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
September 22, 2014 -- Updated 1259 GMT (2059 HKT)
You could be forgiven for thinking no one cares -- or even should care, right now -- about climate change, writes CNN's John Sutter. But you'd be mistaken.
September 21, 2014 -- Updated 2132 GMT (0532 HKT)
David Gergen says the White House's war against ISIS is getting off to a rough start and needs to be set right
September 22, 2014 -- Updated 1300 GMT (2100 HKT)
John Sutter boarded a leaky oyster boat in Connecticut with a captain who can't swim as he set off to get world leaders to act on climate change
September 22, 2014 -- Updated 1917 GMT (0317 HKT)
Ruben Navarrette says making rude use of the Mexican flag on Mexican independence day in a concert in Mexico was extremely tasteless, but not an international incident.
September 22, 2014 -- Updated 1359 GMT (2159 HKT)
Michael Dunn is going to stand trial again after a jury was unable to reach a verdict; Mark O'Mara hopes for a fair trial.
September 19, 2014 -- Updated 2322 GMT (0722 HKT)
Is ballet dying? CNN spoke with Isabella Boylston, a principal dancer at the American Ballet Theatre, about the future of the art form.
September 19, 2014 -- Updated 2147 GMT (0547 HKT)
Sally Kohn says it's time we take climate change as seriously as we do warfare in the Middle East
September 22, 2014 -- Updated 1927 GMT (0327 HKT)
Laurence Steinberg says the high obesity rate among young children is worrisome for a host of reasons
September 19, 2014 -- Updated 1302 GMT (2102 HKT)
Dean Obeidallah says an Oklahoma state representative's hateful remarks were rightfully condemned by religious leaders..
September 19, 2014 -- Updated 1922 GMT (0322 HKT)
No matter how much planning has gone into U.S. military plans to counter the Islamic State in Iraq and Syria, the Arab public isn't convinced that anything will change, says Geneive Abdo
September 19, 2014 -- Updated 1544 GMT (2344 HKT)
President Obama's strategy for destroying ISIS seems to depend on a volley of air strikes. That won't be enough, says Haider Mullick.
September 19, 2014 -- Updated 1303 GMT (2103 HKT)
Paul Begala says Hillary Clinton has plenty of good reasons not to jump into the 2016 race now
September 19, 2014 -- Updated 1501 GMT (2301 HKT)
Scotland decided to trust its 16-year-olds to vote in the biggest question in its history. Americans, in contrast, don't even trust theirs to help pick the county sheriff. Who's right?
September 19, 2014 -- Updated 0157 GMT (0957 HKT)
Ruben Navarrette says spanking is an acceptable form of disciplining a child, as long as you follow the rules.
September 19, 2014 -- Updated 1547 GMT (2347 HKT)
Frida Ghitis says the foiled Australian plot shows ISIS is working diligently to taunt the U.S. and its allies.
September 19, 2014 -- Updated 1958 GMT (0358 HKT)
Young U.S. voters by and large just do not see the midterm elections offering legitimate choices because, in their eyes, Congress has proven to be largely ineffectual, and worse uncaring, argues John Della Volpe
September 19, 2014 -- Updated 0158 GMT (0958 HKT)
Steven Holmes says spanking, a practice that is ingrained in our culture, accomplishes nothing positive and causes harm.
September 18, 2014 -- Updated 1831 GMT (0231 HKT)
Sally Kohn says America tried "Cowboy Adventurism" as a foreign policy strategy; it failed. So why try it again?
September 18, 2014 -- Updated 1427 GMT (2227 HKT)
Van Jones says the video of John Crawford III, who was shot by a police officer in Walmart, should be released.
September 18, 2014 -- Updated 1448 GMT (2248 HKT)
NASA will need to embrace new entrants and promote a lot more competition in future, argues Newt Gingrich.
September 16, 2014 -- Updated 2315 GMT (0715 HKT)
If U.S. wants to see real change in Iraq and Syria, it will have to empower moderate forces, says Fouad Siniora.
September 18, 2014 -- Updated 0034 GMT (0834 HKT)
Mark O'Mara says there are basic rules to follow when interacting with law enforcement: respect their authority.
September 16, 2014 -- Updated 1305 GMT (2105 HKT)
LZ Granderson says Congress has rebuked the NFL on domestic violence issue, but why not a federal judge?
September 16, 2014 -- Updated 1149 GMT (1949 HKT)
Mel Robbins says the only person you can legally hit in the United States is a child. That's wrong.
September 15, 2014 -- Updated 1723 GMT (0123 HKT)
Eric Liu says seeing many friends fight so hard for same-sex marriage rights made him appreciate marriage.
ADVERTISEMENT