Addiction Treatment Leader Addresses State of the Art

Brad Lamm has worked in addiction treatment for the past decade. | COURTESY: BRAD LAMM

Brad Lamm has worked in addiction treatment for the past decade. | COURTESY: BRAD LAMM

Brad Lamm was wearing a Washington Capitals baseball cap when he arrived at Le Pain Quotidien near his Chelsea home a little after noon one recent Sunday. The place was packed with strollers and brunchers, making for a dull roar. He ordered an herbal tea and a pumpkin muffin, saying he was fighting a cold.

“You’re the first person I’ve spoken to today,” he said.

It wasn’t very long before he pulled out an iPhone embossed with an “Oprah’s ‘The Life You Want’ Weekend” logo to show off photos of his beloved dogs Bandit and Oliver, whom he pampers with his husband, Broadway producer Scott Sanders.

Lamm, 48, looks and sounds about as normal a good guy as you could ever want to meet. We could have been in a Starbucks in his hometown of Wenatchee, Washington, or almost anywhere else and his easy smile would have been pleasantly unremarkable if you didn’t know he is Dr. Oz’s interventionist, the author of five books on topics related to addiction and compulsive behaviors (the most recent 2014’s “Hand to Mouth: 4 Steps in 4 Weeks to Quit Smoking Now”), the consulting producer on a series about obesity for the Oprah Network, and the founder of the Breathe Life Healing Centers in New York, Los Angeles, and Detroit, which help people overcome problematic behaviors in their lives.

Given my own experience as a psychotherapist working with the LGBT community, I was eager to hear Lamm’s insights from his cutting-edge work and the new treatment model he has built.

Brad Lamm, Dr. Oz’s interventionist, talks rehab and LGBT people’s specific needs

Christopher Murray: What’s wrong with rehab?

Brad Lamm: In early 2003, a therapist suggested I go to rehab. January. I looked at Hazelden and thought, Minnesota in the winter? And instead decided to go to a crummy treatment program that was very spa-like in Laguna Beach. So, I packed away $35,000 in cash and took a leap of faith. That’s one of the big challenges of finding treatment, it doesn’t matter if you’re gay or straight –– it’s kind of a Wild West show.

There’s a big controversy in addiction treatment right now. Some of the big players are owned by big hospital groups now and many of the programs follow the tenets of Twelve Step recovery, but, it’s not really enough. That’s a big part of the problem right now. What do you do? I’m a believer in the spiritual component, but you also need great clinical. If someone is sick enough to go to rehab, you need more than working the first three steps of AA. You can do that for free at home.

I think, too, that it’s an issue of coming of age. The current model for treatment providers has been around since the ‘60s, and for many of them the Twelve Steps are the fundamentals. I’m such a believer in Twelve Step, I think it’s awesome. Outcome-based studies show peer-to-peer is important, but so is great clinical and so is medication management for some. Along with exercise and diet.

CM: What about trauma work?

BL: That’s what I think has been the missing component.

CM: How was the place in Laguna?

BL: I went to crummy, expensive treatment in Laguna and it changed my life. I was introduced to the Twelve Step model there.

CM: What made it so?

BL: Well, I know how they are run now. They were really real estate people, business people. They had a relationship with a psychiatrist, but I never saw him. The therapist was unlicensed. She was someone that had been there for a long time and she was okay, but I also paid $100 extra a week to get soul readings from her. She read my cards. It wasn’t based in anything but someone’s desire to maximize the profits per bed.

CM: Did you know that at the time?

BL: No, they were very good marketers. If you wake up one morning and the doctor says, “You have stage three cancer,” your first call ––

CM: Is going to be to Sloan-Kettering Cancer Center.

BL: But for addiction treatment, most people rely on Google.

CM: Almost every rehab will tell you, “Oh, yes, we work with gay people! We’re great for gay people!” They will tell you they have a specialized track for crystal meth users, which is usually one meeting a week.

BL: I went where I did because they had a gay track. The same guy who ran the gay track ran the Christian track. He had relapsed the week before I got there, so both the gays and the Christians had no leader.

Twenty-five years ago I think gay-specific treatment was really useful. Now it’s less so because we are living out.

CM: But what about gay men dealing with crystal meth? That’s a whole different kettle of fish. People coming into treatment, they may be paranoid, exhausted. If they are gay, they may have sexual trauma.

BL: If you are dealing with crystal specifically, I happen to agree. We have a sexual health program, we make sure our Twelve Steps meetings are crystal meth-safe. There are plenty of meetings where people wouldn’t feel safe talking about crystal meth. Good psychiatry is very important for a meth addict. In the in-patient treatment milieu, meth has the highest rate of relapse. And the related issue of sexual compulsivity is massive.

We [LGBTQ people] are a unique subset. The treatment has to be sensitive to that so that the person can feel safe and can talk, be vulnerable and get better. I think it all comes down to trauma. Everyone who comes into treatment has a unique trauma history, whether that’s big “t’ or little “t” trauma, that is resulting in a connection to a behavior that is interrupting the kind of life they want. Everyone has got their own story. I think though if we talk ourselves into being so unique, we can miss out on being part of the community in the treatment milieu.

The people at Breathe are very diverse –– gay, straight, black, white.

CM: Don’t you think there are some gay people who walk into a room in a rehab and there are straight guys there who are maybe just a little bit rougher and so hunker down into a defensive posture?

BL: I hear you. But what if for that same person one of their primary triggers is not being able to be open and vulnerable and honest? If you treat them in a ghetto, a gay program, where everybody’s gay, then if they return home and their primary triggers remain around those very issues –– honesty, vulnerability, self-awareness –– how then does that person navigate the world after we actually encouraged stratification in treatment?

CM: Well, everyone who goes into a rehab is probably pretty beat up, right? And coming out of some pretty nasty stuff. Don’t they need a circle of safety before they start dealing with that stuff?

BL: I give a talk at Breathe occasionally called “Seeking Safety” –– it’s the only group I do. If you don’t feel safe, it would be very difficult to be vulnerable and do the work.

CM: I’m a big fan of the idea of “safe enough.” I think the [Twelve Step] rooms are safe enough. I don’t think they are necessarily always safe.

BL: There are many rooms that aren’t safe at all. You have no professional moderators in the rooms. That’s the beauty and the beast of Twelve Steps, right? I’m a believer in gay Twelve Step groups for folks, but I push against gay-specific rehabs in 2015. I could have done Breathe LA as a gay rehab, there are enough gays going to rehab out there. PRIDE is still in Minnesota. But I don’t think corralling the gays for treatment is the answer.

I think creating a safe environment from the top down where you can explore who you are safely is important. It used to be you’d go away to rehab in the country somewhere on 22 acres –– that’s not the real world either. My model for Breathe was a clinically sound model in urban hubs so you are not cloistered on a yurt so far away from your life that when you get back it’s such a shock.

For more information on Lamm’s work and the Breathe Life Healing Centers, go to breathelhc.org.

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