Affluenza Anonymous: Rehab for the Young, Rich, and Addicted

Staff members at Newport Academy in Bethlehem, Conn.
It’s easy to sneer, but maybe there’s something to the premise that wealthy kids have a particular set of mental health and addiction problems.

Tall, lean, and lantern-jawed, Jamison Monroe Jr. could pass for a third Winklevoss brother. His childhood in Texas, as he recalls it, was a series of misadventures with addiction: pretending to have ADHD in ninth grade to get Adderall; getting booted from his Houston prep school; being arrested five times and cycling through four rehabs, all with no real effect. He was a spoiled rich kid, the namesake of a prominent Houston financier. “I had such low self-esteem and such severe depression that drugs and alcohol worked,” Monroe says. Until, of course, they didn’t. “I did self-harm, cutting myself, burning myself, contemplating suicide. Plus a lot more cocaine, a lot more drinking, blacking out a lot more. Everything just got progressively worse and worse.”

Even at his life’s darkest moments, young Jamison had something available to him that thousands of other people don’t: seemingly limitless access to wealth. Despite going through a divorce, his parents could afford to help him through his DUIs and expulsions and send him anywhere in the world to get better. In 2006, after a host of false starts and detours, including a therapeutic wilderness program, he found the right place for him—a 30-day, $2,200-a-day program in Malibu with a full team of specialists drilling down into the root causes of his addictions. “I had a primary therapist, I had a family therapist, I had a recovery counselor, I had a spiritual therapist,” Monroe says. Slipping easily into the patois of recovery, he explains that the real culprit behind his drug use was a lack of self-worth that all the money in the world couldn’t help him overcome; all that overflowing privilege, he suggests, may have been part of the problem. “The focus was on my negative self-beliefs, which stem from early childhood—this feeling of not being good enough.”

When he emerged from the program he was 25, with no college degree, no career, and no obvious prospects. Six months later, Monroe came up with a startup idea. He went to his father and asked for the money to open a drug rehab facility of his own. It would have been comical if it weren’t also poignant: What do you do if you’re a young, rich screw-up who wants to help other young, rich screw-ups? Ask Dad to buy you a rehab.

Jamison Monroe Sr. let his son down gently. “It’s not happening at this point,” he said. But what both understood, after so much exposure to so many addiction treatment services, was that opening a rehab center in America is practically as easy as opening a fast-food franchise. From the research he’d done since getting out of rehab, Monroe knew that of the 10,000 or so behavioral health-care providers in this country, more than 90 percent are single operators, mom and pops. A large number of those are started by people in recovery themselves. You don’t need to be a doctor to start one; you just have to hire a qualified staff.

One more thing made the rehab business appealing: The demand for treatment constantly overwhelms supply. So many providers are springing up so quickly that quality varies wildly, and regulation and oversight are spotty. Many rehabs avoid regulation entirely by being what the industry calls “sober houses,” where the license sits not with the residence but with the professionals doing the clinical work. Monroe spent a year starting a sober house for an investor friend, in part to prove to his father that he was serious. “When I showed him that I had basically broke even the first two months of operations with a shoestring budget, that gave him enough confidence to say, ‘OK, yes.’ ”

Jamison Monroe Jr.
Monroe was a privileged teenage addict himself.
Photographer: Simone Lueck for Bloomberg Businessweek

In the spring of 2009, a few months after Monroe’s 28th birthday, Newport Academy opened the doors of a six-bed rehab facility for adolescent girls in a spacious house on a residential street in the hills of Orange County, a horsy suburban neighborhood miles away from the more glitzy, Real Housewives-ready Laguna Beach. This house came to be known as the Ranch—a one-floor Spanish modern on 3 acres of arid California hillside. A few months later, Monroe opened a second location in another house not too far away, for six boys. These rehabs were more regulated than sober houses, licensed as group homes by the California Department of Social Services. Anxious to establish a serious pedigree, Monroe appointed David Smith, founder of the Haight Ashbury Free Clinics of San Francisco, as his medical director. Smith, who stayed four years before leaving Newport Academy in 2013, says he was glad to help start a facility that “demonstrates that you can successfully treat adolescents. For adolescents, just talking about how bad drugs are, that isn’t going to do it. They have to find positive alternatives.”

Monroe was alone in the Orange County marketplace, without any serious competition. “There were teen treatment centers in L.A.,” he says, “but you had 6 million people between Orange and San Diego counties and nothing for them.” He also stood out for the sheer opulence and pampering he provided his young patients. The Ranch’s nickname may make it seem rustic, approachable, back-to-the-land, but its parlor has four ornate chandeliers. Its grounds have a rose garden and stables. There’s an on-site gym for mixed martial arts, yoga, meditation, and dance and movement therapy. There’s art therapy, cinema therapy (watching and discussing movies), and an on-site chef offering organic nutritional counseling and cooking classes. Newport Academy’s staff-to-client ratio is 4 to 1—not counting the horses that each resident is given regular time with for equine-assisted psychotherapy. At $40,000 a month, there may be no other teenage rehab in America that, at first glance, seems more like Canyon Ranch. “What’s the price on a kid’s life?” Monroe said in an interview a few years ago about the cost of Newport Academy. “If you’re a parent of a child, there’s no price tag you can put on that.”

The first few years were a struggle. With no reputation, Monroe had difficulty filling beds. But in some ways, his timing couldn’t have been better. The opioid epidemic was hitting all segments of America, and many wealthier families are eager to resolve their child’s problems with as little stigma as possible. To build credibility, or at least visibility, Monroe became a talking head on CNN, opining about Charlie Sheen (“He’s in the vicious cycle of relapse”), Lindsay Lohan (“Her mother was the ultimate enabler”), and Amy Winehouse (“The only thing that is worse than the drugs themselves are the enablers. ... It is actually cooler to be clean”).

In 2012, Newport Academy got approval from the Commission on Accreditation of Rehabilitation Facilities, a 50-year-old international nonprofit that issues a sort of Good Housekeeping Seal for the industry. Since then, Monroe says, he’s operated in the black. In 2013 he opened a 20-bed facility in a 65-acre nature preserve in Bethlehem, Conn. Then came a private school and outpatient facility in Darien, Conn., then a therapeutic high school in Manhattan, and just this year an expansion to 50 beds in Bethlehem and 24 in Orange County. Monroe is scouting locations in Tennessee and Georgia and hopes to open a facility serving the Southeast as early as 2017. “You just have to love them,” he tells many of the people he’s hired to care for his clinic’s young patients. “Just love them.”

Newport Acadamy Bethlehem compound
The Bethlehem compound, where 50 young people are treated at a cost of $40,000 a month apiece.
Photographer: Simone Lueck for Bloomberg Businessweek

Simply by design, Newport Academy would seem to endorse the idea that rich addicts need a different kind of treatment from the rest of us, one that caters to the very specific issues deriving from their wealth—what some might call “affluenza.” That decidedly nonclinical term gets thrown around a lot when we talk about kids who grow up in a world where they don’t suffer consequences, where entitlement creates a sense of infallibility and blots out any desire for a conscience or responsibility or right and wrong. Monroe, now 35, maintains that he doesn’t believe in affluenza. At the same time, he does believe in “providing above-average living standards” as “a way to destigmatize, take away the shame of having to go through a very, very difficult process. Because change is not easy.”

Everything that seems like a perk at Newport Academy, Monroe argues, is therapy. His favorite is yoga and meditation, which he credits with helping bring about his personal transformation. He still meditates daily. Equine therapy, he says, helps kids focus on and care for something other than themselves. “Equine therapy is a metaphor for relationships,” he says. “You cannot approach a horse with anger and rage. You have to build trust.” Even baking in the kitchen or pruning roses in the garden can be therapeutic, he argues, if it helps draw out kids who can’t just sit and talk about their problems.

In this way, Monroe has embraced an increasingly popular model of drug and alcohol treatment that shifts the focus from the patient’s willpower. Too many 12-step-based programs are about “forcing people to be contrite,” says David Sheff, author of Clean, an excoriation of the 12-step model. “It’s all about punishment and prayer and morals.” In his 2008 memoir, Beautiful Boy, Sheff memorably wrote about his son Nic’s failure to respond to that traditional approach. “You’ve got a teenager who by definition is not interested in following rules,” he wrote, “and then he’s on methamphetamine, which means he’s even less likely to follow the rules, and then he’s in a place where he’s punished for not following the rules.”

Monroe goes one step further by describing Newport Academy as a mental health facility first and an addiction center second. About a quarter of the kids, he says, aren’t there for substances but for self-harm, eating disorders, or suicidal depression. A few employees from Newport Academy’s early days privately express skepticism about a treatment center offering an addiction framework to kids who might not even need it. “If you admit a teen that doesn’t meet criteria for dependence,” one says, “and the first thing you ask them to do is to admit they’re powerless over a chemical, then that’s inappropriate.” Monroe, in turn, says he uses 12-step programs only for the kids who need it, and the exposure to those programs mostly is a way “for our kids to see and hear from other kids who are living successful lives.” To steer them in that direction, he employs alumni coordinators to stay in touch with patients after they leave and keep them coming back for reunions and hikes and parties and discussions. This, he says, has helped them maintain a success rate of 85 percent.

Newport Academy towels
Photographer: Simone Lueck for Bloomberg Businessweek

The perks of the place inevitably serve two purposes: They calm wealthy parents afraid of sending their children to a facility that seems like a prison, and they get the kids to feel a little less persecuted. “I didn’t think that I needed to go,” says a young woman named Carter, who was one of Newport Academy’s first clients in 2009, after being expelled from her boarding school. “I made a lot of poor choices with alcohol, drugs, boys, food.” Her family was wealthy, and their intervention took her by surprise. The facility itself surprised her, too. “The whole mentality of ‘We’re going to love you, so you can love yourself’—it’s not a shame-based program. It was in a beautiful house.” Slowly, she opened up. “It gave me the opportunity to talk about things that I had never spoken about,” she says, “like the low self-esteem and the anxiety and depression.” At home, she says, all that “was like a taboo topic.” She’s since graduated from college and is seven years sober.

One barrier many of the kids face, at first, is their sense of entitlement. Jake Giffin, admitted to Newport Academy in 2013 for alcohol, pot, and Adderall, was attuned to the wealth of his fellow patients. “I had memories of wealth, but we weren’t rolling in money,” he says. “You get a lot of people there that have been pampered their whole life, and they don’t do so well entering a structured environment. There’s a lot of name-calling and just a general sense of, ‘I don’t have to listen to you.’ That disappears pretty quickly when all your freedoms are being taken away.” He’s attending the University of California at Berkeley now. “I don’t know how much I believe in the whole affluenza thing,” he says, “but I can certainly see the perspective there.”

On the night of June 15, 2013, a 16-year-old from Dallas named Ethan Couch was driving 70 miles per hour in his dad’s hulking Ford F-350 truck when he lurched off the road and collided with another car. He killed four people and seriously hurt two friends who were sitting in the back. One of those friends is paralyzed for life. Couch’s blood alcohol level was 0.24, three times the legal limit. He was also on Valium. His wealthy parents were divorced, and he’d been overindulged his entire life. His mom let him have Vicodin when he was 9; his dad had let him drive to school at 13. At the time of the crash, he’d been living more or less alone, partying constantly, in a 4,000-square-foot house.

The damage he caused was shocking enough. But it was what the defense’s psychologist, G. Dick Miller, said in court that launched a thousand cable-news tirades. For perhaps the first time in a courtroom, the term “affluenza” was invoked to describe Couch’s upbringing—that is, he grew up in a world without any consequences and suffered from an undeveloped sense of responsibility. Shockingly, the judge seemed to agree. She sentenced Couch to 10 years of probation; prosecutors had asked for 20 years in prison. And the California rehab where he was expected to spend a year after the ruling was Newport Academy.

The outrage was palpable. Less wealthy children across the country got jail time for far less severe offenses. Even the famous rehab booster Dr. Drew Pinsky called it “disgusting.” The ruling was like the O.J. verdict in some ways, but in one way it could be worse: Successfully arguing for mercy based on affluenza seemed to prove not only that money buys the best defense but also that money is its own defense.

Newport Academy became the symbol of everything wrong with the justice system. Couch had already spent 60 days at one of the Newport Academy houses in Orange County before the trial, wearing a neck brace from the crash the whole time; his parents had participated in family therapy there, too. Now, with everything Monroe had worked for in the cross hairs, he found himself defending the poster boy for affluenza, live on CNN.

Monroe believes in “providing above-average living standards” as “a way to destigmatize, take away the shame”

“I don’t believe in the term ‘affluenza,’” Monroe told Anderson Cooper on the air. He noted how Couch had been diagnosed with a substance abuse problem and grew up in a dysfunctional family with verbal, emotional, and physical abuse. “You know, in a country where we allow alcohol and pharmaceutical companies to advertise and promote the use of drugs and alcohol, I really think we have it backwards if we keep just sending kids to jail,” Monroe continued. “They’re simply acting in the way the popular media in this country is telling them to.”

When the anchor cheekily complimented the amenities of Monroe’s facility—“I mean, honestly,” Cooper said, “it sounds like a place I would like to go to for a year”—Monroe’s response was sarcastic, defensive: “If I put 20-foot walls and barbed wire around the property, would that, you know, arguably change someone’s opinion?”

Pinsky, also part of the roundtable, jumped in: “Unfortunately, it’s a place he should have gone before he killed other people.”

Couch never returned to Newport Academy. His parents, citing cash-flow issues, sent him to a state-run facility in Texas. His story only got worse. Early this year his mother helped him leave the country and violate probation, and he’s serving an adult sentence of nearly two years in jail. Monroe sees a wasted opportunity. “Instead of taking accountability for Ethan’s actions, he was enabled to run away from them,” he says. “They only created more chaos for themselves.”

There’s likely one reason, above all others, that Monroe never wavered in his sympathy for Couch: He couldn’t help but identify with him. He remembers being 18 and just starting college at the University of Texas at Austin. “I was drinking and taking Xanax and Valium and Vicodin,” he says. “I was very scared because I would wake up and not have any recollection of the night before.” Late one night, he was driving and took a right from a left-turn lane across two other lanes. He was luckier than Couch. A cop pulled him over and arrested him. He has no memory of being behind the wheel.

The court mandated a psychiatric evaluation. He was told, for the first time, that if he didn’t go to rehab, he might kill himself or someone else. He remembers his father coming for him, his suit on, the picture of authority. “We walked outside to the parking lot and my dad, in his very businesslike manner, said, ‘What’s the plan of action here?’ ”

Monroe told his dad he wanted to go into treatment. It would take seven years for him to get clean. But this was a turning point. “It was the first time in my life,” he says, “that I’d ever seen my dad cry.”

Newport Academy poster
Photographer: Simone Lueck for Bloomberg Businessweek

This is the part of the story where one makes the awkward case for, if not affluenza, then at least the emotional vulnerability of the young, rich person. The most widely known progenitor of this idea is Suniya Luthar, a psychology professor from Arizona State University whose research suggests that affluent youth suffer in very specific ways—depression, anxiety, self-harm—that can lead to substance abuse and “rule-breaking behaviors.” Luthar often talks about how well-off kids can, in a way, be as neglected as kids in poverty and forced, as Couch was, to grow up fast in a world without structure. It’s two versions of neglect—one rich, one poor; one filled with material things, one submerged in scarcity. “For both rich and poor teenagers,” she has concluded, there can be “low levels of maternal attachment, high levels of parental criticism, and minimal after-school adult supervision.” Among the wealthy, Luthar has blamed some of the problem on parents who treat their children as machines even as they largely ignore them. Those are the two big parental mistakes, as she sees them: “excessive pressures to achieve and isolation from parents.”

While other rehabs have family weekends, Newport Academy requires more regular sessions with a family therapist. It’s the job of Heather Hagen, the academy’s family program director, to bring families into the treatment. Sometimes it means confronting those issues of neglect. Wealth, she says, is just one more factor to deal with—an enabler.

“With affluence comes a lot of access,” she says, sitting with Monroe in a den at the Ranch. “They’ve got a car. It’s easier to get over on your parents. They aren’t going to notice if $500 is gone out of their wallet.” She has stories about mothers whose kids pawned Mom’s engagement ring while in the throes of addiction. The flip side of wealth, she says, is how it facilitates neglect. “If you’ve got unlimited resources,” she says, “you can justify your not being there by providing monetary things.”

Monroe nods. “Dads who say, ‘But we gave you everything.’”

Hagen smiles and adds: “ ‘But the nanny was there.’”

Monroe again: “‘I bought you this brand-new Mercedes. I pay for your private school. You’ve got the best tutors. You’ve got a private baseball coach. I don’t come to your games because I’m working all the time.’ I’ve heard so many dads, including my own, say this. ‘I work all the time to provide you with this lifestyle, to provide you with all these things. That’s how I love you.’ But a young person—an adolescent, and especially a newborn, a toddler—they obviously don’t get that.”

There’s a cognitive dissonance to their predicament. And their parents have bought into it and reinforce it: this sense that these kids ought to be grateful for everything they have, and that failures, small and large, aren’t justifiable. Is it any wonder, then, that they grow up paralyzed, lacking the most elemental of life skills? It’s beyond entitlement—it’s a corrosive arrested development. Until they come to rehab, they can’t even come up with a rational narrative of neglect because they’ve been so coddled.

Part of the cure for affluenza, then, requires the parents to realize and acknowledge that money does not equal love. The kids, in turn, need to be validated. As Monroe puts it, it’s about “letting them know it’s OK that if your dad drives a Tesla and you live in a gated community and you’re still miserable, you have as much of a right to need help as anyone else.” The big accomplishment for these kids, he says, is “to be able to sit there with their family and say, ‘I don’t need any money, don’t need a new car. I just need you to have dinner with me. I need to go on walks with you.’ ”

At times it can be difficult to see exactly where the teen’s rehab ends and the parents’ begins. “Once we start peeling the onion,” Monroe says, “the parents realize it goes all the way back to the parents’ childhood and how they were raised and the insecurities that they have about themselves.”

“I have a dad right now whose daughter’s getting ready to graduate with us,” Hagen says. Through family therapy, he realized something about himself. “He’s sober now,” she says. “He’s on Day 35.”

At times it can be difficult to see exactly where the teen’s rehab ends and the parents’ begins.

At a certain level, Monroe is a businessman marketing an expensive product. “What we tell parents, and the way I look at it, is it’s an investment in your kid’s future,” he said a few years ago in a documentary he helped produce about the drug problem in Orange County. “First of all, we’re saving your kid’s life. Second, we’re setting them up for success with treatment.” The amount of money parents spend, he notes, is comparable to what they might waste on tuition for an addicted child. “You don’t get refunded when your kid drops out of college, right?”

He’s also a patient, after a fashion—shaping and maintaining these facilities and programs is part of his own ongoing treatment. “When I was in my last treatment center, one of the things that I worked on with my last therapist was to figure out, Who is Jamison?” Monroe says. “And Jamison, at the core, is a nerd. I love to learn, and I love to go deep on things and figure out why things work.”

This side of Monroe is gaining him at least some acceptance from his peers. “I don’t think he’s just in this for the money,” says Tom Horvath, an influential addiction expert who founded Practical Recovery, an alternative to 12-step programs. Still, Horvath offers measured praise to Newport Academy; the luxury can’t help but put some people off. “I don’t actually object to Newport Academy’s existence,” he says, “but they are only a part of what our health-care system needs to have.”

Monroe hears this a lot. He usually responds by detailing how hard Newport Academy works to get insurance to cover costs for most kids, and how not all the kids who come are rich. Do rich kids need something different? To him, that’s not the question. “I think everybody needs something different,” he says.

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