"I can tell you ways to get high you wouldn't believe," Sandi Schraut, RN, says with such conviction that you know it must be true.

Schraut, 52, deals with the chemically dependent in a 28-bed alcohol rehabilitation unit and 12-bed detox unit at the Anoka (Minn.) Regional Treatment Center. In eight years at the state hospital, starting as a float nurse and for a time as an admissions RN, she also has worked with the facility's mentally ill: schizophrenics, bipolars and anti-socials.

"Anti-social personality disorder seems to go hand-in-hand with chemically dependent folks," Schraut said. "Anti-social people don't think rules are meant for them or they think that if no one sees them break a rule, they haven't broken it."

The nursing staff has to meet regularly to agree on rules to put up a unified front, Schraut said, because "It's easy for these people to do staff splitting. If one staff says no, they'll go to the next staff and the next until they can find somebody who's a little more easy to push around."

It's alcohol, though, that makes for a tough crowd. In detox, "A lot of times they're brought in by the police and they're not happy about being there," let alone for the minimum 48 hours, Schraut said.

In treatment, about 90 percent of patients are committed by the court; many are resentful and unmotivated. Some go through treatment three or four times before they see-if they ever do-the benefits of sobriety, she said.

But even in them, Schraut sees the positive. They are living examples for the younger people, testimonies to the effects of drinking for 25 or 35 years.

Particularly memorable for Schraut was a woman in her early 50s with "a lovely Southern accent," a standout in Minnesota. "The sweetest lady you'd ever want to meet in your whole life could not stop drinking," Schraut said, and despite having gone through treatment several times, she was found dead of liver disease with a bottle in her hand.

Chemical dependence RNs see all manner of liver, kidney, pancreatic and brain disease.

Schraut said she's seen patients who, at 40, are in the late stages of dementia. Then there is Wernicke's syndrome, the alcohol-induced deterioration of the brain that is roughly equivalent to Alzheimer's disease. And the facility sees more than its share of AIDS patients. At one time, three of 28 treatment beds were AIDS cases, Schraut said.

She said she set out to be an RN after high school and worked as an LPN in orthopedics and orthopedic surgery while rearing six children. Ten years ago, she completed the RN program at Anoka-Ramsey Community College and soon found her way to the state hospital.

The nursing staff's priority is to stabilize patients medically and then pursue treatment, whether it be solely for alcohol or abuse of alcohol and other substances that ranges from "huffing" paint to the use of heroin or cocaine.

"It's easy to get real sour when you're working with these people," Schraut said.

To cope, it's important to remember that you're dealing with an illness, she said. "Nobody sets out in life saying, 'I'm going to be a drunk.' When you're a young kid and you're looking at your future, that's not what you're looking for."

Schraut has another way of coping: writing.

Her first book of self-published poetry was colored by life experiences. Her next, to be titled Psychotica, will draw heavily on her work with the addicted and mentally ill, she said.

She also has a couple of novels in the works. "One is medical fiction, surprise, surprise," she said. "The other is science fiction.

"Writing is part of the outlet, part of the way I deal with emotions that come out of working with hard cases and difficult people," Schraut said.

It's also her way of speaking personally to thousands of people on the fringes of mental illness and chemical dependence. Between depression and alcohol, not to mention other substance abuse, "Everybody has had some experience with it, either personally or with a family member," she said.

As a nurse and a writer, Schraut said her heart goes out to the chemically dependent "because you know how big that monkey is on their back."

Contact Phil McPeck at getpjm@aol.com.