Skip to main content

Did rehab fail McCready?

By Anne M. Fletcher, Special to CNN
updated 2:14 PM EST, Tue February 26, 2013
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
updated 4:06 PM EDT, Tue October 21, 2014
Timothy Stanley says Lewinsky is shamelessly playing the victim in her affair with Bill Clinton, humiliating Hillary Clinton again and aiding her critics
updated 10:14 AM EDT, Thu October 23, 2014
Imagine being rescued from modern slavery, only to be charged with a crime, writes John Sutter
updated 12:00 PM EDT, Tue October 21, 2014
Tidal flooding used to be a relatively rare occurrence along the East Coast. Not anymore, write Melanie Fitzpatrick and Erika Spanger-Siegfried.
updated 7:35 AM EDT, Tue October 21, 2014
Carol Costello says activists, writers, politicians have begun discussing their abortions. But will that new approach make a difference on an old battleground?
updated 9:12 AM EDT, Tue October 21, 2014
Sigrid Fry-Revere says the National Organ Transplant Act has caused more Americans to die waiting for an organ than died in both World Wars, Korea, Vietnam, Afghanistan and Iraq
updated 2:51 PM EDT, Tue October 21, 2014
Crystal Wright says racist remarks like those made by black Republican actress Stacey Dash do nothing to get blacks to join the GOP
updated 6:07 PM EDT, Tue October 21, 2014
Mel Robbins says by telling her story, Monica Lewinsky offers a lesson in confronting humiliating mistakes while keeping her head held high
updated 9:29 AM EDT, Mon October 20, 2014
Cornell Belcher says the story of the "tea party wave" in 2010 was bogus; it was an election determined by ebbing Democratic turnout
updated 4:12 PM EDT, Mon October 20, 2014
Les Abend says pilots want protocols, preparation and checklists for all contingencies; at the moment, controlling a deadly disease is out of their comfort zone
updated 11:36 PM EDT, Sun October 19, 2014
David Weinberger says an online controversy that snowballed from a misogynist attack by gamers into a culture war is a preview of the way news is handled in a world of hashtag-fueled scandal
updated 8:23 AM EDT, Mon October 20, 2014
Julian Zelizer says Paul Krugman makes some good points in his defense of President Obama but is premature in calling him one of the most successful presidents.
updated 10:21 PM EDT, Sun October 19, 2014
Conservatives can't bash and slash government and then suddenly act surprised if government isn't there when we need it, writes Sally Kohn
updated 8:05 AM EDT, Wed October 22, 2014
ISIS is looking to take over a good chunk of the Middle East -- if not the entire Muslim world, write Peter Bergen and Emily Schneider.
updated 9:00 AM EDT, Mon October 20, 2014
The world's response to Ebola is its own sort of tragedy, writes John Sutter
updated 4:33 PM EDT, Fri October 17, 2014
Hidden away in Russian orphanages are thousands of children with disabilities who aren't orphans, whose harmful treatment has long been hidden from public view, writes Andrea Mazzarino
updated 1:22 PM EDT, Sat October 18, 2014
When you hear "trick or treat" this year, think "nudge," writes John Bare
updated 12:42 AM EDT, Sat October 18, 2014
The more than 200 kidnapped Nigerian schoolgirls have become pawns in a larger drama, writes Richard Joseph.
updated 9:45 AM EDT, Fri October 17, 2014
Peggy Drexler said Amal Alamuddin was accused of buying into the patriarchy when she changed her name to Clooney. But that was her choice.
updated 4:43 PM EDT, Thu October 16, 2014
Ford Vox says the CDC's Thomas Frieden is a good man with a stellar resume who has shown he lacks the unique talents and vision needed to confront the Ebola crisis
updated 4:58 AM EDT, Sat October 18, 2014
How can such a numerically small force as ISIS take control of vast swathes of Syria and Iraq?
updated 9:42 AM EDT, Fri October 17, 2014
How big a threat do foreign fighters in Syria and Iraq pose to the West? It's a question that has been much on the mind of policymakers and commentators.
updated 8:21 AM EDT, Fri October 17, 2014
More than a quarter-million American women served honorably in the Iraq and Afghanistan wars. Now they are home, we have an obligation to help them transition back to civilian life.
updated 4:27 PM EDT, Thu October 16, 2014
Paul Begala says Rick Scott's deeply weird refusal to begin a debate because rival Charlie Crist had a fan under his podium spells disaster for the Florida governor--delighting Crist
updated 12:07 AM EDT, Thu October 16, 2014
The longer we wait to engage on Ebola, the more limited our options will become, says Marco Rubio.
updated 7:53 AM EDT, Wed October 15, 2014
Democratic candidates who run from President Obama in red states where he is unpopular are making a big mistake, says Donna Brazile
updated 12:29 AM EDT, Thu October 16, 2014
At some 7 billion people, the world can sometimes seem like a crowded place. But if the latest estimates are to be believed, then in less than a century it is going to feel even more so -- about 50% more crowded, says Evan Fraser
updated 12:53 PM EDT, Mon October 20, 2014
Paul Callan says the Ebola situation is pointing up the need for better leadership
updated 6:45 PM EDT, Wed October 15, 2014
Nurses are the unsung heroes of the Ebola outbreak. Yet, there are troubling signs we're failing them, says John Sutter
updated 1:00 PM EDT, Wed October 15, 2014
Dean Obeidallah says it's a mistake to give up a business name you've invested energy in, just because of a new terrorist group
updated 7:01 PM EDT, Wed October 15, 2014
Fear of Ebola is contagious, writes Mel Robbins; but it's time to put the disease in perspective
updated 1:44 PM EDT, Tue October 14, 2014
Oliver Kershaw says that if Big Tobacco is given monopoly of e-cigarette products, public health will suffer.
updated 9:35 AM EDT, Sat October 18, 2014
Stop thinking your job will make you happy.
updated 10:08 PM EDT, Tue October 14, 2014
Ruben Navarrette says it's time to deal with another scandal involving the Secret Service — one that leads directly into the White House.
updated 7:25 AM EDT, Tue October 14, 2014
Americans who choose to fight for militant groups or support them are young and likely to be active in jihadist social media, says Peter Bergen
updated 9:03 AM EDT, Mon October 13, 2014
Stephanie Coontz says 11 years ago only one state allowed same sex marriage. Soon, some 60% of Americans will live where gays can marry. How did attitudes change so quickly?
updated 4:04 PM EDT, Tue October 14, 2014
Legalizing assisted suicide seems acceptable when focusing on individuals. But such laws would put many at risk of immense harm, writes Marilyn Golden.
updated 9:07 AM EDT, Mon October 13, 2014
Julian Zelizer says the issues are huge, but both parties are wrestling with problems that alienate voters
updated 6:50 PM EDT, Mon October 13, 2014
Mel Robbins says the town's school chief was right to cancel the season, but that's just the beginning of what needs to be done
updated 11:43 AM EDT, Sat October 11, 2014
He didn't discover that the world was round, David Perry writes. So what did he do?
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT