Marc Lewis took a very round about route on his way to becoming a neuroscientist. He spent his youth experimenting with all manner of drugs and chronicled his experiences in his best-selling memoir, Memoirs of an Addicted Brain. His second book, The Biology of Desire: Why Addiction Is Not a Disease is a lone voice in the addiction debate as is his assertion that rehab is a waste of time.
His criticism of rehab programs relates closely to his rejection of addiction as a disease. He says the rehab industry pretends to offer medical treatment, but actually offers little more than 12 steps and pep talks.
Lewis stops short of calling the industry an evil conspiracy, but only just. He told VICE in an interview that in the US, there are a lot of violations and a lot of improprieties. He asserts that the treatment is inadequate — the opiate substitution doses are wrong as is the period of time allowed to get off the drugs.
Rehab centers have generic policies that don’t work for everyone and the medical care is a fairly small aspect of the program in general, while 80-89% of the program focus on the so-called 12-step methodology. He is also very critical of group sessions that form a typical part of programs offered at these type of centers.
The bottom line: rehab doesn’t work.
For a small number of people it works because they are taken out of their environment and dry out, but as soon as they return to their environments, all the triggers are still there, Lewis said.
Here is the key point: what they need is the necessary psychological skills to move on. “They have to self-regulate and be conscious in order to put their lives into perspective.”
According to Lewis, a lot of people who run rehabs are under-skilled, recovered addicts who did a crash course. They’re unregulated and unsupervised.
Lewis’s opinion is supported by a groundbreaking report by the National Center on Addiction and Substance Abuse at Columbia University. According to the report, “the vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care.” The report added, “Only a small fraction of individuals receive interventions or treatment consistent with scientific knowledge about what works.”
And this really hurts.
Many rehab centers charge such exorbitant sums for treatment that they are completely out of the reach for all but the most well-heeled.
Be that as it may, if you can afford $50,000 to $100,000 per month, you probably expect the five-star luxury treatment you get there.
If you can’t fork out that kind of money, you have to get on a waiting list at a state-run rehab, which can torpedo an addict’s attempt to get sober. Timing is crucial and a waiting period can be fatal as people are often willing to get sober within a small window but that window closes, explained Lewis.
It is the premise that the whole concept of rehab is built on that is at fault: the medical model that treats addiction as a disease that requires treatment.
The rehab industry is clearly failing people more often than not and that should be challenged. How many people do you know of who have spent years in and out of rehabs? How many to have you heard of that went once and left sober and stayed sober?
“It’s a self-reinforcing system that waves this banner that says you have a chronic disease that will kill you, so you better come to us,” says Lewis.
So, where does all this leave addicts?
Instead of accepting that you are a patient who has to listen to the doctor, you can define your own goals, empower yourself and motivate yourself to get out of the hole you’ve dug for yourself. It’s extremely difficult, but it has been done before.
Anne M. Fletcher, a science writer who wrote Inside Rehab and Sober for Good refutes the myth that addicts need to go to rehabs, saying that most people recover completely on their own, or by attending self-help groups or by seeing a counselor.
Besides, a 30-day stint at a rehab is a pretense at rectifying a situation that for the most part takes much longer to recover from.