Clicking to Recovery in Twelve Cyber Steps


When Chuck Warner, 74, sold his San Francisco company, Bayside Metals, in 1996, he fell off the wagon. After 19 years as a CEO, Warner was miserable, feeling he wasn't prepared for retirement. He caught a cold and suddenly found himself spending two weeks at home drinking bourbon after 13 years of sobriety. "I always thought that if you don't drink, you can't sell steel," he says by way of explaining how he acquired his taste for liquor during the early days of his career.

Since then, Warner has been attending Alcoholics Anonymous meetings. That makes him one of an estimated 5.8 million people in the U.S. getting some kind of substance-abuse treatment. There are some 18 million Americans with alcohol problems, and an additional 5 million who abuse drugs, according to a March, 2001, report by the Robert Wood Johnson Foundation, a nonprofit organization devoted to health and health care. In 1997 -- the last year for which figures are available -- an estimated 73% of illicit-drug and alcohol users were employed.

CYBER SPIN-OFF. Now there's a cyber alternative for Warner and others like him: A new startup called eGetgoing has created an online 12-step program to help alcoholics and drug users through recovery. In July, 2000, the $5 million San Jose (Calif.) company was spun out of CRC Health Corp., which owns and operates 25 U.S. residential and outpatient facilities that have treated more than 30,000 people in 20 years. CRC, which retains a 10% stake in the startup, expects the two companies to get back together later this year, if eGetgoing can prove that its concept works.

Launched on Mar. 5, the program lasts 12 weeks and requires patients, who are referred by counselors, companies, or courts, to attend two online group meetings per week. eGetgoing links group members by voice and chat rooms, while guiding them through discussions, explanatory videos, and slides by one of eGetgoing's 10 therapists. After the program, eGetgoing stays in touch with weekly follow-up cyber meetings for nine more months.

Plenty of other sites, such as thekouch.com and soberrecovery.com, offer discussion boards and links to resources for recovering substance abusers. But David K., who tracks developments in online recovery programs for Alcoholics Anonymous, says that eGetgoing is the first program he has seen that offers assessment-based therapy online.

BABY STEPS. EGetgoing CEO Barry Karlin, who also heads CRC, is the first to point out that this effort is in its infancy. "We have to do a bigger sample to prove this thing beyond doubt," he says. Only 15 patients have completed the full program. To date, Karlin hasn't signed a contract with a company or agency that would feed large numbers of patients into the program, although that's what he hopes to achieve over the next four months.

Karlin says that a few big companies, including Cigna and Boeing, are already taking a look at the program, which eGetgoing hopes to market as an adjunct to the employee-assistance programs many companies already use to aid troubled employees. CRC, for instance, is promoting the program with its clients. The ever-optimistic Karlin expects the company to have generated $3 million in revenues by yearend and says his goal is to increase that tenfold in 2002 by expanding to offer treatment for eating disorders, depression, and anxiety.

The company believes demand for online counseling could explode. In November, California passed Proposition 36, requiring the state's nonviolent drug offenders -- estimated at 37,000 each year -- to undergo treatment rather than incarceration, starting at midyear. Demand from companies also could be strong. That's because with labor in short supply, many companies have raced to fill job vacancies in recent years, often without doing adequate drug testing, says Robert Stephenson, director of the division of workplace programs for the U.S. Substance Abuse & Mental Health Services Administration (SAMSHA). Many of those employees may need therapy.

CHEAP CURE. At $1,200 for the full therapy program, eGetgoing isn't cheap. But for HMOs and companies (which often end up footing the bill for employees' treatment), eGetgoing could be highly attractive. That's because it's far cheaper than residential programs, like the Betty Ford Clinic's 28- to 32-day inpatient care in Rancho Mirage, Calif., which costs nearly $15,000. Online therapy also eliminates the need for patients to travel to meetings. That's a big plus because only 10% of patients complete outpatient therapy, and the dropouts often cite a commute as the reason for not finishing the program, says psychiatrist Paul Rosenberg, eGetgoing's chief clinical officer.

Some patients prefer online counseling. The anonymity of dealing with others through a screen name was one reason a 52-year-old mother of three in California turned to eGetgoing for help dealing with her 10-year binge-drinking habit. "I have a hard time being honest in front of a lot of people," she says. But online, opening up to other group members was easy, she says, adding that she has been sober for four months and is now back at work. The eGetgoing program also bestowed an unexpected benefit: It helped overcome her wariness of speaking in front of others. She now attends daily AA meetings and finds herself being "more honest" than before. She says she now refers other AA members to eGetgoing's Web site, too.

EGetgoing's eight-person sales force has been making sales presentations to corporations, insurance companies, federal agencies, and the courts. In May, the company is hoping to close on a second, $5 million round of financing so it can expand its marketing effort. The aim is to do 1,000 presentations to potential clients this year. "AA isn't everywhere, and eGetgoing could be," says Judi Kosterman, vice-president for business relations.

But will companies and organizations buy into the idea? Terree Schmidt-Whelan, executive director of the Pierce County Alliance in Tacoma, Wash., is interested. Her nonprofit helps 300 felons beat their drug habits every year. She's considering using eGetgoing's online lectures, among other things, for a segment of that group.

EMPLOYER LIABILITY. Skeptics of online treatment say there's no substitute for in-person therapy and evaluation. "Is [online treatment] better than ignoring an issue? Yes," says Mark A. de Bernardo, founder and executive director of the nonprofit Institute for a Drug-Free Workplace. But under the rosiest of scenarios, such treatment may have to be augmented with in-person assessments of an employee's progress. One reason is that most workplace violence involves substance abuse, so to avoid lawsuits down the road, employers need to be sure that an employee isn't faking recovery.

Still, online treatment clearly has value. AA members have formed more than 140 online groups, notes David K. "When I wake up troubled [early] in the morning, I don't have to wait for a meeting to start" to get support, he says, because chat rooms are always active. Of course, therapists can't reach out from behind a computer screen to stop a patient from taking a drink. But Karlin believes some cyber counseling could help a lot of troubled employees get back on track. By Mica Schneider in New York


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