Exactly, Slate article: does Lohan, or anyone else get a refund when rehab gives no result after the high cost is paid? No. I believe you have a valid question, there, one that should be addressed more fully by the American public and healthcare providers, and...I guess, the government. Let me state at the outset that I am not a conservative "hang 'em high" hard on the drug addict person. Some of my best friends are drug addicts, as are most of my family members. I wish them all well. But if treatment doesn't work 84% of the time (or make up some other number, everyone does it), why keep paying? Can't we come up with an alternative that does work? Instead, I believe we bury our heads and just accept it, and I believe most throw up their hands "well, it's their choiice, the addicts, nothing can be done." That's unnacceptable, as are the utterly fake statistics proclaimed by treatment programs, AA, etc. Fake, fake, fake, numbers, all of them. I know.

Thankfully, I am sober at the present time. The first time I went into treatment was at age 22. Most of the counselors were eminently qualified, having been through the program. Qualified to call all of the clients names, in the name of tough love, or honesty, doing little good, and a lot of harm to people with already low self-esteem, and of course all the blame for any failure fell on the clients. I stayed straight a while in spite of the incompetents running that place, who helped themselves way more than they helped me, but eventually, I went to treatment again, 5 years or so later. Then I went again, then I went to prison for 5 years after that for a drug-related crime. Prison offered a little treatment, too, mostly "go to AA" would sum up all of the knowledge, strategy, scientific study, research, teaching, and practice that our tax dollars pay for such treatment. I don't exaggerate, that is all of the expertise contained in such programs, all of it in one sentence. If that doesn't work for you, it's your fault. Ask anyone, ask Lohan. I suggest it is time for America to start selling some effective drug treatment and ban the quackery. It's a shame. Don't misunderstand either, I assume the consequences for my actions, as Lohan will suffer for hers, and that is fair, to me. But that does not invalidate the need for our society to seek a solution, instead of just paying for the same scam, ineffective product, and locking up the non-rich drug criminals.

I am so bored with these blonde blisters that somethink should dominat the news..they are just overgorwn spoiled brats that had to grow up without parents. most of them were raised by some paid nanny that had to give them their way or get fired and that is a poor way to raise children that never grow up. and then let them produe more children is a sorry thing..

(Some of this is a paraphrase of stuff I wrote yesterday on the Washington Post forum)

The problem is that the vast majority of rehabs are based on the unproven, religion-based 12-step program. I believe there is a vital need for addiction and substance abuse to be brought back into the mainstream of the mental health field. Lets have some research and find out what works and what doesn't. Show me one research study that's been done to determine whether AA is effective - it doesn't exist. Why, I don't really know. But it's irresponsible to keep pushing people into a program that's somehow managed to exempt itself from science.

Say my kid has a substance/alcohol problem so I hire a psychotherapist - expensive but licensed, qualified, subject to stringent codes of professional conduct etc. - so I assume my kid is at least not going to come to harm. He/she then turns my kid over to AA, and the care of an organization and persons who have no known training, qualifications, licensing, regulation, or clinically validated treatment protocols - heck, we don't even know WHO THESE PEOPLE ARE (anonymity). Worse still, my kid is forced to spend time hanging out with lots of people with the same problems - a recipe for trouble.

Everyone just takes it for granted that the 12 steps are the definitive answer to the epidemic of addiction. Even though it HAS NOT BEEN SHOWN TO BE EITHER SAFE OR EFFECTIVE under the standards universally applied to medical procedures, devices, medications etc. I believe the AA monopoly has the effect of suppressing research, so badly needed, into new methods of treatment which might really benefit persons troubled by dependence on drugs/alcohol. I believe that there is an unhealthy codependency existing between the health care establishment, rehab industry, the courts and the Program which is making matters worse, not better. I loathe hypocrisy: how come it's a disease when it suits them to be, and at the same time a moral character defect which must be confessed and atoned for?

I think most "civilians", if they read the Steps, would be shocked. AA is fundamentally concerned with religious matters - literally a faith cure - put one's faith in God and He will cure you. (AA denies this - they call it a "spiritual", not religious. Yet every court that's considered it has found that it is a religious program for purposes of the first amendment. On this basis, it's been found unconstitutional for judges to order criminal defendants into AA - a practice that nevertheless persists in many jurisdictions.)

Sure, there are millions who will tell you it "works if you work it". All that means is that it works for some people. A (literally) countless majority receive no benefit. Group therapy to support sobriety has its place, but it should be under the supervision of trained professionals, especially where young people are involved. And stop telling them they are helpless. Nobody is.