Pubdate: Sat, 16 Dec 2006
Source: Wall Street Journal (US)
Page: P1
Copyright: 2006 Dow Jones & Company, Inc.
Contact:  http://www.wsj.com/
Details: http://www.mapinc.org/media/487
Author: Christina Binkley
Bookmark: http://www.mapinc.org/coke.htm (Cocaine)
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)

SOBERING VACATION

A New Wave of Addiction Treatment Centers Is Turning Malibu into the 
Capital of Luxury Rehab -- and Raising Questions About Whether 
Five-Star Service and Recovery Mix.

MALIBU, Calif. -- Each sumptuous bed here at a retreat called 
Promises has been fitted with Frette linens and a cashmere throw.

The elongated pool beckons as does the billiard room beyond, tucked 
into the Santa Monica mountains overlooking the Pacific Ocean.

But not just anyone can come to this exclusive getaway -- and really, 
not many would want to. Promises is an addiction-treatment center 
that caters to a mix of celebrities, corporate chiefs, their families 
and people who want to live like them.

Promises is part of a growing niche in the burgeoning business of 
addiction treatment: centers that are truly, deeply luxurious.

With more than a dozen recovery centers in this seaside village, 
Malibu has become the center of the high end of the industry -- 
perhaps logically, given its resort-like location, enclaves of 
celebrity homes and proximity to Los Angeles, a city whose primary 
industry is rife with partying and free-flowing cash. California law 
has helped by allowing rehab centers to be located in residential 
neighborhoods if they have no more than six beds. At Renaissance, 
where a staff of 50 caters to a dozen patients, one bedroom suite for 
a single resident measures 2,000 square feet -- as big as many 
three-bedroom homes.

Another center, Harmony Place, will supply personal concierges and 
pedicures if patients ask. A few miles north of Promises on the 
Pacific Coast Highway, Passages offers surfing instructors. Clients 
stroll around in swim trunks chatting on cellphones in a sprawling 
sea-view mansion that is hard to distinguish from a luxury resort. 
"We are a very comfortable place to do some very uncomfortable work," 
says Don Grant, admissions director for Harmony Place.

There are conflicts between recovery and luxury, according to 
addiction experts. Many of the 14,000 or so treatment centers in the 
U.S. adhere to guidelines that include an element of hard labor -- 
bed making, floor scrubbing, laundry and other duties that are 
intended to serve as equalizers among all addicts.

Robert DuPont, former national drug czar under presidents Nixon and 
Ford and now president of the nonprofit Institute for Behavior and 
Health in Rockville, Md., says: "Self-centeredness is the key to the 
addiction....To get well, they have to leave their ego behind."

But at luxe centers that charge $35,000 to $75,000 a month, many 
clients expect five-star service, not equality.

Some Malibu facilities argue that they treat people who might not 
otherwise seek rehab. "We're talking about people who wouldn't go 
into treatment in a place where they had chores," says Mr. Grant, of 
Harmony Place, where clients do their own laundry. Chris Prentiss, 
co-founder of the center called Passages, eschews the benefits of 
chores. "We don't believe in punishment," Mr. Prentiss says. "There's 
no floor washing here."

Most of the other treatment facilities here adhere to the traditional 
12-Step philosophy that has guided addiction treatment for decades: 
 From Step 1, an admission to being powerless to the addiction, 
through Step 12, promising to carry the recovery mission to other addicts.

The rehab process involves hours of daily group and individual 
therapy with licensed counselors treating people who generally arrive 
in crisis, often with injuries sustained in falls, car accidents or 
other mishaps that precipitated their arrival.

The minimum stay for most centers is about 30 days -- an industrywide 
norm established by insurance carriers.

Some carriers might reimburse for a fraction of the cost, but many 
patients in these places pay for the whole thing themselves.

Patients at some Malibu centers can take acupuncture and walks on the 
beach with therapists. There is also equine therapy, an art that Sal 
Petrucci, a former dentist who founded Renaissance Malibu, says 
doesn't involve riding, but involves getting a horse to respond to 
vocal commands.

He describes it as trying to "get into the soul of the horse and 
connect as one with it." In the case of a celebrity who is in the 
midst of a project, Promises will provide a sobriety escort who will 
ferry the celebrity to and from the set, making sure he or she 
doesn't sneak off and relapse. For many years, the Betty Ford Center 
was considered the pinnacle of addiction treatment.

But in recent years, as the rehab taboo has lessened and more people 
have sought treatment, the Ford Center's larger, more hospital-like 
facilities, with costs of roughly $21,000 for month's stay, have 
maintained their reputation for excellence but have come to seem more 
clinical against the new competition.

While earning double-digit profit margins, many Malibu operators are 
expanding rapidly.

Renaissance is working on a plan to expand to the Philippines and 
England as well as elsewhere in the U.S. Passages has purchased two 
houses on one gated Malibu street and is in negotiations to buy a 
third, and Mr. Prentiss, its co-founder, says he hopes one day to own 
all seven homes on the street: "At nearly $60,000 a month, it doesn't 
take a rocket scientist to figure out we're taking in $20 million a 
year." It's hard to tell, though, whether these places are any more 
successful than any other.

And with the exception of Passages' Mr. Prentiss, the Malibu centers 
aren't claiming to be more successful -- just more comfortable. There 
is no standard to measure the success of addiction treatment.

The problem lies both with the lack of a clear definition of success 
- -- sober for one year, five years or a lifetime? -- and verifying it, 
which would require addicts to report in honestly.

People often say they choose the Malibu facilities because they've 
heard famous people went there, and assume the treatment must be 
good, or because they want the creature comforts. "I knew I had to do 
something," says Kristen Bufe, who attended Passages for two months 
in 2004 after she could no longer find a fresh vein to shoot up 
heroin. "I'd heard of rehab, but I had this vision of Betty Ford 
where you had to clean toilets and things like that." Many experts 
believe that creature comforts have little to do with success in 
recovery, and that the best way for addicts to improve their chances 
is to simply spend more time in rehab.

Dennis O'Sullivan is the executive director of People in Progress, a 
residential rehab center that treats former prisoners and other 
down-and-out addicts in the San Fernando Valley. At a cost per client 
of $60 a day, covered largely by donations and government programs, 
People in Progress clients sleep on bunk beds with blankets donated 
by a local homeless shelter.

But clients are required to commit to living there for a year. "The 
longer your exposure to treatment, the better your chances of 
recovery," Mr. O'Sullivan says. Just a few years ago, Promises was 
the only luxury rehab center in Malibu. Richard Rogg, a lanky 
recovering cocaine addict, was running a West Los Angeles recovery 
center in 1997, when some deeply troubled clients surprised him by 
demanding more luxury. "They're being wheeled in on a gurney to save 
their lives, and they're looking around going 'what's the thread 
count of the sheet?' " Mr. Rogg says with a shake of his head. Still, 
he looked around with the thought of upgrading his center when he 
came upon a sprawling Mediterranean home in Malibu with a separate 
guest house. He bought it.

Within weeks of opening in Malibu, "some of my friends referred some 
celebrities," Mr. Rogg says. Soon, comings and goings at Promises 
were being photographed by paparazzi from on a hillside using 
long-range lenses.

Mr. Rogg, a lantern-jawed former real-estate developer with a 
sometimes morose demeanor, says he was surprised by the center's 
popularity with big names. "I didn't come up here and say, 'Let's hit 
up the rich and famous and get all these celebrities,' " he says.

His celebrity contacts have come in handy.

These days, Mr. Rogg is creating a new Los Angeles facility that will 
treat low-income mothers and their children, to keep the children out 
of foster care.

Earlier this year, at a fund-raiser at the polo games at Will Rogers 
State Park, actor Tom Arnold spoke, as did comedian Richard Lewis. 
Actor Louis Gossett Jr. addressed the crowd: "My name is Louis and 
I'm an alcoholic." They raised $280,000 for the treatment shelter 
that day, Mr. Rogg says, noting with a hint of cheer, "That's enough 
for our first year of operations."

A 12-Step devotee, Mr. Rogg and others say that Promises Malibu 
maintains a sober approach to recovery.

Every patient has chores.

Corporate executives, he says, are often the best workers, wiping out 
ashtrays with fervor. Promises patients have come to call the 
facility "the Rock" for its seat in the coastal mountains, as well as 
its tough-love role. "They hit you mind, body and spirit.

The money spent has given me a new life," says one former client, 
whose employer, an advertising agency, sent him there, and is now 
deducting the cost from his pay. "It might have fancy sheets and it 
might have triple-A food, but at the end of the day, it's a hard-core 
program." It took only a few years before other entrepreneurs -- many 
of them recovering addicts themselves -- began to replicate Promises' 
business model. The copycats are a source of steady irritation to Mr. 
Rogg and none more than Passages, whose treatment philosophy is at 
odds with Promises but whose name he says is similar.

One former Passages client says he ended up there because he was 
looking for Promises when he was loaded and got the names mixed up.

Mr. Prentiss, of Passages, argues that he has discovered a cure for 
addiction that involves uncovering a core problem through hours of 
individual therapy.

This approach stands in stark contrast to many rehab centers around 
the country.

Mr. Prentiss is a real-estate developer and the self-published writer 
of self-help books with titles like "For Once in Your Life, Be Who 
You Want, Have What You Want." He opened Passages as the "recovery 
plan" for his son Pax, the now-32-year-old co-founder, who had been 
addicted to heroin and other drugs since adolescence. "We cure people 
every day," says Mr. Prentiss. He argues that "alcoholism doesn't exist.

It's a condition created so that insurance companies would pay for treatment.

If I had an itch and scratched, would you say I have scratchism?"

Claims of a "cure" run counter to most in the addiction-recovery 
business. "I know of no reputable scientist who doesn't see it as a 
chronic disease," says Barry Karlin, chief executive of CRC Health 
Group Inc. in Cupertino, Calif., a fast-growing chain of rehab centers.

The evidence Mr. Prentiss offers of his success is anecdotal: It 
includes the case of a young woman who did drugs because, Mr. 
Prentiss says, she believed she wasn't pretty. "I took her into the 
bathroom and stood her in front of the mirror.

I took her hair back and I took her shoulders and pulled them back. 
She was lovely." Mr. Prentiss says that by the end of her stay, the 
young woman was using makeup, had her hair fixed and now makes a 
living as a model.

Two koi ponds flank the entrance to Passages' marble and gilt main 
building, where 34 therapists treat 29 patients in three residences 
where most share a room. They include two spiritual counselors -- one 
drives a Lexus sports car and says she's psychic -- as well as 
massage therapists, "life purpose counselors," hypno-therapists and 
an "image therapist" who encourages patients to use digital cameras 
to express themselves. One chef came from Spago. The staff leans 
toward attractive young women dressed in jeans and T-shirts. Sitting 
in a cushy leather lounge chair in Passage's great room, Mr. Prentiss 
greets, hugs, and pats his clients as they roam by. "How ya doin'?" 
he asks a young woman who passes with her just-delivered dry 
cleaning. "Not too well," she responds.

After she disappears, Mr. Prentiss confides, "She just found out 
she's pregnant two days ago."

Not everyone who attends these places is rich. One patient at 
Passages recently was a Hawaii bartender who paid the fee for three 
separate stays with an inheritance from her mother.

Her hands shake as she pours herself a glass of lemon water. "She'll 
be dead if she doesn't get it this time," Mr. Prentiss says, out of earshot.

Another recent client there sells cable-television services door to 
door. Convinced that Passages offered a solution that didn't label 
him diseased, he paid his bill by remortgaging his Los Angeles condo. 
"When you're there putting your heart and soul into therapy -- and 
then you get a massage," he says, "it's the relief." 
- ---
MAP posted-by: Richard Lake