The Devolving Impression of Rehab in Our Era

British singer Amy Winehouse always seemed to have a knack for drawing attention. For alcohol and drug rehabilitation programs in her appropriately-titled, haunting 2007 earworm song “Rehab”:
They tried to make me go to rehab…

I said no, no, no!

Yes I been black, but when I come back

You won’t know, know, know.

And when you add frequent Hollywood rehab denizens of late Britney Spears and Lindsay Lohan not wanting to make the effort to stay in rehabilitation to treat their demons–it paints a picture of this recovery process all of a sudden becoming obsolete. But, I know, we shouldn’t get a picture of reality through celebrities who may be beyond the scope and help of rehab. It may be a hint, though, of something we probably thought we’d never hear in a time when rehab is so much needed for so many: The concept of rehab may need rehab on its own.

Just what is it that’s bringing rehab into such a negative light of ineffectiveness all of a sudden? PCP rehab among other types of Alcohol and Prescription drug abuse is causing a surge in centers opening up. Prior to the early 1980’s, rehab was usually considered to be a bit of a blight to a notable person’s career–yet usually successful in cleaning people out who had drug or alcohol dependency.

Rehab clinics were usually hideaway places, too, where the press couldn’t easily get information whether the celebrity was actually there, how their treatment was going and when they’d be released. In 1982, the Betty Ford Center opened in Rancho Mirage, California…and it began a whole new era of rehab for celebrities. It became a cultural rite of passage for many a celebrity to end up in the Betty Ford Clinic for some kind of drug or alcohol problem. Pop culture references alluded to it all the time and made it seem it was an honor to be there as if staying in a posh hotel. Now we know through rags what every step of recovery a celebrity is going through before being released (sometimes too early under their own will) to flashing camera bulbs.

Outside of pop culture obsessions, the BFC has obviously helped countless celebrities–while also gradually seeming to fail in permanently reforming people in the limelight. It’s just been in recent years where you hear about celebrities and people with normal lives having to re-enter rehab multiple times for being unable to conquer their drug and alcohol addictions. The inner workings of rehab have now become an annoying cliché it seems in a lot of people’s minds, which automatically ruins any mental determination in wanting to stop drinking or abusing drugs. Some doctors have already long-ago opined that programs rehab centers use aren’t approached in the right way. That usually applies specifically to the process of drug treatment and the old classic stand-by word used as a subtitle to rehab: The 12-step program.

12 steps to the same 12 steps…

One of the most controversial aspects to the twelve-step program is the utilization of immediate abstention as the only way to overcome addiction to drugs and alcohol. Some doctors contend that working gradually toward a particular goal works much better for many addicts so they don’t go on binges as some do after quitting completely. This is really a normal psychological impulse as people would do in a diet. When you abstain of anything for a long time…the chances of going on a dangerous binge is always possible…and frequently happens.

These doctoral opinions against twelve-step programs continue to show their view of moderation being the better approach in success against conquering drug and alcohol addictions. It really hasn’t been tested in anybody, but it may be that some are finding they can perhaps handle that process on their own rather than relying on clinics to clean them out. That idea aside, few to none have been known to really conquer heavy drug or alcohol dependency on their own. Other opinions say that the moderation process is really another dangerous road to falling off the wagon along with the abstention route. These opinions are in the minority, however, and the general establishment says that abstention is the only way to true recovery.

In the psychotherapy realms, an internal battle still goes on with the idea that a drug user has a disease possibly passed on through genetics that makes them more vulnerable. That addiction as disease model is the philosophy of most recovery programs today and places no psychological aspects to it as some contend drug addiction really is. It has to be noted that the idea of addiction being “deprogrammed” from someone’s mind could be a useful experiment in the age when many people experience fruitful results with hypnotherapy and mind reprogramming procedures to stop other bad habits. It really hasn’t been proved scientifically that drug and alcohol addition is a hereditary trait rather than a bad habit simply acquired. Others might say it’s both and depends on the environment that surrounds you.

Recovery programs have turned to new drugs, too, in helping people keep away from addictive behavior. Methadone and Buprenorphine are two widely used drugs in the area of Pharmacotherapy. A new experimental drug that supposedly stimulates the mind to the point of abstaining from hard drugs is Ibogaine. Critics say it’s merely just a substitute for morphine and the high it gives you–hallucinations included. When you research the history of the drug in the U.S. and realize that Hunter S. Thompson once wrote about the drug being abused by various candidates and surrounding people during the 1972 Presidential election–it gives connotations of Ibogaine just being a substitute for the other drugs it conquers.

And then you have the most sensible route by many–that’s thankfully still used in most twelve-step programs: Finding your own sense of a higher power. While the classic twelve-step program designed through Alcoholics Anonymous have never defined it as forcing religion on people–about half of the classic twelve steps (the Twelve Traditions) cite a relationship with God as an essential element to recovery. Some celebrities have used that as their main source of getting sober–and it’s quite often successful. Perhaps some people deriding rehab are realizing it matters more as an isolated concept than checking into a clinic and using other procedures that overrides a direct pipeline to God helping you. At best, we can only guess that this is what the worldly famous mentioned in the beginning of this article are actually thinking.

The Establishment Clause Conundrum…

In the mid-90’s, a famous New York court case (Griffin vs. Coughlin) put a problematic spin on the twelve-step program. An inmate in a New York state correctional facility, David Griffin, was ordered to attend a twelve-step program in order for him to take advantage of a family visitation program available. Griffin was an apparent atheist and complained about the twelve-step programs using the basis of developing a relationship with a higher power. This led to Griffin hiring a lawyer and getting the New York Court of Appeals involved in stating that an atheist shouldn’t be allowed to go through a twelve-step program under the Establishment Cause of the First Amendment of the Constitution. The “Coughlin” in the case happened to be Thomas Coughlin, who was the commissioner of the New York State Dept. of Correctional Services.

Ultimately, the New York Court of Appeals ruled that the Establishment Clause is clear enough in definition to warrant a person skipping over a twelve-step program if they so choose based on the idea of separation of church and state. The Supreme Court later upheld this ruling–even though it’s contingent on what each state finds acceptable.

This leads to a deep, dark question (so celebrities reading…cover your eyes): Will a celebrity eventually end up using the Establishment Clause someday to keep themselves out of a legally-mandated recovery program? Many celebrities go in to rehab willingly, but a court-ordered rehab program is bound to happen again to one of them. In an age now where the concepts of rehab are apparently annoying people to the point of not bothering–it seems possible a legal mandate to attend by a notable person will be fought again with the old standby shield of the First Amendment. This all depends, of course, whether California (or the rest of the country) looks at it the same way New York did.


Fortunately, rehabilitation for drugs and alcohol hasn’t run into huge legal stumbling blocks yet. If only some clinics in Hollywood and elsewhere offered the psychotherapy alternates (and other alternate therapies) to give people different choices in what works for them–things might reverse in people starting to put down the concept of rehab recently. We all know precedents don’t have to be set just by legal means. Sometimes something as simple (or complex) as a compelling and catchy pop song can set a negative new view on a useful institution that only needs some streamlining before it gets destroyed by misconceptions or legal red tape.

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