DRINKING GAMES

Kevin Mills has lived here all his life but still is amazed at how little
tolerance the city has for weakness. The restaurant owner has told some
former employees to leave town. If you have any sense, he tells them, just
get on the next bus and kiss this place goodbye.

In 1991, he purchased the Omelet House on West Charleston Boulevard and
inherited a group of employees more interested in getting stoned than doing
their jobs, he recalls. Out of more than 20 employees, only about three were
not abusing drugs or alcohol.

Those who were abusing stashed alcohol in the back delivery area or came to
work looking as if they'd slept in their clothes, he says. They were given a
few chances to straighten out, but most of them never did. Find another
place to live, Mills would tell them. This is not a town for the feeble.

Three years ago, Mills raised his wages, hoping the move would attract clean
and sober job applicants, and adopted a drug and alcohol abuse policy.
Prospective employees now are required to take a drug test, and those
suspected of using also can be tested. But even last year, months after the
policy was adopted, he fired 11 employees because of substance abuse.

"I think these are good people if they weren't involved in this type of crap.

"It's not just the drugs and the alcohol. That's their personal thing. It's
the peripheral effects. ... And the town takes them like a piece of chewing
gum, pops them in, takes all the flavor out and spits 'em out."

Las Vegas is a city like no other. It relies on the nation's need to party,
take chances and stretch the limits even just a little, even for a moment.
But does this trickle down to residents, either causing the habitual use of
drugs and alcohol or fueling addictions that already exist?

Treatment experts know addiction comes with the person. Scientists have
confirmed that the addictive brain is different from the nonaddictive brain.
In other words, there is a physical predisposition to addiction, so it's
just as easy to get hooked on drugs and alcohol in a small Midwestern town
with no casinos, no 24- hour bars.

"I want to sort of dispel the myth that alcohol causes alcoholism, because
it doesn't," says Mel Pohl, service director for Charter Hospital's
addictive disease program. "Long before they ever take their first drink,
there is a difference in somebody who's got alcoholism or drug addictions
from somebody who doesn't."

Whether a person is living in Las Vegas or not, they are going to be exposed
to messages that glamorize the use of substances such as alcohol, adds Ron
Lawrence, executive director of Community Counseling Center, which provides
treatment services.

"The issues are the same as that person who lives in a nongaming community
and has a corner bar and beer commercials on TV all the time. It's the same
stuff, and in that way it's no different. So we have to look at the
vulnerability that person expresses.

"We have people in recovery, I mean, God bless, I have cocktail waitresses
that are treated in this agency that are in recovery that do not drink. They
manage to make that separation. They go out and serve the tourists. They do
very well in hotel-casinos. They do not touch a drop. It's recovery. It's
the ability to make those delineations between indulging and serving."

Statistics do not necessarily point a finger at Las Vegas, either. There are
no current data that actually compare cities or states based on the number
of residents abusing alcohol or drugs.

Nevada consumes more alcohol per capita than any state in the country,
according to recent studies released by the National Institute on Alcohol
Abuse and Alcoholism at the National Institutes of Health. But these figures
include sales of beer, wine and liquor to casinos, which means a significant
portion of the alcohol is being consumed by tourists.

There are data that compare states as far as alcohol-related traffic deaths
and mortality. A National Highway Traffic Safety Administration report shows
that Nevada had 160 alcohol-related traffic fatalities in 1997, fatalities
in which either the driver or pedestrian had a blood-alcohol concentration
of .10 grams per deciliter or more. This represented about 46 percent of
total traffic fatalities that year. Only seven other states had a higher
percentage of alcohol-related fatalities.

Another study, State Trends in Alcohol-Related Mortality, 1979- 1992, from
the National Institute on Alcohol Abuse and Alcoholism, looked at deaths
caused by the use of alcohol. It included dozens of conditions such as
cirrhosis of the liver and alcoholic gastritis, as well as accidental
poisoning, suicide and traffic accidents. According to the study, 41.2 per
100,000 Nevada residents died of alcohol-related causes in 1992. Only five
states had a higher rate: Alaska at 51.2; New Mexico, 48.1; Mississippi,
46.7; South Carolina, 43.6; and Louisiana, 41.6. The District of Columbia
topped all 50 states at 75 percent.

While these rankings are disconcerting, they do not necessarily make a
connection between the very nature of this 24-hour town and substance abuse.
Even recovering addicts give mixed opinions on whether Las Vegas life makes
it difficult to stay clean.

Tracy Kaye, a native Las Vegan, started drinking by the time he was 12. By
17, he was downing shots of 151-proof liquor every day. After a monthlong
binge in 1996, a binge that left him with about $4,000 in debt at local
bars, he finally sought help. He has been sober ever since and has opened
two Christian-based halfway houses, the House of Tom and Bud's Light House,
for recovering addicts who need shelter while turning their lives around.

Kaye, 39, sees no link between the town he grew up in and his cravings for
alcohol. A dealer by trade, he is surrounded by alcohol for hours at a time
but no longer drinks. An alcoholic can drink anywhere, not just in Las
Vegas, he says.

He does, however, understand how the throng of workers moving to Las Vegas,
those who see it as the land of plenty, can get lonely and try to escape
through drugs and booze. Some of them end up in his halfway houses.

"I'm certain that there are people that come out here, who move out here,
and they're not addicts. They move out here and might develop an addiction.
One of the things that prompts us to pick our addictions is loneliness, and
that can happen if you move from Las Vegas to Florida. Hungry, angry,
lonely, tired .. those are the things that prompt us the easiest.

"If you're a smoker and you're hungry or you're lonely, you want to pick up
a cigarette. That's an easy analogy to understand. Well, the same thing with
alcohol or whatever the addiction. All addictions are the same. Their
primary purpose is to take our life."

There are others, however, who say the 24-hour bars and the constant flow of
free drinks at the casinos are definitely a danger. They say Las Vegas'
partying atmosphere certainly can make it harder to take the giant step into
sobriety, and gambling is just another habitual behavior that adds fuel to
the fire.

Katherine, who asked that her last name not be used, started drinking at age
9. By the time a judge finally forced her into treatment 18 years later, she
was drinking and using methamphetamine, cocaine, marijuana and downers.

She doesn't blame the city for causing her addictions. She grew up in a
family soaking in it; her father died from alcoholism when she was 16. But
the memories of sitting in a string of Henderson casinos for hours on end
and drinking free booze still haunt her. Once, she played for 2 days
straight, just sitting there tweaked on methamphetamine and drinking alcohol.

"You know, you can go into casinos with $2 and you can drink - say you're on
methamphetamine and you're drinking, you could stay there for three days.
It's been done. It's done all the time," Katherine says.

She now works for the Healthy Families Project, counseling pregnant women
who are using. She also speaks to groups around town about the effects of
addiction and the vital role treatment plays in helping addicts get their
lives back.

It is easy, Katherine says, for some addicts to slip back in Las Vegas.
Casinos and 24-hour bars are not the causes of their addictions or relapse,
she says. But they are an enticement. She has watched friends go into the
casinos to cash their paychecks, sit down at a machine and start drinking again.

"Everywhere you go there's a memory," she says. "Whether you've been at that
casino or not, it's there, it's alcohol. It's like, come and get me, come
and drink me. They glorify it. They glorify it."

The Rev. Bill Shumate of Grapevine Fellowship Church also contendsbelieves
the connection between Las Vegas and substance abuse is as obvious as the
sea of clanging slots and cocktail calls. Shumate, who stopped using drugs
and alcohol before moving to Las Vegas in 1992, works with parishioners who
are in the midst of addiction and want to get help. About 70 percent of
Grapevine's 850 members are current or recovering addicts, he says. Over
the years, the church has become a haven for those struggling with addiction.

"Once you cross the line from substance abuse to addiction, it doesn't
matter where you go. You're gonna find it. But I'm just saying here, in the
city of Las Vegas, we have an environment that allows all of that to be met
pretty easily. It's not in other cities.

"I've lived in New York City. I've lived in major cities all around the
country. It's there, too, but it's just not like Las Vegas. This is an open
environment. ... Here you can get a roll of quarters, and if you're an
alcoholic, and even a down-and-out alcoholic, with a roll of quarters you
can go get high every day. It's all that you need."

This doesn't mean residents of Las Vegas ignore the issue of substance
abuse, he adds. When a city runs on gaming, you try to balance the dangers
and the advantages as best you can.

"Outside of all that there's a community here. It's a pretty conservative
community. It's people who care about other people, who care about these
issues. ... The school district is very, very up on drugs, the DARE program,
so there's a community here that is almost in total opposite, in a sense."

Indeed, anyone who needs support in Las Vegas can find it. There are, for
example, more than 600 Alcoholics Anonymous meetings and 70 Narcotics
Anonymous meetings each week.

"People come to Vegas and expect it to be very crazy here, but we have a
very strong fellowship," says "Tom," a longtime Narcotics Anonymous member
who asked that his real name not be used. "They just don't expect it to be
so together, so rock solid."

Most of the major Strip casinos also have proactive employee assistance
programs. Mirage Resorts Inc., for example, allows employees to take up to
six months' leave for inpatient substance abuse counseling. The company
health plan also offers generous coverage for outpatient counseling for both
workers and their immediate families.

"Those of us that are involved in substance abuse treatment and prevention
get a lot of, I'll call it, cooperation from the resort industry in that
they have employee assistance programs," notes Lawrence, who also is
southern vice president of the Nevada Association of Drug and Alcohol
Treatment Providers.

"Some hotels do random drug testing at frequent intervals, and they will
mandate that person to treatment on the basis that they get to keep their
job if they get treatment. So the way I see it, the fathers of the community
want a healthy, substance-free, active, vital work force."

But while support groups are thriving and the city's major industry is
looking after its employees, treatment services are lagging behind. There
are a string of publicly funded programs such as the Community Counseling
Center, Nevada Treatment Center, the Economic Opportunity Board and Westcare
that provide inpatient or outpatient assistance, not to mention private
hospitals such as Montevista and Charter. But there still is a shortfall.

According to a study, "Estimating Substance Abuse and Treatment Need in the
State of Nevada," by the Center for Applied Research at the University of
Nevada, Reno, about 13 percent of Nevadans suffer from substance abuse. Most
of them are addicted to alcohol. Marijuana is the next most frequently used
substance, followed by stimulants and cocaine. About 93 percent of those
abusing at the time of the study had failed to receive treatment by the time
the report was released in June.

"We have reached the conclusion that in Nevada there is a significant need
for increased educational efforts, including prevention, community outreach
and expanded treatment availability," the report states. "Finally, there is
an urgent need to increase the availability of treatment services throughout
Nevada. This is especially true for outpatient treatment, but there are also
significant shortages in terms of the availability of residential and
detoxification treatment services as well."

Last year, about 9,000 Nevada residents received treatment from publicly
funded programs.

"I think we could easily say that you could take that figure and immediately
add 5 percent to 10 percent and we'd still just be meeting the need," says
Rob Johnston, acting chief of the Nevada Bureau of Alcohol and Drug Abuse,
which is a major funding source for many of the state's treatment programs.

"We fund 13 treatment programs in Southern Nevada that offer outpatient
counseling, day treatment for families, long-term residential care for men,
and women and youth, to programs specifically targeted to pregnant women and
women with children to methadone programs. So we've actually covered the
whole gamut, which is part of our salvation and part of our problem at the
same time in that we have a little bit of everything and not enough of
anything."

One of the best indications of this problem is the backlog of people trying
to get into treatment programs, Johnston notes.

"In some cases you cannot get them in fast enough. I may be able to get
somebody in for an assessment interview, but if they need a bed, it could be
a three-month wait at a good many of our facilities in town. And the goal is
that when somebody calls in for help, you want to be able to engage them as
quickly as possible, and so if we can at least get them involved in some
kind of counseling, even while they're living at home or with friends, until
we can get them the level of care that they need, that tends to be what
occurs right now."

Outpatient treatment is not immune either. A few weeks ago, about 250 men
and women were waiting for their intake interviews at the Community
Counseling Center, Lawrence says. Those on these lists usually have to wait
about two weeks for their interviews, he adds.

In addition to the expansion of services, Las Vegas needs a centralized
referral system so people can be led to the right programs, Johnston says.
There also is a great need for supervised transitional housing that does
more than provide a roof over someone's head, he says.

"I would like to see those places expanded so that we have certified staff
who are kind of running those facilities so that you could build in more of
an employment component, more of a case management kind of approach so it's
not just going to bed and going to an AA meeting.

"They need a sense that it'll get better. They need to have this sense that
no matter what has happened, their lives can turn around. And part of the
recovery process is such that it doesn't get better all at once. For many
people, the drinking and the using has just been a symptom of other issues,
and they've never had any time where they haven't been under the influence.
... To me, a supervised transitional living environment gives us that safety
net that right now I don't think we have."

While the major casinos have strong employee assistance programs, there are
many small businesses that have nothing set up at all, Lawrence adds. This
is a danger because employers hold a unique position. They can give workers
some of the tools, such as insurance programs and leave time, to break the
cycle, he says.

"The theory behind this type of intervention is that a work force that can
heal, and really be in a recovery mode and be strong that way, is much
better than bringing employees in and throwing them out on a continuous
basis, because if we do that, we can only be perpetuating the problem,"
Lawrence says.

There have been strides, however.

Local coalitions, city and county representatives and community leaders are
working closer to address the problem of substance abuse on a communitywide
basis, Johnston says. "I think we're in much better shape than we were five
years ago in terms of at least who is all at the table and who is talking to
one another."

Even the criminal justice system is starting to take a different approach.
The year-old Serious Offender Program run by the district attorney's office,
for example, is trying to stop the cycle of habitual drunken driving by
using treatment as the major component.

The program takes offenders with three drunken driving convictions and,
instead of placing them in prison, places them under house arrest. A breath
interlock device is placed in their car so they cannot drive the vehicle
under the influence. But in addition to the monitoring, they are required to
join Alcoholics Anonymous and attend both an individual and group counseling
session each week.

According to Chief Deputy District Attorney Gary Booker, who oversees the
program, every time a person is caught driving under the influence, there
were an average of 75 previous instances they drove drunk without being
discovered. The Serious Offender Program is aimed at getting the offenders
off alcohol for good, something a jail sentence cannot do for some of the
most chronic abusers, he notes.

"Some people have a genetic predisposition toward the use of alcohol and the
behavior of alcohol. ... If I can break the cycle on the father, maybe the
son won't emulate (the father) and say, `Well, I don't want to do this. It
will be unacceptable,'" Booker says.

Booker's view is, perhaps, the linchpin in all of this, according to local
treatment experts. The point may not be whether Las Vegas fuels addictions
to drugs and alcohol. No matter how a person gets to the point of chronic
use, a community has to look for solutions because addiction reaches most
of us, somehow.

"It's estimated that for every alcoholic there's four or five people that
are affected by that alcoholic," Pohl says. "Typically it's families, but if
there's someone who works with them, function is diminished when somebody's
got alcohol or drug dependence. They don't work as good, they don't love as
good, they're not as good parents, they're not as good friends, they're not
as good children in terms of their ability to do the normal functioning things.

"There's a sense of morality attached to addiction, like you're a bad
person," he adds. "Hey, if you're a diabetic, people don't say, `bad
diabetic.' The culture really judges people for their drug and alcohol
addictions."

Estimated percent

of traffic fatalities in which alcohol contributed:

1. District of Columbia: 58.5

2. Rhode Island: 54.6

3. Texas: 49.8

4. Puerto Rico: 49.5

5. North Dakota: 47.8

6. New Hampshire: 47.7

7. Massachusetts: 47.4

8. Nevada: 46.2

U.S. average: 38.6

Source: National Highway Traffic Safety Administration, 1997

(Statistics gathered by National Center for Statistics and Analysis)

Alcohol-related deaths

(per 100,000 residents)

1. District of Columbia: 75

2. Alaska: 51.2

3. New Mexico: 48.1

4. Mississippi: 46.7

5. South Carolina: 43.6

6. Louisiana: 41.6

7. Nevada: 41.2

U.S. average: 33.6

Source: National Institute on Alcohol Abuse and Alcoholism, 1992.