Eight things film and TV get wrong about drug and alcohol treatment
Drug use and addiction are popular themes in movies and television, but they often get things very wrong. Here are eight common myths about drugs you'll see on the silver screen.
1. Rehab goes for 28 days
In the movie 28 Days, Sandra Bullock is given a choice between prison and 28 days in a rehab center.
The 28-day program, popular in the United States, actually has nothing to do with the optimum treatment period.
Health insurance companies in the US are only prepared to fund 28 days in rehab. So the 28-day rehab model was developed around funding, not effectiveness.
2. Rehab is a luxury retreat
Some luxury private rehabs are pretty fancy, but these can cost A$35,000 a week or more, which is out of reach for most people.
The public residential rehabilitation system is is far less glamorous because it is severely underfunded, resulting in long waiting lists and little money to spend on pleasant surrounds.
There is no evidence the more you pay the better your success in treatment. And yoga and a private chef won't solve your drug problem. What's important is developing specific skills that can help prevent going back to problematic drug use. For that, you need trained professionals and good supports.
Take care, because currently the private rehab sector is unregulated so anyone can set up a rehab without the knowledge, skills or experience to do so.
3. 'Once an addict, always an addict'
In the original Sherlock Holmes books, Holmes used morphine and cocaine (legal at the time) whenever he was bored between cases, without any problems. In the TV series, Sherlock, he is shown as an "addict," always on the edge of relapse. Watson starts out as his "sobriety coach."
The idea that alcohol and other drug use is an incurable disease comes from 12-Step programs. It has been a widely held view, especially in the U.S., for many decades, despite evidence against the idea.
Many people return to "controlled drinking" or move from problematic to low or moderate illicit drug use, especially if they access help early. It's just as realistic as abstinence-based recovery.
There's also no such thing as an "addictive personality".
But for many people, a period of abstinence (sometimes a year or more) may help them gain the skills they need to go back to moderate use and to understand the reasons behind their use. For some it is easier to be abstinent for life, but that's not universal.
4. Recovery only comes after 'rock bottom'
Movies, like Requiem For A Dream and Trainspotting, often show people at their lowest point as a turning point for recovery. But the idea that someone has to hit "rock bottom" before they will seek help is not true.
First, it's impossible to know what "rock bottom" is for any one individual. Potentially, aside from death, there is always something worse. Second, many people successfully change their alcohol or other drug use early, even after the very first signs of a problem.
If someone isn't ready to go into rehab it's not because they've not yet reached their lowest point. People tend to seek help when something else outweighs the importance of using alcohol or other drugs, such as family, friends or career.
The "rock bottom" idea can be dangerous because people may delay treatment until things are really bad. But the earlier someone seeks support, the better the outcome.
5. 'Tough love' works
Tough love is acting harshly with the aim of helping a person in the longer term. This might include locking them out of the house if they refuse to go to rehab, refusing money for food if they are still using, or refusing to pick them up if they are intoxicated.
In <"a href="https://en.wikipedia.org/wiki/Four_Good_Days">Four Good Days, Glenn Close's character shuts the door on her distressed daughter, played by Mila Kunis, telling her she can come back when she is "clean."
There might be good intention behind tough love, but not only does it not work, it often makes things worse. Leaving someone homeless or starving or in a dangerous situation when they are intoxicated or dependent on alcohol and other drugs may be harmful.
There are better ways to set clear and consistent boundaries and still maintain relationships that can provide support for recovery.
6. Addiction happens after one use
The main character tries a drug for the first time and then spirals into unbridled drug use. This dramatic shorthand saves time in the plot, but gives the impression that anyone trying a drug will become dependent on it instantly.
In the 1991 movie Rush, Jennifer Jason Leigh is an undercover cop who has to use heroin to show a dealer she is for real, then spirals into a well of addiction.
But dependence (the more technical term for "addiction") is a gradual process in which your brain and body get used to having a drug regularly.
What might happen is the first time someone tries a drug they might like it. A lot. Then they might use it frequently over time until they become dependent.
7. All drug use is to 'self-medicate'
Some people use alcohol or other drugs to help manage the difficult emotions they experience as a result of trauma or other mental health issues—like Rue in the television series Euphoria, who descends into drug problems after the death of her father.
There is a much higher rate of alcohol or other drug use among people with mental health problems. But even among people with mental health problems, around two-thirds don't have an alcohol or other drug problem.
Most people use alcohol or other drugs because it makes them feel good and is fun. Most typically use occasionally for a short period in their lives, never experiencing significant problems.
8. 'Interventions' help
Picture this scene: a character returns home only to be greeted by family and friends sitting in the living room to confront them about their drug use. This popular trope was brought to life by the show "Intervention".
When family and friends raise their concerns, it can influence a person's decision to get help. But taking a confrontational approach will probably backfire. Confronting a person is likely to make them feel embarrassment and shame, both key barriers to entering treatment.
Taking a supportive approach or seeking family therapy usually results in better outcomes.