Skip to main content

Did rehab fail McCready?

By Anne M. Fletcher, Special to CNN
February 26, 2013 -- Updated 1914 GMT (0314 HKT)
A teenage girl takes a look at a substance abuse booth that didn't seem to be staffed all day at a county fair in Wise, Virginia.
A teenage girl takes a look at a substance abuse booth that didn't seem to be staffed all day at a county fair in Wise, Virginia.
STORY HIGHLIGHTS
  • Anne Fletcher: Tragedies similar to Mindy McCready's addiction and death happen often
  • Fletcher went to 15 rehab programs and found one-size-fits-all addiction treatment
  • She found lack of one-on-one counseling and no integrated mental health treatments
  • Standards for certification of addiction counselors woefully inadequate

Editor's note: Anne Fletcher is a health and medical writer and author of seven books, including "Sober for Good" and "Inside Rehab: The Surprising Truth About Addiction Treatment -- And How to Get Help that Works" (Viking, 2013). She is recipient of the Research Society on Alcoholism Journalism Award and a former contributing editor for Prevention Magazine. 

(CNN) -- Tragically, another celebrity has died after years of struggling with addiction, personal demons and multiple stints at rehab. Country singer Mindy McCready's death is in the headlines, but similar tragedies happen every day and you never hear about them.

Take the case of Wyatt D., who went to rehab at least 12 times for treatment of heroin addiction and whose family notified me last summer of his death from drug-related causes. Caroline R. went to rehab five times before medical complications related to severe alcoholism took her life. And Marnie M. died from a cocaine overdose after attending more than one famous rehab where she never received any professional psychological counseling for her troubled past. These aren't their real names, but sadly, they were real people.

All these people desperately wanted to overcome their drug and alcohol problems and, like McCready, they sought help. They attended some of the most recognized facilities in the country, only to be offered the same type of treatment over and over and to have it suggested that something was wrong with them when treatment failed.

Anne Fletcher
Anne Fletcher
Become a fan of CNNOpinion
Stay up to date on the latest opinion, analysis and conversations through social media. Join us at Facebook/CNNOpinion and follow us @CNNOpinion on Twitter. We welcome your ideas and comments.



Just this week, Drew Pinsky, who treated McCready on the third season of his show "Celebrity Rehab," said in reaction to her death, "Unfortunately, it seems that Mindy did not sustain her treatment." TV show hosts offered the typical platitudes: "Stay in treatment; treatment is effective; please get help."

I'll speculate that something else might have been going on with McCready, as it was for many of the more than 100 people I interviewed who had recently experienced the American addiction treatment system.

I visited 15 addiction treatment programs across the country -- from celebrity rehabs to high-end 12-step facilities to outpatient programs that treat indigent people.

The stories I heard illustrate what some studies show to be shortcomings of our drug and alcohol treatment system -- that the approaches tend to be one-size-fits-all, even at expensive residential rehabs -- and that patients often receive very little individual counseling. Instead, they participate in some form of group activity for around eight hours a day, not including meals, even though there is no evidence that group treatment is best for addiction recovery.

Some outpatient programs provide no one-on-one counseling at all. Many said they weren't comfortable sharing problems with peers and couldn't get sober until they found one-on-one treatment.

Was McCready's last song a suicide note?
Mindy McCready's dad defends her
McCready's ex speaks about suicide

Although about seven out of 10 alcoholics who are encouraged to go to Alcoholics Anonymous during treatment drop out in less than a year, the 12 steps of AA are included in some form in the great majority of addiction programs. Research shows there are other ways to recover and many clients said AA didn't work for them. Still, they weren't told about other options, such as Women for Sobriety or SMART Recovery.

Rose T. thought her relapse after her first treatment might have been prevented had she been told about Women for Sobriety. She found the organization on her own and said, "To sit in a room with others like me makes me feel less alone." At AA, if addicts relapse, they're often told they must start over, losing their sober time, which can be a setup for a drug or alcohol binge rather than a fresh start.

Many programs are not using approaches that scientific studies find to be effective. For instance, only about two out of 10 programs use one of the FDA-approved medications for treating drinking problems, such as Naltrexone or Antabuse.

And some prominent programs that treat opioid addictions, heroin or prescription painkillers such as OxyContin, refuse to send patients home with the very medications that can help keep them sober or "clean." Research shows these medications, such as Suboxone and methadone, are the most effective approach for opioid addiction, and that they both lower the death rate and the relapse rate. I have talked with people who had struggled for years and finally found an end to their drug obsession when they received such long-term treatment.

A recent report in the journal Substance Use and Misuse that analyzed Dr. Drew's "Celebrity Rehab" found that "although many patients had histories of opioid use, there were no positive messages" about Suboxone or methadone -- in fact, the medications were portrayed as unacceptable treatment options. The authors believe that this further stigmatized methadone and Suboxone use and that many opportunities to provide science-based information were missed.

For people to get well, treatment for psychological problems or "demons" must be integrated into care for addictions, and by qualified professionals. Unfortunately, the standards for gaining the credentials to be addiction counselors, who provide most of the care at treatment programs, are woefully inadequate. According to a 2012 report by the National Center on Addiction and Substance Abuse at Columbia, 14 states don't require licensing or certification of all counselors, only six states require a bachelor's degree and just one requires a master's degree to gain credentials.

We'll never know if another episode or type of treatment would have saved Mindy McCready, but we do know that, for a significant number of Americans, business-as-usual addiction treatment isn't working.

Follow us on Twitter @CNNOpinion

Join us on Facebook/CNNOpinion

The opinions expressed in this commentary are solely those of Anne Fletcher.

ADVERTISEMENT
Part of complete coverage on
August 19, 2014 -- Updated 2203 GMT (0603 HKT)
It used to be billy clubs, fire hoses and snarling German shepherds. Now it's armored personnel carriers and flash-bang grenades, writes Kara Dansky.
August 19, 2014 -- Updated 1424 GMT (2224 HKT)
Maria Haberfeld: People who are unfamiliar with police work can reasonably ask, why was an unarmed man shot so many times, and why was deadly force used at all?
August 18, 2014 -- Updated 2152 GMT (0552 HKT)
Ruben Navarrette notes that this fall, minority students will outnumber white students at America's public schools.
August 19, 2014 -- Updated 2121 GMT (0521 HKT)
Humans have driven to extinction four marine mammal species in modern times. As you read this, we are on the brink of losing the fifth, write three experts.
August 19, 2014 -- Updated 1158 GMT (1958 HKT)
It's been ten days since Michael Brown was killed, and his family is still waiting for information from investigators about what happened to their young man, writes Mel Robbins
August 19, 2014 -- Updated 1158 GMT (1958 HKT)
Sally Kohn says the Ferguson protests reflect broader patterns of racial injustice across the country, from chronic police violence and abuse against black men to the persistent economic and social exclusion of communities of color.
August 18, 2014 -- Updated 1242 GMT (2042 HKT)
The former U.K. prime minister and current U.N. envoy says there are 500 days left to fulfill the Millennium Goals' promise to children.
August 18, 2014 -- Updated 1310 GMT (2110 HKT)
Julian Zelizer says the left mistrusts Clinton but there are ways she can win support from liberals in 2016
August 20, 2014 -- Updated 1237 GMT (2037 HKT)
Peter Bergen says the terror group is a huge threat in Iraq but only a potential one in the U.S.
August 16, 2014 -- Updated 1734 GMT (0134 HKT)
Mark O'Mara says the way cops, media, politicians and protesters have behaved since Michael Brown's shooting shows not all the right people have learned the right lessons
August 17, 2014 -- Updated 1523 GMT (2323 HKT)
Retired Lt. Gen. Mark Hertling says the American military advisers in Iraq are sizing up what needs to be done and recommending accordingly
August 15, 2014 -- Updated 1941 GMT (0341 HKT)
Marc Lamont Hill says the President's comments on the Michael Brown shooting ignored its racial implications
August 15, 2014 -- Updated 2146 GMT (0546 HKT)
Joe Stork says the catastrophe in northern Iraq continues, even though many religious minorities have fled to safety: ISIS forces -- intent on purging them -- still control the area where they lived
August 14, 2014 -- Updated 2226 GMT (0626 HKT)
Tim Lynch says Pentagon's policy of doling out military weapons to police forces is misguided and dangerous.
August 15, 2014 -- Updated 1315 GMT (2115 HKT)
S.E. Cupp says millennials want big ideas and rapid change; she talks to one of their number who serves in Congress
August 14, 2014 -- Updated 2357 GMT (0757 HKT)
Dorothy Brown says the power structure is dominated by whites in a town that is 68% black. Elected officials who sat by silently as chaos erupted after Michael Brown shooting should be voted out of office
August 14, 2014 -- Updated 1149 GMT (1949 HKT)
Bill Schmitz says the media and other adults should never explain suicide as a means of escaping pain. Robin Williams' tragic death offers a chance to educate about prevention
August 15, 2014 -- Updated 1505 GMT (2305 HKT)
Nafees Syed says President Obama should renew the quest to eliminate bias in the criminal justice system
August 14, 2014 -- Updated 2024 GMT (0424 HKT)
Eric Liu says what's unfolded in the Missouri town is a shocking violation of American constitutional rights and should be a wake-up call to all
August 13, 2014 -- Updated 1922 GMT (0322 HKT)
Neal Gabler says Lauren Bacall, a talent in her own right, will be defined by her marriage with the great actor Humphrey Bogart
August 15, 2014 -- Updated 1056 GMT (1856 HKT)
Bob Butler says the arrest of two journalists covering the Ferguson story is alarming
August 13, 2014 -- Updated 2035 GMT (0435 HKT)
Mark O'Mara says we all need to work together to make sure the tension between police and African-Americans doesn't result in more tragedies
August 18, 2014 -- Updated 2006 GMT (0406 HKT)
Pepper Schwartz asks why young women are so entranced with Kardashian, who's putting together a 352-page book of selfies
August 13, 2014 -- Updated 2308 GMT (0708 HKT)
Michael Friedman says depression does not discriminate, cannot be bargained with and shows no mercy.
August 12, 2014 -- Updated 1525 GMT (2325 HKT)
LZ Granderson says we must not surrender to apathy about the injustice faced by African Americans
ADVERTISEMENT