Intervention: The Rehabilitation Craze

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Pinsky echoes Kerlikowske's sentiments. "It's a massive problem right now," he says. "A CNN poll revealed that one in five Americans abuse prescription drugs at some point in their life and 20,000 die each year. And the National Association of School Nurses reported that a quarter of 12th-graders abuse them."

"More often than not I see people on prescription drugs," confirms Storti of his field observations, adding that "the availability of them over the Internet has really exploded the problem."

In spite of illegal online trafficking of prescription medications, however, Pinsky says that even when taken legally under doctor's orders prescribed drugs can become a problem. About his friend DJ AM's death from crack cocaine and an overload of prescription drugs, Pinsky says the over-the-counter pills likely triggered AM's old habits (he was a recovering heroin addict): "When I first heard the news, I thought no way. And then I thought, Oh God, someone put him on prescription antianxiety meds after that plane accident last year in September. Even if medications are appropriately prescribed and used, the disease of addiction is building momentum the entire time you're exposed to that chemical and will eventually explode back to your drug of choice."

"There's some controversy in the field and people would argue with me here, but every day in my professional life I see that you can not stay sober long-term if the biology of addiction is being massaged by a pharmaceutical or pharmacological agent," Pinsky continues. "AM went through tons of stresses while sober—breakups with Mandy Moore, career changes, trying to work in the clubs. But when he's on an addictive chemical and has major stress—pow. That's what happened to him. It's subtle, cunning, and pernicious and it requires people who manage it to have a lot of experience."

Overcoming Addiction
The first step in battling addiction is being able to recognize that your loved one has a problem—something that's hard to detect in the early stages, according to Pinsky. "There are no signs, but when it progresses, it becomes obvious—the tensions begin to mount, the person has interpersonal difficulties, erratic behavior, absences, emotional outbursts, changes at work," he says.

Casolaro agrees with Pinsky that detection can be tough, but says a good indicator of when an intervention is needed is when your norms and values—as well as the chemically dependent's norms and values—start changing. "People are aware of what they're doing—they start enabling and making excuses for the person—but they continue to do it because they think someday it's magically going to get better," he says.

Adds Pinsky, "Because the objective data is difficult to put your finger on, when you get a sense that something's up, know that it is. Trust your instincts."

Once an addiction is identified and you decide to intervene, begin what Finnigan calls "intervention shopping." Visit reputable websites such as AIS and the Addiction Resource Guide and be sure to find a specialist with at least a few hundred successful interventions under their belt. Also contact licensed rehabilitation centers, which usually have a list of preferred interventionists that they use.

Interventionists should be licensed clinical social workers (LCSW), psychologists, or individuals with a CADC (Certified Alcohol and Drug Counselor) or CASAC (Certified Alcohol and Substance Abuse Counselor) certification. "You should feel comfortable with the interventionist and ask them about their own history—see if they understand recovery and will follow the patient through treatment and help them get the help they need," says Finnigan.

Adds Mettler: "It's very important that interventionists put in their time in the recovery field, whether it's at treatment centers or getting their master's in psychology."

The downside of interventions is that unlike various treatment centers that accept insurance, the act of intervening is not covered. "And there's no regulation of intervention fees," says Finnigan. "There are people I know in Los Angeles who do interventions for $12,000 to $15,000. I don't think they have any more credentials or power than anyone else but they've chosen to charge that amount. But I also know a guy in his 70s—he's been doing it for years and he does it for $750."

Says Casolaro, "Interventions run anywhere from $5,000 to $25,000, depending on how long you work with the family and where you're traveling to." (Casolaro says he and Smith have traveled as far as Singapore and Beirut.)

That said, Smith explains that you can get a lot for your $5,000: "It sounds like a tons of money but it's important to consider how much time the interventionist is spending with the family. It's a six-month process and the interventionist provides plenty of support."

"I spent 38 hours straight with a family last weekend," says Casolaro, who talks of the Inter-Care Family Foundation that he and Smith founded to help those who can't afford an intervention. "Families will go to any lengths—they'll mortgage their house, max out their credit card—but we want to make sure it's healthful. With the foundation, we now have the luxury of coming up with monies to help people who are unable to afford the intervention process."

For her fee, Finnigan says she also helps families locate the proper treatment facility for their loved one. "Based on their physical and mental conditions, I'll choose the appropriate facility," says Finnigan, who notes that the designated treatment center "depends on what drug they use, what kind of detox it is—you also have to fall into line with what the family can afford, whether they have insurance for rehab treatment, and if the place is around them."

In addition to the financial hurdles surrounding interventions, the acknowledgement of an addiction's seriousness can make getting to the actual intervention stage difficult. "Addiction has a worse prognosis than most cancers," says Pinsky. "I tell someone they have cancer and they want to be airlifted to a cancer treatment center; I tell someone they have an addiction and they're going to die and they want to argue with me about the treatment."

Smith agrees: "It's the saddest part about intervention. When people come to do it, it's usually during the late stages of the disease. It takes a lot for them to reach outside that shame circle and ask for professional help. But the earlier people do it, the better off all of us are. Addiction is an involuntary situation—it's a terminal illness that keeps progressing, and it's not anybody's fault."

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