When news circulated last week that Lindsay Lohan had hired attorney Robert Shapiro, I believed that things were finally looking up for the troubled star. Shapiro, whose son died from a drug overdose five years ago, clearly understands the disease of addiction—and seemed to have a sincere interest in ensuring Lindsay’s recovery. That is, until he mysteriously quit her case Monday night, just hours before she “surrendered” for her 90-day prison term.
Lindsay no longer has Shapiro in her corner, but watching her estranged father and “friends” on Larry King Live on Tuesday night, I realized that what she really needs is a “dream team” of a different sort. I’m not talking about agents or PR reps who could remake her image. I’m referring to a dedicated team of treatment professionals and other recovery supporters who could help her get back on track.
After her stint in jail—which is likely to be around three weeks—she’ll head to three months of mandated in-patient drug treatment. Some commentators have suggested that treatment won’t work for Lindsay unless she’s ready to admit she needs it, but people who become addicted are rarely able to see that their behavior is out of control before others do. Research has shown that those who are coerced into treatment by the criminal justice system can be just as successful as those who seek treatment voluntarily. That said, barring a miracle or a spiritual epiphany, 90 days of treatment will not be enough to change Lindsay’s behavioral patterns. After all, she’s been in rehab three times before—without much success.
What will make the difference this time is if she remains in residential treatment for an extended period of time— at least six months, followed by a minimum of six months of outpatient care and ongoing monitoring. At the beginning, she should not head to a transitional living facility as she did in the days leading up to her surrender. Her best shot at recovery will be an intensive, medically based program where doctors and other addiction specialists are on staff—and are actively involved with the treatment plan.
According to probation reports, Lindsay has been taking a dangerous cocktail of pills, including the powerful opiate painkiller Dilaudid —leading her father and others to suspect prescription drug addiction. According to SAMHSA Administrator Pamela S. Hyde, “The non-medical use of prescription drugs is now the second most prevalent form of illicit drug use in the nation.” In May of 2008, my stepson died from mixing alcohol with prescription drugs, so I know first-hand that prescription medications can be just as lethal as heroin. If it turns out that Lindsay is, in fact, abusing prescription meds, she’ll need a team of experts to work with her and with each other: a psychiatrist who is highly skilled in psycho-pharmacology, a pain specialist, and a host of other substance abuse professionals.
Additionally, the criminal justice system should remain involved to ensure that Lindsay’s progress and her drug use is continually monitored—and that she stays engaged with the process. In the treatment system, those who have the most success are those who are monitored for a considerable length of time. This type of supportive monitoring will hold Lindsay accountable and offer her additional treatment if she veers off course.
The eventual goal for Lindsay—or for anyone who struggles with substance abuse—is independence and self-management. Like diabetes, addiction is a chronic condition. However, relapse is not inevitable. Just as diabetics must monitor their disease and adjust their medications, Lindsay must learn to adjust the volume and intensity of her recovery support for the rest of her life. She needs a “dream team,” but she also needs to keep her eyes on the prize. This could be her moment to get it right.
Chief Clinical Officer, Phoenix House