John Oliver can be very funny. His show, “Last Week Tonight” cuts up everything from federal fundraising to the royal wedding to cryptocurrencies. I get it. I even like him. I previously applauded his 2016 segment on the behavioral health industry when he said we needed “more investment in treatment programs.”
While I know that comments on his show are made purely to engage television viewers—not to report any news with accuracy—there are many things in his riff this week on “rehabs” that deserve clarification.
1. Let’s start with a term “rehabs,” which he used intentionally.
Yes, John, there is no definition for “rehab,” and maybe that’s why there’s also no “set definition of what it should consist of.” The term “rehab” is a colloquialism referring to all manner of treatment for substance use disorders, such as residential treatment, detoxification, outpatient treatment and more.
The specific forms of treatment do indeed have extensive definitions and service expectations. Just check out the American Society of Addiction Medicine for the most often used criteria. These treatment programs—not “rehabs”—meet criteria from state and federal agencies, and the best are accredited by the Joint Commission, which is the gold standard in accreditation of all types of healthcare organizations.
2. It’s clear that the interviews shown in the segment are not done by John Oliver or his staff but are edited excerpts from other sources.
What is unclear to viewers is how he strings interviews together to present information in a misleading way. The one closest to my heart is a clip of Tom McLellan, PhD, the founder and chairman of the board at the Treatment Research Institute, in an interview where he is talking about his lack of knowledge of treatment programs back when he thought his teenage son had a drug problem. What is left out is the context indicating that the scenario happened more than two decades ago. That issue was the reason why McLellan, a true icon in our field, started the Treatment Research Institute to transform the research done in academic settings into information that could transfer how we deliver, evaluate and measure treatment in the real world.
Let’s not pretend that something that happened more than 20 years ago happened just this week.
3. Another example of poor representation is John Oliver’s clips of Richard Taite as the owner of Cliffside Malibu and several review websites.
Yes, the clips are not flattering for Taite, and I bet he wished he was more eloquent describing his programming and its benefits. However, Taite doesn’t even own Cliffside Malibu anymore. My point is that Oliver is picking and choosing outdated material to enhance the hyperbole of his comedy show.
4. Oliver takes issue with Marvin Ventrell, the executive director of the National Association of Addiction Treatment Providers (NAATP).
Oliver picks up a quote stating that the operation of addiction treatment “in some sectors, is out of control.” I actually applaud Ventrell’s honesty as well as NAATP’s focus on resolving industry issues. What Oliver fails to mention is that the vast majority of treatment centers are ethical, compliant healthcare operations, and NAATP and others are actively involved in educating consumers on what to look for.
The few bad operators do not represent the industry.
5. Oliver just further stigmatized addiction and recovery.
We all know is that this profoundly stigmatized field is full of thousands of good people dedicated to and passionate about helping those struggling with substance use disorders. We all know that the treatment programs of today grew out of a para-professional system of one person with this problem helping another, and that it’s only recently that substance use disorder treatment has had the benefit of numerous evidence-based practices. We now have the research showing that this is a disease that changes the way the brain works, and insurance coverage for this disease finally approximates the coverage for other medical disorders.
You can’t help but wonder how many people watching Oliver’s show decided to give up on seeking treatment. It’s a tragedy. The viewers who rely on his sarcastic satire weren’t given the opportunity to see the success stories of the many people who are living wonderful lives in recovery, thanks to the hard work and dedication of those of us who work in “rehabs.”
Deni Carise, PhD, is chief scientific officer, Recovery Centers of America and adjunct assistant clinical professor at the University of Pennsylvania. She will be speaking at the National Conference on Alcohol & Addiction Disorders, August 18-22 at Disneyland in California.