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The State of the Rehab Union

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By Hunter R. Slaton

08/05/12

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No. 2 on the factors list was location, selected by 14% of respondents, followed by accommodations quality (10%), amenities (9%), price (8%), insurance and privacy (both 7%), smoking policy (5%), food quality and co-ed or single-sex (both 4%), reputation (3%) and religious affiliation (2%), with gay-friendly, “family decision,” non-12-step and “medical advice” bringing up the rear with 1% each.

Location being near the top of the list makes sense to Andrew Rothermel, executive VP and COO of Caron Treatment Centers, CEO of Hanley Centers and president of Caron’s Florida market, who noted that as the family component has become more important, so too has choosing a rehab that isn’t logistically difficult for the family to visit—not to mention the addict. “If people can’t get there, they can’t get well,” quipped Dr. Deni Carise, senior VP and chief clinical officer of the nonprofit Phoenix House, which has rehab programs in 10 states.

Furthermore, as the vast number of rehabs in Florida and Southern California—Los Angeles and Malibu specifically—makes apparent, people consider the climate when choosing a rehab. “We get asked, ‘How’s the weather?’” said Cassidy Cousens, founder of Authentic Recovery Center (ARC). (Cousens also speculated that California’s licensing laws have encouraged a proliferation of rehabs in that part of the country.)

The largest number of people, 37% percent, reported that they sought treatment for alcoholism. The No. 2 cause, opiates and prescription pills, reported by 15% of respondents, fits with national news stories about the prescription-pill epidemic currently sweeping the nation.

The fact that accommodations and amenities ranked so highly on the list (Nos. 2 and 3) jumped out to Phoenix House President and CEO Howard Meitiner. Demanding high quality in these areas is a luxury that most people who go to treatment can’t afford, as Meitiner noted that, historically speaking, the majority of people in treatment are mandated there. (Individuals who responded to The Fix’s survey had been to treatment at 19 different rehabs, 16 of which had a base price of $11,000 or more.)

Two related factors, price and insurance, occupy spots five and six. The latter is something that Ross sees increasing in importance, especially with the Affordable Care Act having been upheld by the US Supreme Court. “Whether it be Medicaid or the new focus on substance-use-disorder benefits, [insurance] is going to be more and more of an issue,” he said, adding that, with the economy in the limping-along shape that it’s in, “people can’t afford not to use insurance benefits if they have them.”

One more factor worth special mention is smoking, which came in at No. 8 on the list, cited by 5% of respondents. That number struck The Fix as low, given the cliché of chain-smoking rehab denizens. Ross, whose Austin Recovery banned smoking campus-wide this spring, said that he feels people care a lot about smoking under certain circumstances. “It may not affect their decision to go, but not being able to smoke may affect their decision to stay,” he added.

The next big survey question was simple: What brought you to rehab? While some had snarky answers (“a plane and a limo”; a trip to Whataburger with one’s father that served as cover for telling the person to go to rehab or move out of the apartment complex his dad owned), most respondents were deadly serious about what addictions or problems led them to seek treatment.

The same number of individuals, 333, was posed this question. Not everyone answered in a way that was readily classifiable or valid (“plane and limo”), but 438 substantive responses were given, with some respondents reporting more than one reason why they needed rehab.

what led respondents to seek rehab

It came as no surprise to Foster that the largest number of people, 37% percent, reported that they sought treatment for alcoholism. CASAColumbia’s own study found that 38.6% of rehab admissions were linked to alcohol. The No. 2 cause, opiates and prescription pills, reported by 15% of respondents, fits with national news stories about the prescription-pill epidemic currently sweeping the nation, supplanting (and in fact surpassing) more traditional drugs of abuse such as heroin, cocaine, crack, meth and so on. (The unspecified category of “drugs and drug addiction” was a close third, with 14%.)

Rothermel noted that Caron, with more than 200 beds in South Florida, is smack in the middle of the opiates epidemic, which he said is affecting even patients who don’t fit the traditional mold of addiction. In the program for Boomers and seniors at The Hanley Center, Rothermel said they are seeing an influx of people who, although they’ve lived a lifestyle where addiction was not prevalent, maybe had an accident and were prescribed painkillers, after which “they are off to the races on these pills.”

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