It is August 1995. I am sitting in a lecture hall at my treatment center, listening—and quietly wondering—why recovery seems so elusive for people with money, visibility, or a recognizable last name. A friend’s brother in St. Paul has cycled through multiple treatment programs. A celebrity’s child has died. Several relatives never even made it through the door. The pattern feels impossible to ignore. What is going on?
One crucial and often unspoken factor is anti-affluence bias within treatment settings—held not only by fellow patients, but at times by the very professionals entrusted with our care.
Many people are surprised by this reality. After all, treatment is supposed to be a refuge from judgment where we all share the same goal of recovering. Yet for affluent patients, it can become another place where we are quietly disliked, openly resented, or subtly dismissed. Some providers fail to intervene when wealth-based hostility emerges in group settings; others, consciously or not, allow stereotypes about privilege to shape the level of empathy and therapeutic rigor they offer.
The peer community we are told to rely on—our fellow addicts—can present its own challenges. Rather than finding solidarity, affluent patients may encounter resentment, suspicion, or exploitation. Financial stability or social status can make us targets rather than equals, undermining the safety and trust essential for meaningful recovery.
When this bias goes unacknowledged, it does real harm. It fractures the therapeutic alliance, distorts group dynamics, and leaves affluent individuals navigating addiction in an environment that treats them as fair game rather than as human beings in pain. Recovery requires honesty, vulnerability, and connection—conditions that cannot flourish in the presence of prejudice, regardless of its source. Let’s explore in depth these rarely talked about barriers to recovery.
Defining Wealthism: Prejudice Against the Well-Off and Well-Known
Wealthism refers to prejudice against wealthy individuals—attitudes and behaviors that dehumanize, stereotype, or objectify people based solely on their financial status[i]. It is often fueled by a complex mix of awe, envy, resentment, and moral judgment.
The term was first defined by Joanie Bronfman in her doctoral dissertation, which drew on in-depth interviews with one hundred men and women raised with significant financial resources. Her research made explicit what many affluent individuals already knew intuitively: bias against the well-off and well-known is not rare—it is pervasive. Nowhere is this more evident, or more consequential, than in addiction treatment settings.
Wealthism: Impactful Clinical Consequences
Within the treatment community, wealthism is not merely an abstract social phenomenon; it has concrete clinical consequences. It is, in my view, a significant and underrecognized contributor to relapse. Many affluent families, often guided by well-intentioned but poorly informed interventionists, send their loved ones into treatment environments that are not emotionally or psychologically safe. In these settings, self-protection becomes the primary task. Recovery—rooted in vulnerability, trust, and openness—takes a back seat.
Counselor/Staff Bias
How do I know this? In the late 1990s, a local treatment center conducted an internal survey assessing staff attitudes toward wealthy patients. Nearly half of respondents expressed explicitly negative views about this population. Later, while interning at an inpatient facility, I witnessed how these biases surfaced in subtle but damaging ways: treatment planning discussions colored by assumptions about privilege, lax or uneven group oversight, and offhand staff comments that reinforced stereotypes rather than challenged them.
Patients, too, often mirror society’s broader resentment of wealth and fame. Group dynamics can shift quickly when an affluent peer is perceived as “offending” the group norm. The individuals who seemed to attract the most hostility were not necessarily the loudest or most disruptive, but those who symbolized inherited or marital wealth—stay-at-home spouses of high-powered executives, or so-called “silver spoon” patients. In these moments, the therapeutic container fractures, and the very environment meant to foster healing becomes another arena of judgment and harm.
The Treatment Environment: Peer led AA Philosophy
Most inpatient treatment centers organize daily life around a peer-led Alcoholics Anonymous model. In practice, this means patients largely regulate themselves, with counselors present primarily during standard working hours. Outside of those hours—particularly in the evenings—groups are often led by designated patient leaders following lectures or structured programming.
In theory, this model is meant to foster accountability and shared responsibility. In reality, the absence of consistent adult oversight can create a volatile social environment. It can resemble a fraternity or locker-room culture for men, and a sorority or bachelorette-party dynamic for women—energetic, insular, and largely unsupervised. Under these conditions, treatment can devolve into a Lord of the Flies setting, where group norms are enforced through ridicule, exclusion, or outright shunning. Patients who are perceived as “different” are especially vulnerable, and for the wealthy or well-known, this experience is distressingly common.
My own experience stands in contrast. As a former DKE member and football team captain, I was socially equipped to navigate—and even thrive in—this environment. But many children of wealthy or famous families are not. Adolescents, in particular, often struggle deeply. Their most common survival strategy is concealment: hiding their background, minimizing details during group sharing, and carefully editing their stories to avoid triggering resentment.
For a short stay, this kind of emotional self-erasure may be enough to get through twenty-eight days. But for minors and young adults—those seventeen and under—who are confined to treatment for months at a time, hiding is not a viable solution. In these prolonged settings, harm and exploitation frequently go unchecked. See Paris Hilton’s, This is Paris. For her perspective on abuse and failed treatment in under 18 “camps”.
When recovery never truly begins, repeated relapse is not evidence of defiance or failure—it is the predictable outcome of an unsafe therapeutic environment.
- This is why the rhetoric of “tough love” after two or three relapses is so misguided.
Many of these young people were never given a genuine opportunity to recover. That’s how someone can go through 17 treatments and never maintain abstinence. Treatment failed, not the patient. (See my article, Addiction Treatment Designed to Fail, for more on this topic.)
To summarize: most treatment environments are not safe for individuals from wealthy or prominent families. Yet parents and family members are rarely told this. When patients raise concerns or report mistreatment, they are often dismissed as manipulative or dishonest—a consequence of having lied while actively using substances. Even in sobriety, they remain presumed guilty. To quote Rob Reiner:
When Nick would tell us it was not working for him, we wouldn’t listen, he said. We were desperate, and because the people had diploma’s on their wall, we listened to them when we should have been listening to our son.[ii]
Never, ever put a young adult out on the street. There are many better ways of dealing with resistance.
This dynamic fractures families and makes it easier for interventionists and treatment providers to demonize patients, mislead parents, and protect financial interests. When the system prioritizes profit and reputation over patient safety, the burden of disbelief falls squarely on those who are already most vulnerable.
Protecting Ourselves: Avoiding Anti-Rich Sentiment
Exposure to wealthism often begins early. Many affluent individuals encounter it first in childhood and then again, more acutely, when they seek help as adults. Outside of these contexts, affluent young adults frequently move into social and professional environments where interactions with the broader population are limited, buffered, or mediated by status, role, or hierarchy. Even the workplace—one of the few remaining points of contact—tends to be voluntary. Many step away from demanding careers to prioritize family life, asking a reasonable question: What is the value of wealth if it costs us our ability to be present parents?
Childhood, however, offers no such insulation. Name-calling—“rich kid,” “silver spoon”—along with heightened aggression in competitive settings such as sports, is a common experience. Over time, many of us learn not to deflect this hostility, but to absorb it. Rather than bouncing off, the message sinks in. For some children, the conclusion becomes internalized: there must be something wrong with us. That belief often follows us into adulthood.
Internalizing Shame
This internalized shame becomes especially consequential in treatment settings, where wealthism, as discussed earlier, remains a significant barrier to recovery. Here, affluent patients face a double bind. The psychological wounds created by wealth-based prejudice are legitimate therapeutic material—yet speaking about them risks provoking the very bias that caused the harm. To raise the issue is to invite further judgment or dismissal.
The result is silence. We are left trying to heal injuries we are not allowed to name, navigating recovery in environments where honesty about our lived experience can make us less safe. It is a profound contradiction: treatment asks for radical vulnerability, while the culture surrounding wealth punishes those who dare to describe its costs.
What Time is It?
When we finally seek help, we know exactly what time it is. Our reality is no longer abstract—it is crashing into us, demanding action now. Recovery begins with telling the truth: sharing our story and being accepted for who we are, both the damage and the dignity, without spin, secrecy, or image management for the sake of family or reputation.
That is why, when I visit well-off patients, they are often relieved to talk with me—someone they believe they can trust with their truth. Ironically, it is rarely the specific details of anyone’s life that matter most. What connects us is not the résumé or the backstory, but the emotional struggle of coming to terms with addiction itself. Despair, fear, grief, and frustration are universal. The facts vary; the feelings do not.
For affluent patients, however, this process frequently breaks down. When we speak honestly about our lives, we are not met with acceptance but with judgment or rejection. As a result, many learn to protect themselves by editing their stories or remaining silent altogether. They hide. I often advise speaking in generalities at first:
- I work in a family business. I grew up with money and it’s part of what’s killing me. My parent was successful, but emotionally unavailable.
Avoid unnecessary details. Let peers come to know you as a person before you share the specifics of your background.
At the same time, it is important to remember that self-advocacy is not arrogance. It is okay to say, This is my life. I am dying from this disease, and I am going to speak my truth. When it comes from the heart, it lands as sincerity, not entitlement. I deserve to be heard. How often do any of us say that—out loud—outside of a therapeutic space?
Some affluent individuals choose segregated treatment settings designed specifically for professionals or wealthy clients. While these programs often offer luxurious amenities, comfort is not the same as clinical depth. High thread counts do not substitute for effective therapy. More importantly, recovery should not require retreating from the broader community out of fear. Specialized groups can be valuable, but prejudice should never dictate where we are allowed to seek help.
I was reminded of this at my fifth-year anniversary medallion presentation, when two peers—a lawyer and a psychologist—remarked that coming from money must make abstinence easier. The truth is more complicated. Yes, money can fuel addiction, often making it harder to stop. Over time, financial stability can ease certain pressures, if the family welcomes the recovering person back into the fold. But that was never the point.
After five years, I stepped away from regular AA meetings, returned to my men’s support group, and continued working in the field. I had learned what I needed—and I no longer needed the additional burden of navigating bias alongside recovery.
Next time: How Wealthism Harms Us.
[i] The Experience of Inherited Wealth: A Social-Psychological Perspective. UMI 1987
[ii] LA Times, 12/15/25 What we know about Nick Reiner, who struggled with addiction and shared his recovery with the world