Big Sky life in the bottom of a glass
Holiday drinking points to an epidemic of alcoholismStudies have shown alcohol is easily Montanans' intoxicant of choice. Despite the ongoing vilification of marijuana and harder drugs, as well as the recent, warranted attacks on the tobacco industry, beer, wine and liquor have largely escaped public scrutiny.
Still, like most Americans during the holidays, folks in Montana enjoy kicking up their heels, toasting each other with fine wine and egg nog, and getting red-nosed and rosy-cheeked. But for all those who imbibe moderately, studies show that Montanans drink more, drink younger and drink less responsibly than those in other states.
A statewide survey completed earlier this year concluded nearly one in 100 of all Montanans currently abuse a drug, and for 90 percent of those people that drug is alcohol. In a state with roughly 800,000 residents, that means more than 7,000 people are alcoholics.
In the eyes of many, this is part of the myth of what it takes to be a true Montanan. And though they're critical of booze's popularity, the cops and counselors who must deal with the hard realities attributed to alcoholism -- the accidents, deaths and violence -- perhaps even more than the drinkers themselves recognize the pervasive romance of drink.
"Play hard, work hard and drink hard," says Missoula's police chief, describing the drinking culture. "A four-wheel drive with a can of snoose in your pocket and a six pack on the floor. It's about being a real redneck Montanan," explains a local treatment program director.
Even before the recent issuing of cabaret licenses, Missoula County establishments boasted nearly 100 liquor licenses, according to the state Department of Revenue -- and that's doesn't count the beer and wine sold at grocery and convenience stores. On top of that, in 1998, the city will allow 15 more restaurants to put alcohol on the menu under a new cabaret ordinance.
But from drunk and disorderly conduct to fatal auto accidents to fetal alcohol syndrome, the dangers of drinking too much are inescapable. And as reflected in a new Alcoholics Anonymous commercial aired on local television (a woman slips something from a bottle in her desk, as the narrator explains that alcoholism is all around us), the destitute are not the only ones debilitated by what some consider a disease on par with schizophrenia or clinical depression.
At some point, the hangovers and bruises cease to be merely a personal problem. Like other forms of mental illness, alcoholism doesn't just affect the afflicted. Family members and total strangers both can be harmed by drunkards -- and the costs to society can be counted in terms of both dollars and health.
In Montana, the price tag of substance abuse comes in at $780 million in medical and criminal justice costs a year -- that's nearly $1000 for each man, woman and child in the state, according figures released by the state's Addictive and Mental Disorders Division.
The expense of excessive drinking can also be measured in lives. This fall, after the highly-publicized deaths of half a dozen college students who drank themselves into an early grave on campuses across the country, the University of Montana decided to team up with Missoula cops and others to address the problem of binge drinking throughout the community.
"We realize that college students have been consuming large amounts of alcohol for many generations," says UM Dean of Students Barbara Hollmann. "But we also realize that doing so in a short period of time can be fatal."
Missoula Police Chief Pete Lawrenson, Hollmann and others say Missoula needs to keep better track of its kids' drinking habits in particular. Starting this month, Hollman and Lawrenson will bring together a "campus-community coalition" to target binge drinking throughout Missoula.
The hope for a more sober community lies, say treatment experts, with Missoula's youngsters. Kids are out there experimenting, they say, and too many parents turn away, tolerating a rebellion that often turns serious; if teens don't learn to drink responsibly early, they may not learn at all.
"It's the first thing kids do to declare their independence -- they get drunk," says Dorothy Leskanz, who directs St. Patrick Hospital's Addiction Treatment Program. "By the time they're 18, they've seen 100,000 beer commercials. And on TV, what do they see their heroes do? Suck down the suds. We're not winning the war."
JoAnne Blake runs the UM's Self over Substance program, counseling students who have chemical abuse problems. "Most students come into this school with their drinking behaviors intact," Blake says, explaining that college may not be many young people's first experience with booze.
But, she adds, "the thing that really concerns us are the ones who don't use much in high school, they come here and don't know what their limits are. They're inexperienced and not knowledgeable about the amount they can safely use."
Blake's conclusion borne out by the Missoula Measures, which reports that "a 13-year-old in Missoula is more than twice as likely to have started drinking than his peers elsewhere in the country. Of UM undergraduates, 65 percent reported at least one episode of binge drinking during the past 30 days."
A 1996 survey cited by Missoula Measures found that 37 percent of the 7th and 8th graders polled drank during the past month.
Blake says her counselors have three questions for the college students who walk in for an evaluation: Do they have high tolerance? Gulp drinks? Experience blackouts? For students, she says, these are more appropriate measures of substance abuse than standards used for adults.
"A lot of kids think an alcoholic craves booze. That's the last stage of alcoholism," Blake says.
Substance abuse has a decided effect on the intellectual and emotional lives of students as well, Blake says, acknowledging some kids can get good grades despite having an alcohol problem. She quickly adds that most can't. And student alcohol abuse affects more than just a person's GPA. "It exacerbates problems with date rape, assault and damage in the dorms," Blake says.
Crime and Punishment
Missoula Police Department statistics are as sobering as the Missoula Measures' numbers on youth drinking. As of the end of October, Missoula police had made 345 drunk driving arrests in 1997 and issued 1,941 liquor law citations for offenses ranging from open containers to underage drinking. Other, occasionally alcohol-related arrests included 185 for partner assault, 438 for disorderly conduct and 226 for non-specific assault.
"You can see by virtue of the statistics that alcohol plays a major role," says Lawrenson. "That's not to say that alcohol is part of all such incidents, but it is in a great many."
Lawrenson points out that he has put some thought into the topic -- and not just from a lawman's perspective. His father, he says, was a "classic alcoholic father -- always drunk, physically abusive." So was his grandfather. "It just seems to be a part of our culture, I don't know what it is," he says. "Maybe it's the wide open spaces, the idea that we play hard, work hard and drink hard.
"Now I love to go out and have a beer, a glass of wine, sometimes a shot of Canadian Whiskey with dinner," he says. "But it doesn't occupy a large part of my life. There's a place for it in society but we haven't found that niche yet."
The war on drugs, Lawrenson says, is a bust when it comes to addiction, including alcoholism. "From a police perspective, most of us agree that arresting an alcoholic for related crimes doesn't even come close to breaking the cycle," he says. "It doesn't stop 'til the person dies, moves away or goes to prison."
When Missoula cops do arrest drunks, whether chronic or not, the case generally winds up before Municipal Judge Don Louden. In the case of drunk driving, controversial mandatory sentences established a couple of years back take away the guess work, but for other crimes Louden makes the call.
Still, the judge has no authority to order people into an inpatient treatment program, leaving him with two choices: mandating an evaluation of a person's alcohol problems or ordering abstinence. Generally speaking, he says that "in assault or domestic abuse cases, I will order an evaluation.
"But for a bar fight or trespassing, I'm more likely to order abstinence. "
Like Lawrenson, Louden says it's ineffective to use the law enforcement and court system to punish alcoholics for drinking too much. "It's a disease," he says. "It's a difficult situation to deal with if someone is not causing problems for others in terms of physical danger or loss of property."
Youth, adults at risk
From the cops to the courts to chemical treatment programs, all interviewed for this story say the future of alcoholism in Missoula depends on the sobriety of its kids. It's a theory supported by AA meetings where, to a person, recovering alcoholics describe growing up in families that tolerated rampant alcohol abuse.
"With the holidays coming, when we as adults and parents invite people to our homes for parties and our kids see us getting drunk and laughing -- boy, doesn't that look like fun?" says Leskanz. "Or we'll talk about last New Year's when Sally got so drunk she danced on the table -- doesn't that sound like fun?"
Effective drug and alcohol education, Leskanz says, doesn't mean declaring war; it's a matter of being a good role model and communicating with your children. "I'm not saying they're not going to get in trouble, but if they have strong values and a support system in place, they'll know how to get out of it."
The first thing an alcoholic has to do before he or she can get better, goes the lore, is admit that there is a problem.
That's part of the goal of UM's efforts, and it's something every treatment specialist knows only too well. Identifying the problem breaks the code of denial which allows heavy drinkers to keep on drinking, which allows young people to believe they're invincible.
But it's not just individuals who need their eyes opened. Everybody in the community also needs to recognize the problem of substance abuse, says Leskanz; most people tell her that alcoholics are "'skid row, sleeping under a bridge, scraping to pay for a bottle -- and I don't meet that criteria,'" she says.
The truth, she says is that "90 percent of alcoholics look just like you and me. They're lawyers, waitresses, CPAs and journalists. The average alcoholic is a white man in his forties with a family and a job that says he's a productive member of society."
Attending local Alcoholics Anonymous meetings brings to light the depth of the problem, and the diversity of those who must cope with it.
Taking the first steps
Housewives, artists, sales people, professionals, and even a handful of destitute, stereotypic looking "alchies" attend daily the multitude of AA meetings taking place around Missoula each week. AA meetings are ritualistic, following a pattern recognizable by those in recovery everywhere.
The gathered introduce themselves, usually by first name only, then state their problem. ("My name is Bob. I'm an alcoholic.") The 12 steps are read from beginning ("We admitted we were powerless over alcohol -- that our lives had become unmanageable") to end ("Having had a spiritual awakening as a result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs").
The stories told at AA meetings, meanwhile, can be at once heart-breaking and heartening. A mill worker says he was born drunk, his mother's water breaking as she sat on a barstool. A farm hand who did time for beating his wife, explains that he's hanging on to his month-and-a-half of sobriety like a drowning man might cling to a raft.
A stoic rancher states plainly how drink cost him his wife and kids: "I knew I could do real good for myself, but I drank it all away. Now I have nothing." When such an individual is done talking, the group thanks him or her for sharing. It's not idle gratitude -- these folks bare their souls to help each other learn to deal with their common disease.
Though all denominations are welcome, many meetings end in a circle, with participants holding hands and reciting the Lord's Prayer. And it's clear that most attendees welcome this as another show of mutual support.
A participant in one of the meetings, Greg, agrees to an interview. He lives at Missoula's Share House, a downtown facility with six beds primarily serving indigent men who are drug addicts or alcoholics.
The 45-year-old is thin, malnourished, with a bushy beard. He takes vitamins, which he says are helping him get healthy. His eyes are lively, but he stops often in midsentence, having forgotten his point. For Greg, the progressive nature of alcoholism took hold over a long period of time, and its harrowing results were slow to emerge. Over the years, he explains, he made his living as a construction worker in Jackson, Wyo., traveling in a circuit back and forth to Big Sky, where he liked to party with friends. Missoula was another fun stop, he says.
"I used to move around a lot," he says, "drink a place up, wear it out. The law, the hospitals, even other street people -- you fight or steal from someone and have to move on.
"Missoula is pretty liberal -- it reminds me of the '70s. The cops don't harass you too much just for being drunk," he says.
Greg's ended up spending time in jail for domestic abuse, and he's camped out in temperatures reaching 40 below. He lived on the street for years -- can't quite recall how many -- but used to be married to a geologist, with whom he had a child. Greg found himself at Share House after a brief stay at St. Patrick Hospital, following a bad depression.
"You should have seen me when I came in here," he says. "I was a mess, stepping in front of cars, drinking down by the train tracks, walking by the river. I probably would have taken someone with me if I'd had the chance."
According to St. Pat's Leskanz, people want to believe most alcoholics are like Greg -- and that, she repeats, is a problem for all of us. It keeps people from getting help. The community, meanwhile, is hard pressed to admit that its prominent members can have alcohol problems just as severe.
"I've had a few new doctors come in from out of state, and they're amazed at how acceptable alcohol use and abuse is," she says. "One went to far as to describe it as 'malignant.'"
"If you say 'I can control it' or 'I can quit whenever I want,' you've got a problem. Those aren't questions for social drinkers," Leskanz says. "It's a progressive disease. You can be in the early stages of alcoholism without having lost control. The middle stage is more or less defined as not being able to predict the amount you will drink."
For those who have already developed bad drinking habits, Missoula's got more than just AA. Although it's a little pricey, St. Patrick Hospital's program has a high success rate -- and the return on the investment is invaluable.
Leskanz's program takes on an average of 300 patients a year, who pay between $7,000 and $8,000 for the three-week inpatient program. With a year's worth of follow-up care, the program claims a 70 to 75 percent success rates. The national relapse rate, Leskanz says, is closer to 50 percent.
"It's a chronic disease so we assume we're going to see some relapses. Generally, if you've been through the program once, you've had quality care. If you come back, we put you on a relapse track because you have the knowledge and tools you need, so we focus on relapse triggers and how to deal with them."
And for the truly down and out, there's the Share House.
"In Missoula, there's an abundance of resources but to a great extent, it all comes down to whether a person is at a point in his life that treatment is appropriate," observes Judge Louden. "There's a high rate of relapse -- it's just that kind of problem."
The Share House, Greg says, has been his salvation. "The hospital can only do so much," he says. "They keep you from getting ill, from going through the DTs. After that you need a place to go. It gives you incentive and time to get things clear in your life, get your priorities straight."
Greg says that during his stay at the house, he's seen the counselors turn people away for lack of space. "I know it costs a lot of money, but it pretty much saves peoples lives," he says. "If I weren't here, I'd be out doing something stinky wrong and might not be so lucky next time."
His priorities, for now, are simple: He says he is learning how to communicate with people, to have fun while sober, and to respect his housemates. "My days are structured and that helps. I have to learn to deal with the other people I live with, know that they have bad days. It makes me get out of feeling sorry for myself.
"Alcohol has taken me so far down I've forgotten how to relate to the opposite sex, how even to date. You go out to dinner, what do you talk about? It's like being a small kid; I've got to learn to do things over.
"Now, I don't have a job, I lost my wife, I don't have a home," he tells others during the AA meeting. "But none of that matters. What's important is I'm sober, and maybe eventually I'll get to be a contributing member to the community."
Photos by Jeff Powers
The Oxford is just one of more than 100 liquor-serving establishments in Missoula, and sometimes even during the day people line the bar.
Missoula Police Chief Pete Lawrenson has given plenty of thought to alcoholism on a personal and professional level. He says that hard drinking is part of the Montana mystique.
Dorothy Leskanz works at St. Patrick Hospital, helping addicts find ways of getting better. It's up to parents, she says, to teach their children to be responsible.