’s a problem.”But there are signs to watch out for, she says. They include:Big increases in the amount of alcohol consumedConcern expressed by family or friendsChanges in sleep patterns, either more or less sleep than usualAny time that drinking interferes with everyday lifeJohnson noted that for many people, living under stay-at-home orders without the demands of a daily commute or lunch break could be problematic.“Routine and structure are important to overall mental health because they reduce stress and elements of unknown or unexpected events in daily life,” Johnson said. “These can trigger individuals in recovery to revert to unhealthy coping skills, such as drinking.”Johnson explained that while some people may be predisposed to problematic drinking or alcohol-use disorder, these can also result from someone’s environment.Johnson said that people who are unable to stop problematic drinking on their own should seek help. The federal Substance Abuse and Mental Health Services Administration runs a 24/7 helpline (800-662-HELP) and website, www.findtreatment.gov, offering referrals for addiction treatment.Peer support is also available online. Many Alcoholics Anonymous groups have started to offer virtual meetings, as does the secular recovery group LifeRing. And for people who are looking for more informal peer support, apps such as Loosid help connect communities of sober people.Darrell Loo at Waldo Thai said that he has been concerned at times about people’s drinking but that he generally has seen customers back off from the heavy drinking they were doing early in the pandemic.Loo and others in the Kansas City restaurant business are pushing for the carryout cocktails and other looser laws to stay in place even as restaurants slowly start to reopen.“This will go on for a while. It’s going to change people’s habit,” Loo said. “People’s spending habit. People’s dining out habit. So there’s definitely a need to keep doing it.”This story is part of a partnership that includes KCUR, NPR and Kaiser Health News.

A Partnership Approach to Recovery

If you’re like a lot of people, you’re struggling right now. You might be white-knuckling it through early sobriety during a global pandemic, or finding yourself using drugs and alcohol more and more, tipping the scales from acceptable use to problematic abuse. If you’re in either of those situations, finding a sober partner to help you though recovery can be an important tool.A sober partner is someone who works with you one-on-one to support your journey to sobriety or help you through the ups and downs of early recovery. While entering a treatment center with other people can seem risky, there are ways to get help for your drug or alcohol addiction in an individual or small group setting that allows you to tightly control your exposure.An individualized approach to treatmentIn order to succeed in treatment, you need to feel comfortable. If you can’t imagine lying in a bed in a detox facility or even sharing a double room with someone else in early recovery, you might need a more individualized approach to treatment.Luckily, there are plenty of options available that can be tailored to your specific needs. For example, executive treatment plans. This approach to treatment is designed for people who are accustomed to being in control and living with certain amenities. You’ll be treated with respect and understanding that you might not find in other treatment centers. Plus, you’ll be exposed to other people who are in your situation — highly accomplished and skilled individuals who happen to also struggle with substance abuse.Executive treatment plans give you all the creature comforts that you’re accustomed to on a high-end business trip. You can have a chef to meet your dietary needs or a personal trainer to keep you mentally and physically fit. Without worrying about the inconveniences of living at a treatment center, you’ll be able to focus on your recovery.What is sober coaching?You might have seen the term “sober coach” in the newspapers, describing someone who accompanies the latest celebrity around after their rehab stay. But sober coaches aren’t just for the famous — they’re for anyone who needs one-on-one guidance for early recovery.Sober coaches have been where you are. They’re in recovery as well, and they’ve figured out how to balance sobriety with living a full and fun life. A clinician can help you identify destructive patterns or underlying mental health issues that contribute to your substance abuse. A sober coach, on the other hand, gives a more intimate approach, relating to you on a personal level. Your sober coach will be able to share that they’ve learned, giving you a glimpse into how recovery will fit into your day-to-day life.In that way, sober coaches help to fill the gap between your life in rehab and your normal life. Rather than worrying about making the transition from treatment to home, you’ll be working to ease that transition from the start. Your sober coach will be able to give you insight into navigating social events, repairing your relationship with your children or spouse, or saying “no-thanks” to a drink at your next big work function.Treatment that works for youWhether you’re a high-flying executive, an artist, or an introvert who does best in small groups, you deserve to have a treatment option that works for you. There’s no one-size-fits-all approach to drug and alcohol treatment.Before signing up for treatment, think about what your priorities are. Do you want to keep in touch with work and family, or take some time away? Do you want your treatment plan to have a spiritual or religious component? What creature comforts will make you feel more at ease, and ready to tackle the hard work of recovery?Putting in legwork ahead of time to find a treatment that is right for you can go a long way toward ensuring your success in recovery.Sober Partners provides residential treatment in Newport Beach, California. Get more information at their website, by calling 855-982-3247, or on Facebook.

A Thousand Wasted Sundays

I heard the baby crying again.I didn’t get up. I stayed, hiding in my bedroom. He needed me, but I couldn’t do it. I was too hungover. Again.I don’t remember getting home. The last thing I recall was seeing both my hands outstretched in front of me clutching two huge jugs of Sangria. The red liquid was lapping over the sides as I declared triumphantly,“It’s two for one!” to my wasted, smiling friends.My life had always been one big party. A social drinker extraordinaire. A binger that never drank alone and never went home early. I wouldn’t have described my drinking as a problem. I thought I was just like everyone else, overdo it on Saturday then feel like killing myself on Sunday. That’s normal right? Wasted hungover days were as ingrained as my habit. My drinking felt ordinary, typical. You wouldn’t have picked me out as an alcoholic, you’d have thought I was great company. My addiction was clever, absorbed into everyone else’s, diluted by the crowd.I had my first child at 34. Mothers group nights out catapulted me into a whole new style of heavy binge drinking. The mundanity of motherhood and the long gaps between piss-ups accentuated my indulgence. By the time a night out was upon me I was gagging to get annihilated. I was expected to be tucking in, singing lullaby’s and instead I was going out and dancing on speakers in a dodgy underground nightclub.Weeks would pass of being good mummy. I had the right snacks, the softest cotton wraps and a sporty three wheeled pram. I’d fought my way out of germ-infested ball play pits and had wipes on hand for any unpredictable leeks, drips or explosions. On the outside I was doing well at my new role. But, inside I was hurting, mourning the loss of that fun party girl I knew, the one that linked arms with strangers and did bad 80’s dancing.I wanted to go out and be me again.Drunk me, the only me I knew.Mum’s nights out became my escape.I heard the crying again. There was no point in feeding him, my milk was toxic. Spoiled. The sun shone through the bedroom window, cutting the room in half. As I closed the curtains I had a sudden flash back of stumbling around in the bathroom with my bra shoved down around my waist, demanding my husband hand the baby over. I was covered in vomit.“Get in the bath” he’d said.I sat in the empty bath as my husband put the baby to bed with a bottle. He then plugged the hose in and sprayed me down, fully clothed, like a zookeeper that was washing a muddy elephant. I saw lumps of sick lodged in the plug hole….The embarrassing memory stung my heart, guilt crept into my bones. Panic kicked in and filled my body with negativity. I began the slow painful demise into my hangover. My mind took over and led me down a dark and frightening path. I envisaged dreadful ways I might die; irrational thoughts filled my being.It wasn’t meant to be this way.I thought I’d be able to carry on being me, a Rockstar mum that partied, got the kids mohawks and wore ripped jeans. This motherhood thingy was ruining my fun, interrupting my hangovers. Giving me consequences.I sighed as I heard the front door open and close. I guessed it was my family going out, doing fun stuff without me. Joining them wasn’t an option. I was too broken. Instead I chose to lay there in my pit of self-hatred and discontentment hoping to fall asleep.Sleep didn’t come. Only questions did…Why do I keep doing this? Why do I keep doing something I hate?What’s wrong with me?My anxiety had been getting progressively worse every time I went on a bender. Being the drunkest person at every pub, club or wake for the previous 26 years was catching up with me. I was losing my sparkle, suffering with terrible panic attacks and low self-worth. I felt depressed, I was lost and had no idea how to stop.I tried slowing down. I failed at moderation. I drank waters between gins and ate carbs before big nights. Dry July’s dribbled down the drain along with my own sour tasting bile. None of it worked.Then the baby.That perfect little bundle of human that was crying beyond my bedroom door got me questioning my drinking. Questioning my life. I had a baby to look after. I had to do better.Laying there that afternoon, smelling like a brewery with a bucket of sick next to me, I knew the time had come.I stood up, put on my bath robe and plodded into the lounge. My son was eating spaghetti in his highchair. I leaned down and gave him a kiss on his forehead and whispered that I was sorry. I plonked myself down on the couch next to my husband and said,“I want to stop drinking. I think I need help”At last, I had taken responsibility for my drinking and admitted that, perhaps, I had a problem.My husband took my hand and promised to support me. He said he hated seeing me so unwell and he told me he loved me.The next morning, I searched the internet for help. I reached out.I found a local counselling service and dialled the number.“Hello, I’m Vicky. I’m a mum that hates binge drinking but can’t seem to stop. Can you help me?”I thought she was going to laugh and say,“Sorry love, we only deal with real alcoholics here”But she didn’t, she said,“Yes, we can help with that”I booked an appointment.That exact moment is when my sober story began. Reaching out saved me, therapy cracked me open and helped me understand my reasons why.One Saturday, a few months after my therapy finished, I asked my husband,“What shall we do tomorrow?”It sounds like a simple statement, but it was the first time in my adult life I’d considered doing something on a Sunday. It was the moment I became an available parent instead of a drunken one.I’m now a better mum that’s determined to never waste a Sunday again.Read about my journey -www.drunkmummysobermummy.com

Waismann Method®

Waismann Method® Opioid Treatment Specialists have been providing rapid detox since 1998. Although they are recognized as a rapid detox center, they also provide a number of medically assisted detox options in a private room of a full service, accredited hospital. On the first day of treatment, patients undergo a comprehensive medical assessment, which often includes blood work, EKG, stress test and any other recommended examinations based on the health needs of each patient. Patients also receive IV fluids, vitamins, and electrolytes to stabilize nutrients in the body before, during and after the detox process. On the second day, those who receive rapid detox are transferred to the ICU. Patients remain in the hospital overnight or until they are physically stable. Then they are discharged and transferred to Domus Retreat, a private recovery center where guests receive around-the-clock aftercare and support during the physical and emotional adjustment period.Since Waismann Method® is primarily a medically assisted detoxification, it differs from the typical rehabs that are reviewed in this section of The Fix. Because of this, the following alumni-provided details mainly describe the aftercare component of treatment, which takes place at Domus Retreat. For more information about Waismann Method’s medically assisted detox, please see their website.Waismann Method® specifically treats patients who are dependent on opioids. The alumni who took our survey report a variety of opioid drugs of choice and patterns of abuse as well as variation in length of treatment. Some clients arrived dependent on heroin or methadone while others reported an addiction to Oxycontin, for example. One patient who was “addicted to prescription pills for 7 years,” stayed about two weeks in treatment, while another who had been addicted to methadone was home in less than a week. This is not a long-term facility.When asked why they chose Waismann Method®, the vast majority of respondents placed quality of treatment and privacy above all else. While undergoing the detox process in the hospital, patients do not interact with one another. Once they have completed detox and move on to the Domus Retreat, there is some interaction with other residents. For the most part, other patients were “respectful and helpful. There was a feeling we were all getting our lives back and so we could appreciate each other’s experience.”Accommodations at the retreat were very highly rated by former clients. Rooms were described as “big, private and clean,” all with televisions, internet access, and private bathrooms. There is a private chef and maid service. Clients do not do any chores.Treatment at the retreat is “centered around physical recovery along with emotional recovery.” To that end, clients avail themselves of any of a number of services including individualized psychotherapy, massage, acupuncture, and yoga. There are no group therapy sessions and no 12-step meetings. Those looking to stay fit can choose from an array of activities such as “basketball, swimming, Jacuzzi, exercise equipment...things to keep you occupied.” There is also art therapy and Tai Chi. Unlike typical treatment centers, there is not a lot of structure and scheduling. Clients are free to choose how they spend their days. There are no restrictions on phone, internet, or TV but “You are encouraged to not do too much work so this can be a respite.”All meals are prepared to order for each client by a private chef. The menu consists of “very healthy meals (fresh salads and smoothies, for example) along with immense flexibility in our choices.” If clients have any specific requests, dietary restrictions, or food allergies, accommodations are made. Clients described the food as “healthy,” “gourmet,” and “delicious.” Favorites were steak and vegetables for dinner as well as fish, chicken and pesto pasta. “It was like dining out all the time,” said one client who “Couldn’t have been happier.” When a client didn’t like a particular item, they would request something different for the following day.Patients spoke highly of the staff, describing them as “always friendly and respectful.” When asked how infractions are handled, one person described staff as “very accessible,” and that they “explain the rules in a way that helps you feel safe and helps with relaxation.” Additionally, “The staff was open to the patients’ input and they helped us understand the thinking behind each decision.” Most clients felt infractions were rare or non-existent. “Everybody seemed civil and well taken care of.” For example, one alum who was smoking near the house “was asked politely to move further away.”For the most part, clients gave high marks to medical personnel, both in hospital during the detox and at the retreat which has full-time nurses in residence as well as a visiting physician who is also on call. Doctors and nurses were described by one client as “compassionate, respectful, and humane.” While one alum felt the doctor should have been more attentive in the period post-detox, another described him as “extremely helpful and knowledgeable and he never treated me like an addict but instead like a patient with respect and kindness.” This sentiment was echoed by others who appreciated the medical approach to their addiction. One client described it as “different than a rehab. I was treated like a medical patient and received therapy.” When asked what was most memorable about treatment at Waismann Method®, there was a variety of responses. Many clients appreciated being in a place that offered an alternative to 12-step programs. Several people gained insight from the one-on-one psychotherapy, which was “Very helpful - I gained a real understanding of some of my concerns.“ Another alum recalled “Being treated with such respect and empathy while going through such a rough time in my life.” Another was grateful for the speed with which they were able to detox from opioids, appreciating “How good I felt, and how fast I recovered.” One person did not have a good experience and said that withdrawal symptoms remained after the procedure.The alumni who took our survey have been doing well since treatment, with some reporting multiple years clean. Their parting sentiments were overwhelmingly positive, with comments such as: “Very satisfied and happy. Getting off methadone maintenance can be difficult but it is possible.” “Excellent experience. Top level care which minimized my discomfort and helped me get better quickly.”

Unacceptable

Even if they’ve only dipped their toes into Alcoholics Anonymous, recovering alcoholics and addicts are familiar with one of the organization’s go-to passages: the Serenity Prayer.God, grant me the serenity to accept the things I cannot change,courage to change the things I can,and wisdom to know the difference.True to its first line, the recitation’s overarching message is that most matters are beyond our control. The vast majority of items within our power to change are internal: our thinking, our actions, our sobriety. Many of us, myself included, are recovering control freaks accustomed to banging our heads against the wall in vain attempts to get the world around us, including its inhabitants, to bend to our will. In sobriety, we learn that placing outsized expectations on others invariably leads to disappointment and resentment.As someone who is decidedly not a “God person,” I have found the Serenity Prayer refreshingly non-religious and spiritually simple. Its first word aside, the passage logically dissects the overwhelming majority of situations into two columns: those that I can do something about, and those that I can’t and must therefore, however begrudgingly, accept. All that is required of me is an honest assessment of which column any given matter occupies.This binary system has helped successfully steer me through nearly nine years of sobriety and all the marital, financial, interpersonal and attitudinal progress it has made possible. For someone who lacks a traditional God, it has been... well, a godsend.Until now. Until COVID-19.A Delicate DanceAfter three months of house confinement, Americans are beginning to reemerge and reengage. Vaccine or no vaccine, the reopening was inevitable because the opposite was unworkable: if we didn’t start returning to some semblance of business as usual, there wouldn’t be an economy to return to. Unemployment figures exceeding 40 million simply aren’t sustainable. Zero income is not an outcome and, while many of us can work effectively from home, most can’t make a living from their laptops.So here we are, restrictions easing, preparing to head back out into the world. Successfully reopening the economy will require a critical mass of people to perform a delicate dance of mask-wearing and social distancing. And already, the Serenity Prayer's well-founded advice of limiting our expectations of others runs into a stubborn contradiction: it is one thing when the actions of others merely threaten to impinge upon our spiritual well-being; it is quite another when those actions threaten our very lives.Expert simulations have shown that if 80 percent of the population wore masks, infection rates would plunge by more than 90 percent; a study published by the World Health Organization on June 1 aligns with these findings.Americans' response has been... mixed. A USA Today poll found that 84% of Americans have worn masks in public, while other surveys put the total closer to two-thirds - figures that, unsurprisingly, include a gap according to political leanings. The protracted nature of our efforts is an additional hurdle, as many are understandably fed up with treating every excursion like a germ gauntlet; even in epicenters like New York, there are signs of citizens waning on safe practices, prompting warnings from government officials.My daily life reflects these concerns. Each day, I go into my empty office (my colleagues are currently working from home; I have a visual disability, and the customized setup at my office makes working there far easier). While offices are mostly empty, the building manager has taken the opportunity to undergo a renovation. The number of workers wearing masks? Close to zero.A few weeks back I got into the elevator. Then a worker – sans mask – got on with me.I got off the elevator, shaking my head. The displeasure on his bare face was evident. Apparently my self-preservation had offended him.This isn't a spiritual inconvenience; it's a potentially life-and-death health issue. The two choices I had were physically endangering myself and my family, or offending someone. I chose the latter, because the former is simply unacceptable.It is a microcosm of what recovering alcoholics everywhere now face. In exercising the courage to change what we can – in my case, proximity to someone who refuses to abide by the simple recommendations of health officials – we will inevitably do something else we are taught to avoid: cause friction and conflict with those around us.With COVID-19, we are living through a crisis that is both all-permeating and all-important. Efforts to mitigate the spread of a deadly, highly contagious disease have touched every single American and stretched into every corner of the economy and society at large. Everyone has been forced to react to it as best they deem fit.Therein lies the rub: something all-encompassing and lethal has been foisted upon society without warning, causing a widely disparate set of perceived best practices to combat it. Many of us are on the same page – wearing face masks, socially distancing – but many are not. And considering the stakes, the majority of responsible citizens are ill-advised to tolerate the significant minority of those literally throwing caution to the wind around their bare faces.In this fashion, COVID-19 has drawn a red line between recovering alcoholics and the crucial tenet of acceptance espoused by the Serenity Prayer.An Inconvenient Lack of TruthI feel comfortable sharing exactly none of what I just wrote in a meeting of Alcoholics Anonymous. Why? Because AA is a strictly apolitical organization attempting to navigate a society in which indisputable facts have become politicized.Until COVID-19, this was manageable, because topics whose facts have been tainted by politics – climate change is a prime example – are easily avoided. They don’t directly factor into our day-to-day recovery.In stark contrast, the coronavirus pandemic has affected everything. It saturates every aspect of our lives, including AA. For example, we aren’t meeting on Zoom because of climate change, or the #MeToo Movement, or Donald Trump’s latest Tweet. And even if we were, it wouldn’t trickle down into essentially every action every person takes.But such is COVID’s cascading impact: an unprecedented health crisis has caused an unprecedented recovery conundrum – and one that we can’t even talk about as a group, no less. Unfortunately, a sizable subset of society seemingly doesn’t believe in simple science; and AA, of course, is simply a subset of society. The problem is societal, and we are part of society.Regardless, even if I could share this in AA, it wouldn’t change the current contradictions of applying my recovery’s teachings in the outside world. That guy is still getting on that elevator without a mask, AA or no AA. I cannot choose to just stand there, and a proselytizing conversation only invites further conflict and confrontation. My only answer – the least bad option – is abrupt, unsettling, silent avoidance.In this fashion, COVID-19 has made recovery more brusque, curt, cold. I cannot convert the maskless masses, nor can I abide them. I did not recover from a progressive, incurable and potentially fatal disease, alcoholism, only to succumb to another.

Is the Time of the No-Knock Drug Raid Coming to an End?

In the mass protests over out-of-control and racially biased law enforcement ignited by the killing of George Floyd by Minneapolis police officer Derek Chauvin, Floyd’s name isn’t the only one being chanted by the crowds. There’s also Ahmaud Arbery, the Georgia jogger gunned down by white vigilantes. There’s Rayshard Brooks, the Atlanta man who was shot and killed by police after he fell asleep in his car in a Wendy’s drive-through lane and got into a tussle with the officers when they tried to arrest him.And then there’s Breonna Taylor. The 26-year-old Black EMT and Louisville resident was killed near midnight on March 13, as police executed a no-knock drug search warrant at her apartment, waking Taylor and her boyfriend. The police opened fire after they were met by gunfire from Taylor’s boyfriend, Kenneth Walker. As the circumstances of her death emerged, she has become the face of the burgeoning movement to radically restrict the police resort to no-knock warrants, which could just as aptly be referred to as home invasion warrants.That’s what it must have felt like to Taylor and her boyfriend Kenneth Walker. Although Louisville police claimed they knocked and announced their presence, they were operating with a no-knock warrant; the police claim that they knocked is disputed by Walker and Taylor’s relatives. Walker said he and Taylor were in bed together when the door crashed in and he thought someone was breaking into their home. In his statement after the incident, Walker said he fired in self-defense. (Here is that fraught zone where the war on drugs encounters the Second Amendment.)Walker’s single shot wounded one officer, who returned fire along with two other officers. Breonna Taylor was hit by at least eight bullets and died at the scene. Walker was charged with attempted murder (although those charges have now been dropped). No drugs were found at the apartment. To make matters even worse, the drug suspect the police were looking for was already in custody when police raided Taylor’s apartment.“They executed this innocent woman because they botched the search warrant execution,” attorney Benjamin Crump, who is representing the Taylor family in a lawsuit filed over the killing, told the New York Times. “They had the main person that they were trying to get in their custody, so why use a battering ram to bust her door down and then go in there and execute her?”Outrage over the killing of Breonna Taylor quietly festered as the country hunkered down amidst the coronavirus pandemic, but when the killing of George Floyd finally galvanized protests against police brutality, the pain and anger over Taylor’s killing became a rallying cry not just in Louisville but also across the country. And it’s bringing a laser-like focus on a practice more akin to raiding terrorist hideouts in the Middle East than to serving and protecting American citizens, which in turn is leading to a renewed focus on the role of the drug war in all of this.The war on drugs provided the impetus for no-knock raids from the beginning, and the courts were all too willing to help. The 1963 U.S. Supreme Court case Ker v. California, which gave constitutional imprimatur to forcible police entries, was a drug case where the possibility that evidence could be destroyed carried the day for the cops. When the Supreme Court revisited and refined its no-knock doctrine in the 1990s, the impetus once again was enforcing drug prohibition.In a case involving small-scale sales of marijuana and meth to an informant, the court ruled in 1995 in Wilson v. Arkansas that police must generally “knock and announce” before kicking in a door with a search warrant, although it allowed for exceptions as per Ker. In another small-time drug sales case in 1997, Richards v. Wisconsin, the court held that police needed to demonstrate “a reasonable suspicion” that announcing their presence before bashing in the door would be dangerous or allow for the destruction of evidence for a no-knock warrant to be permitted.Those rulings left “reasonable suspicion” up to state and local judges, and while little national or even state data exists on the rates at which judges rejected no-knock warrant requests, a couple of local studies suggest they essentially acted as rubber stamps. A recent PBS NewsHour report cited a Denver Post analysis of no-knock warrant requests from Denver police in 2000, a year after Mexican citizen Ismael Mena was killed in a no-knock drug raid. The cops got 158 out of 163 requests approved. Similarly, a Washington Post analysis of no-knock warrant requests by police in Little Rock, Arkansas, between 2016 and 2018 showed that the cops got approvals for 103 out of 105 no-knock warrants from judges.Police resort to no-knock raids has gone through the roof in recent decades, according to a 2007 study done by Peter Kraska, a professor at the School of Justice Studies at Eastern Kentucky University. He found that while the number of no-knock warrants or announce-and-enter raids served during SWAT team deployments had grown to about 1,500 annually in the early 1980s, that figure skyrocketed to about 40,000 a year by the turn of the century as the drug war deepened. Kraska estimated the number of such raids to be about 45,000 by 2010.The raids are mainly for drugs. A 2014 ACLU report investigating SWAT teams doing no-knock raids found that 62 percent of them were for drugs. In at least a third of those raids, no drugs were found. In nearly another third of those raids, it’s not known if any drugs were seized because police did not report that information.And such raids can be deadly—both for their targets and for the officers undertaking them. According to a 2017 New York Times report, between 2010 and 2016 alone, at least 13 police officers lost their lives during such raids, but so did more than six times as many civilians. The New York Times report put the civilian death toll at 81, with many more injured or wounded. These include cases of people who were completely innocent like the 19-month-old baby “Bou Bou” Bounkham Phonesavanh, who was severely burned by a flash-bang grenade thrown by a Georgia SWAT officer in a 2014 no-knock raid.But now, with the widespread public outcry over the unjust killing of Breonna Taylor, no-knock raids are being challenged like never before. The Democratic congressional response to the upheaval has been the rolling out of the Justice in Policing Act, which directly targets the practice. As the Democrats put it, the bill “[b]ans no-knock warrants in drug cases at the federal level and conditions law enforcement funding for state and local governments banning no-knock warrants at the local and state level.”Kentucky’s libertarian-leaning U.S. Senator Rand Paul (R) introduced the Justice for Breonna Taylor Act on June 11, “to prohibit no-knock warrants.” The bill would mandate that federal law enforcement officers must announce their presence and purpose before executing a search warrant, and it would condition federal aid to law enforcement agencies to ensure they follow the same rules.“After talking with Breonna Taylor’s family, I’ve come to the conclusion that it’s long past time to get rid of no-knock warrants. This bill will effectively end no-knock raids in the United States,” said a statement from Sen. Paul’s office.Meanwhile, even his Republican colleagues are climbing on the no no-knock bandwagon, although to a more limited degree than the Democrats. The just-introduced Justice Act, largely crafted by the GOP’s sole Black senator, Tim Scott of South Carolina, wouldn’t ban no-knock raids but would increase federal reporting requirements for no-knock raids and use of force. It would also increase penalties for false police reports.It’s unclear whether any of these bills will pass or whether compromise legislation will emerge, and it’s unclear just how strong any language on no-knock raids will end up being. What is clear is that Congress finally has the issue squarely in its sights.But law enforcement is largely a state and local matter, and it’s going to be up to state legislatures, governors, city councils and mayors to address the issue at the local level. Louisville’s city council has already unanimously banned no-knock raids. Only two other states—Florida and Oregon—have banned no-knock raids, but this is likely to change, given the anger against police misconduct. In fact, this is something that should have happened a long time ago.Source: Independent Media InstituteThis article was produced by Drug Reporter, a project of the Independent Media Institute.