“Bob, this place sucks. I can’t take it here.”
“What’s the problem?”
It could be almost anything. “They don’t treat me right. They talk down to me. They’re late with my medication. They told me I couldn’t smoke over in that area.”
“Well, look. I can see your point, but come on. Those are the reasons why you want to leave? You want to leave because you want to get high. And if you leave now, you’ll be high within twenty-four hours. Guaranteed.”
The thing that I’ve found is that addicts have an almost unwavering belief in the righteousness of their arguments and complaints. About everything. And a lot of the time, they are right. I’ll take their side against the facility. But my job is to get them to see that the real issue at play isn’t some supposed slight or a restriction, but that those are just excuses to give in to the disease. If you throw bullshit at a patient, they’ll leave. If you show some compassion and they can see that you’re straight with them, most of the time, they’ll stay.
I also learned that there was an underlying problem with addiction: personality disorder. It often leads to self-medicating, which often leads to addiction. And unless a person’s sober, they can’t begin to work on that successfully. I knew that from my own experiences. I started to see connections between my work and my personal history, although it took me a while to recognize them. When I was at Las Encinas, they’d send me to the locked ward to do consultations. I’d go and evaluate the patient.
“What do you think, Bob?” Drew would ask.
“That girl’s just another addict! She could be any one of us.”
“Bob, there are other psychiatric conditions besides addiction, and you have to sort those things out.”
“No, no. She’s been completely adulterated by medications. She’s an addict and needs recovery.”
“Bob, it’s a little more complicated than that.”
However, he did respect my belief that for a lot of patients, medicine was overdone and overprescribed. Drug addicts used to populate the fringes of society, and they slipped in and out of a shadowy world most people didn’t even know existed, or, if they did, they didn’t know where to find it. Now you see great, wonderful people—young, old, in between—from all walks of life who desperately scuttle about to maintain that buzz, and in the process, sometimes they overdose and die. It’s a shameful thing and it gets worse every year. An entire industry keeps people doped and drugged and reaps huge profits under the guise of modern medicine.
And growing right alongside the pharmaceutical industry is the business of rehabilitation. My experiences through more than twenty different rehab programs have given me more than a little bit of insight into the game. Far too often, rehab just sells a commodity—sobriety—in the same sleazy, cynical way a late-night TV pitchman hawks used cars. And, like those cars, sobriety’s often a shoddy product. What else would you call something with such a spectacular failure rate? A lot of the time it looks like a straight con job. A distraught parent or relative calls up to say, “I have a loved one who’s an addict! I don’t know what to do!” The calm voice on the line says, “You have to get them into treatment immediately. If you don’t, they’ll die. We have a bed waiting.” Now, that’s a heavy thing to lay on a near-hysterical person. When a thirty-day stay can cost tens of thousands of dollars—or more—and insurance won’t cover it, then what? Well, your understanding friend on the end of the line will just transfer you over to the facility’s very own credit bureau, which will advise you about mortgaging your home to pay for treatment—which may or may not do your loved one any good at all. But those beds have to stay occupied and the facility gets its cut whether the program succeeds or not. I frequently find myself questioning the ethics of this business.
People in the rehab industry want to make money just like everybody else who works for a paycheck, but too often they get greedy. I’ve never been overly concerned about how much money I could make at this. I want to get paid too. This is, after all, a job I do. But I don’t feel the need to make millions of dollars. And if you think I couldn’t make that kind of money in this industry now, you’re nuts. I just couldn’t live with myself if what I did was con families out of a huge fee and exploit their fear and desperation.
At times, it seems that much of the recovery industry is riddled with corruption. You can’t trust anybody. Celebrities, especially, have it tough when they seek treatment. Not only are they ridiculed in the press and popular culture, they’re often exploited and their confidentiality as patients is violated. Any program that treats an A-list star can get put on the map by that one famous client. One of the reasons I chose Hazelden as my first rehab facility was because Elizabeth Taylor had gone there. Some of these places are prepared to leak that information to the press, although it doesn’t always happen that directly. Some hospitals have publicity and advertising departments that exist solely for the purpose of exploiting this kind of information. Worse, staff and patients have been known to sell out their celebrity clients to the tabloid press in order to flip a quick buck. Aerosmith front man Steven Tyler once told me he had been in the Priory—a well-known, high-end London clinic—for treatment and his roommate had sold the intimate details of Steven’s stay to one of the big British tabloids—which all too happily published the salaciously edited details.
Almost worse is that in the effort to keep celebrity patients in the facility and to exploit them as powerful marketing tools, the stars are allowed
