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“Inside Rehab”: How it could work better, and why it doesn’t

Oklahoman Published: February 4, 2013
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Amy Winehouse had a point: However flippant that sounds, many a reader will be thinking it (or something like it) after finishing Anne M. Fletcher’s “Inside Rehab.” Fletcher visited 15 addiction-treatment programs, from the high-end to the bare-bones, and interviewed staffers, researchers, experts and over a hundred clients and their families. She collected data from an impressively wide range of studies and surveys. Nearly 3 million Americans seek help for substance-use disorders in speciality facilities annually (not including the nearly 2.5 million who opt for self-help groups like Alcoholics Anonymous) and we spend $35 billion on treating these disorders, so it’s surprising how little most of us know about what goes on in rehab.


Even more eye-opening, however, is what Fletcher discovered during her investigation. She learned that most people who recover from addictions do it on their own, by attending a self-help group or by working with a therapist rather than through a treatment program, and that most use programs are that outpatient operations, not residential. She found that a lot of the treatment offered in those programs, especially the residential ones, is known to be relatively ineffective and is, furthermore, often provided by people with little professional training or formal education in the field. The success rates of residential facilities are unimpressive and, whatever they say in their glossy brochures, many are not up on the newest developments in treating addiction. Many are overly wedded to the twelve-step method, which — gasp! — is not necessarily an indispensable part of getting and staying sober.



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