Stuff You Should Know - How Rehab Works

Episode Date: November 11, 2010

These days, alcoholics and other people suffering from addictions are often sent to rehabilitation centers to kick their habit. But how long has rehab been around, and how does it work? Listen in as Chuck and Josh present the fascinating process of rehab. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

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They just have way better names for what they call, like what we would call a jackmove or being robbed. They call civil acid. Be sure to listen to the war on drugs on the iHeart Radio App, Apple Podcast, or wherever you get your podcasts. Brought to you by the reinvented 2012 Camry. It's ready. Are you? Welcome to Stuff You Should Know from HowStuffWorks.com. Hey, and welcome to the podcast. I'm Josh Clark. There's Charles W. Chuck Bryant doing his cheeks. He was just informed that he has to do that for the rest of our career,

whether he likes it or not, because that's our lucky thing. My cheeks are actually expanding. They're actually looser than they were two and a half years ago. I know. You look like Walter Matthau. He's one of those guys that he looked elderly when he was in his 40s. Or 20s, I think. He kind of had that hunched over look, the sarcopenia, if you will. Yes, nice. Isn't that sarcopenia? That's muscle loss, age-related muscle loss. Oh, I thought that was literally the hunchback. That's where you get the hunch. Sure. Yeah, like you lose control or you just lose your muscle mass, including the stuff that has you stand up, right? So yeah, you're right. But he also had the jowls and a five o'clock shadow that was

ever-present, but he was just a great actor. Dude, I love him. He was great in that. Bad news bears. Bad news bears is a good one to start this one with because he was a drinker. He was a drinker. He was what you might call an alcoholic. Right? Yeah. In the 70s though, it was... Everybody was an alcoholic. Drive around with the schlitz in your car and it's no big deal. Now let's say, but remember Chuck, this is the third out of three. This is the end of the trifecta. This is the jewel in the crown jewels, in the family jewels. This is it. Yes. We did addiction, prohibition, and now rehab. Yes.

Yes. If Walter Mathau had wanted to go to dry out, as they say, for his alcoholism in bad news bears, in the mid 70s, he would have had a very limited choice of where he could go. Probably, most likely, he would have gone to what is called a sanitarium, aka an insane asylum, aka a mental hospital. Yes, or a regular hospital. Yes, but most likely, it would have been some sort of medical clinical setting where his addiction was treated. Yes, it wouldn't be private Malibu promises by the seashore. Not yet, because rehab, as we know it today, which makes the cover of tabloids as frequently as any celebrity, just the concept of rehab does, sure, didn't start until the 80s, actually. I thought I was very shocked by that.

Have you ever seen Valley of the Dolls? I have not, believe it or not. That's a good movie. I had actually forgotten that I'd seen that movie until I reread this article that I wrote. I think I'd seen the movie, I guess at some point around there, I was like, oh yeah, Valley of the Dolls, it's perfect. If you have not seen Valley of the Dolls, go see it. It's an excellent movie, and Petty Duke's character goes to dry out at a sanitarium. Which means shock treatment and being strapped down so you can't drink. It could be. If you had been going to one far enough ago in the 30s and you're a particularly rabble rousing alcoholic or drug addict, they may have lobotomized you. Yeah, McMurphy style. Yep, exactly. So, Josh, you kind of blew the cover off of the fact, well, that was the first fact.

They didn't start until the 80s. Hey, I've been doing this a while. So where are we now then? Well, now. As they exist now? One of the other things that would have changed that anyone listening to our Prohibition and Addiction podcasts would know that one of the other things that changed and burgeoned alongside of rehabs as we know it, non-medical facilities, right, is the idea that addiction is a brain disease, which we should cover real quick. Yeah, a little rehash. So before it was. Stun gravy. It was blamed on the demon juice. Right, it was inherent in that substance. Yeah, that was the evil thing, was the substance itself. Then it shifted and all this started about the 19th century, late 18th century, early 19th

century, the concept of addiction came about. Then it shifted from the stun gravy to the person. It was a character flaw, right? Yeah, exactly. Something's wrong with you because you are not able to drink in. You have a weak will. Yeah, not able to not drink until you fall down flat. Right, exactly. And then finally, in the 80s, I would say about the 80s, the idea that addiction is a brain disease, that there is a process that an addict undergoes, a substance user, undergoes and becomes a substance abuser, that is the direct result of the substance hijacking that person's reward center in their brain. Exactly. That the decision of whether or not to engage in that risky behavior or do that substance, snort it, shoot it, smack it, slam it, drop it,

that kind of thing is out of the user's hands and therefore they're an addict. It's a disease. It's a chronic disease that has relapses and all that kind of stuff and needs boosters. So that model, the brain disease model, along with the creation of rehab, is where we are now. Well, yeah, it's not funny because I'm sure you're planning this, but the fact that you mentioned the temperance movement and prohibition in figuring out what addiction was, they actually ended up leading to rehab because back in those days, they were they called sober houses? Yeah. Just get locked up, basically, right, where you can't drink. Did you see the picture? You don't get the pictures, do you? No. Okay, so check that picture out. I think that's Kerry

Nation, the head of the Women's Christian Temperance Union, standing next to a man who's taken a sip and she's standing at a bar looking a little upset. Boy, that's the definition of buzzkill. So the temperance movement definitely gave rise to rehab by setting up, like you said, what are called sober houses. Like the drunk tank, almost. Like on Andy Griffith, you would lock up the drunk, of course. On Andy Griffith, the guy was in the drunk tank, Otis, I think, for weeks and weeks. I think they more resembled halfway houses that are transitional homes between prison and society. I wouldn't know about those. I think your dad's house. I think that they resembled that. It was like this house is among houses and you can't get booze there. You can't

bring booze. You kind of need to say where you're going and why. They set up these houses, called sober houses, that were sequestering people from regular society because alcohol was out there. And that was like the first rehab centers in the United States? In the 1840s, I think. Man, that's crazy. They did this that long ago. And then we did the failed noble experiment prohibition, which was basically like if you can rid society of alcohol, you can rid society of alcoholics. But you can't. So maybe we can only set up places for them if they have troubles. Right. They went back to the sober house idea. It's interesting that prohibition actually kind of led to rehabilitation clinics. Yeah. And more drinking. Well, that's not true because

they said overall it went down, but 30 to 50 percent across the board. But the alcoholics, the number of alcoholics increased. Yes, exactly. Right. So Chuck, where are we? We're past the 1930s. Oh, one of the other things that came up, not just rehab, like as we understand it today, like a place where you go that's sequestered from the temptations of society to rehabilitate yourself. One of the other things that came about as a director's role of prohibition in the temperance movement is 12 step programs, specifically alcoholics anonymous, right? Yeah. Dr. Bob and Bill W. Robert Smith and Bill Wilson created this in 1935. And I don't think I realized it was that old either. Yeah. Long time ago. I remember Bill W. wanted to give everybody

acid who came through the program because he was like, it's really great. Yeah. He thought it might help. Yeah. That was the first support group treatment program. And the 12 steps has, well, let's not jump there. Let's just finish the history out. Well, the international order of good Templars. Oh, yeah. They were a society dedicated to assisting alcoholics during the temperance movement. Supporting them, man. And they created these support groups that eventually gave rise to this AA model that's been proven like you're about to say so successful. Yeah. Which we'll get to. And then Chuck, right? Yeah. At this point, thanks to AA, almost exclusively, and the idea that you can treat. You can lick it. Yeah. You can treat addiction,

especially in a medical setting before the advent of the 80s. The US started throwing money, not just at eradicating the supply of illicit substances, but also the demand. And even more so, the demand under Nixon, right? Yeah. Dick Nixon put two-thirds of his drug, kind of anti-drug policy money toward recovery and treatment, which is a really kind of a forward thinking thing if you think about it in today's terms. Especially for Nixon. You would have thought he like, let's throw all of it toward locking people up. Yeah. But Ford came along and redistributed that to about a half and half model, half toward policing and arresting and trying to get drugs off the street and half toward treating people with the disease.

Why is that ironic, Chuck? It's ironic because you might have heard of the Betty Ford Clinic. And that was his wife who had a pretty bad pill addiction and alcoholism problem. Yeah. And she started it. She was like, oh, I can get clean. And I should set up a treatment center. Yeah. And she did in Rancho Mirage, California, the Betty Ford Clinic. In 1982, it opened its doors. And that, I think, was one of the models for the current incarnation of rehab. That was the first big, and I know celebrities went there, but that was just the first all-star treatment center that you heard on the news and probably, and not probably most definitely because her name was on it. And it also, her lending her name to that treatment facility and admitting that she

had been addicted to pills and booze. It also had a lot of a big effect, I think, on getting people into treatment because it is still, but it was at the time, even more so, such a shameful thing to be addicted to something. Still is, but it's way more accepted now. But in terms of like religious circles, I know it's still pretty shameful. Sure. I would definitely imagine so. But I think her putting her, like even the first lady can get hooked, then, you know, and if the first lady can kick it, then I can too. You know what other effect it had, I bet? What? People with the name Ford, not naming their daughters Betty. I'll bet you would name your daughter Betty Ford, would you? No. Well, I might, but I'm kind of a jokey kind of guy. Betty Ford Clark. Betty Ford Clinic Clark.

That reminds me, actually, I think I might have told you this. My friend Joey used to say that if he ever had a son, he would name him Thomas Magnum Dorlech. His last name is Dorlech. I think that's a good. I thought that was pretty good. That's a good name. But he had like three sons that didn't name any of them. That's so. So he's a liar. Yeah, he's a lying liar. And he's been called out as a liar on this podcast. I don't think he listens. Once Reagan got into into office, the policy of paying more for policing the supply side than paying any attention to the demand side was continued. Yeah, the war on drugs, the war on drugs in earnest. But by this time, people were seeing like, okay, rehab can work. Sure. It's a viable solution to treating our

nation's substance abuse problems. And it was kind of etched in popular culture in American psyche. Yeah. And it boomed like private institutions all over the country started popping up. Yeah. And I think also that just say no campaign and like the idea of like, you know, drug, the drug addiction and how bad it was probably got a lot of kids, a lot more kids thrown into rehab by their parents than it ever been before. Yeah, I bet. You know, yeah, like 13 year old to snuck some beer out one night. They're all sudden in rehab. Exactly. I've heard stories about that. Did you go to high school? I did go to high school. So check, let's talk about different types of treatment. There's four, really, actually three, technically four. And by the way, I need to change

the headings of this. I need to switch to chapter headings I realized because it's very misleading. Well, we can do it on the fly. I'm going to start with inpatient. Is that still correct? Yeah. Okay. Inpatient and this we should point out this can take place in a private facility. It can be in a hospital still. I think prison you said is a big place for a forced rehab. It is technically an inpatient facility. Very much inpatient. Yeah, you're not going anyway. What inpatient is though, just like being a hospital stay, it means you're there living there 24 seven. Yeah, usually for that 28 days for any Sandra Bullock fans, probably more for this podcast for any Vigo Mortensen fans, 28 days, not 28 days later.

Right. The other one. Oh, was he in 28 days Vigo? Yeah, he played a sex addicted like football star or something like that. That's funny. I ran into him like three times on one week in LA one time. Really? To the point where he looked at me and he was like, are you following me? Yeah. I thought he was going to kill me. Yeah, I'll bet. So, oh no, not Vigo Mortensen. I was thinking, who's the creepy guy from Buffalo 66? Vincent Gallo. Yeah. Disregard that whole story. I could see him. Yeah, I wouldn't want to run into him that third time. I'd be afraid of him. Yeah, for sure. Thinking anything like that. Have you seen Hidden Seek? No. It's an awesome movie. Really? It is so twisted.

Interesting. Is that more? It's a thriller. Okay. Vincent Gallo. Jennifer Tilly is excellent in it. Darrell Hanna actually does a really good job. That's pretty much the cast and it's really something. We'll have to check that out. Yeah. All right. So, where were we? We were inpatient. We were staying overnight, Josh, is where we were. And that can range, like you said, from 28 days all the way to basically when you need to leave six months a year. Or when your insurance runs out. Yeah. If you're in there for a year, then you might be a hopeless case. Well, that'd be pretty bad. Yeah. But you really just inspired the hearts of a lot of people who've been in rehab for 11 months. I know. Just say that. And it can be court ordered as well. And they also,

in some of these long-term programs, can offer you like re-socialization. Because I imagine being in a rehab clinic for three or four months, six months. Right. They're like, keep your milk in a refrigerator or failing that a cool wet sack. Outpatient is next. That's basically where you go in to visit on a set schedule. It could be daily. Right. But you're doing your regular life. You're sleeping at home. You're going to work. And then probably in between work and going to sleep, you're spending a significant amount of time in counseling and group sessions, 12-step, maybe receiving medication. Methadone treatment usually takes the form of outpatient treatment. And that's actually one of the longest treatments, apparently, is methadone,

prescription methadone treatment. Yeah. To get you off of the white pony. Yeah. Whenever I see those on the documentaries, it's very much outpatient. Like you literally see the junkie walk up to the window to get his daily dose or her of methadone. Yes. Lastly, there is partial hospitalization. This is basically the opposite of outpatient. Right. Well, it's not the opposite, but it's pretty close. Rather than go to work from nine to five and then go to rehab. You go to rehab from like nine to five during the day, but you stay at home and all that. Now, I don't understand the difference between that and outpatients. Outpatient, you're just not necessarily there all day. You might go for like your two-hour meeting and leave every day. Yes. Okay. Yeah. Whereas

like partial hospitalizations, you're spending way more time there during the partial hospitalization treatment because after work for outpatient, you're there for maybe a couple hours, three hours, but it's like a part of your day. Instead of going home and sitting on the couch and watching TV, you're going to rehab. Or going to happy hours. You don't want to do that. Well, no, that's what I'm saying. Oh yeah. Or going, yeah. After work, it's probably a good time for a lot of people because a lot of people associate the five o'clock bell ringing with that first drink. Right. Exactly. I'm sure that's a huge part of it as well. Partial hospitalization is where you're spending your days in rehab and then you go home. That is your job.

Yes. Okay. Your job is to get well. Prison. You mentioned prison or I did. And when they do this in prison, they take you out of the general population typically. Didn't we have somebody right in after the prison? Yeah. The listener mail on prisons, the guy was like, it's the, it was the easiest place to score drugs and I've ever been. Yeah. Exactly. Was prison. Yeah. So that, I think that's kind of cool though. It shows like a real dedication to rehab. Yeah. Among prisons by, by taking the people away rather than pretending like there's not a problem. Exactly. And I could actually see that being the case where they said, no, we're rehabbing people, but they're, you know, getting drugs being passed between the bars. Right. And readily. Yes. And

other things. It's key stirred. So check, let's talk about treatment. Technically, I would call this one how rehab works. I wanted to switch those two. Oh, okay. Gotcha. Cause really types of treatment was what we just talked about. Right. Yeah. And then how rehab works is what we're about to talk about. I just don't know how that got passed. Well, it did. So let's talk about how rehab works, man. Well, it's a long process. Don't expect to be out of there in a week. Although that one program that you point out says they can do it in six days. Which one? Six months. Oh, six months. No, I thought that one. Yeah, was that six months or six weeks? Six weeks, I'm sorry. Okay. Six weeks, Chuck. So I would say don't plan on spending more than like a week in your

rehabilitation clinic would be my guess. Yeah. You can also, we failed to mention ERs can technically be an inpatient rehab that lasts long enough to get you over your withdrawals or to bring you back to life from an acute drug overdose. So if you are taken to the hospital, OD, they'll keep you there as long as you're physically or until you're physically well. Yes. Which means drugs right at your body. That can, yeah, it can rehabilitate you. I mean, you can. Yeah. But so it can last for as little as several hours. So like you said, months and months, possibly a year, right? But yeah, everybody who buys into the brain disease model of addiction says, okay, because of this, there's a lot of facets to addiction, which means there's a lot of facets to rehabilitation. Sure.

It's going to take a while. Yeah. Yeah. But step one is always just withdrawal, get the drugs out of your body and get clean physically. Yeah. And you're not going to have any physical withdrawal from behavioral addiction, compulsive behavior, but you're still probably going to have a rough time at first. Oh yeah. You know, with the desire to do that. When you are stable, I guess, and probably before you're stable, you're probably going to be introduced to a 12 step program of some sort, right? Now, did AA create the 12 step? Yes. Okay. Yeah. There was no such thing as the 12 step before that. But there's all sorts of variations on the 12 step now. Yeah. And one of the things like we were saying, AA is incredibly successful. It's been study after study after

study done on AA and any kind of relapse associated with the people who go through it. Right. And it's a very successful program, but it's also very criticized often because one, it's criticized for being too indulgent on the addict's ego. Sure. Right. Like this is not your fault. It's all okay. Yeah. Or if you go through these steps, you're going to be a great person. Yeah. And it's also very reliant on a belief in God. Yeah. I don't think there's, it's not like a Christian God or a Judeo Christian God or any specific God, but I think they call it like a higher power. And there's plenty of atheist addicts out there. Well, they call it, I actually looked at the original 12 steps today, and they say the word God in four of the 12 steps. But on the,

before that first mention of God, it says God as you understand him to be. So that's the little caveat. Like we're not saying, like, like you said, the Judeo Christian God must be the one, but they definitely say you got to have a higher power here or else that's not going to work. Right. And the problem is that there's a lot of people whose conception of God is that they understand him to be non-existent. Right. Or that I am God. Right. Yeah. Yeah. There was like a joke that just flitted right through my prefrontal cortex. It wasn't funny. No. So Chuck, Narcotics Anonymous, I believe, and some others, but most notably, Narcotics Anonymous has adjusted the 12 step model to accommodate atheists as well. And you

know what? I bet regular AA meetings are a little less centered on that now. That would be my guess. They probably wouldn't refuse you at the door if you said you were an atheist. Oh, I don't think they're refusing. I don't think it's or try to convert what they're what they're saying is like, if you're an atheist and you don't buy into the God thing, like you're not going to be as successful as somebody who does because part of it is like giving it over to this higher power. Okay. So I don't think that they're exclusive or anything like that. I think that it's like atheists aren't going to do as well. Gotcha. All right. Have they done studies on that? I wonder. I'm sure. I bet they have. I didn't go to that detail,

though. It's okay. CBC. Is that next? Yeah. Cognitive Behavioral Counseling, which is psychotherapy. And that is when they, I mean, they can treat mental disorders. They can treat depression, PTSD. Yeah. And basically, they're, they're trying to eradicate addiction from the life of someone by looking at their behavior. Yeah. Very thoroughly. That's most, most therapy that anyone goes in for these days is cognitive behavior therapy. Right. One of the most prevalent. And yeah, it's, it's looking at behavior. First of all, it's recognizing patterns of behavior, especially destructive patterns of behavior. Yeah. And then figuring out why you're doing that and then eradicating it. Yeah. And it's this multi step process.

CBC is less effective according to studies as 12 step programs by itself. Either one by themselves. Right. Right. 12 step usually beats cognitive behavior, behavioral counseling. Right. Yes. What about meds? Well, if you know, you need meds like methadone to get through your treatment, then your rehab center is probably going to have them for you. Yeah. Or antidepressants are a big one too. Sure. And one of the things that's very effective is identifying usually through CBC, other underlying comorbid conditions. Oh yeah. Like if you have a binge eating disorder or you are depressed and an alcoholic, treating those two things simultaneously in the same umbrella. Yeah. Yeah. Has been shown to provide the most success.

Sure. Cause if you're depressed and you can't get treatment for alcoholism if you're suffering through depression and just leave the depression alone. Right. Cause you're probably an alcoholic because of your depression or that's a large part of it. Or it could be because you're an alcoholic but that doesn't necessarily mean that curing your alcoholism will cure your depression if you've gone into a clinical degree of depression. Right. Like a chicken or the egg kind of scenario. Yes. To get to the other side. And acupuncture, Josh, you mentioned a few non-traditional methods. Acupuncture is one of them. Have you ever done that? I have not. Have you? It's awesome. Yes. I can imagine. It's one of the most relaxing things I've ever done in my life actually.

I went to a place in LA that had, it was a school where you get really cheap acupuncture. Was Vincent Gallo your acupuncture? He was actually. But he used nails, 10-pinny nails. It's very relaxing. It's not painful at all if you're little weirded out by needles. Yeah. Cause I'm totally freaked out by needles, but it's not like that. I'm freaked out about them not thoroughly cleaning their needles enough. I've heard accusations of that. Oh, they're new though. Not all the time. The ones I got were taken out of the little package there right in front of me. Yeah. No, I'm sure. Like most of them, but there's ones out there that are just like, yeah, I guess needles. I just used it to some other guy because I'm cheap. If they're

wiping blood off the end of them, I wouldn't get that. If you are a Scientologist, you might go in for Elrond's patented addiction treatment, maybe we'll call it. Yeah. It's like a vitamin, regimen and exercise sauna. sauna as part of it. What else? The Jude Daddy's program. We talked about that. No meds. No meds at all. And I got one. I don't remember because I didn't go back and look, but I got the impression that this, they're kind of, this is something of a closely guarded secret. Right. And it may or may not be viewed suspiciously by conventional rehabs. Oh, really? But they, they boast a 65% success rate for their six weeks days. Wow. And yeah, they don't, they don't use meds. It's all just like, you are bad. You're a bad person and they, they,

they're like, you eat like this and they push your head down into a dog bowl. Then they do a clockwork orange movie viewing experience with your eyes. And then six weeks later you're like, oh, I'll never do that again. Josh, let's say you love Eastern medicine and things like acupuncture and you're afraid that if you go into your traditional rehab clinic that they won't oblige to those kinds of things. Is that, is that a worry that you should worry about? It depends on how much money you have. Oh, really? Yeah. Some of the higher end ones will combine a lot of stuff, even cool stuff like helicopter rides or wilderness survival based on the idea that things like wilderness survival can, can show you how self-reliant you can be.

Or a helicopter ride is meant to just be like, wow, look at how beautiful life is, even without booze. Right. Or yeah, maybe acupuncture, spot treatments, things like that. Like the higher end you go that the more pleasurable the experience is going to be, I imagine. I'm glad that works, but when I hear something like that, I think, you know, look how beautiful that the world looks from a helicopter flight along the shore of the Pacific coast. Like you don't need drugs to witness this, but you need a helicopter. Right. Yeah, exactly. You come out like hooked on helicopter rides. I guess what they're looking for is just to inspire you with that notion that, yeah, I don't need it.

So I agree with you though. I think that is kind of, no, but it was funny and true, Chuck, which is the best kind. This stuff actually does work. As we said, people have been studying this stuff since they started in the 80s. Right. And one of the things that they found that the most effective kind of treatment is rehab, where you are sequestered away, or you have some form of rehabilitation treatment, right? A 12-step group and weekly counseling, like cognitive behavioral counseling, throwing everything at it. Meds are not necessarily included in that. Yeah, I noticed that. But being part of a group, especially a 12-step group,

plus counseling, plus a stint at rehab, is the most successful as far as the rate of relapse goes. Yeah, to the tune of 87%, the target cities project study, yeah, quoted. If you do all those three things, that's an 87% chance of not relapsing after six months. Yes, and get this. This is surprising to me. I remember this. When you factor in treatment dropouts, people who just, you know, were like, they were like, I'm not going to stay the whole 28 days, but I'm going to keep going to a weekly 12-step meeting. Right. And I'm going to go to counseling five times a week, which is a lot. Oh yeah. They still had a success rate. The abstinence rate was 74%. So even without treatment drops, it can be, yeah. It's not bad. No, no. And then it's

62%. Actually, it keeps going down. If you complete the treatment program aspect, but you didn't go to the 12-step meetings and you did go to counseling. So the two out of the three minus the 12-step, you have a 62% chance. Right. So the 12-step as they found is the most significant, followed closely by individual counseling, usually CBC. And what they found is that a person who goes to four 12-step sessions a month, or even one individual counseling session per month, more than anybody else, has a 40% better chance of success in remaining abstinent. Well, that says that these work, these programs work. They actually do work. But here's the thing. They work best, again, studies show, when the person is ready and willing to give up this

behavior. Yeah. That's what they always say. When, you know, you got to be ready to change anything in your life in order for that to change. Yes. And that makes sense. Otherwise, you're just going to be, you're just doing it for your, your parents or your wife or your husband. And, and if it's not coming from you, then good luck. Do you know what's funny though? What's that? I just realized this. That was conventional thinking. But with the advent of prison rehab. Yeah, new information. Studies have also shown that if you force someone into rehab, in prison specifically, they will still, there's, they still have a pretty high success rate and abstinence rate and even a lower rate of recidivism. Recidivism. Right. It's a bonehead word.

Yes, you're right. I know. The war on drugs impacts everyone, whether or not you take drugs. America's public enemy number one is drug abuse. This podcast is going to show you the truth behind the war on drugs. They told me that I would be charged for conspiracy to distribute 2200 pounds of marijuana. Yeah, and they can do that without any drugs on the table. Without any drugs, of course, yes, they can do that. And I'm the prime example of that. The war on drugs is the excuse our government uses to get away with absolutely insane stuff. Stuff that'll piss you off. The property is guilty. Exactly. And it starts as guilty. It starts as guilty. The cops, are they just like looting? Are they just like pillaging? They just have way better names for what they call

like what we would call a jack move or being robbed. They call civil acid. Be sure to listen to the war on drugs on the iHeart radio app, Apple podcast or wherever you get your podcast. Hey, y'all. This is Dr. Joy Horton Bradford, host of the award-winning weekly podcast therapy for black girls. Our incredible community of sisters has been building the therapy for black girls podcast for five years running. And over that time, we've published over 250 episodes and gained over 18 million podcast downloads. During this time, we've tackled the stigma surrounding mental health and shared conversations to help us all understand ourselves and others a little better. Hundreds of incredible licensed mental health care professionals and other experts have joined us

to share tips on taking better care of ourselves. We flipped through the pages of your favorite romance novels with author Tia Williams, checked in with Grammy award-winning artist Michelle Williams and discussed the hurdles of balancing competitive sports, motherhood and mental health with Olympic athlete Natasha Hastings. Five years down and many more years of work to be done. Join us now by checking out the therapy for black girls podcast on the iHeart radio app, Apple podcast or wherever you get your podcast. Oh, was that the end? Yeah. Well, and to that tune, Josh, they've now got these awesome situations called drug courts where they pass out drugs for you to take before your sentence. Drug courts actually are when it's set up specifically for drug cases

and instead of putting you in jail, they send it to you to treatment programs. Right. And out of the 100% of people in treatment programs in the United States, 36% were referred there by the courts. Right. In 2004. Yeah, that's a lot. Yeah. Let's talk, let's talk some stats, buddy. In 2008, so I wrote this and I think 2007 maybe. 2007. Yeah. And I think the most recent statistics I could get were about 2005. Yeah. So it was about 3.9 million people in 2005 that went in for treatment. In 2008, it was pretty much the same 4 million people in the US age 12 or older. Yeah. Went for treatment for drugs or alcohol. Right. Or possibly both. Right.

Of that 4 million people, that was a fifth of the estimated people who were current illicit drug users in the US in that same year. So not very many people are going to rehab? No, but I also wonder what percentage of that 20 million illicit current drug users, which are people who have used a drug within the past month. Right. Age 12 or older admitted to using POT and just POT. Right. Sure. Let's go. I don't think they take you at rehab for POT. No, they do. Do they really? Oh yeah. There's POT. There's POT marijuana specific rehabilitation groups. I don't know about clinics where you actually stay, but I know there's marijuana addiction

groups for sure. I did not know that. Yeah. 17 million though. Hold on. This is a much better set. 17 million heavy drinkers in the US age 12 or older. I wonder how many of the 20 million and the 17 million overlap. Right. Well, you mentioned 4 million and you said some were in there for both. You actually had the stat. 1.3 million out of the 4 million were in there for both drugs and alcohol. Got you. 0.8 million for just drugs and 1.6 million for just alcohol. So what does that say about what's the real gateway drug? I don't know because we talked about that. Remember during the prohibition podcast, even I predicted that if I think I predicted you, you didn't necessarily agree that prohibition has taught us that if you

legalize something or if you prohibit something, it makes it more forbidden. But apparently, it's not the case. No, I agree with it. Well, these numbers show different. I mean, alcohol, you can get everywhere. So yeah, it's clearly a big problem. Yeah, it's true. Maybe we're both wrong. Maybe. Let's talk about money because these things ain't cheap necessarily. No. When you look at the grand total. And especially if you want to meet Eric Clapton, it's not cheap. In 2002, Josh, the average cost of a program was about 1,400 bucks residential at 3,800 and outpatient methadone treatment for $7,400 for the average cost of a full treatment program. Right. And that's the average cost. They go up considerably if you're interested in the luxury tour. Right. I had down

that promises or not promises, Crossroads, which was founded by Eric Clapton in the West Indies in Antigua. It was 15 grand per month. Apparently, it's gone up since 2007. It's now 19.5 a month. Right. Yeah, it's a lot of money. That is a tremendous amount of money, but it is far and away not as expensive as the most expensive one that I found that you found, I should say, is the sanctuary in Byron Bay, Australia. Holy cow. I didn't see that. $18,500 per week. Per week. A week. So Clapton's is $19,500 for a month. That's a bargain. It is. Passages in Malibu is 40 to 50 grand a month. Promises, which you've all heard of because Ben Affleck and Robert Downey Jr. had a lovely stay there, among others, 33,000 per month. And they've, you know, they've all

had their roster of celebrities, depending on where you live. Yeah. And isn't that just, isn't that kind of odd if you step back and look at it like, like celebrity and rehab is just their hand in hand. Our fascination with both are equal. Well, and interrelated. Your career publicity wise. So. Sure can, which is weird. It is weird. It's also weird when you look at the fact that it says, it's, there's like a one to one correlation of how luxurious the rehab is and what list, a list or B list you're on a connector because promises, like I said, Charlie Sheen, Ben Affleck, Robert Downey, and then you work your way down to Cottonwood in Tucson at a mere

thousand dollars per day has had the likes of Rowan Atkinson and Spice Girl, Jerry Hallowell. A thousand dollars per day is still. That ain't cheap. No, no, per day. Yeah. Okay. I take that back then. Rowan Atkinson's making some cheese apparently. I didn't know that Mr. Bean went to a rehab. I didn't either. And we shouldn't make fun of Jerry Hallowell because the Spice Girls are the best selling female band of all time. Is that right? That was one of our trivia questions. So it took people are kind of like, yes, yes, celebrities can afford this. Yes. What if I'm an average Joe who's trying to kick the dope? Well, insurance can cover a lot of it. It used to cover even more. It used to be about 30% was paid by insurance, right? And then by 2003,

the burden of cost had shifted away from not just the insurers, which were paying about 8% and not even the patients who were paying just 10% but to the state, generally society. Right. Right. Taxpayers. Medicaid started picking up a lot of the tab up to 60% of the tab. And so let's say 78% between the insurance company, Medicaid, and the patient. And then the rest was being picked up by other state agencies. Yeah. And so, yeah, the burden of cost shifted to the society, which made a lot of people start to wonder, wait a minute, wait a minute, what are we doing here? Right. And so the cost benefit analysis was born as far as rehab goes. Right. So there's something to that though. When you look at the fact that in 2003, $20 billion in change was spent

in all overall, Medicaid picked up 60% of that. So about 12 or so. And you think that's a lot of money, $12 billion. But they did a study that they looked at the cost of alcohol and illicit drug use. Including tobacco. Including tobacco. And that includes healthcare, crime, property theft, stuff like that. Prison. Prison. $500 billion in 2002 alone. Wow. That's so okay. So $12 billion paid by the state to offset $500 billion in cost to society. It's a pretty good deal. Well, that's what I think. You get some of these people healthy. They might not be robbing you. They might not be crashing their car into your loved ones. They might not be stealing things and going to prison. And you're putting the bill for all that. There was a study

by the National Institute of Alcohol Abuse and Alcoholics that also found that for every dollar spent on rehab, $3 were saved in larger cost to society. Which is not bad. It's a pretty good return on investments. What they call that. Well, yeah. And you know, when you break down, those numbers sound expensive. And obviously the luxury places are expensive no matter who you are. But I think they also skew the average quite a bit as well. Oh yeah. But if you look at a per visit treatment average cost, it's really not that bad. Outpatient non-methodome treatments are about 26 bucks per visit. That's the one where you go to work and then go to rehab after work. Right. Non-hospital residential treatments. It's like promises in crossroads. $76 per day.

On average. That's including every place. That's including like the place in the back of Joe's Crab Jack where they lock you up for 28 days to, you know, the place in Byron Bay, Australia. But when you break it down like that, it's not that much money. No. And even more so, methadone, which you'll remember, the average is about 7,400 bucks in 2002. Yeah. It's also the longest overall. The longest treatment overall. And that broke down to $17.78 per visit to get somebody off of the dope, which is pretty, I think that's worth investing in. And that includes the methadone too, right? The actual. Yeah. That's the whole shebang. Yeah. And then Chuck, there's also the human expense that you're saving that cost when you invest in

treating addicts, right? There was a study by Bioti, I think that said that there are 12 million alcoholics in the United States, roughly, right? And if you consider that each alcoholic has a spouse, possibly children and family in some way, say five people that are in that alcoholic's life, that means that 60 million Americans are affected by alcoholism and affected not in good ways. Well, I'm possibly creating new alcoholics for future generations to pay for too. Yeah. You got to think about that. So Chuck, I would say that that is the end of the addiction rehabilitation trifecta. Actually, you know what we should mention though? Did you read a million little pieces? The book by James Fry? No. That was the. I was specifically told by Oprah not to

Well, that's the deal is that was the infamous bestseller about a memoir quote unquote memoir about one young man's stay in rehab. And it is awesome. It was found out afterward famously to not be 100% true. After Oprah had said it was the best memoir she'd ever read. And so he took a lot of heat over that. I read the book and it's amazing. And you should read it. I wrote the guy letter saying, dude, I don't care whether it's true or not. Just call it a novel and call it great. Yeah. And he was like, thanks, man. I really appreciate that. He wrote you back. Yeah. A letter? Well, an email. So I recommend people read it. Just don't get all mad and say this isn't true. Just consider it a novel and a very good novel at that. That's what I say. Okay. It's really,

really good. And for every dollar spent on James Fry's book, a million little pieces, chuck it 50 cents a day. I wish. So if you want to learn more about addiction, rehab, prohibition, anything like that, type those words into the search bar at howstuffworks.com and it'll bring up some delightful articles. And it's time now, at long last, Listener Mail. Josh, I'm going to call this email from a new 12 year old fan. I saw this one. It's from Emma. Or maybe that was Emma's mother's email address. I'm not sure. Yeah. But it said Emma. No kids these days, they have their own email. Today. Hi, Josh and Chuckers and Jerry. I don't know when I can do this, but I'm going to donate to Kiva. I'm 12 years old and I'm going to get a job, walking

dogs and babysitting, et cetera. As soon as I do get $25, I will donate it. But to get the job, I have to print flyers to pass out, print flyers. We need to buy ink to buy ink. We need extra money that isn't going to stuff we need right now. No, but you do have to break a few eggs to make an omelet, Emma. That's right. And if you want to work at the omelet station, especially. If you want to be the squire of the omelet, that's right. Gotta break a few eggs. But please read this part of the podcast, guys. Whenever it happens, I am going to save up the money because I'm getting this babysitting job, babysitting snotty nose kids so I can give this money to Kiva and tell everyone they have no excuse if you have a real job. That was from Emma.

And thank you very much, Emma. I think my hat is off to you. If Chuck were wearing a cap, he would tip it. If you're one of Emma's neighbors, please forgive her for her description of your kids and hire her anyway because it's going to go toward a good cause. That's right, right? And if Emma can do this, you can do this too. If you want to donate to the, donate heck, lend. You get the money back. If you want, yeah. In $25 increments, you can go on to www.kiva.org slash team slash stuff you should know. Join our team. Leave some messages on the message board. Make some donations. Have a good time, right? Agreed. And if you want to email us to let us know what you're doing to save the world, whether it be dog walking or babysitting snot nose kids or what have you,

we want to hear about it in an email. Send it to stuff podcast at howstuffworks.com. For more on this and thousands of other topics, visit howstuffworks.com. The howstuffworks.com iPhone app is coming soon. Get access to our content in a new way, articles, videos and more all on the go. Check out the latest podcasts and blog posts and see what we're saying on Facebook and Twitter. Coming soon to iTunes. They call civil answer. Be sure to listen to the war on drugs on the I heart radio app, Apple podcast or wherever you get your podcasts. I'm Langston Kermit. Sometimes I'm on TV. I'm David boring. I'm probably on TV right now.

David and I are going to take a deep dive every week into the most exciting groundbreaking and sometimes problematic black conspiracy theories. We've had amazing past notable guests like Brandon Kyle Goodman, Sam J. Quinta Brunson and so many more new episodes around every Tuesday, many episodes out on Thursdays where we answer you, the listeners conspiracy theories. Listen to my mama told me on the heart radio app, Apple podcast or wherever you get your podcast.