In the late stages of her drinking, Laura Eben was too weak to hold a can of beer.
She felt her body shutting down. Time and time again, at critical moments, Eben went to one of two detox centers in Anchorage. She spent days in the painful throes of detox, her body withdrawing from long-term alcohol abuse.
A combination of prayer and a 90-day treatment program ended Eben's drinking years ago. But Eben, 66, said detox gave her the chance to do it.
"If I did not have detox, I would have died," said Eben, originally from the Bering Sea village of Scammon Bay. "If I hadn't stopped drinking, I would be dead today, too."
In Anchorage, a city of 300,000 people, there's just one center providing 14 beds for detox, a medically supervised period of alcohol withdrawal. In the past year, a coalition of Anchorage churches has stepped up efforts to find solutions for what they say is a critical shortage of detox beds outside of emergency rooms.
On Monday, a town hall meeting in East Anchorage will mark the second such meeting on the issue in a year. It comes after a series of "research meetings" that members of the coalition, AFACT (Anchorage Faith & Action -- Congregations Together) have held with politicians, state officials and social service providers. The effort stemmed from dozens of one-on-one interviews between church leaders and parishioners, where alcohol and detox access emerged as the primary concern.
Eben and other church members, affected personally by alcohol, have joined the effort. While detox is not a cure for addiction, they say it's the first step for an alcoholic who wants to make a change.
In February 2015, people lined up in First Covenant Church to testify about their experiences with alcohol and detox before Anchorage Assembly members Dick Traini and Bill Evans, members of the Assembly's ad hoc committee on alcohol and substance abuse.
Since that first meeting, not much has changed, said Phil Cannon, associate pastor at First Covenant Church. Now AFACT leaders are looking elsewhere in government -- two state health officials are expected to attend Monday's meeting, as well as Mayor Ethan Berkowitz.
Coalition leaders say the scarcity in detox beds is creating a bottleneck. A person seeking treatment for alcohol abuse needs to be detoxed first, but access to detox in Anchorage is limited, said Sister Mary Peter Diaz, an AFACT coordinator from Anchorage's Catholic Native Ministry and Hispanic Ministry.
One particular factor to be highlighted at Monday's meeting is nursing oversight.
In 2012, after a state audit, the Alaska Board of Nursing said only registered nurses could conduct the initial assessment for a client, which includes recording vital signs and noting tremors, nausea or other symptoms specific to detox. For about a decade until that point, less extensively trained licensed practical nurses, or LPNs, performed the assessment.
The board's ruling has translated into fewer nurses who are qualified to admit patients to the Ernie Turner Center. By extension, fewer people are being treated, said Rebecca Ling, director of recovery services for Cook Inlet Tribal Council, the nonprofit organization that runs the center.
"We're not turning anyone away, but there's no available beds for people that are calling," Ling said. "No available beds, or no nurse that could do an admission at that moment."
Between 2009 and 2012, the Turner center admitted an average of 543 people per year, Gloria O'Neill, president and CEO of CITC, wrote in a May 2015 memo to the state nursing board. She said the number had since fallen to 339, in spite of staffing increases and shift changes.
O'Neill estimated it had cost the tribal council an extra $400,000 per year to staff the detox program with RNs.
AFACT leaders say in their view, the regulations need to be revised, or the state needs to boost funding to allow for more nurses to be hired.
"We're not the experts here, but we see this as a clear route that needs to be considered at least," said Heidi Jensen, a member of First Covenant Church who testified on the issue at the state nursing board's January meeting. "The way things are, with the current regulation, it's blocking access to care."
With the hiring of a new homelessness coordinator, Nancy Burke, Berkowitz has intensified efforts to house the city's most vulnerable homeless people and expand treatment options. He and Burke met with AFACT recently to discuss the concerns about detox. But they didn't deliver the message the coalition hoped for.
"We shared with them our view that detox is one very, very important part of a continuum of access to treatment," Burke said in a recent interview. "And it doesn't make too much sense for us to emphasize building detox units without then having some place where people can go."
Burke said the mayor's office is currently focusing on a $5 million pool of money, appropriated to the city years ago, that was supposed to be used to renovate the Clitheroe Center, an intensive substance abuse treatment center that also used to offer detox services.
The mayor's office is seeking legislative changes to the appropriation to allow the city to move forward with rebuilding Clitheroe's treatment beds, and potentially expand into more of a full-service "recovery campus," Burke said.
Randall Burns, the acting director of the state Division of Behavioral Health, said in a Friday interview he's heard reports of people having trouble getting into detox. But he said no recent studies have been completed assessing the need.
He added that to his knowledge, no social service providers had approached the division about providing new detox beds in Anchorage.
"It's a complicated service," said Burns, who is scheduled to attend Monday's meeting. "It takes a lot of staff."
In a group interview last week, members of the church coalition said they see detox as a critical intervention point. Detoxing from severe alcoholism can be more dangerous than detoxing from drugs, Ling said -- withdrawal symptoms can include delirium, heart failure and seizures.
"Detox saves lives," Eben said. "And detox gives a person a chance to listen to family and change behavior and stay away from that bottle."
In the short term, the state nursing board is scheduled to discuss the nursing oversight question at its March meeting. Funding is a different problem. As the state grapples with a fiscal crisis, AFACT leaders acknowledge it's unlikely more money will be put toward adding detox units.
But they say they want to at least convene the people who can do something about the issue.
One of Margie Bell's family members was 43 when he died waiting to go to detox. Bell watched it happen. And she's heard of many others dying the same way.
"That's why I do this," Bell said. "I'd like to see my people stand up sober and proud one day."
As of Friday, Ling said, between 58 and 62 people were on the waitlist at the Turner center. The way to get in, she said, is to call every single day.
The town hall on Monday is set to start at 7 p.m. Monday at St. Anthony's Catholic Church in Anchorage.