Rehabilitation centres offer a holistic approach to treatment in comfortable and conducive surroundings, writes Nadia Badarudin
ON the banks of the serene Ping River outside the city of Chiang Mai in Thailand, sits The Cabin Chiang Mai, a luxurious resort that boasts fine wooden architecture amidst well-manicured tropical gardens.
Stepping into the premises, one may mistake it for a posh retreat for the rich and famous. But people check in here for a different reason — to get treatment for various addictions, especially drugs and alcohol.
These are not the typical homeless addict. They are more likely to be executives, high-ranking officials, lawyers, models, celebrities or key decision makers.
IN-PATIENT TREATMENT CENTRE
The Cabin is an exclusive Western-style inpatient treatment centre for chemical (drugs and alcohol) and process addictions (such as sex, gambling, impulse spending and overeating).
Since its establishment in 2009, the centre has treated over 1,000 from around the globe, mainly from Australia, the United Kingdom and the expatriate community in Asia, with a programme completion rate of 96 per cent.
From 2010 to the third quarter of 2014, 18 per cent are Malaysians aged between 27 and 37.
The top three addictions for men are alcohol, meth and ketamine, while women’s addictions are related to alcohol, prescription drugs and ketamine.
As with the rest, the Malaysian clientele comprises mainly business owners, executives and medical professionals.
HOLISTIC TREATMENT
With its team of psychiatrists, psychologists and counsellors, The Cabin provides a holistic treatment programme that includes relapse prevention therapy and aftercare, says Alastair Mordey, its co-founder and programme director.
He says The Cabin pioneers the implementation of the 3 Circles Recovery framework to treat chemical and process addictions.
“Clients usually come with not only one addiction. It is common for an alcoholic to have issues with drugs, gambling and sex,” he says.
“We provide a programme to treat both chemical and process addictions. We combine Cognitive Behavioural Therapy (CBT) which is tailored to the individual’s specific needs, with the 12-Step Method which has been modified to be culturally-friendly and better suited to modern addiction treatment (the 12-Step Method was originally proposed by Alcoholic Anonymous as a set of guiding principles to recover from alcoholism).
“The model is then applied in the 3 Circles framework, which is particularly effective with process addictions where abstinence cannot be practiced.”
Mordey, also a certified addiction counsellor, says the programme is augmented by mindfulness therapy (therapeutic meditation technique) and tailored exercise therapy. Besides being a primary care facility, the centre has a sober house and an online video aftercare set-up.
EX-ADDICTS
The Cabin shares some similarity with Pengasih Malaysia (a non-governmental organisation that provides rehab and treatment programmes for recovering addicts) in a sense that both have ex-addicts to help addicts in their recovery process.
“You got to have ex-addicts to help the addicts because they will have a better understanding of the situation,” says Mordey.
“There isn’t a good or a bad addict. The addict behaves in such a way because of the addiction, which is an illness. Addiction is often characterised by hiding, lying or manipulation, which can only be understood by another addict or an ex-addict.
“Ex-addicts will know all the excuses and tricks. They will also be stricter in helping addicts to overcome their illness,” he adds.
CLOSER TO HOME
At Pengasih Malaysia headquarters in Bukit Tunku, Kuala Lumpur, the rehabilitation programme involves therapeutic, psycho social, behavioural and spiritual approaches.
“When it comes to religious practices, we segregate them according to their religion,” says co-founder Datuk Yunus Pathi.
Primary treatment at Pengasih lasts at least six months and costs RM700 per month.
“Our strength,” Yunus says, “is the involvement of family members in the rehabilitation process.”
“We do this because families need to break their denial and accept a member’s condition so this involvement helps them understand addiction better.
“This also helps families understand that an addict needs time and effort to re-assimilate into society.
“Our main objective is to rekindle family ties. It has a stabilising effect on clients’ emotional state,” he says.
Following that, Pengasih offers after care clinics and helps them start a small business for example, in a night market, cash crop farming or as a mobile food vendor.
Pengasih has rehabilitation centres in other states like Selangor, Malacca, Johor, Kelantan and Perak.
NEW GEN CENTRE
At US$12,900 (RM45,202) a month, a client has the luxury of having good facilities and medical care.
With such comfort and indulgence, aren’t the addicts actually spoilt?
Mordey says about 10 years ago the rehab field saw the emergence of a new generation rehab centre where rules can be strict but implemented in a comfortable setting.
“These centres, like ours, cater to wealthy addicts who are unlikely to get clean and sober in a place where they have to share a room, or one that offers only the basics.
“This place might look plush but there are rules that clients have to follow strictly. The daily regime is tough,” he says.
Each client has a busy schedule every day, where he has to go through meditations, group and individual counselling sessions and extraneous physical training.
“Counselling can be gruelling as it is not easy for an addict to be honest, open up and admit to having a problem,” says Mordey.
He says that since the clients are professionals or high-functioning addicts, they are mostly allowed to use the Internet at night or early in the morning to take care of their business. However, Internet use is restricted for sex and gambling addicts.
FAR-REACHING IMPACT
Addiction is a family illness as it affects the whole family, emotionally, financially and physically.
It particularly has a far-reaching impact on an organisation or the society if it involves a high-functioning addict.
“That explains why we focus on helping those who are influential, or high-functioning addicts,” says Mordey.
“I believe that with their influence, they will do a lot of good when they recover, not only for the family, but also other addicts and the society,” he adds.
For Yunus, his family also plays a role in keeping an addict sober.
“Besides other trigger factors, family’s high expectations during recovery might also be a reason why an addict relapses.”
Pengasih’s family support group and monthly family education programme help inculcate better understanding on the condition among family members.
“Family shouldn’t expect miracles or have unrealistic expectations,” Yunus says.
“The most important thing is to not be in denial. Find a way to get professional help. Understand that addiction is a disease that may not be curable but is definitely treatable.”
New life
TEE (not his real name), 33, is a Malaysian seeking treatment at The Cabin for drug addiction.
He comes from a wealthy background and used to run his family business before he became hooked on alcohol and ketamine, no thanks to peer influence.
“I checked into several rehabs including one in our country, but nothing worked. I got divorced, and my relationship with family and God was strained due to addiction,” says Tee.
He says the treatment at The Cabin has helped him get back on track. He has been clean for seven months now.
“It was a difficult journey for me, and I relapsed several times during my treatment. However, after a while, I was back on my feet. I’ve obtained joint custody of my daughter, and I’m taking things easy now — doing one thing at a time,” he says.
What is addiction?
ADDICTION is generally caused by a state of low dopamine in the midbrain whereby positive feelings of reward for undertaking rewarding activities are not felt as strongly as in a person with normal dopamine levels.
As a result, addicts “self-medicate” with drugs, alcohol and certain behaviours which provide a huge hit of dopamine and pleasurable feelings.
In other words, an addict’s automatic response is to compensate for low dopamine levels by abusing substances or engaging in harmful behaviours.
The goal of rehab is to teach the techniques of recovery so that necessary changes in behaviour are adopted instinctively and easily.
Effective treatment means a change in behaviour that becomes second nature and enables them to maintain an ongoing life of recovery.
Downside to the achiever
A high-functioning addict can be a doctor, chief executive officer, pilot, homemaker or any achiever who is driven by the need to excel, who works long hours balancing multiple responsibilities and faces pressure at work or home on a daily basis.
High-functioning addicts:
• Consider their substance abuse a reward
• Use substances as a coping tool
• Are obsessed about their next drink or high
• Hide or sneak alcohol or drugs
• Lead a compartmentalised life (begin to hang out with other heavy users but keep up appearance of professional family man/woman)
• Are unable to control the amount of alcohol and drugs consumed
• Deny the consequences of their substance abuse