Whether or not you're watching Charlie Sheen go from TV actor to celebrity train wreck, the "Two and a Half Men" star has stirred a pot when it comes to his criticism of the addiction treatment industry.
Sheen's televised rantings against Alcoholics Anonymous, his statements that he possesses "tiger's blood" and has cured himself of drugs and booze through "his mind" have raised eyebrows among professionals who treat people with addictions.
The question remains: can you quit smoking, drugs or alcohol by willpower alone? Experts say it's possible, but add that many who do usually relapse or weren't technically addicted in the first place.
"Lots of people can quit on their own for a short time, but there's always the risk they may return to use and that happens frequently," said Ryan Vandrey, assistant professor of medicine at the Johns Hopkins University School of Medicine in Baltimore.
"How do you define recovery?" Vandrey said. "I'm sure (Sheen) has gone several weeks or months without getting high or getting drunk, then he goes again. At what point do you define him as cured? Many people say it's an ongoing disorder."
For those who haven't been following the tabloids, Sheen has had a public history of stays in various rehab centers beginning in the 1990s. He has also been arrested in several publicized domestic violence episodes and accidentally shot an ex-girlfriend.
But it's the past few days when things started getting weird. CBS shut down production of the top-rated show "Two and a Half Men" after Sheen's verbal attacks against the show's producer. Sheen said he left rehab to cure himself at home along with two girlfriends he calls "The Goddesses." And this week, a Los Angeles judge issued an order removing his two-year-old twins from his home after allegations of violence by his soon-to-be ex-wife, Brooke Mueller, who also has had a public history of drug use.
Despite Sheen's history (and perhaps because of it), some psychologists say that rehab centers that offer an intense 30-day stay aren't the answer for all patients.
"This is one of the big myths that the treatment industry perpetuates on the public," said A. Thomas Horvath, a psychologist and president of Practical Recovery, a San Diego treatment center. "The majority of the public do so on their own. Rehab in itself is no panacea or (Sheen) wouldn't have to go so many times."
Horvath says his program tries to change people's behavior without using a 12-step program, the model used for decades by Alcoholics Anonymous.
"The most common way out of addiction is natural recovery, which occurs using informal resources, and not treatment or a recovery support group," Horvath said. "The treatment industry downplays this fact or denies it, probably because it is not good for business."
Horvath says his approach uses standard psychological techniques to change behavior. He and others interviewed by Discovery News agreed that most people suffering from drug or alcohol dependency have multiple problems, which may include various forms of mental illness or psychological conditions, such as bipolar disorder or manic depression.
That makes identifying the causes or behavior -- and getting people to quit -- even harder, according to Michael Fingerhood, director of the Center for Chemical Dependence at Johns Hopkins Bayview Medical Center.
Fingerhood said he has had patients relapse after 15 years of staying sober and their tolerance for high levels of drugs or alcohol returns as if they had never stopped. He noted that different drugs affect the brain in different ways. Smokers who use a nicotine patch have about a 25 percent success rate, while those who stop without anything have a 5 to 10 percent rate, Fingerhood said.
When it comes to alcohol, Fingerhood said about 5 percent of people who say they can do it on their own actually succeed.
"It takes months of abstinence to be able to think clearly," Fingehood said. "Your neurons aren't connected for a while after drinking heavily."
Drugs like cocaine and heroin have a success rate somewhere in between smoking and alcohol, he said. With his patients, Fingerhood says he looks for small improvements rather than absolute cures.
"You hope that as people go along, the amount they relapse gets shorter," he said. "Some will go a month of being sober, then they drink for five or six days. Then maybe they'll stay sober for several months or a year. "