Shia Laboef – One Size of Addiction Treatment Does Not Fit All…

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images-2After his most recent public calamity, the young actor is “seeking treatment for alcohol problems” confirms one of his handlers. What is unique about the rote Hollywood tale is that he is doing it without checking in to a tony Malibu rehab with an ocean view. There seems to be an air of skepticism about how effective this type of rehab can be, mainly because outcome studies are scant, if the exist at all. The “traditional” 28 day acute care modality of alcoholism treatment is statistically very ineffective. In fact, the idea that 28 days is what is required to treat addiction is purely a financial insurance play, and has absolutely nothing to do with evidence based medicine. While “success” is an individual’s definition which may not align with what the people around them want, it can never be a theoretical process. That is, it is one thing to feel better, dry out and learn skills while living in a plush environment thousands of miles from home, but the rubber hits the road once a person returns home and has to face all of the stressors that contributed to problems in the first place. There is no doubt that change is needed, but creating change is one thing, maintaining change is quite another.

Based on the public information, we don’t know much about the treatment Laboef is experiencing. It could be effective, managed by a physician that specializes in addiction medicine who is looking to medications that can help. Perhaps he has a sober companion or is attending daily group process. Clearly the treatment options available to a young movies star are plentiful and varied and not so for most people. What is interesting about this is the eyebrow raised naysayers who think he needs to be “in rehab”. Maybe he does but what happens when he is out of rehab?

At Rebound Brooklyn we offer three tiers of care, residential, partial, and an even more autonomous level of residential care. Some of our patients seek to address their problem without the residential aspect, some find great success, some don’t. We specialize in helping people evaluate and treat their addictive problems here in New York City where they need the help. We do not have a crystal ball, and we have to be honest about all treatment options. Addiction treatment cannot be a “cookie cutter” process. We can speculate and be informed by experience and the literature but we also have to address each client’s individual needs. Laboef could be successful with this level of care, if not, we hope his providers level with him and try another road.

Joe Schrank

Scott Bienenfeld, M.D.

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