When a man feels ready to graduate, he fills out a seven-page application that includes such questions as “What is the most dangerous trigger which could…lead to a relapse?” and “What are your short-term and long-term goals after graduating, and how do you plan to achieve them?” Step Up ceremonies and graduations are held every two weeks, and it is not uncommon for someone to be held back. About 25 percent of the men graduate, but the number has been increasing. Before the program was restructured in 1999, only 12 percent graduated.
Throughout the entire program the men have to undergo random drug and/or alcohol testing. A bad test gets a man exited immediately. Violence or threats of violence also get a person discharged, as does continuous violation of rules and policies.
This is a simplified description of the program. What is left out and what receives intense emphasis all the way through is a commitment to Alcoholics Anonymous and Narcotics Anonymous, which begins with embracing the first of the programs’ 12 steps: to admit you are powerless over drugs and/or alcohol and your life is unmanageable. The men attend AA/NA meetings almost daily, and each man must get a sponsor right away, an experienced member of AA or NA who will help him do the 12 steps to recovery. Before a man can leave Casa Raphael, he has to have studied the first 9 steps of AA/NA and worked the 5th step with his sponsor.
Casa Raphael’s director of operations, Margaret Larson, is the only person on the staff who doesn’t have a history of addiction. She is also the only woman at Casa Raphael, apart from a psychological counselor who comes in three or four days a week. Larson’s eight staff members are all recovering alcoholics and addicts, and all but one came originally to Casa Raphael as a client. All have no doubt that AA and NA are the only ways to recover from addiction, and statistics bear them out. So by the third step of AA/NA, the men have to surrender their will to a higher power — mostly this is God, but for some it can be simply the group itself. The point, as AA’s founder Bill Wilson once wrote, is to admit that one is not God oneself, that there is something higher and more important than oneself. And the driving idea of AA/NA is that it is not enough to put down the drink or drug, but you must change yourself as a human being, and that begins with self-knowledge and self-acceptance, coming to terms with who you are, what you have done, and eventually forgiving yourself. It would seem that a 25 percent graduation rate isn’t very high, but it is far higher than any other program’s, and it is the success rate that AA itself points to. Men who don’t make it through the first time have two more chances to try, and many come back.
I spent two weeks in May at Casa Raphael, talking to the staff and many of the clients, watching the hawkers and work crews, and attending a Step Up ceremony and graduation. What is impressive is that the men are able to come out after nine months to a year not with a minimum-wage job but a job earning at least $11 or $12 an hour. A number continue in college or go into different trades. As Margaret Larson told me, “It’s amazing how many of our program participants never completed even elementary school or high school. And now they’re challenging themselves by getting their high school diplomas and moving on to regional occupation and program-training classes at Palomar College. About 15 clients each year go on to get certificates in refrigeration, heating, air conditioning, computers, electrical, welding, and in other areas. Palomar has two-year programs, and the men get financial aid. I wanted them to have the opportunity not to go back to a work environment of working in McDonald’s or digging ditches or washing dishes. I wanted them to really challenge themselves and give them the opportunity to open doors for better-paying jobs, and without an education and some basic skills, that’s not going to happen. It doesn’t break the cycle of homelessness and criminality. You can’t survive on $6 an hour, not even up here in Vista.”
What else is remarkable at Casa Raphael is the commitment the men make to their recovery from alcohol and narcotics addiction and their understanding that to relapse means returning to the wreckage of their lives with no future except homelessness and jail. I asked Mark Gregory, who as intake coordinator is the first person men see when applying to the program, about the effect of having a staff made up of recovering addicts and alcoholics.
“I think it means everything because you can totally relate. For the staff, we know exactly what they’ve been through. We can really empathize with them. For the client, they know we’re not bullshitting them, that we’ve been there. We know what we’re talking about, and we really care.”
Gregory is 46, muscular, blond with short receding hair, a gunfighter mustache, and a general look of surprise on his oval face. He stoops when he walks, and when he sits he likes to lean forward with his hands folded and his arms on his knees. Around his neck is a silver chain with a religious medallion. He exudes compassion the way a fire gives warmth. I thought of him interviewing guys who had suffered serious addictions, had been homeless and in jail. What kind of history did Gregory have to set up against theirs?
“I’m from Northern California, San Jose,” he told me. “At the age of 12 I started drinking and using drugs. By 12H I was hooked. I never completed high school. I was married in 1972. I was in the military in 1974. Divorced in ’75. I was out of the military in ’77 due to drugs. I came down to San Diego in 1980 and was homeless from ’80 to ’93. I lived under a lot of bridges. In 1983 I was diagnosed with pancreatitis. I couldn’t stop drinking. In ’83 I had my third pancreatic attack; a cyst burst on my pancreas. Emergency operation, it was drained. I got my first contact with AA at that time, but for the next six years I just couldn’t stop drinking. I had 27 pancreatic attacks, three major surgeries. They removed part of my pancreas, my spleen, part of my stomach, large intestine. I would drink until the pain started, would really drink to cover the pain. It got to a point where I could just about have it timed by the time I hit the emergency room, and an hour and a half later I was getting 150 milligrams of Demerol. That would last a while, and then I would come out of the hospital with a bunch of pain pills, and when they were gone I started drinking. And that cycle just went on for six fucking years till I just couldn’t drink anymore. One drink and I’d go right back in the hospital. I finally quit in ’88, but I was really hooked on drugs at that time — methamphetamines. I was taking a lot of pills, a lot of painkillers, and then I started shooting methamphetamines in 1989 and had two heart attacks, and I finally was done in ’93, living on the streets. I just couldn’t walk anymore. The Veterans Outreach Program put me in crisis house for mentals for 30 days, and then for a year and a half I was in a recovery home in south San Diego. In 1995 I came up here to Vista to work for a detox program. Then in ’99 I came to work for Casa Raphael. And I’m still claiming wreckage of the past, physically, from those days. In ’97 I lost my gall bladder, and they had to do just a bunch of work again. If I can get two solid bowel movements a week, I’m blessed. They’re doing a lot of tests right now to see if there’s something they can do for it, but it’s probably something I’ll just have to live with because of all the work that’s been done down there and the lack of organs. My heart’s fine now. Once I stopped drinking and using drugs, my heart healed. Right now my life’s fantastic. I’m married. Four years ago I met a woman, and she was just coming out of jail into this program I worked for, and a year and a half later we were married. And we have a fantastic life, just fantastic.”