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
December 20, 2014 -- Updated 0242 GMT (1042 HKT)
Conservatives know easing the trade embargo with Cuba is good for America. They should just admit it, says Fareed Zakaria.
December 20, 2014 -- Updated 0112 GMT (0912 HKT)
We're a world away from Pakistan in geography, but not in sentiment, writes Donna Brazile.
December 19, 2014 -- Updated 1709 GMT (0109 HKT)
How about a world where we have murderers but no murders? The police still chase down criminals who commit murder, we have trials and justice is handed out...but no one dies.
December 18, 2014 -- Updated 2345 GMT (0745 HKT)
The U.S. must respond to North Korea's alleged hacking of Sony, says Christian Whiton. Failing to do so will only embolden it.
December 19, 2014 -- Updated 2134 GMT (0534 HKT)
President Obama has been flexing his executive muscles lately despite Democrat's losses, writes Gloria Borger
December 18, 2014 -- Updated 1951 GMT (0351 HKT)
Jeff Yang says the film industry's surrender will have lasting implications.
December 18, 2014 -- Updated 2113 GMT (0513 HKT)
Newt Gingrich: No one should underestimate the historic importance of the collapse of American defenses in the Sony Pictures attack.
December 10, 2014 -- Updated 1255 GMT (2055 HKT)
Dean Obeidallah asks how the genuine Stephen Colbert will do, compared to "Stephen Colbert"
December 18, 2014 -- Updated 1734 GMT (0134 HKT)
Some GOP politicians want drug tests for welfare recipients; Eric Liu says bailed-out execs should get equal treatment
December 18, 2014 -- Updated 1342 GMT (2142 HKT)
Louis Perez: Obama introduced a long-absent element of lucidity into U.S. policy on Cuba.
December 16, 2014 -- Updated 1740 GMT (0140 HKT)
The slaughter of more than 130 children by the Pakistani Taliban may prove as pivotal to Pakistan's security policy as the 9/11 attacks were for the U.S., says Peter Bergen.
December 17, 2014 -- Updated 1600 GMT (0000 HKT)
The Internet is an online extension of our own neighborhoods. It's time for us to take their protection just as seriously, says Arun Vishwanath.
December 16, 2014 -- Updated 2154 GMT (0554 HKT)
Gayle Lemmon says we must speak out for the right of children to education -- and peace
December 17, 2014 -- Updated 1023 GMT (1823 HKT)
Russia's economic woes just seem to be getting worse. How will President Vladimir Putin respond? Frida Ghitis gives her take.
December 17, 2014 -- Updated 0639 GMT (1439 HKT)
Australia has generally seen itself as detached from the threat of terrorism. The hostage incident this week may change that, writes Max Barry.
December 12, 2014 -- Updated 2020 GMT (0420 HKT)
Thomas Maier says the trove of letters the Kennedy family has tried to guard from public view gives insight into the Kennedy legacy and the history of era.
December 15, 2014 -- Updated 1456 GMT (2256 HKT)
Will Congress reform the CIA? It's probably best not to expect much from Washington. This is not the 1970s, and the chances for substantive reform are not good.
December 15, 2014 -- Updated 2101 GMT (0501 HKT)
From superstorms to droughts, not a week goes by without a major disruption somewhere in the U.S. But with the right planning, natural disasters don't have to be devastating.
December 15, 2014 -- Updated 1453 GMT (2253 HKT)
Would you rather be sexy or smart? Carol Costello says she hates this dumb question.
December 14, 2014 -- Updated 2253 GMT (0653 HKT)
A story about Pope Francis allegedly saying animals can go to heaven went viral late last week. The problem is that it wasn't true. Heidi Schlumpf looks at the discussion.
December 14, 2014 -- Updated 1550 GMT (2350 HKT)
Democratic leaders should wake up to the reality that the party's path to electoral power runs through the streets, where part of the party's base has been marching for months, says Errol Louis
December 13, 2014 -- Updated 2123 GMT (0523 HKT)
David Gergen: John Brennan deserves a national salute for his efforts to put the report about the CIA in perspective
December 12, 2014 -- Updated 1426 GMT (2226 HKT)
Anwar Sanders says that in some ways, cops and protesters are on the same side
December 11, 2014 -- Updated 1439 GMT (2239 HKT)
A view by Samir Naji, a Yemeni who was accused of serving in Osama bin Laden's security detail and imprisoned for nearly 13 years without charge in Guantanamo Bay
December 14, 2014 -- Updated 1738 GMT (0138 HKT)
S.E. Cupp asks: How much reality do you really want in your escapist TV fare?
ADVERTISEMENT