The re­al­ity of Ir­ish ad­dic­tion cen­tres is very dif­fer­ent from the me­dia’s take on celebrity re­hab, writes Jen­nifer O’Con­nell

The public per­cep­tion of ad­dic­tion re­hab cen­tres can of­ten be skewed. The the stark re­al­ity be­hind closed doors in­volves hard work, em­pa­thy – and a lot of plain talk­ing, writes Jen­nifer O’Con­nell

The Irish Times Magazine - - INSIDE -

Astint in re­hab has be­come short­hand for some­thing celebri­ties do when they’ve been caught inge sting sub­stances they shouldn’t, or when they want to es­cape the heat from the pa­parazzi for a while. Open any tabloid news­pa­per or celebrity web­site al­most any day, and you can read how Se­lena Gomez is stay­ing away from al­co­hol af­ter her stint, or how Ant McPartlin is do­ing well af­ter his. It’s no won­der the phrase con­jures up im­ages of spoiled celebri­ties en­joy­ing a few weeks of peace sur­rounded by fluffy bathrobes, aro­mather­apy oils and detox fa­cials.

But the re­al­ity of what goes on be­hind the doors of Ire­land’s re­hab clin­ics, or – as they’re more cor­rectly termed – ad­dic­tion treat­ment cen­tres is very dif­fer­ent. There are no fluffy bathrobes, no caviar- based fa­cials, and if there are any celebri­ties, they’re treated just like ev­ery­one else. In­stead, there is a lot of hard work, em­pa­thy, talk­ing – and a series of slow and dif­fi­cult re­al­i­sa­tions.

“You’ll have a sur­geon sit­ting be­side a school teacher sit­ting be­side a stay- at- home par­ent sit­ting be­side a guy who’s home­less in Cork sit­ting be­side a lad who’s just out of prison. There’s no ‘ typ­i­cal ad­dict’, and ev­ery­body gets treated with the same re­spect and com­pas­sion. It could be your sis­ter, your dad, your brother. Ad­dic­tion doesn’t care who you are,” says Sara Cas­sidy, team leader at Aiséirí Cahir in Co Tip­per­ary.

All the same, you could eas­ily mis­take Aiséirí for a com­fort­able coun­try house ho­tel. A hand­some, white- painted Ge­or­gian build­ing with tidy gar­dens is sur­rounded by more mod­ern out­build­ings, where it’s more than pos­si­ble to imag­ine gen­tle yoga ses­sions tak­ing place. In­side, the tall ceil­ings, soft car­pets, plush flo­ral fur­ni­ture and tea and scones laid out on trays for visi­tors re­in­force the im­pres­sion– which lasts un­til pre­cisely the mo­ment Noelle Ryan starts show­ing me around.

“This is where we ask res­i­dents to pro­vide a urine sam­ple when they first ar­rive,” she says, show­ing me a small toi­let on the ground floor. “We need to start off on an hon­esty path, and some­times there can be a temp­ta­tion to twist the truth about what’s in their sys­tem. And we need to know be­fore we can start detox­ing them.”

Ryan looks af­ter the med­i­cal needs of res­i­dents in re­cov­ery, as well as over­see­ing the detox ser­vices it has of­fered since 2016, mak­ing Aiséirí’s the coun­try’s only ad­dic­tion re­cov­ery cen­tre with an in- house detox fa­cil­ity. This means that peo­ple who need to detox can spend three to 15 days do­ing that here, be­fore their 28 days in re­cov­ery be­gin. Aiséirí is not an emer­gency ad­mis­sion type set­ting, and some res­i­dents will need to start cut­ting down on their own first, she says.

Ryan is clear that ad­dic­tion is an ill­ness, and speaks with com­pas­sion about the peo­ple she treats. “To see some­one who needs to have a bot­tle of wine in their sys­tem just to come to an ap­point­ment is so, so sad.”

A decade ago, most peo­ple came to Aiséirí seek­ing al­co­hol treat­ment, and while lev­els of al­co­holism re­main high with both gen­ders, rates of drug ad­dic­tion – par­tic­u­larly heroin and ben­zo­di­azepine – “have gone through the roof” in re­cent years, says Sara Cas­sidy.

The day at Aiséirí, which fol­lows the 12- step Min­nesota model, runs from 7.30 in the morn­ing un­til 7.30 at night, of­fer­ing a struc­tured pro­gramme of in­di­vid­ual ther­apy, group ther­apy, lec­tures, work­shops and med­i­ta­tion. The cost of a 28- day stint is ¤ 6,804, a rate that hasn’t in­creased in a decade.

In the dining room, lunch is un­der way for the 17 res­i­dents and staff. On the menu is mush­room soup, fol­lowed by roast pork and roast pota­toes. It looks – and tastes – de­li­cious. Res­i­dents wear­ing green aprons over their jeans and track­suits dish up steam­ing plates of veg­eta­bles and pass around jugs of gravy. I sit with the staff and coun­sel­lor Robin Hawthorne, and we talk about hol­i­days and what’s on TV. But the five or six other ta­bles around us are largely silent. At one point, a wo­man gets to her feet and reads a few lines in a shaky voice about the ef­fect of al­co­hol ad­dic­tion. When she sits down, a few peo­ple thank her, and then the si­lence re­sumes.

Is it al­ways this quiet, I ask Hawthorne after­wards. It’s Wed­nes­day, he ex­plains, which means it’s fam­ily day, a day when rel­a­tives and friends come and talk about the ef­fect their loved one’s ad­dic­tion has had on them. Some of the res­i­dents are hav­ing a hard time pro­cess­ing what they heard.

“Fam­ily day is an enor­mous part of their treat­ment. The fam­ily mem­bers will come and they get an op­por­tu­nity to say, in a safe place, what it’s like for them. And it’s re­ally tough,” says Cas­sidy.

“The fam­i­lies are of­ten more sick than the res­i­dents. They’re re­ally, re­ally un­well. They may have been ver­bally abused, po­ten­tially phys­i­cally abused, fi­nan­cially abused. It’s re­ally in­tense, but they of­ten have no idea how it hap­pened.” They’re like the prover­bial frog in boil­ing wa­ter, she says.

Af­ter lunch, I go to the tele­vi­sion room where Neal*, a thin, hand­some man in his early 60s with deep brown eyes and a soft voice, is wait­ing to talk to me. Orig­i­nally from the Nether­lands, he’s reach­ing the end of what will have been 32 days in Aiséirí, and will re­turn in two days to the home he shares with his wife. She was here to­day, and it was “very good”, he says. “She’s very strong. She’s well able to tell me her bound­aries.” She told him there was “still some love there”, so he is hope­ful that bridges can be built.

Six weeks ago, she asked him to leave the house, af­ter she had dis­cov­ered his ad­dic­tion to oxycon­tin and heroin. By then, he

To see some­one who needs to have a bot­tle of wine in their sys­tem just to come to an ap­point­ment is so, so sad

had reached a point where, “I wanted help,” he says, “but no­body wanted to help me be­cause I was cross- ad­dicted to two sub­stances.”

He be­gan his detox on his own in the place where he was stay­ing, spend­ing five days in agony. “My older son bought my pills for the first time” to help him come down. And then he ar­rived in Aiséirí on April 10th. “I wanted it. I threw in the towel. I couldn’t fight the ad­dic­tion any more. The first step of the pro­gramme is to ac­cept that I am pow­er­less over ad­dic­tion and my life has be­come un­man­age­able. I’ll be do­ing that step for the rest of my life.”

Neil’s first re­hab ex­pe­ri­ence was in 1993 for al­co­hol, he says. “I was clean and sober from then un­til 2012. I went nearly 20 years with­out even a drink.” But six years ago, a per­fect storm of stres­sors – the down­turn in the econ­omy that af­fected his busi­ness, his two boys leav­ing home – found him go­ing to his GP seek­ing pre­scribed pain med­i­ca­tion “and I’ve been us­ing on and off since”.

He looks 10 years younger to­day than he did when he came here in April, he says. “You can ask the kitchen staff.”

What he has learned here for the first time is that his fam­ily have “ex­actly the same feel­ings I do, whether it’s fear, re­sent­ment, lone­li­ness, hate, love. They ex­pe­ri­ence the same things be­cause of me. And if I re­cover, they will re­cover.”

Robin Hawthorne says that, in the aver­age fam­ily, a min­i­mum of 10 peo­ple are af­fected by the im­pact of one per­son’s ad­dic­tion. “So across so­ci­ety as a whole, you can mul­ti­ply the im­pact of ad­dic­tion out ten­fold. But fam­i­lies of­ten don’t recog­nise the im­pact it’s hav­ing on them, or the im­pact their be­hav­iours are hav­ing on the ad­dicted per­son.

“The phrase we use is ‘ en­abling ad­dic­tion to foster’. We’re not say­ing fam­ily mem­bers are to blame. A lot of what they do would be ra­tio­nal be­hav­iours in any other con­text – pay­ing off a debt to help a rel­a­tive for ex­am­ple, or en­cour­ag­ing them to take part in so­cial events. The prob­lem is that ad­dic­tion is not a ra­tio­nal dis­ease.”

Jason*, a thin, po­lite and ob­vi­ously bright young man in his 20s, is feel­ing pos­i­tive af­ter his ses­sion with his fam­ily to­day. His par­ents, his brother and his girl­friend all came to see him. “It was tough to hear” what they had to say. “There was a lot of sad­ness there. I knew my­self I was put­ting them through a lot, but to­day I felt it, and let it sink in. It was way more good than bad.”

He was ad­dicted to weed, and “my life be­came a mess re­ally”, he says. Peo­ple don’t think of weed as ad­dic­tive, but “it was for me. I was on it every sin­gle day”.

His prob­lems started when he got mumps dur­ing his first year in col­lege, and spent six or seven weeks alone in his room

re­cov­er­ing. “Be­fore then, every­thing was de­cently on track. I was do­ing arts, and wanted to go on to study psy­chol­ogy. When I got sick, I de­ferred from col­lege, and spent a lot of time in my room, pon­der­ing on every­thing and not re­ally sleep­ing. It was all neg­a­tive think­ing, prob­a­bly be­cause I was on 14 or 15 tablets a day.”

He was a so­cial drinker and a recre­ational mar­i­juana smoker up to that point, but once he re­cov­ered, his mar­i­juana use spi­ralled out of con­trol and be­came a daily, and then an al­most con­stant, habit. “I spent less and less time at home. My fam­ily didn’t re­alise the ex­tent of every­thing un­til the last 12- 18 months. I wasn’t go­ing to col­lege, I would jump from job to job. I lost my drive. I hated my­self. I used to know who I was, and be com­fort­able with who I was, but that all went. Even if I was with peo­ple, I wasn’t with them, I was lost in my own neg­a­tive thoughts. I would over- an­a­lyse every­thing, I’d look into the last blade of grass on every­thing.”

When his par­ents sug­gested a treat­ment cen­tre, “I just said ‘ yeah’ to every­thing, not re­ally know­ing what I was get­ting into. I just wanted some­thing to change. I knew I needed some­thing. The first few days were very tough. The long­est I’d gone with­out smok­ing be­fore com­ing in here was not even 24 hours. My anx­i­ety went through the roof, and all my emo­tions started to come back. Anger was the only emo­tion I could show when I was us­ing, and now I had to feel emo­tions again.”

Now, he’s feel­ing a lot of guilt and shame for what he put his fam­ily through “but it’s emo­tion, and at least I know I can feel emo­tion”.

Jas­mine* is also in her 20s. She left school in first year af­ter a friend died from ad­dic­tion, and be­gan drink­ing and do­ing drugs from the age of 14. She plays with her hair as she de­scribes, softly, how she started on heroin when she was 18, af­ter she re­turned from Aus­tralia, and found a lot of her friends were on it.

This is her sec­ond time at Aiséirí . She was here at 21, and man­aged to stay clean for over a year af­ter she left. “Af­ter a year, I stopped go­ing to the meet­ings. I thought I was grand.” This time, she detoxed for 10 days be­fore she be­gan her re­cov­ery. “They leave you in detox un­til you’re ready, and I still wasn’t sleep­ing. I was in a bad way,” she says.

Now, she’s in a good place, “a much bet­ter place than even I was a week ago. The work they do with you here is just magic. When I started the pro­gramme for the first week and a half, my head was still fo­cused on us­ing. I couldn’t think about any­thing else, I couldn’t fo­cus on the fu­ture.

“And then I went from want­ing to use, to think­ing about my fu­ture, and think­ing that I can have a great life, and never want­ing to use again. When I came in here first, I couldn’t even look in the mirror. There’s low self- es­teem and there’s no self- es­teem and I had no self- es­teem. I still have a bit to go, but I’m get­ting there. They re­ally do work mir­a­cles with you in here.” * Names of res­i­dents have been changed to pro­tect their pri­vacy

When I came here first, I couldn’t look in the mirror. There’s low self- es­teem and there’s no self- es­teem

One of the res­i­dents in a bed­room at the Aiséirí Re­ha­bil­i­ta­tion Cen­tre in Cahir, Co Tip­per­ary. PHO­TO­GRAPH: DY­LAN VAUGHAN

Clock­wise from main: one of the 12 steps in the gar­dens at the Aiséirí ad­dic­tion treat­ment cen­tre in Cahir, Co Tip­per­ary; the hall at the Aiséirí cen­tre; Sara Cas­sidy, man­ager; coun­sel­lor Robin Hawthorn and one of the res­i­dents go for a walk in the grounds. PHO­TO­GRAPH: DY­LAN VAUGHAN

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