Michael Fowler had alienated his entire family, dropped out of college, and been in and out of about 10 rehabilitation centers before he truly realized that he needed help. After spending the better part of 15 years in substance abuse programs, he was well into his 30s before figuring out that he had to want to get better to make it work.

Today, the former Preston Hollow resident, now nearing a decade of sobriety, is back in touch with his family and spends his days encouraging others with similar struggles. Fowler began working at Caron Texas, a Collin County in-patient rehabilitation center in 2011. Part of his role at Caron involves speaking to the patients in group meetings, showing them the road isn’t easy, but that it can lead to a life they’re proud of. Because patients know he’s been down that road himself, they’re more willing to listen.

Caron helps patients overcome alcohol and/or drug dependencies. A relative newcomer to Texas—its Collin County facility opened about two years ago—the Caron name is well known in eastern U.S. states, where it has been operating for six decades.

Caron Texas is located in the tiny, out-of-the-way Collin County town of Princeton, by design. The expansive facility, nestled in a peaceful setting, offers perks like meals prepared by an on-site chef and personal exercise instruction—even horse and water therapy. But Caron executives want people to know that just because patients are in a nice place, it doesn’t mean their treatment is any less difficult, or that the program is any less effective.

According to the Texas Department of State Health Services, nearly 700 Collin County residents were admitted to addiction treatment centers like Caron’s in 2009, the most recent year for which figures are available.

Addicts must first realize that addiction is a disease, says Stephen F. Garrison, MD, medical director. He likens addiction as being similar in nature to diabetes, in that it requires lifelong maintenance.

“If you were a diabetic and you went to your doctor and got medicine for your diabetes, or you were told to avoid certain foods like desserts or a lot of starches, you have to follow all of the advice,” he says. “If not, you’re going to have some problems.”

Physicians teach their diabetic patients about the disease, provide follow-up advice, and often refer them to a dietician or counselor. The same thing is true with addiction, Garrison says. Treating the disease is a daily process, and it’s something that people must deal with for the rest of their lives.

Hope and Change
To start showing people they can change, hope is often the most important factor, Garrison says. The first time he meets with patients—and he meets with all Caron patients their first day—he strives to get them excited about life. One of the problems a person dependent on drugs or alcohol may have, Garrison explains, is that they have reached a point where they can no longer live on life’s terms without self-medicating.

Garrison is a board-certified addiction-ologist, specializing in addiction medicine. Before he found his true passion, he was a pediatrician. It’s an unusual transition, but he believes he can help more people in his new field.

“A lot of times pediatrics is treating earaches and sore throats; this is much more of a critical thing,” he says. “Hopefully we can make a change in a person’s life and also help them through the rest of their lives.”

Garrison, who works roughly 60 hours a week, says a lot of people don’t understand that addicts have created a true chemical dependence to their drugs. That’s why abusers respond differently to substances than the non-abuser does.

When they begin using, they respond to it the same way as everyone. But they become determined to keep that feeling of euphoria going. Afterward, they come crashing down—often like a roller coaster, Garrison says. Eventually, the drugs or alcohol don’t make them high anymore; they just bring them back to normal.

Everyone has days when they’re more stressed, and days when they’re more happy. But alcoholics and addicts reach a point where they become depressed or anxious about the substances themselves. And, because the chemicals change abusers’ gene structures, addicts physically react differently to the alcohol or drugs.

“Once the genes are altered, they’re altered forever,” Garrison says. “They’re reset. That is why addiction is a disease. Getting back to the diabetes example, once diabetics have reached the point where if they eat a sugary food their blood sugar runs up, they can’t ever go back.”

Because addiction requires lifelong  attention, many facilities, including Caron, recommend ongoing participation in a 12-step program. “If they were to use the drug or alcohol again, they have reset themselves right back into their addiction,” Garrison explains. “They have to have total abstinence from mind-altering drugs for the rest of their lives, lest they reach a point of going back.”

Not all cases are as severe as Fowler’s. For example, according to the National Survey on Drug Use and Health, more than 70 percent of people who use drugs illegally are employed. For those more highly functioning individuals, it can be even harder to admit they have a problem.

Caron alum Richard Moore, who lives in the northern U.S., is a small business owner with a wife and three children. He achieved years of sobriety in between bouts of alcoholism. “I can’t say that I lost everything before I realized I needed help in my life,” he says. “It was just that I got to a place within myself that ... the best way for me to put it is that I kind of went insane in my own mind.”

Moore says it came to a point where he was trying to numb himself because he didn’t want to deal with daily trials and tribulations anymore. “It felt like there was too much chaos,” he says. “My best way to cope was to use instead of dealing with things.”

A Life-Long Process
McKinney-based Lifepath Systems in an outpatient treatment center that offers mental health treatment, in addition to drug and alcohol recovery. Strategies include group sessions with licensed professionals, therapy, and a skill-based curriculum for recovery, in addition to random drug testing. Once patients are finished there, the next step is Alcoholics Anonymous or a similar group.

Tandy Mahen, director of behavioral health for Lifepath, says patients often avoid treatment due to cost. Many have blown their money on drugs, she says. Although state funding is available, it can be a bit of a struggle to apply and go through the steps, especially if individuals aren’t convinced they need the help. Some facilities, including Caron, offer a couple of scholarships and sliding scale pricing for locals who need help and can prove they don’t have the finances.According to Garrison, “There are three outcomes for addicts: rehabilitation, jail, or death. They can pick as many of them as they like, or just choose one.”

For those choosing recovery, the three primary detoxes are for alcohol, benzodiazepines (such as Xanax or Valium), and barbiturates (sleeping drugs). These kinds of dependencies are more difficult to get over due to the depressant effect that they have on the central nervous system, says Will Alexander, counselor and residential unit clinical supervisor at Caron.

“If you look at your central nervous system as a spring, and this depressant is just pushing it down more and more because you’re taking more and more of it, once you take it off, it goes crazy,” he says. For this reason, hallucinations and seizures are common during detoxes, and can become life-threatening.

Caron’s detox center, one of the few in Collin County, is monitored 24 hours a day, seven days a week. Because detoxification can be such a brutal process, it’s best to do it in a safe environment.

However, as Caron staff members stress, the process is only as effective as the patient allows it to be.

Alexander says if a patient wants to, they can go on the Internet and find misinformation touting miracle cures, or 10-day rehabilitation programs. But recovery is something addicts must work on for the rest of their lives.

“I’ve only been sober for a couple of years,” Moore says, “There’s a lot of my life where I felt that I didn’t need it, or didn’t want it or could do it on my own.” This kind of mentality is why it’s so hard for people with the disease to admit they need help. The concept is mirrored in Caron’s slogan: “If you want to drink, that’s your business. If you want to stop drinking, that’s our business!”

rehab_02 Caron Texas, which opened in 2010, is located in the rural Collin County town of Princeton, east of McKinney. photography by Billy Surface

Fowler says his last rehab stint was in Mississippi, where he recalls being asked, “Are you sick and tired of being sick and tired?” He was; and, finally, the treatment stuck.

According to Garrison, patients often long to be forgiven by others in their lives. But first, they must forgive themselves, something that typically happens within the first 10 days of treatment. He sets the stage by telling new patients that “shame is not part of recovery; we’re going to throw that out with the bath water.”

This approach is one of the reasons the non-Texan Moore felt comfortable in Caron. He also needed to detach from his regular environment. “It was one of the best treatment centers  we could find that suited me well,” he says. “And it was in a place that was comfortable, in a good area, and away from my normal environment. It was secluded and private.”

Getting Families Involved
Caron treats patients from adolescents upward. The average patient age ranges between 35 to 45; the gender split is 51 percent men to 49 percent women. The facility offers gender-separate, gender-specific treatment because there can sometimes be more of a stigma for women who are drug or alcohol dependent because their role is often to be the caregiver.

Alexander says it’s for this reason women from affluent areas can easily go from social drinking to abusive drinking to dependent drinking. Because of the social stigma of alcoholism, these women are likely to become closet drinkers. Often, family members don’t realize there’s a problem until health issues—such as liver, kidney, or pancreatic problems—arise.

It hits close to home in Collin County, where residents, on average, make 28 percent more than the national average and the county itself is the wealthiest in Texas.

Alexander says the behavior for drugs is a little more pronounced because people are trying to seek the drug, and it can be hard to explain
their behavior. “Going out at midnight, coming home at 3 a.m., bank-account draining, stuff like that,” he says.

In either case, family members are affected in multiple ways, often dealing with anger, resentment, and sadness. Alexander likens it to a mobile that hangs above an infant’s bed.

“If you take one piece off, it wobbles, and doesn’t work the same,” he says. “All those little pieces, just like a family, revolve around a normalcy, and when you change that, the family has to change along with it.”

This is one of the reasons Caron offers a program for families of the patients. Having an informed family is important for recovery, because sometimes it is hard for them to realize they can help.

Fowler says it wasn’t until his mother began to cut ties that he saw he needed to change. No matter how much his mother loved him, it had to be his choice to turn away from drugs and get the help he needed to stay clean.

While patients are in treatment, they form a new family, or unit of support. Even after they leave, many, including Moore, continue to be a part of the community through continuing care. Moore makes the trip out to Collin County about two to three times a year; he is also very active in the treatment facility near where he lives.

Moore says he’s now more active in his children’s lives and has a better relationship with them than he did before—better, he thinks, than many people who have not gone through an addiction and recovery. His son has even picked up on his dad’s lessons, often reminding him they need to take things “one day at a time.”

Moore says the staff at Caron seemed to have a true understanding of his disease—and how to treat it. “I can safely say that on a couple different occasions I was ready to go AWOL, as it were, but there was somebody who said to me, ‘You can, but I really, really don’t want you to,’ and I really, really believed it.”