In February, 2017, I stepped off a plane in Tampa, drunk and dope-sick. I was twenty-four, and for the past eight years I had been shooting up heroin, cocaine, and all manner of pills: Dilaudid, Opana, OxyContin, Desoxyn, Ritalin. Now I was on my way to River Oaks, an addiction-treatment center, where I would spend the next forty-five days. River Oaks was on a gated campus, surrounded by a small forest with trails running through it. I was withdrawing from heroin and benzodiazepines at the time, and mornings were the worst: I woke in the dark at 6 A.M., the pain of withdrawal not yet mediated by the day’s first dose of Suboxone or Librium. I promised anyone who met me that I would die, simply die, of withdrawal; when, on day twenty-three, I had a seizure, I thought, Yes, I am really dying, but then I lived.

We had access to dietitians and personal trainers, yoga sessions and intravenous vitamin therapy; pharmacogenetic testing determined which medications worked best with our DNA. When it was time to leave, I had become so comfortable that I walked the grounds barefoot, making laps around the Serenity Trail, feeding apples to the horses by the stables where we met for equine therapy, on Wednesdays.

I made a few friends there, but we soon dispersed, some to Baltimore, others to New Jersey, one to wake up in the morning to find that his girlfriend had died beside him in the night, high on heroin, having aspirated her vomit. The rest of us—those without jobs, school, or families calling us home—moved into sober homes in South Florida.

South Florida—the densely populated area comprising Palm Beach, Broward, and Miami-Dade counties—has four hundred and seventy-eight licensed facilities for drug treatment. There are more treatment centers than public elementary schools. It’s difficult to live here for long without hearing someone’s sad story: the Lyft driver who loved cocaine and still does, but from a distance now; the anesthesiologist who studied at Johns Hopkins and shot up fentanyl before it was popular.

For the next few months, I moved between recovery and relapse, cycling through the Twelve Steps, then going off in search of drugs. I would walk out of group therapy in a huff and then, days later, check into another detox for whatever length of time insurance would cover. After inpatient rehab, I’d move to sober housing and enroll in an outpatient program at a nearby clinic. As long as I was insured, I didn’t have to touch money. There’s a name for this peripatetic life style: clinicians, clients, and local officials call it the Florida Shuffle.

I spent the month of May in Delray Beach, in an antebellum-style mansion with Spanish moss hanging from the trees in the front yard, spiral staircases indoors, and large white vitrified tiles in the dining room. This was a partial-hospitalization program, where people are sent after they detox from a relapse. We recited the Serenity Prayer before we ate, pleased by the way we felt ourselves rising to the occasion. Many of us were not yet twenty-five, but we had lived in a disorderly way, and because of that we felt ancient, as if we had survived something, which we had. It was only honorable that we should try to live well.

In June, I found myself living, for the second time, in an old residential motel in Boca Raton, which had been converted into apartments for drug addicts and alcoholics passing between rehab and polite society. The apartments were on a street called West Camino Real; nearby, houses sell for about a million dollars and even the grocery store offers valet parking. My building was tiny, spare, and utilitarian. Each day, we were required to attend four hours of group therapy; each week, we had our urine tested for drugs. Both of these services were billable to insurance.

In our spare time, in the desolating heat, we would sit at a picnic table in the parking lot to chain-smoke and drink Red Bull and play spades or poker. I smoked forty cigarettes a day—Marlboro Red 100s, the long ones. Struggling to bury how lonely we were, and how afraid, we traded war stories, recalling the drugs we had done and loved, and the times they took us down—each of us striving to top his neighbors’ wretchedness, to prove himself exceptional in his ability to ruin himself totally. It was easy to get lost, to lose track, to lose time between the weeks and days and palm-tree afternoons. News of relapses, of overdoses and deaths, was always breaking, and so the emergencies that one day held us rapt were soon supplanted by new ones.

We spoke about emotions, trauma, illness, about whether we had succumbed to influences, experiments, pressures—or whether we had been born this way. Perhaps the source of our addiction lay deep in our genes, beyond poppies or cartels or Big Pharma. Or perhaps we had simply made bad choices.

One day, I get a phone call from Michelle, whom I know from River Oaks. (Some names have been changed.) She moved to South Florida the week after I did, at the age of nineteen, after twelve trips to detox in the previous five months. Now she says that she left her sober housing the night before, with her boyfriend, Dylan, and that since then they have been shooting heroin in his car, where, she supposes, they live now. But the dope was so good, she says, that she had to use only a quarter of her usual dose to wreck herself.

It isn’t as if Michelle is pressuring me to get high with her, but she reminds me of drugs, of their purchase on total escape. She reminds me that I wish I were on drugs right now.

“The frame is too Louie-Schmooie.” Facebook

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Shopping Cartoon by George Booth

“And you’re getting more?” I ask.

For many years, South Florida’s addiction-treatment landscape was celebrated as a haven for Twelve Step programs. In 2007, the Times described the constellation of sober homes in Delray Beach, a city of sixty-eight thousand, as “a funky outpost of sobriety,” and “the epicenter of the country’s largest and most vibrant recovery community.”

This community began to take shape in the late sixties, when a doctor, a pharmacist, and a police officer—Frank Kucera, Bill Plum, and Bill Cochran—assembled the Drug Abuse Foundation, a small group of volunteers concerned with drug-use-prevention efforts. In the following years, the main substances abused were alcohol, cocaine, barbiturates, and amphetamines—Quaaludes, Miltown, Dexamyl, Dexedrine. Responding to a mounting public need, Palm Beach County started the Comprehensive Alcohol and Rehabilitation Programs, in 1967. Several new halfway houses opened, funded by the county, but many of their rehabilitation methods were experimental, such as forcing residents to wear a sign around their neck if they broke a house rule.

Still, South Florida appealed to private residential-rehab facilities, which developed outpatient treatment plans of their own. Soon, people came from across the United States to Delray Beach to open what would be called “recovery residences.” John Lehman, a consultant for the Recovery Outcomes Institute, a research agency and mentorship program, told me, “What emerged in Delray Beach was a very robust Twelve Step community, a lot of A.A. and N.A. meetings. Those meeting rooms were filled with individuals who were coming from all over the world to live in recovery residences, and it flourished—it just grew—and people were doing really well.”