It worked like a charm: Alcohol monitor ankle bracelets

Dr. Howard Markel's story:
Like most patients assigned to my substance abuse clinic these days, John, a stylish 22-year-old cosmetology student, did not arrive voluntarily.

John had had two drunken driving violations, one in which another driver was injured. A judge had ordered John to attend my weekly recovery group for young adults facing legal trouble. The judge had also ordered him to obtain and wear a boxy plastic ankle bracelet – a SCRAM – Secure Continuous Remote Alcohol Monitor.

The SCRAM records his alcohol intake by measuring air and perspiration emissions from the skin every hour. Once a day, John goes to a modem so it can transit data from the last 24 hours to a monitoring agency and his probation officer. "SCRAM keeps me from even thinking about drinking," John said.

Last year, American judges ordered SCRAM devices for thousands of defendants released on bond and awaiting trial for alcohol-related offenses, those sentenced on probation, and under-age drinkers.

Yet the device is not perfect. When John was chosen by a favorite instructor to work on a fashion show at the airport, he worried about how to inform her before security personnel discovered it. I urged him to be honest, and fortunately the teacher proved to be entirely supportive. She suggested letting the others in their group pass through security first and a little later, explaining the situation to the inspectors. "It worked like a charm," John told me the next week.

John is beginning to understand the severity of his alcohol addiction and how it threatens his life and well-being. Over the past five months, he has remained sober and has made significant progress.

One could argue that SCRAM and the threat of jail bought those five months of sobriety and treatment for John. As a physician, I remain uncomfortable aiding and abetting coercive methods like SCRAM. But this concern is overshadowed by a far greater one surrounding his long-term health. Soon John will "graduate" from his court-supervised treatment. His real test of recovery begins the day his SCRAM device is removed from his ankle.

Advice to families of problem drinkers: If your drinker has been involved with the criminal justice system, consider asking law enforcement officials about SCRAM.

Read another recovery story.

Thanks to Dr. Howard Markel for the source article in the May 6 issue of the NY Times.

Pulling in the same direction: Alcoholics Anonymous

I sat near the back and looked out over the room. Familiar faces, unfamiliar faces, all of us more or less like John, pulling in the same direction. Then I had an image of every person in that room climbing into bed that night, all fifty of us getting into our beds clean and sober, another day without a drink behind us. It was a simple image but it filled me with a range of complicated feelings: appreciation for the simple presence of all those people, admiration for their courage and strength; a tinge of melancholy for the amount of pain it must have taken each and every one of them to put down the drink; affection for their humanity.

I didn't realize until hours later that there was a name for that feeling. It's called love.

Advice to recovering drinkers: Find a sustaining source of love to support you in your recovery.

Read another of our AlAnon stories, or read more from Caroline Knapp's memoir, Drinking: A Love Story.

A steadfast partner: Sobriety and relapse

From Caroline Knapp's memoir:

Michael and I still see each other most nights, but I am taking time to be alone, trying to understand myself as a person a little better before I make any choices about myself as part of a couple.

Choice is the key word here, and it's still a relatively foreign one for me. For the first time the relationship with Michael isn't washed over by waves of alcohol or haunted by Julian; for the first time I feel I'm with him because I've decided to be, not just because I've been buffeted in his direction by circumstances or pain or need. There's great relief in that: I often look at Michael these days with the sense that I'm finally seeing the relationship through glasses that have the right lenses. Sobriety has helped me appreciate his kindness with greater purity and depth, as though it exists in its own right now and not merely as a measure of comparison to Julian. I can't imagine a more steadfast or supportive partner: Michael hasn't had a drink in front of me since I went off to rehab, and he's as bolstering about my sobriety as anyone in AA. These days he does a great imitation of me in the kitchen before a dinner party, compulsively trying to drink a glass of wine and smoke a cigarette and stir a sauce all at the same time, and I appreciate his ability to capture the frenzied insanity of those days and to help me laugh at it too. If I've been through a war, he's been in charge of triage through most of it, and sometimes the gratitude I feel toward him wells up so powerfully I think I'm going to burst.

Advice to drinkers: Find a loyal friend to help you stay sober.

Read one of our stories about a friend as patient advocate, or read more from Caroline Knapp's memoir, Drinking: A Love Story.

Some little room in her mind: Dependence on alcohol

From Caroline Knapp's memoir:

Nan Robertson wrote [in Getting Better], "I withdrew in subtle ways. My husband used to say, 'When Nan gets bombed, she goes off into some little room in her mind, and pulls down the shade.'"

That line stuck with me for many years….that image had to do with the places alcohol can take you. It had to do with transportation…taking psychic flight…leaving yourself behind….A liquid makeover, from the inside out.

Alcohol melts down the pieces of us that hurt or feel distress; it makes room for some other self to emerge, a version that's new and improved and decidedly less conflicted. And after a while it becomes central to the development of that version, as integral to forward motion as the accelerator on a car. Without the drink you are version A. With the drink, version B. And you can't get from A to B without the right equipment.

Advice to readers who drink: Find a person who can help you learn to get from version A to version B without alcohol.

Read another story of recovery from alcoholism, or read our source, Caroline Knapp’s memoir, Drinking: A Love Story.

I went wherever help was available: Recovery from addiction

Shivakumar’s story

I am a 37 year old recovering drug user. When I was 19, my friend and I had a road accident in which I broke my left hand. I was hospitalized at the same hospital where I was working. The pain was unbearable so the doctor gave me an intramuscular injection. For three hours there was no pain and the drug was giving me some high – which I was enjoying! When the drug wore off, I started feeling pain again, the high was gone, and my addictive personality was calling for me to take one more shot without the doctor’s knowledge. So I raided the hospital storeroom and took another injection.

For three years, I kept taking injections. My physical condition deteriorated to the point where I couldn’t perform my duties. Being around drugs at the hospital on a daily basis didn’t help, I came to realize, so I decided to move on.

Once out of work, I started to mingle with brown sugar users and very soon, I got hooked to it and cannabis. My drug use landed me in a local jail three times. It was there that I became ashamed of myself. I wanted it all to end. So I loaded a barrel full of drugs hoping for a last dying trip.

When I came to, I was in a hospital. After a few days, I was released and I started using again. I injected for six months but, this time, my family came to help me. They took me to TTK Hospital, where I enrolled in a three-month treatment program.

It didn’t take long for me to relapse. Again, the downward spiral which led to my second suicide attempt. After that, I went back to TTK and cleaned up my act, went to self-help group meetings where I got strength and hope and I went wherever help was available. With God’s grace and the precious help I found at TTK, I am recovering from drug dependence, staying away from all drugs for more than ten and a half years now, and still attending the self-help meetings on a daily basis.

Since I beat my addiction, I have been working at TTK’s Outreach Center for six and a half years as the buprenorphine project coordinator. My work and the pharmacotherapy allow people to get jobs, enjoy their family lives and maintain decent social relationships.


Advice: Look for ways to apply what you have learned the hard way to help others, as Shivakumar is doing.

Read a sad story about problem drinking, or read Shivakumar’s source story.