At Options, almost all counseling
comes from those who have been
there and done that. To put it
another way: The patients are
running the asylum.
May 2005
Room for Recovery
At Options, Dr. Davida Coady and her staff are helping substance abusers become clean and sober.
by Lewis Dolinsky
Wanting to get their lives back, drug addicts and alcoholics have been finding hope at Options Recovery Systems, a day-treatment recovery program located inside the auditorium of the ramshackle Veterans Memorial Building near Berkeley’s City Hall. Options Director Dr. Davida Coady, tall, angular and earnest, tries to meet them on that first visit. She is more than an administrator. Options is a hands-on operation.
Help is free and instantly available, 8 to 6:30, Monday through Friday. No one is turned away except the violent. Many come from jail or the streets; some were middle-class before they fell. Some have been panhandlers, thieves, prostitutes. More blacks than whites, a few Hispanics, rarely Asians. Gathered in a circle, they read aloud from the Twelve Steps. “I’m Alex ....I’ve been clean and sober 25 days.”
Building on the 12 Steps of Alcoholics Anonymous and Narcotics Anonymous, Options provides treatment, a curriculum in addiction, a place to learn about one’s own triggers. Clients exercise, do yoga and have acupuncture, which sometimes helps control craving and can reduce stress. They find a higher power — God or some strength within themselves. In smaller groups, they discuss their problems: I lost my home, my wife, my child, my husband. I was looking for C&H, and I don’t mean sugar.
They got hooked on speed or heroin or crack or vodka because of genetics, because of mental illness, because of sexual abuse, because of stress, because of hopelessness, because drugs were available on every street corner.
Masking pain, embarrassment, feelings of inadequacy, they created new pain and a spiral that could only head downward. The test of addiction is not how much you do but whether you can stop when the consequences stare back: You’ll lose your kids. You may go to prison for life on a third strike. You may kill. Or be killed.
Options clients begin with Denial Management and go through three stages of counseling. If they abstain from using, they graduate in nine months. For some, there are postgraduate sessions. Those who relapse can try again, or be referred to another program.
Options services include help in getting drivers licenses, ID cards, transit passes or finding housing. (Options has four houses of its own.) Even before 2001, when Proposition 36 gave users the possibility of rehab rather than jail, Options was working closely with courts and police. Options is recognized as a form of crime prevention because so much crime is linked to substance abuse. At graduations, one can see Berkeley police officers hugging Options clients they once arrested.
Mother Teresa, with an M.D.
What began eight years ago with few clients and no money, now has a budget of more than a million dollars, the result of government aid, foundation grants, donations and a Saturday carwash. There is a staff of 27 and an equal number of volunteers. In March, there were 210 clients. Women’s programs are separate from men’s, because women have different problems. There are psychotherapists trained to treat both addiction and mental illness. A Weight Watchers-style program helps those who trade addiction for overeating; an obese client died from a stroke.
The late, beloved Father Bill O’Donnell of St. Joseph the Worker Church helped to get Options started. (He once called Coady “the Mother Teresa of the East Bay.”) Berkeley Police Captain Bobby Miller came on board early. Berkeley mayors Shirley Dean and Tom Bates and actor Martin Sheen have been big supporters. (Sheen serves as Options’ honorary chair.) But Options began with, and is largely sustained by, Coady’s vision. As Captain Miller says, Coady saw a need and filled it. “Judges were seeing a revolving door of the homeless — disturbing the peace, sleeping on private property and refusing to move, petty theft, public drunkenness, fights. She recognized that (many of) these people had a disease that needed to be treated.’’
“In the 36 years I’ve been here [in Berkeley],” says Miller, “I can’t think of one program that has helped homeless people more.”
When Coady, a pediatrician, worked at Children’s Hospital emergency room, she found that kids’ injuries and illnesses were often linked to drug and alcohol abuse of parents and guardians. As a recovering alcoholic herself, she understood. She did not have to learn about caring; that was her history.
Davida Coady grew up working-class in Berkeley. Her mother was Portuguese American. Her father was a Scottish immigrant, a clerical worker at the University of California who played the Campanile chimes when a substitute was needed. Her first mentor was the minister of a nondenominational church full of Quakers, Buddhists and excommunicated Catholics. At age 12, she joined the Junior Red Cross. Summer before college, she worked at a camp for diabetic children. She never wanted wealth. Her altruistic drive was “somewhat pathological,’’ she says. “My mother criticized me for everything, and I wanted to do something that she couldn’t criticize. She did anyway.’’
Coady graduated from the University of the Pacific, Columbia Medical School and Harvard School of Public Health. The list of boards she has served on goes on forever. She worked in 35 countries in Asia, Latin America and Africa, in pediatrics, infectious disease control, and nutrition. During the Biafra war, she got out of Nigeria twice by the skin of her teeth, once after being sent by Henry Kissinger. She says she was in line to be medical director of the Peace Corps until the Nixon White House discovered she had registered with the Peace and Freedom Party. While living in Los Angeles, she ran a free clinic, mainly for immigrants, and gave medical advice and injections to Hollywood personages traveling to the Third World. One of them was Martin Sheen. After consulting with Coady, he donated his salary from Gandhi to refugee aid programs. Ever since, he has been a financial supporter of her projects. They have stood together on many peace marches and anti-nuclear protests.
Options Beyond Drug Courts
Eleven years ago, on her 56th birthday, Coady invited several women friends to her Berkeley home “to talk about the rest of my life and what I was going to do with it. A lawyer said: ‘If you want to work with poor alcoholics and addicts, go to the courts.’ I started volunteering at the Berkeley courts. They started a felony drug court and a misdemeanor treatment court in ‘96 or ‘97, but there were no programs for most (offenders). There had to be a program that was free and immediately available. The finances were not there for a residential program, so we started a recovery group within Berkeley Mental Health. They named it Options. We grew too fast for them. It was an evening program. Then we started one during the day within BOSS [Building Opportunities for Self-Sufficiency], a multi-agency service center, and rapidly became too big for them. So we moved into our own space provided by the city as an independent program. My office was old boards and other junk till the guys in the program fixed it up. It was all-volunteer in the beginning. We got a little grant, $25,000 from Fund for Nonviolence in Santa Cruz. We expanded like an octopus and stayed close to the courts because we believe that most people who are addicted need an intervention. They don’t wake up and say, ‘It’s a nice day today. I think I’ll join AA.’
For middle-class people, Coady says, intervention usually comes from family or employers or from a DUI citation. For the poor and homeless, most interventions come from the justice system. Berkeley police often bring people to Options rather than jail. Options has staff working in six courtrooms in Oakland and Berkeley and runs an introductory treatment program in the Oakland jail. Seventy percent of Option’s clients come from the justice system. Some referrals come from Alta Bates’ emergency room, some from shelters. Some are brought by friends or relatives who went through the program.
“Twenty-two graduates are studying to be alcohol and drug counselors,’’ Coady says. “They intern with us, and we pay their way through school, whether UC Extension, Merritt College or JFK.” A mother and son graduated together. Three brothers are in the program. “Seven graduates have been with us five or more years continuously clean and sober, working as paid staff or volunteers — eight, including Tom. Four have completed counseling training. One manages our houses. One is our janitor.”
Tom is Tom Gorham. She bailed him out of jail and, after he graduated from Options, she hired him. Four years later, she married him. He’s now clinical director for Options, a certified addiction counselor, and getting his master’s in counseling psychology. (“But I got my PhD on the streets.’’) Captain Miller calls Gorham the poster child for Options. Gorham had two businesses and a family history of alcoholism. When life went wrong, he wound up living under a freeway where people congregated not by race but by drug of choice. Gorham says he was arrested “over 400 times.’’
Streetwise Therapy
At Options, almost all counseling comes from those who have been there and done that. A recovering addict or alcoholic speaks with authority. To put it another way: The patients are running the asylum.
This lack of “professionalism’’ is the program’s strength and its weakness. That, and being spread too thin. Also, the acoustics in the Veterans auditorium are terrible. It’s hard to hear across the circle, but private counseling can sometimes be overheard. The place could be cleaner, more cheerful. As in all organizations, there is occasional grumbling from staff. Nothing and nobody is perfect, and there is always the question: Shouldn’t there be a life beyond Options?
Dr. Alex Stalcup, who runs the private New Leaf Treatment Center in Lafayette, says: “Ultimately fish gotta fly. Everybody can’t be a counselor.’’ He has no recovering addicts on staff. He thinks former users are too close to the problem. “You don’t have to have cancer to treat cancer,” he says. “I want Options to be more professional, more medical, more open to medications for people who need them.’’ But Stalcup also says: “Options is doing God’s work’’ And he is “a big fan’’ of Davida Coady, whom he calls “an unusual wonderful lady with special grace.’’
Amen to that.
Quarterly graduations at Options (most recently in March) are a bit like the Oscars: Many people get thanked. Family, friends, Tom and Davida. Graduates speak of the counselors who helped pull them through, including Tamara Middleton, Paul Wilson, Tom Reed, Robert Davies, Wayne Grigsby, all former users. (“Wayne is one of those guys who will let you run your mouth until you figure out you don’t know nothing.’’)
One mystery is why people try to get clean at a particular time. Robert Davies sums it up: “When an addict hits bottom, he has two choices — die, or quit using.’’
As Dorothy Parker once said: “You might as well live.’’
Lewis Dolinsky spent 26 years as an editor and foreign affairs columnist at the San Francisco Chronicle.
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