By SARAH KERSHAW


In the days following Michael Jackson’s death, people close to him said they had warned his family and pleaded with him to get help for drug problems.

Authorities looking into his death now say they believe Mr. Jackson, who in 1993 was treated for a painkiller addiction, had prescriptions written under more than a dozen false names.

“He was surrounded by enablers, including a shameful plethora of M.D.’s in Los Angeles and elsewhere who supplied him with prescription drugs,” Deepak Chopra, the high-profile spiritual guru and a friend of Mr. Jackson’s, wrote on the Huffington Post Web site on June 26, shortly after the singer’s death. “As many times as he would candidly confess that he had a problem” to Dr. Chopra, he wrote, “the conversation always ended with a deflection and denial.”

Specialists in drug interventions - a rapidly growing field since the concept was developed in the late 1960s - have watched the Jackson case closely, viewing it as a classic example of lost opportunity. Denial is at the core of addiction, and breaking through it, many experts say, can require extreme measures.

Whether Mr. Jackson was addicted has not been established, but investigators are proceeding under the assumption that drug abuse was involved. They are pursuing a homicide case against his personal physician, who reportedly administered a dose of a powerful anesthetic, propofol, before he died.

Mr. Jackson’s biographer, J. Randy Taraborelli, who knew him for 40 years, said in an interview that family members had made attempts at interventions in recent years.

The most common form of intervention, known as a “living room ambush,” relies on surprise and an ultimatum. The addict is lured to a meeting with a promise like “Grandma has a check to give you this Sunday.” Bags are packed for a stay in a treatment center, and the family is encouraged to draw the line in unison: get clean and sober, or get out.

This approach is also called the Johnson method, named for an Episcopal priest, Vernon E. Johnson, whose seminal book, “I’ll Quit Tomorrow,” gave rise to the belief that family and friends, aided by a professional interventionist, could break through the alcoholic or addict’s denial.

Some experts now caustically refer to traditional intervention as the “A&E model,” a reference to the popular reality show “Intervention,” which profiles families and addicts and ends with a surprise confrontation.

But critics say such a showdown can add more trauma to already devastated families and addicts, and deter an addict from getting help.

Just as Mr. Jackson’s death has highlighted the difficulty of trying to help a chronic drug abuser, it was the death of another celebrity, Kurt Cobain in 1994, that added momentum to an alternative philosophy of intervention known as “motivational interviewing” or “invitational” intervention.

Mr. Cobain, a heroin addict, committed suicide days after disappearing from a rehab center he had agreed to enter after a classic tough-love intervention staged by his wife, Courtney Love, and his Nirvana bandmates, according to news accounts at the time.

It prompted concerns about all-ornothing interventions among psychologists and addiction experts, according to G. Alan Marlatt, director of the Addictive Behaviors Research Center at the University of Washington.

Motivational interviewing and other less confrontational approaches involve asking an addict to join family members, who may attend lengthy counseling before and after the encounter with the addict. The family does not necessarily demand that an addict or alcoholic quit using or drinking; they may be asked to cut down their use - part of a treatment known as “harm reduction,” which is itself controversial.

“I guess motivational interviewing is not going to be the next reality TV show because it’s so boring,” said Jeffrey Foote, a founder and the executive director of the Center for Motivation and Change, a treatment and research center in New York. “It’s nuanced, it’s gentler, it’s working with people in a slower way, and it’s effective. But that’s not good TV. What’s good TV is taking drug addicts, harnessing the anger people feel toward addiction and drug addicts, and smashing them in the face.”

One of the newest alternatives to the Johnson model, developed by Brad Lamm, a New York City interventionist, relies heavily on technology like Skype, podcasts and Internet chatting to connect families with addicts in an effort to include as many significant friends and relatives as possible.

“The thinking was that the addict needs to be captured, then once captured needs to be treated,” Mr. Lamm said. “But what I know from working with families is that we can use the family strength to get us where we want to go, to healthier relationships, even in the face of crushing addiction.”


Addicts are confronted on the show Intervention.