THE FIX, an addiction and recovery website run out of Los Angeles, covers subjects such as celebrity sex addictions as well as more serious topics about, say, the state of addiction research. There’s also a section called “rehab reviews” where you can take a look at independent write-ups of various facilities much like you would before going on holiday.
At the top of the current list is the Cliffside Malibu, where celebrity gossip website TMZ swears Lindsay Lohan checked in for her sixth attempt at recovery. Like many treatment centres in Malibu, it comes with a chef, walks on the beach, workouts with personal trainers, acupuncture, massages and “manis and pedis” – all for just $58 000 a month for a “semi-private” room or $73 000 for a private one. Oh, and outside of therapy groups and one-on-one counselling, clients are welcome to use their phones, watch TV or surf the web.
The beachfront neighbourhood is saturated with rehabs like this one that employ the “Malibu Model” of treatment. It’s a play on the industry standard, the “Minnesota Model”, a disease-based model of addiction, fostered by the respected treatment centre Hazelden in Minnesota, and is based on the 12-step programme of Alcoholics Anonymous. The Malibu Model comes with highly individualised treatment plans and extras such as acupuncture, equine therapy, yoga and meditation, a sumptuous departure from the clinical, bare bones, tough love approach that’s offered at many rehabs.
“What are Malibu’s growth industries?” asked a recent New York Times article. “Answer: Winemaking and sobriety.” It’s a question that could be as relevant to Cape Town as it is to Malibu.
I thought I might begin my journey at Montrose Place where, in the early days of 2010, there was rampant speculation by both local and international media that Tiger Woods had checked in for sex addiction after his string of marital infidelities became public.
It was never proved that Woods even set foot in the country, much less the luxury treatment centre, which opened in 2007. But, out of it, a star rehab was born.
With a price tag in pounds – 10 000 of them a month – it unabashedly catered to a British clientele of “actresses, burned-out City types, sports stars and over-privileged teenagers”, according to a lengthy 2010 article about the facility, and its founder Johnny Graaff, in the Daily Mail.
Along with a formidable team of psychologists, occupational therapists and addictions counsellors, the mansion in Bishopscourt came with its own gym, home cinema, swimming pool, chef, dietician and koi pond.
“Why should people go into a grotty dive because they’re ill?” Graaff told the London Evening Standard later that year. “There can be a punitive environment in other clinics,” he told the Mail. “They’ll tell you you’re a terrible person and you need to pull yourself together, which is traumatic for someone who’s ill.”
He should know. Graaff, the grandson of Sir De Villiers Graaff, told the Mail he was a four-gram-a-day cocaine addict who seemed to have hit bottom after his involvement in a car accident that led to the death of 35-year-old Guida Correia in 2003.
Local papers reported that Graaff’s Corsa bakkie allegedly hit Correia’s Jetta at 160km/h near the family’s De Grendel wine estate in the Tygerberg Hills. She died later in hospital. Graaff was eventually acquitted of culpable homicide. After that, he ended up in various rehabs, relapsing, and going back for more. It was after he finally had some time sober that he went to his father with a business plan that seemed destined for success, considering what was happening overseas.
But when I tried to contact the facility in May, I found it had been replaced by something called Montrose Manor, which specialises in eating disorders. “We are not an addiction treatment facility anymore,” the message came back.
And so, as quickly as it appeared to have shot to international success, the most exclusive drug treatment centre South Africa had ever seen seemed to have all but evaporated.
Allan Sweidan is a psychologist with salt-and-pepper hair and a specialisation in addiction care. He’s also the managing director of Akeso, a group of six psychiatric hospitals and two treatment centres, including the recently acquired Stepping Stones and its secondary treatment facility, the Beach House. Both are based in the sleepy seaside resort town of Kommetjie.
Unlike most treatment centres, the well-regarded Stepping Stones is a registered psychiatric facility that specialises in dual diagnosis for patients suffering from a mental illness as well as addiction, as so many addicts are. It has 30 beds, which are filled by a generous helping of foreign clientele, mainly Dutch, an attractive hold-over from the previous owners, one of whom was Carrie Becker, the original founder of the facility who ran it until it was sold to Akeso last year.
Donald Grove, the hospital manager, says it’s like “running a hotel for people with special needs”. There are counsellors, nurses, administrators, catering and maintenance staff – 38 in total, making the staff-to-client ratio better than one to one. And that type of treatment doesn’t come cheap. The facility charges R56 000 for locals and €6 700 for foreign clients.
A lot in rands, but translate that into the high-quality treatment with the beachfront view and travel to the tip of Africa, far away from your drug-abusing environment, and it all makes good sense. Still, although you’ll find it listed on the website luxuryrehab.in, Stepping Stones is no Cliffside. “There is a great therapeutic environment at Stepping Stones,” said Sweidan. “But it’s the old Kommetjie Hotel. It’s hardly Sun City.”
I had been told the inside of its walls have seen the likes of rock stars and best-selling authors, politicians and TV personalities. But, from the outside, Stepping Stones looks like an aging block of white-washed beach flats. Enter through the glass doors and into the lounge area and you’ll find a whiff of the hotel lodge, what with the old-school African décor, oversized fireplace and comfortable couches in a dated colour scheme of maroon, yellow and beige.
If patients weren’t in detox (there are facilities on the premises, staffed with 24-hour nurses who monitor the intense process of relieving bodies of their drug of choice), their day would have begun with coffee and a walk on the beach. At 7.30am they would have shown up for their “serenity meeting” and breakfast, and 9am their programme would have begun: presentations on their drug histories, some Nia dancing, drum or equine therapy, some group work around the 12 steps or a one-on-one with their counsellor. The day might have been complemented with a massage, a trip to the gym or an outing to the local mall to get their hair cut. They would end their day with a beach walk, dinner and an AA meeting. Lights out at 11pm.
“They work really hard when they are with us,” says Sweidan, who lost a brother to a drug-related illness. “They are in groups all day, five and a half days a week. They aren’t sweeping the floors but they aren’t doing whatever they want when they want. It’s damn painful. The process of recovery is not a holiday camp.”
That comes into sharp focus in the room where art therapy classes are held. On the walls the minds of patients are sketched out on oversize brown paper. Life-sized outlines of their bodies are filled with paint: chakras are presented in muted, muddy colours; a bottle of wine protrudes from the side of a head like an extraneous limb; a genital area explodes in great blobs of golden glitter.
So while art therapy might sound namby-pamby, it appears to bring out some seriously deep-seated issues.
Still, I was reminded of something New York Times columnist David Carr wrote in his gripping memoir, Night of the Gun. In it, Carr recounts the strict, rough-and-tumble treatment centre where he got sober where even the notion of art therapy would have been laughed out of the grubby building. His Rx for Garbage Heads: “Enter the booby hatch. Preferably a place you never, ever want to go back to. Avoid treatment centres with duck ponds, good food, or a record of admitting Britney Spears or Lindsay Lohan.”
Next stop: facility with duck pond.
I arrived on a stormy day in Hout Bay and nearly parked in the best available space until I read the sign. “Goats may climb on vehicle if you park under tree.”
Confused, I decided to squeeze in a bit further down. As I walked toward Harmony’s office, I realised they weren’t being funny: two goats sat comfortably on the tennis court near the swimming pool. They were joined by a coalition of animals: chickens, two donkeys, an ostrich and, yes, ducks that had their very own pond.
I was ushered in by one of the counsellors to the day’s lecture. At the top of a set of stairs, in a cold room with turquoise curtains and long desks, a blonde woman with a ponytail pulled up a Powerpoint presentation.
“Why do some people use?” asked the presentation, which was created by Dr Rodger Meyer, who many refer to as the father of addiction medicine in South Africa. “Intoxication, experimentation, celebration, deviation, medication, obfuscation, annihilation,” it answered. The patients slowly nodded their heads in agreement as we moved on to the more pressing part of the discussion. Why do some people become addicts and others don’t?
The counsellor presented the Vietnam Study, often quoted research in halls such as these, which found that 46% of soldiers in Vietnam had used heroin at least once during their tour. But when they returned home, only 12% continued to use, the analogy being that some people use drugs environmentally and can stop taking them. Others can’t.
Harmony’s founder, Steve Thomson, is part of that 12%.
A towering, charming man in his 50s with a shaved head, a stern brow and deep-set blue eyes, he still maintains his thick Scottish accent, despite a childhood growing up in Benoni with two alcoholic parents.
He left Cape Town for Glasgow at age 20, returning 15 years later with an addiction to “anything that was going”. Eventually, he checked himself into Kenilworth Clinic, then relapsed. He entered Tharagay House, another treatment centre, this time for four months. It was there that something took.
“Sometimes you enter a treatment centre and form a bond. That’s what happened to me. That same bond, if I’d been in Malibu or in some shithole, it was that bond that got me clean and sober. The first time in my life, someone got me. And she would have got me anywhere.”
Hippie suimmer camp
Thomson hopes that some of the bodies that pass through Harmony – one of the most well known being cricketer Herschelle Gibbs – will get got. What Thomson has managed to create in this rustic beach cottage compound is more hippie summer camp than luxury beachside resort. But the rules are strict: like it or not, you are going for that 7am beachwalk, rain or shine.
Men and women are segregated in both sleeping areas and in most activities. There will be no sugar, no junk food, no processed food and the carbs served by the kitchen will be few and far between. (The facility recently teamed up with Professor Tim Noakes for an inpatient programme for sugar and carbohydrate addiction.)
They offer massage, meditation and yoga, as well as holotropic breathwork. The cost for 30 days: R35 000; foreigners pay double. Add on a bit more for one of the two private suites, one of which is named after Desmond Tutu, who gave the facility his blessing. Thomson opened Harmony in 2008, but it all started with Serendipity, the tertiary care facility in Woodstock in 2001. Since then, he’s opened Akron Addictions Clinic in Kommetjie, the secondary care facility Harmony House, as well as three sober living houses around Cape Town.
Rehab is big business that feeds on itself and, as Thomson knows as well as anyone else, tends to come with plenty of repeat customers.
“The nature of the disease is such that people will be back. And they will go back to those who helped them originally. You have this carousel of broken people that you fix, but not completely. It’s a cash cow.”
That’s Herman Lategan, a freelance writer who lives in Cape Town. A friend insisted I meet him, saying he would give me the inside scoop on all things rehab precisely because, well, he was on the inside. A lot. I emailed Lategan when I arrived in the city and got an enthusiastic, though interesting, response for someone in recovery.
“Let’s meet for drinks,” he wrote.
Over a glass of beer at the Devil’s Peak Brewing Company, Lategan told me of his battle with benzodiazepines, the class of sedative-type prescription drugs fondly known as “benzos” to addicts, and more than his fair share of cocaine. He’s been to five rehabs in total – twice at Kenilworth Clinic, stopping off at Stepping Stones, and over for a stint at Harmony, after meeting Thomson in “The Rooms”, the accepted code word for 12-step meetings. Each time, he relapsed. Finally, in 2009, at the government hospital, Stikland, where “everything was tidy and the food was dreadful”, something clicked.
“I walked out of there and I was whole,” he said. “I have never gone back to sleeping tablets, or Xanor, or cocaine or anything else.”
Eventually he went to work at Montrose Place. It was 2011 and, as Lategan tells it, Graaff’s behaviour was erratic; not long after that the facility closed down and Graaff disappeared from the scene. And that, he said, was while the family had already made plans to open another facility in the winelands near Somerset West.
That night I ended up at the Pot Luck Club, overlooking the city lights from the top of an old Woodstock warehouse. Over exquisite small plates of Korean fried chicken with pineapple and miso slaw, I met a woman who was eight months sober. I’ll call her Patricia.
Patricia wore diamond earrings the size of plump peas and a diamond ring that acted as a small hand weight on her slender, pale finger. Patricia sipped on Coke Lite and told us of her addiction to benzos. It was her second tour through treatment; 10 years before she had found herself in another one, overseas.
She openly talked about her recovery, about The Rooms where she now spends much of her time and about her current volunteer work at her treatment alma mater, Harmony.
As we spoke, our waitress – a perky, attentive blonde – rang in with her own story.
“Everyone is taking drugs. Except him,” she said, giggling, and pointing across the room to another waiter. And then, almost as an aside: “My father just got out of Kenilworth. Alcohol, you know?”
The next day I found myself in the genteel suburb of Kenilworth meeting Dr Roger Meyer at the psychiatric group practice which specialises in addiction medicine. Housed in a refined office with hardwood floors and dark leather couches, it exudes the particular, fragile quietness found only in rooms such as these.
The practice sits across from the Akeso-owned Kenilworth Clinic, the psychiatric hospital where Meyer began his foray into addiction medicine.
Meyer, who wore comfortable jeans and a grey K-Way sweatshirt, his readers perched on top of his head, told me he worked as a GP through a harrowing intravenous drug addiction that left his hands severely damaged; they are thick, like baked bread, and if you look closely you will see the tiny pockmarks, which are scars from abscesses left from repeatedly injecting himself.
“My little works of art,” he says.
Meyer got clean in the United Kingdom more than 25 years ago. But upon his return to South Africa, he couldn’t find a Narcotics Anonymous meeting to support him in his recovery. So he started his own. (There are now more than 70 meetings you can attend on any given week in the Cape Town area.) He continued in private practice until he began to amass a patient roster that included an increasing number of addicts.
In 1992 he and Carrie Becker, who would handle the therapeutic part of the project, started up an addiction unit at Kenilworth Clinic, the first in the country. (They split, with some differences, in 1996 when Becker was offered the hotel in Kommetjie. Eventually Meyer acquired a share in the clinic, selling it later to his partner, who then sold it on to Akeso in 2012.) Since then, the number of private treatment centres has mushroomed. There are now more than 30 operating in the Cape Town area, 19 of those being in-patient clinics.
In his silver Mercedes, we took a tour of the addiction medicine saturated neighbourhood – Tharagay House, Meyer’s own treatment centre, the secondary facility Kenilworth House, as well as the Living House, a sober living home, are just a few – while he told me of his journey through addiction medicine.
“Nobody has spawned their own competition more successfully than I have,” Meyer told me. “They have either worked for me or been patients of mine, and I won’t say which. And I’m proud of that. If you look around the world, there are little focuses of addiction treatment expertise – southwestern England, the States, Australia. We’ve got a whole network of respected facilities.”
One of those is Seascape House, which Meyer opened in 2008.
Situated in Dolphin Beach, Bloubergstrand, from the outside it looks like a boutique hotel. I found the chef, who trained at Zevenwacht Wine Estate in Stellenbosch, in the kitchen, preparing rocket, avocado and feta salads for lunch.
The 12-person facility, which, when I was there had almost all foreign patients, charges R35 000 for locals with an extra 20% premium for foreigners. It has a unique setup. Clients who come here have already detoxed and most stay for two months. After the first week, they have access to their cellphones and their computers; they can even go down to the corner café for a coffee, and hopefully not something more stimulating.
But, as Meyer says: “If you are going to relapse, the best place to do it is in treatment.”
Sadly, relapse is often part of the recovery process. But try telling that to an addict’s family member who has just shelled out tens of thousands of rands, only to find their loved one smoking or snorting or shooting up days, months, or even years later.
“It’s not like having your appendix out, where you go in a hospital with a sore tummy, your appendix is removed and you leave three days later and you are more or less cured. Addiction is a chronic problem. It needs to be understood that rehabs are part of the process.”
It was just outside Somerset West, along Winery Road, that winemaking and sobriety finally did meet. Rustenburg Addiction Care is South Africa’s upmarket rehab pièce de résistance.
As we drove down the brick road into the facility, which was shrouded by a canopy of trees, a small herd of springbok dined on a manicured lawn. Here, on this Dutch colonial estate, there is a French chef, two swimming pools, a rose garden and – never mind a duck pond – a small lake with weeping willows that look on to the vineyards beyond.
This would have been Johnny Graaff’s next treatment centre. But he moved to London, abandoning it along with Montrose Place, which, according to an attorney for the family, was repurposed for “business reasons”. What he left behind allowed “a little piece of rehab paradise” to fall into Meyer’s lap.
It’s clear Meyer is proud of what he’s built, revelling in his latest treatment acquisition. But throughout all his successes Meyer is most proud of his own recovery from an addictive disorder.
“At the end, if I had died, it would have been a relief. To carry on the addiction had become such hard work and I didn’t know how to get out of it. Sometimes you wish death would embrace you. But I went to a treatment centre where the disease-model theory began to make sense and I realised this was something I could recover from.”
And that, says Meyer, is what is really what treatment centres –whether they come with high thread counts or threadbare sheeting – are offering.
“The fundamental commodity of what we sell, what the client is buying from us,” he says quite simply, “is hope.”
This article was originally published in the Mail & Guardian in July of 2014.