Pubdate: Sun, 11 Sep 2005
Source: Detroit Free Press (MI)
Copyright: 2005 Detroit Free Press
Contact:  http://www.freep.com/
Details: http://www.mapinc.org/media/125
Author: Patricia Anstett, Free Press Medical Writer

ROAD TO REHAB

Brighton Hospital Offers Addicts -- Including Eminem -- Sparse 
Accommodations But Healthy Direction For Regaining Control Over Drugs And 
Alcohol

The Brighton hospital Eminem chose for his recovery from a sleeping pill 
addiction is a bare-bones facility with a 6:30 a.m. wake-up call, a 10:30 
p.m. bedtime and rules banning hip-hop music or movies that don't have a 
recovery theme.

A white picket fence and old-fashioned chapel suggest a country club, but 
the nation's second-oldest private substance abuse facility, an hour's 
drive northwest of Detroit, is more boot camp than sumptuous retreat.

Two-thirds of the staff are recovered addicts, including the medical 
director of its detoxification unit, a doctor whose medical license once 
was yanked over his addiction to booze and drugs.

A third of the clientele are addicted to sleeping pills and other sedative 
medicines, making it a logical choice for the rapper born Marshall Mathers. 
Numerous sources close to Eminem say he admitted himself to Brighton 
Hospital for an addiction to the sleeping drug Ambien days after an Aug. 12 
concert at Comerica Park in Detroit. Officials at Brighton and the St. John 
Health System, of which the hospital is a part, cited federal health 
privacy laws in declining to confirm whether Eminem was or remains a 
patient at the hospital.

But Tuesday, hospital officials spent nearly three hours with a Detroit 
Free Press team answering questions and providing a limited campus tour.

Their willingness to admit the newspaper team suggests Eminem is no longer 
there. Patients generally stay at the facility for 10 days, followed by as 
much as six months of outpatient therapy.

"The people who follow up with a treatment plan are the ones who do well," 
said Dr. Mark Menestrini, medical director of the detox unit.

Menestrini, 52, tells his own story of addiction, without shame, if for no 
other reason than to provide hope to all who will listen. After 12 arrests, 
four relapses and the near-collapse of his marriage, Menestrini regained 
his medical license and went on to pass national board certification exams 
as an addiction medicine specialist.

Admission and detox

Most patients arrive by appointment, sometimes arranged after family 
intervention. Ambulances shuttle those whose rehab is complicated by 
gunshot wounds, burns, broken bones and bruises from booze and drug-related 
falls, stupors, fights and auto accidents, the ugly underside of addiction.

The 92-bed hospital usually is packed at 95% to 100% of occupancy, a stark 
contrast to many general hospitals struggling half to three-fourths full.

Brighton provides care for 2,400 patients a year, 60% of them men. Just a 
few years ago, it treated 2,000 people a year. The increase reflects the 
closing of other programs and the epidemic of addiction in America.

Once the hospital housed more alcoholics than drug abusers. Now, at least 
half of the patients have more than one addiction problem.

Increasingly, many are addicted to prescription painkillers and sleeping pills.

"We live in a society that reinforces that you take something when you have 
heartburn, hemorrhoids, excess gas, erectile dysfunction or any possible 
symptoms," Menestrini explained.

Many patients start in the 29-bed detox unit, where heroin addicts share 
rooms with longtime alcoholics, and prescription drug abusers with crack 
addicts, three to a room.

Sparsely furnished, with white sheets and a blanket covering standard-issue 
hospital beds, the rooms have no TVs or radios. No headphones are allowed. 
There is no Internet access -- and no visitors -- so patients can focus on 
recovery, said Denise Bertin-Epp, president and chief of nursing.

A TV room offers satellite TV stations and movies limited to spiritual and 
meditation shows. Too many programs and movies "sabotage sobriety," 
Bertin-Epp said. She allows movies such as "Hoosiers" and "28 Days." 
Reading materials are equally limited to recovery materials and the Detroit 
Free Press.

For the bored and restless, there are coloring books, crayons and a 
colorful, 300-piece puzzle.

Sleeping rules are relaxed in the detox unit. Some patients, particularly 
those addicted to sedatives, arrive unable to sleep more than an hour or 
two, a problem known as rebound insomnia.

Stays in the detox unit are $900-a-day; inpatient rehab adds another 
$750-a-day, bringing a 10-day bill easily to $8,000 or more.

Many insurance plans don't pay for rehab or limit time in the programs to 
no more than 10 days. They also often require patients to pay half the 
bill, a co-pay that puts inpatient rehab beyond the reach of many who might 
benefit, said Bertin-Epp. The staff spends their time trying to coax health 
plans to pay for care, even a day or two more.

"Every dollar spent on rehab saves society $5-$7," Menestrini said.

Precise medicines are used to help reduce nausea, vomiting, headaches and 
tremors that can occur with withdrawal.

"It's pretty rough, there's no getting around it," said Stewart Francke, a 
metro Detroit singer who checked himself into Brighton last year for 
addiction to painkillers he took after cancer treatment.

Patients with sedative addictions receive gradually reduced doses of the 
sedative phenobarbital and anti-seizure medicines like Tegretol and 
Depakote to relieve anxiety, often for several months, Menestrini said.

Rehab

Once past detox, which typically takes a few days, patients are reassigned, 
two to a room in another building where the units look like college dorm 
cubicles, only cleaner.

Rules are more relaxed, except for the 6:30 a.m. wake-up, 10:30 p.m. 
bedtime and a no-nap rule.

Twice-a-week family sessions are offered and visitors encouraged. Patients 
can roam the wooded campus, play volleyball or do crafts. A historic chapel 
constructed with donations from auto pioneer Henry Ford is the signature 
landmark on the campus, with a new perennial garden in front.

Brighton's program is nationally accredited and recognized. Seven full-time 
doctors, four psychiatrists and a team of therapists, all with master's 
degrees, offer group and individual counseling, morning, afternoon and 
night, all in the 12-step model. That approach, begun in the 1930s with 
Alcoholics Anonymous, adheres to anonymity and group counseling as key 
dynamics to the rehabilitation of addiction.

Therapist Virginia June works to counteract years of self-loathing common 
in addicts.

"We love them until they learn to love themselves," she said. "You honor 
the person they are, not the behavior, not the disease."

June, 44, a mother of two, is a former addict who straightened herself out 
at Brighton 19 years ago after four relapses. Her stumbling block was 
making it beyond the first month of recovery, a tough problem with its own 
name, Post Acute Withdrawal Syndrome. A Brighton counselor and 
participation in 12-step programs got her clean for good 19 years ago.

Patients get photos of themselves on entry and at the time of their 
release, along with a gold coin with a serenity slogan. Many continue 
outpatient therapy at Brighton's Southfield or Livonia centers. Staffers 
regularly call former patients and offer a range of programs, including 
quarterly tune-ups.

For Andy C., 48, of Clarkston, the approach stuck. (The Free Press is 
honoring the anonymity traditions of the 12-step process.)

He hasn't had a drink of booze or ounce of cocaine since his October 2001 
discharge from Brighton, after a two-week stay.

Once, he drank three to five fifths of vodka a week and snorted $1,000 to 
$2,000 worth of cocaine.

"I asked God to please get me help." The road led to Brighton.

There, he met doctors, lawyers, priests, prostitutes, "all with remarkably 
similar stories."

Now, Andy C. is married, has a 3 1/2 -month-old baby daughter and is out of 
debt. He attends 12-step programs three to five times a week, by choice, 
and returns to Brighton about once a month to speak to groups.

"When I recovered, I got my soul back," he said. "I recovered the ability 
to participate in my life again. I wasn't running from myself.

"I'd recommend it to anyone who feels that alcohol or drugs are keeping 
them from being the person they want to be."
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MAP posted-by: Elizabeth Wehrman