KATE MOSS’s rock star boyfriend, Pete Doherty, should at this moment be facing what has become a rite of passage for any self-respecting party boy: rehab. This is not the first time for the former Libertines frontman. Indeed, he is already something of a veteran.

If you have followed his stumbling trail, you will know that he is quite familiar with the 12-step programme and other programmes. Last May there was the Priory in West London, but he checked out before the rehab was complete. Then it was off to France, where again he didn’t fare well. Finally he was booked into the Thamkrabok monastery in Thailand, where the regime includes emetics and prayers. He lasted three days. So this is attempt number four. Will he make it this time? Who can say, but in all the coverage no one has questioned that rehab is his only hope.

In the last decade or so, it has become a kind of modern heresy to doubt the efficacy of residential rehabilitation, and of the 12-step programme on which it is often based. Nothing else works, we are told.

But does rehab actually rehabilitate? As private individuals and the NHS pour millions into this method, a growing number of addicts and those involved in their treatment are asking if it is really the only way.

“The NHS should get out of it entirely,” says Mike Fitzpatrick, a London doctor. “As a GP, I see people who were involved in drugs years ago and now have stopped. Very rarely has it got anything to do with therapeutic interventions, it is usually down to something that has happened in their life. The drugs lifestyle is so boring, so tedious, that most people come to realise there is something better out there.”

He is not alone in thinking this. In America, there is a vociferous lobby that says people give up drugs and drink because they “grow out it”. They realise that there are more interesting things to do than nurture their addictions. The trouble with 12-step programmes and rehab, say critics, is that they encourage people to build their lives around drugs and alcohol when they are no longer indulging.

Take Kelly Briggs, a 27-year-old who has been in residential rehab four times. As she tells it, the funding, procuring and taking of large amounts of crack cocaine and heroin is a full-time job. But so is not taking crack and heroin. I meet Briggs a month after her last rehab has ended. Her time is spent liaising with her key worker, her probation officer, her drug testing supervisor, and other recovering addicts. There is still a lot of time to kill, a junk-shaped hole to fill, and the few hours a week she spends on a GCSE course doesn’t seem engaging enough to make a life without drugs more stimulating than a life with them.

“It’s good in rehab because you are in a bubble,” she says. “You are not really in society, just in this house, working on your emotions and s**t like that. It’s good because you don’t have feelings when you are on drugs. But after six months you have to go into the real world and that is the hardest part.”

Briggs started smoking crack at 14, taking heroin at 18, and was a daily injecting addict by the time she was 20. In trouble with the law for prostitution, she made her first attempt at detox at a residential rehab centre in London. She stuck it out for two days.

She tried to get clean again in 2002, when she was 25. “They said there would be a doctor 24/7 but all I saw was a nurse.”

Briggs eventually went abroad for implants which make heroin ineffective. She then went to prison, was released on a drugs treatment and testing order (DTTO), and went to a daily centre for meetings with other addicts. That was not a success “We used to use the breaks to plan where we were going to score,” she says.

After four months in a residential rehab, she spent two months in a unit in Hastings. “I just cleaned toilets. It was like slavery. They didn’t help me find a place to live or tell me how to get a job.” (The treatment centre say they work hard on helping clients find a place to live, a course or job to do.)

Just what constitutes good treatment and failure is open to interpretation, but the numbers don’t look good. The National Treatment Outcome Research study, which looked at over 1,000 drug users with long term opiate dependency found that only 38 per cent of them were drug free five years after treatment.