Alcoholics saved by ambush

Roger Green has been off the booze for 26 years but it is still his life. The sheep farmer who became a Mediterranean-based businessman found his vocation as an addiction counsellor, specialising in what he knows best - alcoholism.

Life was comfortable in Cyprus from where he worked as a meat company representative. He was 10 years into his own "recovery" but, he says, "I knew I didn't get sober just to sit there".

Affable and measured, Green is aghast so few resources are put into a disease that causes so much damage. One reason for this may be because alcohol is the accepted drug of societies such as ours, where drinking to excess has been a virtual rite of passage to adulthood.

A major stumbling block to treatment is that alcoholism is a disease characterised by denial. How do you get someone to agree to treatment if they deny they have a problem? That's where Green comes in.

Though he works in all aspects of chemical dependency counselling, Green is a specialist in "structured intervention", where the addict is confronted in a way designed to break through their denial.

Green's company, Recovery Resources, was a pioneer of the method in Britain. He is based in Wellington but expects to have a treatment programme running in Auckland by April, followed by an in-patient operation in the South Island.

Air New Zealand, a client of Green's, includes structured intervention in its drug and alcohol strategy.

It sounds like an ambush and in some ways it is, but Green says it is carefully structured and sensitively managed.

The aim is to encourage addicts to accept treatment.

"Often those closest wait until the person is at rock bottom, when they have no other option. But it is cruel and unnecessary to leave a chemically dependent person until they hit rock bottom," he says.

"Drug and alcohol addiction is progressive, and rock bottom can mean death, irreversible liver damage, or insanity."

Green aims to get people into treatment "while there is still time to salvage their job and pride".

It involves several people who are close to the person - family, friends, colleagues, perhaps a boss - confronting them, with the help of a doctor and the therapist.

Green learned the technique while training as a counsellor at the Hazelden Foundation's Minnesota clinic, where Betty Ford went when she set up her operation and where many of her staff were trained.

Structured intervention does not always have immediate success but Green says it always has an impact. "Even if that person does not seek help immediately, they will never again have a drink or take a drug without a feeling of discomfort. That alone can trigger the decision to seek help. It may take a week, sometimes years."

Those involved in the intervention - other than the subject - undergo two days of education to prepare them. They come to understand the person has a disease and how they have enabled them to carry on their addiction.

"Everyone enables this to happen, from the Government down. It's a disgrace that this disease is allowed to go on as it does simply because it is easily diagnosed and eminently treatable."

Green calculates there may be as many as half a billion alcoholics in the world, each on average impacting on 10 people around them.

It's a disease that is no respecter of status or wealth. Eighteen per cent of Fortune 500 executives surveyed admitted they drank too much.

The crux of the intervention is in the detailed accounts that those involved prepare about how the person's addiction has caused them considerable anguish.

"Times, places, events. You have to have specifics," says Green, "and you don't give the subject many opportunities to talk because the disease will find a way around it."

"What structured intervention does is to help the person to break through their iron wall of denial. It's a disease that tells you you haven't got it."

The group elects someone other than the counsellor to lead the session. Green usually says little until the person has decided to seek treatment, whereupon he explains what is available, or tells the person they have been booked into a particular treatment programme (see case study).

"I rarely disclose, but sometimes I say, 'Look, I've been sitting where you are sitting, I know how you feel'. That can help."

Green, 68, was a typical Kiwi male of his generation, growing up at a time when the cliche of rugby, racing and beer applied. You played the game hard, drunk a lot and kept your emotions in check.

"At 42 I learned about getting in touch with my feelings, when I went into treatment."

At the request of former All Black manager Andrew Martin, Green wrote a policy on alcohol abuse for the New Zealand Rugby Union. He is disturbed but not surprised by All Black Anton Oliver's revelations that heavy drinking sessions have been regarded as an integral part of team bonding.

"I can tell you about drunkenness and camaraderie because I've been there and it's false," says Green. "It doesn't bear any resemblance to reality. I certainly didn't bond with anyone who was sober. They just thought I was an ass."

He knows about denial from personal experience, too. "I knew for about 20 years that I couldn't drink successfully though, as a sheep farmer in New Zealand's culture of rugby, racing and booze, I tried.

"I knew that when I drank I sometimes went into blackout and I did things I was ashamed of [and yet] when I first went for treatment I went for my [former] wife's drinking. I was still denying that it was my problem."

What worked for him was being surrounded by people who were beginning to be truthful about their addictions.

Green says group therapy that is properly facilitated is a powerful recovery tool because the person will find someone they can identify with.

"They will take it from someone who has had similar experiences to them rather than a professional in a white coat."

Since returning to New Zealand, Green has helped companies in the safety-sensitive industries of aviation, timber and construction with drug and alcohol policies.

Though it will take time for companies to adopt methods such as structured intervention - it took one company two years - Green says more are becoming interested in helping employees. He says they realise it costs less to help the person deal with the problem than dismiss them and train someone new.

* * *

Intervention subject: Jayne, 32, retail manager

I had a hangover that morning. I worked for a big New Zealand company, had done for the best part of a decade. I was called in to discuss what I thought [were] my sick days.

Then my brother walked in. Then my mother came in, then some senior colleagues, then two company doctors. My brain was going overtime.

Jayne*, one of the doctors began, "we've brought you here today because we are very concerned about you. We feel you have a problem with your drinking."

Then my brother told his story, how he loved me dearly, how he had watched me deteriorate through my drinking. And he gave examples; his words tore at my heart. My mother was bawling her eyes out.

Then these colleagues I so respected said, in turn, how they wanted to help me because they cared about me.

After everyone had spoken, Roger [Green] explained that alcoholism is a disease, that there is help available and that it had been booked for me.

This was a Tuesday and I was scheduled to fly to the Hazelden Clinic in Minnesota in two days' time. I was given the chance to have a cigarette and let it sink in and was told to come back at 4pm with a yes or no. I felt humiliated, my pride was battered but I thought, 'okay , all these people can't be wrong'.

I'd never heard of intervention therapy and I did feel cornered. I felt my options were treatment or eventually lose a job I adored.

My boss said the clinic was like a plush hotel by a lake and, as I've always been a five-star girl, that helped. I insisted on having beauty bits and pieces done. If I was going to "rehab", I was going in style.

You convince yourself your drinking is okay, that alcoholics are people on park benches, not people like you with well-respected jobs.

It didn't hit me until I was saying goodbye to my father and brother at the airport that I was going. Mum came, and on the aircraft I had one glass of special French champagne.

Mum and I were separated on arrival; I went to an assessment area and mum to a wing for family.

The programme was all-consuming. It was exhausting and invigorating. It was tough, traumatic, confronting, life-changing.

I came to understand that alcoholism is a disease. I was able to separate my drinking from other issues. I'd thought I was depressed because I had a bad relationship but in my case alcohol made my problems seem bigger and the depression came from that.

I haven't had a drop of alcohol since and I haven't felt so alive. I feel fortunate. I have a new job in a new sector in a new city, I've gone from size 16 to size 10 and I know who I am now, where I'm going, what I want.

The big hurdles for me with intervention were denial and pride. And, know what? I'm still proud - so proud that I did it.


* Name changed to protect identity.
* The total cost of Jayne's 28-day treatment, including her mother's 10-day stay, was $50,000, met by the family.

* * *

Intervention support: Rose, Jayne's mother

Rose*, 55, a manager, is Jayne's mother. She took part in the intervention and accompanied her daughter as a supporter to the United States for treatment. It began with a phone call from Jayne's employer.

It was a shock but also a huge relief because her drinking was eating us up and we were at a loss to know what to do.

It was horrendous. She'd say things she'd regret, have memory lapses and one time a couch cover caught fire when she was drinking and smoking. I came home to find the room full of smoke and I dragged her out. She didn't believe me the next day until I showed her the damage.

We couldn't talk to her about her drinking. On occasions she'd hang up or not open the door. She was in total denial. I'm sure it would have killed her, either the drink itself or late at night, not knowing where she was or whatever. She came home in a few bad states. It was heartbreaking.

She was very good at her job, never drank at work but when [she wasn't] working she'd go on binges.

I wasn't confident she'd go along with the intervention because she's very strong-willed. We'd had two full days of briefings to prepare but Jayne had no idea it was coming.

We all told our stories. It was draining. The more people who contribute at the intervention the better, because it makes it harder for the person to deny or minimise.

When Jayne left the room I thought we'd lost her but she eventually came back. She looked daggers at us but it was wonderful because for the first time she admitted she had a problem.

We were on tenterhooks that she would change her mind between the intervention and flying out, even though the delay is purposely kept to a minimum to narrow the opportunity for them to back out.

On the plane she was poured a glass of champagne and she clicked glasses with me and said, 'Well, so long to that.' That was the moment I felt she'd made up her mind. I was so proud of her.

I can't explain how marvellous the clinic's programme is, but it's certainly not easy. She's not had one drink since. We have got back the Jayne we used to know.


* Name changed to protect identity.