It took one drink to reverse countless hours in group therapy, months of rehabilitation in hospitals and group homes and even the will to help other alcoholics as a sponsor and a hotline volunteer -- in all, three years of sobriety.
Just blocks from her parents' house, after a night of partying with friends, Lisa Stoefen plowed her Mazda Protege into a concrete pole. The car overturned and tumbled down an embankment, crushing the front seat into the back, leaving the remnants of a case of beer. The 21-year-old died instantly.
In the nearly three months since that accident, her family has mounted a public-awareness campaign in her name. Her father, Gary, set up a Web site (www.lisastoefen.com) to alert people to Lisa's story, with poems and photographs. He has given countless speeches around the San Diego area, and he has appealed to Larry King, Oprah Winfrey and "Dr. Phil" in hopes of broadcasting Lisa's story to a national audience.
Lisa's mother, Judy, is lobbying for a house-party ordinance in San Diego that would allow the city to jail or fine adults who allow minors to drink alcohol. And one of Lisa's sisters, Jennifer, works at the North Inland Regional Recovery Center in Escondido.
They say they want as many people as possible to know that abstinence is the only true route to recovery for alcoholics. Gary Stoefen himself is a recovering alcoholic, sober for 23 years.
"There's this myth that somehow we can go back out there and do it differently. It's that delusion that we can become normal drinkers again," he said.
The early signs of Lisa's addiction might have gone unnoticed when she was about to finish the eighth grade. The mood swings, isolation and falling grades could have been attributed to the hormonal turbulence any teenager encounters.
But the Stoefens were alert. Alcoholism hangs heavy on their family tree: In addition to Gary, his son from a previous marriage is in recovery, and Gary said both of his parents and an aunt died of alcoholism. Judy said her uncle also did.
According to the National Institute on Alcohol Abuse and Alcoholism in Bethesda, Md., about 13% of the adult U.S. population will have an alcohol-related disorder at some point.
A person with a parent who is an alcoholic is four times more likely to become an alcoholic, no matter what that person's upbringing, said Dr. Marc Schuckit, a psychiatry professor at the San Diego Veterans Hospital and UC San Diego's medical school.
But, like a tornado that hits one home and spares the next, alcoholism can afflict one child while missing the siblings. Schuckit said Lisa Stoefen's family history made her a likely candidate for the disease. But history didn't predetermine her problem. Schuckit's research, along with that of others who have studied alcoholism, has shown that genes explain a significant portion of the risk but that environment is also a major factor.
From the day they first smelled alcohol on 14-year-old Lisa's breath, the Stoefens said, they took her addiction seriously. They confronted her, sent her to counselors, consulted psychiatrists, forced her to take random drug tests and eventually had her arrested and taken to treatment in Orange County.
By her senior year of high school, seemingly out of options, they sent Lisa to a group home in Louisiana. They took out a second mortgage to pay for the six months of therapy -- well worth it, they said, to see their daughter return healthier than she had been in years.
"When she came home, she was just transformed," Gary said. "She was glowing."
Lisa attended 12-step meetings, including father-daughter sessions. She made new friends. Eventually, she became active in a national group of Alcoholics Anonymous for young people.
"We were so proud of her," Gary said.
Lisa's downfall started about six months before her death. She took a job selling cell phones at a nearby mall and started socializing with people she called "normies," or people who she thought could drink without becoming alcoholics. One of those friends apparently convinced her that drinking in moderation would work for her.
"She said, 'You know Dad, I'm not an alcoholic, don't you?' " Gary recalled. "I knew she was in trouble."
So-called moderation management has worked for fewer than 10% of alcoholics, said Ann Bradley, a spokeswoman at the national institute. They sustain some type of moderate drinking for a time, but even most of them, Bradley said, find abstinence easier.
As her father predicted, Lisa relapsed, then picked up with the 12-step meetings again. Only this time, her father said, her commitment was half-hearted.
Lisa relapsed again, for the final time, in January. Tests showed she had a blood-alcohol level of 0.22, or about three times California's legal limit. Methamphetamine was also found in her system.