THE BLOG
07/25/2007 06:23 pm ET | Updated May 25, 2011

Lindsay: 28 days in Rehab is a Joke!

The great myth in the rehab community is that you can go in for a month and come out clean and sober.

This is just the sales pitch. As Howard Samuels says, "Right off the top, you can't tell an individual, you have to go away for six months. They will never come in."

Samuels would know. A former heroin addict and son of a famous NY politician, he has been clean for 22 years. He is also executive director of the Wonderland Center, which had Lindsay as a patient for 28 days this last January. "At Wonderland, our work is to convince the clients to stay longer, and the people who do stay longer usually have a higher rate of success."

During the 28-day detox, which is often all insurance companies will pay for, if you are lucky, they get you clean and try to talk you into an extended stay of 8 to 12 weeks.

Then the good programs, like Caron, Hazelden, and Betty Ford, move you to the vocational phase where you find a job, live in a sober community, and partake in intensive outpatient therapy.

This is often called a Semester of Sobriety. You definitely cannot go back and associate with "the people, places and things" that got you into trouble. The whole process takes one to two years. Relapse is a part of the process.

The success rate at the first stage of rehab, even at the best places (without extended care) is about 20%. With longer stays, the success rate goes up to 70%.

Lindsay, Paris, Britney -- there are no short cuts. You all are addicts! A key to sobriety is the active involvement of the family and the employer, who have been supporting and enabling the addicts' behavior. But the wealth and position of these celebrity addicts, and the deep denial of their families, insulate them from the usual hard knocks that addicts face and prevent them from hitting bottom.

The classic maladaptive behaviors of the addict - we are talking about you Paris, Lindsay, and Britney, are:

Profound narcissism. They are self-centered and selfish.
Extreme grandiosity. Mostly image, addicts "front" strength but are actually weak.
Manipulation and lying. Con games, stealing, cheating - the whole gamut.
Impulsiveness. Like lighting they move from impulse to action, bypassing the weighing of possible consequences to self or others.
Extreme risk taking. Crime, overdose, HIV infection, etc.
Externalizing of blame. It's always someone else's fault, never theirs.
Isolation. They retreat into a secretive world filled with secrets, shame and guilt.
Passivity. At times, they collapse into inaction, awaiting rescue by others. See My Name is Paris and I am an Alcoholic and other previous posts.

Few people entering rehab do it on their own. They are forced by their parents, their wives and children or their employer. They go in kicking and screaming. But studies of arrested felons -- diverted and mandated to a year-long drug program -- show that if they stay in long enough, even if they say they are faking it, they get sober.

If you have been abusing for years, it's going to take years of living in a sober community to beat this deadly illness, which affects one family in four.

jfleetwood@aol.com