All language subtitles for Addiction.2007.1080p.WEBRip.x264.AAC-[YTS.MX]

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Man:
I WAS SURPRISED TO HEAR
ALL THE DRUGS HE DID.

I HAD NO IDEA HE
WAS DRINKING THAT MUCH,

OR THAT HE WAS HIGH
EVERY DAY IN SCHOOL.

Young man:
I'D GET UP SOME MORNINGS
AND I'D BE LIKE,

"MAN, TODAY'S
GOING TO SUCK."

AND SO I'D JUST HAVE,
LIKE, YOU KNOW--

I'D PUT A LITTLE VODKA
IN MY COFFEE.

SOME DAYS, IF I HAD
SOME PRESCRIPTIONS PILLS

LEFTOVER FROM THE WEEKEND
I'D POP A COUPLE OF THOSE.

Mark Willenbring:
THIS IS A DISORDER
OF YOUNG PEOPLE.

VERY LITTLE ADDICTION STARTS
AFTER THE AGE OF 30.

IT ALMOST ALWAYS STARTS,

BETWEEN THE AGES
OF 18 AND 25.

Woman:
WE KEPT THINKING ONCE
SHE GOT OUT OF HIGH SCHOOL

IT WOULD BE OKAY.
ONCE SHE GOT OUT OF COLLEGE
IT WOULD BE OKAY.

ONCE SHE GOT
MARRIED IT WOULD BE OKAY.
ONCE SHE BECAME A MOTHER...

UNTIL SHE DECIDES
TO LAY DOWN THAT ADDICTION

THERE'S NOTHING
I CAN SAY OR DO THAT'S
GOING TO MAKE ANY DIFFERENCE.

THERE ARE MISCONCEPTIONS
THAT REALLY DRIVE ME CRAZY

WHEN IT COMES TO ADDICTIONS.

ONE OF THEM IS THIS WHOLE
IDEA THAT AN INDIVIDUAL

NEEDS TO REACH
ROCK-BOTTOM

BEFORE THEY CAN
GET ANY HELP.

THAT IS ABSOLUTELY WRONG.

IT'S A MYTH THAT THEY
HAVE TO CRASH AND BURN

BEFORE THEY CAN GET BETTER.

IT'S MORE LIKE ANY OTHER
CHRONIC CONDITION--

THE SOONER YOU START
THE BETTER,

THE MORE YOU STAY ON TOP
OF IT THE BETTER.

I GOT SOBER IN 1981
AND STAYED SOBER

FOR 17 AND A HALF YEARS
THROUGH AA.

I HAD NO PROBLEM AND THEN

SOME PERSONAL THINGS
HAPPENED TO ME IN MY LIFE

AND I'VE BEEN
DRUNK EVER SINCE.

I'M ASHAMED BECAUSE I LOOKED
INTO THE EYES OF MY CHILDREN

AND THAT WASN'T ENOUGH

TO MAKE ME STOP.

HOW CAN WE COMPREHEND

THE CONCEPT OF A PERSON,

THAT WANTS TO STOP DOING
SOMETHING AND THEY CANNOT,

DESPITE CATASTROPHIC
CONSEQUENCES?

WE'RE NOT SPEAKING
OF LITTLE CONSEQUENCES.
THESE ARE CATASTROPHIC.

AND YET, THEY CANNOT
CONTROL THEIR BEHAVIOR.

I MEAN, THERE HAVE
BEEN SO MANY THINGS THAT
I HAVEN'T ACCOMPLISHED

BECAUSE--

BECAUSE OF THE PROBLEM.

I THINK... SO...

THAT'S ALL.

MY DRINKING
IS KILLING ME

AND I DESPERATELY
NEED HELP.

THERE'S MORE
TREATMENTS AVAILABLE.

THERE'S BETTER
UNDERSTANDING.

THERE'S MORE ACCEPTANCE THAT
THIS IS A MEDICAL CONDITION

WITH REAL MEDICAL SOLUTIONS
THEN THERE EVER HAS BEEN.

THE RIGHT MEDICATION
WITH THE RIGHT THERAPY

REALLY CAN GIVE
AN INDIVIDUAL

A LEG UP IN RECOVERY.

Woman:
THIS WHOLE ADDICTION

WILL RUIN YOUR MIND
AND THOUGHTS.

EVEN THOUGH
I LIVED THROUGH IT,

I STILL DON'T
UNDERSTAND IT.

THIS IS EXCELLENT.
WHAT WE SEE IN YOUR BRAIN
IS WHAT YOU SEE...

THE CORRECT DOSING
TECHNIQUE IS TO PUT IT
UNDER YOUR TONGUE.

YOUR CRAVINGS
ARE ACTUALLY MUCH LOWER
THAN WHEN YOU STARTED,

WHICH IS REALLY NICE.

THE OPIATES THAT WE'RE
USING NOW, IT STIMULATES

THE PARTS OF YOUR BRAIN
THAT HELP YOU WANT TO GET
UP GO DO YOUR JOB...

( siren wailing )

HE'S GOT A BRUISE
UNDER HIS MID-LEFT
CLAVICLE.

Larry Gentilello:
HERE AT THE TRAUMA CENTER
IT'S SATURDAY NIGHT,

THESE ARE WHERE
THE PROBLEMS REALLY ARISE FROM

TOO MUCH DRINKING,
TO MUCH DRUG USE
IN OUR SOCIETY.

PUT THE ULTRASOUND AWAY.
OG-TUBE, LET'S GO.

WE'RE HERE IN THE ER.
I'M NOT FLOODED TONIGHT

WITH PEOPLE WHO NEED
THEIR APPENDIX TAKEN OUT

OR THEIR GALLBLADDER.
IT'S ALL DRINKING AND INJURIES.

HAVE YOU EVER HAD
SEIZURES FROM STOPPING
DRINKING BEFORE?

- I'VE HAD BLACKOUTS.
- YOU'VE HAD BLACKOUTS?

THIS IS PROBABLY
OUR THIRD INCIDENT
THIS EVENING

WHERE WE'VE HAD ALCOHOL
OR DRUG USE INVOLVED.

GO, GO, GO.

- WHAT HAVE YOU GOT THERE?
- TRACE AMOUNT OF CRACK HERE.

THEY USE THAT
TO SMOKE IT.

HE'S POSITIVE
FOR BENZODIAZEPINES
AND OPIATES,

BUT ALSO POSITIVE
FOR COCAINE.

WHAT HAPPENED TO YOU?

I GOT IN A FIGHT
WITH TWO YOUNGSTERS,

CUT ME ACROSS THE HEAD
AND CUT ME RIGHT HERE.

- ( yells )
- I'M SORRY.

I THINK IT'S PRETTY LIKELY
THAT DRUGS AND ALCOHOL

WERE INVOLVED IN
THIS INJURY,

BOTH ON THE PART
OF THE PATIENT AND ON THE PART
OF THOSE WHO STABBED HIM.

WHAT HAPPENED TO THIS
PATIENT OVER THERE?

42-YEAR-OLD MALE
IN THE PARKING LOT
SLIPPED BETWEEN

THE CURB AND THE WALL,
SNAPPED HIS ANKLE.

- HAS HE BEEN DRINKING?
- HE'S BEEN DRINKING.

- I HAD ABOUT A SIX-PACK.
- A SIX-PACK, OKAY.

- IT'S DEFORMED THERE.
- I HONESTLY DON'T THINK

THAT THIS HAPPENED
BECAUSE I WAS DRINKING.

I THINK IT'S JUST BECAUSE
OF THE WAY I STEPPED.

YOU MAY BE RIGHT.
I'M NOT SAYING YOU'RE NOT.

NORMALLY, A PATIENT
LIKE THIS WOULD COME
TO AN EMERGENCY ROOM,

EVERYONE WOULD FOCUS ON HIS
ANKLE AND NOTHING WOULD BE DONE

FOR THE UNDERLYING DRINKING
PROBLEM THAT CAUSED THIS INJURY
IN THE FIRST PLACE.

NOW'S THE TIME
TO OFFER HIM SOME COUNSELING.
HE'S AN EXCELLENT CANDIDATE.

WE'RE GOING TO KEEP
AN EYE ON HIM, GIVE HIM
HIS MEDICAL CARE.

BY TOMORROW MORNING
WE'RE GOING TO MAKE SURE

HE SEES A COUNSELOR
BEFORE HE GOES HOME.

- HOW YOU DOING THERE, SIR?
- I'M DOING ALL RIGHT NOW.

I'M 20 RIGHT NOW.

BARELY TURNED 20--
HAPPY BIRTHDAY TO ME, HUH?

TODAY YOU'VE BEEN DRINKING?

LITTLE BIT, YES, SIR.
I HAVE BEEN DRINKING TODAY

- WHAT DID YOU DRINK?
- I DRANK JIM BEAM, SIR.

TODAY IS MY BIRTHDAY.
RIGHT NOW IS MY BIRTHDAY.

AS OF 12:00 TONIGHT
IT'S MY BIRTHDAY.

- HOW OLD ARE YOU?
- I'M 20 YEARS OF AGE.

- 20?
- YES, SIR.

HOW MANY JIM BEAMS
DID YOU HAVE?

I PROBABLY HAD ABOUT
15 TO 20 SHOTS.

( yells )

WE'RE GOING TO FIX
THAT UP FOR YOU.

YOU'RE LUCKY YOU DIDN'T
DAMAGE ANY ARTERIES

OR NERVES THAT CONTROL
THE FUNCTION OF YOUR ARM.

THIS COULD HAVE
BEEN A LOT WORSE.

DO YOU HAVE ANY OTHER
HISTORY OF DRUG USE

AMONG PEOPLE WHO ARE
CLOSE TO YOU?

YES, THEY ALL
USE DRUGS.

I WISH THEY
WOULD ALL QUIT.

MY BEST FRIEND
IN THE WHOLE WORLD--

I LOVE HER SO
SO SO MUCH.

BABY, I WISH
YOU WOULD QUIT.

YOU KNOW WHAT I'M TALKIN' ABOUT?
I AIN'T SAYING NOTHING ELSE.

PLEASE, BABY.
PLEASE.

Gentilello:
THIS IS WHAT WE CALL
A LEVEL-ONE TRAUMA.

THIS IS SOMEONE
WHO IS BADLY INJURED

WHO THE PARAMEDICS
HAVE PRETTY MUCH DECIDED

IS AT RISK OF LOSING
LIFE OR LIMB.

THE RESOURCES THAT WE
COMMIT TO TRAUMA CARE
ARE ENORMOUS.

IN FACT, IN SOME WAYS,
IT'S ONE OF THE MOST

EXPENSIVE DISEASES
THAT WE FACE IN MODERN SOCIETY.

AND ABOUT HALF OF IT'S RELATED
TO ALCOHOL USE.

- DO WE HAVE A PULSE?
- DO YOU HAVE A PULSE?

NO, HE'S 26 YEARS OLD.

Gentilello:
WE'VE GOT TO GIVE HIM
EVERY CHANCE.

THE MAIN THING IS TO STOP
THE BLEEDING FROM HIS
PELVIC FRACTURE.

LET'S SHOCK HIM.
LET'S SHOCK HIM.

- GO TO 400.
- CLEAR.

- CLEAR
- WE GOT A PULSE.

- WE HAVE A PULSE?
- YES.

HE'S GOT A RAPID PULSE
AND A WEAK BLOOD PRESSURE.

NOT MUCH. I MEAN HIS CHANCES
ARE PRETTY SLIM TO NONE.

BUT AS LONG AS HE'S GOT
A PULSE AND A FAINT
BLOOD PRESSURE

WE'RE GONNA KEEP
DOING ALL WE CAN.

- YIKES!
- WHAT'S HE GOT?

ALL RIGHT. ALL RIGHT.
WE FOUND WHAT YOU FOUND.

IS HE BLEEDING
FROM HIS BACK?

HE'S GOT A BALLOTABLE BACK.
HIS WHOLE BACK'S
FULL OF BLOOD.

Woman:
THERE'S MORE BLOOD.

HOW LONG HAVE WE
BEEN DOING CPR?

Woman:
WE'VE BEEN DOING
CPR FOR 19 MINUTES,

AND HE WAS DOWN
SEVEN MINUTES WHEN
HE GOT HERE.

GENTILELLO, WE DON'T
HAVE ANYTHING.

ALL RIGHT,
LET'S CALL IT.

PATIENT'S EXPIRED.

WE DID EVERYTHING
WE COULD.

THANKS A LOT.

YOU NEVER GET OVER
SEEING YOUNG PEOPLE DIE.

SO WE JUST CHECKED
THIS PATIENT'S URINE
TOXICOLOGY SCREEN.

HE WAS UNDER
THE INFLUENCE OF MARIJUANA.

SO HE DIED BECAUSE
OF INTOXICATION.

HE'S A YOUNG PERSON.

IT'S NOT LIKE TAKING CARE
OF SOMEBODY WHO'S 75 YEARS OLD

AND DIED OF A HEART ATTACK,

OR 80 YEARS OLD
AND HAS CANCER OR DEMENTIA.

THIS IS A YOUNG PERSON
IN THE PRIME OF HIS LIFE.

LEFT HIS HOUSE TODAY
AND EXPECTED TO COME HOME
TO HIS PARENTS TONIGHT.

BUT HE WON'T.

Radio:
Dispatch.

HEY, I GOT A WARRANT
FOR AN INDIVIDUAL THAT
I'M LOOKING FOR.

AND WE'RE HEADED
OVER THERE NOW TO
CHECK THE HOUSE.

SHE COULD BE
ANYWHERE AROUND HERE.

I'VE HEARD ABOUT PEOPLE
HAVING THEIR CHILDREN
ARRESTED TO GET HELP.

AND I THOUGHT,
"WHAT A DESPERATE MEASURE."

I USED TO THINK,
"I HOPE I NEVER GET
TO THAT POINT."

AND I THOUGHT,
"I COULD NEVER ARREST
MY OWN CHILD."

I MEAN HOW COULD
YOU DO THAT?

THAT'S LIKE AN ADDICT
GETTING DESPERATE.

THAT'S HOW A PARENT--
I'M DESPERATE NOW.

I WILL DO ANYTHING
TO HELP MY CHILD.

( dog barking )

Donna:
MY DAUGHTER HAS BEEN
AN ADDICT FOR SEVEN YEARS.

SHE'S BEEN OUT ON THE STREETS
RIGHT NOW FOR...

30 DAYS.

BUT SHE'S MANAGED
TO AVOID THE LAW
AND AVOID US.

AND THEY'RE
VERY RESOURCEFUL.

- THEY'RE VERY STREET SMART.
- SHE'S OBVIOUSLY BEEN HERE.

BECAUSE THAT'S HER STUFF
ON THE OTHER SIDE.

ON THE FLOOR THERE.

CLIMB IN THROUGH
THIS WINDOW--

THEY ACTUALLY CLIMB UP THE ROOF,
SNEAK IN THE WINDOW.

I'VE SEEN HER
OVERDOSE TWICE.

AND THE LAST ONE
SHE ALMOST DIDN'T MAKE IT.

WE'VE ALREADY FOUND
DRUG PARAPHERNALIA--

SPOONS, RAZORS,
CRACK PIPES,

SUBOXONE--

SEVERAL DIFFERENT THINGS.

MY DAUGHTER HAS STOLEN
ITEMS FROM ME.

AND IN THE PAST
I'VE OVERLOOKED IT, BUT...

I'M HOPING DETECTIVE MITCHELL
CAN GET HER IN JAIL,

GET HER THROUGH DETOX
WHERE SHE CAN THINK CLEARLY,

BECAUSE RIGHT NOW
SHE CAN'T THINK CLEARLY.

ALL SHE CAN THINK ABOUT
IS THE NEXT FIX.

IN THE END OF HER LETTER
SHE SAYS,

"THERE IS NO ESCAPE,
BUT I'M TERRIFIED

OF GOING TO JAIL, AND EVEN MORE
OF BEING DOPE SICK."

THIS IS WHEN
SHE WAS ABOUT 15,

BEFORE THE ADDICTION
HAD STARTED.

THIS IS HER GRADUATION PICTURE
WHERE SHE, AT THIS POINT,

WAS SOMEWHERE AROUND
SEVEN TO EIGHT MONTHS CLEAN.

AND THIS ONE WAS TAKEN

PROBABLY ABOUT
TWO MONTHS AGO.

AND SHE LOOKS HIGH TO ME.

SHE WAS IN THE GIFTED
PROGRAM AT SCHOOL,

CAPTAIN OF THE
CHEERLEADING SQUAD.

SHE HAD A LOT
OF FRIENDS.

SHE HAD
A BEAUTIFUL VOICE.

SHE SANG AT WEDDINGS AND PLAYED
THE PIANO BEAUTIFULLY.

SHE GOT THAT TALENT
FROM HER FATHER.

BUT SHE NEVER
LIKED HERSELF.

WHEN YOU TALK TO PEOPLE
THAT DO NOT HAVE ADDICTS,

THEY JUST
DON'T UNDERSTAND.

YOU'LL OVERHEAR,
"WELL, WHERE WERE THE PARENTS?

WHERE WERE YOU
WHEN THIS WAS HAPPENING?"

I WAS RIGHT HERE.
I MEAN, I WAS RIGHT
WITH MY DAUGHTER.

I HAD HER
IN EVERYTHING.

I WAS-- YOU KNOW,
I KEPT HER BUSY.

BUT, YOU KNOW--

OR "WHY DON'T YOU
DO SOMETHING ABOUT IT?"

YOU KNOW, I'VE DONE
EVERYTHING I COULD POSSIBLY
DO ABOUT IT.

WHEN I PUT HER
IN TREATMENT, I WAS
LED TO BELIEVE--

AND MAYBE IT WAS JUST ME
BECAUSE I DIDN'T KNOW,

AND THEY DIDN'T
EXPLAIN IT TO ME--

THAT WE'RE GOING TO PUT YOUR
DAUGHTER INTO TREATMENT

AND SHE'S GOING
TO GO THROUGH THE TREATMENT

AND SHE'S GOING TO LEARN
WHAT SHE HAS TO DO.

AND WHEN SHE CAME OUT
OF TREATMENT I THOUGHT,

"THIS IS IT.
YOU KNOW, THIS IS GOOD."

BUT IT WASN'T.

WE'RE ALSO GOING TO NEED
TO CHECK THE HOUSE,
IF YOU DON'T MIND.

( radio chatter )

I HAVEN'T
SEEN HER OR SPOKE
TO HER SINCE...

DID PATOSKI GO
THROUGH EVERYTHING ELSE?
THE ATTIC AND ALL THAT?

...SINCE ABOUT
TWO WEEKS AGO.

I CRY A LOT
AND SOMETIMES I THINK
I'M NOT GONNA MAKE IT.

BUT THEN I TURN AROUND AND SAY,
"I HAVE TO MAKE IT."

I MEAN,
SHE'S ALL I HAVE.

IF ANYTHING HAPPENS TO ME,
SHE WON'T MAKE IT.

I WANT HER TO MAKE IT
BECAUSE I BELIEVE IN HER.

I KNOW SHE CAN MAKE IT.

STEP.

THERE YOU GO,
'CAUSE I DON'T WANT
IT TO CHOKE YOU.

Donna:
AUBREY WILL BE PICKED UP TODAY
BY DETECTIVE MITCHELL.

SHE'LL BE TRANSPORTED
FOR A HEARING.

I GOT THE CALL WHEN HE ALREADY
HAD HER AT THE STATION.

HE SAID, "I HAVE SOMEBODY HERE
THAT WANTS TO TALK TO YOU,"

AND I JUST CRIED.

I THINK IT WAS
JUST THE EMOTIONS
THAT BUILT UP INSIDE.

I HEARD HER VOICE
AND I JUST ALL LET LOOSE.

BUT I'M NERVOUS.
I'M NERVOUS WITH
WHAT'S GONNA HAPPEN

AT THE MAGISTRATE'S
OFFICE.

AND I'M PROBABLY
MORE NERVOUS WITH HER
COMING HOME.

'CAUSE IT'S NEVER
WORKED IN THE PAST.

I WAS JUST
DONE RUNNING.

I COULDN'T
DO IT ANYMORE.

YOU GOTTA FIND
A PLACE TO SLEEP
EVERY NIGHT.

YOU GOTTA FIND
WAYS OF GETTING
MONEY EVERY DAY.

IT'S JUST TOO MUCH.

I DIDN'T CARE WHAT
HAPPENED JUST AS LONG
AS I GOT HIGH.

BUT THEN NEAR
THE END IT'S JUST
THE MONEY RAN OUT.

I HAD NOWHERE TO GO.

I WAS LIKE--
RIGHT NOW, I CARE.

THIS ISN'T
WHAT I WANT.

Mitchell:
YOU READY? OKAY.

THAN YOU VERY MUCH.
HAVE A GOOD DAY.

- ONE MORE.
- DID YOU SAY THANK YOU?

YES, MANY TIMES.

I TOLD HER,
NO FRIENDS,

NO NOTHING,
NO VISITS,

NO FAKE EATING
PARK LUNCHES, NO--

- NOTHING.
- NOTHING.

WE'RE GOING TO RUN
THE HOUSE LIKE A REHAB.

I HOPE SO.

I'M JUST TRYING
TO GET AT: WHAT'S
IT GOING TO TAKE

FOR YOU TO REACH
YOUR BOTTOM?

I DON'T REALLY KNOW
WHAT A BOTTOM IS.

I GUESS IT'S DIFFERENT
FOR EVERYBODY.

I MEAN, CAN I SAY
I'M NEVER GOING TO TAKE

ANOTHER DRUG
OR ANOTHER DRINK

FOR THE REST OF MY LIFE?
NO, I CANNOT SAY THAT.

CAN I SAY I'M NOT GOING
TO TAKE A DRUG OR DRINK TODAY?

YEAH, I CAN.

YOU KNOW?
IT WORKS LIKE THAT.

I'M JUST THINKING,
WHAT DID WE DO WRONG?

OR DID WE DO
ANYTHING WRONG?

WHAT DIDN'T WE DO
THAT WE NEED TO DO
THIS TIME?

LIKE, STICK
TO A PROGRAM.

I DON'T KNOW.
I NEED-- I NEED
TO NOT BE BORED.

I NEED TO GET A JOB.

I NEED TO MAKE
NEW FRIENDS THAT
DON'T USE.

YOU NEED TO
GO TO MEETINGS.

I KNOW ENOUGH
ABOUT ADDICTION
AND RECOVERY.

I MEAN, I'VE BEEN
GOING TO REHAB SINCE,

FOR WHAT, 10 YEARS
OR SOMETHING.

- SO--
- 16.

16, WHATEVER.

EIGHT YEARS, SEVEN YEARS.

I COULD RUN A REHAB.

WE NEED TO SIT DOWN
AND MAKE A PLAN,

A GOAL, A CONTRACT,
SOMETHING,

AND LIVE BY IT.

- DOES THAT SOUND GOOD?
- YEP.

YOU HELP ME
AND I'LL HELP YOU,

AND MAYBE
WE'LL MAKE IT.

- WHAT DO YOU THINK?
- SOUNDS GOOD.

WHEN SOMEBODY
BEGINS TO THINK

THAT A LOVED ONE
OR FAMILY MEMBER

HAS A DRUG OR ALCOHOL PROBLEM

IT IS REALLY FRIGHTENING.

BECAUSE NONE OF US KNOW

HOW TO START, WHERE TO START
AND WHERE TO GO.

ADDICTION IS UNPLEASANT
TO THE PERSON WHO HAS IT,

AND TO THE FAMILY
OF THE PERSON THAT HAS IT.

AND THAT'S WHY
YOU WANT TO TREAT IT.

THIS IS NOT SOMETHING
THAT DEVELOPS

OVERNIGHT FOR ANY INDIVIDUAL.

AND GENERALLY THERE IS
A SERIES OF STEPS

THAT THE INDIVIDUALS
GO THROUGH

FROM EXPERIMENTATION
AND OCCASIONAL USE

THROUGH THE ACTUAL LOSS
OF CONTROL OF USE.

USE BECOMES COMPULSIVE.

AND PEOPLE BECOME
PREOCCUPIED WITH IT.

IT BECOMES VERY
VERY IMPORTANT TO THEM.

ONE OF THE WAYS
I DEFINE ADDICTION

IS WANTING THE WRONG
THING VERY VERY BADLY.

DRUG ADDICTION
IS A DISEASE OF THE BRAIN

THAT TRANSLATES--
THAT THAT DISEASE

TRANSLATES INTO
ABNORMAL BEHAVIOR.

WHEN A PERSON
WHO HAS THIS DISEASE

IS EXPOSED TO CUES
OR STIMULI

THAT REMIND THEM OF,

OR HAVE PREVIOUSLY
BEEN ASSOCIATED WITH
THE USE OF A DRUG,

THERE IS AN UNCONTROLLABLE
REFLEX.

IT HAPPENS VERY
VERY QUICKLY IN THE BRAIN.

WE CAN SEE IT
IN BRAIN IMAGING.

AND THE PERSON DOESN'T HAVE
THE ABILITY TO STOP IT.

AS A MATTER OF FACT, IT MAY
HAPPEN BEFORE THEY'RE EVEN
CONSCIOUS OF IT.

Man:
I'M OUT HERE ALONE NOW,

TRYING TO HANG ON
AND SURVIVE.

THE HOLIDAYS WERE ROUGH.

I ACTUALLY THOUGHT
THIS ONE WOULD BE DIFFERENT.

BUT RIGHT NEAR THE END

SOME OTHER
THINGS HAPPENED...

WITH MY WIFE
AND THE FAMILY

AND I DIDN'T
RESPOND VERY WELL.

I SAID, "I'M GOING
OUT FOR A LITTLE WHILE."

I WENT OUT.

I DON'T EVEN REALLY
REMEMBER WHERE I WENT
OR WHATEVER.

BUT I DO REMEMBER
GOING OUTSIDE,

WALKING AROUND, BUYING DRUGS.
I HAD MONEY.

AND...

USED--
AND JUST USED.

EVEN AFTER PEOPLE HAVE BEEN
DRUG FREE FOR

NOT JUST DAYS OR WEEKS,
BUT MONTHS OR YEARS,

THE TENDENCY TO RELAPSE
IS VERY STRONG.

SO IT IS THE WAY
TO UNDERSTAND

WHAT ADDICTIONS ARE.

THE TENDENCY TO RELAPSE
IS PART OF THE DISORDER.

IT'S NOT A FAILURE
OF TREATMENT.

IT'S PART OF THE DISORDER.

I'VE ALWAYS LOST THE BATTLE,
AND THAT'S HOW I FEEL.

I'VE LOST THE BATTLE AGAIN
AND I'M USING AGAIN.

YOU KNOW, I SIT AND WHEN
I'M ACTUALLY USING

AFTER A BATTLE LIKE THAT,
I FEEL SO BAD.

BECAUSE I COULDN'T WIN.

OR I DIDN'T WIN.

Childress: YOU'VE HAD A WILD
THREE OR FOUR MONTHS HERE.

William:
A ROLLER-COASTER RIDE.

RIGHT NOW I'M
IN A PERIOD WHERE

I JUST CAN'T SEEM
TO GET WHAT I WANT.

I DEFINITELY KNOW
WHAT I WANT.

AND THAT'S CLEAN AND SOBER.
THAT'S THE END.

- THAT'S THE END RESULT.
- YOU WANT TO GET
TO A GOOD SPOT.

IT'S SO IMPORTANT TO DO
EXACTLY WHAT YOU'RE DOING,
WHICH IS TO SAY,

"IF I HAD 11 MONTHS

GOOD FUNCTIONING,
CLEAN TIME BEFORE..."

- YES.
- "...I CAN DO THAT AGAIN."

IN FACT, ALL THE DATA
SAYS THAT THE MORE TIMES
YOU KEEP TRYING

YOU INCREASE YOUR
LIKELIHOOD OF THAT SUCCESS
BEING MORE SUSTAINED.

AND THAT'S REALLY
REALLY IMPORTANT.

PATIENTS SAY,
"WHY CAN'T I JUST STOP?

I'VE LOST SO MUCH.
I'VE PAID SUCH A HIGH PRICE."

PARENTS SAY,
"WHY CAN'T THEY JUST STOP?

THEY'VE COMPLETELY
WRECKED THEIR LIVES.

OUR LIVES TOO.
WHY CAN'T THEY JUST STOP?"

AND WHAT WE'RE
BEGINNING TO UNDERSTAND
NOW AT THE LEVEL OF THE BRAIN

IS THAT THERE ARE
A LOT OF CARDS

THAT ARE STACKED
IN THE WRONG DIRECTION HERE.

I'M SO STRONG-WILLED
IN SUCH OTHER THINGS

THAT PEOPLE-- PEOPLE COULD
ACTUALLY-- THERE'S PEOPLE
THAT WOULD SAY TO YOU,

"YEAH, HE'S STRONG-
WILLED IN THIS WAY."

- SO WHY CAN'T HE BE STRONG-
WILLED IN THIS WAY?
- EXACTLY.

SO IT'S VERY IMPORTANT FOR
PEOPLE TO TRY TO UNDERSTAND

IT'S NOT A MATTER

OF MORAL FIBER OR
CHARACTER OR JUST
WANTING IT ENOUGH.

YOU'VE GOT PARTS
OF THE BRAIN HERE
THAT THINK

WHEN THEY SEE
THESE SIGNALS FOR A DRUG,

THAT THAT'S AS IMPORTANT
AS A RELATIONSHIP,

AS THE BEST FOOD
YOU EVER SAW.

IT'S-- IT'S A TRICK THAT'S
PLAYED ON THE BRAIN.

AND IN A WAY THAT
TENDS TO LEAVE OUT

THIS DECISION-MAKING
PART OF YOUR BRAIN.

SO IN THE BRAIN WE HAVE
THESE TWO IMPORTANT SYSTEMS.

THE "GO" SYSTEM,
THE ANCIENT "GO" CIRCUIT
FOR HELPING US RESPOND

TO NATURAL REWARDS
THAT ARE SO IMPORTANT
FOR OUR SURVIVAL.

AND THE "STOP" SYSTEM,
THE MORE RECENT FRONTAL
LOBE SYSTEM

THAT'S IMPORTANT
FOR HELPING US CONSIDER
WHEN IT'S IMPORTANT NOT TO GO,

NOT TO ACT ON THE PULL
OF THAT REWARD.

WHEN THINGS ARE WORKING
RIGHT, THE GO CIRCUITRY

AND THE STOP CIRCUITRY
REALLY ARE INTERCONNECTED

AND REALLY TALKING
TO EACH OTHER

TO HELP YOU
WEIGH THE CONSEQUENCES

OF A DECISION AND DECIDE
WHEN TO GO OR NOT TO GO.

SO IT'S NOT THAT
THEY'RE SEPARABLE.

THEY'RE INTERACTIVE.
THEY'RE INTERLINKED
AT ALL TIMES.

IT'S JUST THAT
IT'S INTERESTING,

WITH OUR PATIENT SITUATION,
IT IS AS THOUGH THEY

HAVE BECOME FUNCTIONALLY
DISCONNECTED.

IT IS AS THOUGH
THE GO SYSTEM

IS SORT OF RUNNING OFF
ON ITS OWN,

IS A ROGUE SYSTEM NOW,

AND IS NOT INTERACTING

IN A REGULAR, SEAMLESS,
INTEGRATED WAY WITH
THE STOP SYSTEM.

THIS IS THE TRIGGER--
ALL OF THIS AROUND ME.

YOU CAN TURN AROUND
AND LOOK AT ALL THAT, AND ALL
THAT'S A TRIGGER

BECAUSE ALL OF THIS
IS WHERE I'M FROM

AND I'VE ALWAYS USED
IN THIS AREA.

SO YOU IMAGINE,
THE TRIGGER IS HERE.

THE TRIGGER
IS NOT ONLY UP HERE,

THE TRIGGER IS WHEN
I WALK OUT, OPEN MY EYES
AND WHAT I SEE.

THE PATIENT SEES,
SMELLS, EXPERIENCES

THINGS THAT REMIND THEM
OF THEIR DRUG OF ABUSE.

AND INSTEAD
OF BEING ABLE TO SAY,
"WAIT A MINUTE.

THINK ABOUT WHAT
HAPPENED LAST WEEK.

YOU LOST YOUR JOB.
YOU ALMOST LOST YOUR LIFE."

INSTEAD THE STOP SYSTEM
DOESN'T SEEM TO GET INTO
THE PICTURE AT ALL.

IT'S ALL ABOUT GO.

ONE OF THE EXCITING
THINGS ABOUT NOW

IN TERMS OF OUR
UNDERSTANDING ADDICTION

IS THAT FOR
THE FIRST TIME

IN ALL OF HUMAN HISTORY

WE CAN PEEK
INSIDE THE BRAIN

AND SEE
WHAT MAY BE BROKEN.

AND IF WE CAN SEE
WHAT'S BROKEN,

WE HAVE AN IDEA

ABOUT HOW
TO GO ABOUT FIXING IT.

WE WANTED TO UNDERSTAND
HOW LITTLE DOES IT TAKE

TO GET THIS SENSITIVE
REWARD CIRCUIT

ACTIVATED AND OFF
TO A HEAD START.

SO WHAT WE'VE NOTICED
IN THE PAST YEAR IS THAT
THE SYSTEM

CAN BE ACTIVATED
WHEN WE SHOW PICTURES

THAT ARE AS SHORT
AS 33 MILLISECONDS;

WITH THINGS
THAT ARE SO SHORT

THAT THEY ARE
OUTSIDE AWARENESS.

SO WHAT'S REALLY DIFFICULT
HERE FOR THE STOP SYSTEM

IS WE KNOW THAT THE MESSAGE
DOESN'T EVEN HAVE A CHANCE

TO GET UP TO THE FRONTAL LOBES
FOR THEM TO WEIGH IN.

IT'S COMING IN
UNDER THE RADAR

BEFORE YOU HAVE
A CHANCE TO MOUNT
A DEFENSE.

SO WHAT'S SO IMPRESSIVE
TO ME IS THAT

THIS GO SYSTEM
IS SO INCREDIBLY SENSITIVE

THAT WHILE MANY
OF THE THINGS

WE EXPERIENCE
ARE MULTIPLE SECONDS LONG,

THEY DON'T HAVE TO BE
TO GET IT GOING.

FOR OUR PATIENTS,
I THINK IT WILL BE

A HELPFUL PIECE OF NEWS

BECAUSE FOR THEM,
THEY SOMETIMES COULDN'T
POINT TO THE CUE

OR LABEL THE CUE
THAT SET OFF THIS
CRAVING STATE.

IF THIS KIND
OF MOMENT ARISES
SO QUICKLY,

WE NEED SOMETHING TO BE
IN PLACE

TO SORT OF BRING THINGS
INTO A MANAGEABLE RANGE

BEFORE THE CHALLENGE
OF A GO MOMENT.

WE'VE BEGUN TO STUDY
A MEDICATION

THAT WOULD HELP
QUIET THINGS DOWN,

THAT WOULD SORT OF, LIKE,
TUNE DOWN THE VOLUME ON
THE GO SYSTEM.

THIS MEDICATION, CALLED
BACLOFEN , IT'S FAMILIAR.

IT'S BEEN AROUND
A LONG TIME.

BUT WE'VE FOUND THAT
IT CAN REDUCE

THE ACTIVITY IN THIS
SYSTEM A LITTLE BIT,

BRINGING IT SORT OF INTO
A MORE MANAGEABLE RANGE.

SO WHAT THIS
PICTURE SHOWS

IS THAT IN PATIENTS

WHO ARE UNTREATED,

WHO HAVE NO MEDICATION,

WHO SEE HALF-SECOND
COCAINE CUES,

THE BRAIN
HAS AN INTENSE DIALOGUE.

ONE WAY TO THINK
ABOUT THIS PICTURE

IS THAT YOU'RE SEEING
A VISUAL REPRESENTATION

OF "LET'S GO FOR IT."

AND YOU CAN TELL THAT
IT'S A VERY INTENSE DIALOGUE

BECAUSE OF THESE
VERY HOT SPOTS.

ON THE OTHER HAND,

WHEN WE LOOK AT PATIENTS

WHO ARE TREATED FOR SEVEN
DAYS WITH BACLOFEN,

WHAT YOU CAN SEE
IS THAT NOW

THIS INTENSE CONVERSATION

HAS BEEN REDUCED
TO A WHISPER.

IT'S NOT THAT
THE BRAIN IS DEAD.

THERE'S ACTIVITY.

BUT INSTEAD OF
"GO GO GO,"

IT'S "I DON'T KNOW.

DOESN'T SEEM LIKE
IT'S WORTH GOING."

SO THE HOPE IS THAT YOU
WOULD HAVE A CHANCE

FOR THE FRONTAL LOBE
TO DO ITS THING,

TO BE ABLE TO WEIGH IN
AND HAVE A CHANCE

TO PUT INTO PLACE
GOOD DECISION-MAKING.

I DO NOT WANT
TO LIVE MY LIFE

UNDER THE GRIPS
OF MY ADDICTION.

I WILL BE AN
ADDICT PROBABLY--

I WILL BE AN ADDICT
ALL MY LIFE.

BUT I WANT TO NOT BE
AN ADDICT USING.

SO THE HOPE
OF THE FUTURE IS

MEDICATIONS AND BEHAVIORAL
TREATMENTS

THAT CAN COMBINE

TO LITERALLY
RESET THE BRAIN.

THIS IS ME
IN THE SIXTH GRADE.

I WAS KIND OF HIGH
IN THAT PICTURE.

VISINE'S ALL YOU NEED.

OF ALL OF THE MENTAL DISEASES
THAT I'VE SEEN,

THERE'S NOTHING
THAT I HAVE SEEN

THAT DISRUPTS MORE A FAMILY
THAN HAVING A KID
WHO'S ADDICTED.

IT CAN BE DRUGS OR ACTUALLY
IT COULD BE ALCOHOL.

I JUST EXPERIMENTED
WITH ALL OF THEM.

LIKE EX, METH,
MUSHROOMS.

THE ONE THAT I LIKED
THE BEST WAS BUD BECAUSE

IT JUST-- LIKE, IT WAS--

IT WAS A CALMING FEELING.

I HAD RACING THOUGHTS
ALL THE TIME AND IT JUST
CHILLED ME OUT.

AND I LIKED
THAT FEELING.

( heavy metal music playing )

YEAH, I REMEMBER
I TOOK 10 CAPS OF SHROOMS.

AND THAT'S ENOUGH
TO KILL YOU.

SO I JUST THOUGHT--

I WAS LIKE, "WOW, I'M AMAZED
THAT I'M STILL ALIVE
AFTER THAT."

THE ADOLESCENT BRAIN
IS DIFFERENT

FROM THAT OF AN ADULT.

AND THAT LEADS
TO BEHAVIORS

THAT DEFINITELY PUT THEM

AT MUCH HIGHER RISK
TO WANT TO TRY DRUGS

THAN THE BRAIN
OF AN ADULT.

THEY HAVE EVEN LESS OVERRIDE
OF THEIR IMPULSIVITY.

AND PROBABLY FROM FACTORS

THAT EXISTED BEFORE
THEY USED DRUGS

AND EXACERBATED
BY USING DRUGS.

Scott:
DYLAN WAS TURNING 10--
10 AND A HALF

WHEN HIS FATHER,
HIS BIRTH FATHER, LEFT HIM.

HE LEFT WITHOUT GIVING
HIS KIDS ANY WORD.

AND THEN HE STARTED
TO WITHDRAW AND GET--

HE WENT INTO
A DEPRESSED STATE

THAT WE DIDN'T
RECOGNIZE AT FIRST.

WHEN HE WAS IN
FIFTH AND SIXTH GRADE

HE STARTED USING
AT THE GRADE SCHOOL

VARIOUS DRUGS
THAT WERE AVAILABLE,

AND THEN EVEN ALCOHOL
THAT HE COULD FIND.

AND HE DID THIS FOR--
WELL, UP TO PRESENT DAY.

BUT HE USED
ANY TYPE OF DRUG,

ANYTHING HE CAN GET
HIS HANDS ON.

HE WAS KNOWN
AS A CUTTER.

AND WE FOUND OUT A LOT
OF ADOLESCENT TEENS
ARE DOING THAT.

HE THOUGHT IT WOULD
RELEASE STRESS,

BUT IT DID
NOTHING MORE THAN LEAVE
PERMANENT MARKS.

AND THEN HE STARTED
BEING AGGRESSIVE AGAIN
TOWARDS HIMSELF

BY CUTTING HIS FACE.
HE BURNED HIS FACE
WITH A NEEDLE.

HE TOOK IT OUT
ON THINGS

THAT HE KNEW HE
WOULDN'T HURT PEOPLE,

BUT HE WOULD
EITHER HURT HIMSELF
OR MATERIAL THINGS.

IF YOU LOOK AT KIDS
COMING INTO TREATMENT,

THEY'RE CHARACTERIZED
BY HAVING MULTIPLE PROBLEMS.
IT'S NOT ONE THING.

ALCOHOL OR DRUG USE
MAY NOT EVEN BE THEIR
MOST SEVERE PROBLEM.

THEY MAY HAVE PROBLEMS
WITH DEPRESSION, WITH SUICIDE
IDEATION.

THEY MAY BE CUTTING
THEMSELVES OR BURNING THEMSELVES
OR MUTILATING THEMSELVES.

ABOUT A THIRD OF THEM DO.

THEY MAY HAVE PROBLEMS
WITH ANGER AND CONTROLLING
THEIR TEMPERS.

THEY MAY HAVE PROBLEMS
RUNNING AWAY OR FOLLOWING
RULES AND ORDERS.

SO IT TENDS TO NOT BE
ONE THING BUT MULTIPLE THINGS.

DYLAN GOT IN TROUBLE
LAST FALL.

BASICALLY HE WAS STARTING
TO HAVE RAGE EPISODES

WHERE HE WOULD COULDN'T
CONTROL HIS ANGER AT ALL.

THE DAY DYLAN DECIDED
TO BREAK OUR WINDOWS

WITH A SLINGSHOT
WRIST ROCKET,

HE HAD AN ARGUMENT
OVER DOING A CHORE.

IT WAS A VERY SIMPLE TASK,
BUT HE DIDN'T FEEL HE NEEDED
TO DO IT.

SO HE SNUCK OUTSIDE,
SHOT OUT THE WINDOWS.

AND BY DOING SO I HAD
TO GO OUT AND CONFRONT HIM.

AND HE WAS HOLDING THE WEAPON,
AIMING IT AT ME.

I WASN'T SURE IF HE
WAS GONNA SHOOT ME OR WHAT.

BUT HE DIDN'T.

HIS MOM ACTUALLY CALLED
THE SHERIFF.

AND THAT WAS VERY HARD,
TO TURN IN YOUR OWN SON.

I FELT LIKE I WAS--

LIKE THE WORLD WAS
ON MY SHOULDERS.

LIKE, "OH, I AM THIS RESPONSIBLE
ADULT FOR THIS CHILD

AND THIS KID AND HE'S
DOING THIS STUFF

AND THERE'S NOTHING
I CAN DO."

LESS THAN ONE IN 10
ADOLESCENTS WHO ALREADY

MEET CLINICAL CRITERIA
FOR ABUSE OR DEPENDENCE

ARE SHOWING UP
TO TREATMENT.

NOW WHAT THAT MEANS
IS WE'RE DOING A BAD JOB

OF IDENTIFYING
AND GETTING YOUR KIDS

WHO HAVE PROBLEMS
INTO TREATMENT.

THIS IS VERY DIFFICULT
BECAUSE IT'S NOT ONE THING.

PART OF IT MAY BE THAT
PARENTS AND TEACHERS

ARE HOPING, POSITIVELY,
THAT THEY'LL GROW OUT OF IT.

UNFORTUNATELY THIS
IS A VERY RISKY THING TO DO.

IT'S MUCH MORE IMPORTANT
TO OVERREACT, POSSIBLY.

BOREDOM IS A REALLY
BIG TRIGGER.

LIKE, YOU KNOW,
YOU'RE JUST SITTING AROUND
THE HOUSE BORED.

YOU GOT A BIG SACK
OF WEED AND A COUPLE BEERS.

HAVE A PARTY
RIGHT THERE.

MY PARENTS WOULD BE
LIKE STRAIGHT UP,

LIKE YELLING IN MY FACE.
LIKE, YOU KNOW,

"YOU FUCKIN' BLAH, BLAH,
BLAH, BLAH."

AND I'D JUST BE SITTING
THERE LIKE, "UH-HUH."

AND MY MIND WOULD
JUST BE SOMEWHERE ELSE.

AND I WOULD JUST
BE THINKING ABOUT,

"THANK GOD I GOT ANOTHER GRAM
STASHED SOMEWHERE IN MY ROOM."

HE'S HAD ONE TOOL
IN THE TOOL BAG. YOU KNOW?

"IT'S, YOU KNOW, IT'S A BAD DAY.
I THINK I'LL GET HIGH.

THE SUN IS SHINING.
I THINK I'LL--

MY GIRLFRIEND BROKE UP WITH ME.
I THINK I'LL GET HIGH."

KIDS DIDN'T COME
TO TREATMENT AND SAY,

"I WANT TO STOP USING DRUGS,"

BECAUSE THEY'RE THE BEST THING
THAT EVER HAPPENED TO THEM.

WHY WOULD THEY?
IT'S THEIR ONE COPING SKILL.

TED'S FLUNKED OUT OF
AN OUTPATIENT PROCESS.

I MEAN, THE VERY FIRST DAY
THEY TOLD HIM HOW TO FAKE
THE URINE TESTS.

AND SO FROM WEEK ONE
HE WAS DOING IT.

IT FINALLY GOT TO THE POINT
THAT TED HAD BEEN KICKED
OUT OF BOTH OF OUR HOUSES.

AND THAT WAS THE ONLY WAY
WE GOT HIM IN HERE.

THE ONLY WAY WE GOT HIM INTO
INPATIENT TREATMENT

WAS TO REALLY PUSH...

THAT FAR.

SO THE PARENTS BECOME
VERY ANGRY AT THE KID.

AND THE KID THEN REACTS OUT.

THEN YOU START TO CREATE
A DYNAMIC THAT'S VERY NEGATIVE.

THAT'S NOT GOING TO HELP
THE ADOLESCENT,

NOR IS IT GOING
TO HELP THE PARENT.

BECAUSE THE ADOLESCENT
WILL REBEL AGAINST THESE
NEGATIVE ATTITUDES.

ONE OF THE INTERVENTIONS
THAT HAS BEEN SHOWN

TO BE QUITE EFFECTIVE
ARE FAMILY INTERVENTIONS

WHERE YOU ENGAGE THE FAMILY
AS PART OF THE TREATMENT.

THE CHOICES THAT DYLAN MAKES
WILL RESULT IN EITHER

MORE FREEDOM...

OR A TIGHTER BOX.

AND IT'S ALL ON DYLAN.

Riggs:
OFTENTIMES FAMILIES
ARE REALLY ANGRY.

PARENTS ARE REALLY ANGRY
WITH THEIR KIDS

BY THE TIME THEY GET TO DRUG
TREATMENT BECAUSE THEY'VE
LIED TO THEM.

YOU KNOW, THEY SNEAK
OUT THE WINDOW.

THEY GO OUT AT NIGHT.
THEY AREN'T HOME ON TIME.
PARENTS ARE REALLY ANGRY.

THEY HAVE A HARD TIME
WITH TRUST

OR EVEN POSITIVELY
REINFORCING THEIR KIDS.

DYLAN, LET ME PUT IT
THIS WAY:

IF YOU GIVE ME REASONS

TO PUT MY THUMB ON YOU,
THAT'S YOUR FAULT.

AND IF YOU GO CRAZY
BECAUSE YOU'RE SO RESTRICTED,

THAT'S YOUR FAULT.
AND YOU PAY THE CONSEQUENCES
FOR THAT.

YOU CAN GO BACK TO MONTVIEW,
TO DETENTION.

WHAT A CONCEPT.

THERE ARE VERY
ABNORMAL PATTERNS

IN THE COMMUNICATION
OF THE FAMILY MEMBERS

THAT DEVELOP AS A RESULT
OF THE ADDICTION.

IF NOT DEALT WITH,
THOSE ABNORMAL PATTERNS

MAY CONTRIBUTE
TO RELAPSE.

HOW ARE YOU GOING
TO TELL THESE PEOPLE

I CAN'T GO WITH YOU?

I'M NOT REALLY SURE.
I JUST...

KNOW THAT I, UM...

I'M A STRONG ENOUGH
PERSON THAT I WOULDN'T
DO THAT KIND OF A THING.

HE DOESN'T HAVE A LOT
OF SKILLS YET

IN ASKING FOR HELP
WHEN HE NEEDS IT.

Dennis:
IF YOU REALLY WANT
TO BREAK THE PATTERN

YOU HAVE TO IDENTIFY ALL
OF THE CO-OCCURING THINGS

THAT ARE FEEDING OFF
OF EACH OTHER

AND ADDRESS THEM AT THE SAME
TIME IN TREATMENT.

IT'S BEEN
GETTING EASIER.

- OKAY.
- BUT, UM...

THIS IS NOT JUST WHAT
DO YOU DO FOR YOUR SON
OR DAUGHTER TODAY.

BUT THIS IS AFFECTING THE NEXT
50 TO 70 YEARS OF THEIR LIFE.

YOU MAY CONTROL WHETHER
THEIR WHOLE LIFE--

MEASURED IN DECADES, NOT WEEKS
OR MONTHS-- IS AFFECTED.

THIS IS A TREATABLE
ILLNESS.

EVERY DAY, ALL DAY I SEE KIDS

WHO ARE THE MOST SERIOUS KIDS,
THEY GET MUCH MUCH BETTER.

EVERY TREATMENT PROGRAM
ALL OVER THE COUNTRY

SEES KIDS WHO GET MUCH
MUCH BETTER.

I DON'T-- I'M LIKE
OVER IT NOW, BUT...

( applause )

TED, I'M SO PROUD OF YOU.

AND THANK YOU FOR CHOOSING
TO DO THIS HARD HARD WORK.

'CAUSE I REALLY-- I'M REALLY
LOOKIN' FORWARD

TO BEING AROUND YOU

AND HAVING YOU
IN OUR LIVES.

SO THANK YOU.
AND I LOVE YOU.

( applause )

ALL OF THE DRUGS,
WHETHER IT'S HEROIN,

ALCOHOL, CIGARETTES,
MARIJUANA--

ALL OF THEM ACTIVATE
THE DOPAMINE PATHWAY.

ALL OF THEM.

DOPAMINE IS
THE NEUROTRANSMITTER

THAT'S RELEASED WITH
PLEASURABLE EVENTS.

AND IT IS BASICALLY
THE NEUROTRANSMITTER SYSTEM

THAT DEFINES
THE PLEASURE PATHWAYS
IN THE BRAIN.

THE DRUGS OF ABUSE ARE FIVE
TIMES, AT LEAST,

MORE REINFORCING
AND COMPELLING

AS THE THINGS THAT OUR
BRAIN REWARD SYSTEM EVOLVED

IN THE FIRST PLACE
TO BE REWARDED BY--

LIKE FOOD OR
SEX OR WHATEVER.

AND DRUGS ARE SO MUCH
MORE REWARDING

TO OUR BRAINS THAN THAT.
WE WILL DO ANYTHING.

THEY COMMANDEER
OUR BRAIN REWARD SYSTEM
AND DRIVE OUR BEHAVIOR.

AND THAT TAKES POWERFUL
TREATMENTS

TO THWART THOSE DRIVES.

HELLO,
I'M DR. NORA VOLKOW.

I WANT TO ASK YOU
SOME QUESTIONS.

AT ANY POINT IF YOU FEEL
UNCOMFORTABLE JUST LET ME KNOW.

NOW, YOU ARE HOW OLD?

43.

SO YOU HAVE BEEN
TAKING METHAMPHETAMINE
FOR 10 YEARS?

- YEAH, OR MORE. ABOUT 11.
- SO HOW DID IT START?

WELL, I WAS DOING
A LOT OF COKE.

AND THE METH
GOT ME OFF OF COKE
FOR ONE THING.

METH GAVE ME THE SAME
KIND OF BUZZ,

BUT IT WOULD LAST LONGER
AND WOULD COST LESS.

HOW DID IT AFFECT YOUR LIFE,
METHAMPHETAMINE?

WHEN YOU'RE NOT ON IT
YOU JUST FEEL SO UNNORMAL.

AND YOU'D KIND OF REALLY
LIKE TO GET SOME

JUST TO GET BACK
TO A NORMAL FEELING.

PLACE YOUR HAND
IN THAT BOX.

THAT'S GONNA GET
A LITTLE WARM.

WE'RE GONNA LET YOU REST
FOR ABOUT 10-15 MINUTES
TO GET WARM.

- DO YOU FEEL COMFORTABLE?
- SURE.

Volkow:
WITH IMAGING TECHNIQUES NOW
WE CAN DIRECTLY TAKE PICTURES

OF THE WORKING
HUMAN BRAIN.

WE CAN COMPARE THE BRAINS
OF PEOPLE THAT ARE ADDICTED
TO DRUGS

WITH THAT OF PEOPLE THAT
ARE NOT ADDICTED TO DRUGS

UNDER VERY DIFFERENT
CONDITIONS.

FOR EXAMPLE, WE CAN STRESS
THE DOPAMINE SYSTEM,

WHICH IS THE SYSTEM THAT
IS ACTIVATED BY DRUGS.

Man: 20 SECONDS.

Volkow:
SO WHAT WE WANT TO DO NOW
IN THIS STUDY IS TO SEE

IN PEOPLE THAT ARE ADDICTED
TO METHAMPHETAMINE

HOW THE DOPAMINE CELLS
ARE FUNCTIONING.

Man:
FIVE, FOUR...

Volkow:
SO WE'RE MEASURING
THE MAGNITUDE OF THAT SEARCH,

WHICH IS AN INDICATION
OF REALLY, ONCE YOU STRESS

THE DOPAMINE CELLS,
HOW DO THEY RESPOND.

IT'S EQUIVALENT
TO WHEN, FOR EXAMPLE,

THEY SEND YOU
TO A CARDIOLOGIST AND THEY
PUT YOU ON A TREADMILL.

SO THEY STRESS YOUR HEART

TO SEE HOW IT RESPONDS.

OKAY, SO WE HAVE
THE RESULT.

THIS IS YOUR IMAGE.

AND WHAT WE'VE SHOWN
IS AN IMAGE OF A PERSON,

ALSO OF A MAN
OF THE SAME AGE

THAT HAS NOT
TAKEN ANY DRUGS.

LET'S LOOK AT
THE NORMAL BRAIN.

AND YOU SEE THEM, THE AREAS
IN RED SHOW VERY VERY HIGH
CONCENTRATIONS.

THIS IS ONE OF THE CELLS

IN THE BRAIN THAT'S
MOST SENSITIVE

TO THE DAMAGING EFFECTS
OF METHAMPHETAMINE.

LOOK AT YOUR BRAIN
AND SEE HOW

THAT RED BASICALLY
HAS DISAPPEARED.

ALL OF THIS PART
HERE IS GONE.

YOU CAN CLEARLY
SEE THERE IS MUCH LESS
ACTIVITY IN YOUR BRAIN

THAN IN THE BRAIN
OF THIS PERSON.

SO ONE OF THE CONCERNS
IS OF COURSE, THAT AS PEOPLE

THAT TAKE METHAMPHETAMINE
GROW OLDER

AND CONTINUE
TO TAKE IT,

ARE THEY PUTTING
THEMSELVES AT RISK

FOR NEUROLOGICAL
DISEASES?

- THAT WON'T GO AWAY.
- THAT WON'T GO AWAY.

AND THAT WILL
CREATE SYMPTOMS.

SO, I MEAN, WHEN WE WERE
SPEAKING-- AND I'M BEING
CANDID WITH YOU,

BECAUSE THERE'S NO POINT
OF NOT BEING IT.

IF YOU CONTINUE
TO TAKE METHAMPHETAMINE,
THIS WILL NOT RECOVER.

I MEAN, IT'S BOTTOM LINE.

THE OTHER THING
THAT CONCERN ME TOO
IS THIS THING.

AND IT'S ACTUALLY--
THIS IS YOUR BRAIN MRI.

THIS BRAIN LOOKS
LIKE THE BRAIN

OF A MUCH
OLDER PERSON.

IT LOOKS LIKE
THE BRAIN OF A
60-YEAR-OLD.

HE CLEARLY STATED TO US
THAT HE HIMSELF

IS NOT CONVINCED

THAT HE WANTS
TO GET DETOXIFIED.

AND THAT'S EXACTLY
NOT UNCOMMON,

THIS AMBIVALENCE
OF THE PERSON THAT'S ADDICTED.

BECAUSE IN A WAY-- IT'S LIKE
THEY ARE IN LOVE WITH
THE DRUG IN A WAY.

BUT AT THE SAME TIME
THERE IS THIS HATRED

BECAUSE THEY ACTUALLY--
THIS LOSS OF CONTROL.

BUT THERE IS
CLEARLY AN AMBIVALENCE,
AND HE EXPRESSED IT.

Woman:
DO YOU FEEL CONCERNED ABOUT
THE IMAGE OF YOUR BRAIN?

NOT REALLY.
AGAIN, I DON'T THINK--

I DON'T KNOW IF THEY
CAN REALLY REALLY TELL,

WHETHER THEY'RE
FUDGING THE PICTURE.
I DON'T KNOW.

IT IS ACTUALLY
INCREDIBLY TELLING,

THE NOTION OF SELF-DECEPTION,
TO WHAT EXTENT YOU CAN

SELF-DECEIVE
YOURSELF TO SAY,

"THIS DRUG HAS NOT DONE
ANYTHING WRONG FOR ME."

WHAT I WANT TO IMPRESS
UPON YOU IS THE IMPORTANCE

OF REALLY TRYING
TO STAY CLEAN.

BECAUSE YOU CAN DO
A LOT OF RECOVERY.

OUR BRAIN HAS A TREMENDOUS
CAPACITY FOR RECOVERY.

SO HOPEFULLY
IF I STOP USING,

IN A YEAR OR TWO IT MIGHT--
THE RED MIGHT COME BACK SOME?

YEAH. WE'VE SEEN IT
IN THE PAST, BUT YOU
HAVE TO STAY CLEAN.

AND IT'S NOT
STAYING CLEAN FOR
THREE MONTHS.

NO. OVER A YEAR.
SO IT DOES REQUIRE THAT.

OKAY.

DENIAL IS CLEARLY A CORE
FEATURE OF THIS DISORDER,

AND THAT, PARTICULARLY

IN THE EARLY STAGES
OF THE ILLNESS,

PEOPLE JUST REFUSE
TO FACE UP TO THE FACT

THAT THEIR USE OF DRUGS
IS IMPACTING THEIR LIFE

IN IMPORTANT
AND SUBSTANTIAL WAYS.

YOU KNOW IF YOU HAVE
A DISEASE, WHY NOT DENY
THAT YOU HAVE IT?

WE DO IT ALL THE TIME.

SO DENIAL IS NOT SORT
OF UNIQUE TO THIS DISEASE.

AND PART OF THE DISEASE
ITSELF, OF COURSE,

IS TO DENY
THAT YOU HAVE IT.

IT REALLY IS THE JOB

OF THE TREATMENT PROFESSIONAL
TO TAKE THAT PERSON,

WITH ALL THEIR AMBIVALENCE
ABOUT BEING IN TREATMENT--

THEY DON'T REALLY WANT
TO BE THERE,

THEY'RE HALF IN
DENIAL ABOUT IT--

AND HELP THEM SEE
BOTH WHAT DAMAGE

ADDICTION HAS DONE
IN THEIR LIVES

AND HOW MUCH BETTER
THEIR LIFE CAN BE

IF THEY GET CLEAN.

RECENT RESEARCH HAS MADE
A GREAT DEAL OF PROGRESS

IN UNDERSTANDING WHAT'S
GOING ON IN THE BRAIN

WITH ADDICTION.
AND USING BRAIN IMAGING

WE CAN ACTUALLY SEE
WHAT'S HAPPENING IN THE BRAIN.

WE CAN SEE WHICH PARTS
OF THE BRAIN ARE ACTIVATED.

AND THIS HAS HELPED US
TO DEVELOP NEW MEDICATIONS

FOR NICOTINE, ALCOHOL,
COCAINE, METHAMPHETAMINE.

BUT WITH OPIATES
SUCH AS HEROIN,

THE REAL
BREAKTHROUGH BEGAN

IN THE 1960s WITH
THE USE OF METHADONE.

FOR THE FIRST TIME
IT WAS FOUND THAT A MEDICATION

COULD REDUCE CRAVING

AND BLOCK
THE USE OF HEROIN,

OR AT LEAST
THE PLEASURE FROM THAT,

AND ENABLE PEOPLE
TO LEAD NORMAL LIVES.

THEY COULD BE ON METHADONE
AND FUNCTION IN SCHOOL

OR IN A PROFESSION
OR DRIVING A CAR AND DO
PERFECTLY WELL.

THEN MORE RECENTLY,
BUPRENORPHINE HAS COME ALONG.

AND BUPRENORPHINE ITSELF
IS A VERY SAFE DRUG.

IT'S ALMOST IMPOSSIBLE
TO OVERDOSE ON IT

BECAUSE IT ONLY
PARTIALLY ACTIVATES
THE OPIATE RECEPTORS.

IF SOMEONE TAKES
AN OPIATE WHILE THEY'RE
ON BUPRENORPHINE

IT'S GONNA BE
RELATIVELY BLOCKED

BECAUSE OF THE STRONG
AFFINITY THAT BUPRENORPHINE

HAS FOR THESE RECEPTORS.

IT'S SO SAFE THAT A DOCTOR

CAN GIVE A PRESCRIPTION
FOR BUPRENORPHINE

FOR AS MUCH
AS A MONTH'S SUPPLY
AND THE PATIENT

CAN HAVE THEIR
ADDICTION TREATED,

HAVE THEIR CRAVING
REDUCED OR ELIMINATED,

AND STILL LEAD
A RELATIVELY NORMAL LIFE.

Man:
IT SEEMS LIKE THERE'S
A LOT OF CONNECTION

BETWEEN DEPRESSION
AND DRUG USE.

ESPECIALLY OPIATES,
BECAUSE THEY ARE--

EVEN THOUGH
THEY ARE DOWNERS,
WHAT IT DOES MEAN--

DEPRESSION PRETTY MUCH
IS WHEN YOU DON'T TAKE
THEM THE RIGHT WAY.

LIKE THEY MAKE YOU FEEL
VERY COMFORTABLE AND RELAXED,

ESPECIALLY WITH ANXIETY.
A LOT OF PEOPLE DO THEM.

YOU'RE PRETTY MUCH VERY RELAXED
AND, LIKE, CHATTY,

AND YOU FEEL GOOD
FOR, LIKE, FIVE OR SIX HOURS.

THEN WHEN YOU COME OFF OF THEM
YOU FEEL LIKE CRAP. SO...

SHE ALWAYS TAKES IN
THE ANIMALS THAT ARE HURT...

OR SOMEWHAT BRAIN DAMAGED.

THE LAST ONE WE HAD
WAS-- IT HAD A--

HAD SEIZURES
AND THAT KIND OF STUFF.

Amanda: HE DIED.

Justin:
YEAH, AND IT DIED

- HOW YOU FEEL, GIRL?
- I COULD BARELY SLEEP
ALL NIGHT.

AND LIKE, I COULDN'T GET OUT
OF BED THIS MORNING, BARELY.
I WAS LIKE, "OH GOD."

- Man: OKAY WELL, WE'D BETTER
GET CRACKING.
- Justin: YEP.

Amanda:
I FEEL REALLY CRAPPY.

I HOPE IT WORKS,
AS GOOD AS EVERYBODY
SAYS IT DOES

SO I DON'T HAVE TO WORRY ABOUT
FEELING LIKE THIS ANYMORE.

WHAT HAVE YOU
BEEN USING FOR DRUGS?

I STARTED SMOKING POT
AND DOING VICODIN
AND DRINKING.

THEN I GOT INTRODUCED

TO ACID AND ECSTASY.

- VICODIN. PERCOCET.
- YOU STARTED RIGHT OUT
ON THOSE DRUGS?

- YEP.
- YOUR MAIN-- WHEN YOU
FIRST STARTED USING?

- YES.
- IS THIS THE FIRST TREATMENT
PROGRAM YOU'VE BEEN IN?

YEP. IT'S HARD FOR ME
TO GET UP IN THE MORNING

AND COME, THOUGH,
BECAUSE I WORK SO LATE.

BUT I'M TRYING
MY HARDEST TO GET UP

AND BE HERE BY 9:30
OR 9:00 OR AT LEAST BY 10:30,

AND AT LEAST MAKE ONE GROUP
OR COME FOR THE AFTERNOON GROUPS

OR WHATEVER I CAN.
YOU KNOW?

EVERY PERSON WHO'S
BORN IN THE WORLD

HAS A MOLECULE IN THEIR BRAIN

THAT'S EXACTLY
THE SAME AS MORPHINE.

FIRST THING IT DOES
FOR YOU IS IT HELPS

LIFT YOUR MOOD
SO THAT YOU FEEL BETTER.

SECOND THING THAT
IT DOES FOR YOU

IS THAT IT HELPS
YOU FEEL MOTIVATED.

IT STIMULATES THE PARTS
OF YOUR BRAIN

THAT HELP YOU WANNA
GET UP, GO DO YOUR JOB,

TAKE CARE
OF YOUR KIDS,
WORK ON YOUR CAR--

MOW YOUR LAWN.
ALL THAT KIND OF STUFF.

WHAT HAPPENS WHEN YOU
USE OPIATES, LARGE AMOUNTS
OF OPIATES

IN PARTICULAR, THAT YOU
INTRODUCE FROM THE OUTSIDE,

IS THEY GO TO THESE SAME
RECEPTOR SITES IN YOUR BRAIN

THAT THIS NATURAL OPIATE
GOES TO, RIGHT,

AND STIMULATES THEM.

ONLY THE DIFFERENCE
IS THAT TYPICALLY WHATEVER
DRUG YOU'RE USING

IS WAY MORE POTENT
THAN ANYTHING

THAT YOUR
BRAIN'S PRODUCING.

OXYCONTIN, MORPHINE,
HEROIN, DILAUDID--

THOSE DRUGS ARE
WAY MORE STIMULATING

TO THOSE PARTS
OF YOUR BRAIN.

AND WHAT HAPPENS
IS YOU GO THROUGH THE GROSS
WITHDRAWAL, RIGHT?

THE JONESING THAT
EVERYBODY TALKS ABOUT.

BUT THEN WHAT HAPPENS
AFTER THAT IS A LONG
PERIOD OF TIME

WE CALL POST-ACUTE
WITHDRAWAL SYNDROME.
THAT'S JUST A FANCY WORD

FOR FEELING LIKE SHIT
FOR DAYS,

WEEKS, MONTHS,
YEARS ON END.

AND THAT'S WHY
90% OF THE PEOPLE

WHO DON'T USE REPLACEMENT
THERAPY RELAPSE, 'CAUSE
THEY CAN'T STAND

HOW THEY FEEL OVER
THE LONG PERIOD OF TIME.

Man:
IT SEEMS LIKE THE WORLD
COMES DOWN ON YOU.

( phone ringing )

Woman:
SOME PEOPLE SAY THEY TASTE
LIKE AN ORANGE PEEL. OKAY?

IT USUALLY TAKES
ABOUT FIVE MINUTES.

SUBOXONE-- WHICH IS THE BRAND
NAME OF THE BUPRENORPHINE--

THE SUBOXONE
IS A VERY EFFECTIVE DRUG

WITH THE RIGHT
KIND OF A PATIENT.

AND IF YOU HAVE SOMEBODY
WHO HAS TYPICALLY SOMEWHAT

OF A LOWER ADDICTION PROFILE,
MEANING

THAT HAS NOT BEEN
USING FOR AS LONG,

OR MAYBE NOT BEEN USING
INTRAVENOUSLY,

THEN SUBOXONE
IS A MEDICATION

THAT IS EFFECTIVE
VERY QUICKLY.

TYPICALLY WHAT YOU SEE HAPPEN
WITH PATIENTS WHO TAKE IT

IS THAT THEY WILL
START REPORTING FEELING
BETTER THAT DAY,

THE DAY THEY INITIATE.

ANOTHER FRIEND OF MINE
IS ALSO ON SUBOXONE, AND HE
SAID IT HELPS HIM.

YOU KNOW, HE HASN'T DONE
A THING IN YEARS.

I'VE BEEN TRYIN' TO GET OFF
OPIATES FOR OVER FOUR YEARS.

I'VE BEEN TRYING
TO DO IT BY MYSELF.

I REALIZED THAT AFTER
TWO OR THREE YEARS OF TRYING

TO DO IT BY MYSELF
THAT I NEED HELP AND THAT I
CAN'T DO IT BY MYSELF.

SO JUSTIN HAS
A FAIRLY LONG
HISTORY OF USING.

WE'RE NOT POSITIVE
THAT THIS DRUG

IS GONNA BE ABLE TO MANAGE
HIS ADDICTION WELL ENOUGH.

HE MAY HAVE TO LOOK
AT DOING METHADONE.

YEAH.

AMANDA'S PROBABLY
GOT A LESSER USING
TIME, RIGHT?

- LESS TIME USING.
- TWO YEARS.

SO IT'S MORE LIKELY OR IT'S--
SHE MAY ACTUALLY RESPOND

TO SUBOXONE VERY WELL
AND JUSTIN WOULDN'T.

IN THAT CASE HE'D BE
A METHADONE CANDIDATE.

AMANDA WOULD STAY
ON SUBOXONE.

THE SUBOXONE
ACTUALLY IS REALLY GOOD.

YOU GET ALL OF YOUR ENERGY BACK.
I'VE ONLY BEEN ON IT FOR LIKE
THREE WEEKS.

I THINK IT'S A WONDER DRUG.
I DON'T HAVE NO CRAVINGS.

I DON'T EVEN CRAVE
DRINKING ANYMORE REALLY.
NOTHING.

I STILL HAVE
A COUPLE OF THOSE.

BUT I MEAN, I HAVEN'T
USED ANY DRUGS SINCE
I'VE STARTED IT.

THE FIRST DAY YOU TOOK IT,
DID YOU FEEL FINE

OR DID YOU STILL GET
WITHDRAWALS?

IT WAS ALL RIGHT,
I WAS JUST LIKE...

WERE YOU SORE, STILL?

IT DOESN'T TAKE ACHES AWAY.
IT'S NOT LIKE METHADONE.

IT HAS, LIKE,
NO NARCOTIC REALLY.

YOU KNOW, THESE PEOPLE
ARE ASHAMED TO SOME DEGREE

OF THE THINGS THAT THEY'VE
HAD TO DO IN ORDER

PEOPLE ARE-- EVERYONE'S
MAD AT THEM, RIGHT?

THE WHOLE WORLD BASICALLY SAYS,
"YOU'RE A LOSER."

AND YOU HAVE TO HAVE
A TOLERANCE FOR MISBEHAVIOR

OR WHAT MANY PEOPLE PERCEIVE
AS MISBEHAVIOR,

BUT REALLY ARE SYMPTOMS
OF A DISORDER THAT PEOPLE HAVE,

AND NOT ELIMINATE PEOPLE
FROM TREATMENT FOR EXHIBITING

THE SYMPTOMS OF THE DISORDER
THAT THEY HAVE.

I MEAN, IF YOU WERE TREATING
SOMEBODY WHO WAS DEPRESSED

AND THEY CAME IN AND SAID,

"GEE, I'M HAVING
A TERRIBLE DAY AND I FEEL
LIKE KILLING MYSELF,"

YOU WOULDN'T KICK THEM OUT
OF YOUR TREATMENT PROGRAM

BECAUSE THEY WEREN'T
GETTING UNDEPRESSED.

BUT WHEN SOMEBODY
COMES IN WITH AN ADDICTION
AND THEY SAY,

"I RELAPSED LAST NIGHT
AND I USED COCAINE,"

VERY OFTEN THE REACTION
IS TO SAY, "GO HOME

AND COME BACK
WHEN YOU'RE READY."

IT'S AN EPIDEMIC.
IT IS SO CONCERNING.

AND IT-- YOU DON'T--
PEOPLE AREN'T TALKING
ABOUT IT, YOU KNOW?

MAINE IS THE NUMBER ONE
STATE IN THE NATION

FOR TREATMENT ADMISSIONS
RIGHT NOW FOR OPIATE ADDICTION.

WE ARE THE MOST
OPIATE-ADDICTED STATE
IN THE COUNTRY.

OUR RATE IS
GROWING FASTER THAN
ANYBODY ELSE IN AMERICA.

KEEP THE FRIES
IN IT THIS TIME.

MY PERSONALITY
AND MY STATE OF MIND
SIX MONTHS AGO

WAS TOTALLY DIFFERENT THAN MY
STATE OF MIND RIGHT NOW.

LIKE THE WAY I THINK,
THE WAY I TALK,

THE WAY I DO EVERYTHING
BASICALLY CHANGED TOTALLY

WHEN I STOPPED DOING OPIATES
OR WHEN I GOT ON THE SUBOXONE.

WHICH IS WHAT I WAS
LOOKING FOR. IT'S EXACTLY
WHAT I WAS LOOKING FOR--

JUST TAKING MY LIFE AND TOTALLY
TURNING IT UPSIDE DOWN

AND GOING
THE OTHER WAY WITH IT.

HAVE YOU THOUGHT ABOUT
THE FUTURE FOR YOU

WITH SUBOXONE?
I MEAN, IS THIS SOMETHING
THAT YOU'RE GOING TO CONTINUE

TO DO OVER A LONG PERIOD
OF TIME, DO YOU THINK?

I FEEL LIKE
IT'S HELPED A LOT ALREADY.

LIKE I DON'T THINK
THAT I'LL HAVE TO BE ON IT

NEARLY AS LONG
AS JUSTIN WILL HAVE
TO BE ON IT.

LIKE I FEEL THAT
I COULD BE OFF IT
IN LIKE A YEAR.

NOW THAT I'M ON SUBOXONE

AND I'M HAVING TROUBLE
GETTING THE INSURANCE

TO BE ABLE
TO GET IT MYSELF,

I'M ACTUALLY THINKING
ABOUT THE POSSIBILITY

OF SWITCHING
TO METHADONE

BECAUSE IT'S CHEAPER

AND I CAN GET IT FOR--
AS LONG AS--

I CAN GET IT FOR THE REST
OF MY LIFE FREE, BASICALLY,
FROM ACADIA.

BUT SINCE I'M ON SUBOXONE
IT'S GONNA COST ME

CLOSE TO $150 A WEEK
WITHOUT INSURANCE

JUST TO GET
MY MEDICATION.

THIS IS THE HARDEST PROBLEM
THAT OUR PATIENTS HAVE--

IS AFFORDING THE MEDICATION.
BY FAR, HARDEST PROBLEM WE HAVE.

ESPECIALLY
THE SUBOXONE.

- SUBOXONE'S VERY EXPENSIVE.
- IT'S VERY EXPENSIVE.

WELL, THE SCIENCE
OF UNDERSTANDING ADDICTION

HAS JUST BEEN EXPLODING
IN RECENT YEARS

THROUGH THE USE OF ANY NUMBER
OF DIFFERENT TECHNOLOGIES

INCLUDING GENETICS,
ANIMAL STUDIES,

STUDIES IN HUMANS
AND BRAIN IMAGING.

WE ARE REALLY STARTING
TO PIECE TOGETHER

SOME OF THE BRAIN
MECHANISMS INVOLVED

IN THE DEVELOPMENT OF
AND RESOLUTION OF

DRUG DEPENDENCE
AND ALCOHOL DEPENDENCE.

THERE ARE CURRENTLY
THREE MEDICATIONS AVAILABLE--
ON THE MARKET FOR

TREATING ALCOHOL DEPENDENCE
IN THE UNITED STATES.

DISULFIRAM,
BEST KNOWN AS ANTABUSE,

IS FOR PEOPLE WHO
ARE IN RECOVERY

WHO ARE ABSTINENT
AND ARE GOING INTO
A HIGHER-RISK SITUATION.

IF YOU TAKE A DRINK,
ANTABUSE CAN MAKE YOU SICK.

ACAMPROSATE WORKS
ON THOSE

PROTRACTED
ABSTINENCE SYNDROME,

THE KIND OF SYMPTOMS
THAT PEOPLE GET

AND CAN HAVE FOR
A YEAR OR TWO EVEN AFTER
STOPPING DRINKING.

NALTREXONE REDUCES THAT PRIMING
OF THE PUMP PHENOMENON.

IF YOU ARE WORKING
TO STAY ABSTINENT

AND YOU HAVE A SLIP
AND YOU TAKE A DRINK,

IT MAKES IT MUCH EASIER
FOR YOU TO STOP DRINKING

BEFORE YOU GO ON TO
A FULL-FLEDGED RELAPSE.

ONE OF THE MORE
PROMISING MEDICATIONS
THAT'S BEING TESTED RIGHT NOW

IS A MEDICATION
CALLED TOPIRAMATE.

I GUESS I'VE ALWAYS KNOWN
THAT I WAS AN ALCOHOLIC,

BUT I WAS--

WELL, FOR LACK
OF A BETTER TERM,
I WAS A FUNCTIONAL DRUNK.

MY DRINKING HAS NEVER BEEN
BROUGHT ON BY...

SWINGS OF DEPRESSION

OR JOY OR DISAPPOINTMENT
OR ANYTHING.

I JUST DRANK BECAUSE
I WANTED TO GET HIGH.

EVER SINCE I WAS YOUNG
I STARTED SNEAKING LIQUOR

AND DRINKING
JUST BY MYSELF.

THEN WHEN I GOT TO COLLEGE
I JUST WENT KIND OF CRAZY.

THEN I STARTED FALLING BACK
INTO DRINKING ALONE,

WHICH IS WHAT WORRIES
ME THE MOST.

WHEN I RETIRED
I DRANK...

MORNING,
NOON AND NIGHT.

I FEEL AN EMPTINESS
THAT NEEDS TO BE FILLED,

AND ALCOHOL IS ONE WAY
THAT I DO IT.

IT IS-- I WOULD SAY
THERE'S A CRAVING FOR
ALCOHOL THAT I HAVE.

MY DRINKING'S KILLING ME

AND I DESPERATELY
NEED HELP.

Doctor: DID YOU BRING
BACK YOUR OTHER MEDS?

Adam:
THEY'RE ALL USED UP.

Woman: YOU DON'T NEED THEM.
BUT THE MOST DETAIL
THE BETTER.

I'LL CALL IF THEY
HAVE YOU BRING BACK
THE BOTTLES OR NOT.

Bankole Johnson:
TOPIRAMATE IS A MEDICATION
THAT REDUCES

THE WITHDRAWAL SYMPTOMS
FROM ALCOHOL.

- I THINK YOU PRETTY MUCH
ANSWERED ALL MY QUESTIONS.
- OKAY.

IT'S A VERY GOOD DRUG
AT CUTTING

THE CRAVING OR THE BUZZ
FROM ALCOHOL.

SAY IF AN INDIVIDUAL WENT
TO TRY AND TAKE A DRINK

OR SLIP
BACK INTO DRINKING,

THEY FEEL LESS LIKELY TO TAKE
THE NEXT AND THE NEXT DRINK.

I WAS DRINKING, JUST LEFT THEM.
I'M ASHAMED TO SHOW
YOU ALL THIS.

THIS IS A MESS HERE.

IT'S LIKE MY LIFE
IS UNRESOLVED.

IT'S JUST NOT
GOING ANYWHERE RIGHT NOW.
I MEAN, JUST CRAZY STUFF.

IT'S LIKE I'M IN A HAZE.
I DON'T EVEN NOTICE IT.

BUT IF SOMEONE ELSE
IS AROUND THEN I GET
SELF-CONSCIOUS ABOUT IT.

LAST NIGHT
WOULD BE THIS...

AND THREE OF THESE--

FOUR OF THOSE.

Man:
THOSE ARE THE BIG
MALT LIQUOR BOTTLES.

YEAH, THIS STUFF WILL
KNOCK YOU OUT.

IT'S CHEAPER
AND IT'S A LITTLE MORE...

ALCOHOL CONTENT.

HAD ANY FAMILY
HISTORY OF DRINKING?

A FEW.
YOU KNOW, MAYBE.

MY FATHER, HIS SON
FROM HIS PREVIOUS MARRIAGE,

MY HALF BROTHER,

BASICALLY DRANK
HIMSELF TO DEATH.

THEY FOUND HIM
DEAD IN HIS APARTMENT.

BEEN ROTTING
FOR A COUPLE DAYS.

BUT I MEAN, THERE ARE
A LOT OF OTHER WAYS
OF GETTING HIGH

OTHER THAN CHUGGING
EIGHT BEERS, RIGHT?

TELL ME ONE
THAT'S BETTER FOR ME
AND I'LL BELIEVE IT.

THE BEERS ARE THE ONES
THAT DO IT FOR YOU?

YEAH. I-- WELL, ALCOHOL
IN GENERAL IS JUST

AN OLD REGULAR.
IT'S WHAT STUCK WITH ME.

BUT I WANNA STOP.
I'M HOPING THE MEDICINE WILL
HELP GIVE ME SOME INCENTIVE

TO FEEL A LITTLE BETTER
DURING THE DAY,

SO I DON'T HAVE
TO REACH FOR THE BEER

JUST TO DROWN
MY FEELINGS.

WHEN I FIRST
CAME HERE

IF SOMEBODY
HAD ASKED ME

IF I WANTED
TO HAVE A DRINK,

I WOULD HAVE
TOLD THEM YES.

I WOULD HAVE LIKED
TO HAVE HAD A DRINK.

NOW IF SOMEBODY
TOLD ME

WOULD I LIKE
TO HAVE A DRINK,
I'D SAY, "NO."

IT TOOK A WHILE.
THE FIRST THREE OR FOUR WEEKS

I NOTICED VERY
LITTLE EFFECT AT ALL.

THE PATTERN STAYED
PRETTY MUCH THE SAME--

DRINKING LATE
INTO THE EVENINGS.

BUT THEN IT GRADUALLY--

I STARTED GOING
TO SLEEP EARLIER

AND I STARTED
DRINKING LESS.

YOUR CRAVING'S
ACTUALLY MUCH LOWER

THAN WHEN YOU STARTED,
WHICH IS REALLY NICE.

IT DOES-- IT'S
GETTING EASIER.

I THINK WHEN I DECIDED
TO QUIT DRINKING,

THAT MEDICINE BEING
THERE WAS REALLY--
IT WAS A BOOST.

IT WAS A-- IT MADE ME

FEEL COMFORTABLE ABOUT IT.

YOU KNOW, WHEN
AN INDIVIDUAL'S AT THE HEIGHT
OF THEIR ALCOHOL DRINKING,

IT'S ALMOST LIKE
AN UNQUENCHABLE THIRST.

YEAH, YOU COULD SAY THAT.

AND SO IT'S GOOD
TO HAVE A MEDICATION

THAT TAKES THE EDGE
OFF THAT UNQUENCHABLE
THIRST

AND PROVIDES THE INDIVIDUAL
WITH ACTUALLY A MECHANISM

WHEREBY THEY CAN SAY,
"OKAY, I'VE NOW GONE OFF
THE ACUTE PERIOD OF TIME.

NOW I CAN START THINKING
ABOUT INCORPORATING OTHER
THINGS IN MY LIFE,"

LIKE YOU HAVE DONE,
TO BE ABLE TO HELP
THE OVERALL PICTURE.

( dog barking )

BEHAVE YOURSELF,
YOU BIG SILLY.

Tom:
I THINK YOU HAVE
TO REACH A POINT...

AND MAKE A-- YOU'VE
GOT TO MAKE A DECISION.

YOU'VE GOT TO MAKE
A PERSONAL STATEMENT.

BUT I THINK
THAT MEDICATION

MADE IT SO MUCH
EASIER FOR ME.

FOR EXAMPLE, TODAY I CAN PICK
AND CHOOSE WHAT I WANNA DO.

IF I WANT TO
DO SOMETHING IN THE HOUSE

OR IF I WANT TO GO OUT
OR GO SOMEWHERE,
I CAN DO THAT.

IN DAYS GONE BY
I KNOW WHAT I'D DO.

I'D BE SITTING HERE DRINKING
IN THE MIDDLE OF THE DAY.

THE DRINKING WAS
BECOMING

A 24-HOUR-A-DAY,

SEVEN-DAYS-A-WEEK
AFFAIR FOR ME.

IT'S TOO BAD
I DIDN'T COME

TO THIS REALIZATION
A LONG TIME AGO.

I CAN'T CHANGE THAT.

BUT I CAN DETERMINE

WHAT'S GOING TO
HAPPEN TOMORROW.

AND I'M NOT GONNA DRINK.

IT WAS ABOUT THREE WEEKS AGO
AND I WAS STILL DRINKING.

A SORT OF DEPRESSION
LIFTED FROM ME

AND I STARTED LISTENING
TO BEETHOVEN IT WAS,
I THINK AT THE TIME.

AND I STARTED FEELING
LIKE I COULD WRITE MUSIC.

I STARTED WRITING BEFORE
I STOPPED DRINKING.

I STARTED WRITING MORE
AND THE ALCOHOL

STARTED HAVING
LESS OF AN EFFECT.

THEN LAST WEEK,
I FIGURED

AS IT WAS HAVING
VERY LITTLE EFFECT ANYWAY,

I JUST DECIDED TO STOP.

I HAVEN'T LOOKED BACK YET.

SO THAT'S WHERE I STAND.

ONE OF THE THINGS THAT'S MOST
IMPORTANT FOR PEOPLE
TO UNDERSTAND HERE

IS THAT THE MEDICINES
WON'T DO THE WORK FOR YOU.

YOU'VE GOT TO WORK AT THIS
IN ORDER TO CHANGE.

PEOPLE HAVE THE IDEA THAT,
"I WON'T WANNA DRINK ANYMORE."

THAT IT'LL MAGICALLY MAKE
THE WHOLE THING DISAPPEAR.

FOR THE MOST PART
THAT WON'T WORK.

WHAT IT CAN DO IS
IT CAN MAKE IT EASIER

TO DO THE RIGHT THING.

IT CAN MAKE IT EASIER
TO ACHIEVE YOUR GOALS.

THERE'S NO MEDICATION
THAT I CAN EVER CONCEIVE OF,
EVEN IN THE FUTURE,

THAT WILL TAKE AWAY
THE NEED FOR THE STRUGGLE,

THE HARD WORK THAT'S REQUIRED
IN PSYCHOTHERAPY,

FAMILY THERAPY,
GROUP THERAPY, WHATEVER.

BUT THE MEDICATIONS
WILL GET BETTER AND BETTER

AT HELPING THE PERSON
TO CONTROL THESE EXTREME
COMPULSIONS

TO GO BACK
AND USE DRUGS.

SO BECAUSE WE DON'T
HAVE A SINGLE CURE

AND BECAUSE TREATMENT,
WHILE IT'S PROVIDED,

CAN HELP THAT,
IT'S FAR BETTER

TO KEEP AN INDIVIDUAL
IN TREATMENT,

IN SUPERVISION
AND WITH PROPER FAMILY SUPPORT

FOR A VERY LONG TIME.

BEST COFFEE IN ASTORIA.

- HOW ARE YOU DOING?
- ALL RIGHT. DON'T WORK
TOO HARD.

KNOCK 'EM DEAD KID.

I'M DON PERKS.
GONNA BE 65 YEARS OLD.

I'VE BEEN A STEAMFITTER
SINCE 1962.

I WANT EVERYBODY
TO GO HOME SAFE
AND SOUND.

WORK SAFE, FELLAS.

Don:
A STEAMFITTER IS SOMEONE
WHO PUTS IN

THE HEATING, VENTILATING
AND AIR-CONDITIONING SYSTEMS.

WE PUT IN THE BOILERS.
WE PUT IN THE STEAM PIPE.

WE DO POWERHOUSES.
WHENEVER YOU SEE A POWERHOUSE,

IT'S ALMOST
ALL STEAMFITTER LABOR.

( scraping )

GO AROUND
TO THE OTHER SIDE.
HOLD THAT IN THERE.

Don:
WE WORK IN UNITS OF TWO.
EVERYBODY HAS A PARTNER.

( chains rattling )

IN OUR BUSINESS WE
CALL IT A MARRIAGE
WITH NO DIVORCES.

EVERYBODY KNOWS
THE STEAMFITTERS.

WE'RE THE HARDEST WORKING
AND PROBABLY THE BIGGEST
DRINKERS.

DRINKING WAS LIKE HAVING
A SODA ON THE JOB.

IT WASN'T-- NOBODY
FROWNED ON IT.

I THOUGHT I'D DIED
AND WENT TO HEAVEN.

I WAS 22 YEARS OLD
AND I WAS DRINKING EVERY DAY

ON THE JOB
AND IT WAS OKAY.

NOBODY WOULD ADMIT
TO ALCOHOLISM. NOBODY WOULD
ADMIT TO ADDICTION.

YOU WIND UP DOING THINGS THAT
YOU WOULDN'T DREAM OF DOING.

I WAS IN AN ACCIDENT ONE TIME
WITH MY SON IN THE CAR
AND HE GOT HURT.

AND I WAS DRUNK.
YOU KNOW, IT WAS LIKE,

"OH MY GOD, HOW-- YOU KNOW,
WHAT'S WRONG WITH YOU?"

WE WATCHED OUT
FOR EACH OTHER.

WE TOOK CARE OF EACH OTHER
BY ENABLING.

WE DIDN'T KNOW THAT
BY PUTTING A GUY
IN THE BATHTUB

AND PUTTING PLYWOOD
OVER IT

AND KEEPING HIM IN
THERE FOR SIX OR SEVEN HOURS

'CAUSE HE'S SO DRUNK AND THEN
GETTING HIM BACK ON HIS FEET

AND GETTING HIM HOME
SO HIS FAMILY COULD GET
HIS PAY--

WE THOUGHT THAT WAS HELPING.
WE REALLY REALLY DID.

WHAT, ARE YOU KIDDING ME?
THAT'S A LAME EXCUSE, JIMMY.

I ONLY TOLD YOU
I DIDN'T WANT YOU GOING OUT.

I DON'T GIVE A SHIT
WHETHER YOU GO OUT OR NOT.

BUT DON'T ASK ME
TO PUT YOU ON A JOB,

BECAUSE EVERY TIME YOU
GO OUT TO LUNCH YOU GOT
THAT DRINK IN YOU

AND YOU COME BACK
AND NOBODY KNOWS WHAT
THE HELL YOU'RE DOING.

LET ME TELL YOU--

HEY, WAIT A MINUTE, LET ME
TELL YOU SOMETHING, JIMMY.

YOU'RE NOT TALKING TO SOMEBODY
THAT GREW UP YESTERDAY.

GOD DAMN IT,
I'M AN ALCOHOLIC.

I'M AN ALCOHOLIC MYSELF
WHO QUIT DRINKING

AND I'M NOT PISSED OFF
AT ANYBODY THAT DRINKS.

YOU GOTTA GET
YOUR ACT STRAIGHT FIRST.

I'M TELLING YOU, JIMMY,
FOR YOUR OWN GOOD.

Samuel Bacharach:
STEAMFITTERS, LIKE MANY
PEOPLE IN CONSTRUCTION,

HAVE HAD A LONG TRADITION
OF DRINKING.

THE STEAMFITTERS STUCK
THEIR NECK OUT AND SAID,

"YOU KNOW WHAT?
THE BUCK STOPS HERE.

WE'RE TAKING RESPONSIBILITY FOR
OUR OWN BROTHERS AND SISTERS."

IT IS IN THE VERY BEST
SENSE OF THE WORD

WHAT THIS SOCIETY
IS ALL ABOUT.

HOW DO WE HELP
OUR NEIGHBORS?

IF I HAVE A PROBLEM,
THIS PROGRAM WILL SAY TO ME,

"GUESS WHAT?
COME TO SEE ONE OF
OUR PEERS.

WE WILL GET YOU
THE TYPE OF HELP WE NEED.

WE WILL BE YOUR GUIDE.

WE WILL BE THERE
IN YOUR CORNER ALL THE WAY.
TRUST US."

- ( phone rings )
- HELLO. STEAMFITTERS INDUSTRY
ASSISTANCE PROGRAM.

CAN I HELP YOU?

Don: AN EAP IS AN
EMPLOYEE ASSISTANCE
PROFESSIONAL.

WE ARE THE FIRST PEOPLE
THAT MEET WITH SOMEONE
IN TROUBLE.

WE ARE THE FIRST ONE
THAT THEY COME TO.

IT'S AN INCREDIBLE EXPERIENCE
TO HAVE SOMEONE CALL YOU UP.

LIKE WHEN I CALLED,
I WAS SO BROKEN
AND SO SCARED.

I STILL AM
IN AWE THAT PEOPLE

WOULD ACTUALLY TRUST ME ENOUGH
TO CALL FOR HELP AT THAT--

AT THAT POINT
IN THEIR LIFE.

'CAUSE UNLESS YOU EXPERIENCE
SOMETHING LIKE THAT,

IT'S HARD TO DESCRIBE
HOW LOW YOU ARE,

HOW LOST YOU ARE,

HOW DESPERATE YOU ARE.

Man on phone:
You know I'm drinking
too much.

And, you know
my life's a mess.

- I'm just a little
scared of this.
- YEAH, YEAH.

YOU KNOW ABOUT
WHAT THE DEAL IS

HERE WITH THE ASSISTANCE
PROGRAM?

YOU KNOW IT'S A DETOX,
IF IT'S NECESSARY.

THEY'LL DO AN EVALUATION.

AND ALSO IT'S A 30-DAY
INPATIENT REHAB.

Yeah, I'm probably
gonna need that.

YEAH, YOU KNOW,
TRUTHFULLY IT'S THE BEST WAY.

- IT'S REALLY WHAT WORKS.
- How quickly can I get in?

WELL, IT'S 10:00 NOW.

IT'S POSSIBLE TO GO IN TODAY.

WE CAN GET 'EM PICKED
UP RIGHT AT THEIR HOUSE.
AND THEY'LL TAKE 'EM UPSTATE,

DO A QUICK EVALUATION
AND STICK THEM RIGHT
INTO DETOX.

AND WHEN THAT DETOX IS DONE,
THEY'LL PICK THEM UP

AND BRING THEM BACK DOWN
TO THE REHAB.

IF I AS A STEAMFITTER
GO TO ANOTHER STEAMFITTER

AND SAY TO HIM,
"BROTHER, I'VE BEEN
WHERE YOU ARE.

I KNOW
WHAT YOU'RE GOING THROUGH.
YOU'VE GOT A PROBLEM,"

THAT'S A HELL OF
A LOT DIFFERENT

THAN SOME MANAGEMENT PERSON
OR SOME SOCIAL WORKER COMING IN.

SO THE STEAMFITTERS
USE THEIR BROTHERHOOD

AND THEIR SISTERHOOD
AS A WAY OF INTERVENING.

Don:
THIS UNION IS AN ABSOLUTELY
INCREDIBLE UNION,

WHAT THEY DO
FOR THEIR MEMBERS.

WE WANNA GET THE TREATMENT
THAT THE DOCTORS RECOMMEND

WITHOUT HAVING SOMEONE
INTERFERING AND TRYING
TO TELL YOU

YOU DON'T NEED THAT OR YOU
DON'T NEED THAT MUCH.

THE UNION DECIDED
TO GO SELF-INSURED

BECAUSE THE PREMIUMS
KEPT INCREASING.

WE HAVE BASICALLY DRIVEN
THE INSURANCE COMPANY

AND MANAGED CARE OUT
OF THE PICTURE.

WE DON'T ALLOW THEM
TO CALL THE FACILITY.

THEY CAN'T CALL
THE HOSPITAL TO FIND OUT
HOW THE GUY'S DOING.

THAT'S OUR JOB.
WE DO THAT.

I'M NOT GONNA ALLOW
MY MEMBERS

TO BE KILLED
BY AN OUTPATIENT DETOX.

I'M JUST NOT GONNA
ALLOW THAT.

YOUNG GUY, 33 YEARS OLD,

HE COULDN'T DO IT
AND HE DIED.

HE KILLED HIMSELF.
HE TOOK HIS LIFE.

BEAUTIFUL KID.

I GOT CLOSE WITH HIM BECAUSE
HE REMINDED ME OF MY KID.

AND HE TRUSTED ME
AND I'VE SEEN HIM LAUGH--

NOT MUCH, BUT--

AND HIS OWN OLD MAN,
I KNOW HIM.

HE COULDN'T-- HIS OLD MAN
COULDN'T LOVE HIM.

COULDN'T LOVE HIM.
AND THAT'S ALL HE NEEDED.

BUT WE COULDN'T
GIVE HIM WHAT HE NEEDED

AND THAT'S THE STUFF
THAT HURTS.

THAT'S WHAT MAKES
YOU FIGHT HARDER.

HE DIED
IN HIS FATHER'S YARD.

ALONE. FUCK.

IT'S TERRIBLE.

YOU DON'T HAVE TO GET THERE.

YOU DON'T HAVE TO GET THERE.
YOU KNOW THAT.

AND THAT'S WHAT
WE TRY TO TELL 'EM.
YOU DON'T HAVE TO GO THERE, MAN.

DON'T FOLLOW THAT.
DON'T FOLLOW THAT.

MY NAME'S WAYNE.
I'M AN ALCOHOLIC
AND A DRUG ADDICT.

HI, I'M GENE.
I'M AN ALCOHOLIC.

HOW YOU DOING? MY NAME
IS MIKE. I'M AN ALCOHOLIC
AND AN ADDICT.

Don:
THE THURSDAY GROUP
IS THE AFTERCARE GROUP

THAT WE PUT TOGETHER
BACK IN 1990.

I'VE BEEN IN REHAB SIX TIMES
AND I'VE NEVER LET IT WORK.

AFTERCARE IS JUST THAT--

IT'S A CONTINUING CARE THAT YOU
REALLY NEED TO BE INVOLVED IN

IF YOU'RE GONNA
WANT TO SURVIVE THIS.

IF YOU JUST LEAVE 30 DAYS
TREATMENT AND YOU DON'T GO
TO MEETINGS

AND YOU DON'T GET INVOLVED
WITH A SPONSOR AND A GROUP
AND A COMMITMENT,

YOU'RE GOING BACK.
IT AIN'T GONNA BE NO TIME
AT ALL THAT YOU'RE BACK.

YOU CAN'T
RESIST THE TEMPTATION.

WHEN I HEARD THE WORD AA,
I WOULD RUN AWAY FROM 'EM.

Don:
I TELL 'EM YOU GOTTA COME
A MINIMUM OF SIX WEEKS.

'CAUSE IF WE CAN
GET 'EM SIX WEEKS,
WE GOT 'EM. WE OWN 'EM.

I GOT A LITTLE OVER 11 MONTHS
NOW WHICH IS LIKE--

( applause )

I NEVER-- I WOULD
HAVE BEEN WITH THE PEOPLE
I USED TO HANG OUT WITH,

LEAST LIKELY EVER
TO WANNA GET SOBER.

THEY ARE NOT BUILT
TO SIT AROUND IN GROUPS

AND WHINE
ABOUT THEIR LIVES,

AND TALK ABOUT THEIR PAIN

AND ASK OTHER PEOPLE
TO HELP THEM

OR EVEN UNDERSTAND THEM.

THEY'RE TOUGH GUYS.
THEY'RE VERY TOUGH GUYS.

I FEEL GOOD.
I'M TAKING ALL THE SUGGESTIONS
THIS TIME.

I'M DOING IT THE WAY
THAT THEY SUGGESTED TO ME

RATHER THAN DOING
IT MY WAY.

Don:
IT'S A TEAM EFFORT.
SO WE WATCH PEOPLE.

YOU SEE SOMEONE
THAT LOOKS A LITTLE BIT--

HE COMES IN
AND YOU CAN JUST SEE
THERE'S SOMETHING ELSE.

HE'S ISOLATING,
HE'S DRIFTING AWAY
OR HE'S OVER TALKATIVE.

WE SAY,
"PIN HIM DOWN TONIGHT."

AND THEY DO ONE-ON-ONE.

JUST TO GIVE THE GROUP
A LITTLE BIT OF
A BACKGROUND--

THIS IS MY FIFTH
TIME TO THE VILLA.

AND I FELT DIFFERENT
THIS TIME.

YOU KNOW, I FELT LIKE A BIG
WEIGHT COME OFF MY SHOULDERS.

THE FIRST YEAR IN RECOVERY
IS SO FREAKING IMPORTANT.

IT'S SO IMPORTANT.
AND WE KEEP THEM FOR A YEAR.

MORE, YOU KNOW,
IF WE SEE THAT

THEY'RE STILL
A LITTLE ANTSY OR A LITTLE--

WE'LL KEEP 'EM LONGER.
WE'LL KEEP 'EM FOR 10 YEARS
IF THEY HAVE TO.

YOU KNOW, WAKING UP
EVERY DAY AND HAVING TO GET

A COUPLE HUNDRED DOLLARS
JUST TO FEEL NORMAL,

IT'S NOT
A GOOD PLACE TO BE.

AND I DON'T WANT
TO BE THERE EVER AGAIN.

Don:
WE'RE NOT HERE TO STOP
PEOPLE FROM DRINKING.

THAT'S NOT OUR PURPOSE.

WE'RE HERE TO HELP PEOPLE
THAT WANT TO STOP.

THAT'S OUR PURPOSE.
IF YOU WANT TO KEEP DRINKING,

THEN THAT'S WHAT YOU DO.

IF YOU WANNA STOP,
COME SEE US. WE CAN HELP.

GOOD JOB.
NOBODY GOT HURT.

EVERYTHING'S WHERE
IT'S SUPPOSED TO BE.

THIS PROGRAM WITH DON
HELPS YOU THINK AGAIN.

GETS YOU CLARITY.
IT JUST, IT BRINGS
YOU BACK TO LIFE.

IT HELPS YOU
LIVE LIFE AGAIN.

TOUGH GUYS AIN'T
ON THE STREET REALLY ANYMORE.

YOU WANT TO BE A MAN?
STEP UP TO THE PLATE.

DO WHAT YOU'RE
SUPPOSED TO DO.

- GOOD NIGHT.
- SUPPORT YOUR FAMILY.
TAKE CARE OF YOURSELF.

PAY YOUR RENT,
PAY YOUR BILLS.
YOU KNOW?

AND THAT'S WHAT
I'M DOING.

THAT'S WHAT
WE'RE ALL DOING.

ADDICTS ARE DISCRIMINATED
AGAINST IN WAYS

THAT PEOPLE SUFFERING
FROM NO OTHER DISEASE
ARE AFFECTED.

SO THERE'S HUGE DISCRIMINATION
AGAINST ADDICTS,

WHICH MAKES IT MUCH
MUCH HARDER FOR THEM
TO RECOVER.

ONE OF THE THINGS
THAT IS VERY VERY TRAGIC

IS THAT MANY
OF THE INSURANCES

DON'T PAY FOR THE TREATMENT
OF DRUG ADDICTION.

THEY DON'T COVER TREATMENT
AT ALL OR THEY COVER IT

WITH SIGNIFICANTLY HIGHER
DEDUCTIBLES AND COPAYS,

WHICH IS A VERY EFFECTIVE
BARRIER BECAUSE PEOPLE DON'T

HAVE THE MONEY TO PAY
OUT OF THEIR POCKETS.

MANAGED CARE HAS
REDUCED THE AMOUNT,

DURATION, QUALITY
AND INTENSITY

OF ADDICTION TREATMENT
FAR MORE

THAN IT HAS REDUCED
DURATION OR ANY OF THOSE
PARAMETERS

IN ANY OTHER AREA
OF CARE.

Beverly Mackereth:
ADDICTION TREATMENT
CANNOT WAIT.

WE NEED TO HELP INDIVIDUALS
AND SAVE LIVES NOW.

( applause )

IT IS BECAUSE
WE NEED TO ACT NOW

TO SAVE THE LIVES
OF THOSE SUFFERING
FROM ADDICTION

THAT WE ARE HAVING
ANOTHER HEARING TODAY.

THIS HEARING WILL FOCUS
ON THE IMPACT

OF DENIED TREATMENT
ON CRIME IN OUR STATE,

ON EMPLOYERS,
ON MEDICAL PRACTICE,

AND MOST IMPORTANTLY,
ON OUR FAMILIES.

THIS INDUSTRY HAS
TURNED THEIR BACK

ON THE STATUTE
OF PENNSYLVANIA

THAT IS THE LAW.

AND I DON'T WANT
TO LINE THE POCKETS

OF THE INSURANCE PEOPLE
AND PROVIDERS WHEN
YOU HAVE PEOPLE

LIKE THESE PEOPLE BEHIND YOU
THAT HAVE TO STAND THERE

AND HOLD THEIR SONS
AND DAUGHTERS

BEFORE THE PEOPLE
OF PENNSYLVANIA.

IT'S NOT FAIR.

IT'S NOT RIGHT.

- AND IT'S AGAINST THE LAW.
- ( applause )

THE MANAGED CARE SYSTEM
HAS TAUGHT DESPAIR TO FAMILIES

THAT MY LOVED ONE
WILL NEVER GET WELL.

IT HAS ALSO GOT FAMILIES
BEATEN UP ON TREATMENT
PROGRAMS SAYING,

"YOU DIDN'T WORK,"

WHEN IN FACT
THE TREATMENT PROGRAM
WAS NOT PERMITTED

TO PROVIDE THE CARE
THAT IT KNOWS IT NEEDS
TO PROVIDE.

THERE'S NOTHING
THAT SAYS SOME BUREAUCRAT

IN AN INSURANCE COMPANY,
A HEALTH INSURANCE COMPANY,

HAS THE RIGHT TO OVERRULE
OVER THE TELEPHONE

WITHOUT LOOKING
AT THE ADDICTED PERSON;

HAS THE RIGHT
TO OVERRULE A DOCTOR,

A LICENSED PSYCHOLOGIST
WHO'S JUST SPENT TWO HOURS

DOING A PROFESSIONAL,
CAREFUL DETERMINATION

OF WHAT THE TREATMENT
NEEDS ARE OF THE PATIENT.

BUT THE SUFFERING
THAT'S CAUSED, GOOD GOD.

( applause )

MY NAME'S ROBERTA LOJAK.

THIS IS MY DAUGHTER
ASHLEY.

ASHLEY WAS
MY FIRST CHILD.

SHE WAS A BLESSING
FROM THE DAY SHE WAS BORN.

I KNEW MY DAUGHTER
HAD A PROBLEM

PROBABLY IN
MARCH OF 2001.

WE WENT TO A REHAB CENTER
ON OUR OWN.

THEY WOULD NOT ADMIT HER
TO AN INPATIENT TREATMENT,

BUT THEY DID ADMIT HER
FOR AN OUTPATIENT.

I'D LIKE TO READ A LETTER
THAT ASHLEY WROTE TO ME.

"I'M STILL YOUNG AND I STILL
HAVE SOMETHING TO LIVE FOR.

I DON'T WANT TO END UP
LIKE MY OLD FRIENDS

AND BE A DOPE HEAD
MY WHOLE LIFE.

'CAUSE I KNOW I'M HERE
TO DO SOMETHING GOOD.

AND I HAVEN'T SEEN ANYTHING
IN THIS WORLD SO FAR
AND I WANT TO.

AND I DECIDED
THAT ALL THAT

WAS MORE THAN ENOUGH
REASONS TO QUIT.

I AM ENOUGH
REASONS TO QUIT.

MOM,
I LOVE YOU."

BUT I CALLED
ANOTHER REHAB FACILITY.

IT WAS A COUPLE HOURS
AWAY FROM MY HOME.

WHEN WE WERE THERE

THEY TOLD ME THEY WERE
GONNA ADMIT HER.

THEY SAID SHE WOULD
PROBABLY BE THERE

AT LEAST 28 DAYS
TO START.

- NOW WAS THAT A SURPRISE?
- OH, YEAH.

WHY?

'CAUSE THEY TOLD ME
SHE'D BE THERE AT LEAST
28 DAYS.

SHE WASN'T
READY TO COME HOME.
I KNOW SHE WASN'T.

I KNEW SHE WASN'T.
SO WENT BACK HOME

AND ASHLEY MADE US DINNER
AND SHE WENT TO BED.

THE NEXT MORNING
I LOOKED IN AT ABOUT 8:00

AND I SAW HER LAYING
THERE SLEEPING.

TV WAS ON.
SHE STILL WAS
HOLDING A REMOTE.

AND I LOOKED AT--
HER FINGERNAILS WERE BLUE.

SO I STARTED SCREAMING.

I RAN OUT OF THE ROOM.

I CALLED 911,
WENT BACK IN THERE.

I PICKED HER UP
AND PUT HER ON THE FLOOR

AND TRIED TO DO CPR
TO MY OWN DAUGHTER.

BUT SHE
WAS ALREADY DEAD.

I'VE BEEN A PROSECUTOR
FOR 25 YEARS. I DEAL WITH
CRIMINAL CONDUCT.

I'M GONNA READ YOU A STATUTE
THAT I HOPE THE LAWYERS

FOR THESE PEOPLE
WILL TAKE A LOOK AT.

TITLE 18, SECTION 2504:
INVOLUNTARY MANSLAUGHTER.

GENERAL RULE:
A PERSON IS GUILTY

OF INVOLUNTARY MANSLAUGHTER
WHEN AS A DIRECT RESULT

OF DOING OF AN UNLAWFUL
ACT IN A RECKLESS

OR GROSSLY NEGLIGENT MANNER
HE CAUSES THE DEATH
OF ANOTHER PERSON.

IS IT INVOLUNTARY MANSLAUGHTER?
THERE DISCUSSIONS ABOUT THAT.

NO ONE'S EVER BEEN
PROSECUTED FOR THAT.

BUT THERE'S A FIRST TIME
FOR EVERYTHING.

THOSE OF YOU IN THE MANAGED
CARE INDUSTRY

THAT ARE LOOKING
AT THIS ISSUE, ASK YOURSELF:

DO YOU WANT TO
TAKE THIS CHANCE?

I MEAN YOU'RE DANCING
RIGHT UP TO THIS--

TO THE EDGE
OF THIS STATUTE.

THE THING THAT I WOULD TELL
A FAMILY TO DO

IS-- NO MATTER WHAT THEY'RE
BEING TOLD, IS KEEP FIGHTING,

IS TO SAY,
"NO, THIS IS WHAT IT
SAYS IN MY BENEFIT.

AND I NEED THIS BENEFIT."

IF THE FAMILIES
DON'T MAKE AN ISSUE OF THIS

AND DUST IT UP,
IT'S GONNA CONTINUE.

GOOD EVENING.
MY NAME IS JOAN WARD.

I LIVE IN
CRANBERRY TOWNSHIP.

THIS IS OUR SON ROB.

WHEN ROB WAS A SENIOR
IN HIGH SCHOOL

WE DISCOVERED
THAT HE WAS ABUSING DRUGS.

YOU'VE HEARD A NUMBER OF VERY
TRAGIC STORIES HERE TODAY,

OF YOUNG LIVES LOST.

PLEASE DON'T BE COMFORTED
INTO BELIEVING

THAT THESE ARE ABERRATIONS.

WE ARE NOT THE EXCEPTION.
WE ARE THE RULE.

THE WORLD LOOKS
AT OUR CHILDREN

AND THEY SEE DRUGGIES,

JUNKIES, FELONS.

WE LOOK AT OUR CHILDREN

AND WE SEE COWBOY BOOTS
AND BALLET SLIPPERS.

WE SEE CHRISTMAS MORNINGS
AND BIRTHDAY PARTIES.

WE HOLD FOREVER IN OUR HEART
THAT FIRST INSTANT

THAT WE FIRST LOOKED
INTO THEIR INFANT EYES

AND WE KNEW IN A HEARTBEAT

THAT WE WOULD GIVE OUR VERY
LIVES FOR THEM.

UNFORTUNATELY THAT'S
THE LAST ABSOLUTE OF PARENTING.

IT'S ALL GUESSWORK
AFTER THAT.

WHEN YOU GET
RIGHT DOWN TO IT,

OUR OPTIONS REALLY ARE
QUITE LIMITED.

WE CAN BUILD
A BETTER SYSTEM

OR WE CAN CONTINUE
TO BURY OUR CHILDREN.

I GREATLY APPRECIATE
YOUR EFFORTS IN THIS AREA.

THANK YOU FOR
YOUR TIME TODAY.

( applause )

All:
KEEP COMING BACK.
IT WORKS IF YOU WORK IT.

Woman:
OKAY, FELLAS, THANK YOU.