Is out-patient drug rehab bad medicine? Fitness Education

Is out-patient drug rehab bad medicine?

30 June, 2011

BILL: I remember when I was in rehab, the end of my twenty eight days, I was ready to go. But when Whitney Houston recently completed “a 30 day outpatient program,” she hired “an around-the-clock life coach” to keep her on track. Dave, do these deluxe outpatient or inpatient programs ever work? I figure if they did, then the insurance companies would be paying for them—instead of having to be able to afford them out of pocket.DR.DAVE: Bill, are you agitated over the rent-a-recovery-buddy fad, outpatient versus rehab success –or, what I think has you going, the refusal of managed care insurance to pay for rehab?BILL: My feeling is what really goes on in a good residential rehab is that group morale takes over – you’re like fans at a foot ball game, all cheering for sobriety, 24 hours a day, seven days a week. And if I may use the word, the feeling is intoxicating.” It’s hard to see how that can go on doing your rehab solo in some mansion or deluxe hotel. DR. DAVE: I’m with you on that Bill, no matter how someone argues the research on outpatient or inpatient. We are trying to help the addict learn relapse prevention skills and how to live an abstinent life on a round-the-clock basis. BILL: And how can you do that if the addict is going to treatment for 3 hours a night, 3 to 4 nights a week? They are still living in the manner that enabled their addiction. DR. DAVE: I want to help our readers understand that in a 24/7 rehab, the addicts themselves – who better? — knock down each other’s denial. In Whitney’s infamous interview with Oprah about her previous recovery in 2009, Whitney herself says she is clean from pot and cocaine—BUT, she is still drinking alcohol. Oprah, chimes in to help [read "enable"] her with “Because alcohol wasn’t really your issue.”BILL: My favorite explanation about why her addiction wasn’t really too bad was in that same Oprah show, the interview goes on to have Whitney talk about her drug-using with singer and partner Bobby Brown: “We were lacing our marijuana with [cocaine] base. We weren’t on crack. We weren’t on no crack stuff.”DR. DAVE: That interview, dissected for denial and misperceptions of the drug addict, was extensively described in Psychology Today.BILL: How can our readers get a more detailed grasp of how an addict’s defense system protects their continued using?DR. DAVE: They can read the story here.BILL: Addiction is sort of like a cancer. You don’t just cut out the obvious denial, You have to dig into its roots, down to the areas the addict keeps hidden. How that would ever happen in outpatient is beyond me—whether you are Whitney Houston, me or Aunt Mabel. DR. DAVE: Sort of like in physical medicine: if you don’t take your antibiotics as long as prescribed, you kill off the weak part of the infection and it grows back in a stronger form. BILL: Which sounds like Whitney Houston, And now there are these newly reported rumors that she has emphysema. Whether or not that’s true, her agent says her cigarette smoking causes her voice problems—on top of all the other toxic stuff she admits to putting down her throat! With her incredible gifts of singing and music, imagine how strong her denial has grown into!DR. DAVE: And it doesn’t get any easier, Bill, when the insurance company screeners won’t authorize rehab because, “your problem doesn’t sound so bad that you need rehab.”BILL: Doc, you’ve run some big treatment outfits, including rehab and outpatient programs. What insider tip can you share with our readers about how to get past the addict’s defenses and the managed care screener’s accountant perspective?DR. DAVE: I will tell you the only insider advice I know—there is nothing fiendishly stronger than an addict’s desire to avoid rehab combined with the managed care insurer’s desire to avoid paying for it. So, when addiction struck in my own family, that’s what I told my family members—and we passed the hat to pay for rehab ourselves.BILL: Being familiar with your family members stories, I happen to know that worked for both of them…DR. DAVE: …but even if it hadn’t, we would also have known we did what we could in the small window of opportunity that you often have for an intervention.

Fitness Education