The Tragedy of the Betty Ford-Hazelden 'Alliance'

I do know that as major treatment centers start to move away from abstinence-based treatment, what I -- and many people I know and love -- received when we were desperate for help is in jeopardy.
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The Betty Ford Center and the Hazelden Foundation recently announced that they were pursuing a "formal alliance." Mainstream outlets picked up on the story but in general the news didn't raise a single eyebrow. And, on the surface, why should it? Hazelden has been around since 1949 and was, according to Betty Ford Center Board of Directors Chair Dr. Mary Pattiz, a major inspiration to the Betty Ford Center when they launched in 1982. And so, to the casual observer, this sort of announcement is a no-brainer at least and a logical partnership at most. But to those of us who owe the freedom in our lives -- and, in fact, our very lives -- to abstinence-based treatment and recovery from addiction, the news was hardly run of the mill and in fact more like an announcement that we're going to war.

Those who don't follow recovery news -- which is to say most of the free world -- may be only vaguely aware of the fact that there's a battle going on. Words like "evidence-based" treatment are thrown around, and that certainly sounds like something wise and logical, especially when measured against an anonymous organization that has never and does not plan to track its membership numbers or the success of those members. Those who are threatened by AA, or who have met and not liked some of its members, commonly toss out the unproven stat that the 75-year-old 12-step organization has only a 5 percent success rate, when the truth is that the largest study ever done on the topic, out of Stanford, reported that there were 33 percent higher success rates for AA participants than non-AA participants at the 16-year follow-up mark. You do not hear about this because AA understands that the many millions of people whose lives are possible because of it know the truth. AA, in other words, doesn't make any attempt to influence people's perceptions on the matter.

The same cannot be said for the other side -- the medication-assisted treatment and recovery folks. While methadone has long been accepted as a method for treating heroin addiction, it's hardly been on the menu of services at established treatment centers. But a fresh new crop of drugs has appeared in the past decade or so that don't require any waiting in unsavory lines. And yet some central facts about them don't seem to make the headlines -- facts like that there's no exit strategy in place for a number of them. In other words, drug addicts are going into treatment and being told that they're "sober" when in fact they're continuing to be dependent upon medication. I'm not arguing against medicating addicts who are detoxing off of the lethal amounts of drugs that they've been ingesting. I'm talking about the people who are still taking those drugs after they "graduate" from their treatment programs.

When Hazelden announced last fall that they were going to be offering medication-assisted treatment (or MAT), the usual collection of folks who endorse news of this sort quickly jumped aboard. But within the tightly-knit treatment industry, there was none of the clapping that New Yorkers complain Californians do too much of in meetings. At first the concept of Hazelden switching away from abstinence-based treatment seemed nearly unfathomable. And yet it became impossible to ignore the fact that as the treatment industry has grown, those folks out in Minnesota have appeared to be in more and more of a bubble. So their announcement, which came via a Hazelden alum with an M.D. and 37 years of sobriety, resulted in rumblings of dissent, though only a brave few were willing to express it publicly. Still, for Hazelden, perhaps the bubble had burst.

But the news this week that Betty Ford is forming an alliance with Hazelden is even more notable. To me, this doesn't sound like your average alliance meant to garner market shares. Hazelden, when it made its foray into non-abstinence-based treatment, essentially announced that it's not the institution it once was. But Betty Ford, for all its troubles of late, has remained the gold standard for addiction treatment. Located in Palm Springs, the Betty Ford Center is deeply embedded in the treatment and recovery industry. Some are speculating that this alliance is the facility's attempt to escape their problems. But who announces an "alliance," anyway? And that begs the question: Was this news leaked early by Hazelden as an attempt to launch them back into legitimacy within abstinence-based circles?

I certainly don't know. But I do know that as major treatment centers start to move away from abstinence-based treatment, what I -- and many people I know and love -- received when we were desperate for help is in jeopardy. And if the recent news results in a conglomerate that owns both Betty Ford and Hazelden and supports medication-assisted treatment, that would be a tragedy of unspeakable proportions. Because abstinence -- and particularly the abstinence-based treatment that I was given when I went through treatment in 2000 -- not only saved my life; it also gave me one. A life that involves continuing to be enslaved by drug dependency isn't one I'd want to have now that I know the other side.

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