Kathy Nelson’s recovery narrative draws on two specific American institutions. The first is Alcoholics Anonymous, which was founded in 1935 by Bill Wilson and Dr. Bob Smith in Akron, Ohio. Their 12-step program is the basis for Kathy’s account of herself at the AA meeting. Notably, Step Eight asks the recovering person to make a list of everyone their addiction has harmed, and Step Nine asks them to make direct amends as long as doing so does not cause additional harm. Kathy’s letter to Joe is written from that framework, for she names what she did, accepts that Joe may not respond, and promises not to contact him again. Additionally, the medallion that Terry Bremer shows Joe—a triangle stamped with “UNITY, SERVICE, RECOVERY” and the inscription “TO THINE OWN SELF BE TRUE” (194)—is a standard AA sobriety token marking 25 years of sobriety.

The second institution that holds relevance in the novel is the Drug Court program, which Kathy mentions as the reason she avoided prison after her second methamphetamine charge. The first American drug court opened in Miami-Dade County, Florida, in 1989, and the model has since spread to every state. The programs combine close judicial supervision in the form of weekly court appearances with mandatory treatment and graduated sanctions. The program typically lasts from 18 months to two years. Eskens’s description tracks the model accurately; Kathy describes weekly court, mandated psychological treatments that deliver diagnoses of bipolar disorder and PTSD, and a length of “at least eighteen months and more likely a couple of years.”

These two frameworks shape the novel’s argument about recovery. Kathy is not cured at the end of the novel; she is sober. She takes lithium, attends meetings, and puts tangible reminders of her past mistakes in prominent places in her home. The novel’s refusal to treat sobriety as a finished state comes directly from the framework established by AA and drug court alike.