I’m grateful to Counselor: The Magazine for Addiction Professionals for giving me this opportunity to share some thoughts with so many people who work in the addiction treatment field.

Let me begin by saying: I salute you all! I know what challenging work you’re involved in. I am in awe of your dedication, your sacrifice, and the contribution you make to helping alcohol- and drug- addicted persons get their lives back!

What I’d like to share falls into three categories: treatment at the Betty Ford Center, treatment in general, and some reflections on my own recovery.

Treatment at the Betty Ford Center
This October, the Betty Ford Center will celebrate its 22nd birthday. I suppose you could say we’re no longer adolescents; we’re now adults!

We’ve learned a lot in these first 22 years. I think I’d group what we’ve learned into six categories.

1. The 12-Step Basis of Treatment. Bottom line: it worked for us 22 years ago, it works for us today. I know some people view the 12-Step philosophy as “old-fashioned.” Well, all I can say to those people is, “It may be ‘old-fashioned’ — but guess what, it works!” And as long as it works, it will guide us in all our treatment efforts. I know new fads regularly come upon the treatment scene, but at the Betty Ford Center that’s exactly what we think the “new, improved” treatment models are — fads.
I’m so proud of the fact that treatment at the Center has remained steadfastly rooted in the 12-Step philosophy.

2. Family Treatment. As we say over and over at the Betty Ford Center: addiction to alcohol and/or other drugs is a FAMILY DISEASE and the whole family really needs to be involved in a patient’s treatment (and recovery). We believe so strongly in family involvement that if a patient can’t afford to have his or her family come to the Center for the Family Program (usually during the third week of primary care), we “scholarship” family members so they can attend. Fortunately, grateful members of our 64,000-member alumni family have given generously so we can offer this financial aid.

During the five-day-long Family Program, loved ones learn about the disease of addiction, they learn that the alcoholic/addict’s addiction isn’t their fault, and they learn what they can — and cannot! — do to help the alcoholic/addict. So many family members arrive here carrying enormous psychological baggage. We help them deal with that.

As many of you know, we also have a Children’s Program at the Betty Ford Center. It’s for young people age 7-12 who are not themselves addicted to alcohol or other drugs, but who live in a family environment where addiction is present. The Children’s Program lasts for four days, and believe me, if you want to have a good cry, come hear what these kids have been through in their lives, see them learn about the disease, and watch them learn to be kids! In so many cases, these children have taken upon themselves the heavy responsibility of maintaining some form of “normalcy” in their homes. When that weight is lifted from their shoulders, it is something to behold.

When I drop into a Children’s Program session, I always make sure a box of Kleenex is nearby!

3. Gender-Specific Treatment. When we started back in 1982, men and women patients were treated together. In my heart of hearts, I knew from my own treatment experience at the Long Beach Naval Hospital (where there was mixed-gender treatment) that that was far from ideal. But at the beginning, quite honestly, we weren’t sure we could fill 50 percent of our beds with women, so we waited a few years until we were on firm financial ground — and until we knew we could fill half our beds with female patients — before offering gender-specific treatment.

Why should women be treated separately from men? It’s simple, really. When they’re in the presence of men, women just don’t open up and reveal what really lies at the core of their being. And, of course, that total honesty and total opening up is absolutely essential if a person is going to really come to grips with her or his addictive self.

Providing an environment for our female patients where it was safe to speak openly and honestly was just the first step. Our staff has developed a host of gender-specific services that are directed toward healing the whole person. Besides the disease of addiction, women who come to us often have a broad range of issues that need special attention if the healing process is to take hold and the possibility of relapse is to be significantly reduced.

A woman’s search for wholeness is made more difficult by the culture in which she finds herself. So often, women — when they’re growing up, when they’re wives and mothers, when they’re at work — find themselves playing subservient, secondary and dependent roles.

Our culture is slowly changing, but that hasn’t been much help when it comes to rebuilding our fragile self-esteem and strengthening our self-image as we women attempt to recover from the disease of addiction. I’m afraid it’s safe to assume that a chemically dependent woman is on the bottom rung of the ladder of self-esteem.

I’m so proud of the fact that one of the real “signatures” of the Betty Ford Center is that we’ve evolved a treatment process for female patients that’s been crafted by female professionals to specifically address the specific needs of our sisters.
For over 20 years now, half our patients have been women, half men. Treatment is separate and fraternization discouraged. It’s a simple formula, and it works.

4. Individualized Treatment. No two alcoholics/addicts are the same. And no two treatment plans should be identical. The old “28-day” cookie-cutter model is just plain outmoded. Now, when a potential patient inquires about treatment, we tell him or her that depending on the intake assessment — and on the progress made during treatment — length of stay will range from 30 to 90 days.

I’m sure some potential patients have not come to the Betty Ford Center because we’ve refused to tell them with certainty that they’ll be on their way home — “cured” — in precisely four weeks. But we think it’s more important to be honest with the person before he or she comes to us for treatment. And honesty demands that we level with them: addiction is a complicated and stubborn disease; it’s a disease of which you’ll never be “cured”; it’s a disease that requires an individual treatment plan. We also point out to our patients that length of stay often correlates with the chances of relapse: the chances of relapse increase if you don’t “pay your dues” during your first, critical treatment experience.

5. Facilities Growth. I’m proud of our 20-acre Rancho Mirage campus and our nine buildings. But when I’m giving a tour, I always qualify my pride in the buildings and the grounds by pointing out that over the past 22 years we have not grown for growth’s sake. Every building serves a defined purpose.

Take our two most recent buildings. Ottenstein Hall provides a home for incoming patients, so they can undergo medically supervised detoxification and receive a comprehensive clinical assessment; only after those vital steps are concluded is the patient assigned to his/her residence hall. The Daniels Children’s Pavilion — our newest structure — is the largest one on campus, and as its name implies, it is the home of our Children’s Program.

I’ve always thought it important to remember: the buildings should serve the mission of the treatment center; they are not an end unto themselves.

6. Staff. Buildings are nice. Staff is essential. I’m proud of the fact that we have an incredible staff and leadership team. Most folks who work here have been with us a long time. Turnover is relatively low. I am in awe of the 200-plus individuals who make the Betty Ford Center what it is. They are so dedicated. They work so hard. When I’m asked to enumerate the factors that make the Betty Ford Center the leading addiction treatment hospital in the country, I don’t hesitate to start the list with what I believe is the Number One factor: our staff.

Treatment in general
1. Stigma. Sadly, I’m not convinced we in the addiction research and treatment fields have made much progress over the past couple of decades in spreading the word that addiction is a disease (just like cancer and diabetes are diseases), a disease that is treatable. I must admit I despair when I see the ABC network broadcast an hour-long “news” special in 2003 that questions the very concept of addiction being a disease. Not only was it shocking to see an hour of prime-time
television dedicated to debunking what all of us know is a fact; it was dispiriting to see such a travesty of a program barely challenged. It should have been greeted with outrage; instead, it was greeted with a whimper.
It reminded me of another ABC News special a few years ago which was an hour-long plug for “moderation management,” that sick notion that alcoholics can indulge their “weakness,” as long as they consume alcohol “reasonably.” It just takes my breath away that something that irresponsible could be broadcast on the public airwaves. But it was, millions of people saw it, and I’m sure it gave “permission” to many individuals who were in recovery and/or had been abstaining to start drinking again. And I’m sure some of those people are dead today because they felt they’d been given “permission” to go back to the bottle.

2. Insurance. The treatment field — as everybody reading this undoubtedly knows — has been decimated by the short-sighted actions of so many corporations that have so drastically cut back payments for drug and alcohol treatment. A lot of treatment centers have gone out of business. The drastic cutbacks have affected us all. When the Betty Ford Center opened back in 1982, over 80 percent of our patients used their health insurance to pay for at least part of their treatment. Today that number has fallen below 20 percent.

That’s not the way it should be! We’re talking about a disease here! Can you imagine businesses telling their employees with cancer or diabetes to go take a hike? It would be a huge, noisy national scandal. And yet that’s exactly what’s happening with the millions of people in our society who are addicted to alcohol and/or other drugs. They’re being told, “Too bad. You’re on your own.”
It’s been so frustrating to have in hand the hard figures that prove that appropriate intensive treatment for persons who suffer from alcoholism and/or addiction to other drugs ends up saving those corporations money. Yet they seem to be fixated on the short term; they just don’t seem to “get it,” that investing now in adequate treatment for their employers/customers who are alcoholics/addicts will save them money in the longer term.

This is a battle, I’m afraid, that we’ve fought and lost. The only hope appears to be a grassroots effort to get people to speak up. Several of these efforts are trying to gain momentum, including backing federal legislation that will force insurance companies to provide adequate treatment for persons with the disease of alcoholism and drug addiction. I urge readers of Counselor who have not already done so to contact their U.S. Senator and Congressman or Congresswoman and get them to support the Treatment Parity Bill. That legislation is really all about stopping the discrimination against alcoholics and addicts that happens every single day.

3. Invisibility. This is closely related to the issues mentioned above. How I wish more individuals who’ve been given their lives back thanks to receiving treatment for their addiction would come forward and talk publicly about the disease, about treatment, and about their recovery.

Several women who’ve been through treatment at the Betty Ford Center agreed to share their stories in a book that was published last year, Healing and Hope: Six Women from the Betty Ford Center Share Their Powerful Journeys of Addiction and Recovery. My hat is off to those women, they really told it like it is. Sure enough, I’ve got hundreds of letters from women alcoholics and addicts who decided to get help because they read Healing and Hope and came to that age-old realization: “If they can do it [get sober], so can I!”

I’ve tried to do what I can to make this disease public, but really I can only do so much. We need to put many, many more faces on this disease, faces on treatment, faces on recovery.

Every little bit helps. Every “Larry King Live” appearance. Every “Today Show” and “Good Morning America” opportunity. There is no “silver bullet” in this area, we just have to keep taking small steps in publicizing the reality of this disease and the fact that it is treatable. It’s an uphill battle, to be sure. But it’s a battle we must fight — and win.

My recovery
Thankfully, and mercifully, my life took a giant turn for the better after that fateful day in 1978 when my family staged an “intervention.”

I say a prayer of thanks every day for both the intervention and what followed.
I think it’s so important that the treatment and recovery communities spread the word every day, every way, that alcoholism and addiction to drugs is a disease. A treatable disease. Alcoholics and addicts need to know that there is hope — if only they’ll reach out for help!

Neither the co-founder of the Betty Ford Center, Leonard Firestone, nor I ever thought the day would come when we’d have 64,000 alumni, or that the Betty Ford Center would end up being a kind of de facto “clearing-house” for information about the disease of alcoholism/drug addiction as well as for treatment, but I suppose that’s what we’ve become. It’s not a mission we pursued, but it’s one we embrace.

May I say, finally, that if anyone reading this does want information, please pick up the phone and call us, or go to our Web site. All you have to do is ask!

First Lady Betty Ford co-founded the Betty Ford Center — a facility that has treated more than 64,000 patients and family members since opening in 1982. For more information about her life’s work and the Betty Ford Center, call 800-854-9211 or visit http://www.bettyfordcenter.org/.

This article is published in Counselor,The Magazine for Addiction Professionals, October 2004, v.5, n.5, pp. 21-24.

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