Bob Forrest Should Keep His Ignorance to Himself

[Jabberwocky]

Dr. Drew's Celebrity Rehab sidekick is a Greedy Bigoted Idiot

Bob Forrest Should Keep His Ignorance to Himself
Dr. Drew's Celebrity Rehab sidekick now has his own treatment program and blog, which he's using to dispense a dangerous brand of intolerance.

In a better world, there would be no conflict between abstinence-based treatment and harm reduction: As in other types of medicine, addiction care would occur on a continuum. Just as you don’t see cancer doctors blogging that radiation is a “con” and only chemo should be used in all cases, you wouldn’t see addiction counselors making a similar case that abstinence should always be used, never maintenance.

Unfortunately, thanks to the likes of Bob Forrest, that’s not the world we live in. Forrest, who identifies himself on his website as the “longtime partner of Dr. Drew,” now runs his own treatment program, Acadia Malibu. It’s hard to believe, but yes, a man who worked on Dr. Drew’s Celebrity Rehab actually advertises this fact to sell addiction services—despite the show having a mortality rate of nearly 13% among its “patients.”

Forrest opposes maintenance treatment—even though three of the five patients who died after their season on the show lost their lives to opioid overdose or its complications, which could have been prevented if they had been given support for maintenance, rather than told abstinence is the One True Way.

Nonetheless, here’s what Forrest—after noting, “I thought of calling this blog ‘The Open-Minded Report’”—writes about harm reduction:

“It’s a con in my opinion. I have seen the suffering and degradation it causes: the confusion it brings to the 12-step community about who is sober and who is not; the irrational fear of detox, where the list of medications designed to help you avoid actually experiencing any withdraw symptoms grows longer and longer every year; and just generally, the lies and danger and horror it is causing. The medical profession and pharmaceutical industries drive the use of Suboxone and Subutex. This is code for ‘profitable to doctors and drug companies.’”

Nearly everything about this paragraph is wrong. For one, if harm reduction—by which he means opioid maintenance here—is a “con,” why is it endorsed by every major public health organization that has investigated the issue, from the Centers for Disease Control and the National Institutes of Health in the US to the National Institute for Health and Care Excellence in the UK and the World Health Organization?

Why does the Cochrane Collaboration—an independent organization widely viewed as producing the highest-quality evidence on which to base medical decisions—say this about methadone: “It retains patients in treatment and decreases heroin use better than treatments that do not utilize opioid replacement therapy,” while concluding of 12-step programs that “no experimental studies unequivocally demonstrated the effectiveness of AA or [12-Step Facilitation] approaches for reducing alcohol dependence or problems”?

And why does research show that patients who leave methadone treatment double their risk of dying—and quintuple their risk of overdose death if they are injection drug users? Why do studies consistently find death rates among addicted people in methadone treatment to be about one-quarter or one-third the rate of those not on maintenance? Even if Forrest relies only on anecdote, not data, his own experience with Celebrity Rehab deaths clearly bears this out.

OK, so it’s clear that Forrest is on the fringes here, ignoring both an overwhelming international consensus on best practices and the evidence of his own eyes. Let’s move on.

Is there any truth to the idea that maintenance treatments are simply a profit center for doctors and drug companies? While some money is being made, a look at the actual history of maintenance makes evident that if this is a pharma conspiracy, it’s an extremely strange one, because the US government basically had to pay drug companies to participate in it.

Let’s start with methadone. It’s a generic drug, long off patent and therefore definitely not of current interest to Big Pharma. As an addiction treatment, methadone was developed by Vincent Dole and Marie Nyswander of Rockefeller University in the mid-1960s—starting with money scraped together mainly from the government of New York City, not drug companies.

At first, virtually all methadone treatment was funded by the federal government as an anti-crime measure—and while there certainly have been unscrupulous providers, that’s linked far more to the stigma of addiction, and the lack of oversight of the care addicted people actually get for the money spent on us, than to any drive for pharmaceutical profit related to selling methadone.

What about Suboxone? It, too, was first studied as an addiction treatment, by the government—in fact, there was so little commercial interest in it that the National Institute on Drug Abuse had to push the FDA to give it “orphan” status in order to get the company that now makes it to enter the market. As Nancy Campbell writes in Discovering Addiction: The Science and Politics of Substance Abuse Research, “Lack of coordination between public and private interests delayed development far longer than the notoriously slow FDA approval process. To bring ‘bupe’ to market, NIDA worked to stimulate private interest.”

In other words, we have Suboxone despite the disinterest of pharma in the addiction market—not because it saw dollar signs when it looked into our eyes. While Reckitt Benckiser did ultimately profit from the drug, this is not a scandal like the overselling of antipsychotic medications, for which every single manufacturer has paid at least multimillions, and sometimes billions, of dollars in fines for misleading marketing. Indeed, it’s an example of a drug that is doing precisely what a drug is supposed to do: restoring health more often than harming it.

Of course, it’s not completely wrong to say that there is an excess of shady doctors in the Suboxone business—but again, the reason for this is that addicted people are, to put it mildly, not popular with physicians. Those who have the choice not to work with us generally make that decision whenever they can—because of both the stigma and the legal scrutiny that maintenance treatment for addiction brings.

All of this is not to say that everyone who has ever had an opioid addiction should be on maintenance: I am personally an example of someone who is not. But good medical practice is about finding the right treatment for the right person—not prescribing the same therapy at the same dose for every patient with every variant of the disorder in which you supposedly specialize.

Finally, I have to add that it’s laughable that someone like Forrest would claim that maintenance proponents are scaring people away from abstinence by raising fear about withdrawal—when on Celebrity Rehab, patients were brutally detoxed in the most uncomfortable way possible.

Need I remind him that one person who later died of an overdose actually became psychotic during withdrawal on the show and another, who later committed suicide, suffered a seizure? Actual experts say that neither symptom should have been allowed to emerge in appropriate medical treatment with slow, careful detox—but this is the picture of withdrawal that the supposed abstinence advocate presented to the world.

There’s truly no need for abstinence and harm reduction advocates to be at each other’s throats: Both forms of treatment are needed and belong in the continuum of care. Not every person addicted to opioids needs lifelong maintenance—but some do; likewise, while some people benefit greatly from 12-step participation, others don’t. We can, and should, all get along here, to paraphrase Rodney King, another patient who died after Celebrity Rehab.

While there is room for many different approaches in addiction treatment, we’ve got to start being intolerant of this absurd and often deadly intolerance.

http://www.substance.com/bob-forrest-celebrity-rehab-ignorance/

What a great article! I fucking love Maia, what a wonderful journalist. Superb writer imho. Anyways, enjoy you freaks

 

[cj]

Good article. By running a 12 step treatment center Bob has a financial stake in pushing people away from maintenance. But I will say that a found many counselor at the rehab center I was last at had the same attitude. Some examples "did you know the nazis created methadone to keep people under control" "it's called deathadone for a reason" and my fave "liquid handcuffs". All these are total bullshit of course especially the first one. During WW2 the nazis where cut off from the opium market used to make morphine this they needed a fully synthetic opiate to use on wounded soldiers. That's why methadone was used along with other fully synthetic opiates no conspiracy there.

 

[ro4eva]

If only I could - I'd personally inject this arrogant cockroach with high dosages of heroin every day for half a year, then ask him to use his method to get off of it. And I'm willing to bet everything I own + my liver (which is still functioning very well) that he'd fail miserably and end up on MMT or BMT - probably in tears.

These assholes are like ticks dug into out society to spread misinformation for the financial betterment of himself. Another poser - move along idiot.

 

[neversickanymore]

People should research what type of treatment they are going into well. Many times people are not aware of how most rehabs in the states work, if they were there is no way they would pay thousands a day to be introduced to a something they could have gotten for free. More and more reliable studies are exposing the low success rate of the absolutest twelve step approach. As this continues I hope that a portion of the recovery business will see that there is good money to be made by providing top notch treatment for addiction that does not require using a form of brain washing while requiring patients to surrender to an extremist religious organization that utilizes many of the same techniques that cult do.

I have never read about how much money the fellowships bring in. We can make a good estimate of some of the money they are likely to bring in the states just from asking members for money.

estimated numbers of AA membership in the US 2,131,549>source<

9. Pass the basket(s). The secretary can say something like:

We have no dues or fees in A.A. We are entirely self-supporting,
declining outside contributions. This self-support includes our rent
for this room, the coffee and refreshments, and contributions to our
Central Office, the New York Office and to General Service. The
pink can is for loose change and supports the Hospitals &
Institutions Committee. H&I takes meetings into many facilities
where members are not able to attend outside meetings.

From A Suggested Format for Conducting an A.A. Meeting

So if we just figure they receive on dollar a week from each member we would have 2,131,549x52= 110,840,548 This is likely a very low estimate as many people give a dollar a meeting and attend multiple meetings a week. So lets figure it for every one giving a dollar three times a week for a year. 332,521,644 and this is only an estimated amount for AA in the US.

At every NA meeting the amount of people attending is counted by the chairman and recorded and handed in along with how many celebrations for clean time, how many days those celebrations where for, How much money was collected, and what literature was sold and how much money was collected for that. Pretty nice way to see how many people are coming, how long they are staying and how much money they are making.

Admissions to Treatment of Persons Aged 12 and Older in the US, 2011, by Primary Substance >source study 10<

Total=1,844,719
Alcohol only = 400,012
Alcohol + drug(s)=324,370
Total alcohol=724,382

Cost of a new AA big book $8.00
Cost of Twelve Steps and Twelve Traditions $7.25
cost of Daily Reflections $8.25

>Source<

724,382 x 8 = $5,795,056
724,382 x 7.25= $5,251,769
724,382 x 8.25= =$ 5,976,151

5,795,056+5,251,769+5,976,151= $17,022,976 Since the printings numbers of these books are so large the price per book has to be pretty cheap. Even if it costs half the price of the book to print and ship AA could be making $8,511,488 dollars per year off just selling there literature to people attending rehab.

How many Big Books have been sold?
The October/November 2001 issue of Box 459 had an article on some Big Book sales milestones:
in 1973 copy 1,000,000 was given to President Nixon
in 1985 copy 5,000,000 was given to Ruth Hock (non-alcoholic), who typed the original manuscript
in 1990 copy 10,000,000 was given to Nell Wing (non-alcoholic), Bill W.?s longtime secretary
in 1996 copy 15,000,000 was given to Ellie Norris, widow of former trustee chairman John L. Norris, M.D. (non-alcoholic)
in 2000 copy 20,000,000 was given to the fellowship of Alanon
At the current average of around one million sales per year the total as of 2012 was probably around 32 million.

>source<

That comes out to an average revenue of 8,000,000 dollars a year generated with what would seem to be a nice profit from just the AA book. Given the fact that AA is so into the book business I would assume that they own their own printing facilities and are able to make substantial profits off the sale of these books.

Lets not forget that the fellowships are world wide organizations. What a business model though. Very cheap overhead as most of the meetings are held in structures they dont own or maintain. The rent they actually pay is most likely cheap or free. Their workers are volunteers so they need not pay most of them. The board enjoys tax exempt status in the united states.

Like I always say follow anything far enough in the drug racket and you will get to the money. Following AA far enough lead us to the AA general service office and the General Fund and the Reserve Fund. This appears to be were all the milk and honey end up for the fellowship of AA.

How are G.S.O.’s services funded?
Answer: Approximately 70% of G.S.O. services’ funding comes from
group contributions, the Birthday Plan, central office/district/area
contributions, and excess funds of A.A. events or conferences. The
balance is made up of profits from the sale of A.A. literature.

Question: I keep hearing about the Birthday Plan. What is it?
Answer: The 1955 General Service Conference approved the
Birthday Plan, under which some members of the Fellowship send a
dollar a year for each year of sobriety they have in A.A. Others use
a figure of $3.65, a penny a day, for each year. Some give more, but
the amount cannot exceed $3,000 for any year.

Question: What is Gratitude Month all about?
Answer: Many groups have designated November as a particular
time to give thanks to the A.A. program. In 1970, as an extension of
the Birthday Plan, the General Service Conference recommended
that “area and state committees supplement regular group contributions by
sponsoring a gratitude month.

sourced from
AA financial guidelines

Addicts and alcoholics need to choose the best course of treatment. They should not have an abstinence only based treatment pressured upon them by extremist 12 step promoters who manipulate vulnerable and desperate addicts and their families by insisting their approach as the one and only way.

 

[Jabberwocky]

Best post of the week goes to NSA well done

 

[bagochina]

This Bob Forrest guy just rubs me the wrong way, so much so that I read his book. Pretty good drug-a-log while he was a roadie with RHCP's.

As for AA collections... I was at a meeting a week or so ago and looked and the financials for our district and just last month we sent like 80k in donations to the home offices. One of the higher district donations out of the 25 or so districts designated just for the northern section of Illinois, not including Chicago districts, central Il., and southern Il. districts.

 

[neversickanymore]

Rite its allot of money.. and that basket keeps going around and the books keep getting sold. wonder what they do with all this money? profit keeps coming in but I don't see to much happening with the assets, so where does it go?

Follow anything long enough in the current drug game and you get to the money.

GENERAL SERVICE BOARD OF ALCOHOLICS ANONYMOUS INC

And here we have it

a person working 17 hours a week making I think $210,000.00 a year.. though someone who knows tax law will need to confirm that all this.
a person working 17 hours a week making $310,000.00 a year
an assistant secretary working 17 hours a week making $134,000.00 a year
another assistant secretary making 185,000.00 a year for what they reported to be 35 hours per week
four staff members making like 140,000.00 per year for 35 hours a week.

The we have them benefiting from pension plans that have contributions of 1/3 of their salaries every year.

I'm just going to quit locking at this.. utter scam, they don't even pay their trusties anything. It all ends up in the hands of a few people who pretty much suck it dry.

Return of Organization Exempt of Tax GSB of AA >> whose service is seems to be to serve themselves as much as possible.


"OBJECTIVE OF CREATING A GREATER UNDERSTANDING OF THE AA PROGRAM"

Total claimed revenue= 10, 430, 352.00

compensation to themselves = $464, 537.00
not including wages
and pension

salaries and wages to themselves=$3,184,818.00

pension contributions to themselves = $1,095,895.00

other employe benefits= $596,262.00

payroll tax from them selves= 257,235.00

Other??= 486,373.00

Total=$6,440,59.00

Not to mention

what they claim to do..

"Handling of thousands of communications from individuals and AA groups"
Translated this means they open their envelopes full of money?

"Conduct the annual service conference"

Expenses claimed for = 934,076.00
conferences and
meetings

considering they spend
IT??=$384,548.00
office expenses=$352,471.00
ocupency=499,780.00

they end up spending $7,677,390.00 to collect their money and put on a 934,076.00 convention which totals out at.. $8,611,466.00

I didn't even bother adding in some of the other expenses, because they may have been legit. But If someone can't get the picture from this what's happening they never will. And these people enjoy a tax exempt status. Ever wonder why we pay so many taxes, it because "god" never has to... end the tax exempt status.

So here we have a body making millions and doing nothing claiming to be a tax exempt entity that provides so much good to the world that they should not be paying taxes. When in reality if the groups themselves kept the donations and printed their own literature they would be way better off and could throw a massive convention at about any location on earth and still have tons of money left over.

So keep filling those baskets as there are like five super wealthy ass holes who are counting on your money8)

Fuck the service board of AA

2012 tax filing AA

it causes: the confusion it brings to the 12-step community

huhh, that program worried about confusion8)