Intoxicating

It’s nearing midnight on a Saturday when a thirtysomething in a baseball cap bellies up to the bar at Washington Park West’s bustling Kentucky Inn. He catches the attention of the barkeep, who promptly lines up three shots of brown liquor in front of him. In less than 30 seconds, he downs the trio and walks out into the night. When asked how often she sees something like that, the bartender stops pulling a Juicy Banger IPA just long enough to say, “Every night.”

Every night is not a physician-recommended pattern of behavior when it comes to ingesting booze. But Dr. Bill Burman, director of Denver Public Health, sees just as much of a problem with the bottomless mimosas, burger-and-a-beer lunch combos, and all-day “happy hours” that restaurants and bars marketed before the COVID-19 lockdown—and will revive after it’s over.

That’s not to mention the drink-all-day vibe that local breweries can engender. “What concerns me,” Burman says, “is the socialization of gradually increasing our alcohol intake.” Although it’s his job to worry about making Denver healthier, Burman’s interest in local alcohol culture and its impact on the city led him and his Denver Public Health cohorts to conduct a study in late 2018, the conclusions of which were released in May 2019. The results were disconcerting.

The standout statistic: More than one in four Denver adults reported binge drinking in the previous 30 days. That puts our penchant for quaffing ahead of residents in every other comparable Western city, including Seattle, Las Vegas, Salt Lake City, and Austin, Texas. In medical parlance, binge drinking is a manner of imbibing that brings a person’s blood alcohol concentration to 0.08 or higher. This generally occurs when women consume four or more drinks or men put away five or more in approximately two hours. So, basically, something that the Centers for Disease Control and Prevention calls the most “costly and deadly pattern of excessive alcohol use in the United States” is what many in Denver call Tuesday night.

It’s understandable why many Coloradans—and Americans in general—don’t view alcohol as harmful. As recently as early 2018, much of the medical literature had suggested that low levels of alcohol consumption were mostly innocuous and even potentially protective against maladies like heart disease. (What we read: Drinking is good for you! Shots for everyone!) However, in August of that year, a widely acclaimed study on global alcohol use appeared on the website of the Lancet, a peer-reviewed medical journal. In short, the research determined that alcohol “causes substantial health loss” and that “the safest level of drinking is none.”

We’ll wait for Denverites’ collective guffaw to die down before we point out that exactly no one is suggesting another go at Prohibition, especially in a place that not only exhibits libertarianism when it comes to intoxicating substances but also sees a $3 billion economic effect from the craft brewing industry. What experts want us to understand, though, is this: Binge drinking is associated with some serious adverse outcomes—for individuals and city systems, like police departments and emergency medical services—some of which you probably aren’t aware of. “Most everyone has the sense that the alcohol use of the guy who is falling-down drunk every day is not healthy,” Burman says. “But there is a range of use here in Denver that is completely socially acceptable but is also not healthy.” That is where our story begins.


Photo courtesy of Getty Images

Over-served

Studies show that alcohol has a vast array of deleterious effects on users and society. Based on statistics, the damage associated with alcohol use in Denver—and in Colorado as a whole—is nothing short of devastating.
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53,293: Number of 911 calls in the city of Denver in 2018 (out of 169,642) in which the caller indicated recent alcohol consumption or that alcohol was a contributing factor to the call

$5 billion: The yearly economic cost—including lost productivity, health care expenditures, and criminal justice costs—of excessive drinking in Colorado; binge drinking is responsible for roughly 75 percent of those costs

2,035: Alcohol exposures reported to the poison center in Colorado in 2015, 2016, and 2017; in the same time frame, only 679 marijuana exposures were reported

35%: Percentage increase in the death rate from alcoholic liver disease in Denver County between 1999 and 2017. “Today, liver disease is really affecting women and the young,” says Dr. James Burton, a transplant hepatologist at UCHealth University of Colorado Hospital. “The idea of evaluating a 25-year-old for this 15 years ago would’ve been unthinkable.”

5: Deaths each day in the state of Colorado that can be attributed to excessive drinking; 54 percent of those deaths can be attributed to binge drinking. “Statistics suggest that if you die of an alcohol-related cause,” Denver Health’s Dr. Julie Taub says, “your life was likely shortened by an average of 30 years.”

38%: Percentage of driving deaths in Denver involving alcohol (U.S. average: 29 percent)

36%: Percentage of Denver Health ER visits for substance use in 2018 due to alcohol (the second highest category was psychoactive substances at 14 percent). “In the ER, we are concerned with flow—getting patients in, treated, and out,” says Dr. Christine Riguzzi, an emergency medicine doctor at Boulder Community Hospital. “People who come in with alcohol intoxication can be in the ER for hours while they sober up. There have been times when I felt bad a kid with croup was still in the waiting room because some drunk guy was taking up a bed.”

80%: Percentage of the domestic violence perpetrators who killed their partners in Colorado in 2018 (43 deaths total) who had histories of alcohol and/or drug abuse

14,965: Ambulance transports by the Denver Health Paramedic Division in 2019 due to acute alcohol intoxication—roughly 15 percent of the annual call volume. “Alcohol is a significant impact and stressor for paramedics,” says operations lieutenant Michael Morris, with the Paramedic Division for Denver Health and Hospital Authority. “People on alcohol don’t follow commands. They get frustrated, they vomit, they spit on you, they lose control of bodily functions—they can create small hazmat scenes in an ambulance.”


Anecdotally Speaking

Hard numbers are difficult to come by in some arenas, but health care pros regularly see the well-known secondhand effects of alcohol.
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Parental Neglect
“I ask my patients about how alcohol impacts their relationships, and they tell me their kids get upset when they drink, mostly because they are less present and don’t pay attention to the things they should.” —Dr. Susan Calcaterra, addiction medicine physician, UCHealth University of Colorado Hospital

Divorce
“I hear it all the time. ‘Arguments with my spouse were way worse when I was on alcohol.’” —Dr. Josh Blum, addiction medicine physician, Denver Health

Suicide
“Depression and substance abuse go hand in hand. If someone tells me they have bouts of depression, I do a deeper dive on their substance abuse, because alcohol can be disinhibiting enough to lead to self-harm.” —Dr. Ken Cohen, internal medicine physician, New West Physicians


Your Cup Runneth Over

Why having two drinks can sometimes mean having four.
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We’ve all said it, even though we know the phrase I only had a couple is a pathetically weak defense against what is likely unflattering evidence to the contrary. The truth is that although we may have consumed the liquid from only two containers, the hooch held therein may have constituted more than two drinks. Everyone from the CDC to the National Institute on Alcohol Abuse and Alcoholism agrees that a so-called standard drink contains 0.6 ounces of pure booze. “The problem is, people don’t think in ‘standard drinks,’” says Dr. Josh Blum, an addiction medicine physician at Denver Health. Instead, we look at that Big Tex margarita on the menu at Rio Grande Mexican Restaurant and trick ourselves into thinking that tall glass of cocktail-y goodness—which has three ounces of tequila and cordial—is one drink. In fact, based on the widely agreed-upon measures of pure alcohol found in different adult beverages (shown below), that tasty margarita actually constitutes roughly two.

Wine

Five ounces at about 12 percent ABV
Keep in mind: California Chardonnays and Cabernet Sauvignons, French Rhônes, Italian Barolos, and a host of other vinos can have ABVs 13.5 percent or higher. Also: Contrary to popular belief, there are five standard drinks in a bottle of 12 percent ABV wine, not four.

Beer

12 ounces at about five percent ABV
Keep in mind: Many Colorado craft brews contain well over five percent ABV; if you’re sipping a 10 percenter, you’re drinking two standard drinks for the price of one. Also: A pint isn’t 12 ounces—it’s 16—so factor that into your beer math as well.

Hard Liquor

1.5 ounces of an 80-proof spirit
Keep in mind: Alcohol content in cocktails is difficult to gauge. For example, a traditional martini has roughly 2.25 ounces of fluid with 32 percent alcohol, making it equivalent to 1.2 standard drinks.


How Much Is Too Much?

There’s a general lack of awareness about the definitions surrounding alcohol use. Here, an easy way to help you self-diagnose your drinking habits, all of which could have short- or long-term consequences (see “Your Body On Booze” below).
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You are considered…a moderate drinker
If you have…up to one drink a day for women or up to two drinks a day for men

You are considered…a binge drinker
If you have…four or more drinks in about two hours for women or five or more drinks in about two hours for men

You are considered…a heavy drinker
If you have…eight or more per week for women or 15 or more per week for men

You are considered…alcohol dependent*
If you have…lost control over your alcohol intake, use alcohol compulsively, and experience a negative emotional state when not using alcohol

*Possibly with a diagnosis of Alcohol Use Disorder; see “Hard Questions” below


A Few Too Many

It’s been 10 years, but I can still feel the flush of shame when I think about getting arrested for driving under the influence. —Patricia Kaowthumrong
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The dial tone of the collect call phone. The sensation of the cold concrete floor under my feet. The hum of the Saturday morning news on the 24-inch box TV. These are the details I can remember from my three-hour stint in the Boulder County Jail a decade ago.

I was arrested on the corner of Canyon Boulevard and Broadway on the morning of August 14, 2010, for driving under the influence. After a late night out with co-workers, I was so drunk I couldn’t recall how many cocktails I’d had or how I’d ended up in a friend’s guest bedroom, but I do remember getting into my car and leaving her place around 7 a.m. after grabbing a few hours of sleep. Turns out, I should’ve stayed in bed.

I wish I could say my behavior that evening was rare, but it was a ritual I’d participated in about three times a week for more than two years. I worked at a pizza joint on Pearl Street, often imbibing during work hours and joining other industry folks out at the bars before and after shifts. Like many other servers, bartenders, and kitchen staff members, I was lost in the cycle of the alcohol-fueled restaurant industry. While I frequented watering holes in Boulder, I lived in Superior, meaning the joy of sleeping in my own bed required a $50 taxi ride or driving home intoxicated, something I’m ashamed to admit I did many, many times. Having avoided repercussions, I’d deluded myself into thinking my habits were reasonable.

That is, until I found myself under the fluorescent lights of the county jail, shoeless (footwear is retained with the rest of arrestees’ belongings during bookings) and bleeding more dignity with every passing minute. Before my first ride in the back of a cop car, I’d caught the eye of a police officer who arrested me after she watched me run over a curb. A blood alcohol level test revealed I had a reading of 0.08—and that was roughly seven hours after I’d stopped drinking.

The moment I blew over the legal limit, I was inducted into a club I never wanted to join. Alcohol abuse doesn’t discriminate, which means the Hangover From Hell Society—some members of which I met in therapy, others I later realized I already knew from work—had a diverse membership: business owners, young parents, teachers, college students, and, of course, a 23-year-old waitress who really hadn’t understood how bad things had gotten. The months that followed were painful. The financial repercussions—fines assessed by the court and fees to hire a lawyer—were straightforward. The emotional toll of a DUI conviction was far more nuanced.

I had plenty of time to reflect on my wrongdoings. The results of an alcohol evaluation meant hours of mandatory therapy as well as time spent enduring random weekly blood alcohol level and urine tests. A 12-month driver’s license revocation confined me to my suburban home and forced me to rely on family and friends for rides to and from alcohol screenings, work, and therapy. The shame was overwhelming, and pervasive. I felt it during silent car rides with my father to visit my probation officer; while a person who I was sure was judging me watched me pee during screenings; and while walking more than three miles home from the bus stop when no cabs were available.

It’s been 10 years, but rarely does a day go by when I don’t think about that time in my life. With every boozy brunch and every happy hour comes the knowledge that I once allowed alcohol to make my decisions for me. And they weren’t good decisions. I wasn’t an alcoholic, but I’d abused the privilege—and neglected the responsibility—that comes with turning 21. I put myself and others in danger. I became someone I didn’t want to be. It’s a shame that it took losing my shoes for me to realize that, but I’m ultimately glad it did.


Habit Check

Coloradans like their hooch—do they really have to give it up?
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“Doughnuts,” Dr. James Burton says. “I want you to think about doughnuts and then think about beer.” As the medical director of liver transplantation at UCHealth University of Colorado Hospital, Burton sees some of the worst outcomes when it comes to abuse of alcohol. But his point is well-taken: Rarely has anyone ever said you can never have another doughnut because doughnuts are bad for you. Says Burton: “It’s about moderation, right?”

For many physicians and counselors who toil in the realm of alcohol use and abuse, being pragmatic about consumption is imperative. “We lose credibility when we don’t acknowledge why someone might want to drink, why someone might enjoy drinking,” says Denver Health’s Dr. Josh Blum. “Instead of finger wagging less-than-ideal behavior, we should try to help with harm reduction.” Blum says the medical community should explore patients’ use and talk about negative consequences. Sometimes, he says, people don’t see that their alcohol use isn’t OK until someone “plants the seed of doubt.” That might mean pointing out that being late for work because of nasty hangovers or gaining weight because you’re quaffing 1,000 calories a night are clues that you should reevaluate your habits.

The notion of simply mitigating the ramifications might sound irresolute to those who think alcoholism—or alcohol use disorder (AUD), in medical lingo—is the biggest problem when it comes to abusing alcohol. In truth, only about 15 percent of people who imbibe qualify for an AUD diagnosis. “There’s a lot of emphasis on the severe end of the spectrum,” says Denver Health’s Dr. Julie Taub. “It’s the middle of the spectrum where changes—having two instead of four—make the most impact.”

That impact isn’t just about helping people get to work on time. Consumption of any kind has short- and long-term health effects. Even minor decreases can have positive results, because, as Taub points out, “the across-the-board trajectory is that the more alcohol you intake, the worse the consequences are going to be.”


Your Body on Booze

Alcohol is the only intoxicating substance that affects nearly every part of the human body. Here’s how.
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Heart

  • Drinking too much, too quickly can lead to alcohol poisoning, which can affect breathing, heart rate, body temperature, and gag reflex—and can lead to coma or death.
  • Heavy drinking is associated with chronic high blood pressure.
  • Alcohol use can lead to heart problems, including heart failure, arrhythmias (like atrial fibrillation), and valve problems.

Pancreas

  • Roughly 70 percent of cases of chronic pancreatitis—a swollen pancreas that can cause abdominal pain, nausea, and vomiting and may require hospitalization—are caused by long-term alcohol use.

Bones

  • Because alcohol affects balance and gait, heavy use has been linked to more frequent falls and subsequent bone fractures (some of which likely can be attributed to alcohol-related osteoporosis).
  • Alcohol can interfere with the balance and absorption of calcium and certain hormones that affect bone density and strength, leading to osteoporosis.

Gastrointestinal Tract

  • Alcohol-induced digestive disorders and damage in the gastrointestinal tract can cause an array of problems, including loss of appetite and a host of abdominal complaints, such as nausea, vomiting, diarrhea, and abdominal pain.

Kidneys

  • Alcohol suppresses the release of vasopressin, a hormone that typically sends signals to the kidneys causing them to retain fluid. As a result, alcohol increases urination.

Blood

  • Large amounts of alcohol increase fat in the blood and can increase the risk of clots, which can cause heart attack, stroke, or pulmonary embolism.

Liver

  • Abuse of alcohol can cause liver failure, including acute hepatitis, cirrhosis, and fatty liver disease; the risk of alcoholic liver disease is higher for women than for men.
  • Because of body structure and chemistry, women absorb more alcohol than men and take longer to break down booze and remove it from their bodies. Upon drinking equal amounts, women will have higher alcohol levels in their blood than men.

Brain

  • Because alcohol can be a short-term anxiolytic—a substance that inhibits anxiety—many people use it to relax. But the overuse of the substance disrupts serotonin and blood-sugar levels and can actually make you feel more anxious.
  • Alcohol affects the mood centers of the brain, potentially exacerbating depression; its disinhibiting effects can lead to acts of self harm.
  • Withdrawal from alcohol—which is a consequence of drinking cessation after long-term use has forced the brain to chemically adjust itself to a constant influx of a depressive substance—creates a cascade of potentially serious and/or fatal medical problems, including nausea, anxiety, sweating, and delirium tremens, a dangerous set of symptoms that can include hallucinations, seizures, disorientation, agitation, and tremors.
  • Excessive alcohol use may increase the risk of dementia. Short-term memory is also negatively affected by booze.
  • Although it’s unclear why, long-term alcohol use can cause neuropathy—a deadening of nerves in the peripheral nervous system that causes tingling, numbing, or burning sensations, often in the feet, hands, arms, and legs.

Bone Marrow

  • Alcohol can damage the bone marrow, where new blood cells are born. This can cause low platelet counts and result in bleeding and bruising.

Cancer

  • Alcohol use increases the chances for developing cancer of the mouth, throat, esophagus, liver, and colon in both sexes. In women, it significantly increases the risk of breast cancer.

Immune System

  • Alcohol suppresses the immune system, making it more difficult for you to fight off infection.

Reproductive Organs

  • Drinking while pregnant increases the chances of miscarriage, stillbirth, and premature delivery plus fetal alcohol spectrum disorders and sudden infant death syndrome for the baby.
  • Alcohol can hinder women’s menstrual cycles and increase the risk of infertility. In men, alcohol can inhibit testicular function and male hormone production, leading to impotence and fertility reduction.

Sleep

  • Alcohol can seem like a short-term fix for bad sleep because it’s a depressant and makes you drowsy. However, studies have shown that alcohol contributes to poor sleep quality, sometimes interrupting the circadian rhythm and rapid eye movement sleep, sending you to the bathroom during the night, and aggravating breathing problems.

Photo courtesy of Stocksy

Cultivating Alcohol Culture

Experts say there are at least three reasons why Colorado is such a good incubator for one of the most widely used intoxicating substances on Earth.
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1. No New Taxes

Most people don’t know that booze is subject to both federal and state excise taxes. Colorado’s tariffs went into effect in 1935—and haven’t changed since. The state’s taxes were low to begin with, but the erosion of them due to inflation has created a scenario in which the purpose of these “sin” taxes—to raise prices on superfluous products to decrease their use and, in some cases, pay for negative consequences—has lost its effectiveness. Among U.S. states, Colorado ranks 40th for taxes on wine, 46th for beer, and 47th for distilled spirits. “Hundreds of studies show that an increase in the price of alcohol decreases drinking,” says Dr. Tim Naimi, a professor at Boston University School of Public Health, who has long studied the public health aspects of alcohol. Even if someone spearheaded a movement to increase excise taxes in Colorado, the measure would have to go through voters as a ballot initiative.

2. It’s Everywhere You Want It to Be

Denver is absolutely saturated with alcohol. Seemingly every restaurant has a liquor license, even the breakfast joints. There are approximately 150 breweries, a dozen wineries, and a handful of cideries. And that’s not to mention the grocery chains and liquor stores that live on every corner. “Along with cost, availability is a huge factor in rates of alcohol consumption,” Naimi says. “Availability is an accelerant on a simmering fire.” If that’s the case, Denver is a conflagration: Compared to all 3,142 counties and county equivalents across the country, Denver County ranks 20th for alcohol accessibility, according to a study printed in the International Journal of Health Geographics in 2018. Not surprisingly, certain neighborhoods within Denver proper have particularly high accessibility, including Berkeley, West Highland, RiNo, LoDo, Baker, Capitol Hill, City Park, Cherry Creek, and Platt Park.

3. Everyone Wants to Get in on the Colorado Lifestyle

At least, that’s what the marketing departments at, oh, every single alcohol purveyor operating in the Centennial State want you to think. And what exactly is the Colorado lifestyle? Well, it’s an athleisure-bedecked thirtysomething sitting on a patio sipping a skinny margarita mixed with agave spirits from Boulder. It’s a snowboarder taking a break on Vail Mountain with a Bud Light. Hell, some of Colorado’s most famous craft breweries extort the Colorado way right on their labels. The message? Booze and Colorado are like peas and carrots. But it’s not just the manufacturers pushing the ostensibly inextricable connection. “I was getting some ski boots fit at Neptune Mountaineering,” Denver Health’s Dr. Josh Blum says, “and they asked me what kind of beer I wanted while I was waiting. I’m an addiction medicine doctor, but I was like, ‘This is awesome.’”


In Search of a Slogan

Alcohol is the third leading cause of preventable death in the country—so why haven’t you seen one PSA about it?
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For decades we’ve seen messages about why we shouldn’t smoke and why we should exercise, which makes sense considering deaths related to cigarette use and obesity are the top two causes of preventable death in America. Strangely, though, you probably can’t remember seeing a social marketing campaign that told you to reduce your Chardonnay intake. “Alcohol is a big underlying cause of health problems,” says Denver Public Health’s Dr. Bill Burman, “yet there are almost no alcohol awareness campaigns to speak of.” The reasons for this include factors like the Big Alcohol lobby; the failure of Prohibition; and the fact that alcohol plays an important role in society. There’s also the pesky problem that the effectiveness of PSAs—for illegal drugs, for smoking—has been mixed. “Education does not usually help people quit,” says Denver Health’s Dr. Julie Taub. “It does seem to help them not start.” Still, Denver Public Health has been studying how to turn medical knowledge about alcohol into consistent messaging to counter the ubiquitous marketing of booze. “I don’t know what the messaging will be yet,” Burman says, “but we’re so used to alcohol we don’t even see it as a substance anymore.”


The Last Drink

A Grand Junction man didn’t know he was sick—until he was dying.
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Brian Elam was what you might call a social drinker. He and his wife, Leigh, rarely drank at home, but for roughly three years Brian had gotten in the habit of knocking back five or more beers after work with his colleagues almost every day. He’d get a buzz on, but he wasn’t coming home sloshed. “I never considered myself an alcohol abuser,” Elam says. “I mean, I just drank beer. Never hard liquor.”

The then 43-year-old knew he was drinking more than was healthy, though, so when he scheduled a routine physical in June 2016, he decided to take a few days off from the Bud Light ahead of the visit. It was too little too late. “The doctor called me just hours after I left her office to tell me my bilirubin was off the charts,” Elam says, adding the only symptom he’d had until then was some jaundice. “I was in liver failure.”

Photo by Amanda Matilda Photography

Within a week, it was as if a switch had been flipped: Elam’s health deteriorated. He ended up in the ER, where doctors told him he likely needed a liver transplant, a procedure for which he’d have to see Denver-area specialists. By mid-July, Elam and his wife were in Dr. James Burton’s office at UCHealth University of Colorado Hospital in Aurora. “At my first appointment, Dr. Burton came in and simply said, ‘You’re gonna die if you don’t get a liver transplant,’ ” Elam says.

But getting a new organ doesn’t just happen. Being placed on the transplant list requires a long checklist of machinations, including sobriety testing. Then, once a patient qualifies, it’s a special kind of purgatory on Earth. “I was getting sicker and sicker as we waited,” Elam says, his voice cracking at the memory. “My body was swelling. I looked like I’d swallowed a basketball. My ex-wife brought my two teenage kids to Colorado to say goodbye to me.”

Unlike so many others, however, Elam was fortunate. The call came on October 11, 2016. A new liver was waiting for him in Denver. Although he experienced some complications with excessive bleeding and an early rejection scare, Elam couldn’t believe how good he felt just a few days after the surgery. “I hadn’t realized just how sick I’d been,” he says, “even though I knew I was dying.”

The beer Elam drank three days before that fateful physical exam was his last drink—ever. He jokes that sales of Bud Light have plummeted on the Western Slope since he got sick but says he hasn’t missed drinking at all. “When you get that close to death, things change,” he says. “Plus, this liver was a gift. I can’t destroy that gift.”


Desperately Seeking Sobriety

A 50-year-old Denver woman talks about why she drinks, why she should stop, and why that’s so difficult for those with alcohol addiction.
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I drank for the first time at 15. I went to high school in Westminster, and it was what we did. I drank all through high school. But I was one of those who drank until she threw up. I never, maybe in my entire life, had just three drinks.

My father was an alcoholic. I have to look at that and wonder if I inherited the gene. And now I look at my kids, who are adults, and I see problems with their habits. It concerns me.

I’ve gotten sober off and on throughout my life. I didn’t drink when I was pregnant, but I wanted to. I drank the moment I was no longer pregnant. I did stop for two years after one of my babies was born. But then there was a divorce, and my second husband was a drinker. I started drinking again and tried to keep up with him. We weren’t a good match; we fought a lot. Had physical fights, especially when we were drunk. I drank to numb myself from it all.

I’ve lost two jobs over the years because I couldn’t stay sober. I was actually fired once for drinking on the job.

At one point, I got sober for about 12 years. Alcoholics Anonymous helped me do that, although I stopped going after about seven years of sobriety. AA is the answer in my opinion because it’s free. Rehab is just impossible for most people to afford.

When Donald Trump got elected, I relapsed. I like to say that’s the reason, but there is no reason. I drink because I’m an alcoholic and not for any other reason. My body craves it. The craving becomes an obsession.

I kinda go back and forth between being sober and drinking now. I’m single so no one is watching me. I find myself sneaking anyway. I had a big discussion with my doctor recently because my liver function isn’t great. I’ve got a fatty liver, but he says my liver can recover if I stop drinking or decrease my drinking. He asked me if I can try to just have one. I laughed and said, “One is a thousand to an alcoholic.”

I know I need to get sober again. I know I can get better. I know there’s a chance I will lose everything—again—if I don’t stop soon. Right now, I have two good jobs and my family is doing OK and I have a home. But after a long day—every day feels like Groundhog Day to me—the best thing is a drink. And sometimes that drink is a 12-pack.

I’ve been thinking about going back to AA. But it’s so humiliating to go back to AA after relapsing or when you’re struggling. It can be a very judgy place, to be honest. There are old men there that have been there forever, and they try to give you the tough love. I hate tough love.

So many women die from this addiction. So many whom I’ve known. One of them sticks in my mind. I try to stay sober for her.

I used to drink rum or vodka. But hard liquor makes me mean. Wine makes me black out. I recently went to seltzer. It’s not so harsh. I negotiate with myself about alcohol. I’m the best negotiator ever. No hard liquor. Well, maybe only this much. No wine. Well, you can have three. Problem is I never follow through with my negotiated terms.

When I’m not drinking I’m usually OK to be around people who are drinking. The worst part isn’t the alcohol; it’s that people ask me if it’s OK if they drink around me. I want to yell at them and say, “Have what you want!” I’ve learned it’s not socially acceptable not to drink here. People think you’re odd.


Nobody Remembers Being Here

Roughly 95 people a day end up at Denver CARES, a detox center for the Mile High City’s public inebriates.
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Lieutenant Aaron Rebeterano works what he calls the “out crowd” in LoDo on weekend nights. When the bars close down, he, along with 15 other Denver Police Department officers, monitors the tipsy masses and diffuses tension among the drunken hordes. “One drunk guy bumps another drunk guy in the food truck line,” Rebeterano says, “and a fight can break out real quick.” When that happens, police officers often have to intercede and decide who (if anyone) is going to jail and who is going to Denver CARES.

For the past 50 years, Denver CARES (Community Addictions Rehabilitation and Evaluation Services) has been the drunk tank of choice for officers who don’t want to toss someone in jail for being intoxicated—but who can’t be left out in public either. The 91-bed social detox unit associated with Denver Health serves three populations: the nightlife crowd, people experiencing homelessness, and those who are seeking help to get on the wagon permanently. “Most of our patients are here to sober up safely after a night of too much fun,” says Denver CARES operations manager Allison Pohlmann, “but everyone meets with a counselor to make sure there isn’t a larger problem.”

Of course, not everyone is always happy about being involuntarily admitted by the cops, but Denver CARES relieves pressure on local jails and ERs, neither of which can afford to spare resources on 35-year-olds who should’ve stopped three old fashioneds ago. “We have certified RNs, medical assistants, and addiction specialists,” Pohlmann says, “but we also have TVs and beds and showers and warm meals—it’s not the worst place to be if you can’t be at home.” It’s also not the worst place to turn if you need help beyond the average 12-hour stay. People who need to prove sobriety for insurance purposes or those who may need 60- to 90-day residential treatment can find both at Denver CARES. “There’s a waitlist for most of those beds,” Pohlmann says but adds the professionals there will always do their best to help someone suffering with addiction find the help he needs.


Hard Questions

If your answers to two or more of these inquiries are yes, you should talk to your doctor about whether you have an alcohol use disorder.
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In the past year, have you…

  • Drank more or for longer than you intended?
  • Wanted to cut down or stop drinking, but just couldn’t?
  • Experienced lots of hangovers?
  • Had a strong urge to drink?
  • Found that drinking—or being sick from drinking—interfered with your family responsibilities or caused problems at work?
  • Continued to drink even though it was causing trouble with friends or family?
  • Given up or cut back on activities that were important to you or gave you pleasure to drink?
  • Gotten into a situation while intoxicated that increased your chances of getting hurt (like driving or having unsafe sex)?
  • Continued to drink even though it was making you feel depressed or exacerbating another health problem?
  • Had to drink more than you once did to get the desired effect?
  • Found that when the effects of alcohol wear off, you’ve had minor withdrawal symptoms?
Regaining Control

If you need help with substance abuse, these local services and facilities might be able to help.
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