"Sexual disorders and behavioral addictions will be one of the top two mental health issues of the coming decade."
Those words from Robert Weiss, a licensed clinical social worker who has been treating sex addicts for 22 years.
Three years ago, Weiss merged his private practice with Elements, an umbrella company which owns a range of treatment centers, including Promises Malibu.
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Last week at Promises, Weiss opened "The Stimulant and Sexual Disorders Program." In his experience, the two behaviors are increasingly showing up together in men — often men with high incomes and powerful jobs. Traditional treatment programs have operated under the belief that "you just need to get sober, and all those other problems go away," Weiss said. He disagrees with that philosophy, believing that concurrent addictions need concurrent treatment.
Weiss gave an example of one patient he observed at another facility, a 48-year-old real estate executive who was married and well-off. "He was kind of a big mogul," he said.
The patient was in treatment for cocaine addiction and revealed that when he was high, he would pay for prostitutes, something he would never do when sober. The man told Weiss he'd been with 80 to 100 prostitutes during the previous year. "I thought, 'This guy is going to relapse on cocaine over his sexual behavior, and no one is asking him these questions. ... The environment is only treating half the problem."
Hence the new hybrid program at Promises, which is limited to six beds and is for men only. Weiss said 85 percent of the sex addicts he's seen over 22 years are men. In its first week, three men have taken up residence. Weiss said the problem of drug abuse mixed with sex addiction is increasing. "We have waiting lists for all of our insurance-supported programs," he said.
Why? "This is all technology driven," Weiss said. Psychology Today reported last year: "Subsequent to the Internet, there has been an explosion of out-of-control and illegal sexual behavior."
Weiss added, "I'm working with men who are 25 years old who've been looking at hard-core porn every day since they were 15." He pointed to apps like Ashley Madison, which help married people track down discreet dates. Finally, "Just ask Siri, 'Where are the hookers?' and you'll geolocate escort services," he said. (I tried this and he's right.)
Even as the need is increasing, Weiss said the recession has changed the treatment business. People are being choosier about what programs to pay for, especially at the high end where insurance won't cover the full price. The more expensive facilities, which used to win business on reputation alone, are now having to work harder to lure patients. "People no longer say, 'I've just got to go there.' "
The program at Promises lasts 35 days, and Weiss said the price is similar to other treatment programs at the facility, which cost "in the $50,000s." Promises provides patients with a chef, maid service, other amenities, along with a view.
"I've always believed you've gotta make your own bed," Weiss said, but now he's changed his mind. "Some people simply will not go where they have to make their bed," he said. "I now support whatever gets them in the door."
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Weiss said it's hard work to reverse the effects of mixing, say, meth with Viagra.
"Now you can be up for three days and be up for three days, if you know what I mean," he said. "When you get sober, one of the results is that not much feels pleasurable." His program provides a variety of treatment mechanisms, including things like "brain training" to help repair short-term memory loss that comes from sustained stimulant abuse.
As for potential symptoms that someone has a problem, Weiss had two bits of advice. "There is no such thing as casual use of meth," and, "If you are doing something sexually that you wouldn't do sober, that's a warning sign."