Betty Ford Shared Her Story and Changed Addiction Treatment Forever
Susan Ford Bales recalls how her mother paved the way for destigmatizing substance use disorder.
On a spring day in 1978, former First Lady Betty Ford shared a story.
She told the world she had been struggling with alcohol and opioid medications, and was seeking help for substance use disorder. For any average person at the time, that admission might have turned them into a societal outcast.
But for Betty Ford, it saved her life. It restored her family. And it blasted a fissure into what is considered the biggest barrier to drug and alcohol addiction treatment: stigma.
It is estimated some 23 million Americans a year meet the criteria for substance use disorder while only about 10% access treatment, according to John F. Kelly, Ph.D., the Elizabeth R. Spallin Professor of Psychiatry in the Field of Addiction Medicine at Harvard Medical School, in The American Journal of Medicine, attributing the lack of treatment to stigma.
Betty Ford’s first step toward sobriety on April 1, 1978, was in response to desperate pleas from her family that she seek help. It would eventually turn into so much more: the founding of an addiction treatment center that would open in 1982 and bear her name. And decades later in 2014, The Betty Ford Center would merge with another addiction treatment center, Hazelden Foundation, to form the largest nonprofit addiction treatment provider in the country. The single goal was to deliver what Betty Ford initially envisioned when she recovered—to ensure access to high-quality treatment for individuals and their families.
Betty Ford has advocated for several causes, including the Equal Rights Amendment and Breast Cancer Awareness through her own diagnosis in 1974. So as another Dry January gets underway, the outcome, in a big way, surpasses the initial vision of Betty Ford. The foundation serves tens of thousands of patients and family members annually through treatment and many thousands more through its education, publishing, research and advocacy.
Susan Ford Bales—daughter of Betty and Gerald R. Ford Jr., the 38th president of the United States (1974-1977), and trustee of the Hazelden Betty Ford Foundation—spoke with East Wing Magazine in a Zoom interview about her mother’s legacy in addiction treatment. But as she recounted in our interview just two weeks before Christmas, that first step came with excruciating pain to her family.
Betty Ford’s alcohol and substance use are well documented in Lisa McCubbin’s 2018 biography of the former first lady, Betty Ford: First Lady, Women’s Advocate, Survivor, Trailblazer, which traces the root of her addiction to factors including being prescribed opioids for a pinched nerve stemming from her early days as a dancer, the demands of mothering four young children mostly on her own while her husband traveled during his political career, and the transition out of the White House. It was not unusual for Betty Ford to take prescribed medication and then continue the ritual of drinking a daily five o’clock cocktail.
In the early post-White House days, Bales, the youngest of the Fords’ four adult children, recalls her mother calling and inviting her to lunch at the club or to go shopping. “It was like watching a robot,” she says. “It was so slow. She was so medicated.”
Watching her mother’s condition degrade, Bales decided to do something about it.
“I was the one who confronted it. And it was hard to do,” explains Bales, who was 20 when she first tried to convince her mother she needed help. “But I was desperate, just like most family members are.”
The first time she confronted her mother about her health, Bales was accompanied by her mother’s personal assistant, Caroline Coventry. “She kicked us out of the house and called me a monster and said: ‘I never want to see you again,’” Bales recounts.
In hindsight, Bales says she blames her mother’s doctors for overprescribing medications. But in the 1970s, pharmacies were not connected, meaning they did not track prescriptions. Furthermore, labels on painkiller prescriptions warning about addiction wouldn’t be proposed until the United States was in the midst of an opioid drug crisis decades later.
“It just got worse,” Bales says. “So it was a real painful time for our family.”
Several weeks later and after pleading with her father to return home from a trip to help with her mother, the family made an agonizing decision to stage an intervention with their mother. It was April 1, 1978. The date, 15 months after serving as first lady, was so pivotal that the event is the centerpiece of the prologue in McCubbin’s book. There, in painstaking detail, the author tells how each family member, one-by-one, under the guidance of a doctor, pleaded with their mother to seek treatment. Seared in their memories, the author describes, is the image of their mother, dressed in a quilted, pink satin robe, blindsided by the confrontation.
In the end, as difficult as it was, it worked. Bales describes it as “extremely successful.”
“They’re not all successful,” Bales notes of interventions. “The biggest thing is mother agreed to go for treatment, so we were thankful for that.”
Treatment, however, wasn’t easy. Bales recalls certain bumps in the road. Like when Betty Ford arrived at the treatment center, she was shown to a room she would share with three other women. She was taken aback. The doctor, says Bales, was clever and offered to the former first lady to ask the other women to gather their things and move out of the room. To that, apparently Betty Ford said, “Oh. No, no, no.” She didn’t want to put anybody out.
“Addiction doesn’t care if you are the former first lady of the United States,” Bales says. “Addiction hits the painter, the plumber, the teacher, the veterinarian, the airline pilot—all of the above.”
What recovery is about is to stop isolating and start joining. In treatment, sharing rooms is an important part of connection, says Bales, adding that is why most treatment centers don’t have single rooms. For Betty Ford, that was probably the best thing.
“She had a clean toilet … and a list of chores,” Bales says. “What happens in isolation is the patient is not involved in life anymore. So [taking] small steps [like] going out and exercising and walking. Get back into life and experience life. And eventually, it’s with your family.”
Recovery becomes a cause
Betty Ford stepped into the addiction treatment field at the urging of her close friend Leonard Firestone, a staunch Republican, diplomat and businessman with ties to the family business, Firestone Tire and Rubber Company. He also had an alcohol use disorder. A year after Betty Ford celebrated one year of sobriety, she and her husband helped stage an intervention for Firestone.
“I’m doing the same thing Betty Ford did.” — Leonard Firestone, a Republican, diplomat and businessman with ties to the family business, Firestone Tire and Rubber Company
In that exchange, according to McCubbin’s book, she insisted he go to treatment. And when he told people around him that he was going to rehab, he said, “I’m doing the same thing Betty Ford did.”
That sense of pride and respect in invoking Betty Ford’s name would help bring addiction treatment out of the shadows. And when Firestone completed his treatment, he proposed he and Betty Ford co-found a treatment center that would eventually bear her name.
At first she was reluctant about having the center named after her. Bales remembers when her mother asked the family about the center having her name attached to it. “She came to all of us kids and she said, ‘I’m going to be around for a while, but you guys are going to be around even longer. How do you feel about it?’”
At that point, Betty Ford had been only four years sober. The family couldn’t have been prouder about the prospect.
“I’ve never had a day where I’ve thought, ‘Oh, I wish she wouldn’t have done that,’” Bales says. “I’m so proud of her. She did incredible things and she helped so many people—between breast cancer and substance use disorder—and has offered hope to many more.”
Tessa Voss, vice president of the California region and administrator for the Betty Ford Center in Rancho Mirage, California, knows this for a fact.
In 1978, when Betty Ford first sought help, she issued a press release on the same day announcing she was seeking help for substance use disorder. A couple days later, according to Voss, Betty Ford followed up with another press release that said she was struggling with alcohol and opioid medications. Those actions signaled the beginning of a long effort to destigmatize addiction, Voss says.
“Many people, after she was open and honest about her struggles, followed in her footsteps and sought help. We hear stories like that even today. People hear her name and say, ‘She got help, so can I.’” — Tessa Voss, vice president of the California region and administrator for the Betty Ford Center
“She kind of paved the way,” Voss told me in a Zoom interview. “Many people, after she was open and honest about her struggles, followed in her footsteps and sought help. We hear stories like that even today. People hear her name and say, ‘She got help, so can I.’”
Betty Ford also recognized how difficult it was at the time, and still is today, for women to seek treatment. Early on at the Betty Ford Center, she made sure there were always equal beds available to men and women.
“It’s hard to get women into treatment because they have family and children,” Bales says.
The Betty Ford Center started with one unit and has since expanded to 100 residential beds and 84 recovery housing beds. The Betty Ford name is on all of the 15 sites located across the country that offer inpatient and/or outpatient services, bio-psycho-social assessments, medical detox, mental health services, animal-assisted programming, education and support for families and children and post-rehab continuing care treatment.
More than 40 years have passed since the Betty Ford Center opened and nearly 10 years since the merger with Hazelden. The organization is still guided by Betty Ford’s early vision statement of “serving patients and saving families.” Her focus on families, including children, has been the cornerstone of the Betty Ford Center, according to Voss. In fact, in 2023 it received its largest donation ever—$10 million—to fund the creation of a national center for families and children.
“Another guiding light she provided not just for us but for the world is advocacy and the power of recovery and recovery stories to overcome stigma and shame, educate the public, and inform policy,” Voss says.
Although progress in reducing the shame associated with substance use disorder has come a long way, Bales believes it is still the most important aspect of addiction treatment to address.
“It should be treated medically, by the world, as any other disease,” Bales says, adding that no one blinks an eye if someone says they have heart issues.
She remains optimistic.
A legacy lives on
Perhaps Betty Ford, today, would have a hard time imagining the sustained impact she’s had on addiction treatment with her name emblazoned on a nationwide system of care like Hazelden Betty Ford.
The former first lady cared about expanding access to treatment for substance use and mental health. She cared about helping individuals and families find recovery. And, according to Voss, she wanted the Betty Ford Center to be a beacon of hope during challenging times in people’s lives.
“She accomplished all of these things and more,” Voss says. “She reduced stigma and increased hope people would feel by simply hearing her name, and just how synonymous her name would become with recovery across the globe. Her legacy is multifaceted and truly remarkable.”
The biggest thing Betty Ford did before dying in 2011 at the age of 93 was share her own story and normalize it.
“That impact is immeasurable,” Voss says.
To this day, Voss hears stories about people who are unsure about going to treatment until they hear her name associated with the center. Again, it goes back to reducing stigma and shame. “That really makes a difference for people in the depths of this disease,” Voss says.
For Bales, following in her mother’s footsteps is about as good as it gets, she says. Filling her shoes? Never. But she is dedicated to and proud of her work at Hazelden Betty Ford and recognizes the societal impact her mother continues to have on individuals and families seeking treatment for addiction.
“She was one of the first to really do something. She was so open and honest sharing her story,” Bales says. “I’m grateful she told her story and changed our family.”
Help is available. Call the SAMHSA National Helpline at 1-800-662-4357 for confidential, free help from public health agencies and to find substance use treatment informtation.
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