THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
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MEGAN: Why am I struggling and no one has to struggle so much? Why do I think about it constantly and it seems so easy for everyone else?
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UNIDENTIFIED MALE: We brought beer in one night and I don't know how she found out we had it, but she did.
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MEGAN: Oh, I just thought I was going to jump out of my skin, I really did. And I just thought I cannot stand this.
And of course, I thought, you know, god, just a beer would taste so good.
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LEON HARRIS, CNN ANCHOR: Good even and welcome to CNN PRESENTS. I'm Leon Harris.
Tonight, it is one of the most dangerous drugs in America and it is legal: alcohol. It is so ingrained in our society that its prevalence often goes unnoticed, that is unless you're an alcoholic, and then beer, wine and spirits are all-consuming. For addicts, alcohol is their life, their lover, and left unchecked, their executioner.
The consequences of alcoholism and alcohol abuse are devastating, costing you and me $180 billion a year. That's more than all illegal drugs combined. But shifting views and cutting-edge research are opening new avenues to those caught up in this deadly struggle, those like 26-year-old Megan.
Her story in "Wasted," a documentary with CNN's Martin Savidge.
(BEGIN VIDEOTAPE) UNIDENTIFIED MALE: I've got Budweiser, Bud Lite, Miller Lite, Coors Lite.
MARTIN SAVIDGE, CNN CORRESPONDENT (voice-over): Alcohol.
UNIDENTIFIED MALE: A rum and Coke, not a bourbon and Coke?
SAVIDGE: Every day, it courses through the veins of society.
UNIDENTIFIED MALE: Here's to women!
UNIDENTIFIED FEMALE: Whoo!
SAVIDGE: Most people drink without problems, but the 20 million Americans who abuse or are addicted to alcohol inflict billions of dollars worth of damage upon society and themselves.
This is the party scene in Atlanta, a scene 26-year-old Megan had to leave. Bored, lonely and filled with anxiety, she's trying to stay sober.
She's clean for the first time in six years.
MEGAN: I like -- like to party. And it's been -- it's been, especially being here, I mean, I really haven't known what, in six years almost, known what it's like to live a clean, sober life.
SAVIDGE: By chance, she's become part of one of the largest medical research studies over conducted on alcoholism, combining new drugs, new scientific research and new insights into why people drink to destruction.
What led her here to this front line in the battle against alcohol addiction may have begun in childhood.
Megan is a twin.
ARCHER, MEGAN'S MOTHER: This is on their birthday one time when they got breakfast in bed. Well, I won't keep going, but there they are at Christmas.
SAVIDGE: Her mother, Archer, noticed at age five something about her that was different from her sister, Elizabeth.
ARCHER: They were walking in front of me, and I just thought it was so wonderful. And I took the picture and then I painted it from a photograph. But this is Megan right here. I asked her, how do you feel most of the time, happy or unhappy? And she said, oh, I don't know, unhappy I guess, and skipped on off down the beach.
SAVIDGE: Archer suspected Megan might have a problem with depression.
ELIZABETH: ... one of them back here that I couldn't figure out which one was which.
SAVIDGE: Her twin someone sister, Elizabeth, saw it, too.
ELIZABETH: That was kind of a look like "leave me alone" look.
It's really strange. It was just like an, "I'm not happy today."
MEGAN: I've always felt different, always, always. And I couldn't figure out exactly what it was. I was -- I was moody, really moody as a kid. I was very moody.
SAVIDGE: Complicating the issue, attention deficit disorder. Children with ADD have a 400 to 500 percent higher-than-normal risk of growing up with a substance abuse problem.
ARCHER: There was a problem in school. She was as smart as she could be, but it was just not getting it done. Everything became very hard.
SAVIDGE: Megan had her first taste of alcohol at age 13. She drank throughout school.
ELIZABETH: We weren't wild necessarily. We, you know, we were typical teenagers that liked to go out and have fun, you know? And I think something clicked in her. You know, it was always in excess.
There were parties. There were high-school parties where, you know, there's just a lot of alcohol and drugs around here.
SAVIDGE: Megan's family was not aware there was a crisis until she went to college.
ARCHER: It was real hard to say that there really was a problem, as long as she was still working and going to school. Then she quit school, her grades went down, and she quit. She continued to work, and now looking back I realize that that was her money to buy the alcohol. Well, she had to keep working.
MEGAN: When it got really bad was probably when I was 20, when I was going to the liquor store and getting two pints of Jim Beam just to drive, and you know, do a car drive, to get through the day, you know, to go to work, when you're sneaking drinks behind the bar at work. And just to be able to wait tables, and when you can actually, in your mind, do it better if you're drinking.
ELIZABETH: She was very good at hiding it. And I remember one day I went to where she was working, and she had a drink. It was like I though it was a Sprite until I went and took a sip, and I was like, "Whoa." That kind of was when I finally was like, "Wait a minute, you're doing this not just to have fun. You're doing this all the time."
MEGAN: It was binge drinking. It was three, four days where I would blackout for two days and didn't know whether it was Friday or Thursday or Wednesday. And that was -- that's scary, very scary.
ARCHER: I asked her one night if she had a problem drinking and she said no. And then I said, "Are you sure?" And she said maybe. And then she said, yeah, I do.
MEGAN: I knew that there were problems a long time ago. I just didn't want to quit. And then I just thought down the road I will. You know, I just thought -- I was thinking -- honestly, I was thinking one day I'd just, you know, all of a sudden, pop, husband, kids, and I wouldn't have any reason for wanting a drink anymore. Like it was just going to suddenly, overnight happen, everything would be and I would just be normal.
ARCHER: It has escalated in the last couple of years, and I think it has scared Megan now. I think she has realized, as the rest of us did sooner, she couldn't keep drinking. It was going to kill her.
MEGAN: At this point I'm waging war, because I want to have a life. I want to live. And it was getting to the point that that wasn't going to happen if I didn't do anything about it.
SAVIDGE: Megan tried traditional group therapy when she was 20. It didn't work. At rock bottom, she was ready for something new.
When we come back, Megan's big surprise on the very first day of her new treatment.
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MEGAN: I couldn't believe it. I was like there must be some mistake.
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SAVIDGE (voice-over): 26-year-old Megan was on the verge of alcoholic self-destruction. Her family was desperate to find her help.
Megan's mother, Archer, was struggling with a dilemma faced by many families across the country: how to pay for costly treatment of a disease without insurance.
ARCHER: These are the most recent places that I called.
I did not look into the traditional treatments that I knew were 1,000, 1,500 dollars a day that took only insured patients. I mean, there was no point in me looking there.
I was looking for a residential treatment center, but I would have taken anything.
SAVIDGE: Archer's cousin, Sterling, works at the Medical University of South Carolina in Charleston. She noticed an item in the school newspaper concerning a clinical trial on alcoholism at the MUSC Institute of Psychiatry. Megan qualified, so she pulled up roots and moved from Atlanta to Charleston.
MEGAN: To me just being here kind of signals a change and a clean life.
SAVIDGE: She and her family are rolling the dice on a clinical trial called Project COMBINE, named so because it combines new behavioral treatments and medications.
Megan will take part for four months. So far so good.
ARCHER: 35 days ago when I dropped Megan off here, I wasn't sure she really would make it, and she looks great. So it's the first time I've seen her sober 35 days in seven years. It's nice. Good job.
SAVIDGE: Psychiatrist Raymond Anton heads the nationwide steering committee for Project COMBINE and runs the clinical trial in Charleston.
DR. RAYMOND ANTON, PROJECT COMBINE: It's a very exciting time, because in the past few years we've discovered and documented that sophisticated counseling techniques work pretty well, and when combining those with medication, you can actually got an enhanced benefit.
UNIDENTIFIED MALE: Another Bass for you, ma'am?
SAVIDGE: Anton believes despite scientific advances, the general public has many misconceptions about alcoholism.
ANTON: Many people still think that alcoholics have a weak will, that if they only tried harder, they could control their alcohol use, that there's even potentially moral deprivation, that they've succumbed to evil.
SAVIDGE (on camera): For the better part of a century, there has been mainly one way for problem drinkers to stay sober: the 12-step programs of Alcoholics Anonymous. But researchers want to get the word out there's been a revolution in treatment, driven by discoveries about genetics, the brain and psychology.
(voice-over): In Charleston, at her first session, Megan found out from counselor Glenna Worsham (ph) exactly how much she had been drinking.
GLENNA WORSHAM, COUNSELOR, PROJECT COMBINE: The goal in presenting this is to see what numbers get the person's attention: what surprises them, what about these figures might make them say "Wow!"
SAVIDGE: The analysis showed Megan was drinking 216 standard drinks a week.
MEGAN: I couldn't believe it. I was like, there must be some mistake. Then again, I was thinking back into what I would pour and what -- I mean, your average -- when they say standard drink is 1, 2, 3. I know from working a restaurant long enough it's 1, 2, 3, you know, with the pour, and mine would be, you know, this much straight and chase it with a beer. And that's several of those.
SAVIDGE: Binge drinking on a large scale, usually every week on a Thursday through Sunday bender, over 50 drinks a day on those days. One definition of binge drinking, four or more drinks at one sitting.
I mean, I'm laughing. It's not funny. At all it's not funny, because I guess if you don't laugh, you'll cry. But it makes me -- it's a good -- I need to hear these things because I realize, it's kind of a reminder of why I'm here.
So, that's four in the morning...
SAVIDGE: Megan has high expectations the medications will help with her cravings for alcohol.
MEGAN: The reason I got involved with COMBINE is mostly I like the medication part of it, including the combination of therapy and medication. I had tried other things. The, I guess the conventional therapy, and I just couldn't stay sober from that.
UNIDENTIFIED MALE: If you just want to check in and say how things are going...
SAVIDGE: Conventional therapy, like 12-step programs and AA, does work for some people.
MIKE: Nighttime, when the sun goes down, that's where I'm most vulnerable. That's when I used to do, you know, most of my hard- coreness partying or whatever.
SAVIDGE: A year ago, 19-year-old Mike was drinking beer and smoking pot almost every day.
MIKE: Nighttime is when I need -- need to make sure I'm in a good place.
SAVIDGE: His parents threatened to kick him out of the house unless he went into treatment. He's been sober a year with the help of the AA "Big Book."
MIKE: I've got the tools and the necessities to apply to every- day sobriety life: what to do in this situation, how to handle this, how to say no and walk away. I've learned a lot about "The Big Book" and the steps.
SAVIDGE: The 12 steps came out of Alcoholics Anonymous in the 1930s and is still the most prevalent treatment today by far. It has a heavy spiritual component.
The first steps: admit powerlessness over alcoholism and surrender to a higher power to help stop drinking.
MIKE: Without a higher power I would not stay sober, period. This disease is way to tough to fight by myself. And even when I say "by myself," I mean, with parents, with a sponsor, with a counselor, with anything. You have to have a higher power to stay sober.
I have turned my life over. I'm not in control of my life anymore, because it -- the last time I tried to control my life, I ended up in rehab.
UNIDENTIFIED MALE: Anybody else want to just talk a little bit about staying clean, about their recovery?
SAVIDGE: Mike goes to AA meetings and group therapy every week.
MIKE: The Midtown deal Friday, that was wild. I was at Dylan Friday night, and the guy right next to me was smoking a joint. And man, like before last year at Midtown, I would have seriously like beat his ass for all his weed. I would have done it if he wouldn't, you know, have shared it with me.
But I looked at him and I laughed and I just walked away. It was that easy. It was like second nature, I guess, just to walk away.
So I mean, you know, if the -- us in this room can do it, who can't, you know?
SAVIDGE: Megan tried AA. It did not work. It does not work for everyone.
MEGAN: And I'm not getting what I should out of it, so the meeting is kind of wasted.
SAVIDGE: At Project COMBINE Worsham ad Megan came up with a personalized treatment plan. Unlike the more structured therapy of 12 step, Megan herself chooses the goals and direction of her recovery.
One of the newer concepts: Alcoholism is partly a learned behavior, which has to be unlearned. The theory: Megan deals with the pressures of life by drinking, and she must now be taught to cope with those pressures without alcohol.
WORSHAM: We have a therapist checklist where we actually follow a format of the highlights of what we're to cover. Let's look as how alcohol has affected areas of your life and do an analysis of it.
SAVIDGE: Through a series of worksheets, Worsham will try to help Megan understand the triggers that cause her to drink and connect the triggers to the positive feelings she has afterwards.
WORSHAM: Exploring ways to get to those effects of that alcohol.
SAVIDGE: In other words, rewards without the bottle.
A few weeks in COMBINE, there's a red flag. WORSHAM: Actually one of the concerns has come up in her new job, which is serving tables at a restaurant here: Not only does the restaurant itself serve alcohol, there is a bar down below that is a local hangout for young people.
SAVIDGE: The entire Project COMBINE team is worried about Megan's work environment.
UNIDENTIFIED MALE: Has she had any cravings, any strong urges to drink?
WORSHAM: Some in the evenings -- now reporting where she's working seeing people out on the deck drinking. And interestingly enough, as she's working, not triggered by serving the drinks but looking out the window and seeing the people down below at the bar drinking.
UNIDENTIFIED MALE: Kind of like where she'd like to be, huh?
UNIDENTIFIED MALE: Yeah.
SAVIDGE (on camera): The newer treatments of COMBINE diverge from the traditional 12 steps. Rather than tell Megan it is dangerous to work around so much alcohol and so many drinkers enjoying themselves, the COMBINE team tries to guide her into reaching that conclusion for herself. Two months sober and five weeks into the program, Megan has not made that connection.
MEGAN: I've never really had a problem with that. I don't know why. To me it's just, um, like serving food. I mean, it's just kind of like an object. Yeah, really don't think about it. I never really -- years ago I did. But I guess I'm just used to it now.
SAVIDGE (voice-over): When "Wasted" returns, the latest brain research may give clues into why Megan feels normal only when she drinks.
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MEGAN: Why am I struggling and on one else has to struggle so much? Why do I think about it constantly, and everyone else, it seems so easy for everyone else?
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SAVIDGE: Megan has had bouts of depression since she was five. She believes her brain chemistry is different from that of a normal person and that these differences play a part in her desire for alcoholism. At one time, she was drinking more than 200 drinks a week.
MEGAN: I've heard a lot of other people, alcoholics, say that it was really the only thing that made me feel normal. It was like the first time it's kind of like, oh, my gosh, I can -- you feel -- I felt more in control, more awake, more productive, a lot more productive.
SAVIDGE: Drinking to feel normal. Dr. Daniel Hommer studies brain chemistry at the National Institute on Alcohol Abuse and Alcoholism outside Washington.
DR. DANIEL HOMMER, NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM: Things that are normally rewarding, you know, like food and social company, and you know, being with your friends and family are no longer that rewarding: because what's most rewarding for the person now is getting the alcohol.
SAVIDGE: In the brain of a alcoholic, the reward system is disrupted by activity in an area the size of a quarter: the nucleus accumbens. When an alcoholic takes a drink, the nucleus accumbens sends impulses to the rest of the award system. Alcoholics then rely on the drug to feel good. Normal things, like food and sex, lose their appeal.
Hommer also believes the brain's punishment circuits play a role in addiction, because alcoholics do not respond to punishment like normal people.
HOMMER: They keep drinking despite the fact that bad things are happening to them: Their marriage goes down the tubes, they lose their job, they start getting sick. All sorts of awful stuff starts happening, but they keep drinking. Why is that? Is it because for some reason they're not sensitive to punishment anymore? Those punishments don't -- don't have the same impact that -- that they would in other people.
SAVIDGE: Alcohol has many effects on the brain. They are so complicated scientists do not agree on exactly what's happening. But they do agree on this: Alcohol changes the brain.
In an alcoholic, those changes can be permanent. Over time, an addict's brain chemistry is altered to the point where she no longer has total control of her behavior.
Megan is involved in a clinical trial testing two new drugs. She believes they're working on her brain and helping her fight cravens even though it's possible, as in any clinical trial, they are placebos.
MEGAN: You know, they have a 1-in-4 percent -- or yeah, 1-in-4 chance that it's -- that it's a placebo. And I've convinced myself that it's not, because I don't want to, you know, think that -- I've just convinced myself that it's working for me.
SAVIDGE: The two drugs are Naltrexone, believed to work on the brain's reward system to reduce the pleasurable effects of alcohol. Naltrexone is available in the United States. And Acamprosate -- some alcoholics drink to avoid the pain of withdrawal. Acamprosate is believed to ease that pain, making it easier to quit. Acamprosate is not yet available in the U.S.
These drugs are not cures, but they may help fight cravings. Megan describes one of her craving when she went to a bar after work to socialize.
MEGAN: Yeah, it was tough, when he was pouring drinks right in front of my face, and of course, I thought, you know, god, a beer would taste so good, because, you know, I just remember how it used to taste with food.
HOMMER: Craving is basically desire, OK, and that's basically what we're talking about. The key is how do you stop desire for one particular substance and not stop desire, you know, to be a good person, to have friends, you know, to eat, to drink, you know, things that aren't alcoholic.
SAVIDGE: Even though Megan has high hopes for the medications in Project COMBINE, they're not powerful enough to work on their own. That's why they're being combined with talk therapies.
(on camera): So is this really the heart of the research going on up here?
DR. ENOCH GORDIS, DIRECTOR, NIAAA: It's a very important part of it, but there are many important parts all over the place here in the clinical center.
SAVIDGE (voice-over): Dr. Enoch Gordis is head of the National Institute on Alcohol Abuse and Alcoholism, NIAAA, which funds COMBINE.
(on camera): What does the counseling do? Is it supporting the drug? Or is the drug, let's say, diminishing the craving or knocking out the desire?
GORDIS: You might say that each one sort of covers for each other. If one isn't working, the other one will. That's a sort of elementary way of looking at it.
Another thing is that each one sort of reinforces the action of the other. If the counseling is good, then the person might be more anxious to comply with taking the medications. If the medication is controlling craving to some extent, this person will be able to pay more attention to the counseling instead of thinking where the next bar is.
SAVIDGE (voice-over): Even more fascinating: According to Gordis, counseling and therapy can actually produce changes in the brain.
GORDIS: So that means that talk therapy is not somewhere out on Mars. Therefore, we have a combination of two therapies, both of which are affecting our brain function -- the medication on one hand, and the verbal therapy, the behavioral therapy, on the other. SAVIDGE: Halfway through Project Combine Megan is still having a rough time.
MEGAN: Why am I struggling and no one has to struggle so much? Why do I think about it constantly and anyone else -- it seems so easy for everyone else.
SAVIDGE: When come back, her father reveals another piece of the Megan puzzle.
STEVE: I didn't drink all the time, but when I did drink, periodically I would be unable to stop.
SAVIDGE: At party celebrating the upcoming marriage of Megan's twin sister Elizabeth, their father offers a clue into Megan's alcohol addiction.
STEVE: I realized when Megan had a problem that a lot of the genes were inherited -- problems I had had and problems that my father had had.
SAVIDGE: The risk for alcoholism is inherited. That does not mean a person is destined to have a drinking problem, but it does increase the odds.
STEVE: I would have times where I could drink and everything was fine. And then, all of a sudden, I would have that period where it just tasted so good, and I just couldn't stop. But my drinking was never like -- it was never was continual or never stopped me from working. But it would put me in a situation where I did crap that I should never have done.
SAVIDGE: The child of a alcoholic has 300 to 400 percent greater chance of becoming a problem drinker than the child of a nonalcoholic.
STEVE: So when Megan got her problems, I realized that there were certainly elements there that were simply because of heredity, as well as probably behavior that she saw.
SAVIDGE: The genetic tests have not been down, but Megan and Elizabeth are believed to be identical twins, which means they have exactly the same DNA. Megan was a hard drinker, Elizabeth never had a problem.
ELIZABETH: It doesn't do anything for me. I don't like to drink. That's what kind of strange. I really can't figure it out, what clicked in her that didn't in me.
SAVIDGE: Dr. David Goldman head the neurogenetics lab at the National Institutes of Health. (on camera): If you have the twins, one is an alcoholic one is not, and yet, by their genes, they are the same -- that thereby it wasn't a trait in their genes, it was the environment solely that triggered the episode of being an alcoholic?
DR. DAVID GOLDMAN, NIH: Probably they both had the predisposition. Probably one had a trigger that the other one did not. Human experience being so complex, these differences are going to occur.
SAVIDGE (voice-over): Goldman is searching for the differences in genes between alcoholics and nonalcoholics.
GOLDMAN: What this lab ties to do is actually isolate those genetic factors and to identify how it is that they altered the function of the brain, and the ultimately influence the vulnerability to this disease.
SAVIDGE: Goldman believes the science of genetics is on the verge of great strides, pushed forward by the effort to identify all the genes in the human DNA, the human genome project.
(on camera): We were talking about the human genome project. How significant is that for you in your research?
GOLDMAN: It's a watershed moment for the analyses of complex diseases like alcoholism or other mental disorders, because it gives us a complete parts list for the first time, of all of the genes that are involved in the construction and the operation of a human body and a human brain.
SAVIDGE: Just this year, scientists in Indiana found for the first time a link between alcoholism and depression, an area on chromosome one which predisposes some people to alcoholism, others to depression, still some others to both.
(voice-over): Megan has suffered from depression since childhood.
MEGAN: I have been dealing with depression for a long time. But it just gets to where I'm tired all the time, and not -- I don't look -- everything seems like such -- not just a hassle, but overwhelming to do.
SAVIDGE: Sometimes depression causes alcoholism. Sometimes alcoholism causes depression. Chemical imbalances in the brain can lead to both conditions.
Goldman is studying the genes which regulate brain chemistry. The idea is to find abnormalities in alcoholics, then develop medications to target those abnormalities.
GOLDMAN: What we're really talking about is being able to design a diagnostic profile for a person to tell them what time of alcoholism that they have, and more importantly, to which treatment they would be most likely to respond. SAVIDGE: Goldman believes science is five to 10 years away from creating more potent medications for alcohol treatment.
Megan is putting a lot of faith in the drugs available now, but they do not help her deal with her shame.
MEGAN: The cravings have lessened a whole lot. I think the medication has helped a lot. There is a judgment factor that I hate. I don't want to be known -- I mean, even being -- I don't want to be known as a drunk, you know.
SAVIDGE: A big weekend for Megan. Her new roommate TJ is moving in, and Megan's cousin Sterling is the first to get the inside scoop.
STERLING: So tell me about it.
STERLING: When did they get here?
MEGAN: His father came, it took them about...
STERLING: It took them a couple hours to move in.
MEGAN: He's such a boy. Sterling, I'm not kidding, he's such a boy.
SAVIDGE: Sterling placed the ad for the roommate, and was firm about one thing: No alcohol allowed.
STERLING: We wanted someone who felt responsible with their life, that they would need to concentrate and have a reasonably quiet place and accept the fact that there was this strong rule of no alcohol allowed.
SAVIDGE: Megan needs a roommate to help pay the rent. Her family believes TJ's healthy lifestyle will be a positive influence, as Megan struggles with her alcohol addiction.
This is their first weekend together.
Megan left dishes in the sink. TJ washed them before cooking his own meal. The table was cluttered, so TJ ate from the next best thing.
Megan had no groceries in the house and ended up eating some of TJ's food. TJ has a friend.
CHAD: Yes, sir.
SAVIDGE: Chad would also end up staying in the two-bedroom apartment. TJ is a part time bartender, Chad a water.
Early on, Megan felt she had to compromise the no-alcohol rule to keep TJ as a roommate.
TJ: She had said, you know, the deal is you're not to have alcohol in the house with you. If you want to keep a couple beers in your room, you know, I don't care.
SAVIDGE: Chad admitted to drinking in the apartment.
CHAD: We have a few times, but I think that that is something that she saw, and she wasn't -- she told us -- she forbid us to do that, and we hadn't, but we brought beer in one night, and I don't know how she found out she had it, but she did.
SAVIDGE: One night, Chad invited Megan for a sunset walk in the peer.
CHAD: When I met my friend Douglas, when we went and got liquor, on spur of the moment I went to go find out and see if Megan wanted to come with us to get out of the apartment.
MEGAN: He knocked on the door, and said, "Megan," he is like, "we have got beer, but let's grab your grape juice (UNINTELLIGIBLE) out of the fridge and go watch the sunset." And it was difficult watching them drink, very.
SAVIDGE: Megan quit her first waitressing job and Chad helped her get another one. This time, she worked nights. TJ saw trouble coming.
TJ: The food and beverage business isn't the best business for somebody that's trying to get away from alcohol.
SAVIDGE: Therapist Glenna Worsham recognized triggers to drink were all around Megan.
WORSHAM: Seeing other people drink, smelling the drink, even sitting at the bar, the physicalness of being in a bar, hearing music, hearing the chatter of people, hearing the clank of glasses.
SAVIDGE: But in a new kind of therapy Megan is undergoing at the Project Combine, Worsham does not confront Megan for engaging in apparently risky behavior. Change has to come from within.
WORSHAM: We talk about how do you handle a situation like this, and once again with motivational interviewing style, going to the client and saying, "you are the expert on yourself. Let's talk about this together, but you tell me what works for you. What will be useful for you to do to help you not drink."
SAVIDGE: In fact, Megan had reported to Worsham that she craved alcohol less, that the medication was working. On the surface, the picture looked rosy, until one therapy session. It began like any other session, with a Breathalyzer test, but unlike on this date, Megan tested positive for alcohol consumption.
After more than two months of sobriety, Megan got drunk. Twice. Once at work when a fellow employee approached her.
MEGAN: She was talking about differences in wines, gets them out and starts pouring a little in each, tasting the difference, and I couldn't sit there and say, "no, I can't." I could have. I take that back, I could have. I felt so awkward saying, no, I'm sorry I can't take a sip, which I probably should have.
SAVIDGE: The first episode was at home. Alone, bored and restless, Megan drank a bottle of wine.
MEGAN: Oh, I thought I was just going to jump out of my skin, I really did. And I just thought, I cannot stand this. If anything, it will just help me go to sleep. That was really what I was thinking, that anything has to be better than how I feel right now and I will just work on -- just deal with it tomorrow.
SAVIDGE: Depending to whom you talk, 50 to 80 percent of alcoholics have a drinking episode within their first year of treatment.
Even for Mike, successful so far in the more structured 12-step treatment, there are no guarantees. On this day, he is on the way to AA meeting with his family to celebrate one year of sobriety.
MIKE: Who knows. I know I was sober today, so I don't know. I mean, I might relapse tomorrow. One of the greatest sayings is keep it simple. That's how my program is, it's very simple. There is not much to it. I just don't drink.
SAVIDGE: The possibility of relapse is never far away from an alcoholic. Worsham tries to reassure Megan she is not a failure.
WORSHAM: When she came in, looked pretty upset about the drinking episodes, and we went right with it and said, "let's talk about."
SAVIDGE: The current idea in therapy after a slip, it happens. Don't make a big deal of it. Analyze what happened, figure out how you got off track so you can get back on.
WORSHAM: And once again, supporting the idea that she did come back. And she did talk about it, and not considering it as any failure, we don't have any kind of terminology or any kind of judgment. It's so you had a problem here. But you are back. So, this is great. Let's go from here, and that's what he we did.
MEGAN: And I decided that I started it, I'm going to see it through, because I have quit too many things in the past. Otherwise, it would be another quitting.
SAVIDGE: So Megan continued in Project Combine, with its combination of therapies and medications, and came to a hard learned truth: She could no longer work around alcohol.
MEGAN: I just can't do it, because that impulsivity in me just takes over. I mean, besides the triggers it's like this little monster is just doing things that -- I mean, you know what I'm saying? As far as -- drinking it's like all of sudden I just don't think anymore and I just do it.
SAVIDGE: When "Wasted" concludes: What happens when Megan's time runs out in Project Combine?
MEGAN: And it's still hard for me to imagine going for the rest of my life without drinking. It's real hard.
SAVIDGE: Megan's time in Project Combine is almost over. She realizes she is going to need something to take its place. Her mother has convinced her to give AA another chance.
MEGAN: It's been fun.
I think that if I keep going, that it hasn't -- I'm not quite as gung ho as I need to be.
UNIDENTIFIED FEMALE: Megan, I will see you an hour. Yes, OK, bye-bye.
MEGAN: But I got to go, keep trying to go, even if I don't want to sometimes.
SAVIDGE: Even though the idea of higher power was not part of the treatment in Combine, therapists Glenn Worsham has been encouraging Megan to find a self-help group like AA.
WORSHAM: How did it feel being there?
MEGAN: Good. I mean, I used to get kind of like embarrassed by the fact that I even had to go.
SAVIDGE: This is one of their last sessions.
MEGAN: I guess now, obviously, it's more embarrassing to do than the things that I'm doing.
SAVIDGE: Dr. Ray Anton's Project Combine team has arranged for continued therapy and medication for Megan. Her family is trying to figure out how to pay for it.
ANTON: Unfortunately for Megan and for many people that have alcohol dependence, it's a constant battle. She has basically won this battle, this 16-week battle, but the rest of her life may be a continuation of the war. SAVIDGE: Megan has enrolled in a college sociology class, she is looking for a job not in the restaurant or bar business. Her roommate TJ left to live with friends, and Megan, with the help of her mother, asked Chad to leave.
Megan is trying to make changes. Though she admits to two drinking episodes, she has been clean for the better part of five months. It's given her a window of sobriety to think about the future, and the future scares her.
MEGAN: And it's still hard for me to imagine going for the rest of my life without drinking. It's real hard.
SAVIDGE: Megan has come a long way since she was 5 when her mother noticed something different in Megan from her twin sister, the difference which led to depression, then to drink, and finally to awareness. The reason she drank and the reason she is trying to stop: Megan just wants to feel normal.
MEGAN: You know, now I wake up, I don't look forward to a day at all. It seems more like a hassle. And I don't want to get out of bed. And I'm tired of that. And I don't think that not dreading the day is too much to ask, to just look forward to it. I don't think that's too much to ask in life.
HARRIS: Megan says that she is keeping up with AA, her therapy, and she continues to take her medication. As for school and work, Megan is getting A's and B's and now has a part-time job outside the food and beverage industry.
And while it's impossible for recovering alcoholics like Megan to say for sure that they will never drink again, it's important that alcoholism is a treatable disease. People do get better and they do go on to lead happy and fulfilling lives.
That's this edition of CNN PRESENTS. I'm Leon Harris. We'll see you next week.
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