ROAD TO REHAB

Brighton Hospital Offers Addicts -- Including Eminem -- Sparse
Accommodations But Healthy Direction For Regaining Control Over Drugs And
Alcohol

The Brighton hospital Eminem chose for his recovery from a sleeping pill
addiction is a bare-bones facility with a 6:30 a.m. wake-up call, a 10:30
p.m. bedtime and rules banning hip-hop music or movies that don't have a
recovery theme.

A white picket fence and old-fashioned chapel suggest a country club, but
the nation's second-oldest private substance abuse facility, an hour's
drive northwest of Detroit, is more boot camp than sumptuous retreat.

Two-thirds of the staff are recovered addicts, including the medical
director of its detoxification unit, a doctor whose medical license once
was yanked over his addiction to booze and drugs.

A third of the clientele are addicted to sleeping pills and other sedative
medicines, making it a logical choice for the rapper born Marshall Mathers.
Numerous sources close to Eminem say he admitted himself to Brighton
Hospital for an addiction to the sleeping drug Ambien days after an Aug. 12
concert at Comerica Park in Detroit. Officials at Brighton and the St. John
Health System, of which the hospital is a part, cited federal health
privacy laws in declining to confirm whether Eminem was or remains a
patient at the hospital.

But Tuesday, hospital officials spent nearly three hours with a Detroit
Free Press team answering questions and providing a limited campus tour.

Their willingness to admit the newspaper team suggests Eminem is no longer
there. Patients generally stay at the facility for 10 days, followed by as
much as six months of outpatient therapy.

"The people who follow up with a treatment plan are the ones who do well,"
said Dr. Mark Menestrini, medical director of the detox unit.

Menestrini, 52, tells his own story of addiction, without shame, if for no
other reason than to provide hope to all who will listen. After 12 arrests,
four relapses and the near-collapse of his marriage, Menestrini regained
his medical license and went on to pass national board certification exams
as an addiction medicine specialist.

Admission and detox

Most patients arrive by appointment, sometimes arranged after family
intervention. Ambulances shuttle those whose rehab is complicated by
gunshot wounds, burns, broken bones and bruises from booze and drug-related
falls, stupors, fights and auto accidents, the ugly underside of addiction.

The 92-bed hospital usually is packed at 95% to 100% of occupancy, a stark
contrast to many general hospitals struggling half to three-fourths full.

Brighton provides care for 2,400 patients a year, 60% of them men. Just a
few years ago, it treated 2,000 people a year. The increase reflects the
closing of other programs and the epidemic of addiction in America.

Once the hospital housed more alcoholics than drug abusers. Now, at least
half of the patients have more than one addiction problem.

Increasingly, many are addicted to prescription painkillers and sleeping pills.

"We live in a society that reinforces that you take something when you have
heartburn, hemorrhoids, excess gas, erectile dysfunction or any possible
symptoms," Menestrini explained.

Many patients start in the 29-bed detox unit, where heroin addicts share
rooms with longtime alcoholics, and prescription drug abusers with crack
addicts, three to a room.

Sparsely furnished, with white sheets and a blanket covering standard-issue
hospital beds, the rooms have no TVs or radios. No headphones are allowed.
There is no Internet access -- and no visitors -- so patients can focus on
recovery, said Denise Bertin-Epp, president and chief of nursing.

A TV room offers satellite TV stations and movies limited to spiritual and
meditation shows. Too many programs and movies "sabotage sobriety,"
Bertin-Epp said. She allows movies such as "Hoosiers" and "28 Days."
Reading materials are equally limited to recovery materials and the Detroit
Free Press.

For the bored and restless, there are coloring books, crayons and a
colorful, 300-piece puzzle.

Sleeping rules are relaxed in the detox unit. Some patients, particularly
those addicted to sedatives, arrive unable to sleep more than an hour or
two, a problem known as rebound insomnia.

Stays in the detox unit are $900-a-day; inpatient rehab adds another
$750-a-day, bringing a 10-day bill easily to $8,000 or more.

Many insurance plans don't pay for rehab or limit time in the programs to
no more than 10 days. They also often require patients to pay half the
bill, a co-pay that puts inpatient rehab beyond the reach of many who might
benefit, said Bertin-Epp. The staff spends their time trying to coax health
plans to pay for care, even a day or two more.

"Every dollar spent on rehab saves society $5-$7," Menestrini said.

Precise medicines are used to help reduce nausea, vomiting, headaches and
tremors that can occur with withdrawal.

"It's pretty rough, there's no getting around it," said Stewart Francke, a
metro Detroit singer who checked himself into Brighton last year for
addiction to painkillers he took after cancer treatment.

Patients with sedative addictions receive gradually reduced doses of the
sedative phenobarbital and anti-seizure medicines like Tegretol and
Depakote to relieve anxiety, often for several months, Menestrini said.

Rehab

Once past detox, which typically takes a few days, patients are reassigned,
two to a room in another building where the units look like college dorm
cubicles, only cleaner.

Rules are more relaxed, except for the 6:30 a.m. wake-up, 10:30 p.m.
bedtime and a no-nap rule.

Twice-a-week family sessions are offered and visitors encouraged. Patients
can roam the wooded campus, play volleyball or do crafts. A historic chapel
constructed with donations from auto pioneer Henry Ford is the signature
landmark on the campus, with a new perennial garden in front.

Brighton's program is nationally accredited and recognized. Seven full-time
doctors, four psychiatrists and a team of therapists, all with master's
degrees, offer group and individual counseling, morning, afternoon and
night, all in the 12-step model. That approach, begun in the 1930s with
Alcoholics Anonymous, adheres to anonymity and group counseling as key
dynamics to the rehabilitation of addiction.

Therapist Virginia June works to counteract years of self-loathing common
in addicts.

"We love them until they learn to love themselves," she said. "You honor
the person they are, not the behavior, not the disease."

June, 44, a mother of two, is a former addict who straightened herself out
at Brighton 19 years ago after four relapses. Her stumbling block was
making it beyond the first month of recovery, a tough problem with its own
name, Post Acute Withdrawal Syndrome. A Brighton counselor and
participation in 12-step programs got her clean for good 19 years ago.

Patients get photos of themselves on entry and at the time of their
release, along with a gold coin with a serenity slogan. Many continue
outpatient therapy at Brighton's Southfield or Livonia centers. Staffers
regularly call former patients and offer a range of programs, including
quarterly tune-ups.

For Andy C., 48, of Clarkston, the approach stuck. (The Free Press is
honoring the anonymity traditions of the 12-step process.)

He hasn't had a drink of booze or ounce of cocaine since his October 2001
discharge from Brighton, after a two-week stay.

Once, he drank three to five fifths of vodka a week and snorted $1,000 to
$2,000 worth of cocaine.

"I asked God to please get me help." The road led to Brighton.

There, he met doctors, lawyers, priests, prostitutes, "all with remarkably
similar stories."

Now, Andy C. is married, has a 3 1/2 -month-old baby daughter and is out of
debt. He attends 12-step programs three to five times a week, by choice,
and returns to Brighton about once a month to speak to groups.

"When I recovered, I got my soul back," he said. "I recovered the ability
to participate in my life again. I wasn't running from myself.

"I'd recommend it to anyone who feels that alcohol or drugs are keeping
them from being the person they want to be."