Ask an Expert: I Can't Afford Rehab

Ask an Expert: I Can't Afford Rehab

By John Norcross 12/30/14

Today's question is on what addicts can do if they can't afford help.

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What can you tell me about various self-help methods because I can't afford rehab?

John Norcross: You are not alone, friend. The dismal state of healthcare insurance in this country has left millions unable to afford rehabilitation and aftercare for addictive disorders. It’s a national disgrace.

At the same time, let’s focus on what you (and others in your circumstances) can do. First off, don’t rule out rehab until you have investigated all of the options. Most private rehab programs offer scholarships to select patients who can demonstrate financial need. Many public rehab programs provide free care as well. So call around to public and private facilities.

Self-help for addictions is the de facto healthcare system in this country and, fortunately, it works for many.  The research shows that regular AA attendance, for instance, is nearly as effective as formal counseling for alcohol dependence. Of course, self-help groups plus professional treatment typically works better than either alone, but do not discount the power of self-help. 

For the past 20 years, colleagues and I have been identifying effective self-help books, autobiographies, films, online programs, support groups, and Internet sites. The ambitious goal of our book Self-Help that Works (Oxford University Press) is to guide folks in selecting effective self-help resources; we hope to separate the chaff from the wheat among the tens of thousands of self-help books, groups, and websites.

Your question does not indicate your self-help preferences (book vs. groups vs. apps) nor your particular addiction(s), so we will need to go broader than usual with self-help suggestions. Here’s the consensus from our national surveys and research reviews on self-help that works for addictions:

Self-Help Books

· On Alcoholics Anonymous and recovery: Alcoholics Anonymous by Alcoholics Anonymous and Twelve Steps and Twelve Traditions by Alcoholics Anonymous.

· On maintaining sobriety with or without AA: The Addiction Workbook by Patrick Fanning and John O’Neill;  Controlling Your Drinking by William R. Miller and Ricardo Munoz; When AA Doesn’t Work for You by Albert Ellis and Emmett Velton.

· On adult children of alcoholics: A Time to Heal by Timmen Cermak and It Will Never Happen to Me by Claudia Black.

· On women, couples, and drinking: A Woman’s Addiction Workbook by Lisa Najavits and Overcoming Alcohol Problems by Barbara S. McCrady and Elizabeth E. Epstein.

· On sexual and internet addiction:  Out of the Shadows by Patrick Carnes and In the Shadows of the Net by Patrick Carnes and associates.

Autobiographies

There are dozens of excellent memoirs on addiction and recovery as well. These include A Drinking Life by Pete Hamill and Getting Better by Nan Robertson on alcohol, Go Ask Alice by Anonymous and Beautiful Boy by David Sheff on polydrug abuse, Born to Lose by Bill Lee on gambling addiction, and Love Sick by Sue William Silverman on sexual addiction.

Online Self-Help

Much of free self-help is moving online. For evaluation and feedback on gambling:  Check Your Gambling.  For self-assessment and guided treatment of alcohol abuse: Moderate Drinking at and Drinker’s Check-up. For self-assessment and guided treatment of marijuana abuse: Check Your Cannabis and Marijuana 101. 

Final point: It’s not either self-help or professional treatment. Instead, it’s about getting all of the assistance and fellowship that will lead you to sobriety.

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John C. Norcross, PhD, is the author of the critically acclaimed book Changeology as well as co-writer or editor of 19 other books. He is Distinguished Professor of Psychology at the University of Scranton and Adjunct Professor of Psychiatry at SUNY Upstate Medical University. His ideas have been incorporated into addiction treatment by many therapists. Full Bio.

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