Some people seem to spend their time going in and out of rehab, so how can they kick their addiction once and for all, asks FIONOLA MEREDITH
IT SEEMS THAT a regular stint in a rehabilitation clinic has become an expected part of many celebrities’ lives, usually following some kind of spectacularly humiliating – and career-threatening – lapse into addiction.
It’s often portrayed as an act of contrition, a public demonstration of their willingness to put their demons behind them. But many such clinics appear to have a revolving door, with celebrity addicts checking in to dry out, then resuming their self-destructive habits when they’re back in the real world, before eventually ending up in a sorry state back at the clinic again.
It’s a well-worn path, with the likes of Charlie Sheen and Lindsay Lohan providing endless fodder for the gossip columns with their repeated stays in expensive addiction units. The late Amy Winehouse was notorious for her ambivalent relationship with rehab: she checked herself out of the Priory clinic in London just weeks before her death.
So the question is: does rehab really work? For a start, there’s a world of difference between a spoilt celebrity using a stay in rehabilitation as a get-out-of-jail-free card – a way to cover up their excesses and misdemeanours without any real intention of doing the hard work necessary to get better – and ordinary people who are desperate to overcome the addictions that are wrecking their own lives and, by extension, the lives of their loves ones. But whether you attend a luxurious and exclusive “destination” rehab clinic or a less showy (and costly) institution, the process is essentially the same.
Austin Prior, deputy director of the Rutland Centre, a private addiction rehabilitation centre in Dublin, says the people who come to them have often tried to stop their addictions on their own, but without success.
“Institutional rehabilitation provides the opportunity and setting to address the underlying issues associated with addiction. It’s a full-on, full-time process.”
The hot-house environment is a vital part of the five-week residential programme, providing a daily structure for participants from first thing in the morning to last thing at night. It’s a powerful corrective to the chaotic existence of someone who suffers from an addiction.
“The programme is centred around group-therapy sessions, which has been shown to be most effective in addiction treatment,” says Prior.
Addiction thrives on deception and denial, and it’s important for addicts to open up to those around them, seeing their own issues in other people. That’s also the thinking behind the policy of shared rooms at the Rutland. As Prior notes, “People benefit from being in a social setting; a lot of work goes on outside the structured programme”.
There’s also the opportunity for patients to receive one-to-one counselling, attend lectures and readings, and take part in extra-curricular activities such as yoga, dance therapy, mindfulness and meditation. Family members are invited to come in on a special family day every week, where they can get support from counsellors and look at the damaging impact of their loved one’s addiction on their own lives, as well as looking at ways to provide ongoing support and help. Prior says that people generally find that while the first week of the rehab drags, the following four fly by.
According to Prior, rehab is all about changing addicts’ views of their lives, teaching a different way of living. “We maintain that addictions – whether to alcohol, drugs, gambling, sex or whatever – are unhealthy ways of coping. So being open to looking at their own coping mechanisms is a big part of the recovery process.”
Rehab is clearly an incredibly intensive and challenging process, designed to isolate people with dependency problems from the sources of their addiction and to modify the thinking patterns that led them to become an addict in the first place. But such problems are deep-rooted and often life-long ways of coping. So can a five-week corrective programme, however intensive, really have a chance of making a long-term difference?
Prior says that people who have been treated at the Rutland Centre do go out with a better approach to life – especially those who really apply themselves to the programme. Rutland’s figures show that, on average, 53 per cent of clients were abstinent for an entire year after treatment; 63 per cent were abstinent after six months. Over 70 per cent reported substantial improvements in the quality of their lives, with positive changes in relationships with family and friends, a greater degree of contentment, and better job performance.
No one claims that rehab is a quick fix or even a “cure” for those with difficult addiction problems, and that’s why aftercare is a key part of treatment. Most clinics encourage clients to attend weekly support group sessions where they can discuss the progress of their recovery. While addicts rarely quit without any relapse at all, most addicts do have the potential to recover. A life-time commitment to recovery, together with the aim of complete abstinence – as recommended by the 12 Steps programme – is widely thought to have the most chance of working.
Of course, much depends on the quality of the rehabilitation programme. And exclusivity and prohibitive cost do not necessarily equal a premium service. The £10,000 a week Causeway Retreat, on an island off the Essex coast, was once favoured by Amy Winehouse and other celebrities. But it was closed down last year after an investigation by a British health regulator. The company running the clinic was taken to court and admitted running an unregistered service; the judge said its standards would “shame a Third World country”. So while celebrity clients may act as unofficial publicity for high-profile clinics, their patronage is clearly no guarantee of quality care.
Wherever you do your rehab, it seems that willpower and true willingness to change may make all the difference between success and failure.
REHAB and ADDICTION CLINICS AN UNREGULATED INDUSTRY?
There are many accrediting bodies for addiction-recovery professionals and clinics in Ireland, yet there is no State body monitoring or regulating this area.
In Ireland there is no law prohibiting anyone from calling themselves an addiction counsellor or establishing an addiction clinic.
The Psychological Therapy Forum is an umbrella group of therapy professionals that has been working closely with the Government to introduce regulation to professionalise the area of psychotherapy and addiction counselling. So far no legislation has been passed.
Since the late 1970s a substantial number of private residential clinics have sprung up in Ireland to treat every nameable addiction: alcohol, illicit and prescription drugs, gambling, sexual compulsion, even online gaming and social networking. Clients and their families can expect to pay anything from €7,000 to €18,000 for private treatments.
Different clinics are registered with different bodies. For example, since 2009 the Rutland Centre in Knocklyon, Dublin, has been accredited by the highly regarded CHKS (Comparative Health Knowledge System), which derives from the NHS in the UK.
The Temple Centre in St Patrick's University Hospital, Dublin is accredited by the Mental Health Commission. It is unclear if the services are measured by the same criteria or standards.
There are several accrediting bodies for counsellors and clinics, but there is not one definitive organisation that independently monitors addiction services on a national scale.
"This light-touch regulation will end up being a scandal if nothing is done," warns Donal Kiernan, spokesperson for the Irish Association of Alcohol and Addiction Counsellors (IAAAC), which has about 1,000 members.
"There are people out there practising who would not get to first base with our organisation," says Kiernan, who is a trained psychotherapist and addiction counsellor.
The quantitative information on all national addiction trends and treatments is also difficult to obtain because it is not centralised.
There are statistics about illicit drug use and alcohol abuse in reports such as the National Drug Strategy, published in 2009, but these relate to substance abuse and the public-health system.
The private clinics, on the other hand, do not yield any collective statistics, making it unclear how successful treatments are or how their approach could inform addiction treatment in Ireland.
In the UK the situation is similar but under review. It is predicted that by 2012 all practitioners calling themselves psychotherapists or counsellors will be legally required to be registered.
As with other professions, such as accountancy and law, there will be prescribed training in order to qualify, making it easier to monitor standards of practice.
It is clear that there is a need for similar regulation in Ireland, not only to protect the vulnerable but also to gain more insight into this prevalent social issue.