It is not just students, teachers and coaches who gear up for the school year and football weekends. Detox does too.
"We know we will have an increased number on football weekends. We're prepared. We have to be," said Melody Music-Twilla, who runs the Dane County Detox Center on Industrial Drive on Madison's southeast side for Tellurian Ucan, Inc.
Between those sent to detox by Madison Police officers and University of Wisconsin-Madison campus police, Music-Twilla expects all 29 beds in the 24-48 hour triage center to be filled before the end of the night Saturday.
One Wednesday in July, all the beds inexplicably were full. The only other full house this year was during the Mifflin Street Block Party. On a recent Saturday night when there was a band camp in town, they got 20 customers in one night, Music-Twilla said.
But students don't fill up all the beds. On Aug. 23, Dane County Detox started the day with 12 patients. "That's low. The average daily census for football weekends is 19," Music-Twilla said.
With the new hires Music-Twilla has added for the start of school, the Dane County Detox Center has 17 full-time employees and 12 on-call. The all-hours facility has a minimum of four staff on duty at all times, typically one nurse and three nurse extenders, or nursing aides. On the day shift, there are one nurse, two nurse extenders and three counselors plus clerical staff.
There will be four extra staff on duty after 1 p.m. on Saturday. The football game kicks off at 2:30 p.m. and pregame tailgate and house parties will start well before that. So, customers will start rolling in about 1 in the afternoon.
On Sunday there will also be an extra nurse extender and an extra counselor on duty. The next day staff is necessary because everyone who leaves detox has a referral to one of four basic treatment options, according to Tellurian CEO Kevin Florek.
Alcohol Smart is a series of classes to help people learn to make smart choices about alcohol. Tellurian takes the approach that not everyone who ends up with a drunk driving ticket or in Detox is an alcoholic, Florek said. "Less than 5 percent of people are alcoholics," he said.
Counselors' charge
Tellurian also offers weekly outpatient treatment, one-to-four day a week daytime or evening treatment and in-patient treatment at the Teresa McGovern Residential Treatment Center off Femrite Drive in Monona.
Music-Twilla was Teresa McGovern's counselor. McGovern, the daughter of former U.S. Senator from South Dakota and 1972 presidential candidate George McGovern, died at 45 of hypothermia due to acute alcohol intoxication in an alley off Williamson Street in December 1994. She had been in and out of alcohol treatment programs since her arrival in Madison in the mid-1970s.
McGovern's father chronicled her lifelong struggle with alcoholism in a 1996 book, "Terry," and remains a close friend of Music-Twilla's today.
Music-Twilla and George McGovern know that detox workers and substance abuse counselors can't always, or even often, fix things. All they can do is "be there" with the sufferers.
"We see people over and over again," Music-Twilla said. "All we can do is provide them with hope, 'Maybe this time you'll be OK.'"
"We will show respect to clients no matter what. We always respect them, whether they are passed out on the street or here and begging for help. Everyone that comes through these doors is a human being having a problem, whatever that problem may be," she said.
There is lots of staff turnover at Dane County Detox, she added.
"I tell people when I interview them that they will know within three months if it's going to work for them, if it is what they want to do with the rest of their lives. And lots of them are gone within a year," she said. But some stay, advancing like herself from intake worker to counselor to administrator. Others remain in their initial slots for years.
Martine Hoskin, a pale-complected woman with long black dread locks and shining eyes behind wire-rimmed glasses, said she will have been a nurse extender at Dane County Detox for 16 years in October.
"I try to talk to the people and let them know it is up to them to better their lives. This is the field I like: communicating with people that they can help themselves once they make the decision to do it," she said.
Like Music-Twilla, a 49-year-old dishwater blonde with sparkling eyes, a quick smile and a frequent wink, Hoskin's cheerfulness is immediately obvious to all who meet her. "She laughs all the time," Music-Twilla said.
But Hoskin found her life's work much later in life than Music-Twilla. "I didn't find it until I was 50, but I've been at it ever since," Hoskin said.
As president of the Wisconsin Alcohol and Drug Treatment Providers Association as well as in her role as a Tellurian administrator, Music-Twilla helps substance abuse counselors and detox workers cope what they see and feel.
She stresses the need to have a life outside work. "That's where a lot of the dignity and respect come from. You can have compassion, but you are here to help. It's not your problem," Music-Twilla said.
Compassion, she said, is understanding another person's trauma. "It's a terrible thing to end up here," she said. But she also said she is always aware that "there, but for the grace of God, go I."
Some of Music-Twilla's compassion may come from having survived her life's bumps: She is a widow, her father shot her mother and killed himself and her sister died of AIDS.
When she became a counselor assistant, she said she worked "the street team when it really worked the street: checking on street people, diverting them from the police. My beat was the Capitol to the Union." Madison's Police Chief Nobel Wray walked that beat at the same time as a patrolman. "We often shared information and concerns," Music-Twilla said.
Eventually, she became an advanced substance abuse counselor and then a licensed clinical supervisor. She was already the supervisor of Dane County Detox when she was promoted to vice president of clinical services for all of Tellurian's 20 facilities.
However, detox is still her special focus. "Detox is where my soul is," Music-Twilla said.
This Saturday night
The students brought in Saturday night won't necessarily be alcoholics, she said. Most won't be going through withdrawal on Sunday morning. There are specific medical tests that are done to determine if patients actually are in withdrawal to receive medical treatment.
"Withdrawal is very rare, especially among young adults," Music-Twilla said. She said being in withdrawal generally indicates a more significant level of alcohol abuse over a longer time period than just being drunk on State Street.
And just being drunk on State Street won't necessarily get someone to detox either.
"Behaviors are the key. Did they fall down and have trouble getting up, were they picking a fight or beating someone up, or throwing up or urinating in the street?" Music-Twilla said.
To meet the involuntary custody criteria, a person must be unable to care for themselves and their basic needs due to alcohol. City and campus cops will make the determination and take them to the appropriate location. People can be detained involuntarily only for alcohol abuse, not drugs, Music-Twilla added.
Most of the students arriving at detox this weekend will be conscious and upset that they are being detained against their will. The police call for emergency medical evaluation if anyone is found unconscious. If there is any question that their health is compromised, the police will send them to one of the city's hospitals. All three handle medical detox and serve as back up to the Dane County center. The determination of where a person should go is up to the officers, not detox personnel, Music-Twilla said.
After arrival, the person's possessions are inventoried. If their clothes are soiled, they will be cleaned and loaned clothing.
The patients will also blow into a Breathalyzer. Often the tests indicate people brought in have a concentration of .16 liters of alcohol in 210 liters of their breath, Music-Twilla said. In Wisconsin, that's twice the level necessary to be charged with drunk driving.
There is a public phone and people brought in can call someone, like their parents. But detox staff will not call anyone and will not talk to anyone a patient calls because of privacy concerns. "If someone is drunk enough to get here, they are too drunk to give informed consent for us to talk to their parents," Music-Twilla said.
After their initial processing and a medical assessment, detox patients are offered food and water, Kool-Aid, juice or milk to drink. Coffee is only served at 6:30 a.m. breakfast. If someone has been brought in at 4 a.m., the detox staff lets them sleep it off.
The next day, after being moved to the "more social side," they see a counselor to get a referral and are usually released before nightfall.
Most rooms are doubles, with no sheets, blankets or pillows on the beds. There are, however, three singles or isolation rooms.
People are not usually restrained, which is an absolutely last resort. If they are used, the patient will be placed in a isolation room, Music-Twilla said.
No matter how brief the stay, they will have made a difference in the lives of the staff and perhaps the staff will have made a difference in theirs, Music-Twilla said.