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Inside Rehab: The Surprising Truth About Addiction Treatment-and How to Get Help That Works 1st Edition

4.3 out of 5 stars 81 customer reviews
ISBN-13: 978-0670025220
ISBN-10: 0670025224
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Editorial Reviews

From Publishers Weekly

Starred Review. Some things never change. And as Fletcher (Sober for Good) finds in this bold report on 15 rehab facilities—from high-end, celebrity-friendly outposts to those treating people on welfare—that fact especially pertains to addiction treatment. Collecting stories from more than 100 interviews, Fletcher methodically dissects the myths about the programs that treat 2.5 million people every year. She finds, for example, that rehab isn't necessary for recovery—some heal on their own, attend self-help groups, or see therapists; that most of the treatment in rehab programs is handled not by highly trained pros but by counselors with varying levels of education and training. She debunks myths, such as that the 12 steps of Alcoholics Anonymous are essential for recovery. Fletcher concludes that traditional programs, such as group treatment, 12 step programs, and counseling, work for some but not for all. Dimitri, for instance, began abusing drugs at 15 and cycled in and out of programs that failed to help him. Fletcher also highlights the exorbitant cost of rehab: one young woman's treatment drained her parents of ,000. Fletcher presents what works, why, where to find it, and how much it costs. It's startling, difficult, and important information for those traveling toward recovery, and anyone who wants to help. (Feb.)

From Booklist

*Starred Review* Health writer Fletcher adopts a cautious, even skeptical approach in her exploration of current treatments of substance abuse. She warns that her book “is filled with disturbing accounts of seriously addicted people getting very limited care at exhaustive costs and with uncertain results.” Indeed, her portrait of contemporary addiction treatment incorporates numerous stories of individuals who’ve undergone treatment, opinions and commentary from experts in the field, and her own visits to 15 different rehab programs. More than 13,000 addiction treatment programs—outpatient, residential, and hospital inpatient—operate in the U.S. Dropout rates and the frequency of one-year relapses are high. One expert laments, “When it comes to picking a rehab, most people ask more questions before buying a vacuum.” Fletcher has no such bashfulness and provides answers to fundamental questions: How much does it cost? How long does it last? What do people actually do there? She concludes that no particular treatment of substance abuse is superior to others for most individuals. Flexibility—as opposed to a “one-size-fits-all” approach—matters most. One authority on addiction agrees: “There are as many roads to recovery as there are individuals.” Inside Rehab is a valuable road map for navigating the multiple pathways and programs dealing with the problem of substance abuse. --Tony Miksanek

Product Details

  • Hardcover: 448 pages
  • Publisher: Viking; 1 edition (February 7, 2013)
  • Language: English
  • ISBN-10: 0670025224
  • ISBN-13: 978-0670025220
  • Product Dimensions: 9.1 x 6.1 x 1.7 inches
  • Shipping Weight: 1.3 pounds
  • Average Customer Review: 4.3 out of 5 stars  See all reviews (81 customer reviews)
  • Amazon Best Sellers Rank: #142,001 in Books (See Top 100 in Books)

More About the Author

Anne M. Fletcher, M.S., R.D. is a nationally known, award-winning health and medical writer, speaker, and consultant on the topics of weight management and lifestyle change, as well as treatment and recovery from addiction. She spent nearly five years writing her latest book, Inside Rehab: The Surprising Truth about Addiction Treatment - And How to Get Help That Works, which will be published by Viking in February of 2013 along with accompanying eBook titled Holistic Rehab Therapies: Are Alternative Approaches Helpful, Harmful, or Head Games? In advance of publication, Inside Rehab has received high acclaim from numerous experts in the field, as well as several starred reviews.

Known for her ability to weave together her inspiring findings from real-life success stories with state-of-the-art information about health issues, Anne is the author of seven other books (Houghton/Harcourt), including the award-winning national bestsellers, Thin For Life: 10 Keys to Success From People Who Have Lost Weight & Kept It Off and the New York Times bestseller, Sober for Good: New Solutions for Drinking Problems - Advice From Those Who Have Succeeded.

Anne's last book, Weight Loss Confidential: How Teens Lose Weight & Keep It Off - And What They Wish Parents Knew, was featured on the Today Show, on the CBS Early Show, and in The New York Times, USA Today, US News & World Report, and USA Weekend. She has been recognized with a dozen prestigious awards.

A frequent guest of the national media, Anne has also appeared on The View, the Today Show, Donahue, Good Morning America, CNN, National Public Radio's Talk of the Nation, and The Larry King Radio Show.

As a registered dietitian with a B.S. degree from Cornell University and an M.S. from Drexel University, Anne has counseled hundreds of people with weight problems. She is a founding member of her county drug court in Minnesota and helped develop its treatment program, remaining on its steering committee. She serves on the advisory board for a high school for adolescents with substance use disorders and also serves on the editorial board for BASIS (Brief Addiction Science Information Source) of Harvard University's Division on Addictions.

Anne is a former executive editor and chief writer of the "Tufts University Health & Nutrition Letter" and was a contributing editor for Prevention Magazine. Her articles have appeared in Good Housekeeping, Vogue, Shape, American Psychologist, Cooking Light, Bottom Line Personal, Readers' Digest, Restaurant Hospitality, Parenting, Journal of Food Science, Eating Well, The Humanist, Journal of the American Dietetic Association, and Obesity Management.

Customer Reviews

Top Customer Reviews

Format: Hardcover Verified Purchase
Fifteen years ago, I sat shaking with a phone book in my hand. I had reached the end of a 25 year addiction to alcohol and I was desperate. I had decided to quit drinking and I knew, or at least I assumed, that I had to go to rehab to do it.

I'd heard many times that addiction is a disease so I naively assumed that it was treated like other diseases. You called the hospital and they helped you get better, using proven scientific protocols. So based on this assumption, I picked up the phone book, called a local hospital that had an affiliated rehab, and scheduled an appointment.

Since over 90% of rehabs in the late '90s were completely 12 step based, I naturally found myself in a 12 step based program. The main goal of the program was to connect clients to the 12 step community and convince them that the sole path to recovery was lifelong participation in a 12 step group. Its educational component consisted of movies, photocopied literature, and discussions about AA and the 12 steps. We worked steps, and the steps were posted on the wall of every room in the rehab. The sole clinical "credential" of the counselor I saw was that he had been an AA member for nearly 20 years (he did have a masters degree in an unrelated field). In retrospect I should have understood that there was nothing scientific about this experience, but I didn't question it as I might have under other circumstances. It is tough to be an educated consumer when your brain is addled with chemicals; tougher still to question authority when you are beaten down and full of shame as the result of an addiction.

But despite what I'd been taught in rehab, I just didn't care for AA.
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Format: Hardcover Verified Purchase
Anne Fletcher became controversial in 2002 when she released the best-selling Sober for Good: New Solutions for Drinking Problems -- Advice from Those Who Have Succeeded. The book was based on her interviews with 222 "masters," individuals who had overcome drinking problems for at least five years. She was fiercely criticized by members of the addiction treatment industry because of the diversity of her recovery accounts, and her support of the idea that there are many paths to recovery (including moderated consumption). Nevertheless, her book earned awards from scientific societies. Her current book, Inside Rehab, will also be controversial. Controversy seems inevitable when an author is dedicated, as Ms. Fletcher is, to staying close to the scientific literature, and is writing about a field that does not have a similar motivation.

Inside Rehab describes current practices in the US addiction treatment industry, based on in-depth visits to a diverse sample of 15 facilities (including Practical Recovery, the San Diego addiction treatment system I founded and operate), and interviews with approximately 100 experts and facility staffers. She also interviewed dozens of treatment clients, who report their treatment experiences good and bad. What Ms. Fletcher documents should frighten anyone seeking US addiction treatment (including "rehab," the common term for residential treatment).

On average the US treatment system has a one-size-fits-all approach based on the 12-step approach to recovery. Some facilities do a good job, at a reasonable price, in providing this approach.
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While I agree with many of the criticisms of the treatment field in Fletcher's book, such as that most treatment is 12 step based with not enough alternative, that not enough individual therapy is provided, that many counselors are undertrained, and that 28 day residential rehab as a stand along is not enough, I don't agree with her that residential treatment is mostly unnecessary. I don't think people are being overtreated--it is the 90% of people who do not get treatment and need treatment that is the problem. Treatment absolutely needs to be much better, but that does not mean residential treatment is not needed for various reasons. Combining residential treatment with a gradual step down to outpatient treatment over a period of months is offered by many treatment centers, not just 28 days. The problem with non-12 step based treatment is one of access and affordability. If one is to go to residential treatment for a few weeks only before outpatient, and for the family to attend family groups, the center must be close to one's home. Insurance coverage would be helpful, if not a necessity. So if there is no non-12 step program near one's home or covered by one's insurance as was my case for my son, I had to work with a 12 step based program.

Under my insurance neither the HMO or PPO provided residential treatment, so I ended up paying for residential. Here is why: My son went to numerous individual counselors specializing in addiction and various outpatient treatment programs and kept getting worse because he wanted to keep using and found ways to use substances even while in treatment and went back to heavy using as soon as he stopped the treatment.
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