Josh K. knew from an early age he was going to experiment with drugs and alcohol. When a Drug Abuse Resistance Education (D.A.R.E) officer came to his middle school to share about the dangers of drugs and alcohol, rather than hearing to avoid these substances, Josh instead heard what sounded like a good time.
While there may have been some good times in those early days of experimentation, they would all be long gone by the time Josh arrived at Discovery Place in 2013. He was suffering from chronic alcoholism. Days-long blackouts, hallucinations, and seizures plagued his final months of drinking. Coughing up blood had been a regular occurrence for years.
Advanced alcoholism, also commonly called end-stage or late-stage alcoholism, refers to the most severe end of the alcohol dependence spectrum. While the American Psychiatric Association does not specifically outline stages of alcohol use disorder (AUD), or alcoholism, it does offer guiding criteria. The number of symptoms a person presents determines where along the AUD scale he falls, ranging from mild to severe.
As Josh slipped further down the scale, the glimmer of hope for his survival became more and more dim. But his family, his mother and sister in particular, never gave up, even if it meant tricking Josh into a car and driving him nearly eight hours to Burns, Tenn. to check him into Discovery Place.
Early stages of alcoholism and drug abuse
Born and raised in Munster, Ind., a small town about thirty minutes south of Chicago, Josh, 33, was well-liked in school and an average student. But lying to avoid school and homework came easily, and any time Josh could figure a way to get out of either he took it. By middle school his parents had divorced and his lies were continuing to grow. Attention-seeking behavior resulted in stories of hallucinations and the first of many suicide attempts.
“I would do anything to not go to school,” recalls Josh. “So one night I stabbed myself in the side and slashed my arms.” Several weeks in a psychiatric unit followed the event. When Josh returned to school, things had changed.
“I went from being extremely popular to the guy who stabbed himself. It was this big shock to me. In some kind of delusion, I thought maybe people would think that was cool or something,” he says. “But it was the exact opposite. I think people felt sorry for me, and mom and dad didn’t know what to do with me.”
A few years later, at 17, Josh was kicked out of high school. With his mother working two jobs and going to school, he had the house to himself a lot of the time. Ritalin, Adderall, marijuana, whatever Josh could access, he used. Drinking was still just a weekend activity. By 18, however, he was addicted to cocaine.
“Things got so dark with the coke,” says Josh, recalling watching his friend overdose. As he tried to ease off the cocaine, the need for something to fill its place got stronger. “I still needed something to relieve whatever was going on with me. That’s when I really started drinking.”
Identifying symptoms of Alcohol Use Disorder
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association’s handbook, outlines eleven symptoms of alcohol use disorder, a disorder affecting an estimated 15.1 million adults in the United States according to a 2015 National Survey on Drug Use and Health. Failure to fulfill roles at work, school, or home; unsuccessful attempts to cut back or control drinking; and continued alcohol use despite persistent social or interpersonal problems made worse by the use of alcohol make up just a few of the symptoms on the list.
A previous version of the DSM distinguished between alcohol abuse and alcohol dependence, but in 2013, with the release of the DSM-5, the categories were combined and instead called alcohol use disorder. Mild, moderate, and severe outcomes are determined based on the number of symptoms an individual identifies. Two to three symptoms within in a year indicates mild AUD. Four to five symptoms—moderate. Six or more of the eleven symptoms—severe.
“Chronic drinking over a period of a time, it affects every organ system. Really, it’s head to toe,” says Dr. Jan A. Mayer, a Nashville-based psychiatrist and expert on addiction. “The nervous system, the gastrointestinal system, the cardiovascular system—those all suffer severe consequences from drinking over long periods of time.”
Acute pancreatitis, chronic pancreatitis, diabetes, difficulty digesting, alcoholic liver disease, cirrhosis, cardiomyopathy, alcoholic neuropathy, increased risk of lung cancer and Alzheimer’s disease, dental problems—these are only some of the many health-related concerns that can befall a chronic drinker.
“Alcohol is very disruptive to your gut. It leads to a bad balance of bacteria. Your gut is your outside, inside. It’s your connection to the outside world,” says Dr. Mayer. “It has a very tight system for keeping things out of the inside of your body that shouldn’t be there. If your gut wall keeps breaking down from alcohol, then your immune system goes into hyper drive and starts causing problems with your own body tissues.”
Couple the physical consequences of alcoholism with an increasingly deteriorating state of mind and the outlook for any chronic drinker who does not find help begins to look grim quickly.
Mental and physical effects of chronic alcoholism
Over the next several years, Josh bounced in and out of jobs never finding roots or purpose in his work. “All I really wanted to do was hang out. I wanted to spend my life just hanging out and having fun,” he recalls. “But I gotta have some kind of substance in my body. I’m not content with just hanging out with me.”
Eventually, Josh ended up on unemployment and didn’t work for four years. With habits to feed, he became a master manipulator, squeezing money out of his parents and drinks out of the local barflys. He stole DVDs from Walmart to resell for money for cocaine and alcohol.
“Day-to-day there was no work, no structure. I don’t have any responsibilities,” says Josh. “I want to drink forever. That’s my mission.”
Daily life began to appear on repeat: wake up hung over, throw up, pass out, wake up again, binge eat, then head to the bar. “If I had six dollars, I’m going to the bar.”
Near the end of 2012, Josh had his first seizure. Despite multiple previous suicide attempts, the seizure made him realize he really didn’t want to die. But it wasn’t enough to make him stop drinking. Three days later, Josh was drunk again. A week later, he had a second seizure.
Finding treatment for alcoholism
As Josh’s alcoholism continued to close in on him, his family was left wondering what to do. When his mother offered him 50 dollars to clean the attic so he could use the money to look for a job, Josh punched himself in the face repeatedly until the damage was severe enough that he couldn’t go on interviews. He told his mother he’d fallen out of the attic.
Shortly after, when his mother again encouraged him to find a job, Josh smashed his foot with a hammer. This time he said he’d dropped something on his foot. “They were excuses for me to lay around and drink,” he says.
Josh’s younger sister, his roommate, became responsible for ensuring he was still alive when she came home at night. “I would fall asleep on the living room couch, or on the floor, or in the garage, or in the bathroom, and every time she came home the first thing she did was check that was I breathing,” he recalls. “I would fall asleep with food or vomit in my mouth and she would reach in and scoop it out. Her life for two or three years was pretty sad.”
In February 2013, Josh had two seizures in a month. His mother and sister called an interventionist who recommended a couple of places for Josh to go. One of them was Discovery Place.
Following his release from the hospital, realizing there was no longer time for an intervention because he was going to die, Josh’s mother and sister told him they were taking him to see his dog. Instead, they drove Josh eight hours from Indiana to Tennessee.
“I went nuts,” says Josh. “I was hallucinating. I was throwing up. I was coughing up blood. I was violent, kicking stuff. I tried jumping out of the car. I would go into these fits of rage and then pass out. Then I’d wake up and we’d be an hour closer.” Once they finally got Josh to Discovery Place, he told his mother and sister they would never see him again.
Josh remembers telling his father when he was 21 that he thought he had a problem with drugs and alcohol. But the conversation, like Josh’s life, fizzled and burned out. Once Josh arrived at Discovery Place, there was a sense that something could now be different.
“I’m 28 years old but I’m a kid. I don’t know how to do anything,” recalls Josh. “I wanted a real second chance and that was on the table . I was removed from everything I knew, and I didn’t have anything holding me back.”
Not just another drug rehab
At Discovery Place, Josh saw people laughing. He heard men who spoke his language. He saw people who took recovery, but not themselves, seriously. The men guiding him were once just as sick as he was.
“The really important thing is that there’s hope,” says Dr. Mayer of someone with severe AUD like Josh. “Getting help and stopping drinking changes everything. A lot can be reversed.”
Following 30 days at Discovery Place, Josh spent another 30 days in the Long-Term Recovery Program—the program he now leads today, more than five years later.
“I believe in what’s going on here,” he says. “There is a safety that comes with Discovery Place.”
Josh moved into a sober living house after LTR. Each day he returned to Discovery Place to volunteer and to surround himself with a community of men with the same mission. The more he hung around, the better he got. Recovery was no longer just an idea; it was something he was practicing and giving to others.
When Josh was drinking he used to tell himself he was a loser and a degenerate—a nobody. Now each day he sits with men just like him, echoes of his former self, and gets to show them something different. He gets to show them a way out.