When Dr. Drew Pinsky announced he was ending Celebrity Rehab, he complained about being blamed for the deaths of cast members after they got addiction treatment in conjunction with appearing on his show. Mindy McCready, a country singer who died of a self-inflicted gunshot wound in February, was the latest. “These are really sick people, and that’s why they die,” Pinksy said. “I’m tired of taking all the heat…They have a life-threatening disease, and I take the blame?”
I agree with critics that Dr. Drew’s 11% mortality rate—42 cast members and five deaths—is an incredibly high and troubling mortality rate for a treatment provider. Celebrity Rehab is not a typical treatment experience, a factor to consider when evaluating its treatment. As treatment providers, we try to minimize distractions during treatment but they’re always there, whether it’s a divorce or a brand-new relationship, a failing business or a prospering business. It’s plausible that being on a reality TV show was so distracting it prevented someone from fully focusing on treatment. The public nature of Celebrity Rehab treatment may also play a part. Maybe when Dr. Drew’s patients ran into trouble, they didn’t want to admit that they needed help since their recovery was so public.
But if Dr. Drew is doing his part by giving his patients a long-term plan to manage their addiction, and that plan is consistent with their needs and abilities, then it may be unfair to blame him if his patients don’t end up following that plan.
To paint with a very broad brush, there are two main goals of treatment: a) to stop the bleeding and b) to help people gain the motivation, hope and skills to manage their condition on a daily basis. At Phoenix Houses of Florida, we make sure that every treatment experience includes what we call a “continuing care plan,” a prescription for a person to manage his or her condition upon discharge from the treatment center. Relapse prevention starts at Day One, when treatment staff thoroughly assess a client’s needs, abilities and preferences. From assessment to admission to treatment planning to therapy—all of it culminates in a continuing care plan.
Now if a treatment provider sends someone off with the message, “Thank you for your stay! Thank the Lord every day, don’t do any more drugs or alcohol, we now pronounce you well,” that’s not a continuing care plan. Treatment isn’t a cure but instead a guide to managing a chronic condition, just as going to the doctor isn’t a cure for diabetes or hypertension. A continuing care plan may recommend that a person continue with outpatient therapy, go to A.A. meetings or find some other form of fellowship where they can interact with sober people in a healthy way. It includes friends or loved ones who can hold the person accountable for going to meetings or doing drug screenings, and it includes a list of people the person can call if he lapses or feels tempted to.
Most people would find it wrong to blame a doctor for a diabetic patient’s death if the patient received good clinical care but then didn’t follow the doctor’s orders to check blood sugar and take medication. A treatment provider also gives a professional prescription for ongoing care, and then it’s up to the client to follow those recommendations and come back for guidance if needed. The treatment provider gives the tools to manage recovery, but using them is up to the client.
Several months after Mindy McCready finished her stint on Celebrity Rehab, Dr. Drew said he had high hopes for her recovery, but it was up to her: “Like with anybody I treat, it’s really up to them. I never know. If they do the work they’re supposed to do, yes (there can be success). If she does the work it will be great.” When we bring someone into treatment at Phoenix Houses of Florida, it’s a major investment on our part and theirs—one we wouldn’t want to trivialize by airing the drama on a TV show or by creating extra distractions and pressure. Our clients take a courageous step when they enter treatment, and we make sure they leave with a roadmap to stay on track.
VP and Clinical Director,
Phoenix Houses of Florida