How Rehab Works

years ago. I know, you look like Walter Matthoud. I love he's one of those guys that he looked elderly when he was like in his forties or twenties. I think he kind of had that hunched overlook, that sarcopenia, yeah if you will, yes, nice, And that sarcopenia that's muscle loss age related muscle I thought that was literally the hunch bad. That's where you get the hunch. Sure, yeah, like you lose control or you just lose your muscle mass, including the stuff that had you stand up right, So yeah,

you're right, okay. But he also had like the jewels in like a five o'clock shadow that was ever present. But he was just a great actor, dude, I love him. Yeah, he was great in that Bad News Bears everything else. Starting Bad News Bears is a good one to start this one with. Because he was a drinker. He was a drinker. Um. He was what you might call an alcoholic, all right. Yeah. In the seventies though, it was everybody was an alcohol driver around with the Schlitz in your car.

And it is no big deal. Now, let's say, but we remember check this is the third out of three. This is the end of the trifecta. This is the jewel in the Crown Jewels and the Family Jewels. This is it. Um, we did addiction, prohibition and now rehab. Yes. Uh. If Walter math How had wanted to go to dry out, as they say for is alcoholism in bad newspairs in the mid seventies, he would have had a very limited

choice of where he could go. Probably most likely he would have gone to what is called a sanitarium a k A. An insane asylum a k A. A mental hospital or a regular hospital. Yeah yeah, but most likely it would have been uh, some sort of medical clinical setting where his addiction was treated. Yeah. It wouldn't be

uh private Malibu Promises by the Sea Shore. Not yet because rehab as we know it today, UM, which which makes the cover of tabloids as frequently as any celebrity, just the concept of rehab does um didn't start until the eighties. Actually that I thought that was very shocked by that. Have you ever seen Value of the Dolls? I have not, believe it or not. That's a good movie. I had actually forgotten that i'd seen that movie until I reread this article that I wrote. Right, I think

I've seen the movie. It's I guess at some point around there was like, oh, yeah, Value the Dolls. It's perfect. If you have not seen Value the Dolls, go see it. It's an excellent movie. And Petty Duke's character goes to dry out at you know, a sanitarium, which means you know, shock treatment and being strapped down so you can't drink.

It could be and like if you had been going to one, you know, far enough ago and say the thirties, and you're a particularly rebel rousing alcoholic or drug addict, they may have lobotomized you. Yeah McMurphy style, yep, exactly, So Josh, you kind of blew the cover off of the fact. Well that was the first fact. Let's start till the eighties. Hey, I've been doing this a while. Uh so where are we now then? Well, um, now as they exist now, as I exists now, one of

the other things that would have changed. Um that anyone listening to our prohibition an addiction podcasts, I would know that when the other things that changed and burgeoned alongside of rehabs as we know it, um, non medical facilities. Right, Um, is the idea that addiction is a brain disease, which we should cover real quick. Yeah, a little rehash. So before it was stunt gravy. It was blamed on the demon juice, right, it was inherent in that substance. Yeah,

that was the evil thing, was the substance itself. Then it shifted and all this started about the nineteenth century, late eighteenth century, early nineteenth century. The concept of addiction came about. Then it shifted from the stunt gravy to the person. It was a character flaw, right, Yeah, exactly, something's wrong with you because you are not able to drink and you have a weak will, not able to

not drink until you fall down flat right exactly. And then finally in the eighties, I would say about the eighties, the the idea that addiction is a brain disease, that there is a process that an adict undergoes, a substance user undergoes and becomes a substance abuser. That is the direct result of this substance hijacking that person's reward center

in their brain. That the the decision of whether or not to um engage in the that risky behavior or um do that substance, snort to shoot it, smack it, slam it, drop it, that kind of thing, UM is out of the user's hands, and therefore they're an addict. It's a disease. It's a chronic disease. UM that will that that has relapses and all that kind of stuff. It needs boosters. So that model, the brain disease model, along with the creation of rehab, uh, is where we

are now. Well yeah, and it's it's uh, well, it's not funny because I'm sure you're playing this, but the fact that you mentioned UM, the temperance movement and prohibition UH. In figuring out what addiction was, they actually ended up leading to rehab because back in those days. They what you what were they called sober houses? Yeah, so we're locked up basically right where you can't drink. Did you

see them? Did you see the picture? You don't get the pictures to you know, Okay, so check that picture out. I think that's Carrie Nation, the head of the Women's Christian Temperance Union, standing next to you. A man who's taken a sip and standing at a bar looking a little upset. The definition of buzz kill exactly. So the temperance movement definitely gave rise to rehab by setting up, like you said, what are called sober houses like the

drunk tank. Almost like on Andy Griffith you would lock up the drunk of course, you know on Andy Griffith they were the guy was in the drunk tank. Otis I think for weeks and we think they more resembled like you know, halfway houses for that are like transitional homes between prison and society. I wouldn't know about those. I think you know, your dad's house, okay. I think that um that they they resembled that. It was like this house is among houses and you can't get booze there.

You can't bin bring booze you kind of need to say where you're going and why, and um that they set up these houses called sober houses that were sequestering people from regular society because alcohol was out there, and that was like the first rehab centers in the United States and the forties. I think, man, that's crazy they

did this that long ago. And then we did the failed Noble experiment prohibition, which was basically like, if you can rid society of alcohol, you can rid society of alcoholics. But you can't. So maybe we can only set up places for them if they have troubles. Right, they went back to the sober house idea. It's interesting that prohibition actually kind of lead to rehabilitation clinics and more drinking.

Well that's not true because they said, overall I went down butt across the board, but the alcoholics, the number of alcoholics increased, Yes, exactly, right, So Chuck, where are we were past the nineteen thirties. Oh. One of the other things that came up, not just rehab like as we understand it today, like a place where you go

that's sequestered from the temptation of society to to rehabilitate yourself. Um. One of the other things that came about as a director's role of prohibition in the Temperace movement is UM twelve Step programs specifically alcoholics anonymous, right yeah, Dr Bob and Bill w Robert Smith and Bill Wilson created this in nineteen thirty five. And I don't think I realized

it was that old either. Yeah, long time. And remember Bill w wanted to um give everybody acid who came through the program because he was like really great, yeah, he thought it might help. Uh yeah. That was the first support group treatment program in the twelve steps has. Uh well, let's not jump there, let's let's just finish

the history out. Well, the the International Order of Good Templars, Oh yeah, they they were a society dedicated to assisting UM alcoholics during the Temperace movement, supporting and they created the support groups that eventually gave rise to this A A model that's improven, like you're about to say, so successful, yeah, which we'll get to and then chuck right at this point thanks to a a almost exclusively and the idea that um, you you can you can treat, you can

lick it, yeah, you can treat addiction, especially in a medical setting. UM. Before the advent of the eighties. UM, the the US started throwing money not just that eradicating UH, the the supply of illocent substances, but also the demand and even more so the demand. Under Nixon, right, Yeah, Dick Nixon put two thirds of his drug kind of anti drug policy money toward UH recovery and treatment, which is a really kind of a forward thinking thing if

you think about it in today. For Nixon, you would have thought he like, let's throw all of it towards locking people up. But Ford came along and read distributed that to about a half and half model, half toward policing and arresting and trying to get drugs off the street, and half towards treating people with the disease. Why is that, I chock, it's ironic because you might have heard of the Betty Ford Clinic, and that was his wife who had a pretty bad pill addiction and alcoholism problem, and

she started it. She was like, oh, I can get clean and I should set up a treatment center. Yeah, and she did. In Rancho Mirage, California, the Betty Ford Clinic UM in two had opened its doors, and that I think was one of the models for the current

incarnation of rehab. That was the first big and I know celebrities went there, but that was just the first all star treatment center that you heard on the news and probably not probably most definitely because her name was on it, and it also um her lending her name to that treatment facility and admitting that she had been addicted to you know, pills and booze um it was.

It also had a lot of a big effect I think on getting people into treatment because she it's it was it is still but it was at the time even more so such a shameful thing to be addicted to something. Um still is, but it's way more accepted now. But because in like religious circles, I know, it's still

pretty pretty shameful. Sure, I would definitely imagine so um but but I think hers putting her still, like even the first lady can get hooked then, you know, but again yeah, and if the first lady can kick it, then I can too. You know what other effect it had a dobt what people with the name Ford not naming their daughters Betty. I'll bet you would name your daughter Betty Ford, would you know? Well, I might, but I'm kind of a jokey kind of guy. Betty Ford Clark,

Betty Ford Clinic Clark. That reminds me. Actually, I think I might have told you this. My friend Joey used to say that if he ever had a son, he would name him Thomas Magnum Dorlc. His last name is Dorla. I think that's a good I thought was pretty good. It's a good name. But he had like three sons that didn't name any of them that. So, so he's a liar. He's a liar, and he's been called out

as a liar on that's I don't think he listens. UM. Once Reagan got into UH to office, the UM policy of UM paying more for policing the supply side than paying any attention to the demand side, it was continued. Yeah, the war on drugs, the war on drugs in earnest, but by this time people were seeing like, Okay, rehab can work. It's a viable solution to treating our nation's substance abuse problems. And UM it was kind of etched

in popular culture and then in the American psyche. Yeah, and it boomed, like private institutions all over the country started popping up. Yeah, And I think also that just say no campaign, and like the idea of like, you know, drug, the drug addiction and how bad it was probably got a lot of kids, a lot more kids thrown into rehab by their parents than it ever been before. You know. Yeah, like thirteen year old to snugs and beer out one night.

They're all of a a sudden in rehab exactly. I've heard stories about that. Didn't you go to high school. I did go to high school. So check. Let's talk about different types of treatment. There's four really actually three technically four. And by the way, I need to change the headings of this. I need to switch to chapter headings, I realized because it's very misleading. Well, we can do it on the fly. I'm gonna start with inpatient. Is that

still correct? Yeah? Okay, impatient? And this we should point out this can take place, um in a private facility, it can be in a hospital. Still um. I think prison you said is a is a big place for a forced rehab. It is technically, um an impatient facility very much impatient. Yeah, you're not going anyway what impatient is though, just like being a hospital stay, it means you're they're living there. Yeah, usually for that twenty eight

days for any SANDERD. Bullock fans, probably more for this podcast, for any Vigo Mortenson fans, twenty eight days, not twenty eight days later. The other one was he in twenty eight Days Did We Go? Yeah, he played a sex addicted like football star or something like that. That's funny. I ran into him like three times on one week in l A. One time to the point where he looked at me and he was like, are you following me? I thought he was gonna kill me? So, oh no,

not Vigo Mortenson. I was thinking he's the creepy guy from Buffalo sixty six. Vincent Gallo, Yeah, disregard that whole story. I could see him. Yeah, I wouldn't want to run into him that third time. I'd be afraid of him for thinking anything like that. Have you seen um Hide and Seek? Now? It's an awesome movie. It is so twisted, interesting, it's a thriller. Uh, Vincent Gallo, Um, Jennifer Tilly is excellent in it. Darrell Hannah actually does a really good job.

That's pretty much the cast and it's um really something. I'll have to check that out, all right. So where were we? We were impatient we were staying overnight, John, just where we were, and that can range, like you said, from twenty eight days all the way to basically when you need to leave six months a year or when your insurance runs out. Yeah, if you're in there for a year, then you might be a hopeless case. Well

that'd be pretty bad. But you really just inspired the hearts of a lot of people who have been in rehab for eleven months. Just say that, and it can be court ordered as well. And they also in some of these long term programs can offer you like resocialization because imagine being in a rehab clinic for three or four months, six months, they're they're like keep your milk and a refrigerator or failing that, a cool wet sack out patient is next. That's UM basically where you go

in to visit on a set schedule. It could be daily UM. But you're you're doing your regular life, you're sleeping at home, you're going to work, and then probably in between work and going to sleep, you're spending a significant amount of time time UM in counseling, in group sessions,

twelve step maybe receiving medication. Methodone treatment usually takes the form of outpatient treatment, and that's actually one of the longest treatments apparently is um is methodone, prescription methodone treatments for yeah, to get you off of the white pony. Yeah, Whenever I see those on the documentaries, it's it's very much outpatient. Like you literally see the junkie walk up to the window to get his daily dose or her

of methodone. Lastly, there's partial hospitalization. Um. This is basically the opposite of outpatient right. Um, well, it's not the opposite, but it's pretty close. Rather than go to work from nine to five, um, and then go to rehab, you go to rehab from like nine to five during the day, but you you stay at home and all that. Now, what's I don't understand the difference between that and outpatients.

Outpatient you're just not necessarily there all day. You might go for like your two hour meeting and leave every day, yes, okay, yeah, whereas like partial hospitalizations, you're spending way more time there during the partial hospitalization and treatment because you know, um, after work. For outpatient, you're there for maybe a couple of hours, three hours, but it's like a part of your day instead of going home and sitting on the

couch and watching TV. You're going to rehab or going to happy with with you don't want to do that, Well, no, that's what I'm saying. I mean, oh yeah, we're going. Yeah, after work. It's probably a good time for a lot of people because a lot of people associate the five o'clock bell ringing with that first drink exactly, and I'm sure that's a huge part of it as well. Partial hospitalization is where you're spending your days in rehab and then you go home. That is your job. Yes, your

job is to get well. Prison. You mentioned prison or I did, And when they do this in prison, they take you out of the general population typically, didn't we have somebody right in after the prison? Um? Yeah? The listener mail on prisons, the guy was like, it's the it was the easiest place to score drugs and then I've ever been was prison. Yeah, so they I think

that's kind of cool though. It shows like a real dedication to um rehab among prisons by by taking the people away rather than pretending like there's not a problem exactly. And I could actually see that being the case where they said, no, we're rehabing people, but they're you know, getting drugs being passed between the bars and readily and other things. It's key stirred. So, Chuck, let's talk about treatment. Technically,

I would call this one how rehab works. I wanted to switch those two children, because really types of treatment was what we just talked about, right, and then how rehab works is what we're about to talk about. I just don't know how that got passed. Well it did. So let's talk about how rehab works. Man. Well, it's a long process. Don't expect to be out of there in a week, although that one program that you point out says they can do it in six days, which

one six months? Oh six months program? Yeah it was that or six weeks, six weeks, I'm sorry, Okay, six weeks, Chuck. So I would say, don't plan on spending more than like a week in your rehabilitation clinic, would be my guess. Yeah, um, you can. Also, we we failed to mention e r S can technically be an inpatient rehab that lasts long enough to get you over your withdrawals or to bring

you back to life from an acute drug overdose. So if you are taken to the hospital odeed they'll keep you there as long as you're physically or until you're physically well, yes, which can drug that can yeah, it can rehabilitate you, I mean you can, yeah, but so it can last for as little as several hours, like you said, months and months, possibly a year, right, but yeah, everybody who buys into the brain disease model of addiction says, okay,

because of this, there's there's a lot of facets to addiction, which means there's a lot of facets to rehabilitation. It's gonna take a while, yeah, yeah, yeah, but step one is always just withdrawal, get the drugs out of your body and get clean physically. Um. And you're not gonna have any physical withdrawal from behavioral addiction compulsive behavior, but you're still probably going to have a rough time at first,

you know, with the desire to do that. Um, when you are stable, I guess, and probably before you're stable, you're probably going to be introduced to a twelve step program of some sort. Right now, did a A create the twelve step? Yes? Okay, yeah, there was no such thing as the twelve step before that. But there's all sorts of variations on the twelve step. Now, yeah, and one of the things, like we were saying, a A

is incredibly successful. It's been study after study after study done on A A and um any kind of UM relapse associated with the people who go through it, and UM it's a very successful program. But it's also very criticized often because one it's criticized for being too indulgent on the addics ego right like this is not your fault, it's all okay, or if you go through these steps, you're going to be a great person. Um. And it's

also very reliant on a belief in God. Yeah, I don't think there's it's not like a Christian God or Judeo Christian God or any specific god. But I think they call it like a higher power. And there's plenty of atheist addicts out there, well they call it. I actually looked at the original twelve steps today and they say the word God in four of the twelve steps. But on the before that first mention of God, it

says God as you understand him to be. So that's the little caveat like we're not saying, like like you said, the Judeo Christian God must be the one, but they definitely say you've got to have a higher power here or else. That's not gonna work, right. And the problem is that there's a lot of people whose conception of God is that they understand him to be non existent or that I am God. Right. Yeah, Um, there was like a joke that just flitted right through my prefrontal cortex.

It wasn't funny, um, So chuck, Narcotics Anonymous, I believe, and some others, but most notably Narcotics Anonymous UM has adjusted the twelve step model to accommodate atheists as well. And you know, I bet regular a eight meetings or a little less centered on that. Now, that would be my guess. They probably wouldn't refuse you at the door if you said you were an atheist. Oh, I don't

think they refuse you. I don't think it's it's to think what they're what they're saying is like, if you're an atheist and you don't buy into the God thing, like, you're not going to be as successful as somebody who does, because part of his like giving it over to this higher power. So I don't think that they're exclusive or anything like that. I think that it's like atheists aren't going to do as well. All right, they didn't studies on that winder. I'm sure they have. I didn't go

to that detail though, It's okay. CBC is that next cognitive behavioral counseling, which is psychotherapy, and that is when they I mean, they can treat mental disorders, they can treat depression PTSD, and basically they're they're trying to eradicate addiction from the life of someone by looking at their behavior very thoroughly. That's most, um, most therapy that anyone goes in for these days is cognitive behavior therapy. It's like one of the most prevalent um and yeah, it's

it's looking at behavior first of all. It's recognizing the patterns of behavior, especially destructive patterns of behavior, and then figuring out why you're doing that and then eradicating it. Uh. And it's this multi step process. Um. CBC is less effective according to studies as twelve step programs by itself, either one by themselves. Uh, twelve step usually beats cognitive

behavior behavioral counseling. Right, yes, what about meds. Well, if you know you need MADS like methodone to get through your treatment, then your rehab centers probably gonna have them for you or and A. Depressants are a big one too, And one of the things that's very effective is identifying, usually through cbc UM other underlying comorbid conditions, like if you have a binge eating disorder or you are depressed and an alcoholic. Treating those two things simultaneously in the

same umbrella has been shown to provide the most success. Sure, because if you're depressed and you can't get treatment for alcoholism, if you're suffering through depression, and just leave the depression alone because you're probably an alcoholic because of your depression, probably or it could be because you're an alcoholic, if that doesn't necessarily mean that carrying your alcoholism will carry your depression, if you've gone into a clinical degree of depression,

right like a chicken or the egg kind of scenario. Yes, to get to the other side. And acupuncture, Josh, you mentioned a few non traditional methods. Acupuncture is one of them. Have you ever done that? I have not, have you It's awesome, Yes, I can imagine. It's one of the most relaxing things I've ever done in my life. Actually, I went to a place in l a that had it was a school where you could get really cheap acupuncture. Was Vincent Gallow Your acupuncture was actually but he used nails,

Tinpenny nails. It's very relaxing. It's not painful at all. If you're a little weirded out by needles, because I'm I'm totally freaked out by needles, but it's not like that. I'm freaked out about them not um thoroughly cleaning their needles enough. I've heard accusations of that other new though not all the time. The ones I got were taking

out a little package. They're right in front of me. Yeah. No, I'm sure like most of them, but there's ones out there they're just like, yeah, just used some other guy because I'm cheap. If they're wiping blood off the end of them, I wouldn't get that. If you are a scientologist, you might go in for l Ron's um patented addiction treatment. Maybe we'll call it. Yeah, it's like a vitamin regimen

and exercise sauna sauna as part of it. Um what else the Jude Daddy Is program we talked about that, Uh, nomads, no meads at all, And I got when I don't remember because I didn't go back and look, but I got the impression that this they're kind of this is something of a closely guarded secret, and it may or may not be viewed suspiciously by conventional rehabs. But they boast a six success rate for their six weeks days. And yeah, they don't they don't use meds. It's all

just like you were bad. You're a bad person, can they They're like, you eat like this, and they push your head down into a dog bowl and then they do a clockwork orange movie viewing experience, right, and then six weeks later you're like, I'll never do that again, Josh. Let's say you love Eastern medicine and things like acupuncture and you're afraid that if you go into your traditional rehab clinic that they won't oblige to those kinds of things.

That that is that a worry that you should worry about. It depends on how much money you have. Really, Yeah, some of the higher end ones will um combine a lot of stuff, even cool stuff like helicopter rides or wilderness survival, based on the idea that um things like wilderness survival can can show you how self reliant you can be. Um or. A helicopter ride is meant to just be like, Wow, look how beautiful life is even

without booze um or. Yeah, maybe acupuncture, spot treatments things like that, Like the higher end you go, that more pleasurable the experience is going to be. I imagine, I'm glad that works. But when I hear something like that, I think, you know, look how beautiful that the world looks from a helicopter flight along the shore of the Pacific coast, Like you don't need drugs to witness this, but you need a helicopter. Yeah, yeah, exactly, you come

out like hooked on helicopter. I guess they're what they're looking for is just to inspire you with that notion that yeah, I don't need it. So um, I agree with you, though I think that's trying to be funny. No, but it was funny and true, Chuck, which is the

best kind um there? This stuff actually does work. As we said, people have been studying the stuff since they started in the eighties, um, And one of the things that they found that the most effective kind of treatment is rehab where you are sequestered away or you have some form of rehabilitation treatment. Right UM, a twelve step group,

and weekly counseling like cognitive every counts throwing everything at it. UM. Meds are not necessarily included in that, but UM being part of a group, especially twelve step group plus counseling plus a stint at rehab UM is the most successful. Is far as the rate of relapse goes to the tune of eighty seven percent. The Target Cities Project study quoted. If you do all those three things, that's an eighty seven percent chance of not relapsing after six months. Yes,

and get this, this is surprising to me. I remember this when you factor in treatment drop out to people who just you know, we're like they were like, I'm not gonna stay the whole twenty eight days, but I'm gonna keep going to a weekly twelve step meeting and I'm gonna go to counseling five times a week, which

is a lot. Oh yeah. Um. They still had a success rate the abstinence rate with SEV so even without treatment, Yeah no, no, and then at sixty actually it keeps going down if you complete the treatment program aspect, but you didn't go to the twelve step meetings and you did go to counseling. So the two out of the three minus the twelve step, you have a sixty two percent chance. Right, So the twelve step, as they found is is the most significant, followed closely by UM individual

counseling Yeah, usually CBC UM. And what they found is that a person who goes to four twelve Steps sessions a month or one even one counts individual counseling session from a month more than anybody else has a better chance of of success in in remaining abstinate. Well, that says that these work. These programs work. They actually do work. But here's the thing they work best. Again. Studies show when the person is ready and willing to give up

this behavior. Yeah, that's what they always say. When you know, you've got to be ready to change anything in your life in order for that to change. And that makes sense. Otherwise you're just going to be You're just doing it for your your parents, or your wife or your husband, and if it's not coming from you, then good luck. Do you know what's funny though, what's that I just realized this That was conventional thinking. But with the advent

of prison rehab, yeah, new information. Studies have also shown that UM if you force someone into rehab in prison specifically, UM, they will still there's they still have a pretty high success rate and abstinence rate and even a lower rate of recitativism recidivism. Right, it's a bone head word. Yes, you're right. Oh was that the end? Well, and to that tune, Josh. They've now got these awesome situations called drug courts where they pass out drugs you take before

your sence. H. Drug courts actually are when UM it's set up specifically for drug cases and instead of putting you in jail, they sent it to you to treatment programs. And out of the of people in treatment programs in the United States were referred there by the courts into and for Yeah, that's a lot. Yeah, let's talk. Let's talk some stats, buddy. UM in two thousand eight, so I wrote this, and I think two thousands seven maybe, yeah, And UM, the I think that the most recent statistics

I could get, we're about two thousand five. So it was about three point nine million people in two thousand five that went in for treatment. UH. In two thousand and eight it was pretty much the same four million UM people in the US aged twelve or older, UM went for treatment for drugs or alcohol or possibly both. Right, Um. Of that four million people, that was a fifth of the estimated people who were current illicit drug users in the US in that same year, So not very many

people are going to rehab. No, But I also wonder, like, what what percentage of that twenty million illicit current drug users, which are people to admit to have used who to have used a drug within the past month, aged twelve year older, Uh, admitted to using pots and just pot? Right? Sure, I don't. I don't think they take you at rehab for pot. Oh, no, they do, do they really? Oh? Yeah,

there's pot. There's pot marijuana specific rehabilitation groups. I don't know about clinics where you actually stay, but I know there's there's there's marijuana addiction groups for sure. I did not know that. Yeah. Seventeen million though, Hold on, this is a much better stat seventeen million heavy drinkers in the US age UM twelve year older. I wonder how many of the twenty million and the seventeen million overlap. Right, Well, you mentioned four million, and you said some were in

there for both. You actually had the stat um one point three million out of the four million. We're in there for both drugs and alcohol. Point eight million for just drugs and one point six million for just alcohol. So what does that say about what's the uh, the real gateway drug I don't know, because we talked about that, remember during the Prohibition podcast, and I predicted that if problem.

I think I predicted you. You didn't necessarily agree that prohibition has taught us that if you legalize something, if you prohibit something, that makes it more forbidden. But apparently it's not the case. No, I agree with that. Well, these numbers show different. I mean alcohol you can get everywhere. So yeah, it's and it's clearly a big problem. That's true.

Maybe we're both wrong. Maybe let's talk about money, because these things ain't cheap necessarily when you look at the grand total, and especially if you want to meet Eric Clapton, it's not cheap. Uh. In two thousand two, Josh, the average cost of a program was about four hundred bucks residential at thirty eight hundred and outpatient and method on treatment for seventy undred dollars for the average cost of a full treatment program. And that's on the that's the

average costs. They go up, you know, considerably if you're interested in the luxury tour, right. UM, I had down that promises from or not promises UM Crossroads, which was founded by Eric Clapton's in the West Indies in Antigua. Um, there's fifteen grand per month. Apparently it's gone up since two thousand and seven. It's now nineteen five a month.

All right, Yeah, it's a lot of money. That is a tremendous amount of money, but it is far and away not as expensive as the most expensive one that I found that you found, I should say, um is the Sanctuary Enviyron Bay, Australia. Holy cow, I didn't see that. Eighteen thousand, five hundred dollars per week, per week a week. So Clapton's is nineteen thousand, five hundred for a month. It's a bargain. Passages in Malibu is forty to fifty

grand a month. Promises which you've all heard of because been Affleck and Robert Downey Jr. Had a lovely stay there, among others, thirty three thousand per month and they've you know, they've all had their roster of celebrities depending on where you live. Yeah, and isn't that just isn't that kind of odd if you step back and look at it, like like, celebrity and rehab is just their hand in hand. Our fascination with both are equal well and in earlier

career publicity wise, So sure, ken which is weird. It

is weird. It's also weird when you look at the fact that it says, uh, it's there's like a one to one correlation of how how luxurious the rehab is and what list a list or be list your honest sen actor because promises, like I said, Charlie Sheen, been Affleck, Robert Downey and then you work your way down to uh Cottonwood in Tucson at a mirror, thousand dollars per day has had the likes of Rowan Atkinson and Spice Girl Jerry Halliwell, thousand dollars per day is still that

ain't cheap? Okay? I take that back, then, Rowan Atkinson's making some cheese. Apparently I didn't know that Mr Bean went to rehab. I didn't either, And we shouldn't make fun of Jerry Halliwell, because the Spice Girls are the best selling female band of all time, is the right? That was one of her tribute questions so it took people are um kind of like, yes, yes, celebrities can afford this. What if I'm an average Joe who's trying to kick the dope. Well, insurance can cover a lot

of it. It used to cover even more. It used to be about thirty was paid by insurance right um. And then by two thousand three, UM, the burden of cost had shifted away from not just the insurers, which we're paying about eight percent, and not even the patients who were paying just ten percent, but to the state

generally society taxpayers. Medicaids started picking up a lot of the tab, up to sixty percent of the tab and um, so let's say seventy percent between the insurance company, medicaid and the patient, and then the rest was being picked up um by um other state agencies. Uh. And so yeah, the burden of cost shifted to the society, which made a lot of people start to wonder, wait a minute, wait a minute, what are we doing here? Right? And so the cost benefit analysis was born as far as

rehab goes, right. So there's something to that though when you look at the fact that in two thousand three, uh twenty billion dollars and change was spent in all. Overall, Medicaid picked up six of that, so about twelve or so. And you think that's a lot of money, twelve billion dollars. But they did a study that they looked at the debt, the cost of alcohol and an illicit drug use, including tobacco tobaco, uh, and that includes healthcare, crime, property, theft,

stuff like that. Prison, prison, billion dollars and two thousand two alone. That's so okay. So twelve billion paid by the state to offset five billion in cost to society. That's a pretty good deal. But well, that's what I think. You get some of these people healthy. They might not be robbing you, they might not be crashing their car into your loved ones, they might not be uh stealing things and go into prison, and you're footing the bill

for all that. There was a study by the National Institute of Alcohol Abuse and Alcoholics that also found that um for every dollar spent on rehab, three dollars received in uh larger cost to society, which is not bad. It's pretty good return on investments. What they call that. Well, yeah, and you know when you break down those numbers sound expensive and obviously the luxury places are expensive no matter who you are. But I think they also skew the

average quite a bit as well. Yeah. Um, but if you look at a per visit treatment average cost, it's really not that bad. Out paid outpatient on methodone treatments are about twenty six bucks per visit. That's the one where you go to work and then go to rehab after work, right, non hospital residential treatments, it's like promises and in Crossroads seventy six dollars per day on average.

That's including every place. That's including like the place in the back of Joe's crab Jack where they lock you up for twenty eight days to you know, the place in Byron Bay, Australia. So but when you break it down like that, it's not that much money now and even more so um methodone, which you will remember the

average is about sucks in two thousand two. It's also the longest um overall, the longest treatment overall, and that broke down to seventeen dollars and seventy eight cents per visit to get somebody off of the dope, which is pretty I think that's worth investing in, and that includes the methodon too. Right, the actual Yeah, that's the whole, the whole shebangah um. And then Chuck, there's also the human uh expense that you're you're you're saving that cost

and invest in treating addicts. Right. Um. There was a study by Biotie I think that said that there are twelve million alcoholics in the United States roughly, right, And if you consider that each alcoholic has a spouse, possibly children, and family in some way, uh say, five people that are in that alcoholics life, that means that sixty million Americans are affected by alcoholism and affected not in good ways. Well, I'm possibly creating new alcoholics for future generations to pay

for two. Yeah, you gotta think about that. So, Chuck, I would say that that is the end of the addiction rehabilitation trifecta. Actually, you know what we should mention though. Did you read A Million Little Pieces, the book by James Fry that was the specifically told by Oprah not to read. Well, that's the deal is. That was the infamous bestseller about a memoir quote unquote memoir about um one young man's stay in rehab and it is awesome. It was found out afterward famously to not be true.

After Oprah had said it was the best memoir she'd ever read, and um, so if he took a lot of heat over that. I read the book and it's amazing and you should read it. I wrote the guy letter saying, dude, I don't care whether it's true or not. Just call it a novel and call it great. And he was like, thanks, man, I really appreciate that he wrote you back. Yeah, a letter and that well an email. So I recommend people read it. Just don't get all mad and today this isn't true. Just considered a novel,

and a very good novel at that. That's what I said. Okay, it's really really good. And for every dollar um spent on James price book, a million little pieces, Chuck, it's fifty of that. Which so if you want to learn more about addiction, rehab, prohibition, any thing like that, type those words into the search bar at how stuff works dot com and will bring up some delightful articles. And uh, it's time now at long last listener meal, Josh, I'm gonna call this email from a new twelve year old fan.

I saw this one from Emma, or maybe that was Emma's mother's email address. I'm not sure. But it said, Emma, no kids these days, they have their own email. Uh hi, Josh and Chuckers and Jerry. I don't know when I can do this, but I'm going to donate to Kiva. I'm twelve years old and I'm going to get a job walking dogs and babysitting, etcetera. As soon as I do get twenty five dollars, I will donate it. But to get the job, I have to print flyers to pass out. To print flyers, we need to buy ink.

To buy ink, we need extra money. That isn't going to stuff we need right now. But you do have to break a few eggs to make an omelet. Emma. That's right. And if you want to work at the omelet station, especially if you want to be the squire of the OLEMT, that's right. You gotta break a few eggs.

But please read this part on the podcast, guys. Whenever it happens, I am going to save up the money because I'm getting this babysitting job, babysitting snotty nose kids, so I can give this money to Kiva and tell everyone if they have no excuse, if you have a real job. That was from Emma and thank you very much. Emma. I think my hat is off to you, Chuck. We're

wearing a cap. He would tip it. If you're one of Emma's neighbors, please forgive her for her description of your kids and hire her anyway because it's going to go toward a good cause. That's right, right, um. And if Emma can do this, you can do this too. If you want to donate to the donate heck, Lynn, you get the money back if you want, yeah uh in twenty five dollar increments. You can go onto www dot k i v a dot org slash team lash stuff.

You should know. Join our team, leave some messages on the message board, make some donations, have a good time, right agreed. And if you want to email us to let us know what you're doing to save the world, whether it be dog walking or babysitting, snot knows kids or what have you, we want to hear about it in an email. Send it to Stuff podcast at how stuff works dot com for more on this and thousands of other topics. Does it how stuff works dot com, The house stuff works dot com. I phone app is

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