Eight days into his most recent attempt at sobriety, Scott goes to the Serenity Club, an AA bar. The past week has been extraordinarily difficult, but he has pushed through. Then, after three weeks sober, Scott and D.P. are evicted. Scott goes to stay with his new friend David and his wife, Anna, who are both in the program and accustomed to taking in those trying to make sobriety work. Scott starts working with David, who is a freelance mason and occasional metal scrapper. He then begins cleaning the Serenity Club for $7.15 an hour. He dreams of becoming a nurse again.
In some ways, Scott is lucky. He is surrounded by other people who are eager to help make his sobriety work and through them obtains a job and a place to stay. At the same time, Scott’s poverty and housing instability make it extraordinarily difficult to stay on the path of sobriety. Without the security of a stable house and decent income, Scott remains psychologically vulnerable.
In order to get his nursing license back, Scott will have to be clean and sober for five years, which means urine testing 56 times a year—a process that will cost thousands of dollars. Scott still has contacts in the nursing world, but he has hidden his addiction from them, and thus struggles to figure out how to approach them now. Over time, Scott becomes bored with his job at the Serenity Club and his sober life in general. He becomes disillusioned with AA, and decides to break an AA rule by taking methadone or another opioid replacement to help his cravings and depression.
Scott’s disillusionment with AA is not unique—it is a program that doesn’t work for everybody and that some find off-putting. However, Scott does not have the resources or stability to reject the program altogether and choose a different path. Considering his housing and job both come through AA, breaking its rules is extremely risky.
Scott goes to a clinic and talks with a doctor, hoping to be prescribed Suboxone. They discuss Scott’s history of sexual abuse, which lasted from when he was four years old to when he was 10. Scott tells the doctor that he is not interested in seeking treatment to deal with that trauma. Scott receives a prescription of Zoloft and amitriptyline; he is disappointed not to have been given Suboxone but knows it is better than nothing.
Many of the people profiled in the book have a history of childhood sexual abuse. It is clear that for all of them, this trauma negatively affects their ability to have stable, fulfilling lives in the present. Yet each of them are also unable or unwilling to obtain treatment for their trauma.
Three months later David and Anna’s daughter finds a syringe in Scott’s swimming shorts. Although it is possible that it is an old syringe, David and Anna don’t risk it. They kick him out immediately. Scott had been using with David and Anna’s eldest son, who had just moved home. He relapsed a while back after learning that the AA meetings he’d been going to didn’t count in the process of getting his license back. Soon after, he ran into Bill and Heroin Susie, and then David and Anna’s heroin-addicted son moved in. At first Scott confined getting high to the weekend, but soon he abandoned AA and started using full-time again.
For an addict in recovery, even just being in proximity to other users can be enough to provoke a relapse. David and Anna’s no-tolerance policy means that Scott’s ability to stay sober is directly tied to his housing security. Yet without a stable home of his own, it is difficult for Scott to stay on the path of sobriety—and thus a vicious cycle is formed.
Scott returns home, where he is reminded of the love of his mother and the rest of his family. This inspires him to go to the methadone clinic once he gets back to Milwaukee. He plucks up the courage to ask his mother for the $150 he needs for treatment, and she gives it to him. Surveying the clientele, Scott figures the methadone clinic must be “the most diverse place in all of Milwaukee,” with people from every possible race, class, and social world milling around together. A young white woman advises Scott not to start taking methadone, as it doesn’t really help; it is just a ploy to get money out of people.
The book focuses on the negative impact of drug use on poor and housing-insecure populations, yet this passage reminds us that substance abuse affects every kind of person and that the opioid addiction does not discriminate on the basis of class, race, gender, or any other factor.
Scott can’t afford methadone and rent, so chooses homelessness, staying at a shelter called the Guest House where he sleeps in a room filled with bunk beds. Despite its drawbacks Scott continues his methadone treatment and becomes a resident manager at the Guest House, cleaning and providing assistance to residents. Over a year after he began treatment, Scott receives financial support from the county and is able to move into his own apartment downtown. The apartment is plush and costs $775 a month but, through his deal with the Guest House, Scott pays only $141.
The fact that Scott must choose between homelessness and receiving methadone could easily be enough to prevent him from remaining sober. Yet fortunately, staying in the Guest House ends up being the best thing that happens to Scott in the book. Unlike almost all of the other tenants profiled, Scott is able to secure housing assistance, a development that completely changes his life.
Scott composes a five year plan, which involves going back to nursing and saving money. Back in the trailer park, Scott had been suicidal. Now he has found hope and purpose again.
The happy ending of Scott’s story demonstrates what an enormous difference housing makes to the rest of a person’s life.