How US obsession with addiction has spawned a rehab industry

AMERICA:Too fond of sex? Drugs? Food? Gambling? Rehab centres either give you the chance of being cured or condemn you as an addict

IN A last, desperate bid to save his political career before he resigned this week, Congressman Anthony Weiner announced that he was seeking professional help. “Going to rehab” is an obligatory station in the trajectory of flawed politicians and celebrities.

After the arrest for drink-driving, the overdose or in flagrantebust for adultery, there's a tearful, public confession, a spell in "rehab" – no one says "rehabilitation" any more – and usually, eventually, a relapse.

In the old days, it was called sin. Today, it’s addiction. Americans are addicted to alcohol, drugs, food, the internet, gambling, sex . . . America is addicted to addiction. Rehab speaks to their conviction that there’s a solution to every problem, that redemption can be packaged, commercialised and purchased, and that no matter how many times you fall, you can always start over.

Every year, three million Americans seek treatment in some 12,000 rehab facilities, says Adi Jaffe, the founder of the AllAboutAddiction.com website and a columnist with Psychology Today. Alas, he adds, rehab has at best a 25 per cent long-term success rate.

Facilities range from government-provided outpatient clinics to luxury-resort-style complexes, concentrated in California and Florida. On their websites, complete with testimonials, Malibu facilities like Cliffside and Passages offer luxury rooms with ocean views, massages and five-star cuisine. Treatment costs up to $40,000 a month, and clients are advised that the brain needs at least three months to overcome addiction. Loving relatives are ready to pay any price to save errant spouses or offspring.

It is the luxury rehab centres where actors like Charlie Sheen and Lindsay Lohan seek treatment that capture the imagination of the public. The director of one centre in Malibu said celebrity clients consider they’re providing free publicity and often refuse to pay. “They send out SMS messages to the press, and within hours we’re surrounded by photographers. It causes problems with the other clients.”

Addiction was long a source of social stigma, but celebrities have glamorised and banalised it. "There's no getting around the fact that people want to do what celebrities do," says Jaffe. "In the 1980s, everyone wanted to do cocaine because that's what celebrities did. Now they want to go to rehab – that's an improvement." There is even a cable television show called Celebrity Rehabin which Dr Drew (the first-name basis is a legacy of Alcoholics Anonymous) treats washed-out celebrities. Two of Drew's patients – Mike Starr, the bassist with the Alice in Chains grunge band, and actor Jeff Conaway of Greasefame – died of overdoses this year, hardly a recommendation for Dr Drew's method. Perhaps his spin-off programme Sex Rehabis more effective.

The rehab craze has spawned one of the most unregulated industries in the US. “You and I could start a rehab tomorrow in Los Angeles,” Jaffe says. One simply fills out the application form to receive a licence. A cheaper alternative, known as a “silver living facility” does not even require a licence. One of the services Jaffe offers is a referral system to centres he’s inspected. “I’ve seen places that put 20 or 30 people in a single family home, in bunk beds,” he says. A draft ordinance in Los Angeles would limit rehab centres to three patients to a room.

The prevailing method of treating addiction is known as the “Minnesota model”, after the Hazelden organisation’s first residential centre in Minnesota in 1949. “The 28-day patient model was driven by what insurance would pay for,” says Jaffe. The idea was to end the snake-pit-style institutions in which mental illness and addiction were treated until then.

The vast majority of rehab centres have adapted the 12-step therapy invented by Alcoholics Anonymous back in 1935. The first step is to admit that one is powerless to control one’s addiction. Half of the 12 steps mention God.

“It’s very much a carry-over from the temperance movement of the 1800s,” says Steven Slate, a recovered addict and founder of TheCleanSlate.org website.

“Alcohol was from the devil and you were a sinner. The devil got hold of you. Now it’s the disease that gets hold of you. It’s this outside thing; not me. It’s faith-healing and we are calling it treatment.”

Slate is part of the backlash against America’s rehab culture. He believes the obsession with addiction and rehab has become a self-fulfilling – and self-perpetuating – prophecy.

Like Jeffrey Schaler, the author of Addiction is a Choiceand Gene Heyman, a lecturer in psychology at Harvard Medical school and author of Addiction: A Disorder of Choice,Slate says people do drugs, sex and alcohol because they are pleasurable, and that the best way to overcome addiction is to find other things that make you happy.

Slate blames rehab culture for making people believe they’re engaged in a lifelong struggle against addiction. “It’s horrific,” he says. “They don’t allow people to move on with their lives. They keep them in their clutches.”