Aldon Smith walks off practice field

Aldon Smith’s locker at Candlestick Park was cleared out yesterday as reports surfaced that he was on his way to an inpatient treatment facility. His accident and arrest for suspicion of DUI was the first egg smattering on the face of the current 49ers regime — while DUIs are fairly common in the NFL, Smith has been in the center of several dangerous incidents now. Jed York, Jim Harbaugh and the 49ers took a lot of heat for the decision to play him Sunday.

They won’t have to face criticism over Smith’s playing time for a while now. The talented linebacker is off to seek help for his alleged alcohol and drug problems, and while these situations are probably pretty common all over major professional sports, they’re also kept behind closed doors and largely misunderstood.

Before I decided to make a push towards getting into the more entertaining (and much less lucrative) field of journalism, I wanted to be a counselor. I spent a few months working as an assistant at a drug rehabilitation center in the Bay Area, so I have some understanding of what the future might hold for Smith.

Keep in mind that every situation is unique, and no one except for Smith himself and those closest too him know exactly what ails him. What I write in here is not an indictment on Smith or his character. I’m not saying that Smith is an addict or an alcoholic and this may not depict exactly what his recovery entails. But if Smith is actually seeking help for a problem with substance abuse, this should help you understand what the process is like.

What happens now

He is reportedly on his way to an inpatient treatment program, which means he’ll be safely tucked away from drugs, alcohol, media scrutiny and football for an extended period of time. Inpatient programs are facilities where patients check in and live for a while (like what you saw if you watched “Celebrity Rehab,” minus the cameras and all of the manufactured drama), unlike outpatient rehabilitation, which can involve daily visits for counseling, drug tests and groups while still allowing the patient to go back to their home and work.

Checking into inpatient drug treatment means Smith will be away from the team for at least 28 or 30 days. Many treatment programs can last longer than a month — some can last for as long as six months or even a year — but the decision for a patient to stay longer is usually decided upon mutually by the program director and the patient himself based on how much progress has been made over the course of their stay.

Treatment centers are expensive and many are all-inclusive. Some require blackout periods in which patients are restricted from outside contact, usually for the first week. Most don’t allow cell phones — communication is made through pay phones during predetermined times. Visitors are allowed occasionally. Their visits are predetermined by the patient; they must check in before visiting, sign a HIPAA agreement to protect privacy and have anything brought in searched by facility employees.

The recovery regimen usually involves a variety of groups run by counselors. They can include family recovery or relapse prevention in an effort to keep addicts from going back to drugs and alcohol after a period of sobriety. While some treatment centers don’t use it, the most common format for recovery is the 12 steps created originally by Alcoholics Anonymous.

Make no mistake about it: most people don’t end up in a rehabilitation center by accident. Smith acknowledged “this is a problem” when he addressed the media yesterday, but that statement alone won’t be enough in treatment. Patients in drug rehabilitation are encouraged to start accepting their problem and identifying as an “addict” or an “alcoholic,” a symbolic first step towards finding a solution.

The misunderstood case of addiction

Alcoholism and addiction have existed for the entirety of documented human history, but to this day science hasn’t been able to nail down a cause. Substance abuse appears to be genetic (individuals with alcoholic parents or close relatives are much more likely to be alcoholic as well), and yet scientists haven’t found a gene to cause it. Still, the American Medical Association did recognize it as an illness in 1956 — this is why many drug treatment programs are covered under basic insurance policies.

Addiction is considered incurable, progressive (the effects of addiction get worse as it goes untreated) and in many cases, terminal. Unfortunately, people don’t regard addiction as an illness in the same way they see something like diabetes. It seems to be seen as an illness of choice, while most addicts will probably say they’re overwhelmed by an urge to continue using despite the negative consequences. A solution definitely exists — millions have recovered using the 12 steps or religion, for example — but most of these cases involve a complete lifestyle change.

That lifestyle change starts with a change of scenery. An addict doesn’t necessarily need to leave their stomping grounds completely (this is an unsuccessful tactic known as “a geographic”), but avoiding temptation is paramount while the steps are consummated. Old friends have to be put aside, clubs and bars avoided. Addicts are urged to surround themselves with like-minded people in order to reinforce new, healthy life choices.

Working and completing the 12 steps is an arduous task in itself. Once a problem is acknowledged, a regimen is implemented to clean up the past and prepare for a better future. The addict finds a trusted confidant known as a “sponsor,” creates and shares a personal inventory of past misdeeds with them and makes amends to those they’ve harmed. Once the steps are completed, daily reflections and an effort to help others get sober act as maintenance steps. Continued regular attendance at Alcoholics Anonymous or Narcotics Anonymous meetings is a must.

The difficult road for celebrities

“Anonymous” is a misunderstood aspect of AA. The program has no leaders and is largely self-policing, meaning not all members adhere to the saying “what you see here, let it stay here.” It’s the responsibility of any celebrity in the program to keep their own membership anonymous with the media, but it serves more as a protection for the program so there are no spokespeople. They can’t keep others from saying who was at a meeting they attended. This makes the recovery of public figures unusually difficult.

The lifestyle changes may be even more drastic for celebrities. Athletes and movie stars live in a world where parties, money and extravagance define them. Recovery demands a more wholesome way of living, and many have trouble accepting it.

For athletes, long hours at the facility and lots of travel make it tough to sustain a program that requires consistency. Sober companions can be hired (they’re not cheap) to literally stay by their clients side during every waking hour. Josh Hamilton, for example, had an ‘accountability partner’. While it may not be a long-term solution, it can be an effective way to avoid disaster during early recovery.

Whether Smith is actually a drug addict, alcoholic or nothing at all is not for us to determine. This is an extremely personal matter and it’s something Smith will need to find out for himself. But Smith is seeking help now and, labels aside, change will be essential for his future.