In the lush hillside of affluent suburban Cape Town, two women, apparently dressed for a beachside holiday, dangle their legs in a swimming pool, while a group of friends at a table nearby laugh, chat and take in the view. They’re all guests at what looks like an upmarket resort, but they’re not here for a holiday. All are addicts in treatment – most of them from Europe – and are part of a phenomenon that’s making the luxury rehabilitation industry one of the few that’s profiting from the recent recession.

As stressed-out senior executives find themselves under more scrutiny than ever to perform at work, growing numbers are turning to alcohol and cocaine, only to find their habit threatening to lose them their families and their jobs.

“The pressure on people in work is so much harder now,” says Dr Niall Campbell, a consultant from Priory Roehampton, one of Britain’s biggest private residential addiction centres. “Someone said to me the rule is you get two jobs or no job – people are doing twice the work of before [the recession], and there’s a management style that says if you don’t like it you can F-off and we’ll get someone else. Some people will deal with this stress by drinking, and there’s now a tsunami of alcoholism.” In January alone. at Priory Roehampton, where 70% of clients are businesspeople, the number of inpatients went from five to 21.

“People were saying, ‘Jesus Christ, I can’t do another year or another Christmas like that’,” adds Campbell.

At The Causeway Retreat, a residential treatment centre a helicopter ride away from London that attracts patients from across Europe, CEO Brendan Quinn says there’s been at least a 60% increase in inquiries over the past 18 months, and there’s a waiting list for stays at the 15-bed place. “Last Friday alone, I referred six burnt-out bankers to outpatient clinics in central London,” he says.

Curiously, very few of the people seeking treatment have lost their jobs. “These are people on the verge of losing their jobs, and sometimes they come with their employer’s foot on their back,” says Patricia Ryding, executive director of Sierra Tucson, a luxury rehab centre in Arizona. “Companies want their employees back to work and on top of their game, but employees generally want treatment because they fear they could lose their jobs.” Ryding says the centre, which draws Fortune 500 bosses from the US and Europe, is in “a growth phase”, having added 44 beds in 2007 to increase capacity to 139 patients. It’s now running at between 95 and 105.

Luxury rehab doesn’t come cheap, but it can come cheaper. In Mexico and Panama, plush clinics are luring American addicts with add-ons, like massages and Botox, for a third of the price of upmarket clinics in the US, while Cape Town rehabilitation clinic Montrose Place, which opened in 2007, is growing, its founder says, because it can offer cheaper but no less luxurious treatment than in Europe and the US. “The business is doing incredibly well and we’ve expanded very rapidly,” says CEO Johnny Graaff, himself a former addict.

The centre, which has a staff of 40 on a R70m (€7m) property in the exclusive Bishopscourt area, was funded largely by Graaff’s father, former politician Sir David de Villiers Graaff. The centre charges €23,000 a month for a shared room, and double that for a suite; the same amount would buy only a week of inpatient care in London, says Graaff. Montrose Place can hire an experienced nurse for the equivalent of €10,000 in South Africa; that in Switzerland, where Graaff had considered setting up a clinic, would cost €100,000. Last year the company opened a dedicated eating disorders unit near the addiction centre, and plans to open a small treatment centre and office in South Kensington, London, by this summer. A retreat to help businesspeople deal with stress and anxiety is also in the planning.

Treatment centres say people seeking treatment for addiction come from all industries – medicine, advertising, self-made entrepreneurs in a whole range of businesses – though banking and finance is over-represented. David, a recovering addict and former trader in a major European bank, recalls the culture of excess that goes with the high-stress of trading. “There’s a lot of lunches, dinners, drinks after work, parties at the bank and entertaining clients,” he says. “Everyone was drinking a lot of champagne, and that led to cocaine, and it became a daily routine. I became an alcoholic without knowing it, and was still performing very well.” Wealthy at 35, he quit the job and, with time on his hands, began spending all his time drinking and taking cocaine, got married and divorced within a year, and ended up in treatment at Montrose.

The work hard, play hard mentality is common, and costly. In the UK, Department of Health research has found drinkers living in middle-class areas are more likely routinely to consume what is classed a hazardous amount of alcohol than those in poorer areas. Alcoholism is masked by the fact they usually consume wine rather than liquor, and they hold down good jobs. In the US, nearly 73% of drug users are employed; the National Institute on Drug Abuse estimates the cost of substance abuse is about $300bn (€225bn) a year. For employers, it means absenteeism, workplace insurance claims, lost profitability and on-the-job accidents. In the EU, about 12 million adults have used cannabis and a million have used amphetamines in the past month; four million have used cocaine in the past year.

Employers’ responses to staff with addiction are hugely varied. The most likely to be helped and even funded through rehab are the most senior executives; the cost of treatment, even at a luxury clinic, for a month or two is much less than the cost of alarming shareholders or attracting negative publicity if a top manager is fired for drug or alcohol abuse. And, if the person is otherwise valuable to the company, it avoids the inconvenience and expense of having to find a skilled replacement.

While drug testing and punishment or dismissal for those testing positive is still prevalent in safety-critical industries, employers are generally warming to the idea of help as the answer to addiction. “Gone are the days when addiction was a taboo subject and organisations would turn a blind eye,” says Jennifer Stacey, chief people officer in the UK with global HR consultancy Ceridian.

Fear still stops many people coming forward for treatment, and drives others into secret rehab. American Psychiatric Association research has found that 76% of people believe their work status would be damaged by seeking treatment for drug addiction, 73% say the same about alcoholism, while 55% think seeking care for diabetes would affect their position.

At Priory Roehampton, only about 20%–30% of patients are funded by employer health insurance; the others pay their own way to keep it from their employers. “It’s OK to have a physical problem; it’s slightly less OK to have a mental problem; and it’s even less OK to have an addiction,” says Campbell.

At Montrose Place, many senior executives have had their care funded by their employer; the UN is among those willing to pay for treatment for high-level staff, as are several global investment banks. “The people we have here are making their companies an incredible amount of money,” says Graaff. “The company is in a situation where it’s better off getting the person better as opposed to the person completely losing it with substance abuse. An investment bank would always look after someone who’s making them a lot of money.”

It’s the same in Arizona. “It depends who you are and your value to the company,” says Ryder. “We treat a lot of high-level executives from Fortune 500 companies that are making the decision that it’s worth the investment.” Sierra Tucson costs around €30,000 per month of treatment. Most pay for themselves so it doesn’t go on their insurance records.

One senior telecommunications executive kept working throughout several months of treatment at Montrose, where access to phones and the internet is restricted but allowed, unlike in many other centres; his employer believed he was working from home. Konstantin von Vietinghoff-Scheel, a clinical psychologist who has worked with the International Labour Organisation and EU Department of Health on addiction, says awareness of the need to help rather than punish employees with addiction is increasing in Europe. “Larger and more educated organisations are looking seriously at this … but there’s no legal obligation for a company to help,” says von VietinghoffScheel. He says Heineken is a model company on support for staff and investment banks such as Goldman Sachs, Morgan Stanley and JP Morgan have “adequate strategies and policies”, some of which would potentially pay for staff to have addiction treatment, “but it depends who the individual is,” he adds. “If a guy makes €600,000 a year and has a bad habit the company might think about helping him through his problem and maybe pay for it, but those people don’t have a problem paying for their own treatment anyway.”

While some patients can return to their old high-pressure jobs and stay clean after treatment, others call time and seek a new lifestyle. “If they’ve paid their mortgage off they often think it’s time to start a new life,” says Quinn, from The Causeway. “One guy retrained to be a teacher … it depends how they cope.”

Former trader David, now aged 38, has switched industries, and has been clean for six months. He’s moved permanently to South Africa, and now runs a company that provides services to the transport industry, employing more than 200 people. Ironically, he also has a stake in a night club in Cape Town, though he never goes there. “I loved clubbing, I did it for 20 years, and work was just a means of financing the clubbing,” he says. Now, he spends more time outdoors and finds drink and drugs are easier to steer clear of in the transport business. “I’m not stuck in an office frustrated and desperate to have a drink around the corner to escape.”