This article originally appeared on VICE UK.
I'm standing in an unremarkable square in Zurich, Europe's wealthiest city, after stepping out of the chauffeur-driven Bentley limousine that picked me up from the airport. A glamorous client relations rep takes me up an elevator and through a heavy unmarked door into a huge, luxurious penthouse suite overlooking the city's picturesque lake. What a flashy place to have a party.
But this—as well as another even more extravagant apartment next door, and an office and treatment rooms downstairs—is Paracelsus Recovery, where the world's super-rich go to get off drugs.
Saudi royalty, politicians, Russian oligarchs, business tycoons, trust fund kids and A-list celebrities have brushed their teeth in this marble bathroom and slept on this suede bed while confronting addictions to everything from cocaine to Xanax. Paracelsus Recovery is one of only a few clinics which form the elite tier of the luxury rehab market, unrecognizable from the functional rehabs available to most people who run into drug problems. Of course, it's gob-smackingly expensive. Forget the £20,000 [$26,280]-a-month celebrities spend at The Priory in Surrey, or the £41,700 [$54,794] they shell out for 45 days at the Meadows in Arizona. Paracelsus Recovery is on another level. A one week "executive detox" course here costs £78,000 [$102,478]. Five weeks of residential rehab costs a whopping £315,000 [$413,856] —about ten times the average UK annual salary.
In return, with the help of a coterie of 15 specialist staff, including psychiatrists and nurses, patients receive a bespoke "one client at a time" service, tailored around their every need. Anyone staying here gets the full VIP shebang: 24/7 limousine transportation, a personal chef, a butler and a concierge. Then there's the exclusive access to a five-star hotel spa, a live-in therapist (who sleeps in the spare room) and an extensive array of astronaut-style laboratory tests and medical check-ups to assess their brain and body biochemistry. The place only hosts around 20 clients a year here in the global banking hub of Zurich, but its staff are also dispatched abroad to treat wealthy clients who either do not have the time to come here, or who require aftercare.
Unlike most of the famous luxurious rehabs, where patients are humbled by making their own bed or pulling up weeds in a communal garden, the tycoons, princesses, and film stars who come here —a third of clients are from the Middle East, a third from the U.S. and the rest from Europe, Russia, and Asia—are free to carry on living a very comfortable lifestyle. Coming into rehab with an entourage of 50 as one Saudi prince did? No problem: You can take an entire floor at the nearby five-star Dolder Grand Hotel and Paracelsus Recovery will install the live-in therapist in a room there. U.S. talk show host dealing with alcoholism? They will fly you back to the U.S. to appear on your weekly live show before flying you back to Zurich to continue your treatment.
One of the key attractions for clients is the espionage level of privacy. While some celebrities use a stint in rehab as little more than a PR exercise to signal remorse or reflection, those coming here have too much to lose. Guests' real names are redacted in company communications, the apartment's address is not publicized, the limo's number plates are untraceable, emails with clients are encrypted and employees have to sign a very strict confidentiality contract.
"Anonymity was vital for me because I had some serious clients," Lucaz, one of Paracelsus' former clients, told me on the phone. The super-rich Polish-born international financier, who earns €2 [$2.2] million a month, decided to visit Paracelsus in 2015 when his party lifestyle began spiraling out of control. With a close-knit group of colleagues, Lucaz combined business with massive 24-hour party sessions, three days a week, sometimes on chartered yachts off the Cote D’Azur. Surrounded by escorts, Lucaz and his friends often hovered four to six grams of coke a night each, and eased down with the world's most expensive wines. "If it had got out on the grapevine that I was addicted to cocaine and alcohol, about my escapades with women, my clients would have deserted me. I would have lost a lot of money."
By the time he was in his 30s, the wheels came off his playboy lifestyle. Business deals fell apart because the partying was messing with his mind, he crashed his sports car and his girlfriend left him. Lucaz sought help for his addiction at a high-end 12-step rehab in Florida, but relapsed soon after. So, on the nod of a friend, he booked a five-week stay at Paracelsus Recovery. For him, it worked. For others, it didn't. But what's certain about this place is that those who come here will have their body and soul examined with all the scrutiny that money can buy.
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"There's no one-size-fits-all for successful addiction treatment," says Jan Gerber, Paracelsus Recovery's urbane chairman, who set up the clinic with his parents in 2012 after helping a CEO detox in their family home. Gerber believes his clients have a better chance than most, because of the firm's policy of intense focus on the individual, a tactic that's not financially viable in most rehabs.
"The underlying reasons for addiction in each person have to be identified and treated. We need to look at medical factors just as much as emotional ones," says Gerber. "These causes can be psychological, such as trauma, childhood neglect, or personality disorders, but also physical, such as biochemical deficiencies, impaired gut health, gland functioning, hormonal imbalances and chronic pain. They can also be spiritual, such as a lack of purpose."
The links between addiction and poverty are long-running and well-established; there is a correlation between deprivation rates and drug-related mortality rates in England. But having a ton of cash does not flameproof you from becoming addicted to drugs, and some research says it can actually make you more vulnerable.
In Zurich I met up with Michael*, CEO of a "multi-family office," a business that helps some of the richest families in the world spend their money. His company has a portfolio of 42 families who have a total of $4.5 billion in investable assets. Michael tells me rehab is a "big spend" within this group of ultra-high net-worth individuals: "It's shocking how many very rich people have drug addiction problems. Of the families we deal with, we've helped 40 percent with addiction issues."
At the International Conferences on Addiction and Associated Disorders in London in April, Chris Coplans of Narcotics Anonymous told a reporter for Tatler magazine: "The trend is now toward luxury. Rehabs have realized the money's in luxury, celebs and ultra-high net worth." Indeed, the luxury rehab industry is cut-throat competitive—so much so that some rehabs have been using dirty tricks to drum up business. Last year, a Times investigation revealed luxury rehabs had been paying psychiatrists six to seven figure kickbacks to refer addicted patients on to them. The rehabs caught paying psychiatrists included Life Works in Surrey, part of the Priory Group, and the Kusnacht Practice, an elite clinic near Zurich, which paid a British doctor £150,000 [$197,000] to persuade the late singer George Michael to stay there for six months in 2015.
So why are the world's 1 percent so prone to addiction?
Gerber says people who live easy lives, where desires are instantly satiated, eventually get bored. They are also ill-equipped at dealing with life. For some, being catapulted from modest backgrounds into celebrity, power and immense wealth can be as jarring as a fall in the opposite direction.
Being rich and powerful can actually act as a barrier to dealing with a drug problem, says Gerber. Because of their charmed life, they are shielded from the consequences of addiction for longer than most. "You can't be fired for taking drugs at work if you own the company," he points out. So it's harder for them to reach "rock bottom" – the moment of utter despair that can act as a trigger for many addicted drug users to get help. In addition, Gerber has seen many people turn to drugs after selling the company they have spent years building, only to find themselves kicking their heels, surrounded by a pile of cash.
It's not only the wealth creators who run into trouble, but those who become super rich by inheriting it. "We have helped people who have inherited fortunes but who have no job or purpose," says Gerber, "and many people fill that void with drugs or alcohol."
Gerber says some rich kids suffer "affluent neglect." such as being ignored by their parents and parceled-off to boarding school at a young age. "One of our clients got a yacht from her parents for her 40th birthday, which is amazing, but she has never had a relationship with them," says Gerber. "She was an only child brought up by nannies. Her longest relationship with a partner lasted three months, because she doesn't trust anyone—she thinks they're after her money. To fill the void, she became addicted to Xanax and beauty operations."
Among the people from super rich families he sees, sexual repression is a noticeable cause of addiction. "For example, last year we saw a princess who was a lesbian, and it was tough for her, because she feared being punished and locked away. It traumatized her and helped fuel her addiction to prescription pills."
It might be tempting to view the rich as undeserving, but Gerber disagrees: "We don't see them as spoiled, we accept their reality. No matter who they are, every human being deserves empathy. What the general public often sees as diva behavior is in fact a serious obstacle for positive treatment outcomes. They can walk away from treatment at any time they feel frustrated. It's part of the pathology, and we cannot just judge somebody who is ill for their behavior, even if it is seen as entitled or arrogant by many."
However, Gerber's mother, Dr. Christine Merzeder, the clinical coordinator at Paracelsus, says narcissism is a problem with their patients. "We tend to see a lot of clients with narcissistic traits or full-blown narcissistic personality disorder. They have a short attention span. A huge inner void. They don't know who they are. But they can be ruthless snakes-in-suits: they have a lack of remorse. Often they are totally unreliable and have a lack of responsibility for their actions.
"Then, maybe when they get criminally prosecuted or their partner leaves them or their mistress is depressed or their children sue them, their world falls apart and they end up in rehab. We have to help people with the things they cannot buy: self-love, emotional regulation, relationships, being in charge of your own life, being more responsible, and always to keep up hope."
When I ask Gerber about Paracelsus' success rate, he's circumspect: "Every rehab claims its success rate is high, but in reality it's difficult to measure." Because when people leave rehab, many lose contact and many relapse. Nevertheless, Gerber sees the 12-step programm used in many rehab settings—where clients undergo a spiritual awakening and work in groups—as outdated and restrictive.
The man who gets most up close and personal with the super-rich addicts is therapist Louis Fitzmaurice, whose job it is to sleep in a bedroom in the same apartment where clients stay. He usually joins them for meals. I ask him: surely it can't be easy living with a total stranger, let alone an incredibly rich one trying to kick an addiction?
"Yes, this is very intense—most therapy in rehabs is just a few hours a week," says Louis, who's been at Paracelsus Recovery for four years. "Some find it tough. Things get emotional. There's been a few broken chairs. But there's a reason I'm here all the time. You never know when people want to talk – it could be at 4AM, when they wake up needing help."
Before working at Paracelsus, Fitzmaurice spent six years working with homeless and imprisoned drug users in frontline drug treatment services in Liverpool, Glasgow and Dublin. Now, he treats the richest people in world. Are there any common threads? "I have seen the same pain, torment, struggle, abandonment, desperation and insanity here at Paracelsus that I saw on the frontline in prisons and council estates in Glasgow, Liverpool and Ireland. I see the same mental health issues in the housing estates as in here. At the root of it, [Paracelsus clients'] problems are no different than anyone else's."
Their chance of getting off drugs, however, is very different. It's important to make clear that Paracelsus Recovery is a world away from the institutional vibes of the average rehab, and the experience of most people needing to access drug treatment services, even in the most affluent parts of the world.
In the UK, for example, according to drug charity Addaction, cuts to drug and alcohol budgets have drastically reduced access to non-private residential rehabs. A recent study by Kings College University found inpatient detox support in England for people with alcohol problems has been cut by over 50 percent since 2011. Overall, the number of residential rehab centers in England has fallen by a third in six years.
"Residential rehab is a really important option as part of a fully functioning treatment system," says Addaction's Karen Tyrell. "Yet cuts to local authority funding, coupled with the government's decision not to ring-fence drug and alcohol treatment budgets, has created a storm of rehab centers closing their doors for good. Unsurprisingly, private treatment centres have really benefited from these closures, but the knock-on effect is that those without the funds to access them are too often left out in the cold. It's not right that the contents of someone's wallet plays such a big factor in their chances of recovery."
Matthew Gaskell, a clinical lead for addictions working for the NHS in Yorkshire, says that while people from affluent backgrounds experience similar mental health and addiction problems as anyone else, they "can often have greater cushioning against adversity." As a result, Gaskell says, "those from socially disadvantaged backgrounds are harmed in greater degrees, die younger, more likely to overdose, etc. The cushioning isn't there and there are greater stressors."
In the U.S., research has found only one in ten Americans in need of addiction treatment will access it. Ryan Hampton, an American activist and author on addiction, says: "The barriers that exist are enormous. So needless to say, treatment in the U.S. is completely out of reach for those that need it most. Even if you do have resources, you're looking down the barrel of paying up to $50,000 for 30 days. Of course, there are no guarantees it will be a success, even with such a high price tag."
Hampton says the addiction treatment industry in the U.S. is a $35 billion annual operation with little to no regulation: "Providers can literally make up their own care models out of pure air with no one to stop them. Federal and state regulators have provided no guardrails for consumers, and as a result the industry is basically a self-policing, wild wild west with no real accountability." He says families and loved ones have been told by unscrupulous rehabs their loved one will die if they don't take a second mortgage on their house immediately, to pay $40,000 for them to be shipped away and "fixed."
"We don't treat any other chronic health problem like this," says Hampton. "And if you're poor or have no resources, basically: good luck. We have a very poor recovery infrastructure in America to support people on public assistance. We can't even get safe, qualified care to the privileged few." He suggests a new recovery-oriented system of care that focuses on long-term outcomes, standardized and validated treatment modalities, marketing regulation and utilization of evidence-based care methods.
Back at Paracelsus Recovery, I ask Fitzmaurice which drugs the super rich are getting addicted to these days.
"There is still a lot of cocaine involved, but we are seeing people coming in with terrible problems with GBL, prescription opioids and Xanax. But the worst thing is that these people are living in a bubble that is not just of their own choosing," he says. "One pop star told me that when people look at him, 'They look at me like an alien… as if I have something extra, but it's not true, I have something missing.' He said it was a hole he filled with drugs. It's a lie that if you're a millionaire you'll be happy, it's a big con, and this is what people don't want to hear. I wouldn't wish fame on anyone."