Pop star Britney Spears, who twice spent less than a day in rehab before entering a third time for a month after behaving erratically, was also back in the headlines with a celebrity magazine reporting more bizarre behavior by the singer.
"They have to have enough pain or enough external motivation to finally decide that they need to make the changes in their life," said Blank, director of psychiatric and psychological services at Caron.
Most often, that motivation is a run-in with the law, she said.
U.S. government statistics show that the criminal justice system was the main source of referral to treatment for those aged between 18 and 25, making up 47 percent of the 390,000 admitted to publicly funded programs in 2004. Around 17 percent were referred by themselves, friends or family.
CONSEQUENCES
John Southworth was an alcoholic and drug addict for 30 years and spent time in jail, but has been sober for 25 years and now works as an interventionist, helping addicts realize they have a problem.
"It's all about consequences," he said. "If we keep enabling them and don't allow them to feel the consequences then they will continue."
Southworth and William Moyers, also a recovering alcoholic and spokesman at the nonprofit Hazelden -- among the leading U.S. recovery centers for alcoholics and addicts -- both said celebrity entourages prevent famous addicts from realizing how serious their problem is.
"They have the trappings of success and a support structure that keeps them from plunging as quickly as the rest of us," said Moyers, adding that it took him four treatments over five years to commit to recovery. He said he has been sober for 13 years.
"Addiction is a chronic illness that does not discriminate and recovery is only going to happen when that person shows a willingness and a desire to get well," he said.
Some experts have accused Lohan and Spears of making a mockery of rehab by appearing not to take treatment seriously.
"When people deal with rehab as if it were a sentence being served, they are denigrating the value of rehab and it puts out a message to those who could profit from it that it doesn't work," said Sidney Shankman, president of Second Genesis center in Maryland. "Rehab does work."
Blank believes most people make multiple attempts to control an addiction before acknowledging they have a problem that needs intensive treatment.
"For people to take time out of their lives and be detoxed and be away from drugs (or alcohol) and think that then they can just go out and live life as usual, they're going to be sadly mistaken because this is such a serious illness," she said.
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