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					abuse in purely psychological terms. They speak         averages around 15:1. As well as medical, nurs-
of “users”, not “addicts” or fill-in-the-blank-         ing and psychiatric personnel, every client has
oholics. Whatever you call them, they seem to           the services of a massage therapist, naturopathic
be everywhere. And no wonder, when almost               consultant, personal trainer, yoga and meditation
everything we touch is a potentially toxic sub-         instructor, chauffeur (“Our cars aren‟t marked
stance. Work. Sex. Exercise. Email. Even water,         „Rehab‟,” Goldberg assures me), and full-time,
for crying out loud. In an age of affluence, hav-       personal chef.
ing too much of a good thing is pretty much             Luke Southwood is one of those chefs. There is
what we do. And that‟s both our privilege and           something almost palpably restful about this
our curse.                                              man – something about the steadiness of his
When I tell my kids I‟m going into rehab, their         gaze, or the grace of his finely boned frame.
response is nothing short of awe. You would             When he tells me, “I‟ve always thought of food
think I was going on a space shot, or Oprah.            as a healing thing,” I believe him. His last job
“Can I come too?” the 12-year-old begs.                 was head chef at Byron‟s celebrated Dish res-
“Pleeeeease!” It turns out she believes Rehab is        taurant. Before that he had his own restaurant in
a place, like Cleveland. She has visions of me          South Australia. Working at The Sanctuary is
bumping into Britney there, or maybe Lindsay,           the best job he‟s ever had. “You go home feel-
or Keith. If I‟m honest, so do I, just a little.        ing quite amazing,” he says, his brown eyes
At The Sanctuary, Byron Bay – arguably one of           shining.
Australia‟s best drug and alcohol rehabilitation        The meals Southwood devises (in consultation
facilities and, with fees of up to $28,000 a week,      with nutritionists) are organic, low in saturated
certainly the costliest – there is no “there” at all:   fats, and high in comfort. People withdrawing
no driveway, no gates, no “facility” of any kind,       from addictions need “simple, clean flavours”,
unless you count the admin office, housed in a          he tells me. Leek soup with toast. Chicken
modest, conspicuously signage-free unit on the          Provençal, braised very slowly. Crema Catalana.
outskirts of town.                                      Ratatouille (“an exercise in simplicity, if done
Founder and managing director Michael Gold-             properly”). Don‟t people get just a tiny bit …
berg steers his black Range Rover into the drive-       well, spoiled? I ask Goldberg. “Yes!” he replies
way. He is beaming. I am confused. Is this all          happily. Later, he tells me long-term clients will
there is? We have been driving for three hours –        be taught to cook their own meals. In time, they
admittedly, not the longest journey to rehab ever       are even encouraged to cook for their chef.
undertaken, but still. I can tell he is enjoying my     The rest of the therapeutic team, explains client
Peggy Lee moment. “The Sanctuary – and this             services manager Barbara Ellan, is hand-picked
is what people don‟t understand – is nowhere,”          to reflect individual clients‟ needs, desires and –
explains Goldberg. The Sanctuary is so exclu-           it has to be said – whims. A typical program
sive that it doesn‟t reside in ordinary space and       might feature a combination of heavy-duty de-
time.                                                   tox with lifestyle and leisure options from medi-
Instead, it is conjured into existence, de novo,        tation to dolphin kayaking. Ellan tells me about
for each and every admission. There are no pri-         the program she devised for one executive cli-
vate rooms here. There are private residences,          ent, “a high-functioning alcoholic with relation-
one to a customer, leased as needed from among          ship issues”. It revolved mainly around “art and
40 beachfront properties. The one I visit, alas all     surfing and guitar”.
too briefly, is gorgeous. From its walled tropical      Clients like this one, who present with a verita-
gardens and tranquil reflecting pools to the long,      ble cocktail of dysfunctions – alcohol and de-
sloping lawn to the dunes, it oozes the kind of         pression, with a twist of workaholism – are The
Bali-wood glamour Byron is famous for. There            Sanctuary‟s stock in trade. They are harder to
are never more than four clients in residence at        treat than your “pure” addict of yesteryear. But
any one time. And they never, ever, ever bump           they are indisputably the Next Big Demographic
into each other down by the tennis courts.              for addiction services in the age of affluence.
The Sanctuary makes every other rehab look              For many clients, says Goldberg, “addiction is a
like ready-to-wear. At Summit Centres Malibu,           side issue”. Often, the core problem is with rela-
Cousins was attended by a round-the-clock staff         tionships “and they‟re just medicating that”.
of four; at The Sanctuary, the staff-client ratio       But, he adds, “People come to us with a mass of
increasingly regarded as best practice even by the       marijuana – everything,” he replies with a shrug,
mainstream. It‟s an approach that sees addiction as      taking a swig of mineral water. “I just got bored
a disorder of the spirit as much as of the body or the   with it after a while. I got spiritless and I got bored
mind. Call it “caring for the whole junkie”.             and I knew there was a better life on the other side.
The Sanctuary – like London‟s The Priory, or Hol-        I wanted to stop. And then I realised I couldn‟t
lywood‟s Wonderland Centre, or Newport Beach‟s           stop.” He checked himself into The Buttery, a
Beau Monde, or Arizona‟s The Meadows, or any             “residential therapeutic community” with strong
other of the world‟s elite rehab-resorts – is as far     links to Byron‟s artistic and creative communities.
from “rock bottom” as you can get without a doc-         “I was the only person who was up at 5 o‟clock. I‟d
tor‟s prescription. And that makes some people           meditate. I‟d do yoga. I‟d run. I‟d do exercise. I did
mad.                                                     everything. Twice.” Six weeks later, he says, “I was
“This loser is a drug addict,” snarls a letter to the    asked to leave. I was too functional.” It took him
editor upon Cousins‟ return to Perth. “If he wants to    two years to complete the process, which he did on
be a decent human being he should go straight to         his own. He laughs, recalling that he approached his
the police.” Fumes another: “He should have got a        own rehabilitation with exactly the same manic in-
damn good belting when he was about eight or nine        tensity he now channels into his work at The Sanc-
… and he needs another one now.” Many Austra-            tuary. “Everyone has addictions,” he reflects. “We
lians would concur. Yet the vast majority of addic-      just need to keep the healthy ones.”
tion experts are convinced that punitive approaches
are ethically questionable and, worse, ineffective.      The last time I was drunk (and also the first time)
“What parent wants to wait until their kid hits rock     was back in 1977. It was unpleasant. I have smoked
bottom?” asks clinical psychologist and addiction        one joint in my whole life, and I even refused anal-
psychotherapist Anna Emmons (a pseudonym used            gesics during childbirth. Call it a control thing.
here for professional reasons). “At the end of the       And yet, as I am learning, the world is full of addic-
day, everybody who has an addiction is someone‟s         tions. I drink a glass of wine or two or maybe three
child.” That‟s true, of course. Yet we are not used to   every night of my life. (“Whatever amount of alco-
thinking of addiction in terms like this – in terms      hol a patient says he drinks, we automatically dou-
that hit us where we live.                               ble it,” one doctor tells me.) “Can you define
“Society still thinks addicts should be punished –       „alcohol dependence‟?” I ask Emmons. “People
that they should go to a hard-core place, where          who use alcohol to avoid feelings and cope with
they‟ll get taught the error of their ways and told      situations are alcohol dependent,” she replies. I
it‟s all about self-control,” says Emmons, who has       write that down and wait for further qualification.
18 years‟ experience in the field. “But most people I    There is none. Oh dear.
have ever worked with who are addicts have low           A woman I‟ve known for years tells me suddenly
self-esteem ... and have a history of trauma in their    about her cycling addiction. “Cycling?” I repeat. It
background – of violence or abuse.” That emphati-        turns out she started doing spin classes a few years
cally includes the wealthy, she adds. What such          ago and got hooked. Soon, she was spending up to
people require is not tough love (“whatever that         three hours per session on a stationary bike, burning
means”) but respect.                                     about 3000 calories. “That‟s as much as many peo-
Sure – but dolphin kayaking? She laughs. “Yes,           ple consume on an average day!” I splutter. She
people do need at the end of the day to learn how to     nods. “I told you, I was addicted,” she says. “After
get on with life, but I think most people respond to     a while, I could feel the surge of brain chemicals
the carrot, not the stick.”                              from the point I started lacing up my trainers – and I
Goldberg agrees. “You don‟t need to break some-          needed it.”
one down to rebuild them,” he says. “That‟s a very       Dr Robert Kaplan, a forensic psychiatrist in private
humiliating experience.” There is passion in his         practice in Wollongong, south of Sydney, collects
voice. That‟s not surprising. The exuberant 41-year-     odd addictions the way other people collect beer
old is himself a former junkie. He came to Byron,        coasters. “Psychogenic polydipsia”, for example,
as have many before him, to get well. As with            which can cause confusion, lethargy, psychosis, sei-
Cousins, money wasn‟t an issue for Goldberg; a de-       zures or death. Its other name is water addiction.
veloper of nightclubs and restaurants, he was a high     “Oh, it‟s more common than you think,” Kaplan
-functioning addict. Even now he insists his habit       assures me.
“never hampered my life”.                                And did he mention the patient with the poppy-seed
What was he addicted to? “Oh, cocaine, heroin,           dependency? A Viennese woman suffering chronic
pain, it seems she found relief in strudel before mov-      Pleasure-seeking is the root of all addiction. En-
ing on to the hard stuff – jumbo bags of seeds she would    joying the occasional cigarette, or martini – or,
store in the freezer and suck on. (“Poppy seeds do have a   for that matter, the odd hit of cocaine – does not
tiny little bit of opium in them, you know.”)
                                                            a dependency make. Your mother and father
Carrots, too, can be addictive, Kaplan confides.
                                                            may have told you otherwise, but neuro-
“It‟s the beta-carotene, which is a vital ingredi-
                                                            physiologically speaking, there is nothing con-
ent for nervous function. Probably there‟s a link-
                                                            tradictory about recreational drug use. “At least
up with endorphins or serotonin.” He describes
                                                            some persons can use drugs moderately without
one hardcore carrot user who needed three kilos
                                                            becoming abusers,” explains US historian of
a day to support his habit. “You can become ad-
                                                            medicine Susan Speaker, “and even heavy abuse
dicted to anything under certain circumstances,”
                                                            may not be a lifelong pattern” but short-lived.
he says.
                                                            Craving crosses over into addiction, or depend-
From compulsive gambling to cannabis, poppy-                ence, when we are no longer seeking pleasure
seed strudel to pornography, thumb-sucking to               but avoiding pain. Take cigarette smoking: we
self-harm, addictive behaviour is not primarily             draw a distinction, and rightly so, between the
about substances, experts now recognise. It‟s               person who smokes “socially”, for pleasure, and
about pleasure-seeking. And the biggest risk                the person whose smoking is directed primarily
factor for that is simply being human. “What                at relieving feelings of discomfort that arise
we‟re finding is that substance misuse is actu-             from not smoking.
ally recruiting the same motivational features              Liking poppy-seed strudel is one thing. Needing
that underlie other human motivations – and                 it to get through the day is quite another. Yet in
that‟s why they‟re so hard to deal with,” ex-               an age of affluence, the line between “want” and
plains David Kavanagh, professor in clinical                “need” is ever more difficult to discern.
psychology at the University of Queensland.
Kavanagh is an associate editor of the interna-             A reader of this newspaper wrote to the editor in
tional journal Addiction, and craving is his busi-          March: “The treatment of AFL players and other
ness.                                                       sportspeople with drug abuse problems holds up
He tells me a story about a student athlete suf-            a mirror to the worst of our community re-
fering from hockey withdrawal when prevented                sponses to the issue. It reflects the sad fact that,
from playing because of injury, complete with               in Australia, there is still so much stigma at-
sensory hallucinations. Flashbacks, if you will.            tached to alcohol and drug addiction.”
The sound of hockey sticks against the ball. The            It‟s the sort of letter that puts the wind up many
smell of grass and sweat. Visual images of at-              Australians. Too right there‟s a stigma attached
tacks and counter-attacks.                                  to drug addiction, the logic runs. A) Drugs are
New research shows that what separates some-                against the law, and B) People who choose to
thing like hockey addiction from something like             take them do exactly that. They choose. If they
heroin addiction is … well, not a lot, really.              become addicted, well, that‟s a direct conse-
Neurologically speaking, there is a single re-              quence of that choice. Why on Earth shouldn‟t
ward pathway – the meso-cortico limbic system               there be a stigma attached to doing something so
– that is involved in any form of addiction, or             dumb, and so dangerous?
for that matter in any form of gratification, from          Questions of choice, of free (or fettered) will, lie
eating to sex to football. Pleasure, in other               at the core of our collective ambivalence about
words, is a chemical reaction. And the main                 addiction today. Science is helping us to clarify
chemical in question is dopamine: a thrill-                 the issues, as research into the genetics and neu-
packed drug compounded of 22 atoms of car-                  rophysiology of dependence sheds new light on
bon, hydrogen, oxygen and nitrogen. In evolu-               the extent to which any chemical addiction, licit
tionary terms, pleasure-seeking is an adaptive              or not, can be said to be freely chosen.
strategy. The drive to seek out food, drink and             Two generations ago we were taught to regard
sex is directly related to our survival. The drive          alcoholism as a “disease” (and Cousins is still
to seek out Fox Sports and beer, or handbags                referring to the “illness” that led him to rehab).
and chocolate, is simply a variation on the same            Such usage contains a powerful subtext. People
neuro-chemical theme.                                       with diseases are not responsible for their condi-
Some find the illness metaphor objectionable. Oth-     macological treatments for addiction. They point
ers find it “frees them to actually deal with the      to the success of nicotine replacement therapy, and
problem, rather than getting caught up with „What      of drugs like buprenorphine, which reduces heroin
an awful person I am‟”, in the words of one pro-       withdrawal symptoms while blocking the “high”
fessional. Yet Goldberg reckons people who insist      that is the user‟s raison d‟être; and naltrexone,
12 Steps is the Way, the Truth and the Life really     which helps users stay off heroin or alcohol after
need to get out more. “My best friend was a heroin     they‟ve been detoxed.
addict at 14,” he says. “At 30, he got married, he     Other experts look to NeuroElectric Therapy
had kids and that was it. He went to the doctor and    (NET), a treatment for opiate addiction – think an
got a few Valiums, and went cold turkey. He made       iPod with electrodes attached to the base of the
up his own little method. You know, there‟s lots of    skull – inspired by Chinese electro-acupuncture
people like that.”                                     techniques. NET was developed in the ‟70s in
Experts are increasingly clear that addiction is       Scotland, a nation that has more drug addicts per
more accurately a “disorder”, rather than a disease;   head of population than anywhere else on Earth.
a complex interaction of physiological, psycho-        The technique seems to work by stimulating the
logical and social factors. Biology alone does not     brain to produce the natural endorphins that drug-
determine anyone‟s propensity for substance            use kills off, and has been used to treat high-
abuse. Yet some of us do inherit a greater risk of     profile users such as Eric Clapton, Pete Town-
developing addictive behaviours. “And some of          shend and Keith Richards. Evangelists for NET
those risks are fairly generic ones – that is, they    say it has been sabotaged by drug companies.
make you vulnerable to almost any addiction,” ex-      “The time is coming – perhaps even within the
plains David Kavanagh. Anyone whose brain is           decade – when doctors will treat alcoholism with a
hardwired with fewer dopamine-2 receptors, he          pill,” prophesied Newsweek in February, and “it
says, will need a bigger hit of stimulation in order   will be a paradigm shift as profound as the one
to feel good. Such people are practically pro-         wrought by Prozac in the treatment of depression.”
grammed to thrill-seek. They are not only more         Maybe so. But let‟s not forget that, two decades
likely to develop substance problems; they are also    on, Prozac has hardly “solved” the depression epi-
more likely to jump out of airplanes.                  demic.
Alcohol abuse, in particular, has been shown to        The view that addiction is reducible to brain chem-
have a strong hereditary component. The so-called      istry is as simplistic in its way as the conviction
“gene for alcoholism”, identified by researchers at    that all Cousins needs is a “damn good belting”.
the Washington University School of Medicine in        Warns Kavanagh: “It‟s not just about what‟s hap-
2004, is related to a receptor that allows for the     pening in the brain. It‟s about what‟s happening
movement of gamma-aminobutyric acid, a neuro-          through your whole life.” No tablet in the world is
chemical responsible for inhibiting responses. In      going to succeed if the user isn‟t motivated to take
simple terms, people who inherit this gene are         it, and keep taking it.
more excitable (or their brains are). Alcohol may
normalise brain circuits for such people, putting      Roughly 1.5 million Australians have tried ice. Of
them at increased risk of dependence. For them,        those, an estimated 40 per cent are regular users.
alcohol is literally “self-medication”.                (“Addicts”, in the old language.) Ice is the strong-
Similar genetic factors probably underlie other        est form of the synthetic stimulant methampheta-
forms of substance dependency, scientists now be-      mine which, in the old days, we called “speed”. It
lieve. And our deepening understanding of the          can be smoked, injected, snorted, swallowed or
neuro-chemistry of addiction is having important       “shafted” (inserted anally), and induces a high that
implications for treatment. Kavanagh, like many        mingles feelings of euphoria with increased alert-
researchers, is optimistic about the future of phar-   ness, confidence and libido.
The long-term side-effects of ice are largely un-      It‟s all come so easy.‟”
known. The short-term side-effects range from
tremors and irregular heart-beat to hallucina-
                                                       It is not difficult to understand people who turn
tions, paranoid delusions and uncontrollable vio-      to drugs because life is hard. But people who do
lence. Yet the most terrifying thing about the         so because life is too easy? Yet, as Emmons
drug is that so many who use it are the same as        points out: “We learn through struggling and
you and me. Not street kids and criminals, or          having to work hard. If we don‟t have to, if
celebrities and supermodels, but professional          nothing we do is really going to be such a terri-
people and students. People with normal lives. Nor-    ble loss, it can feel as if life lacks meaning.”
mal incomes. Normal families.                          Emmons has contempt for the notion that simply
Dr Alex Wodak, director of the Alcohol and             putting someone in rehab is going to solve the
Drug Service at St Vincent‟s Hospital in Sydney        problem. Rehab, she stresses, should be a last
(and therefore something of a front-line combat-       option, no matter how much money you have,
ant in the war against drugs), has a reputation        not a first one: “You should try harm minimisa-
for shooting from the hip. He says drug abuse is       tion. You should try counselling. You should try
primarily a health and social problem, not a le-       family support.”
gal one – and most definitely not a moral one.         Says Goldberg: “To most people who ring us up
“When you‟ve got somebody who started using            and say, „I need to go to rehab,‟ I say, „Well,
drugs when they were 16 and were sexually in-          have you tried AA or NA? You know, it‟s free.
terfered with by their dad and an uncle as a           You don‟t have to pay a thing. Go every day. Do
child, and they didn‟t have much of a go at edu-       90 meetings in 90 days and tell me if you still
cation, and their family life was a disaster and       want to pay a hundred grand to get well.‟” For
they‟ve never had any significant relationships        Georgoussis, addiction in the age of affluence is
in their life, and they‟ve never been employed         a spiritual issue; revealing the
and they‟ve been in and out of prison, and             “interconnectedness of all things” to clients is
they‟re depressed, and they owe $20,000 and            the key to his professional practice. Shame has
they‟ve got nobody in the world who gives a            no part in the proceedings. In fact, it is what
shit whether they‟re alive or dead – well, no-         drives addiction – never what resolves it.
body‟s going to tell me you‟re going to get            Cousins, the leader of the Brat Pack Eagles,
much joy with that person just wagging your            driven by shame? It‟s hard to imagine, but imag-
finger in front of his face.”                          ine it we must, insists Emmons, who sees the
But what about people who don‟t fit that pro-          “incredible emphasis on fitness and perform-
file? What about Nouveau Junkies such as               ance” in professional sport as a risk factor.
Cousins, or Goldberg, or the coke-snorting             “Your career only lasts, what? Ten or 15 years
stockbroker who lives down your street – high-         max? If you get injured, you‟re out. If you don‟t
earning, high-functioning, high-living profes-         perform well, you‟re criticised. And that criti-
sionals who just happen to enjoy extreme party-        cism gets to people.”
ing? They are not life‟s dregs. They are, if any-      Like every other expert I‟ve spoken to, Emmons
thing, its chosen few. Is privilege itself the prob-   scoffs at the idea that 28 days in rehab has cured
lem in such cases? Is affluence bad for the soul?      Cousins, or that it could cure anyone, or even
Consta Georgoussis, who teaches yoga and               that “cure” is an appropriate term. She says,
meditation at The Sanctuary, has no doubt of it.       “Nobody‟s said to Ben Cousins, „What‟s going
“Among the very wealthy, emptiness – spiritual         on for you? What‟s it like to be you? What does
emptiness – is so much more apparent. And              it feel like to have to perform? What‟s the pres-
that‟s because every sense is satisfied except the     sure like?‟” Celebrity users are in some ways (as
inner sense,” he says.                                 the rich always are) different to you and me.
Anna Emmons is also convinced it is “harder            But, perhaps particularly in an affluent age,
sometimes for the wealthier to find meaning” –         where so many of the rest of our problems have
especially in families where children inherit          been solved, addiction is a great leveller. “It‟s
wealth, rather than earn it. “Then there‟s the         about wanting to be loved,” says Emmons. “It‟s
feeling that, „I may never match that. I may           about wanting to fit in, wanting to have mean-
never actually be as successful as my parents.         ing, wanting to have purpose, wanting to feel