A must-have for recovering addicts: A celebrity's best friend

The actor Owen Wilson has a reputation as a party animal. The star of Wedding Crashers and You, Me and Dupree already had two stints in rehab under his belt when he attempted suicide last August by slitting his wrists and taking drugs.

The drama was played out in the media spotlight. "I respectfully ask that the media allow me to receive care and heal in private during this difficult time," Wilson said from his hospital bed.

The care he received to help keep his demons at bay was a $750-a-day " sober companion". For addicted Hollywood A-listers, a sober companion is the latest must-have accessory, hired round the clock to keep them on track and off drink and drugs.

Other names for the role include clean-living assistant, sober buddy, sober coach, sober babysitter and even "in-situ personal addiction counsellor". Robert Downey Jr, Lindsay Lohan, Matthew Perry and Robin Williams have all reportedly had one.

This minder system is being launched next month in the UK by Doug Caine, the founder of the Los Angeles-based company Sober Champion. Caine has been offering the service to the rich, and often famous, since 2005 at costs ranging from $550 (£270) to $1,500 a day.

"It works best after rehab," Caine says. "Instead of delivering you home without a rudder, we provide treatment in the environment where you need it most – at home, at work and at play. Sober companions help people in early recovery to take what they have learnt and put it to use in the real world."

A sober buddy will keep watch 24 hours a day, seven days a week, to protect a person from relapse, even if that involves sleeping next to his or her bed or on a sofa pushed against the door to prevent escape. Generally, the minimum time a sober companion is hired for is 10 to 14 days, but for a serial relapser it should be four to six weeks.

Caine once handcuffed a client to a radiator, but usually physical force isn't required. "We use every method in the book to strongly encourage our clients to zig instead of zag. Quite often it's about distraction: a client is obsessing about his girlfriend because she hasn't called back. I say, 'OK, let's go for a bike ride.' If a client invites a dubious friend over, I get them strip-searched before they spend any time together. I don't think twice about bringing in a drug-sniffing dog to sweep a client's apartment."

Other helpful tools against relapse include yoga, 12-step recovery meetings and the gym. "To be frank, if they want to play air guitar all afternoon, that's fine by me. Another sober day is a successful day," Caine says.

In some cases, Caine and his team practise fiduciary case management (FCM). "It means I'll have your bank card, ATM, cash, ID, cellphone, internet access, car keys. You'll have nothing."

Is getting a sober companion a good idea? "It's exclusive and expensive; it's not for everybody," Caine says. "Most people with substance misuse problems aren't celebrities, so most of our clients are executives, adolescents, housewives, businessmen, trust-fund kids and hardworking people who develop chronic substance-abuse problems."

One-tenth of his clients are people who need help with stopping smoking, diets, gambling and self-harm. But most of his clients have been to rehab. "It's easy to stay clean in rehab because they don't hand out cocaine. For a person who has been getting loaded and creating wreckage for years, a few weeks elsewhere is not going to 'fix' the problem, because really they need to be in rehab much longer.

"Theoretically, the client is taught to go to 12-step recovery meetings – but for many high-profile clients, once they leave rehab the same sycophantic enablers surround them. We facilitate the client's re-contextualisation of himself and his sickness and his healing – but we do it where they need it done."

Hiring a sober buddy can be substantially cheaper than an four-week stint in rehab. A high-end rehab in America, such as Cottonwood, charges $47,000 per month. In the UK, treatment centres such as Promis in Kent charge £16,660 per month.

A sober companion costs from $20,000 to $30,000 per month – but sober companionship works best in conjunction with rehab. "Most of our clients are not looking to nickel-and-dime their way into a solution – they feel frustrated, scared and alone," Caine says. "Usually, they have experienced multiple relapses. Although our model is more cost-effective, we do not advocate against rehab; we advocate expanding the model so it works after the client returns home."

After a bout in rehab, the newly sober person is very vulnerable. A film star, say, may want a sober buddy because they can't attend daily 12-step recovery meetings, as advised, due to shooting a movie. Rock stars may have to tour. Others simply don't have the time or inclination for rehab.

The music and film industries sometimes hire sober minders to keep watch on stars. "This can be a lot more demanding on the sober companion than a low-impact case with a willing client," Caine says. "A client's representative simply tells us that he has to get through a six-week tour without crack and booze – end of story."

So should we welcome the arrival of sober companions in the UK? Dr Robert Lefever, director of the Promis Recovery Centre in Kent, believes it is only appropriate to hire a sober partner in exceptional circumstances. "The person should be guided towards 12-step fellowship meetings after treatment. They don't generally need a full-time sober partner.

"Somebody who is an addict/alcoholic and also disabled physically or mentally may require personalised care, and it may be advisable if somebody is a recurrent relapser. But it is not acceptable to be too busy to go to 12-step fellowship meetings, however famous you are. Everybody can get to meetings. We get better when we do things the same as everybody else," Lefever says.

From his LA and New York offices, Caine – a recovering addict with eight years' abstinence, who still attends 12-step meetings – is hand-picking British sober companions for his London office. He already has a core team of 35 on call in the US.

Daily rates vary, depending on how much of a challenge the client is likely to be. "The dynamic ranges from cold and clinical to passionate and frenzied. A person in early recovery can appear clinically insane. Whether he is or is not has no bearing. A person in early recovery who is suffering from post acute withdrawal syndrome has incredible mood swings. I charge more for the clients who bring all kinds of drama with them."

What qualifies a person to be a sober companion? The minder is often a recovering addict/alcoholic with at least five years' abstinence from all mood- and mind-altering substances. They must have 2,000 hours' experience working in the field of substance abuse treatment.

"All sober companions have something indefinable that allows them to respond empathetically yet firmly and with appropriate boundaries, to a person in early recovery."

Caine and his team focus on the clients' hopes and dreams rather than deficiencies and pathologies. "The whole world is accustomed to looking at them as idiots and liars. We give them a new experience and give them positive reinforcements as frequently as we can."

The sober companion's goal is to help the client re-pattern his thinking. "All they know is, 'When I walk in my house, I do drugs.' There is nothing in residential treatment that can undo that. We go shopping with you because for a person whose drug of choice is alcohol, they don't know how to walk into a grocery store and buy eggs, bread and butter without stopping in the booze aisle."

Sober companions will go to the workplace and to office parties, weddings and court hearings with clients. "I've even visited them in jail when they blew it," Caine says.

At office parties, the sober companion is introduced as an old friend or a cousin from out of town, but they are there to stop the client picking up a glass. "Part of the psychology is that the client knows I'm there. Sometimes it's a game; the client tres to get one over on me. Often he doesn't know how to avoid picking up a glass. The subtext of 'Walk over here to the buffet' is 'Walk away from the bar, idiot.'"

What is it like having a sober companion? A former Sober Champion client, Brandon Lucks, 19, is now six months clean from class-A drugs. His parents hired a sober companion when he had to leave rehab in LA after 60 days to have heart surgery, before returning to rehab two weeks later. "Doug moved in with me and my parents and slept in the guestroom," Lucks says. "I had the drugs out of my system but I still wanted to get high. I needed somebody to show me how to stay clean until I was back in rehab.

"Doug came with me to 12-step recovery meetings and the cinema, and fitted in perfectly with all my family. He took me to the hospital and was there when I woke up after surgery. A couple of times I didn't want to go back to rehab, but Doug said, 'You can't keep running away.'"

But the relationship between companion and client can be fraught. "I've been fired and then hired 30 minutes later by the same client," Caine says. "But ideally the relationship evolves into one of mutual trust and respect. My goal is not to sit on you; my goal is to allow you to have a liberating experience in your own environment that doesn't involve drugs."

Sober Champion, LA, New York and London (www.soberchampion.com; www.soberchampion.co.uk)

Good buddies: how to keep it clean

* A sober companion is somebody who brings treatment to a client's own home, usually after rehab, to protect against relapse.

* The cost is $550 to $750 a day for a "low impact" case. High-maintenance clients may cost $1,150 a day.

* The companion keeps watch 24 hours a day, seven days a week.

* The minimum period of hire is usually 10 to 14 days. Ideally, they stay for four to six weeks.

* Extras include sweeping property with sniffer dogs and strip-searching visitors.

* Fiduciary case management (FCM) means that the client gives the companion everything from car keys and bank cards to mobile phones.

* The music and film industries are increasingly employing sober minders to keep watch on celebrities who have no desire to stop drinking or drugging.

* Most sober companions are recovering addicts/alcoholics with at least five years' abstinence and more than 2,000 hours of experience working in the field of substance abuse treatment.

* Daily methods vary from distracting clients with bike rides and yoga to 12-step meetings, prayer, blocking exits, confiscating possessions and talking them out of relapse.

* High-end rehab in America costs about $45,000 a month (£16,660 a month in the UK); a sober companion costs from $20,000 to $30,000 a month.