The stereotype of an alcoholic in America is an image of a homeless drunk in a gutter, bereft of family and friends, jobless and destitute.
But a more realistic image emerged just days ago, when longtime U.S. Rep. Phil Crane–an anchor of the Illinois delegation in Congress for 30 years, former presidential candidate and contender for chairman of the influential House Ways and Means Committee–announced that he was dropping out of public life to enter a 21-day residential treatment program for alcoholism.
The public acknowledgement by the Wauconda Republican vividly illustrates that acute alcoholism can envelop even those who appear to have the money, support, medical resources and other means to escape the dependency. It also raises the complicated question of what is the point at which even the most high-profile person can no longer maintain the veneer of self-control and must seek help. Crane in fact represents the majority of alcoholics, experts say, those who appear in the narrow lens of society to be fully functioning, perhaps even in high-profile roles such as CEO, banker, physician, politician.
Crane said Tuesday that his dependence on alcohol had taken a toll on his health and other parts of his life. During his treatment, experts say, he will face hard self-examination and sophisticated training to manage the daily life events that trigger the craving for a drink.
Simply put, he said, “[I] reached a point where I feel I must address the problem.”
Despite the many advances in the last 30 years in the physiological and psychological understanding of alcohol’s effects, the alcoholic zero hour is impossible to codify and standardize. It is as unique as every alcoholic, and there are about 15 million in the U.S., experts say.
One successful banker in Chicago was being promoted even as his drinking caused his wife to leave him and his children to reject him, until he awoke one day and was literally too exhausted to keep up the facade.
A 28-year-old Beverly woman managed to maintain a promising job in business communications, a spotless home and three well-dressed daughters, despite consuming a half-gallon of vodka a day. “Two friends came over and said, `We think you need treatment.’ I was hopeless at that stage,” recalled the woman.
A career military officer sought help after he found himself in the middle of the countryside one morning at 5 a.m., headlight smashed out and blood on the front of his car. He had had another blackout.
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Dr. Jeffrey Tilkin, vice president of clinical affairs at Haymarket Center, the largest treatment provider in Cook County, said an alcoholic’s professional life is often one of the last things to fall apart.
“They can often maintain their work,” Tilkin said. “They think, `If I get to work and do a good job and people respect what I’m doing, then I’m doing OK.’ But the family structure starts to go, and personal self-esteem starts to go. And that usually drives them into acknowledging a problem.”
Denial is a major obstacle to alcoholics undergoing treatment.
“A big part of the battle is getting people to do what Phil Crane has done, to be public about it, to admit they have a problem and choose to do something about it,” said Peter Palanca, regional vice president for Hazelden, which operates substance-abuse treatment centers in Chicago and the suburbs.
In Crane’s case, rumors about his drinking had circulated over the years, but he rarely missed a vote.
Crane’s sister, Judith Crane Ross, 65, of Downers Grove, said she had never seen her older brother drink more than a glass of wine with dinner.
But he didn’t look healthy to her, either, having rapidly gained about 40 pounds after one of his seven daughters, Rachel, died in 1997 at age 31 after a prolonged struggle with cancer.
One of Crane’s other daughters “pointed out to him that in the last 2 years, since he lost his daughter, it was a problem,” Ross said. “His daughter was a precipitating factor in saying, `This is getting out of hand, Dad, and you’d better address it.”‘
“He was never a teetotaler,” added Ross, who said she lectured her children when they were young about alcoholism because it runs in the family. “He quit smoking after her death. He said, `Whenever I get the urge for a cigarette, I fight the urge and say, `Hey, Rachel, this one is for you.’
“In the process, he may have traded one addiction for another.”
Two friends who are recovering alcoholics with high-profile political jobs said Crane consulted with them before checking into a residential treatment facility last week.
One of them was Rod Chandler, 57-year-old lobbyist and former Washington state representative who as a young politician was confronted by concerned supporters. He had formed a pattern of drinking to ease his nerves before social gatherings and campaign fundraisers. The confrontation, when Chandler was 31, prompted him to join a support group.
“You go to a social event and you have a drink,” Chandler said. “It’s so much a part of your life, you can’t imagine life without it.”
The other friend that Crane talked to was Minnesota Rep. Jim Ramstad, who was a state legislator when he woke up in a jail cell in Sioux Falls, S.D., after causing a disturbance while intoxicated the night before. He checked into a residential treatment facility for 28 days and says he hasn’t relapsed in the 18 years since.
“I’m only one drink away from a jail cell or worse. It’s a daily process,” said Ramstad, 53.
Crane has a roughly 50-50 chance of recovery after treatment, some research indicates, though experts disagree on overall success rates. The longer people are in treatment, the better the recovery rates, according to research.
Relapse rates are high, experts say, at 50 percent or more, though those who recover a second time have a better chance of staying sober if they have support systems beyond formal treatment, said Ray Soucek, president of Haymarket Center on the Near West Side.
Crane’s residential treatment program will likely follow some basic steps, experts said.
After a complete physical and assignment to a counselor, patients spend their first days detoxifying. Severely dependent patients may receive medication to help counteract withdrawal symptoms, which can range from shaking and nausea to hallucinations.
One of the most significant advances in alcoholism treatment is the use of medication to help reduce the craving for alcohol. Though it has been slow to filter into regular use in community treatment, federal researchers such as Dr. John Allen, associate director of treatment studies at the National Institute on Alcohol Abuse and Alcoholism, are strong proponents of the medication as an adjunct to behavioral therapies.
Another advancement in treatment, Allen said, is the discovery of more sophisticated ways to teach specific skills such as resisting social pressures to drink or finding the motivation to change behaviors.
In cases such as Crane’s, family members may be asked to come in for counseling as well, experts said. Once clinical treatment is complete, said Haymarket’s Soucek, “the natural experience is to begin to walk on egg shells and [wonder], is he going to drink or not going to drink again?”
Future efforts in alcohol treatment will continue to emphasize destigmatizing the disease.
Said Dr. H. Westley Clark, director of the federal Center for Substance Abuse Treatment: “It is brave to acknowledge there is a problem and deal with it and get on with life. The problem is when you don’t acknowledge you have a problem.”
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