How do sobriety coaches help addicts stay abstinent?

Toronto Mayor Rob Ford is seen leaving a rehab facility north of Toronto on Monday, June 30.

TORONTO -- Toronto Mayor Rob Ford has engaged a "sobriety coach" after completing a two-month stint at an Ontario addiction treatment centre. But just what is a sobriety coach or companion and what do they do to help clients keep off alcohol or drugs as part of their long-term recovery?

While the existence of such sobriety buddies may be unfamiliar to many Canadians, the job of providing support to newly abstinent alcoholics or drug addicts has been fairly common south of the border for a number of years.

Celebrities like Lindsay Lohan, Matthew Perry and Owen Wilson have reportedly hired sober coaches, as they're more typically called in the U.S., to help keep them from taking a tumble off the wagon.

"Somebody needs a sobriety coach when he or she has made multiple attempts to maintain abstinence, multiple attempts at residential addiction treatment ... and multiple attempts at success -- always followed by failure," said Doug Caine, founder of U.S.-based Sober Champion.

The company, begun in 2006, has a stable of trained employees in such cities as New York, Chicago and London, who can be hired as coaches or companions to help keep recovering addicts on the straight and narrow, especially during the early and vulnerable period of sobriety. Last month, Caine expanded the business to Toronto.

"Ordinarily in the States -- and this may not carry into Canada -- when I talk about a sober companion, I'm talking about somebody who's present in your life 24 hours a day," Caine said from the Los Angeles area. "That's real full-time work. And that person may be in your life for a week or month at a time.

"A sober coach typically is a person who will spend a certain number of hours per day or per evening with you, and the truth is the roles can be interchangeable," he explained, noting that a client could, for example, ask the service provider to accompany them on an out-of-town business trip for a couple of days.

The service can last 30 or 45 days or longer, depending on the client's needs and pocketbook.

Sober coaches charge from CDN$75 to $150 per hour, so the service could cost as little as $300 to $400 a day for two to three hours, he said. With a 24-7 companion, who may be staying at the client's home, the cost can easily hit more than $1,000 per day.

Sober Champion employees -- all recovered addicts who must have specialized training -- work not just with the client but also with the person's family, close friends and even co-workers.

"We perform many interventions all day long," said Caine, formerly a professional musician who was hooked on heroin and cocaine until he finally got clean in 1999 and revamped his life.

"The goal is to model behaviour and to keep the eye on the prize -- and the prize is to keep him off drugs (or alcohol) today," said Caine, who is well-versed in Ford's very public battle with substance abuse, which has garnered international attention.

Those interventions can take many forms -- from discouraging contact with people the client used to drink with on adjacent bar stools to shutting down a person's supply of alcohol or illicit drugs.

Caine recalls going to a New York client's three favourite alcohol suppliers and persuading them not to sell to the woman, a "degenerate alcoholic," because they were feeding her illness and would be hastening her inevitable death from drink.

"I'll go so far as stealing somebody's shoes and keys and wallet," he said, adding that a service agreement signed by a client could also require them to surrender their passport, driver's licence, credit cards and any cash.

But Caine admitted that there are times when there's nothing a coach can do to stop a client from breaking down and plunging back into their habit.

"We can't tackle the person."

There are no rules about how far a sober coach or companion can go to protect their client -- nor are their services or training regulated either in Canada or the U.S.

Ford's sobriety coach is alleged to have kicked a protester while the mayor was holding a news conference Tuesday. Little is known about the man, and Ford's spokesman Amin Massoudi did not respond Thursday to a request for information about him, including whether he is on duty with the mayor around the clock or how long he will stay on the job.

Dennis Long, executive director of Breakaway Addictions Services, says the Toronto treatment organization does not use sobriety coaches.

"It's a new term to me," said Long. Although recovering alcohol and drug addicts typically have a sponsor to call on for support and advice through groups like Alcoholics Anonymous, "having someone with you 24-7 is not usual," he added.

"My assumption would be that they act somewhat like a sponsor in the AA sense. It's somebody who is responsible for helping the individual. Somebody would accompany them, be there for advice, for guidance to sort of warn them when situations are getting out of hand."

Long said that if the chemistry works between the two people, the concept of a sober coach or companion could be a good idea.

"But recovery's not a short-term process ... It's not just stopping using. Recovery is a multi-faceted process which requires change in virtually every aspect of an individual's life.

"And in the case of somebody like Mayor Ford, who is in a very, very high-stress, very visible position, it's going to be a big job for the sobriety coach to try to support him in that."

When relying on any service provider, and especially people who may not have had professional training and whose vocation is unregulated, "you can get good ones and you can get bad ones," he offered.

"If it works, it can work really well. If it doesn't work, it can go south in a really big hurry."