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Sunday, February 20, 2011

Wet Houses

There's a new topic going on at SR and I'd like to weigh in on it here. I think these "wet houses" are a fantastic idea. They shed a bit of light on the "harms reduction" model and give a place for the helpless hopeless alcoholic... who just cannot and or will not seem to get it... a place to go.  We're talking about folks who say, "Fuck A.A." and the like.


I'm going to do a big cut and paste here, but if you would just like to go to the article, it's here.

Wayne Britton, 61, known to many as the Can Man, reaches into a garbage can to retrieve two cans during his seven-hour, 20-mile can-collecting routine. (Ben Garvin, Pioneer Press)













At St. Paul 'wet house,' liquor can be their life -- and death



The men at this St. Paul 'wet house' don't want your help, or your hope. And they won't get better. It's a place where the most hopeless of alcoholics can drink away their final days at less risk and cost to the public.


Marion Hagerman appreciates your concern.



But it's OK to give up on him, he says. Everyone else has — which might be the only sensible thing to do.


Hagerman has been drinking for 39 years. He drinks despite decades of lectures, prayers and punishment. He drinks despite two years of homelessness, six DWI convictions, six treatments for alcoholism and 13 months in jail.


What's ahead for Hagerman? The 54-year-old can see only one thing in his future — more drinking.


That's why he feels lucky to live in a hospice for alcoholics — St. Anthony Residence in St. Paul. There, 60 men can — and often do — drink until they die.


There are no counselors, no scolding, no 12-step programs, no group hugs. Just the love of Hagerman's life, waiting for him every day — alcohol.


On his weeklong binges, he chugs vodka, beer or mouthwash. They are interchangeable to him, he said, gazing around his 12-by-12-foot concrete apartment.


"I drink," he said quietly, "until I kill the damn day off."


For three years, St. Anthony has been operated by Ramsey County, St. Paul, the state of Minnesota and Catholic Charities, at a cost of $18,000 per person per year. It's one of four so-called "wet houses" in the state.


Like a growing number of wet houses across the country, it allows alcoholics to drink, even when it's killing them.


Some experts attack places like St. Anthony. "To me, a wet house is nothing more than a house of despair and death," said William C. Moyers, vice president of foundation relations for Hazelden treatment centers.


"It is never too late for someone to get help," Moyers said. "Just because there are people who have been through treatment before does not mean we can write them off."


But the men staying at St. Anthony say alcohol isn't just a habit — it is who they are. If any kind of treatment were required, they would return to a homeless life of fear, disease and tremendous public expense.


It's not uncommon for a homeless alcoholic to cost the public more than $1 million during decades of drinking — for multiple jail stays, emergency room visits, rounds of alcoholism treatment and other costs.


But the costs and the suffering are greatly reduced once they arrive at St. Anthony.


"This place is a godsend," said 61-year-old Ron, a 40-year alcoholic and former South Dakota farmer who didn't want his last name published.


He plans — as much as he plans anything — to drink until he dies at St. Anthony.


"I am happy here," he said.


'IT'S JUST SO HONEST HERE'


Social workers refer homeless alcoholics to St. Anthony.


That usually happens after a dreary cycle of drunken-driving arrests, hospital visits and trips to detox, the county-run centers for sobering up.


"A counselor might say: 'You've been through treatment six times. This doesn't seem to be working for you,' " said Bill Hockenberger, a former alcoholic who manages St. Anthony.


These are not soccer moms on chardonnay. Hockenberger's clients have no family connections, no jobs and no money. "These people have burned their bridges. They are done couch-surfing," he said. "They have peed on their last couch."


The alcoholics arrive at the 3-year-old building, which looks like a modern twin-tower hotel out of place in an industrial park. There's no sign outside.


Inside, each room is like a minimum-security jail cell, with one light on a wall, one window and concrete floors, walls and ceilings.


They arrive as refugees of countless anti-drinking treatments.


"Treatment is a bunch of B.S.," snapped Ricky Isaac, a three-year resident, as he drank a beer on the center's drinking patio.


"Those AA (Alcoholics Anonymous) people make me sick. I hate hearing about other people's problems. I have my own problems. If you want to quit, you quit on your own."


They rebel against the chirpy optimism of abstinence-based programs: Try harder. Pray. Ask for help. Don't give up. We feel your pain.


In contrast, St. Anthony feels like Death Row. The message is refreshingly grim: Everyone is going to keep drinking, it's probably going to kill them, and no one's going to talk them out of it.



"It's just so honest here," Hockenberger said. "I ask someone, 'Have you had a drink today?' and they say: 'Definitely! I wish I had some more!' "


Once inside, the men come and go as they please.


Mostly, they go to buy alcohol. They walk to nearby liquor stores. Or to drugstores, for mouthwash — which has up to 28 percent alcohol.


Hockenberger had to ask the nearby Holiday gas station to stop selling 99-cent bottles of rubbing alcohol — too tempting for his men, he said.


To get money, the alcoholics beg on the streets, collect cans for cash or work odd jobs.


When they bring the alcohol back, they check it in at the front desk. When they want to drink, they check it out and take it to the backyard patio.


There, they drink with others, shouting and waving bottles and telling stories. Or they sit alone, taking a sip every minute or so.


They stagger back to their bedrooms, sleep it off, wake up and do it again.


STILL ALONE


At St. Anthony the men know each other, but it's not like a college frat house. "It's a friendly environment, but they are not my friends," resident Hagerman said. "They are the people I drink with."


The isolation was notable on Thanksgiving Day. During a festive turkey dinner, alongside men they had lived with for years, many sat alone in the lunchroom, eating in silence.


That's because their primary relationship is not with other people, Hockenberger said, but with a bottle.


"I have seen men coming in and they chug down their vodka right there, just because they were afraid of losing it," Hockenberger said.


When that happens, he gently tells them: "It's OK. Check it in. It will be there for you in the morning."


Once alcoholics become residents, the police know their names. If one is found passed out in a park, the police simply return him to St. Anthony — no ambulances, hospitals or trips to detox.


If needed, residents get medical care from an in-house nurse. If they get sick, they go to a hospital.


And when they get extremely sick?


There's an in-house hospice service. Three to five residents die every year.


Resident Wayne Britton, 59, who has 12 DWI convictions, recalled the death of his best friend, Dave, from throat cancer in 2008. In his final days, Dave was given food and alcohol in his room.


"He would send for me and say, 'Come in and have a bump with me,' " said Britton, sadly shaking his head. They sipped vodka together, which Britton said the dying man found comforting.


The deaths don't get Hockenberger down — it's the evictions that bother him most.


He sometimes has to kick someone out for misbehavior. When that happens, Hockenberger knows the man is going back to a homeless life of depression, frostbite and loneliness.


"When I see a client walk out of here," Hockenberger said, "sometimes it's the end of the line for them."


PARALLELS WITH HOSPICE


The St. Anthony approach is anathema to treatment programs, which are based on abstinence as the path to recovery. They believe any alcoholic can stop, and should try to.


"AA does not give up on people," said Tom Noerper, director of the St. Paul Area Intergroup, which refers alcoholics to AA meetings through a hot line.


"We will talk to anyone who wants to talk to us. Even if they were dying, we would want to be with them, as long as they want to see us."


Hazelden's Moyers said that even if St. Anthony's men refuse treatment, housing them with public money is a tacit acceptance of their drinking.


"This is just a place to allow chronic alcoholics to keep drinking and steal from them any sense of hope or redemption," Moyers said.


Jan Hennings, spokeswoman for the Minnesota Hospital Association, questioned whether the wet-house model was humane. "I know some people would say we should keep trying — eight times or whatever — until we break through," she said.


But other experts say the bottomless optimism is naive.


The St. Anthony model accepts the obvious — that a certain number of alcoholics are indeed hopeless, said Katie Tuione, program manager at Dorothy Day Center in St. Paul, a homeless shelter.


"This is about meeting people where they are and loving them. It's not rocket science," she said. "They still grieve, love and hurt. They still need food and shelter. They are you and I."


Dr. Steven Miles, professor of medicine and bioethics at the University of Minnesota, agreed.


The reason to support St. Anthony is not the money saved but the kindness extended to the residents. "It is the humanity of it, just like humanity drives the hospice system," he said.


He said seeing people drink themselves to death is like watching chemotherapy patients gathering outside hospitals to smoke.


"Certainly no one encourages them to do this. But this is a society where people get to make their own choices, however bad they are," Miles said. St. Anthony's, he said, "is a rational response to meeting people's needs."


The approach, manager Hockenberger said, isn't treatment at all, but a "harm-reduction model."


'I KNOW I CAN ALWAYS FIND MY WAY HOME'


And the harm is indeed reduced. Housing the homeless slashes use of hospitals and emergency rooms by 50 percent to 75 percent, according to studies cited by Hearth Connection, a nonprofit group that fights homelessness in Minnesota.


Studies in Seattle, Denver and New York City have concluded that providing housing to homeless people with chronic health conditions — common among alcoholics — cuts time in jail and detox by up to 75 percent.


At St. Anthony, the men are healthier because of the on-staff nurse. She monitors their medications for such diseases as diabetes. Officials know the men and their conditions — so they don't have to rely on emergency rooms for routine care.


St. Anthony residents say the housing quells the anger that homeless people feel. When the men feel cared for — even loved — they aren't as likely to hurt others and themselves.


"This place is different. The staff is great. They are like brothers," said resident Isaac, a 30-year alcoholic who has served time for assault. "It's called respect."


The residents were aghast to hear anyone would question the wet-house approach.


"If not for this, I would be drinking in the street, in and out of detox," said Hagerman, a 39-year alcoholic.


St. Anthony has lifted him out of a life of homelessness. He remembers the panhandling, walking into detox to get some sleep, the petty crime to slake his thirst for mouthwash, which he calls "wash."


"I would buy a bottle of wash or take it away from someone else," Hagerman said.


He was told that some experts question spending tax money on hopeless causes. "F—- 'em," Hagerman said, waving at the four cinder-block walls in his tiny room. It's not much, he said, but it is safe.


"Here," he said, "I know I can always find my way home."


One sunny November afternoon, a drunk staggered up to the building's front door.


His clothes were a mess, his eyes were bloodshot, his words were slurred, and he smelled like a bathroom in a cheap bar. Most any treatment center in the state would have immediately kicked him out.


He ran into Hockenberger at the entrance. "Hey, Bill!" the man said, hoisting a 12-pack of beer. "I went shopping!"


"All right!" said Hockenberger, as he held the door open.


So... I think this is a good thing.  I would recommend that these folks be given a way to be even more self sufficient and cost effective.  Why can't they be given the materials to make their own hootch?  I think it would be less expensive and less dangerous than letting them drink stuff like mouthwash.  How about letting them make shine or something?  Even homemade beer and wine.  Hard alcohol can be made with apples, potatoes, etc. 
 
Some of the comments over at SR are funny.  The first sensible comment that I could find was made by kiki5711.  It's not an all bad thing in deed.
 
Now Mark, I'm sorry buddy, but I have to disagree.  This is NOT a good place to try and do 12th Step work.  They already said they don't give a shit about your story.  All they want is their booze.  They've separated themselves from those of us who want to do something about their alcoholism.  In other words, they've done half our fucking job for us!  If they change their mind down the road after having some more booze, then it's on them.  We don't save folks from booze.  We're not God.  Another subject for another day.  Anybody who says that A.A. is about reform, temperance and the like is full of shit.  This is just not true.  If you're doing that, that's not fucking A.A.!  That's treatment center bullshit at best.
 
I'm no 12 Step expert, but this is two things that are at the absolute top of the list in order for me to proceed with anyone;
 
  1. Are you alcoholic?  If no, see ya have a good day.
  2. Do you want to do something about it?  Do you want to quit for good and all right now?  If no, see ya have a good day.
Some people just cannot and will not be helped.  They are probably late stage alcoholics and won't live much longer anyway.  But... left to their own devices, can cause you and I a bunch of money and suffering, despite themselves.

12 comments:

  1. I gotta go with Patrick here. You have to want, and I repeat want, to stop drinking or all the therapy in the world isn't gonna do shit. AA seeks by attraction and doesn't provide motivation to stop drinking.

    These guys don't want to stop. They know the consequences of what they're doing and accept those consequences. You're not going to do 12 step work here. They've heard the message and reject it. They've made their choice.

    We need to go back and look at our attitude of acceptance, as this is a good place to see how accepting we are. This is reality. These are people. We cannot change them. First part of the Serenity Prayer.

    I've never heard of the "wet house" concept before, but I like it. I think it's a great application of man's humanity to man. These guys aren't forced to be where they are, and if one of them decides he does want to stop drinking, he knows what to do.

    I don't think that letting them make shine or beer etc. is such a great idea, though. You're opening up Pandora's Box with that one. Mouthwash isn't that dangerous, and it's not public money being used to buy it anyway.

    Let these guys live their lives out as they want. A 12 x 12 concrete room ain't much, but it's better than the alternative. Here they're safe and are able to hold on to that last little bit of dignity they have. Let 'em be.

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  2. I like this approach as well. In fact, there is a place like this in Seattle.

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  3. IDK, Depends on what the 12 step work entails... I mean it could just be a walk through, "Hey, how ya doin'?" sort of thing... Yea, I get it, I kinda rethought my comment later...

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  4. Actually it look's kinda cushy... nice bed, clean, warm...

    You made a cogent argument there, Patrick... Alcoholic does not automatically equal bum... and, I guess, vice versa.. hmm... Willful... yep... Bill Morrisey is a folk singer... now getting recovered... he wrote a song about switchyard bums about 20 years ago called "Barstow"... he really got inside their heads... And yea, willful.

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  5. Good to see you stop by, Mark. Glad you got the message.

    And I can't figure out where you're going here, Patrick. You began this thread by saying you think these wet houses are a fantastic idea. They give a place to go to the helpless, hopeless alcoholic who cannot or will not get it.

    Then you're off on a rant calling these same guys "worthless piece of fuck narcissist wet alcoholic(s)" So they piss on our help and say "Fuck AA."? Are these the ones who don't have the balls to jump of the bridge, too. Is this your your attitude? Or am I confused?

    Are you saying that this is the attitude of the folks who provide the wet house to the hopeless alcoholics? That their attitude isn't one of humanity but rather one of disdain? It wasn't really clear to me. Sorry.

    If the argument is that "the people who support the wet house are doing in a self-serving manner, looking at these guys as the fucking dregs of humanity who are best kept the fuck out sight and away from windshields, so let's shut them away in a 12x12 so they stop bothering us", then I disagree.

    Go back and read the quote by Katie Tuione,
    "This is about meeting people where they are and loving them. It's not rocket science.They still grieve, love and hurt. They still need food and shelter. They are you and I." It's also called a "...rational approach to peoples needs." And others say"It's the humanity of it, just like humanity drives the hospice system."

    So I look at this program without the cynicism
    of thinking the providers have selfish motives. There are actually some good people in the world. I see humanity here. I look at the statements from the guys who live there. It's a home for them, an recognition by society that they are who they are. I see gratitude here.

    I'm in no position to judge another person's motives. But I know that if I only look for the bad, then that's all I'll find. So I try and look for the good, too. Here I see some good.

    And these folks are real alkies. Matter of fact, 15% of real alkies fall into this category of homeless bums. Some suffer from clinical pathological mental problems, quite a few actually. But they've long lost any skills, their goose fell from the hook long ago.

    I can understand their defiance. These guys are at the fucking bottom. They don't want to hear any AA shit, they don't want the Salvation Army coming by. They've heard it all before and don't want it. They don't want people trying to keep shoving sobriety down their throats. They just want to be left alone.

    They've been offered every type of help (help being programs to get them sober) available and turned them all down. They don't want help. They want to drink themselves to death. So when some "holier than thou" asshole comes by and tries to convert them to the life of abstinence and recovery, they'll say "fuck you". But it's a "fuck you, leave me alone, I've heard all this shit before and I don't want it" rejection.

    And one more time on the mouthwash. If you only have $3.00, you can't afford bourbon. You can afford some cheap house brand mouthwash, however. And you'll get more of a boost with 28% of a pint of mouthwash that 12% of a pint of Thunderbird, which also runs about $3.00. So it's not a matter of being a fuckin' martyr, it's a matter of only having $3.00.

    Do I have empathy for these guys? No. At some point in all our lives we're all in the same position of which path to choose. I chose sobriety while I was able to make that choice. Had I continued drinking, no doubt in my military fucking mind I'd be in a 12x12 telling you to fuck off. They chose the easier, softer way of the bottle. But they don't have me living in the next cube. It's choices. I made mine. They made theirs and have to live with them.

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  6. I'm in total agreement about the alcoholic/bum thing. May homeless guys on the streets are alcoholics, but many are not. Most are just so impaired physically and mentally by the habit, ie heavy drinking, that they can't stop without medical detox. Others, as this story illustrates, WANT to live the way they are living. Others are mentally ill. We get these types in the place where I work, especially this time of year when it is cold outside. I think it would be a better deal if we had a place like the one described here in Everett. There's one in Seattle, but that's thirty miles away. We bill the county around $270 per patient a day for detox services, so a place where the guys that want to drink can stay costs much less. A better deal all the way around.

    I agree about the dignity thing as well. There are a few of the "do-gooder" types who work where I work. They think that our clients need sympathy and pity. No what they need is compassion and truth. You want to go drink yourself to death, far be it from me to get in your way. It's your God-given right.

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  7. I said what I said. I show no empathy for bums who still have the attitude to say, "Fuck A.A. If you want to quit drinking, you do so on your own."

    Well, thank you for the wonderful advice, low-bottom, pants-pissing-drunk, but thank you no! Or in otherwords, how's that working for you?

    Willfully killing yourself via booze is not something I hold in high regard. I'm not impressed. But the fact seems to remain... some folks seem to be of this category. I'd rather they go drink where they gotta do it and be away from the folks that still care for/about them.

    Mouthwash... is denatured alcohol... aka alcohol that does not need to be taxed. It can contain methyl or kerosene and can make you blind, fuck your organs up, and/or kill you. Work those windshields a little harder and get some Maddog 20/20, I say.

    Now... I say whateverthefuck I want... as some of you know. This is how I feel about the down and out but still willful bum. I judge them, just like I judge anybody. I see no wrong in judging people. Now... standing in judgement is wrong. I do that too. That's ego. I still have one. I do sometimes go on ego rants. But I do so usually to illustrate a point; the point? Though I agree with the need for these places, I'm not going to hang out in them myself anytime soon.

    Just because I was in my cups and drinking without control, did not mean I didn't have the sense to rub two pennies together. I wasn't a fool. A real alcoholic can arrange their life so they don't get separated from their booze. An alcoholic is a drunk, we are not stupid. Some of us aren't lazy either. To the contrary... I busted some ass during my drinking days. An alcoholic ain't got much time for things of the world because we gotta drink. Drinking like the alcoholic requires a high degree of skill... to get your work done so you can get away from it... away from the family... so you can drink. It takes stamina and a cunning twist of mind. Some of us have a knack for drawing a good woman to our side... someone to care for us. Some of us are damned talented and good looking. Fuck, don't hate me because I'm hot. Hate the game... not the playa. We're not all toothless fucking hairlips.

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  8. Well we agree on most of this stuff, Patrick, although we may word it a little differently.
    I, too, have no empathy for these guys. As I said, at some point we're all given the same options. These drunks made their choices, we made ours. Granted, some are, as the Big Book said, constitutionally incapable and all that. But I think that the vast majority of these guys don't fall into that category. These bear full responsibility for the situation they're in. Sorry guys, no empathy for you.

    Their lives end up in a 12x12. They don't want to stop drinking, don't want AA, just want to be left alone to die. If they say fuck AA, fine with me. I'm not gonna change their minds, nor do I really give a shit what they think about anything. I have a pretty low opinion of them, and that's being judgemental, I guess.

    The ones I won't judge are those who're providing for and operating the wet house. I won't judge their motives as self - serving. I think they do show humanity to these bums. They do offer a little dignity. I applaud them for that. They're better people than I am.

    Would I go over to the wet house and help out? No. I'd look at that as validating the choices these guys made. Yet I volunteer at a homeless shelter and stand there dishing out food to guys who would probably be in a wet house if one were available around here. I'll also give a buck to a guy on the street holding a cardboard sign. I don't ask what he's gonna do with the money. Maybe it's for food, maybe for mouthwash. Not my business.

    So I'm a hypocrite, I guess. On one hand I won't help the "fuck AA" types, on the other I will. I keep my head in the sand when I do help them, trying to pretend I'm a good Christian. I delude myself into thinking I'm like the people who run the wet house. I'm nowhere close.

    And one last shot at the mouthwash thing (Patrick, you and I would argue with a fucking signpost). Mouthwash contains partially denatured alcohol. As you said, this avoids the federal tax. But partially denatured alcohol doesn't contain methyl or kerosene. Only fully denatured alcohol does, and that's the reason that mouthwash doesn't contain fully denatured alcohol. Granted, mouthwash still has a lot of other crap that can be harmful if consumed in large quantities, and this stuff is especially dangerous to small children. But if the drunk has enough money from washing windshields to by that much mouthwash, he'll have more than enough for some good MD 20/20, or maybe some good $9.95 generic vodka.

    So rant on, my good friend! Some of us on this blog have to take a stand. Else what the fuck would we have to argue about?

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  9. Well I give a bum a 5-spot so he can get himself some good cheap vodka or maybe some cheap wine... or maybe a couple of 40s.

    There again, I know I shouldn't stand in judgement... but the steps haven't turned me into a Saint just yet. Saint Patrick. Imagine that.

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  10. I was talking to a friend about this last night. He's been in some pretty dark places over the years w/both alcohol and drugs. Lived on the street and in the Union Mission for a while. Drank and didn't give a shit. Had been to AA and all that many times.

    Anyway, he's been sober for a couple of years now and is doing pretty good. Got better sobriety than most folks I know who have been around a lot longer.

    So I asked him what if, when he was at his worst, there was a wet house he could have turned to, would he have done. He told me that he would have moved in there in a heartbeat, no questions asked. He said his attitude was the same as the guys in the wet house that I told him about. Fuck AA, leave me alone to drink.

    He went on to say that the decision would have killed him. It would give him license to drink himself to death. He thinks that if he were in a wet house he would have never come back. Shit, he had a safe place to drink, meals 3 times a day, roof over his head, no one hassling him. He's never had hit his bottom in that case.


    This isn't to throw a damper on the concept, but rather to say that there are 2 sides to the coin here. Here's a guy who turned his life around 720 degrees. I remember the first time he walked in the door he was drooling, completely out of it. Now he's Mr clean and sober. Got back with his wife, kids, and grandchildren - all that stuff. He's a rare success story.

    So could you tell if a guy may have his potential to recover before you let him into a wet house? Beats the shit out of me. No test you could give them that I know about. And that's certainly not a reason to abandon the wet house concept.

    But maybe, just maybe, we're screwing one guy out of 20 of a chance to get sober. I dunno. Hell, we bust our ass to keep one guy in 20 around long enough to give him a shot at sobriety, don't we? Let's face it, that's a pretty good success rate these days.

    Anyway, don't want to rain on the parade here, just thought I'd bring it up.

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  11. Well I have an uncle who created his own wet house... right there in my parents' basement. He drank himself into a hospice bed then his cirrosis did the rest... a painful horrid death.

    I asked my dad, "So... where the fuck did he get the booze in the first place... since he'd been bed ridden the last days?" My dad said, "I got him the booze." I said, "Why?" My dad said, "Because he had a loaded 38 under his pillow and he (my uncle) said, "Either you get me booze or it's my brains splattered on your walls."

    So... to me, that's a man with a plan. I laugh at those who think they can go up to another and "throw that switch." If booze don't help a guy throw the switch, nothing will.

    But I see your point. You're not raining on any happy parade fo sho.

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