How "Rehab" Works

"When we hear the term "rehab," we usually think of a residential treatment facility where celebrities go to "dry out." As it turns out, there are a variety of types of programs, and even more methods of treatment.


The success of prison rehab programs has shown that
involuntary treatment can be effective in breaking addiction.

There are several settings where treatment can take place. Hospitals often serve as rehab facilities, treating people who come into the emergency room with an acute drug overdose. This treatment usually doesn't last long; however, some hospitals do offer longer-term and more expansive treatment programs. Rehabs can range in appearance from a very clinical setting in a prison to a luxurious day spa on an exotic island, and everything in between. What most treatment facilities have in common is that they are divided by the length of the service they offer.

Treatment generally takes place as inpatient, outpatient or partial-hospitalization:

* Inpatient treatment (also called residential) - the addict is cared for 24 hours a day, seven days a week. Inpatient rehab can be offered either as short-term (usually 28 days) or long-term, which consists of residential treatment for six months or more. Often, long-term inpatient treatment is court-ordered, and, in addition to treatment, includes resocialization, the process where patients learn to behave as a normally functioning member of society again.

* Outpatient treatment - takes place on a visitation basis. In this setting, a patient may come to a rehab facility to attend support groups, receive medication (such as methadone for the treatment of heroin), and receive counseling. In outpatient treatment, an addict usually goes about his daily life and sleeps at home.

* Partial-hospitalization - a combination of both inpatient and outpatient treatments. The addict receives treatment during the day and goes home at night. This treatment setting somewhat resembles the 9-to-5 work schedule most people keep, but rather than going to work, the addict goes to rehab.

Prison is another place that can serve as a rehab treatment center. In this setting, substance-dependent patients are removed from the general prison population to diminish the possibility that they'll be exposed to drugs or alcohol. Treatment facilities are becoming popular in American prisons, as they have increasingly been shown to be effective.

Regardless of whether treatment is received in prison or in a spa, the treatment programs are similarly structured."

Note: Convicted felons are usually tested, for drug use, before they are sentenced to prison. Son of convicted operative and politician wannabe, Stan "Pampy" Barre, has already expressed fear that his hair follicles will be tested.

The History of "Rehab"

"The idea of rehabilitating addictive behavior has existed since the beginning of the early temperance movement in19th-century America. This movement, which began in the 1800s, gave rise to our modern notions of addiction and the need for our society to help alleviate the suffering of its addicts.

The goal of the temperance movement was abstinence, or the complete disuse of a substance -- in this case alcohol. Eventually, alcohol became identified as an agent of social decay, and the movement increasingly believed that it was up to society to care for its alcoholics by doing away with any spirituous beverage.

The organization gave birth to the first rehab centers in the United States, called "sober houses," where men lived collectively, sequestered away from the temptations of the world. Sober houses were set up as early as 1840 in cities like Boston and New York by the Washingtonian society, a branch of the temperance movement.

The temperance movement began to focus on the general public. If society could be free of alcohol, they reasoned, then it could then be free of alcoholics.

After a century of gaining momentum in their beliefs and membership, the temperance movement helped to get the Prohibition Act -- the law that outlawed the sale, possession or consumption of alcohol in the United States -- passed in 1920. But American society as a whole wasn't prepared to give up its booze, and the law was repealed 13 years later. The experiment had a lasting effect: If America couldn't provide its alcoholics with a country free of temptation, alcoholics needed a refuge within the larger society where they could be free from the temptation of alcohol: rehab.

Eventually providing treatment for addicts was taken from the hands of goodwill societies and placed in the trust of the medical field. As medical science came to play a larger role in caring for the world's addicts, treatment came to be moved into more of a clinical setting. Rehabilitation now took place in hospitals, psychiatric wards and sanitariums.

This isn't the only contribution that temperance made to our modern rehabs. It also gave rise to fraternal organizations, like the International Order of the Good Templars, which served in part as support groups. These groups set the stage for America's first organized support-group treatment program, Alcoholics Anonymous (AA). Cofounded by Robert Smith and Bill Wilson (Dr. Bob and Bill W.) in 1935, AA created the 12-step program.

Throughout the 20th century, thanks to the success and popularity of programs like AA, it became clear that treatment programs were a viable solution to the nation's substance-abuse problems. As a result, President Richard Nixon was the first commander in chief to create federal funding for treatment programs. The budget for his antidrug policy, which would serve as the origins of the War on Drugs, was divvied up, with one-third toward eradicating the supply (police enforcement), and two-thirds toward getting rid of the demand (treatment). When his successor, President Gerald Ford, came to office he cut the budget for federal funding of treatment programs, making the division fifty-fifty.


This is ironic, because it was President Ford's wife who founded one of the United States' iconic rehab facilities, the Betty Ford Clinic. Mrs. Ford developed an addiction to alcohol and prescription medication in the 1970s, and as a result, she opened the Clinic in 1982 as a way to help others who shared her problem.

In the 1980s, the proliferation of private residential treatment facilities mushroomed. The peak of the War on Drugs fueled fears of addiction, and fueled the demand for rehab treatment. Interestingly, as the War on Drugs was showing a major effect on reducing drug usage in the United States, the use of rehab facilities in the country continued to increase.

So what kind of treatment is offered at these facilities, and how do they help addicts recover from their dependency?"

The Meaning of "Rehab"

"The word "rehab" has become a part of the international lexicon. While it can mean several things, it most frequently refers to a center or program where a person can find treatment for addiction. Although it's become so firmly embedded in our consciousness as a natural byproduct of the addictive nature of Western society, rehab is a relatively new concept.

Prior to the 1980s, anyone seeking help for a drug or alcohol addiction was sent to a sanitarium -- a psychiatric hospital -- or a traditional hospital. Think Patty Duke's character in "Valley of the Dolls" or Winona Ryder's character in "Girl, Interrupted."

In the '80s, rehab centers branched off from their psychiatric foundations to encompass several forms of treatment. This was partly due to a change in the perception of addiction. Rather than pinpointing a substance (with its addictive properties) as the cause of addiction, or believing addiction to be a weakness of will, addiction itself became viewed as a disease. However, what hasn't changed is the purpose of rehab centers: to provide a place of solace and respite where an addict can "kick the habit."

For many years, going to rehab was viewed as somewhat taboo. It wasn't an experience that was openly discussed and is still sometimes looked upon as somewhat shameful, as if the patient had failed somehow. But as more and more people go to rehab to find help for their addictions, it has come to play an accepted -- and necessary -- role in society.

Recently, the acceptance of a stay (or several stays) at a rehab -- as a consequence of fast living -- has became so widespread that some celebrities are reputed to have used rehab excursions as a publicity stunt to boost their fame.

Actress Lindsey Lohan made several highly publicized trips to rehab in 2007. Even Amy Winehouse, the British singer notable for her first American single "Rehab" (including the lyrics "They tryin' to make me go to rehab / I said no, no, no") eventually said "yes" to several short rehab stays after a brush with death from an overdose consisting of heroin, cocaine, ketamine (a horse tranquilizer) and ecstasy [source: Daily Mail].

Celebrities have even managed to boost some rehab facilities to fame. Centers like Promises in Malibu, Calif., and Crossroads in Antigua, West Indies, now enjoy elevated status thanks to some of their high-profile patients.

Although celebrities get the lion's share of the publicity for their visits, they aren't the only ones who utilize rehab services. The 2005 National Survey on Drug Use and Health found that 3.9 million Americans age 12 and older received some kind of treatment for drug and/or alcohol dependency in 2005. Treatment was received in a variety of locales, including inpatient rehab centers, self-help groups (the largest portion) and prison [source: Department of Health and Human Services].

The wide array of treatments for people suffering from addiction reveals that a large portion of Western society has succumbed to dependency on everything from liquor to pills to sex, and even food. So what are these places where people can go to get help?"