IN the weeks before Tara Conner handed over her crown as Miss USA, she talked to television reporters about her stay at a treatment center for drug addiction and alcoholism. At the insistence of Donald Trump, an owner of the beauty competition, Ms. Conner had sought treatment at the Caron center in Wernersville, Pa., a former resort hotel set on a pastoral 110 acres.
She emerged earlier this month the picture of vibrant health and cheer, describing the experience as “amazing, absolutely amazing, a lot of fun.”
Taking in her ebullience, and her glossy good looks, a viewer might have been forgiven for craving a bit of whatever it was that Ms. Conner was having. She is, after all, but one in a coterie of high-profile personalities to have recently undergone well-publicized stays in substance abuse programs that have, to all appearances, less in common with traditional bare-bones detox centers than they do with a luxury spa or resort.
She is also among the latest to have apparently shed a debilitating addiction as lightly as she might have a few unwanted pounds.
Less than a decade ago, a stint in rehab was assumed to be a body- and soul-wrenching experience. A trip to even an elite facility like the Betty Ford Center in Rancho Mirage, Calif., was sufficiently shaming to keep under wraps — the psychic equivalent of a week in the stocks. Today a sojourn at a boutique establishment like Promises in Malibu, Calif., where until last week Britney Spears was tucked away, is openly discussed and in some quarters glamorized as a hip, if costly, refuge for the gilded set.
That idea is perpetuated — indeed aggressively promoted — by the marketers of a handful of high-end facilities, some of which advertise amenities on their Web sites like private rooms with 600-thread-count bedsheets, high-tech gyms, spa cuisine and ocean views. “There used to be a stigma to coming to a place like this,” said Chris Prentiss, the director of Passages, another exclusive treatment center in Malibu. “Now it’s like wearing a Ralph Lauren shirt.”
Richard DeGrandpre, the author of “The Cult of Pharmacology” (Duke University Press, 2006), an exploration of America’s ever-changing relationship with drugs, ascribes the latest cachet of rehab to a prurient, even envious fascination with celebrity culture, one, he said, in which “rehab has become fashionable, almost to the point, ironically, of giving a person status.”
No one seriously disputes that drug addiction and alcoholism are grave and potentially life-threatening. But among devotees of networks like E! Entertainment or the readers of People, which report obsessively on rehab, there is no escaping the conclusion that rehabilitation programs have become a pampering hostelry for the privileged classes, some of whose members bounce in and out like tennis balls.
There are 8,000 programs claiming to treat substance abuse in the United States, according to the Center on Addiction and Substance Abuse at Columbia University. Only a fraction are short-term residential programs, which can cost $25,000 to $80,000 for a recommended one-month stay. That price, their directors say, covers intensive treatment, with some establishments having as many as 10 counselors and therapists per patient. As health insurance coverage of residential treatment has declined, the programs have courted an affluent, lustrous clientele, in large part by touting lavish appointments. Some seem to be promote recovery as a luxury holiday.
Members of glamour industries like fashion, film and publishing have been quick to pick up, and propagate, the message. Earlier this month Us Weekly published a feature laid out like a glossy travel brochure, portraying treatment as something akin to a visit to a five-star hotel.
“After Britney and Lindsay, so many of our staffers were saying, ‘God, what’s it going to take for me to go to rehab?’ ” recalled Janice Min, the editor. “Not to diminish what it takes to get clean, but to some of them, rehab sounded like a great escape from everyday life.”
At the Valentino show in Paris last month, “Rehab,” a popular ditty by Amy Winehouse, pulsed on the runway. Carlos Souza, a public relations executive for the fashion house, crooned some of the lyrics: “They tried to make me go; I said no, no, no.” The song is “great, catchy and of the moment,” he said. “I wouldn’t say rehab is chic, but in the crazy society we live in, it is the new ashram weekend.”
To those in the serious business of recovery, such a position is willfully naïve, at best a double-edged sword. The fanfare surrounding celebrities helps take the disgrace out of treatment, Doug Tieman, the director of the Caron center, acknowledged. But it also fosters the impression that “a daily massage or riding a horse is necessary to recovery.” Caron offers both.
William Cope Moyers, the vice president for external affairs at Hazelden in Center City, Minn., and the author of “Broken” (Viking, 2006), an addiction memoir, said the tendency of equating recovery with rest and relaxation trivializes a serious illness.
Treatment “requires hard work and a willingness to confront your demons,” Mr. Moyers said. “People who seek treatment as 30 days of R & R are only doing themselves and their families a great disservice.”
Addiction, he added, does not discriminate. “It is a disease that doesn’t care whether you are glamorous or gory.” Yet even low-frills residential clinics, which emphasize detoxification and therapy over nutrition and skin care, are inaccessible to the average American.
Hazelden spends about $3 million a year in patient aid, Mr. Moyers said, offering it primarily to employed middle-class patients with private health insurance. They are patients who have nothing in fame or riches compared with those depicted on television shows like “Dirt,” in which a Lohan-like pivotal character enters a boutique center hidden away in the Hollywood Hills; or the series “24,” which shows a fictionalized former first lady being treated in a well-cushioned, pastel-tinted bungalow.
But the Hard Rock resort in Las Vegas, which offers a series of “rehab nights” of poolside drinking and carousing, is among a number of businesses promoting the concept of rehab as an alternately laid back and stimulating retreat for the middle class.
In the popular culture, “rehab isn’t just mainstream, it is seen as inevitable,” said Martin Kaplan, the associate dean of the Annenberg School for Communication at the University of Southern California. Dr. Kaplan, a professor of popular culture, went on to observe that the current idealization of recovery is embedded in the popular psyche. It is an alluring new spin, he said, on the classic American narrative of transgression and redemption, by which “we tell ourselves that life is full of all kinds of twists, falls and dark moments, and that we occasionally need help beyond what we ourselves can provide.”
For some that narrative has acquired an enviable gloss. Those suffering from addictions can comfort themselves that they share the same problems as Ms. Lohan or the designer Marc Jacobs, whose business partner announced this month that Mr. Jacobs was entering rehab. And outsiders can press their noses to the glass.
“I’m starting to feel a tad excluded — resentful even,” Simon Doonan wrote caustically in a recent column in The New York Observer. “I want to eat spa cuisines with Britney and Mel and then do group therapy with Keith Urban.”
In an interview, Mr. Doonan, the creative director of Barneys New York, elaborated: “It’s almost to the point where you suspect that if you’re not going into rehab, maybe you’re not such an interesting person.”
Referring to Isaiah Washington, a television actor who recently entered treatment in part as a public apology for uttering a gay slur, Mr. Doonan argued: “Rehab adds another dimension. It’s a great profile-raiser.”
And a classy comfort station. Facilities like Promises in Malibu, a home away from home to Matthew Perry and Charlie Sheen, compete on the Internet to court the cream. On its Web site, the Wonderland Center, on Mulholland Drive in Los Angeles, with clients like Ms. Lohan and Mike Tyson, offers detox, psychotherapy and spiritual counseling supplemented by peaceful walks in nearby Runyan Canyon and “access to the same trainers and beauty consultants used by Hollywood celebrities.”
Few programs advertise their cure rates. One study, in the journal Psychology of Addictive Behaviors in 1997, found that clients in short residential programs had a 69 percent decline in weekly cocaine use and a 58 percent reduction in heavy drinking in the year following treatment.
Such results can be misleading, said Joseph T. Califano, who heads the Center on Addiction at Columbia, since the figures tend to be based on the number of people completing the program. Many therapeutic communities have a dropout rate as high as 80 percent, he said.
At Passages, a $22 million Malibu estate on a bluff overlooking the Pacific, treatment means four to five hours a day of individual therapy, and perks include tennis lessons taught by a pro and meals prepared by a former head chef at Spago.
Mr. Prentiss, the director and a self-described metaphysician who favors sherbet-colored suits and likens the healing powers of Malibu itself to Lourdes, offers no excuses: “When you are charging close to $60,000 for a monthlong stay, you’ve got to have a facility that goes along with it.
“After all,” he added dryly, “Britney Spears isn’t going to stay in a shack.”