The State of the Rehab Union
(page 3)Nos. 4, 5 and 6 on the list were cocaine/crack, heroin and depression/mood disorder, respectively, each of which were cited by 5% of respondents. (Meth, pot and psychedelics didn’t get much love in this survey, with just a handful of people citing each.) A relapse after a period of sobriety led 4% of those surveyed to seek rehab, while an intervention was what prompted 3% to check in.
Bill Morrison, co-founder and CEO of the Bay Area rehab Alta Mira, said the relatively low numbers for depression/mood disorder stood out to him, given that studies have shown that 50–75% of those who end up in addiction treatment have a dual diagnosis—which, when untreated, is a contributing factor to relapse. So it's a positive trend that, as Morrison said, "A lot of treatment centers understand that now, and those who haven't in the past are becoming able to treat dual-diagnosis." He added, "The problem is it's expensive."
As for pot and psychedelics, one reason why they didn’t score higher could be that they are not often “precipitators of crisis,” which Rothermel said is what typically leads people to seek treatment. “Pot very rarely creates a crisis,” he said. “That doesn’t mean it’s not a serious component of someone’s addiction. It’s just not something that causes the family to get an intervention together.”
A little more than a quarter of respondents, 26%, said they were in rehab for 28 days or a month, while 43% said they stayed in rehab for longer than a month, up to and including 90 days.
Meanwhile, the low levels of reported heroin, meth and crack addictions could also be a result of the population surveyed. “It says more about the upper-middle-class sample as well as availability,” said Dr. Carise. “They don’t have siblings or cousins or neighbors who are using heroin or crack that you see in more impoverished areas.” Carise went on to note that alcohol and pills are different, too, in that both are legal, and are much more socially acceptable than traditional street drugs.
Meitiner, for one, saw this statistic as an argument against the legalization of drugs. “When it’s more difficult to get things, there’s less usage,” he said. But there isn’t general agreement on this topic: Somewhat in line with Dr. Carise’s opinion, Ross said that he believed accessibility to particular individuals, rather than legality, is what determines use and abuse—and that illegality could even encourage experimentation. “These days with the Internet, so much is accessible,” he said. “Does it deter people because it’s illegal? No. Does it attract people because it’s illegal? Maybe so.”
A third survey question had to do with length of time in treatment. This question was answered by 355 respondents, who reported a wide range of time spent in residential facilities, from just two weeks to more than a year. A little more than a quarter of respondents, 26%, said they were in rehab for 28 days or a month, while 43% said they stayed in rehab for longer than a month, up to and including 90 days. Fourteen percent of respondents reported being at rehab for 90 days to six months; 8% from six months to one year; and the smallest group, in treatment for more than one year, had 2% of respondents.
Experts The Fix spoke to were pleased to hear that such a large number of people had been in treatment for longer than a month—because, as a result of the influence of the cost-cutting insurance industry, the length of time in treatment is becoming ever shorter. Furthermore, as Dr. Carise pointed out, many different studies have shown that 90 days is an ideal length of treatment—which of course calls to mind AA and other 12-step programs’ emphasis on 90 days.
“Did AA know stuff we didn’t know, or did AA get lucky?” asked Dr. Carise. “Over and over, a 90-day length of stay is a better predictor of success in terms of sobriety.”
Hunter R. Slaton is the Rehab Review editor for The Fix. Special thanks to all-star intern Gabi Wuhl for compiling the data used in this report, and to Product Manager Jason Gotlieb for creating the charts and graphs.
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