How the Rehab Fame Game Distorts Drug and Alcohol Treatment

By Brian Macaulay 06/16/14
If everything we know about rehab comes from celebrity stories, how are we supposed to recognize and accept real help?

It’s clear that rehab isn’t going to vanish from the cultural zeitgeist this year. Tabloids and entertainment gossip outlets have been packed with enough mentions of addiction treatment to imply that such headlines, which have ballooned in the last decade, will continue to dominate public awareness about an industry that serves more than a million Americans each year.

The precise number of U.S. citizens treated for substance abuse each year (according to statistics from the U.S. Department of Health and Human Services) varies, but has remained between roughly 1.6 and 1.8 million over the last decade. That’s only about half a percent of the nation’s population. Throw in the family members who participate in such treatments, and the industry professionals who do the treating, and the fraction of the pie chart representing those who have had hands-on experience remains barely visible. So, to the rest of the pie, what do words like rehab mean? What thoughts to come to mind when they imagine what help for addiction looks like?

To anyone with a concern about how addiction treatment is perceived, the real question is this—should Dennis Rodman be the spokesperson for an industry serving millions?

F. Scott Fitzgerald once wrote that there are no second acts in American lives, and certainly for the majority of professional athletes—however one interprets that line—this is true. Very often, famous champions leave the court or field and don’t reappear on the public radar ever again.

Dennis Rodman has continuously upset Fitzgerald’s logic. Rodman was a phenomenal player on phenomenal teams, reaching the NBA Finals six times and leaving with the trophy five. It is hard to imagine—for anyone who dreams of emulating him—that one could ask for greater fame and success than this. But despite his retirement from American professional basketball in 2000, and leaving the sport entirely in 2006, Rodman has nevertheless maintained and grown his public profile in the past few years. Always known for having an unsteady personal life, Rodman entered rehab after an arrest for domestic battery in 2008, with his management citing alcohol as the catalyst. Back on his feet the next year, he took the increasingly familiar path of stars into celebrity-reality-TV, as a contestant on Celebrity Apprentice—but he had relapsed into drinking after his treatment, and was booted from the show in part for his alcohol abuse.

What next? Rodman chose to combine the pursuits. He appeared as a patient on Dr. Drew’s Celebrity Rehab. Thus, the Dennis Rodman story, in public consumption form, had been of a man who rose to the height of his field, went to rehab for alcoholism, failed to maintain sobriety, appeared on reality TV, and then sought help for his alcoholism through rehab again, but on reality TV.

Now, recall the aforementioned pie chart. Slices representing the amount of Americans who follow basketball or read gossip pages smash the small slice referred to earlier. Nearly 18 million watched the Finals last year, which is almost exactly the number of unique visits is estimated to have each month. One could add to these whatever number of casual observers followed Rodman’s story through more conventional news outlets or word of mouth, but that's not necessary to understand the message. The picture is very clear, and it shows what events actually put rehab on the lips of Americans at large.

Rodman’s path is by no means unique. The last decade has seen similar escapades from many of the famous, most notably Lindsay Lohan. While celebrities tend to generate press regardless of what behaviors they exhibit, the addiction sector—of the time honored scandal market—has exploded.

A Google News search limited to the past 30 days for the terms “drug rehab” turns up nearly 48,000 results. More than 22,000 of these also contain the word “celebrity.” Contrast this experiment with ones for more benign terms, and the relevance becomes apparent: Of 12.9 million results for “vacation,” only 98,000 cross check for “celebrity.” Rest assured, this is as unscientific as measurements get, primarily due to the secrets of Google’s magic, but when searching for contrast between the details of the Hollywood-gossip mill and the experience of ordinary people, there’s plenty of evidence in real scientific methodology.

What does rehab look like for an ordinary person? While—as in all aspects of life—any individual’s experience is unique, Health and Human Services’ Substance Abuse and Mental Health Services Administration (a mouthful, to be sure) provides demographic data that sheds light on differences between the celebrity experience—as presented in reporting and on reality programs—and that of the majority of Americans.

Celebrity addiction treatment is very often presented like celebrity everything else: extravagant and luxurious. Some reports have been bolstered by advertisements or photos from Malibu's Promises  or Utah's Cirque Lodge that could make a travel agent’s mouth water. Such ideas are part of what’s led to an increasing amount of criticism for drug treatment as an industry primarily concerned with money.

However, according to SAMHSA’s 2012 National Survey of Substance Abuse Treatment Services, 69% of all treatment centers in the U.S. are publicly owned or non-profit. Of the centers as a whole, 50% reported offering some level of free treatment for patients who could not pay, with even 21% of for-profit operations doing so.

Numbers from 2010’s Treatment Episode Data Set (TEDS) highlight other interesting differences. This study showed that at their time of admission, 91% of patients had not been arrested in the last 30 days, whereas a DUI or other charge has been the catalyst for Rodman, Lohan, and others in the public sphere to seek treatment. Lohan was notoriously allowed to come and go from the Wonderland Center during her treatment there, in order to complete the filming of I Know Who Killed Me, but do ordinary patients in treatment share a similar experience? A reading of TEDS suggests this is not the important question—78% of patients reported being unemployed or not in the labor force at the time of their admission.

While celebrity addiction news may be the frontrunner in bringing treatment into cultural awareness, another sphere of public interest has highlighted treatment issues in recent months. As reported by The Fix and the media at large, the Affordable Care Act (colloquially, Obamacare) is beginning to have a broad effect on addiction treatment in the United States. While this has long been seen by many as a positive change brought about by the ACA, others have highlighted what they see as negative changes to treatment access. While this news is much more substantive than the boilerplate of celebrity drunkenness, their mutual ability to bring addiction issues to the table is based on the habits of media consumers. Like sports and Hollywood, politics is another slice of that pie chart which Americans love consuming.

It is not unusual for normal people to have surface levels of understanding about issues that don’t directly have bearing on their lives. Surface level perceptions are what define broad perceptions of most industries. It is not incumbent on average people to be at all times prepared to join that half-percent in rehab. However, what is different in the celebrity/addiction department is what characterizes those surface impressions. To anyone with a concern about how addiction treatment is perceived, the real question is this—should Dennis Rodman be the spokesperson for an industry serving millions?

What became of Rodman? After showing America some of the best NBA rebounding of all time, relapse, and rebounding into rehab, things did not get easier. Following his checkout from Celebrity Rehab, reports quickly surfaced of his being escorted from an Orange County restaurant by police for alleged drunkenness in 2010. This was followed by disputes over child support, controversial media appearances, and other gossip items, but all of that was old news; reruns. None of it foreshadowed what was coming.

In early 2013, Rodman took the remarkable step of allying himself with another controversial newsmaker, and hoops fan: North-Korean dictator Kim Jong Un. He visited the country twice, which, combined with comments he made there, provoked outrage in the states. The affair climaxed in a vulgar, nearly incomprehensible Rodman appearing on CNN to discuss the fate of political prisoner Kenneth Bae. The performance was classically Rodman, and the interview replayed just as endlessly as followers of his behavior would expect. It was hard to imagine what his follow up would be.

Or perhaps, not hard at all. Earlier this year it was reported that, after returning from North Korea, Dennis Rodman had entered rehab. 

Brian Macaulay is a regular contributor to The Fix. He last wrote about addiction and Oscar winning movies.

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Brian Macaulay is a Los Angeles based writer who is a regular contributor to The Fix. You can find Brian on Linkedin and Twitter.