06/26/2007 05:42 pm ET | Updated May 25, 2011

My Name is Paris and I am an Alcoholic

Paris Hilton was released from jail early this morning after a 23 day stint. But can anyone doubt that she will quickly relapse into the same hedonistic, self-destructive behavior?

I write about this not for the reason that I care very much about what happens to Paris Hilton or think that she deserves any more publicity, but because this very public window into the life of a troubled person illuminates the flawed, prevailing, popular perception of drug addiction and mental health.

The same sad story keeps being played out on the media stage with a number of other well known young women celebrities, including Lindsay Lohan, Britney Spears and Nicole Richie, and what usually follows in this youtube age is a voyeuristic (see no underwear) media witch hunt of bad behavior which demands a ritualistic burning at the stake.

The public has a soap opera fascination with celebrities' failures, in controling drug and alcohol addiction and pornography, by these fragile young women. But whether we like it or not, or understand it, these celebrities are role models for millions of young girls and women.

I certainly plead guilty to shamelessly exploiting this high profile case to bring about discussion of the serious issues of addiction (26 million sufferers) and mental illness (54 million), which cripple and kill tens of millions annually in the United States. Research shows that the co-morbidity of addiction and mental illness is more than 50%.

Every month a 747 full of teenagers crashes and all are killed. Alcohol and drug abuse kill about 30,000 drivers per year - ten times the number of young American soldiers that have been killed in Iraq since the start of the war.

Denial ain't just a river in Egypt - Mark Twain

By getting high and drinking and driving while drunk, Paris Hilton demonstrates the classic fantasy of the addict: THE FANTASY OF LIFE WITHOUT CONSEQUENCES. Publicly the addict reveals her or his vulnerability by denial of the very things she or he needs - "I don't need anyone!" - according to Sid Goodman, a noted drug treatment pioneer.

Paris Hilton and her entire family are so far in denial that it's terrifying. Her father's actions, trying to crassly cash in on a million dollar payment from NBC for an interview and some old movies, are disgusting (since cancelled).

One of the most important steps to a healthy life, according to the drug treatment community (Caron, Hazelton, Betty Ford, Renaissance), is the active involvement of the family, which has been supporting and enabling the addicts' behavior. But Paris Hilton's wealth and position, and a family in deep denial, insulate her from all the usual hard knocks that addicts face (e.g. you can't get fired if you don't have a job).

The classic maladaptive behaviors of the addict - Paris Hilton, Lindsay Lohan, Britney Spears, etc., 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. Its always some one 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.

Lindsay Lohan's recent decision to go for extended in-patient care, after a 28 day detox, is a start in the right direction. But most professionals have doubts about Paris Hilton's miraculous religious conversion. It doesn't happen like that.

She clearly has not yet hit bottom. The trauma of time in jail may play a role in bringing that about and hopefully she will now be ready for serious rehab, with at least six months of extended care. This care should include a focus on her character flaws and a supervised outpatient program. This is what the judge should have sentenced her to. Read "It's Not Right!" Paris Should Get Rehab Not Jail and Paris Hilton Should Not Be In Jail.

Many readers have sent me emails saying that rehab doesn't work if the person is not ready for it and does not actively want it. Most of the patients in serious Drug Treatment programs do not want to go in initially. They usually deny that they have a problem to the end. But they are forced by their families or the courts, as a result of criminal actions. Eventually, if the programs are serious and long lasting, many addicts can and may beat their demons.

Rep. Patrick Kennedy, no stranger to addiction and rehab, has been campaigning for the passage of the Paul Wellstone Mental Health and Addiction Equity Act, which would end insurance discrimination against Americans with mental illnesses and addictions. He argues that not only is it the right thing to do, but it is the smart thing to do. Studies done by the federal government, after it ended insurance discrimination, found that the policy change did not increase overall mental and addiction treatment costs. "It's the status quo that is unaffordable. Our nation can not afford the $105 billion annually in lost productivity because of mental illness or the $135 billion attributable to alcohol and drug addiction."

Not to mention the millions of lives lost and wasted every year because of these untreated, and often undiagnosed, illnesses.

When I was younger I had many friends and family who were arrested for drug problems. They were dragged kicking and screaming into Rehab programs. The four who went to extended Rehab with psychodynamic components and attended AA regularly, lived and went on to lead productive, exemplary lives.

The other four who couldn't deal with Rehab or AA mostly died of overdoses, went to jail, got shot up, or killed themselves. This is proof enough for me.

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