High-end dry: Malibu's new rehab centers are posh, but effective?

When L.A.'s elite decide they're done with getting high, it doesn't mean they re finished with the high life.

So it's not surprising that nearly 10 luxurious drug and alcohol treatment facilities--many of them in Malibu--have sprung up, several recently, and are competing fiercely for clients. They try to outdo each other with spectacular settings, palatial accommodations and such amenities as spas, media centers and world-class kitchens run by big-name chefs to lure patients from all over world.

"The people who come here are used to luxury," said Chris Prentiss, who in 2001 co-founded the Passages Addiction Cure Center in Malibu. "They want to be pampered."

His $22 million Passages estate has two juice bars, a library, bedrooms with marble baths and treatment rooms for massage, acupuncture and hypnotherapy. Chauffeurs and recreational activities are de rigueur at the facility. Big bills are, too. A month's stay costs about $60,000.

"At the Betty Ford Center they force clients to do housework, scrub floors and toilets. They punish them like they've been bad," said Prentiss. "Who wants that?"

But even a pioneer in the luxury-treatment field wonders if the focus on treatment is getting lost in the latest round of ultra pampering.

"Lately some facilities have gotten away from the core principles that rehab is founded on; it's whoever can have the bigger house or offer more amenities," said Richard Rogg, who founded Promises Drug Addiction and Alcohol Abuse Treatment Centers in Mar Vista nearly two decades ago as a division of his Westside Sober Living Centers Inc.

The center has treated a slew of big name celebrities including Christian Slater, Robert Downey Jr., Ben Affleck and Diana Ross, and even offers "equine therapy."

"Also, a lot of people who can afford $45,000 or $55,000 a month don't want to have to participate in Alcoholics Anonymous-style 12-step meetings, so that very effective treatment is being cut out," he continued. "Nice facilities are wonderful, but the treatment is the most important part."

The Rancho Mirage-based Betty Ford Center is one of the oldest names in rehab. It utilizes a traditional 12-step approach, a strategy many in the industry say remains a treatment must. Clients pay about $20,000 a month. Representatives of Betty Ford declined comment.

While some critics say the luxury doesn't help cure addiction, the proprietors and clients insist that like any other business, it's a matter of serving a market sector.

Kristin, a 28-year-old from Santa Barbara who was treated at Passages for two and a half months in 2004 and who asked not to reveal her last name, said that the amenities offered made a big difference when she selected a program.

"It was important for me to be comfortable, not like I was in an institution or a hospital, or feel like I was being punished for screwing up," she said.

"Your self esteem is low enough at that point you go for treatment," Kristin continued. "My mom even said, why do you need all of this? But once she saw the whole picture it wasn't really a question."

Susan Blacksher, executive director of California Association of Addiction Recovery Resources, can see both sides of the question.

"In some ways, it's become totally absurd--like going to the spa, not actual rehab." she said, while acknowledging that there is undeniably a clientele for high-end rehab.

"Even though you are talking about addiction, it's still basic supply and demand," she said. "So somebody's just a smart business person if they are creating what people want."

High-stakes competition

There are currently about 870 licensed drug and alcohol residential treatment facilities in California, and 511 residential and outpatient centers in Los Angeles County, according to the state department of Alcohol and Drug programs. Of those, 25 are in Malibu. About one third are in the sizeable-and-luxurious class.

Aside from Promises, which was founded 19 years ago and expanded to Malibu in 1997, few of the other Malibu facilities are more than five years old, and new players continue to pop up in the ultra-luxury sector of the market.

Other luxury centers in or near Malibu include Beau Monde, which treated Courtney Love; Cliffside, which offers spa treatments; and Milestones Ranch, which offers art therapy.

In most facilities, patients typically stay at least 30 days at a time, though that is often extended. All operations interviewed for this article said that their facilities' Malibu location and luxury amenities draw patients from all over the world.

Passages, for example, spends more than half a million dollars a year on landscaping, and the center's monthly food bill alone is $42,000. Top chef Lisa Stalvey headed the kitchen at Spago for several years, and the daily menu typically features lobster, filet mignon and Dover sole.

The rival facilities are competing on a pricey field, with treatment at a top-of-the-line facility typically ranging from $30,000 to $70,000 a month. Promises brings in more than $15 million a year in revenue; Passages tops $20 million, and executives from both centers said business is still growing steadily.

"It's a big business. It doesn't take a rocket scientist to multiply 29 (the number of patients Passages can accommodate) times $60,000," Prentiss said. "But for some it's too expensive to compete these days. They have to make improvements, hire more therapists and raise their prices. Some people get cheated--they pay more but don't get more amenities or more treatment."

However, there's no shortage of clientele: In 2002 there were an estimated 18 million alcoholics in the United States, 15 million marijuana users and another 2 million-plus cocaine users. Alcohol is the addiction most commonly treated at rehab facilities, followed by drugs, gambling, eating and obsessive-compulsive disorders.

The proliferation of the facilities, both high-end and lower, is a problem for some Malibu residents, including Mayor Ken Kearsley.

"It's not the rehab--we are in favor of that. It's the attendant people that come along with the high end facilities--there are cooks, masseuses, attendants, manicurists, and the like," said Kearsley.

"They constitute a medical neighborhood and this is residential zoning. The amount of workers at the facilities is overpowering the infrastructure."

All treatment programs, regardless of size, must be licensed, though residential facilities with six beds or less are treated as single-family homes and are not subject to a city- or county-granted conditional use permit needed for a larger operation.

"If it was a hotel, the city would get a bed tax, a return from the hassle factor that is the cost of servicing these people," Kearsley continued. "We don't get any money out of it and we are impinged upon."

Passages had to fight off a lawsuit from opposing neighbors when it opened in 2001. Also, the Malibu City Council voted to back two state measures that failed last spring which would have given communities more ability to block the centers. The first, Assembly Bill 3008, would have restricted spot zoning approvals for drug and alcohol treatment centers. The second, AB1795, would have allowed cities and counties to deny licenses to treatment facilities based on an over-concentration in a particular area.

For now, the community and facilities have achieved a tenuous peace. And the publicity from the battle may have helped the Passages.

"We had seven TV stations come out," Prentiss said. "Suddenly everyone knew where we were; it put us on the map."

For the treatment center operators, personnel costs are typically the biggest expense, followed by mortgage payments (the median home price in Malibu last quarter was $1.8 million) and operating expenses.

"It's not a small chunk of change," said Dave Johnson, a co-owner of Transitions, a sober living facility in Malibu. "You need more than a few clients just to pay the basic bills, because there's substantial overhead involved. The rehab model where a place has multiple beds is where you will make the best money." Transitions is a smaller operation than most rehab facilities and focuses on sobriety-maintenance, Johnson said that the centers' electric bill alone hovers in the $4,000 a month range.

Even with a small center, maintaining facilities is costly, so offering enough extras to keep up with the Joneses is rapidly becoming an expensive proposition, even for the well-heeled centers. Promises has about 35 beds between its two facilities--22 in Malibu--and 120 staffers total.

"We have to constantly upgrade," Rogg said. "We just bought another 3.5 acres, land with tennis courts, an equestrian area, everything. With a six-bed treatment center you can't build a solid business. You need to be bigger than that to sustain operations."

New facilities tend to struggle with land clients, because they lack ties to the medical community and the word-of-mouth referral bases that established centers rely upon.

Because potential clients today often prefer the anonymity of the Internet when doing their research, many private programs are aggressively trying to connect there. Some use Internet search engine advertising to bring in business, paying for keyword combinations like "Malibu rehab" that will bring their facility name up first in a basic search on sites like Google or Yahoo.

Certain combinations can go for as much as $25 per click-through, which can quickly add up to $100,000 a month in advertising. The newer facilities have to try to meet clients' treatment demands to make a go of it, Johnson said.

"There's a lot of money running around out there, and lately it's not about how good a facility is but how good their marketing plan is," Johnson said.

In Los Angeles, there appears to be enough well heeled clients to support the proliferation of posh rehab centers.

"As far as addiction is concerned it doesn't respect any socioeconomic class," Blacksher said. "People who are very well to do become addicted, and if they can afford it, they want to go where there can be luxury and amenities."

By ANNE RILEY-KATZ

Staff Reporter