For decades, the Fetzers skipped alcohol at their holiday gatherings.
They did it for Racquel. "In a sense, the family was putting everything that we like to do on hold," said Teresa, her mother.
Racquel, who started drinking at 12, rarely turned up anyway. Christmas was a day to get high in front of a tree with no gifts, or perhaps to sell her boyfriend's gifts (as he would sell hers) on the street for drugs — heroin, alcohol, crack, coke, meth, Xanax.
Racquel, now 30, got clean on Aug. 6, 2016, six days after she robbed a Washington Savings bank near her family's Port Richmond home. The gunless robbery netted $986 and set her on a new path, she said, beginning with a 12-step fellowship in jail. Now working as a certified recovery specialist at the Philadelphia Recovery Community Center, she says she feels strong in her recovery and is looking forward to her first holiday gatherings in years. "My family can count on me," she said.
Her parents and other relatives who host family gatherings are taking no chances. "We don't know that alcohol will trigger her but we don't want to encourage it," her mother said. "You have no idea how happy I am that my daughter is OK today."
Nearly eight million Americans have a drug use disorder and 16 million abuse alcohol (and many use both), according to the National Center for Health Statistics. Addiction, driven by opioids, is touching more and more households.
And holiday gatherings — the drinking, stress, and either isolation or reconnection with unhealthy relationships of the past —add a combustible mix. But people in recovery and their families can tamp down the danger, experts say, if they plan ahead and are willing to make accomodations.
There is nothing intrinsically risky about turkey or tinsel. It's the memories of long-ago celebrations and what went with them. Scientists call it long-term potentiation.
"What drugs do is they tend to lend emotional significance to memories of prior drug use," said Kyle Kampman, a clinical psychiatrist and researcher at the University of Pennsylvania. It involves the release of a neurotransmitter that strengthens the brain's pleasure response.
This season of generosity brings more opportunity, too. "Even people who are panhandling, their money goes up during the holidays," said Beverly J. Haberle, executive director of the Council of Southeast Pennsylvania, the regional affiliate of the National Council on Alcoholism and Drug Dependence.
Celebrations "give an addict or alcoholic free rein. Everybody else is doing it," said Michele Pole, director of psychology for Caron Treatment Centers in Wernersville, Pa.
Someone in the throes of addiction often is unable to listen to advice, although families sometimes can use the holidays to motivate their loved ones to get into treatment. Admissions at Caron, typically low in November and much of December, go up the day before Thanksgiving and the day before Christmas, she said, and rise again through the end of December.
Some families may need to set boundaries. You might say, "either you get treatment or you are not part of our lives," said Pole, a clinical psychologist. "It may sound really harsh but active addiction can really ruin [the holidays] for families."
People in recovery, on the other hand, need support, including an environment that won't make the holidays even harder. Alcohol at a party can be a trigger even if it wasn't the drug of choice. The effects may not be apparent for several days. "Just the stress of getting through the event can lead to a relapse," Pole said.
Getting through the holidays is all about support, she said — from sponsors, from 12-step meetings now available at any hour, from attending parties where everyone is sober and working on their recovery.
Salim Rashid, 66, lost both his parents around the holidays when he was a teenager, so this time of year has always brought gloom along with the usual stresses. The retired New York City subway operator who now lives in East Falls refers to a stint in prison in his 30s as a "rescue." It forced him off heroin and, when he got out, into treatment to stay off.
He avoided family celebrations for years, seeking support instead from his new sober community. These days, he enjoys the season. Faced with alcohol, Rashid said, he simply doesn't drink.
"Now after 30 years, I have a healthy relationship with my family. I have a healthy relationship with the holidays. Things have changed."
Ten ways for families and those in recovery to have a better holiday
Michele Pole, director of psychology at Caron Treatment Centers, offers these suggestions:
Tell loved ones in recovery that you are thinking about them. Offer support. Don't avoid them. Isolation makes it worse.
Don't press them to attend a gathering they find uncomfortable. And don't police them if they come.
Avoid offering unsolicited advice.
Don't make alcohol a focus of your gathering. Even if someone in recovery studiously avoids the wine, it could plant a seed and trigger relapse later — even if their drug of choice was something else.
Setting boundaries is fine. If they are still using, make clear they will be welcome only if sober. The holidays can add motivation to enter treatment.
For people in recovery
Plan ahead. Staying clean is priority No. 1. Set your own boundaries. You may need to tell family: "It is really not good for me to be here."
Seek out alternatives. A sober party may be a better choice than a family that likes to drink.
Attend 12-step meetings, which are held at all hours during the holiday season, both before and after a family gathering.
Bring sober support — a sponsor or friend in recovery — to the party.
Stay connected in every way possible. Text your sober friends under the family dinner table if it helps.