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Can outpatient rehab cure Mel Gibson?

/ Source: The Associated Press

A lot is riding on Mel Gibson’s recovery from alcoholism: his health, his image, his reputation and his chance to repair relations with the Jewish community.

But unlike other celebrity alcoholics, Gibson is not checking into a treatment facility. Instead, his publicist says the actor is participating in an outpatient “program of recovery,” declining to provide specifics.

Will that be enough?

Many celebrities who have had public problems with alcohol or drugs choose residential rehab facilities. Nick Nolte voluntarily entered a Connecticut clinic four days after his 2002 drug arrest. Rep. Patrick Kennedy, D-R.I., checked himself into the Mayo Clinic the day after he crashed his car near the Capitol in May. Actor Robert Downey, Jr. was admitted to a live-in treatment center in 2000 after he was released from jail for drug violations.

But a closed-door clinic isn’t the only route to recovery, experts say.

Alcoholics Anonymous is an informal society of recovering alcoholics who help one another stay sober by following a 12-step, spiritual approach. Members attend community meetings where they share their personal problems and triumphs.

“We certainly don’t say we are the best or the only solution,” said Julio, a public information coordinator for the group who asked that his last name not be published. “We only say we have found a solution that works for many of us and we are happy to share information about it with any person interested in not drinking.”

Alcoholics Anonymous, known as AA, welcomes alcoholics at any stage of the disease, he said: “The door is always open to anyone who wants to stop drinking.”

The Promises Treatment Center in Malibu, which frequently treats celebrities and “people with a level of recognition,” offers both inpatient and outpatient programs based on AA’s 12-step principle, said executive director Dr. Donna Markus, an addiction medicine specialist.

'Concurring disorders'

Doctors assess potential patients to develop individualized treatment plans, she said, which may include pharmacological detox support, individual and group therapy and family counseling.

While “the majority” of Promises patients enroll in the residential program, where their stay could last as long as 30 days, others successfully recover with outpatient treatment, Markus said.

Not everyone needs the structure and supervision an inpatient program provides, said Dr. P. Joseph Frawley, an addiction medicine specialist in Santa Barbara.

Many alcoholics suffer from “concurring disorders,” such as depression or anxiety, said Keith Owens, director of the Irvine, Calif.-based Brookside Institute, where well-heeled substance abusers can clean up for $25,000 a month.

Dr. Marc Galanter, director of the division of alcoholism and substance abuse at NYU Medical Center/Bellevue, said there are several proven alternatives to residential treatment and AA, such as one-on-one sessions with psychiatrists or psychologists.

A new program developed at NYU, called Network Therapy, combines this therapy with regular meetings with family and friends, said Galanter, author of the book “Network Therapy for Alcohol and Drug Abuse.”

“It really depends on the individual and what they want to do,” Galanter said. “They have to be interested in not drinking.”

“The foremost challenge is to have a sense of trust and confidence that their privacy will be respected,” she said. “They feel like they’re under the microscope. They need to know that they’re allowed to have their own personal recovery process.”

Celebrities must also be willing to abandon their public persona to do the kind of soul-searching required for recovery, she said.

“It’s a disease characterized by self-deception and delusion anyway,” Markus said. “For a person who is vigilant about maintaining a professional persona, that can certainly compromise (recovery) and make it more difficult.”