Look for longevity, check the facility’s resources and don’t fall for guarantees of success Your life is careening out of control due to excessive alcohol consumption or drug use, and you need to find a treatment center to get off the addiction train before it crashes and wrecks – or ends – your life. Or your child’s drug-fueled reckless behavior has prompted you to look for a treatment center for him or her. Finding the right treatment program for your or your child’s substance use disorder is crucial – and could be complicated, experts say.
A substance use disorder (formerly known as substance abuse or substance dependence) occurs when someone uses alcohol and/or drugs recurrently to the point the usage causes “clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school or home,” according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, also known as DSM-5.
“Perhaps the most critical factor in treating a substance use disorder is finding the right treatment center,” says Beth Kane-Davidson, director of the Addiction Treatment Center at Suburban Hospital in Bethesda, Maryland. “Does the treatment center have the services that match what the person needs?” For example, if the patient has a dual diagnosis of depression and alcoholism, consumers should verify whether a facility they’re considering has the resources to deal with both issues, she says.
1. Get an assessment by a physician or other substance use disorder professional. Before you decide on an inpatient treatment facility for yourself or a loved one, obtain an evaluation from a doctor certified by the American Society of Addiction Medicine, a licensed clinical social worker or a psychiatrist experienced in treating substance use disorders. “Explore all options,” says Mark Cardillo, program director of behavioral health and the detox unit at Tampa Community Hospital. “Not everyone needs residential treatment; an intensive outpatient program or attendance at 12-step meetings might be the right fit for the patient. These approaches can be as successful as a stay in a 90-day residential treatment program.”
Typically, a doctor or therapist trained in treating addiction will recommend inpatient treatment when the patient is unable to stabilize in his or her recovery and can’t perform the activities of daily living, such as going to work and fulfilling family obligations, says Anita Gadhia-Smith, a psychotherapist who practices in the District of Columbia and suburban Maryland. Some patients may need in-patient treatment for help managing difficult withdrawal symptoms, she says. “Also, if the person has already tried 12-step meetings, individual therapy, and intensive outpatient treatment and has been unable to get sober, in-patient treatment is needed,” Gadhia-Smith says. Generally, if a therapist or doctor determines in-patient treatment is the best course, he or she will recommend a 30-day stay that could be extended if necessary. If a patient has previously been to a 30-day treatment program, he or she may need a longer stay, Gadhia-Smith says. If someone has been drinking or using drugs to the extent that loved ones conducted an intervention, they should go directly to a 90-day in-patient program, says Howard Samuels, owner and chief executive officer of The Hills Treatment Center, an alcohol and drug treatment facility in Los Angeles.
2. Research whether the facilities you’re considering provide the resources you need. Many people with a substance use disorder have other clinical conditions, such as depression or anxiety, Kane-Davidson says. Check the website of any rehab center you’re considering to see if they have resources, such as counselors, to deal specifically with a dual-diagnosis, she says. Call the facility and ask them about each of the resources listed on the website; some facilities list services they don’t have, she says.
3. Check whether the treatment center uses medication. If you or your loved one is seeking treatment for opioid addiction and want the option of taking prescription medication to treat the drug dependency, check whether treatment centers you’re considering offer such medication, adds Michael P. Botticelli, executive director of the Grayken Center for Addiction Medicine at Boston Medical Center. Some treatment centers follow the abstinence model to treat opioid addiction, and others offer medication, he says. For example, prescription medications such as naltrexone and methadone have been useful in increasing retention in treatment programs for heroin addicts, according to the National Institute on Drug Abuse. Be aware that some facilities offer detoxification services – helping people medically as their bloodstream becomes free of toxic substances, often shortly after the patient has been using drugs or drinking – and some don’t.
4. Look for a facility with longevity. Shy away from rehab centers that haven’t been in business for at least five years, advises Samuels. Some of these facilities may be fine, but others could be opportunistic, trying to take advantage of the high demand for such services. “Shady treatment centers aren’t in business for long; they end up failing because of unethical or unlawful business practices,” Samuels says. “Look for a track record of more than five years. The ones that have been open longer than that tend to remain open because they do good work.”
5. Don’t necessarily equate luxury with quality. Stays in rehab centers typically range from a few thousand dollars per month to more than tens of thousands of dollars for every 30 days. A 30-day stay at one luxury rehab in Malibu, California, for example, runs $64,500, according to drugabuse.com. In terms of cost, there are three tiers of rehab facilities, says Harry Nelson, chairman of the board of the American Addiction Treatment Association: There are high-end programs that typically cost $50,000 to $75,000 a month; a middle market in the $25,000 to $35,000 a month range; and most traditional inpatient programs, which range from a few thousand dollars to $20,000 monthly.
The pricier centers typically include posh facilities with pools and private rooms and are often located in upscale neighborhoods, sometimes in the mountains or by the ocean. But opulence doesn’t always equate to quality. The Boston Globe recently reported that two rehab facilities run by Recovery Centers of America, which charges patients an average of $24,000 a month, were inundated with problems. The issues included a lack of basic counseling, poor staff supervision, and understaffing, the newspaper reported. “Don’t go to a rehab charging $50,000 a month just because it’s in Beverly Hills or Malibu, has 800-thread count bedsheets and gives clients the option [of] not attending group or going to 12-step meetings,” Samuels says. “It’s a rip-off.”
6. Stay away from rehabs that guarantee success. “That’s a lie,” Samuels says. “It’s impossible to guarantee success for an alcoholic/addict. It’s up to the individual to follow the treatment plan once he or she leaves the center.” Samuels advises choosing a facility that follows the 12-step model, which recommends a continuing program of support group meetings after the initial stay in a treatment center.