Addiction Is Not a Disease and Rehab Is Bullshit

[Jabberwocky]

So I want to remind everyone that the article (and this thread) isn't actually about whether or not addiction is a disease. It is about the failing of the treatment industry to treat it like other diseases. In particular, the failure of the addiction treatment industry in doing so.

Please review the BLUA and in particular the Sober Living Guidelines for what we expect of you in terms of your behavior as members of the BL community.

Let's try and forget the first part of the title of the article in this thread and focus on the second part: How is rehab bullshit? Please avoid a critique of the 12 step community or methodology, particularly outside of its context in formal clinical (or supposedly clinical) treatment for substance use disorder.

To keep this thread open, please discuss the following questions. If things remain civil, the thread remains open. I hope it stays open. This is a very important discussion for anyone interested in recovery or the treatment industry.

Q1: Have you benefited or been held back in your experience with inpatient treatment?

Q2: What was the treatment like, and what do you identify as reasons it benefited or held you back (or some combination of the two)?

Thank you for your cooperation!

This Neuroscientist Argues That Addiction Is Not a Disease and Rehab Is Bullshit

Marc Lewis traveled the long, tenebrous road of opiate addiction, but he emerged out the rabbit hole a neuroscientist, science writer, and author. His best-selling memoir, Memoirs of an Addicted Brain, chronicled his descent into substance abuse, splicing the narrative with neuroscientific lessons about the brain's reaction to each chemical. His latest literary endeavor, The Biology of Desire: Why Addiction Is Not a Disease, asserts labeling addiction a disease is not only specious, it's downright harmful. VICE caught up with the University of Toronto Professor Emeritus, and current faculty member at Radboud University in Nijmegen, Netherlands, via Skype.

VICE: You're critical of the rehab industry because, according to you, it pulls addicts in under the ruse of medical treatment. However, it offers little more than 12 steps and pep talks. You've called it a canard. Can you elaborate?

Marc Lewis: I don't see it as an evil conspiracy, exactly, but it depends where you are. In the US, there are a lot of violations, a lot of improprieties. Treatment is inadequate. Opiate substitution doses are wrong; the period of time for getting off it is often wrong. Individual care is lacking. They have generic policies, which often don't benefit people, and the medical care is a fairly small aspect of the program in general. Eighty to 90 percent of the program is dominated by 12-step methodology. You also throw in a whole bunch of group sessions, in which people are lectured on anything from how to stop making excuses to all sorts of hodgepodge rants. For some people, it can work, because they get them out of their environment and drugs, so they dry out. But it doesn't work for long because they go back to their environments, and all the triggers are there. They don't get the psychological skills addicts need to move on. What you do need is a number of skills: They have to self-regulate and be conscious in order to put their lives into perspective.

I've never been to rehab, so I don't know much about the ways in which they treat patients. Do they claim their methods are predicated upon medicinal practices, and why do some rehab centers charge exorbitant sums of money for treatment?

That's exactly the point. When you get to the upper end, $50,000 to $100,000 for a month, you're basically paying for five-star luxury treatment. I know people who have done that and they're getting gourmet meals, over a Pacific Ocean view, and foot massages. The nuts and bolts of treatment doesn't cost that much. You're also paying for the time, the doctors and other professionals. But a lot of people running rehabs are under-skilled, recovered addicts who got a crash course. They're unregulated and unsupervised. It's a big mess. If you don't pay a large amount, there are state-run rehabs, but often there are waiting lists and other compromises that you need to go through. The waiting period itself can be a real problem because people are often willing to (get sober) within a small window. But that window closes, so timing is also important.

Do rehab centers purposely send patients down a path towards failure so they return and spend more money?

That's a subject of debate these days. I don't know if anybody really knows. I don't think that's the norm, but I think for some that can be a strong motivator, and that's just speculation, because who knows?

Some of the centers in the States are run by a consortia that operate a number of rehabs in different locations. Some patients can be snuck from one location to another in sneaky, insidious ways. You start off in residence in a house with eight people, and a few weeks later you're sent to another house, which is a dormitory. They feel like they're being trampled on and frustrated, and there isn't much they can do because they're in the system and they've made a huge financial commitment. They're stuck and nobody's watching over these guys. It's basically a free-for-all.

I'm criticizing the way the medical model is used both to conceptualize addiction and to underpin, support, and reinforce the philosophy of the rehab industry. Because it fails people so often, the medical model and definition of addiction should be seriously challenged, but it isn't and there's something really wrong with that. It's a self-reinforcing system that waves this banner that says you have a chronic disease that will kill you, so you better come to us.

The rationale that they have a disease has a lot of weight, especially because it's backed up by a lot of high-level bodies, like NIDA (National Institute on Drug Abuse). NIDA funds about 90 percent of addiction research in the world, according to some reports. You're giving money to people who are doing research on the biological or cellular mechanisms involved in addiction, but they're not giving money to people who are challenging the disease model, so that in itself is a self-perpetuating system.

In other words, medicine does not have much to offer addicts? Does that mean treatment is really a testament of will?

Will has an awful lot to do with it. A lot of addiction experts feel that self-empowerment, self-motivation, self-directed activities, self-designed goals for [addicts'] own progress are critical steps on the road of overcoming addiction. The medical model says you're a patient and you have to do what the doctor tells you.

[Del. Dan Morhaim, a doctor and Maryland legislator] is quoted as saying addiction is "a medical issue that has disastrous social consequences." That's very typical. Take those words, turn them around and you have something that's much more accurate: It's a social issue that has disastrous medical consequences.

Throwing people in jail and prohibition are responsible for a lot of the harm that comes with addiction. The prohibitions create this narrow passageway by which addicts have to squeeze themselves through, which drives them into crime, which breathes life into criminal organizations and cartels that get rich on the war on drugs. What Morhaim is proposing, though, is basically giving heroin to heroin addicts in Maryland, making it free by doctors. That's a very credible idea these days. It's been tried it in Switzerland, Germany, and Denmark, and it certainly reduces crime.

Your new book, The Biology of Desire: Why Addiction Is Not a Disease, eponymously puts forward that addiction is not a disease, and calling it such gets in the way of proper treatment.

Firstly, defining addicts as patients makes them passive. It makes them fatalistic and it makes them pessimistic. If you're told you have a chronic brain disease that causes you to do all this nasty shit, you don't think you'll ever get free of it. But, in fact, most addicts do recover and the statistics are very clear on that, whether they're soft drugs or harder drugs like heroin. So, it's a chronic disease? Really?

The second thing is it tends to overshadow other approaches to treating addiction that relies on much more individualized psychological methods. There are various kinds of psychotherapy, counseling, support networks, and mindfulness meditation approaches that are also being shown to be very effective. If you believe you have a chronic disease and so does your care provider, they're not very likely to recommend mindfulness meditation, but it's been shown to be very effective.

While opiate and alcohol withdrawal can wreak physical havoc on addicts, you argue that addiction is purely behavioral rather than physiological, like, say, cancer is?

That's another discrepancy. You have substance addiction on one hand, and behavioral on the other: gambling, sex addiction, porn addiction, a number of eating disorders, internet gaming. The cool thing is when you do brain scans, you get the same neural activation patterns in behavioral addictions as you do in substance addictions. That should be enough to knock out the disease model. If addiction is a disease, then people who spend 12 hours a day playing video games are suffering the same way people who are addicted to heroin do.

What all these patterns have in common is they involve deep learning—a set of assumptions of what you need to get through the day; that learning gets entrenched through repetition and you're addicted, but there's nothing disease-like about it. People recover from all addictions, which means it's all about neural plasticity. It's not that you go back to where you were, because development never goes in reverse, it's that you learn skills that help you overcome your impulses and you learn new cognitive habits. All learning involves changes in synapses, which means creation and strengthening of certain synapses, and the weakening or disappearance of synapses that aren't being used.

It isn't unreasonable to presume your theories are unpopular in the addictions treatment industry. Have you drawn criticism, and have you been publicly undermined?

Yeah, I've been chastized. A review in the Washington Postcalled me a "zealot." Mostly people in the medical camp, they try to ignore people like me and other people who also endorse a learning model or developmental model of addiction. They just ignore us. But this is part of a rising wave. I'm not the only one here. The only difference with me is I can talk their language because I know the brain. I've talked to Nora Volkow, [the director] of NIDA and a very powerful policy maker. She doesn't want to hear it. She's basically saying that addicts need to be told they have chronic brain disease because that will reduce stigmatization. But people like me come along and say, "No, it doesn't look like brain disease. Brain change, yes. But that's what a brain is supposed to do because it's learning." That's when the wall comes down.

If addiction is not a disease, does that render the "alcohol gene" a fallacy?

You get little things that show some genetic correlation with alcoholism, but there is no gene, or cluster of genes, that create addiction. Rather, there are personality traits that have a genetic loading, like impulsivity. So you get these cross-generational correlations that are real and do have genetic loading, but there's nothing like a particular gene or set of genes specific to addiction.

What is the relationship between addiction and developmental age? Is it easier to kick a junk or coke habit at a certain age

Yes, absolutely. For one thing, each of these addictions has an average duration, an average longevity. A lot of research on this was done by Gene Heyman. The median age for quitting cocaine is four years after you start. The median age for alcohol is 12 to 15 years after you start. They're medians, so there are variations. The second thing is the brain continues to develop through the teens and 20s, and you get increasing executive control in your 20s, giving you more of the neural hardware you need to help you regulate your thinking and your behavior. The third thing is, as we age and grow up, our circumstances change. By the time you get close to 30, you realize you have to get certain things under control. Those are all strong reasons why age matters.

You're on record as saying that calling addiction a chronic brain disease combats stigma. Given that we live in an age of hyper political correctness, is there a correlation between stigmatization reduction and the persistence of the chronic brain disease theory?

Yeah, I think there is. If you have a disease and it's not your fault, you're not a lazy, decadent, self-centered, weak-willed whatever... it's that you have a disease, so you shouldn't feel so ashamed or guilty. That's a convenient way for us to forgive addicts and for addicts to forgive themselves, and that is a form of political correctness. Some people have asked me when I do talks or write blogs not to use the word "addict" because you're calling someone a name. It's politically incorrect to designate someone according to a condition they may have. My response is I get your point, but first of all, I called myself an addict for years. I was also a student once and I'm not a student anymore. That's part of the whole political correctness movement—"It's not their fault, they're just human beings." Well, yes, they are human beings, and no, I don't want see them suffer and sent to prison. The idea that these are the only two alternatives—either call it a disease or call it morally decrepit and tar and feather them is ridiculous. It's black-and-white thinking. We can still be humanistic and not slap this label on it.

In layman's terms, what is addiction if it isn't a disease?

Addiction is learning, very simply. It's learning a habit of thinking. It's deeply entrenched learning. So are relationships when you're in love with someone. If that person happens to be abusive, you might still be in love with them for 12 years or the rest of your life. That's through learning. So is being a sports fan or a Jihadist. Religion is another deep substantiation of deep learning. That's what I think it is. The fact that it could be gambling, or eating, or heroin, or meth, it shows there are certain addictions that involve substances that create physical dependency. Physical dependency is a whole other layer of shittiness on top of addiction.

Psychological and interpersonal tools are very important. Addiction has to do with isolation and feeling alone, not having a support network and not being able to deeply connect with other people. You can superficially connect and have a nice circle of addicts, but not connecting with people in a way that's harmonious and fulfilling, those are the people that are really vulnerable to addiction. They're lonely, depressed, anxious, and traumatized. It's just like the Rat Park [Canadian study into drug addiction]. What I said doesn't just apply to humans, it applies to other animals, too. Isolation is really bad for you and it's the underlining factor of addiction.

http://www.vice.com/read/this-neuro...ehab-industry-is-bullshit?utm_source=vicefbus

An oldie, but a goodie.

If you want to discuss it within the contact of formal treatment programs or methology, feel free. However, this thread is not a place to criticize the 12 step community outside that context. We are NOT talking about the larger 12 step self help group community, its benefits or detriments here.

12 step work is often treated by people in the recovery community as akin to treatment, but anyone who knows anything about twelve step programs - ironic how few people who work in the industry actually seem to understand this - understands that 12 step work is NOT treatment, clinical care or evidence based. 12 step groups are non-professional self help groups that some may find helpful in augmenting their recovery, whether or not they receive actual treatment, but nothing more.

Really the title is annoying because, as I said, the article isn't really about whether or not addiction is a disease. It is about how culture and medicine treat it in ways that we don't treat any other disease (prayer and powerlessness are not part of how modern medicine treats any other form of disease, etc. etc.).

I really would prefer this thread not to be any more of a discussion of the issues or benefits of 12 step communities however. So, if you want to avoid any warnings or infractions, please remain civil (and chill on the name calling and personal attacks please) and try not to discuss 12 step stuff, certainly not outside the context of how the role it plays in how the most established addiction treatment model (rehab/inpatient) is a pretty dismal failure regarding treatment efficacy or reducing treatment recidivism.

QUESTIONS:

Q1: Have you benefited or been held back in your experience with inpatient treatment?

Q2: What was the treatment like, and what do you identify as reasons it benefited or held you back (or some combination of the two)?

Thank you again for your cooperation!

 

[crazybollweevil]

thanks for posting, i wish there were more critical thinking about the rehab industry and specifically about the Oxford Group-borne cult of AA/NA.
The key thing to remember is this- AA/NA success rate= 5%, rate of spontaneous remission of addiction=5%
The 12-step suicide rate is far higher than general population as well, but is very difficult to track, with the anonymity and the flux of attendees/members
i remember one jack ass in particular who had been doing a meeting a day for 7 years, reliving and guilt ridden over an admitted 6 months of drinking when he was 17.
that is an extreme example, but representative of the mentality these people cultivate.

 

[Burnt Offerings]

You can superficially connect and have a nice circle of addicts, but not connecting with people in a way that's harmonious and fulfilling

It always comes back to this for me. What exactly does it mean to have "harmonious and fulfilling" connections with others? Obviously it doesn't simply mean having numerous interpersonal relationships with other people, as that was mentioned in the first part of the sentence. You can have friends, lovers, family members who care, and so on and so forth and still become an addict...I know through personal experience.

So, with that being the case, how is addiction supposed to be treated? How are we supposed to fundamentally alter the deep alienation and existential angst which pervades our society like a cancer and help the individual addict? That's what I've never been able to get, as far as a satisfying answer, from the people for whom all roads lead back to "Rat Park" & "enriched environments" when the subject of addiction comes up.

As far as whether addiction is a "disease"...I don't personally call it that. I think people can and have ended addictions through pure force of will alone, and that's obviously not possible with most diseases. I would classify it as a mental illness, though, for some addicts anyway.

 

[bomber]

Im sorry but I can't agree with this neuro scientist knowing that my ex became a normal person with a life after quitting alcoholism in a rehab.
Or my girlfriend being saved from heroin in a rahab.

Addiction is both mental and body illness. It's not mentally right to want as fuck something is bad for you. It's not mentally right not to be able to behave reasonally with out a substance that is not even dezined to make you behave reasonally. There are like a shit ton of things that are not mentally right about addictions.
Also it's not physically right to become sick when your drug isn't there for you. Only exception if the problem was there before you take the drug, and the drug serves as a fixer for the problem.

No mate, addiction is an illness and rehabs are neccesery for some people to face the illness.

 

[Jabberwocky]

He is not saying anything about your ex. He is saying addiction is behavioral, not pathological. It's okay if you don't understand.

 

[spacejunk]

I think it's a really good article.
Having overcome a decade-long opiate addiction without inpatient rehab (just counselling, support from loved ones and determination) i totally agree with his rejection of the addiction-as-disease model.
To me it is a disempowering philosophy.
Learning how to stay off drugs of addiction is the hard part, in my experience - but it gets easier with time.

 

[bomber]

I used them as examples. I would consinder behavioral problems as psychological problems. And no, since drugs can make you physically addicted(and most often that's when the rehabs are neaded) it could be pathological.
And about this disempowering philosofy thing, it's a fact that most people wouldn't be powefull enough to face a strong addiction and rehabs will help.

Congrats for facing addiction alone, but most people wouldn't be able to do that.

 

[Jabberwocky]

I doubt anyone is strong enough to face even a weak addiction on their own. That is part of his point. The reason addiction is so harmful has less to do with anything inherently evil about addiction and everything to do with how we stigmatize and demonize addicts, alienating substance users (and "normies").

 

[alpha_centauri]

So an addict in denial, claims addiction is "bullshit", in a publication run by active drug addicts who openly use drugs at work?

Not surprising. This is typical addict bullshit excuses, and magical thinking where the person who is an addict does not actually want to admit, or believe that that they're an addict, and this type of thinking leads to relapse, addiction to other drugs, and it can even lead to major health problems and death.

Comparing heroin or opiate addiction to video game addiction is laughable. There's no pain and suffering and withdrawals that make you hurt so bad that you will literally steal from your own mother so fuck this guy!

He's doing addicts a disservice with HIS bullshit. Addiction is a mental illness. It changes the way your brain functions, and with addictions to certain drugs there's the physical addiction as well as the psychological addiction. Also, rehabs are not BS as some people do need medical assistance to get sober from drugs. Alcohol and benzos are extremely dangerous to stop on your own and people have died from doing this.

This seems to be along the same line of thinking as saying people who suffer from depression are just sad and need to pep up.

The medical model was a VAST improvement over simply blaming addicts for their problems and calling them bad people. I don't want society to go back to that way of thinking.

First off, poverty is not a result of addiction. If anything, it's an added vulnerability for it to affect you. Impoverished groups are the most likely to feel extreme isolation and anxiousness concerning their environments and relationships. Everyone I know that uses heroin and was privileged beforehand is STILL privileged.

For a Neuroscientist he certainly didn't present a very good case for his theory. What about diminishing GABA receptors making addiction a progressive disease/problem? He also seemed to be a bit clueless on treatment approaches other than 12 step programs which not everyone uses or goes to today.

 

[DaysNDaze]

While the article is interesting, its really a shame that the neuroscientist is painting this kind of picture. Does he understand the definition of disease? Pretty sure addiction fits the profile perfectly: A mental abnormality affecting various brain structures that can be identified by specific signs, symptoms as well as behaviours.

Rehabs are starting to improve in terms of different approaches to recovery. I think rehabs can be very beneficial, the only unfortunate part is many addicts (myself included) could never take advantage for financial reasons and other life responsibilities. I do have access to outpatient counselling though, and I think every addict out there would have a much better recovery and a much less chance of relapse f they obtained SOME kind of help to quit. I do believe that one day, when I'm ready, I could quit without rehab, but the chances that I would use again would be high.

The idea that calling addiction a disease takes away the addict's responsibility for their actions is such an old school ideology. Addicts are held accountable regardless, however when society holds them accountable, we usually do so by throwing the addict in jail because they stole something in order to buy their fix instead of throwing them in rehab because they are making these choices due to the mental illness. It's all a matter of perspective.

Many new studies are published all the time about how addiction literately changes the way the brain functions. Once you are addicted to a substance, say you take the drug when you wake up. Then you use again before work. Then you use during your break at work. You had a bad day at work so you come home and use. Every time you establish patterns of using, over time, the brain's neural pathways change, so when you are triggered by every day activites like the ones mentioned (waking up, going to work, break time, stressful day), the brain's immediate response is to take more of that substance. This is why addicts in recovery say the hardest part is staying off drugs, because neural pathways in the brain have been hardwired (due to compulsive use) to continue the pattern of using. This doesn't even begin to describe the way the brain changes due to substance abuse, so how can he sit there and say its not a disease?

Gambling addiction and heroin addiction are two different things, however, mentally, the addicts are still affected the same way. The only difference would be the physical withdrawal that drug addicts suffer from in addition to the mental aspect.

I don't like this guy. As a so called "former addict" he really doesn't sound like one.

 

[Mmp85]

I agree with his stance on rehab.
It really isn't sufficient in most cases other than the detox phase and giving you a safe haven from your life and whatever is affecting you negatively. At least that was my experience. It was very generic treatment.

 

[MisterNotSoClean]

My personal experience and feelings on addiction lines up fairly accurately with what Marc Lewis is saying.

I think the whole addiction experience is different for most people and some respond well to rehab programs while others don't. For me it came down to myself asking myself a question before I do most things about 3 months ago. "How will this make my life better?" I did this with random tasks throughout the day. This includes taking my suboxone.

Over and over I came up with the same answer. "I will be able to be a productive member of society for today but in the long run, this is not making my life truly better." In the end, It kinda forced myself to look back on all the times where I was anxious if something would happen and I couldn't get it filled due to having to be at work or not being able to make it to the doctor. Also the couple times where I somehow lost a few subs and if I would be kicked for the program etc etc. There's a long list of anxieties that I had about it. I started thinking, all I have been doing is maintaining an addiction for 3 years rather than truly dealing with it.

I've heard addiction called a disease but I honestly never accepted that. I believe personally that I have qualities that make me more susceptible to opiates than your average joe. I have a tendency to be impulsive and do what feels good as opposed to what's best for me. Not really a lack of self control but honestly a lack of analyzing my choices in life. As long as I stop and ask myself the right questions, I tend to be okay.

Another quality I have is that I am stubborn as hell. My mind tends to be like the juggernaut. Unstoppable force once set in motion. I have problems initiating that motion sometimes though but once I do, shit gets done.

That stubbornness was activated after asking myself "How is this making my life better?" every morning while taking my sub. Finally, one morning after months of never coming up with an answer I found satisfying, a switch was flipped and I decided to jump off subs after 3 years. There was about a month of planning and prep prior to doing so to provide myself the best environment for success. Mainly available distractions for the first couple weeks.

Anyways, a month later and still going strong. I just saw my doc on Tues and he honestly was figuring I was there to refill my script for subs. I had no desire to do so. He gave me ambien for sleep which is still unfilled. ( If you have been following my post I actually slept 5 straight hours last night!!!)

Just thought I'd throw in my experience on how I came to the decision to make the jump as it seemed somewhat relevant. I don't feel there's anything special about me as I don't have a very high pain tolerance, I truly don't have a wealth of natural willpower, really the only thing I have going for me is the ability to look at things rationally. I just have to be able to ask myself the right questions I guess... And hella stubborness... just ask my girlfriend

 

[d3athadone]

I believe the physical manifestations of addiction and the changes to the brain are a disease but that the root cause of addiction is not getting crucial needs met.

 

[Sobrietysucks]

I agree with everything he says..

If addiction is a disease, then people who spend 12 hours a day playing video games are suffering the same way people who are addicted to heroin do.

So true. Workaholics have a disease too? No of course not because they benefit society lol.

Rehab can't cure an addict. Only the addict can. Even if you go to rehab, you will have to do the work. They can't fix you.

 

[Sobrietysucks]

Im sorry but I can't agree with this neuro scientist knowing that my ex became a normal person with a life after quitting alcoholism in a rehab.
Or my girlfriend being saved from heroin in a rahab.

Addiction is both mental and body illness. It's not mentally right to want as fuck something is bad for you. It's not mentally right not to be able to behave reasonally with out a substance that is not even dezined to make you behave reasonally. There are like a shit ton of things that are not mentally right about addictions.
Also it's not physically right to become sick when your drug isn't there for you. Only exception if the problem was there before you take the drug, and the drug serves as a fixer for the problem.

No mate, addiction is an illness and rehabs are neccesery for some people to face the illness.

What about the majority lol? They relapse right after getting out of rehab because they don't know how to cope with the outside world. If someone co ws out of rehab and stays clean , it's because they did the work themselves during treatment. They fixed themselves. Rehab is just a change of environment so the addict can work on themselves. Same thing can be done at home . Or anywhere. But the point is it's not rehab, nor the staff, nor doctors nor their 12 steps that fixes an addict.

 

[bomber]

What about the majority lol? They relapse right after getting out of rehab because they don't know how to cope with the outside world. If someone co ws out of rehab and stays clean , it's because they did the work themselves during treatment. They fixed themselves. Rehab is just a change of environment so the addict can work on themselves. Same thing can be done at home . Or anywhere. But the point is it's not rehab, nor the staff, nor doctors nor their 12 steps that fixes an addict.

When a rehab is working right, it will prepare you for the outside world.

 

[cj]

When a rehab is working right, it will prepare you for the outside world.

That's the problem unfortunately. Most rehabs are not incorporating the last 20 years of brain research scientists have done. In fact no rehab I have been to gave much advice beyond go to meetings and do what your sponsor says.

 

[Captain.Heroin]

You have to realize that most rehabilitation centers are for profit, so they're not going to give anything more than bare essentials for living. This is why I think the government needs to have better mental health support for everyone.

 

[cj]

You have to realize that most rehabilitation centers are for profit, so they're not going to give anything more than bare essentials for living. This is why I think the government needs to have better mental health support for everyone.

Don't even get me started man. Its looking like im going to be forced into outpatient rehab. So I have been calling around checking prices and its outrageously expensive. Like 3 grand for 4 weeks of outpatient. Granted its about 80 hours of "therapy" but still who can afford that? The worst part is I know its just group therapy with a bunch of people who all need different types of care all lumped together for profits sake. Its sick if you think about how much money these places bring in.

 

[CfZrx]

Who here has read Gabor Mate's "In The Realm of Hungry Ghosts"? It is really an interesting albeit dismal view of US rehabs.