Top Rehab Facilities in America: Promises' Dr. David Sack talks Recovery

By April MacIntyre Feb 8, 2012, 20:58 GMT

"There are two separate and distinct phases that are equally difficult," says David Sack. " One is getting started in recovery and the second is the first year after someone becomes sober."

Morning television show Good_Morning_America revealed the best places to dry out and recover for substance abuse addicts.

GMA did an in-depth look at the best the USA has to offer for recovery, and Monsters and Critics' frequent guest contributor Dr. David Sack of Promises Treatment Center headed up the exclusive list.

M&C interviewed Dr. Sack about what to expect when seeking recovery.

"There are two separate and distinct phases that are equally difficult," says David Sack. " One is getting started in recovery and the second is the first year after someone becomes sober."

"Addicts usually know they are in trouble for long time before they are ready or willing to give it up.  The signs are everywhere - borrowing money from friends, lying to relatives, excessive absences from work, increasing argumentativeness or indifference, a lack of concern for others in their lives," says Dr. Sack.  "Yet even as the crises multiply, an addict will usually look for more ways to escape accountability before they turn for help, or their family and friend mount an intervention.  Most alcoholics and drug addicts arrive at treatment intensely ambivalent about stopping, and during their first couple of weeks will use any excuse to reject help they could be getting."

Dr. Sack explained the pitfalls of the newly sober lifestyle. "The first year is difficult for other reasons.  Having gone through detox and having been sober for several weeks, it is common for a client to feel much better.  In fact he/she may feel so much better, that they can envision needing more help or support to stay sober.   Unfortunately, the brain recovers more slowly, and it is not unusual for people to experience insomnia, depression, anxiety and memory problems for weeks or months following their initial treatment."

"When they return they find the mess that the mess they’ve made has not taken care of itself.  Relatives and friends whose sole focus before treatment was for the client’s safety, are looking often with considerable resentment and impatience, for accountability and restitution.  Spouses who intend to separate from the addict, often wait until after they are out of treatment, thinking that they are somehow sparing them.  Cravings for drugs that were much improved after thirty days of treatment, emerge as the individual confronts loneliness, anxiety and past failures," says Dr. Sack.

The triggers for abuse come from many past issues, including genetics. 

"There are many factors that contribute to becoming addicted," says Dr. Sack. "Early childhood trauma, including physical or sexual abuse, death of a parent, are thought to contribute to that risk.  There is also a strong genetic component to becoming addicted.  It is estimated that approximately half of the risk of becoming an alcoholic or drug addict is related to genes and anyone who has been addicted to alcohol or drugs is more than 10 times more likely to becoming addicted to a different drug than the general population.  A history of depression, bipolar disorder or anxiety disorder more than double the risk of a drug problem."

Why are celebrities so prone to addiction? Dr. Sack tells us issues of self-esteem and easy access to substances come into play. "Among the performers and professional athletes we see at Promises, an urgent need to succeed, perhaps to offset childhood deprivations or low self esteem, is a common theme.  Working in a culture that tolerates and at times encourages drug use is another factor.  For many performers and athletes, their work life goes through cycles of intense activity like a concert tour, movie sets, baseball season, followed by low periods with fewer commitments and less accountability.  Performers start out using drugs to balance lives and manage fatigue, anxiety and insomnia during the peak periods, and to create excitement and arousal during stretches of boredom and inactivity."

Dr. Sack's Promises Treatment Centers in Malibu and Los Angeles are the top A-list rehab facilities in the United States according to GMA.

Promises Treatment Centers use the "Malibu Model," which allows their clients more liberty, allowing them to leave the facility.

Other notable centers for rehab include The Betty Ford Clinic, the Cirque Lodge in Utah (Brooke Mueller is there currently), Passages Rehab Facility, Pasadena Recovery Center and the Caron Foundation.