Rehab: Last Week Tonight with John Oliver (HBO)

rehab the most common place to go after hitting rock bottom other than Dave & Buster's don't let their smiles fool you every one of those men is at the lowest point in their lives in that photo now rehab is a place where people can address an addiction to drugs or alcohol something that until relatively recently was seen as a moral failing that could be overcome with sheer willpower perhaps best epitomized by this amazing PSA from the 80s starring singer Belinda Carlisle I used to do drugs and one morning I woke up I looked in the mirror and I said you look frightening I got sick of it so I quit and now the beach rat now incidentally Belinda Carlisle has since admitted that after that PSA was shot she used cocaine for another 20 years to a point where and I'm quoting her directly here I'm surprised I still have a nose which is the kind of statement you only normally hear from toddlers who just spent the afternoon with their uncle he he told me he got it did his fingers and I flipped man I was crying screaming the whole thing I'm surprised too still after those right no thankfully thankfully there is now a broader understanding that addiction is complex and that nothing about getting off alcohol or drugs is easy experts now view addiction as a medical problem often lock into a disease or a chronic condition and a common way of treating it is through stints in rehab it is a thirty-five billion dollar industry with over 14 thousand rehab facilities across the United States some of which have fancy names like promises or passages or milestones you know names that sound like perfumes worn exclusively by widows and some rehabs can even afford to run TV commercials like this cliffside Malibu has been helping people just like you for over 12 years except most insurance our experienced compassionate staff will help you get your life back call the number or go to the site below now don't wait because your tomorrow may never come wow that is a hard turn there that's like frosted flakes ending a commercial with Tony the Tiger getting shot by poachers now now in recent years it has gotten easier to get insurance to pay for rehab that's largely thanks to the fact that george w bush passed and Barack Obama expanded laws requiring health insurers to increase coverage for its but while we use rehab as a shorthand it is worth knowing that there is no set definition for what it should consist of in fact there are no federal standards for counseling practices all rehab programs and while many really halves are staffed by people doing their best to help a report a few years ago found that the vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care and for a sense of just how bad things can be look at Florida a state whose rehab industry has seen an epidemic of overdose deaths and fraud to the point where one local official issued a chilling warning the clear message would be stop sending your loved ones to South Florida because we're sending them back in body bags holy that is the worst and yet possibly most honest tourism slogan for Florida I've ever heard come to South Florida we'll send you home in a body bag so tonight let's look at what rehab is and why the industry so troubled and let's begin with the fact that rehab should never be seen as a quick fix it's often just the first step in a lifetime of recovery yet many operators make huge claims about their success rate take passages in Malibu the father and son who run it make some pretty big promises about what they can do for you when you send patients home what do you say to them you're cured totally cured 100% you will never use drugs and alcohol again right your dependency has been cured have a wonderful life for a start there is no way when patients leave this doesn't say ciao there is no way that sound doesn't come out of his lips but it's not just passages lots of rehabs feel free to make suspiciously impressive claims as one researcher found out we called inpatient programs and ask them what their success rate was and the lowest rate we got quoted was 80% you know I do know that about 80% of clients who have come in here are now sober long term we've had about an 80% success rate here at 180 and then we would ask and one what data do you base that and no one had any data they had no hard data to back up their claims and at that point why even stop at 80% why not say you have a one hundred and forty percent success rate for every ten people that come into our facility 14 emerge completely sober where did those extra four people come from we have no idea that's how good we are and that's the thing rehab success rates are often based on self-reported statistics involving them simply calling former clients and those results can be problematic as a man who's participated in one of those studies can tell you they call you up and they ask how you doing and you just lie you know fine you know I was drinking yeah I mean it's it's crazy you know but I was embarrassed to say you know I didn't say sober I mean kind of understand that for every reason it can be hard to admit that you've relapsed plus it's a phone call so you'll say whatever it takes to make it end because getting sober may be hard but nothing is harder than an 8-minute phone call with another human being nothing nothing at all and look for all those claims of success it is very hard to know exactly what you're getting at any given rehab you might get the traditional 12-step based approach which undoubtedly works for some although most experts argue that there should also be consistent access to other newer treatments like certain behavioral therapies or medications like these but rehabs are not required to offer those and because a rehab can essentially be whatever it's proprietor says it is that means they can frame almost anything as treatment for instance many high-end rehabs offer something called equine therapy and again if people respond to that that's great but there is no empirical evidence that as a treatment for addiction it works which means some people who paid a high price for it can end up having this experience they had like the whole equine thing I mean you go and pet horses what is petting horses gonna do for me let me do two a goddamn thing I don't even like horses okay so first of all I absolutely love that guy second of all he's completely right horses can go straight to hell why do we even need them anymore I'm sure you could ride one somewhere or you could just drive the car which is like a horse except it can play music and it doesn't constantly everywhere you're an idiot patches an idiot now one of the places one of the places that offers a coin therapy is cliffside the place from the ad that you saw earlier now a month of treatment there cost tens of thousands of dollars and its founder Richard Tate gets a little defensive when asked if it's worth that price listen seventy three thousand dollars sounds like a lot of money but if you go to the Four Seasons for thirty days okay that's gonna be forty grand right okay what did you get was there any life-changing thing going on there everything that we've done here is mindful it only seems like horse to people that don't know better but you don't have to know better bro because your life didn't depend on it you didn't go through it okay calm down bro besides you being a little unfair to the Four Seasons plenty of life-changing things happen there just last year Jaden Smith claimed that the one in Toronto spiked his pancakes with cheese after kicking him out of his room and if a handful of Canadians tricking into an addicted Charles millionaire with undisclosed ricotta isn't a life-changing thing I guess I don't know what is anymore and $73,000 first 30 days does sound like a lot of money because it is a lot of money and you would hope that at cliffside they could account for every moment of treatment at price but that does not seem to be the case where your where your patients at today I don't know where are they where'd they go no you're not Bub's here I have no idea I have no idea okay no idea do they they probably went to whatever they did there's a therapeutic meaning behind it good site bro because you were in trouble for a minute there but the therapeutic meaning line was absolutely inspired because the truth is anything can have a therapeutic meaning his patients are stroking horses that could be therapeutic they're biting owls that could be therapeutic even the act of them being lost could be therapeutic it's called inadvertent wilderness therapy and it's a hundred and forty percent successful look so far we've just talked about the fancy high-end residential facilities but there are oversight problems throughout this system because in many states the barriers are opening a rehab can be dangerously low for example in Idaho as long as you are not operating a residential program for adolescents you don't need a license at all in California as long as you take private pay clients anyone can start an outpatient rehab center and in Florida if you want to open a sober home a group home where people stay often while they receive outpatient treatment there is nothing in state law to stop you technically oj simpson could open one right now which would obviously be called the juice cleanse and there would be nothing standing in his way and florida actually provides a window into how the flood of insurance money into treatment centers has caused massive problems because the industry boomed there and unscrupulous operators have found it way too easy to gain the system take urine testing insurance covers drug tests and some places have exploited that arranging for kickbacks from testing facilities basically meaning the more you're in they take the more money they make and it adds up fast for a single thirty dollar store-bought urine test you could get up to five $1,800 in payouts from insurance companies so let's do the math if you run five tests a week on a single addict that's seventy five hundred dollars six addicts at five tests a week $45,000 that's over 2.3 million a year exactly urine is so valuable that in the recovery industry it is known as liquid gold and peeing liquid gold sounds like the symptom of an STD you can only contract from c-3po no see I don't think all women born after 1990 have it anyway unless you're sleeping with all women born after 1990 see are you are you doing that see you're a dog see you're a metal dog and with money like that to be made just from urine it is hardly surprising that some operators have gone to extreme lengths to attract patients with insurance even engaging in something called patient brokering or junkie hunting here is how that works Mercedes Smith the recovering addict herself told us sober home operators compete for addicts with good insurance enticing them with promises of free rent free food free cigarettes we would have to drive around Delray and anybody with like suitcases we would have to ask them do you have insurance any place we can go okay so in terms of questions to ask people from the window of a moving vehicle do you have insurance is barely less sinister than would you like some candy or what size of flesh are you and it gets even grimmer because the truth is there can be more money in a patient relapsing than in them recovering so at its worst this system encourages a cycle of admission relapse readmission and relapse again this cycle even has its own special term it's called the Florida shuffle and if you are not extremely lucky this is how it ends in the Florida shuffle you go in and out of recovery in and out of rehab centers in and out of sober homes milking the individual for their insurance until that person dies yeah the Florida shuffle turns out to be horrific and not as I'd assumed a party where everyone throws their keys in a bowl and gets to go home and their neighbors alligator and if at this point you're thinking well I guess I just need to be extra careful when I'm looking for treatments well that is the final big problem here because it can be nearly impossible to find good unbiased information let's say you're sitting at home and you see this ad which plays a lot we are the addiction Network and if you have a problem with drugs or alcohol you need to call the number on your screen now addiction is a disease and you can't go it alone the call is free and so is the consultation so why haven't you called why haven't you called that is a hostile tone that you would not tolerate elsewhere Tampax tampons why isn't one in you right now seriously explain yourself but the important thing to understand is that the addiction network is not a rehab it is a referrals business meaning they make money by routing your call to centers all over the country which reportedly paid them forty to fifty dollars for your call so in a moment of crisis your individual circumstances are not being taken into account they're simply placing your fate in the hands of whoever has $50 which is a terrible system I have $50 but I have no idea how to treat someone with an addiction I'll probably just give them a copy of my handmade anti-drug pamphlet titled napping with the devil please stop doing heroin and if you're thinking now well hold on I wouldn't fall for a sketchy looking TV ad or I'd do my own research that is great but let's say that you saw that cliffside ad and you thought well that looks good but I do want to check it myself first well a Google search will quickly land you on rehab reviews calm which says that cliffside is the choice for those that have to have the finest of everything or you might land on the de fix comm a whose review of cliffside raves that it is a great choice for anyone who has the means to recover their what you probably won't see on either of these websites at least not unless you know exactly where to look is that both of them are actually owned by Richard Tate the founder of cliffside Malibu you remember the guy who looks like Matt Lauer a pair of oakley sunglasses and that fact that fact the fact of ownership certainly casts some doubt or on the fact that the fix awarded cliff side a rating of five out of five stars presumably one star for every ten patients whose location he's completely unaware of and let's say someone you love was truly in crisis and you wanted information on cliff side from an outside source like what complaints had been lodged with the states and what the state found when they investigated well in order to get that information you would need to file a public records request with California's Department of Health Care Services and then wait four months for them to send you what could be a huge pile of documents to sort through and that is too long to wait for urgent information it's akin to a pregnancy test that takes you eight and a half months to get the results that is practically useless and a huge waste of perfectly good urine which as I now understand it is liquid gold everything about this industry is incredibly difficult to navigate which is dangerous because even one of its own trade groups its own trade groups has warned that some sectors of it are out of control and for a sense of just how helpless you can be in the face of all this just listen to Tom McLellan he was Obama's deputy drug czar you would think that if anyone knows this world it would be him well guess what I had become an expert in the addiction field and then my son became addicted and I had no idea what to do all that training all that knowledge about addiction did not prepare me for the most fundamental question of all where do you send your kid for treatment it's true even the nation's deputy drug czar couldn't confidently navigate this system and the tragedy is his son died and remember the funny guy who hated horses he died too so this is a matter of life and death and if you if you're wondering what experts would advise you to do in seeking treatments many that we spoke to suggested beginning not with a rehab which may try and sell you on its own services but with a doctor who is board certified in addiction medicine now it's only recently become an official specialty so there just aren't many of them around but you can find those that do exist at this website here they may be able to guide you toward a treatment that best suits your needs which might well not be a fancy center where you have to pay seventy three thousand dollars to have this guy lose you look look this system clearly badly needs more expertise and oversight and until then it may be really important for all of us to understand that at present the word rehab is so broadly defined as to be close to meaningless it is honestly barely better defined than the word building and and if someone were to tell you I have a drug problem but don't worry I'm going to building in Florida you would naturally say hold on what's building where did you find this building what's happening inside it is it a hospital or a hooters or both is it is it a hoot spittle what what what's the proof that it works and watch the doctor to horse ratio like in there and sadly right now it can be way too difficult to get answers to those questions which is crazy because so much about battling addiction is really hard getting clean is hard staying clean is hard but getting good evidence-based trustworthy help should be the easy part and right now it is way too easy to literally wind up pissing money up a wall you

Channel: LastWeekTonight

Views: 12,389,788

Keywords: last week tonight rehab, john oliver rehab

Id: hWQiXv0sn9Y

Length: 19min 7sec (1147 seconds)

Published: Sun May 20 2018

Reddit Comments

[u/atm153]

If you want some more info on what was covered here, this week’s episode of Reply All went into the same topic. The Verge has some fantastic reporting on it as well, and there’s a few more links in the Reply All shownotes.

[u/KimJongChilled]

I'm about to go to rehab in a few days and this is scary coincidental.

[u/teebird_phreak]

Rehab isn’t recovery for those of you interested. It helped me because it gave me a safe environment to get clean and introduced me to a 12 step program to which I have learned to grow in. My wife was sent to a halfway house in Boca and from her experience it’s mostly trust fund kids from Northeast states that are in So Florida and you start mixing a bunch of early recovery rich kids together with easy to get pharmaceuticals and it’s easy to see why a lot of them don’t make it.

[u/G-A-M-A]

addressing drug addictions with more methods than just "sheer willpower" as he calls it is (obviously) super important. getting addicted in the first place is easier than i personally realized.

i'd had a stressful anxiety-inducing past spring semester and used alcohol or weed to (try to) relieve stress when i could get my hands on them (usually through friends). it dawned on me that if i had the means to acquire them consistently, the tail-end of my semester could easily have gone south.

[u/lexos87]

Like this report says, addiction should very much be treated as a disease, the fact that our prison systems lock people up for years for drugs, but society respects those who choose to go to rehab to treat themselves is so interesting.

The big difference between the two is that "treatment" is either forced through taxpayer funded prisons, or the person comes and goes at will through expensive rehab clinics. Famous people who go to rehab don't suffer the repercussions many others who are caught with drugs do...A more supportive mentality should be applied to those arrested for minor drug offenses as well.

[u/BoogsterSU2]

TL;DR: It's too hard to quit addiction, but it's also too hard to find actual evidence-based information for rehab. Just please don't go to one right now. And please don't send your loved-ones to Florida. They will bag them up and send them back.

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[u/bestversionof]

Over a year sober here (alcohol). Recovery is inherently a personal journey and that journey must continue for your entire life for it to be deemed successful, it is not like a hospital stay where you are cured when you leave. Treatment centers can be beneficial as places to learn about how addiction works and as a place to dry out, but no one has the “cure” for addiction. Anyone purporting that they have a cure is trying to take money from addicts.

It took me reaching my own personal rock bottom and a subsequent and drastic life change to stay sober, and those seem to be common elements to staying sober for those people I know who have remained sober for long periods of time. I recommend r/stopdrinking if you have a problem with alcohol, it is an excellent community and my substitute for AA.

[u/swolemedic]

As someone who has been to rehab this sounds absolutely right. I actually called my family at one point, saying I wanted to leave to go to a different facility, and my dad yelled at me and acted like I was lying. It was a rehab in the south that only served meat basically, I'm a vegetarian and they made it sound like they would have gourmet chefs 24/7 - i basically didn't eat, I didn't see a therapist the entire time, and it had so many frequent flyers there it felt like it was just rotating people. Also, they violated hipaa to contact my family and tell them I clearly needed at least another 6 months of treatment despite never seeing a mental health professional once. The reason it was a violation was because I had revoked the contact permissions once I realized they were doing this to everyone's family, one of the most mild alcoholics there had his family get convinced that he needed two years of treatment and I was like oh my god I need to stop this. I filed a complaint with the company, basically nothing happened.

Hell, they even lied about having a fucking pool. Did I need a pool? No, not at all, but holy shit the whole thing was just lies. Insurance didn't cover it, my family did (my dad, actually), and it was like 30k. I would have been significantly better off flying to hawaii and spending a month there instead. The only reason I stayed, and I really shouldn't have in retrospect, was because I figured fuck it my dad is silly wealthy, I don't like him anyways (we were estranged pretty much my entire life up until he heard I was using drugs and offered to pay for rehab), and I'm getting disability pay for the time here, I'll stay if he's going to be a prick about it. I kept saying I'm eating nothing but veggie burgers and I haven't seen a therapist once... he watches john oliver, I hope he sees this and feels like an asshole.

For those wondering if I stayed sober, the answer is mostly. I think getting out of EMS so I have a lot less empathy fatigue and getting out of the toxic pro drug use relationship I was in were the main factors. I haven't done more than dabs in the last year for recreation, and I say dabs because my doctors want me smoking weed due to an attack of transverse myelitis - flower is more therapeutic for my pain and dabbing is more recreational.

This clip practically gave me flashbacks

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