Does Rehab Really Accomplish More Than 'Maturing Out' of Addiction?

Rob Reiner’s new film, Being Charlie, relates his son’s many stints in rehab and his coming clean at age 19, after which he co-wrote the film. What does this tell us about recovery?

Reiner is promoting his new film about the spoiled son of a California gubernatorial candidate who abuses drugs and cycles in and out of rehab.

The New York Times review characterizes Charlie this way:

The title character, Charlie Mills, is its spoiled golden boy, a surly drug-addicted brat we first meet on his 18th birthday as he abandons the latest in a series of rehab institutions.

It describes his father this way:

Charlie’s father, David is a stunningly fatuous candidate for California governor who made his fortune as the star of a blockbuster Hollywood franchise about pirates. With his slicked blond hair and cold, arrogant sneer, this politician-come-lately is an empty suit robotically shaking hands while spewing inane platitudes at meet-and-greets.

Reiner has made clear that the story replicates that of his own son, Nick, who entered and left 17 rehabs before achieving recovery (at age 19!) then co-writing the script for this film at age 22.

The film concentrates on the superficial aspects of rehab life, including a romance and various shenanigans, followed by relapse (Nick was himself homeless when Reiner followed the advice of a tough-love counselor). Here is how the Times sees this content:

When Charlie inevitably relapses and trolls Los Angeles’s meaner streets for a fix, you feel little sympathy for a character so shallow he seems incapable of introspection. Father-son confrontations and tough-love warnings from a rehab counselor are little more than boilerplate harangues.

Considering both Nick’s recycling through treatment centers in real life (how did he manage 17 of them by age 19?), and the absence of content in rehab depicted in the movie, how are we to understand how Charlie/Nick achieved recovery?  

For starters, if someone is clean at 19 (now for three years), do we really view him as an addict? Not to discount the damage a young person can do to himself or herself by unwise substance use, but isn’t 19 an early age to recover from addiction?

In fact, we’ve known for some time that people naturally mature out of addictive problems. In 1962, social psychologist Charles Winick (who died last year and whose eulogy I contributed to) wrote his classic, Maturing Out of Narcotic Addiction. Examining the rolls of known heroin addicts in New York City, Winick found that two-thirds to three-quarters had emerged from addiction by their mid-30s.

A great deal of research has repeated Winick’s finding—longitudinal studies following young people for decades, representative national studies in which people recap their substance use histories, studies of untreated individuals with substance use problems.

Journalist Maia Szalavitz covered similar material in a piece titled, "Most People With Addiction Simply Grow Out of It: Why Is This Widely Denied?" She writes, "The idea that addiction is typically a chronic, progressive disease that requires treatment is false, the evidence shows. Yet the 'aging out' experience of the majority is ignored by treatment providers and journalists."

In other words, while natural recovery—maturing out—is the standard course for addiction, somehow we never hear about it.

Here’s a mini-experiment I do whenever I speak, often in front of addiction counselors:

Me: “What is the hardest addiction to quit?”

Group response: “Cigarettes, nicotine.”

Me: “Has anyone here quit a smoking addiction?”

From one-third to two-thirds of the audience raise their hands.

Me: “How many of you joined a support group or got any kind of treatment (meaning patches, hypnotism) that enabled you to quit?”

Virtually nobody—never more than a handful, even in audiences of several hundred people—raises their hands.

So we see, maturing out occurs all around us. But somehow, we have become convinced that rehab and 12-step groups are the only solutions for addiction. (Not to be maudlin, but Philip Seymour Hoffman had repeated experiences with both.)

Which brings us back to Nick Reiner. Charlie is depicted as a rich, entitled brat, which may be at the root of his substance abuse. On the other hand, if you had to figure, does someone like Charlie/Nick stands a better chance at maturing out than someone in, say, McDowell County, West Virginia, as described here in the Times:

Towns are hollowed out as people flee, and communities are scarred by family dissolution, prescription drug abuse and a high rate of imprisonment....

He had another seizure the other night,” Ms. Bolden, 50, said of her son, John McCall. John got caught up in the dark undertow of drugs that defines life for so many here in McDowell County, almost died of an overdose in 2007, and now lives on disability payments. His brother, Donald, recently released from prison, is unemployed and essentially homeless.

True, Nick was homeless. But after he quit drugs and went home, he got to write a movie produced by his father, and surely had better life prospects than those depicted in the Times article abut Appalachia.

So, given that rehab failed him 17 times, yet he still recovered by age 19, wouldn’t we be more inclined to explain Nick's recovery in terms of his social advantages and milieu, relative to those in McDowell County, rather than ascribing them to rehab?

My books all take this tack of looking toward the individual, and the quality of life they can obtain for themselves, as being the key to recovery. In Recover!: An Empowering Program to Help You Stop Thinking Like an Addict and Reclaim Your Life, Ilse Thompson and I write:

By reinforcing the myth that addiction is uncontrollable and permanent, neuroscientific models make it harder to overcome the problem, just as the 12-step disease model has all along. Telling yourself that you are “powerless” over addiction is self-defeating; it limits your capacity to change and grow. Isn’t it better to start from the belief that you—or your spouse, or your child—can fully and finally break out of addictive habits by redirecting your life? It may not be quick and easy to accomplish, but it happens all the time. 

Maybe the 17 failures Nick experienced in rehab, where undoubtedly he was filled with messages about his powerlessness, weren’t so surprising after all in one who was capable of maturing out before he was 20.


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