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Let's talk recovery

Once rehab had a stigma, then it was almost cool. What does the term mean today, anyway?

November 08, 2003|Mary Mcnamara | Times Staff Writer

Rush LIMBAUGH in rehab.

Shortly after his Oct. 10 announcement that he was addicted to painkillers, the conservative radio talk-show host checked himself into an undisclosed addiction rehabilitation facility. Instantly, Limbaugh -- who over the years has insisted that drug addicts are simply common criminals -- found himself the subject, rather than the instigator, of heated social commentary.

But it was the first two words of the statement -- Rush Limbaugh -- that made the story, not the second. Because everyone, pretty much, has been in rehab.

A generation ago, seeking professional treatment for drug or alcohol addiction was a last resort, cloaked in silence and secrecy. Nowadays, terms like "rehab," "detox," "12-stepping" and "working the program" are part of the vernacular with a shock value of zero, unless -- as in Limbaugh's case -- a huge amount of irony is involved.

Along the way, "going into rehab" seems to have become cultural shorthand for many things, some of which are related to recovery from an addiction, some of which are not.

It can be an apology for bad behavior and a pledge that the behavior will not be repeated; it can be a bid for time out of the spotlight or a method of stalling a divorce. Certainly, it has become a no-brainer legal-defense tactic -- if your client stands accused of assault, possession, domestic abuse or embezzlement and drugs or alcohol are even remotely involved, then step one is: Send him into rehab.

"It is a way to stop the clock on the conversation," says social critic Virginia Postrel, author of "The Substance of Style: How the Rise of Aesthetic Value Is Remaking Commerce, Culture, and Consciousness." "There has been a big shift in the way it's used, from shameful to almost admirable. Saying you're in rehab is a way to say the problem is being dealt with, it's in the past, 'nothing to see here, folks, let's just move on.' "

"Rehab" has come to mean so many things to so many people that those in the addiction recovery profession fear that the public has lost any sense of its true meaning.

At the Betty Ford Center in Rancho Mirage, the terms "rehab," "detox," and "28 days" are forbidden among the staff and the literature. "This is a licensed addiction hospital," says president and CEO John Schwarzlose in tones meant to kill the sizzle. "Slang like 'rehab' does a disservice to the fact that this is a very complicated disease and today the treatment has become more complex than ever before."

The celebrity factor has a lot to do with the shift in meaning and fashionability. Twenty years ago, a few high-profile individuals including former First Lady Betty Ford and Jason Robards decided to use their fame to increase awareness about addiction and its treatment. This allowed ordinary mortals to draw strength and hope from the knowledge that addiction knows no demographic boundaries. It also meant that the public would now be informed every time a starlet detoxed from painkillers.

Celebrity sobriety also faces a medium versus message problem -- it's a bit difficult to feel pathos for someone whose alcoholism is announced by a publicist.

Schwarzlose has to deal with the slang issue on an even more particular level -- "Betty Ford," who remains a living, breathing person, is also often used as pop-culture code. Schwarzlose remembers watching an actor on "Good Morning, America" answer a question about his problem behaviors. "He said: 'Haven't you heard? I'm a Betty Ford kid now.' And he hadn't even been here. I checked."

Silence, he believes, has been replaced by glibness, which is just another way of minimizing the serious and widespread problem of drug and alcohol addiction in this country.

When the Betty Ford Center opened 21 years ago, there were fewer than 700 treatment facilities in this country. Since then, that number has grown to 13,000; in the last 10 years, the amount spent on treatment has doubled to almost $7 billion. But still, Schwarzlose says, "What dictates most people's attitudes about drugs and alcohol is confusion." Many people, he says, don't understand some of the basic tenets of the recovery profession -- that addiction is a chronic disease, that there is no one-size-fits-all treatment, and checking into an addiction facility is only the beginning.

"The cavalier nature of the language flies in the face of a serious disease that requires serious treatment," he says.

And that cavalier attitude, according to Schwarzlose, is no longer confined to the language. "Boutique" centers, where the rich are allowed to continue conducting business, are popping up all over. Some facilities offer programs that last but a few days or advertise detox in a matter of hours, which Schwarzlose finds troubling.

"If you were looking at how heart surgery was handled and found that one hospital kept patients for 10 days and others two days, you would probably have some serious questions," Schwarzlose says.

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