Commentary

Editorial: Betty Ford Transformed Public Perception of Addiction


 

Betty Ford never intended to become a symbol and international advocate for substance abuse treatment. At the close of Gerald R. Ford’s presidency in early 1977, the first lady anticipated a quiet retirement with her husband in the California desert. Mrs. Ford’s use of alcohol and prescription analgesics, originally prescribed for a pinched nerve, fluctuated throughout her adult life but had not yet reached a level of persistent clinical concern.

The Fords’ relocation to Rancho Mirage, Calif., offered peace and quiet away from the media glare of Washington, but Betty Ford’s use of alcohol and pain medications soon increased to alarming levels. Initial efforts to persuade Mrs. Ford to seek treatment were unsuccessful; as she later wrote of her own thinking, "My makeup wasn’t smeared, I wasn’t disheveled, I behaved politely, and I never finished off a bottle, so how could I be alcoholic?"

Photo courtesy Library of Congress

In 1982, Betty Ford and her friend Leonard Firestone established the nonprofit Betty Ford Center in Rancho Mirage,Calif., where more than 90,000 people have received treatment.

In 1978, her family staged an intervention. After a medical detoxification, she entered the drug rehabilitation program at Long Beach Naval Hospital, based on the Minnesota Model first popularized at Hazelden.

Following her rehabilitation, Mrs. Ford sought to create a treatment center replicating features she found helpful and germane to her own treatment. In 1982, she and her friend Leonard Firestone established the nonprofit Betty Ford Center in Rancho Mirage, where Ford served as chairman until 2005. More than 90,000 people have received treatment at the Betty Ford Center to this day.

Mrs. Ford’s disclosure of her substance abuse during interviews and in her memoir, Betty: A Glad Awakening (New York: Jove Press, 1987), lent legitimacy to the idea of alcohol and drug addiction as disease entities. The stream of Hollywood celebrities seeking treatment at the Betty Ford Center further legitimized the disease model of drug abuse and need for humane, respectful treatment settings.

A key feature of the Betty Ford Center is gender-specific treatment, with a particular expertise on treating women with substance abuse. In 2003, Mrs. Ford wrote, "Female patients are reluctant to discuss their failures, fears and anger, their flights of fancy, their shame and guilt, their abuse experiences openly in front of men." To this day, the Betty Ford Center reserves half of its beds for women, and all inpatients are housed in gender-specific residence halls. Mrs. Ford also sought to replicate her experience of having a roommate during rehabilitation.

Another main aspect of treatment at the Betty Ford Center is an emphasis on family involvement. Mrs. Ford entered treatment at her family’s insistence, and soon after her rehabilitation program, her husband gave up alcohol to support his wife’s efforts at sobriety ("Betty Ford’s final interview with the Desert Sun," July 8, 2011). Families of inpatients at the Betty Ford Center are invited to participate in Family Week, a psychoeducational program that teaches family members about alcoholism and drug addiction as diseases, and uses role playing and communication strategies to modify dysfunctional family interactions.

More recently, the Betty Ford Center developed a specialized program for licensed professionals struggling with substance abuse, including physicians, nurses, attorneys, and airline pilots. The demand for services for impaired physicians has increased recently, particularly as state medical boards have modified or eliminated physician diversion programs. The licensed professional program includes 90 days of specialized treatment with integration of two specialized 12-step programs: Caduceus, comprised of health professionals; and The Other Bar, comprised of legal professionals.

Mrs. Ford’s work also helped to destigmatize other mental health conditions and that co-occur with substance abuse, including depression and bipolar disorder, anxiety disorders, and attention deficit disorder. Sound psychiatric treatment and supportive therapies need to be provided in a balanced way to treat these "dual diagnoses." This has led to the emergence of newer residential treatment models in mental illness that utilize a synergistic, holistic approach to empower individuals to become self-aware, self-monitoring, and able to provide for their own sense of emotional control and eventual wholeness.

Betty Ford maintained her sobriety until the end of her life. Because of the prominence of the center, Ford told an interviewer in 1997, "It certainly made it obvious that if I was not going to stick to my program, it was going to be national news," she said in the final interview. Because of her dedication to this, and other causes, in 1991 Betty Ford received the Presidential Medal of Freedom from President George H.W. Bush.

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