Rehab's Role In Treating Addiction

Rehab clinics are explained by experts -- both for celebrities as well for the common man.

It seems like there is a new celebrity actor or singer every week who visits a rehab center for a substance abuse or addiction problem. Celebrities often go to rehabilitation in exclusive facilities with ocean views and marble baths.

It's enough to give addiction treatment a bad name. A 30-day stay in a rehab clinic used to be a common treatment for addicts. It's not covered by insurance today and is therefore too expensive for the majority of Americans. Is this to say that only the wealthy and well-known can get effective treatment?

The good news is that the answer to this question is "no". Outpatient treatment has proven to be equally effective for many addicts, experts say. No program is perfect. The patient has to make an effort for their recovery. You can learn more about outpatient heroin rehab.

What Rehab Does

Whether you're a celebrity or just a regular person, addiction treatment typically involves a similar series of steps:

Detoxification. About half of the addicts who come to Butler Hospital in Providence, R.I., must check in as an inpatient for three to five days of "acute stabilization," Alan Gordon, MD, Butler's chief of addiction rehabilitation, tells WebMD. Others must deal with withdrawal symptoms such as paranoia and tremors. Some must also deal with their domestic or legal problems. (In outpatient programs, such as the one at Butler Hospital's, detox is the only component.

Diagnosis. Many addicts also suffer from psychiatric problems -- such as sleep disorders, bipolar disorder, depression, and anxiety -- or have faced traumatic life experiences such as rape or incest. While the exact relation between these problems and substance abuse may not be clear, many addiction treatment programs link up patients with psychiatrists or therapy groups.

Cognitive therapy. This therapy helps addicts realize which life situations are most likely to trigger substance abuse, says Newt Galusha, MD, of Harris Methodist Springwood Hospital in Bedford, Texas. Then the addicts develop alternative plans. For example, if an addict usually drinks after arguing with a spouse, he might learn to end those fights by counting to 10 or going to an Alcoholics Anonymous meeting instead of going to a bar. Addicts also learn "assertive skills" that help them learn how to say no to drugs or alcohol, Gordon says.

Therapy for families. Many programs bring family members into the program to heal damaged relationships and shore up the addict's support network. Support from family members is key to helping addicts stay clean over the long run, Garrett O'Connor, MD, chief psychiatrist at the Betty Ford Center, tells WebMD.

Medication. An FDA-approved medication, Campral, helps people with alcohol dependence who have quit stay alcohol-free. Another FDA-approved drug, Suboxone, treats addiction to opiates (including heroin and some prescription painkillers); it reduces withdrawal symptoms and cravings. Gordon claims that Suboxone works in a similar way to methadone and is more resistant to abuse.

Introduction to 12 step programs. Fred Berger MD is the center's medical director. He recommends that patients go to "90 meetings in 90 day" at Scripps McDonalds in La Jolla. Many centers encourage patients to attend Alcoholics Anonymous or other forms of group therapy for a year or more after treatment.

How Addiction Works

Celebrities often check in. With stories about miraculous turnarounds, they check out. They check back in sometimes and then they go on to the next thing. Are they exhibiting poor self-control?

According to experts in rehab, treatment is highly effective. But to understand how to gauge effectiveness, it's good to know a bit about how addiction works.

Experts now agree that addiction is a brain disease with a genetic component, Gordon says. It can also be affected by one's behavior. This behavioral component makes addiction comparable to other chronic illnesses such as diabetes and high cholesterol. There is no pill or operation that can "cure" such diseases. These diseases require long-term treatment along with behavioral and lifestyle changes.

While most addiction treatment programs set abstinence as a goal, a relapse isn't a reason to give up on a patient as hopeless -- just as you wouldn't give up on a diabetes patient who goes on a sugar binge, says Michael Scott, MD of the Sierra Tucson treatment clinic in Tucson, Ariz. "Addicts have their ups and downs, but you can take that information and work with it to see how to do better," Scott tells WebMD.

Gordon states that around 50% of Butler Hospital patients remain sober after one year. Many who do relapse, however, "don't fall in a pit of despair," Gordon says. Relapsed patients return to therapy to improve on their behavioral skills.

Galusha says that studies show an association between success in treatment and treatment length and intensity. It usually means that treatment should last at least 3 weeks, with several hours of therapy per day. This can be followed up by regular attendance at AA meetings or any other group therapy for around a year.

Who is the patient who benefits from inpatient care?

A 30-day stay in a clinic used to be the standard treatment for addicts. Gordon states that insurance companies balked at paying for the treatment after the advent of managed healthcare in the 1980s. Numerous clinics closed, making it difficult for insurers to provide coverage for inpatient care. Galusha states that some insurance policies now cover inpatient care at very affordable facilities.

Experts say inpatient treatment is most needed by addicts coming from a chaotic environment or who suffer from a severe psychiatric illness. Berger states that inpatient treatment is best for family members who are addicted to substances. Outpatient care may not be suitable for patients who are married or have a stable job.

Experts say that a single homeless mom living in a drug-infested area might be eligible for inpatient care. A hard partying star who travels between concert venues or movie sets could also qualify. Celebrities can easily spend thousands of dollars per day on their treatment while the homeless mother is dependent upon the government.

High cost of treatment

Sierra Tucson is a clinic that has seen Ringo Starr, Michael Douglas and Mark Foley. The cost of treatment at the facility costs around $1,200 per person. You can enjoy a pool and spa as well as a gym, climbing walls, and even stables for horses. Scott says Sierra Tucson doesn't serve as a retreat. Instead, patients spend their days in "emotionally draining recovery" activities. We treat them intensely and they respond well to our treatment.

Lower rates are available at other, more simple inpatient facilities. Houston's RightStep chain charges $8500 for one month inpatient care. The company claims to have "preferred agreements” with several major insurers. Intensive outpatient care costs $3,000

What is the Best Way to Find a Good Clinic?

Berger recommends consulting your physician or friends. Look for a clinic that is staffed with addiction-certified counselors and medical staff, says Galusha. Gordon also recommends that you look for clinics that have medical personnel that are able to treat the psychological problems often associated with addiction. This usually involves accessing counselors in addition to psychiatrists.

The High-Profile Ego: How to Treat It

Celebrities and other public figures may be able to afford expensive clinics. Experts who see them often say that they face unique challenges in getting clean and sober.

Scott says that celebrities and high-profile individuals are often surrounded by people with a stake in their success. There is much at stake whether it be a political campaign, concert tour or movie production. So not everyone in the entourage may be so accepting when an addict needs to take time out for group therapy or to stay away from events where liquor is served.

Scott notes that successful people who have large egos can be difficult to deal with. Scott says that these people have done so much in life, it is hard for them to believe they don't possess the ability to [kick this habit].

O'Connor sees a variety of highly-skilled professionals, as well as celebrities. Doctors, pilots, and the like are expected to be high achievers, O'Connor says, and addicts in these professions have developed a matching ability to deny and rationalize their abuse. So it is especially difficult for these people to admit that they have let people down because of their addiction. O'Connor states that a huge cistern full of sorrow accompanies these people to the center. "What we actually treat is the shamefulness of it all."