Most "rehabs", and Tharros House is no exception, in the US embrace a religious/spiritual approach to the problem of addiction which was created by a failed stockbroker in the 1930s and shows remarkably little evidence of efficacy. In fact, from a list of treatments for alcohol use disorder, 12 Step approaches ranked 38th in effectiveness - well behind cognitive behaviour therapy, assertion training and marriage guidance counselling, to name but a few. The treatment industry in the USA is there to make money and has a symbiotic relationship with the fellowships of AA and NA, whose members it employs in large numbers, often despite a lack of good qualifications. That industry is currently worth in the region of $35 billion a year. I do not know how much of the $35 billion is generated by repeat business. I do however know that in any other field of medicine, these results - about one in twenty moves into lasting sobriety - would be unacceptable and considered unworthy of the name "treatment" since it is no better than the rate of spontaneous recovery from the condition. I also know that in other fields of medicine if one treatment proves unsuccessful, you go on to try a different treatment. You do not blame the individual for the treatment failure and put them through the same treatment again, telling them to try harder and change their attitude. I don't know why the USA is so enamoured of "rehab" when it doesn't even work, but my best guess is that one should follow the money to find out who has a financial interest in maintaining the status quo over there. It is very sad, because in the rest of the world, we are much more interested in evidence of efficacy and in harm reduction. The US system is failing many people who could have been helped by other treatment modalities, and this needless loss of life - because of the 12 Step hegemony - is troubling.