by our shared worry about Nic It is with relief that I come to see her not for what separated us but for what unites us We both love Nic in a way that only parents love their children It's not that Karen and Nic's stepfather aren't worried about Nic, but in long telephone conversations that no one else can be part of, his mother and I share a particular quality of worry—acute and visceral Meanwhile, Karen and I go back and forth switching roles When I collapse, she reassures me "Nic will be all right." "How do you know?" "I just know He's a smart boy He has a good heart." Then Karen will lose it, and I console her "It's all right," I say "He's just mixed up We'll figure this out He'll come back." And he does On a still, cold, and gray afternoon, a week later, he shows up at the house Like the time I went to find him in the alleyway in San Rafael, he is frail, ill, and rambling—a barely recognizable phantom I just stare at him standing there in the doorway "Oh, Nic," I say I gaze at him and then lead him by the arm to his room, where, still dressed, he lies on his bed, wrapping himself up in a comforter I am glad that no one else is home so that, for the moment, I don't have to explain I stare at him If all that therapy didn't help, then what? Rehab There is nothing else "Nic, you have to go into rehab You have to." He mumbles and falls asleep I know that I must do everything possible to get him into a drug rehab program I call counselors and other specialists for recommendations Nic's therapist now agrees that rehab is essential, and contacts some of his colleagues who specialize in drug and alcohol addiction My friends call their friends who have been through this Nic sleeps I call the recommended facilities in our area, inquiring about their success rates for treating meth users These conversations provide my initial glimpse of what must be the most chaotic, flailing field of health care in America I am quoted a range from 25 to 85 percent, but a drug and alcohol counselor familiar with many programs says that the figures are unreliable "Even the conservative numbers sound overly optimistic," he says "About seventeen percent of people who go through these programs are sober after a year." An admitting nurse at a northern California hospital may be the most accurate when she tells me the number for meth addicts "The true number is in the single digits," she says "Anyone who promises more is lying." The more I learn about the rehab industry, the more it seems in disarray Some highly touted, and expensive, rehab programs are ineffective Many rehabs employ one-size-fits-all-addicts programs Whether private or public, some are only slightly better than useless when it comes to the treatment of meth addicts, according to Richard Rawson, the associate director of the Integrated Substance Abuse Programs at UCLA, who calls them "the Earl Scheibs of rehab The paint job doesn't last." Dr Rawson doesn't suggest that many programs don't have useful components They tend to be rooted in the principles of Alcoholics Anonymous, which seem to be essential to staying sober for most, if not all, alcoholics and addicts, no matter the drug But other than that, they offer a slipshod patchwork of behavioral, psychological, and cognitive therapies Many programs include lectures, individual counseling sessions, chores with harsh consequences for shirking, and confessional and confrontational group therapy, including badgering patients who resist the gospel of treatment (According to the drug and alcohol counselors in these programs, resistance means denial, and denial leads to relapse.) Some programs offer life-skills training, such as résumé writing, exercise, group and individual sessions with family, and consultations with a physician and psychiatrists, who may prescribe medication Some facilities offer massage and nutrition consultations Some outpatient programs add a relatively new technique called contingency management, a system of rewards for abstinence However, without standards based on proven protocols, patients are often subjected to the philosophies of a program's director, some of whom have no qualifications other than their former addiction "Having six children doesn't make you a good ob-gyn," says Walter Ling, a neurologist and the director of the UCLA program Even rehabs run by trained doctors and clinicians employ a wide range of treatments, many unproven Most important: many programs fail to take into account the specific conditions of methamphetamine, which is, according to some experts, the toughest addiction to treat But what else can I try? I choose a highly recommended place in Oakland called Thunder Road and make an appointment I steel myself to do the hardest thing I can imagine doing, using what is left of my waning influence—the threat that I will kick him out and withdraw all of my support—to get him to come with me That I mean it—because I am convinced that this is our only hope—does not make it easier The next morning, when Daisy and Jasper are at school, I go into Nic's room, where he still sleeps soundly, his face relaxed and peaceful A sleeping child Then, as I watch, he twitches and grimaces and grinds his teeth I rouse him and tell him where we are headed He rages "No fucking way!" "Let's go, Nic, let's get it over with," I plead He gets up, pushes his hair back with a trembling hand He holds on to a doorjamb for support "I said no fucking way." He slurs, staggers "This is it, Nic," I say firmly My voice trembles "We're going It's not a choice." "You can't make me What the fuck?" "If you want to live here, if you want me to help you, if you want me to pay for your college, if you want to see us " I look at him and say, "Nic—do you want to die? Is that what this is all about?" He kicks the wall, smashes his fists on the table, and weeps I sadly say, "Let's go." He rages some more, but follows me to the car ... initial glimpse of what must be the most chaotic, flailing field of health care in America I am quoted a range from 25 to 85 percent, but a drug and alcohol counselor familiar with many programs says that the figures are unreliable "Even the conservative numbers sound... when it comes to the treatment of meth addicts, according to Richard Rawson, the associate director of the Integrated Substance Abuse Programs at UCLA, who calls them "the Earl Scheibs of rehab The paint job doesn't last." Dr Rawson doesn't suggest that many programs don't have useful... overly optimistic," he says "About seventeen percent of people who go through these programs are sober after a year." An admitting nurse at a northern California hospital may be the most accurate when she