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Sunday, November 3, 2013

Welcome to Malibu, rehab city

There's one place the rich and famous head to sober up – Malibu. So why is the town turning against its biggest business? Ann Friedman visits the rehab riviera where they will clean you up – and clean you out

On the drive up to Cliffside Malibu in early September, a breeze is swaying the palm trees that frame a view of the crystalline-blue Pacific. It smells of saltwater and dusty sage. The pristine white clapboard house, situated near the top of the hill on a secluded cul-de-sac, has raffia wallpaper and overstuffed leather couches. Small bundles of fresh rosemary and lavender rest on top of each of the beds, which are fitted with 1,000-thread-count sheets. It's lunchtime, and the meals here, many of which are made using produce from the organic orchard on the premises, rival those on the menu at five-star restaurants. (Today it's seaweed soup, Korean-inspired beef sushi, sesame cucumber salad, Perrier.)

The guests, who are some of the wealthiest people from around the world, have access to yoga, massage, acupuncture and horses. Outside on the deck, a row of chaise longues are arranged perfectly perpendicular to the ocean-parallel pool. The staff, several of whom greet me at the door, are accommodating and cheerful. All I can think is how relieved I am that I parked my dented 1999 Honda Accord around the corner. Most people, it's clear, arrive here in luxury SUVs – some of them evading the paparazzi.

Despite its air of celebrity and enthusiastic embrace of luxury, Cliffside isn't a high-end resort. This is the new rehab. "It's sweet, right?" founder and CEO Richard Taite asks me again and again as he walks me through his drug and alcohol addiction treatment centre, which has catered to "high-wealth individuals" since 2011. Taite has close-cropped grey hair, a goatee and a pair of black-rimmed glasses that automatically tint when he walks out into the southern California sunshine.

Cliffside represents a new trend in treatment that some have dubbed the "Malibu model". It's a shift since the late 1970s, when the Betty Ford Center – located a few hours' drive inland, near Palm Springs – pioneered the idea that the super-wealthy need nearly prison-like conditions to overcome addiction. These days, tough love is out. Opulence is in. And Malibu is the capital.

In the past, says Dr David Sack, CEO of Elements Behavioral Health, "there was an informal view that you don't want to give addicts too much comfort or they won't take their treatment seriously. Hard beds, bad food. Addicts should pay for the discomfort they caused their society and family." Elements Behavioral Health now owns Promises, the original Malibu treatment centre, and several other centres around the country. "That prejudice resulted in there being very few treatment programmes that aspired to the AA philosophy – that people get better because they see it as a better way to live. Yet the programmes themselves were very uninviting."

Today, Malibu-model programmes are nothing if not inviting. Even the centres' websites read like travel brochures. The "amount of fun" that can be had at Milestones Ranch, where they keep goats named Stevie Nicks and Stealy Dan (sic) on the premises, is "limitless". "If you like to sing and dance, we have a vocal coach, dance instructors, music therapy," the website gushes. "And if we don't have it… we will get it." Summit Malibu offers a "world-class chef" and "luxurious living quarters". In its promotional video, Passages Malibu calls itself "palatial" and showcases an entryway framed by classic Greek columns and a pair of stone lions. Hydrangeas and white candles appear everywhere, as do reassuring white men with longish grey hair and white linen shirts unbuttoned to the solar plexus.

"I just think that this is a really comfortable place to do some uncomfortable work," Taite says, back at Cliffside. "When you come here and you have this vibe, are you pissed off even a little? Look at this. I mean, look at this view." Indeed, outside the window is an expansive stretch of ocean, with visibility all the way to Catalina Island, 35km from the coast.

A so-called "Rehab Riviera" has blossomed here in the past decade. This small town in southern California now hosts 34 facilities – one for every 350 residents. "It's an over $100m- a-year business," says Malibu mayor Joan House. Promises charges between $55,000 and $85,000 for 31 days of treatment. A bed at Cliffside costs between $53,000 and $68,000 a month, with a 10% discount for each additional month a client stays. Both facilities are booked out at least six months in advance and other high-end centres are in equal demand. The local residents aren't happy: "All of us would like to see people with addictions and problems well taken care of," House says. But it's hard to work out whether it's proper care or profit margins that comes first: "They're just lining their own wallets as far as I'm concerned."

With the perfect combination of proximity to Hollywood and coastal seclusion, Malibu is the go-to destination for celebrity rehab. Britney Spears and Ben Affleck tried Promises. Mel Gibson and Natasha Lyonne checked into Passages. Lindsay Lohan's father told the tabloids that his daughter tried the Betty Ford Center's disciplinarian model but found Cliffside much more to her liking. "She has more freedom, it's more personalised, and the treatment is better for her," he said. Shortly after, Lohan was photographed there, on her balcony, having a cigarette.

"I've had very influential people here," Taite says. "Not just celebrities – that's the least of it. I'm talking about some of the wealthiest human beings on the face of the earth." There are CEOs, sheikhs, heirs to family fortunes. "These people are used to getting their ass kissed, just like beautiful women are used to being told they're beautiful. They need to learn a new way to live, and they're so successful in other areas of their life that they walk in and almost demean you."

The children of the super-rich are rehab regulars. Some centres even cater to them explicitly. "Many of the clients who come to Passages are intimidated by the success of their parents," says a Passages promotional video. Promises sees many clients who have spent their teens and 20s partying and spending family money, only to hit their 30s and 40s and feel depressed and empty.

Before joining Elements in 2011, Robert Weiss, senior vice president of clinical development, was sceptical. "Betty Ford famously once said, that one of the best things she learned in treatment was how to make her own bed. I was totally on board with that whole way of thinking. Like really, can't you make your own bed? Do you really need a chef? And then I got it. There are some people who won't stay at a Holiday Inn. They're only going to stay at the Ritz-Carlton. They may have a lot of entitlement or narcissism, but does that mean they don't get to recover?" These are people who will use any excuse – be it a lack of macrobiotic cuisine or the absence of their favourite pilates instructor – to quit rehab.

And so, the theory goes, to keep them around and get them sober, you need to offer the sort of creature comforts to which they've grown accustomed, down to the last detail. When Taite goes to a new restaurant, he orders everything on the starter menu to see if there's anything he'd like his chef to recreate at Cliffside. He lists a number of five-star restaurants in LA, asking if I've been to each one. Each time, I shake my head. I explain that most journalists aren't exactly high-wealth individuals. "You're cute," he replies. "Somebody should be taking you out."

I awkwardly change the subject back to luxury amenities; the centres offering everything from hyperbaric chambers and neurofeedback technology to wolf therapy (yes wolf therapy, in which patients commune with domesticated pack animals). At one centre, kayaking is "adventure therapy". Does that mean curling up with a novel is literary therapy? Going for a jog cardio therapy? It's no wonder the centres charge five times the rate of standard-issue, insurance-subsidised, 30-day facilities. But it's expensive for Taite, too. "My overhead every month is above 700 grand," he says. "I don't make what people think I make."

There may be some truth to that: recently, when Amanda Bynes moved from treatment at a UCLA hospital to a Malibu centre, it was reported that the $60,000 Malibu programme was actually half the price of the hospital stay. Round-the-clock care is expensive wherever you get it.

Given the rate that many centres are expanding, it's clear that it's lucrative. But is it effective? Most centres won't promise to get every client clean. "What I consider success is one year clean and sober," Taite says. "My experience is once you get a year, you've got a real shot. I've got a guarantee. If you leave here when we tell you you're ready to leave, and you relapse at any time within one year, we bring you back free of charge." He says about 22% of his clients stay until he tells them they're ready to leave and, for those clients, the success rate is more than 95%. For everyone else, he says the sobriety rate is closer to 50%.

Other centres are more hesitant to talk about the numbers. "We don't have a guarantee, because we think many of them are disingenuous as they come with so many qualifiers," Sack says of the Elements-affiliated centres. Some argue that the Malibu model is actually antithetical to sobriety. Recently, Scott Alpert, a former treatment provider at a Malibu facility, penned a scathing disavowal: "At the Malibu treatment centre where I worked, the focus was on caring for the client's creature comforts instead of healing their core issues that contributed to their substance abuse, alcohol abuse, or other addictive behaviour. How could we? We didn't have a programme at all! Yes, we had group therapy – when the clients were there. Yes, there were individual sessions – when you can track a client down. But treatment wasn't the main focus – keeping the customer happy was."

Taite argues that just because it's luxurious doesn't mean clients always get their way. His patients often get fed up and call a cab to take them away. "I've sent away more cabs than you can shake a stick at," he says. "Get them past the moment. This guy may call up a friend and get picked up in three or four hours. But typically what's gonna happen is he's gonna go, "Fuck it!" and just go to bed, and wake up tomorrow in a new headspace."

There have been a few recent incidents in which fed up, not-quite-sober clients end up on the streets of Malibu. In a much-publicised incident this spring, a local resident found a man wandering around his block naked, having escaped from a rehab facility down the street. At One80, a centre now closed, two clients died of drug or alcohol overdoses in their rooms. Locals want the centres to be regulated more strictly. The town council wants to crack down on centres that violate occupancy codes in order to slow down their rate of expansion.

Then there's the issue of property values. Local law says only six people can occupy a single home, and so many centres have expanded to become complexes of five or more buildings. They've also been accused of tricky manoeuvres such as counting a pool house as a separate residence in order to house more clients there. "There are lots of neighbours that are complaining about the way they're doing business," says Matt Ogden, president of the Malibu Association of Realtors. "Of course buyers are very sensitive to the issue of whether a rehab facility is nearby." But he is reluctant to say whether it affected the value of the neighbours' homes.

Taite has already bought three of the five houses on his cul-de-sac and refurbished them to match his Cape Cod aesthetic. He's put a down payment on the fourth and he's sure the fifth will be his eventually, too. "Who's gonna buy a house right in between four treatment centres?"

The mayor is all too aware of this. "It's so green out there. By state law you're not supposed to have a concentration of these – it totally changes the neighbourhood. More noise, smoking, cars…" In August, a small group of city officials travelled to Sacramento to ask the state government to reconsider the rules governing treatment centres. The city council's Lou La Monte told the local Malibu Times – as well as the national tabloid Entertainment Tonight – that he wanted to enlist other California cities in his crusade against dense clusters of rehab facilities. But Ogden warns that anti-discrimination laws that protect disabled residents also extend to residents with addiction issues. In other cities, such as nearby Newport Beach, rehab centres have sued the local government after it passed laws limiting their expansion.

Ask the CEOs of these treatment centres and they'll tell you that they're here to stay because this slice of land between the ocean and the mountains is perfect. "Malibu is a kind of sanctuary," says Sack. "There's a great sense of space in Malibu. The houses tend to be on big lots. In between the canyons and the ocean there's a sense of sort of infinity – you look at the ocean and its vastness and it's easy to see that your problems are not so big."

Indeed, it's true: people are coming from around the world – 30% of Taite's clients are from outside the United States. Standing on his Cliffside veranda, I understand the draw. I'm happy just to have an excuse to be here, taking in this view and deep breaths of the orchard-sweet air. But I have to wonder if, in their rapid push to expand, the rehab centres are undermining the very selling points they use to draw high-wealth individuals to Malibu to work on their problems. As an outsider, to me there is a palpable sense that part of what's great about these "27 miles of scenic beauty," as the welcome signs say, is the fact that not everyone can afford to live – or get clean – here. Though most of the treatment centres tout their seclusion, as they buy up tightly clustered properties in residential areas and turn them into gated compounds, exclusion might be a more accurate description. And it's hard to maintain the air of exclusivity when you're in the most popular business in town.

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