It wasn't the gripping pains in his stomach or the violent shaking of his hands or even the humiliation of scrounging money for a drink that made Joe Gulick throw away the bottle.
It was a young intern at the Veteran's Administration Hospital and a three-month stay at Alexandria's Steppingstone Halfway House that helped the 31-year-old Gulick stay sober for the first time in 10 years.
The intern encouraged Gulick to enter the hospital's alcoholic rehabilitation unit. Afterward, Steppingstone helped Gulick ease from the safe hospital environment back into the demanding mainstream of society.
While living at Steppingstone, the man who had once begged doctors to cut out his pancreas so he could drink without pain, enrolled in college and made the dean's list. Today he is working toward a degree in human services (alcohol and drug counseling). But for Gulick, the biggest achievement is that he hasn't touched alcohol in 13 months.
Last week, the halfway house that helped Gulick and nearly 200 other alcoholics back into society celebrated its third anniversary with a festive open house. About 100 guests gathered in the unobtrusive, mustard-colored building at King and West streets to toast Steppingstone's success - with fruit punch, soft drinks, coffee and tea.
It was almost like a family reunion. Stacks of cold cuts and piles of homemade salads were devoured as old friends were hugged and stories were swapped.
Current residents and counselors played host to former residents and their families. Community members met their Steppingstone neighbors, and representatives from the city's mental health department chatted with residents in a homey recreation room.
Steppingstone, one of nine alcohol and drug programs administered by the the city division of substance abuse, is the only city-run halfway house for alcoholics in Alexandria.
Up to 15 low-income men and women can be housed in Steppingstone. Past residents have ranged in age from 18 to 62 and have represented a variety of backgrounds. Eight counselors work with the residents to provide counseling, employment counseling and assistance, educational and recreational avtivities and aftercare.
Employed residents are charged $40 a week, with the bulk of the expenses paid by the city, the state and the National Institute on Alcohol Abuse and Alcoholism.
"Recovering alcoholics can stay at the halfway house for as long as six months," said Susan Kirchberg, head of the division of substance abuse. "Whether the individual stay is that long or the average 75 days, each resident works toward the goal of leaving the facility healthy, employed and able to cope with life without the use of alcohol."
The Steppingstone environment is structured to help recovering alcoholics develop responsible living skills, said Kirchberg. Breakfast is served from 6 a.m. to 7 a.m., sandwiches are provided for those who leave for work, and dinner begins promptly at 5:30.
Evenings are filled with group and individual counseling sessions and a weekly Alcoholics Anonymous meeting that is also attended by ex-residents and community members. Curfew is at 11 p.m., and weekend passes may be issued.
Allowances can be made, in unusual circumstances, for missing meals or meetings if the resident calls Steppingstone to let counselors know where he or she is. Only one rule is strictly enforced - the use of alcohol means immediate dismissal.
"A halfway house is an important part of the conitnuum of care required in the alcoholism recovery process," said program director Lamoine Knifelkamp. "A detox unit provides primary medical care, but if a person isn't employed and doesn't have a place to stay there needs to be a facility that will address those kinds of needs."
The halfway house has become an increasingly important stage of treatment for alcoholism, Knefelkamp said. In 1963 there were just 40 halfway houses for recovering alcoholics in the United States, a number that had jumped to 597 by 1973 and 750 by 1977, according to studies done in those years by the NIAAA, the National Institute of Mental Health and Rausche and Rausche.
"It helped me," said Gulick, whose attendance at the party marked his first visit back to Steppingstone since he left last fall. "Everytime I was supposed to be discharged from the hospital I was afraid to leave because I knew if I had the run of the world, I might not make it.
"At first, being at Steppingstone was frustrating for a person like myself used to coming and going as I pleased. But, of course, it was voluntary and I knew there would be enforced discipline. I figured if it was induced on me, maybe I could train myself."
"The thing I like about living here is the support and encouragement," said a 25-year-old woman who had begun drinking to kick her morphine addiction and is now employed by a firm that will pay for her college training. "It's a real caring type of atmosphere where everyone is going through the same thing.
"Everyone pulls for you here, they all really want you to make it," she said quietly, balancing a plate of food on her lap and looking around the crowded room. "These people are very special. In a way, they're closer to me than my family."