Home Special Reports Heir to the Cabela's Outdoor Gear Fortune Tries His Hand at Treatment
Special Reports
Heir to the Cabela's Outdoor Gear Fortune Tries His Hand at Treatment
Written by Ted Jackson   
November 2007


Not too long ago, Chaz Cabela came across a case, a female desperately in need of help, where he could not refuse admission, even though the woman did not have the means to pay for care. A wealthy scion of a catalogue and retailing family, Cabela has sharply boosted the charity care offered at South Florida-based Advanced Recovery Center, ARC, since he bought the cen- ter two years ago. "If there was ever a case of desperate need, this was it," says Cabela, who is of that unique and ubiquitous type of treatment industry entrepreneur, the type who goes to treatment, gets clean, and then decides to buy or start a treatment center...

In Cabela's case, he bought a center that is among the nation's leading providers of extended care treatment services for those suffering from addiction combined with strong co-occurring psychiatric afflictions. And in the case recently where the scholarship was offered, the diagnosis was at a nexus where psychiatry and addiction very often meet, which is trauma. Without, of course, revealing any personal details of the woman, Cabela's staff described a long litany of trauma going back to childhood, culminating in addiction and a horrific assault that had left her virtually helpless.

Getting Help

"Our patient had ceased to function in any meaningful sense of the term," says ARC Chief Trauma Therapist Madelyn Bryson. "She had been stablized in primary care, but with her acute trauma history, she needed much, much more help." The female trauma victim got the help she needed with both her addiction and her trauma issues, just as ARC CEO CHAZ CABELAhundreds like her have at ARC, which is one of very few centers nationwide capable of dealing with very complex co-occurring addiction and psychiatric cases on an extended care basis.

ARC was founded in 1999 by Dr. Jerry Boris- kin, a clinical psychologist who be- gan working on post-traumatic stress disorder, PTSD, with returning vets in the 1970s. Strongly Involved Boriskin, who is still strongly invol- ved at ARC as a clinical consultant, is recognized as one of the nation’s lea- ding experts on the critical clinical ne- xus where trauma and addiction meet, having also been among the earliest advocates and designers of integrative treatment modalities for trauma and addiction. Certainly, the comorbidity between addiction and trauma is enormous, and is probably the highest of any of the common interlocking psychiatric and addiction diagnoses. A 2000 report from the Center for Substance Abuse Treatment, CSAT, revealed that fully 75 percent of men and women who are in treatment for substance abuse report at least some level of a past history with trauma. And a 1990s study by Maine's Department of Behavioral and Developmental Services showed that more than 50 percent of current and past consumers of dual diagnosis services had reported histories of either physical and/or sexual abuse. And the evidence of trauma as a possible causal factor in addiction is also very strong, with studies showing that teenagers with alcohol or drug problems being as much as 12 times more likely to have a history of physical abuse than those who do not have alcohol or drug pro- blems. With sexual abuse, the likelihood is as much as 20 times higher. And other studies have shown that, in general, people with a PTSD diagnosis are more likely to be substance abusers, especially of highly addictive illegal substances like cocaine and opiates.

McLean CliniciansWhile ARC is one of the very few extended care centers nationwide that has the capability to deal with hard co-occurring cases of addiction and psychiatric pro- blems like severe trauma, there are also still relatively few centers that are capa- ble of delivering such services on a pri- mary care basis. But there are certainly now many more primary care centers that are able to deli- ver integrated dual diagnosis care than there are extended care centers capable of doing so. And centers that have been more known for offering traditional 12- Step care are now rushing to beef up their capabilities in dual diagnosis, with players like Caron having made major clinical hires in this area over the past year. And psychiatric players like New England's McLean Hospital, a Harvard affiliated provider that is among the most prestigious purveyors of psychi- atric care in the nation, have been moving to beef up their addiction offerings.

In mid-2006, McLean opened the McLean Center at Fernside, an 8-bed high-end private pay center located in a renovated Federal era home in Princeton, MA, not far from Boston. Deep Expertise And when it comes to treating co-occurring trauma and addiction problems, it would be hard to find a place with more expertise on hand than McLean. Dr. James Chu, along with Dr. Sherry Winternitz, oversees extensive clinical operations devoted to treating trauma victims, while the research of Lisa Najavits informs the integration of trauma and addictions treatment at McLean. Beginning in the early 1990s, Najavits, who was the program director at McLean's Trauma Research Program, was a pioneering advocate gration of addictions and trauma treatment, and whose research over the years has high- lighted the enor- mous links beween the two afflictions. "Very often when ad- diction comes into play with trauma, it is an issue of self-medication," says Najavits, adding that there has been pro- gress when it comes to integrating treatment for co-occurring addiction and trauma cases, but that the process systemwide is still in the very early stages of development and information dissemination. Having said this, Najavits points out that there is now a lot of receptivity on the part of providers dressing co- occurring issues in treatment, with a cor- respond- ingly large increase in demand for clini- cal train- ing in the area. But at Mc- Lean, the process of integra- ting treat- ment of issues like trauma with addictions care is very well advanced already, according to Tom Irwin, who is the program director at McLean Center at Fernside. "We draw intensely on the exper- tise available to us in areas like trauma, and our our approach is highly comprehensive."

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Drug Rehabs
written by richard, November 04, 2008
I like this topic and the working of this NATION'S LEADING TRAUMA AND ADDICTIONS CENTER helping peoples.

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