How to Choose The Best Rehab

By Constance Scharff PhD 04/08/14

What you need to know when choosing an addiction treatment center.


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You’re thinking about rehab. You or someone you love has a serious problem with drugs or alcohol, or what is called a “process” disorder, like gambling. He or she may also suffer from depression, anxiety, or another psychological issue on top of addiction. It’s not getting better on its own…and it isn’t going to. You have to do something now. Right now. But you don’t know what.

This report was put together to help you with the task of finding a quality rehab for you or your loved one. It was compiled to help you know exactly what the addiction rehabilitation process looks like – from beginning to end – and to help you ask the right questions of the addiction treatment center you have chosen. Choosing an addiction treatment center is not a task to be taken lightly. This report gives you a place to begin, so that you will find the best treatment center for your needs. 

Since cost is usually one of the first questions posed when someone inquires about rehab, let’s first consider money. 

The Financial Impact of Addiction

The financial impact of addiction cannot be underestimated. Addicts have trouble maintaining employment. Most move from job to job, then work intermittently and are finally unable to work at all. The vast majority of employees can be easily replaced, and therefore are replaced when their work output is no longer sufficient to meet expectations. Entrepreneurs are often among the first to lose their careers, because businesses can be fragile and if not given the proper attention, fold. This impacts not only the business owner and his or her family, but the business’ employees as well. A few who are in fields requiring a great deal of talent that cannot easily be replaced – professional athletes, “A” list actors, music stars, and heads of companies – may be able to maintain their work lives longer than others because of the specific role they play. But even these people will eventually lose their jobs when they become a liability to the group, company, or project. 

Once income has been lost, addicts turn to conventional means of obtaining money. They will pawn or sell items they own. They will max out credit cards and take out loans. Lines of credit will be added to houses. This process will buy the addict some time, but will create a mountain of debt that is not easily overcome. 

During this period of obtaining money through legal means, the addict will often begin to miss bill payments. Sometimes a spouse or a parent will step in to ensure that bills are paid. But most of the time, late fees and other penalties will begin to rack up. The utilities may be shut off. Cars may be repossessed. Some bills will fall into collections and the addict and his or her family will be harassed. All this creates turmoil and stress for the addict and those who share his or her life. This stress further pushes the addict to use more.

Eventually, when legal means of obtaining money are exhausted, the addict will look to family and friends for “loans.” These are not really loans because the addict knows that s/he will not be able to pay them back, at least in the short term. Some family members or friends will give in to the addict’s demands for cash, not wanting to see the one they love end up on the street with nowhere to go. But unless the addict comes from a wealthy family, this period of being bailed out will be short lived. Families often struggle simply to take care of themselves. While they may be able to afford the living expenses of another person in addition to supporting themselves, the cost of addiction – living expenses and the high price of most drugs – is more than most family budgets can take. The addict will frequently find him/herself cut off before the entire extended family goes down. In those cases where s/he is not cut off financially, many family members may have to make sacrifices to keep the addict clothed, housed, and high. 

At the end of the road, the addict will be forced to become involved in illegal or degrading activities in order to maintain his or her drug habit. This does not always mean homelessness. There are women who will get involved in pornography, which can pay decently, in order to survive. Others may find wealthy people to support them. Some addicts, whether they call it prostitution or not, will trade sex for drugs or money. Many will steal, first from family and friends and then from others. Some will sell drugs. Some will become identity thieves and steal in that way. This is how the cycle of going to jail or prison begins for addicts. Once this part of the cycle has begun, it is terribly difficult to stop. But when all legal opportunities to earn money are gone, illegal activities are the addict’s only option.

The truth is that most addicts are broke when they are ready to seek treatment. Few will be employed and fewer still will have access to great insurance that will cover their treatment. Families may or may not be financially exhausted by the time the addict is ready to seek treatment. Not only has addiction destroyed an individual or family’s financial stability, this financial ruin can impact the quality and duration of treatment available to the addict. 

The Cost of Rehab

Sticker shock is the first response most people have to addiction treatment services. Mid-price treatment centers run around $30,000 per month and many in that range are not-for-profit. High end or luxury treatment centers are more expensive and can easily cost $60,000 per month or more. Keep in mind too that it is a myth that treatment should run 28-30 days. This was a designation created by insurance companies, not addiction treatment professionals, psychologists, or physicians. To get a real grasp on recovery, in the best case scenario, most people require longer-term treatment, with 90-120 days of residential treatment followed by a comprehensive aftercare program. In reality, to give yourself or your loved one a solid foundation in recovery, expect to spend between $100,000 and $250,000 in the first year, assuming insurance covers none of the treatment costs. 

Take a moment and breathe. Now that you’ve pulled yourself off the floor, think about what you are undertaking. If your loved one had heart disease or cancer and required specialized treatment, you would expect to receive medical bills to go along with the treatment. Addiction is no different. To get out of paying for quality addiction treatment, many insurers require addicts to “fail out” of outpatient treatment before higher levels of care will be covered. The problem with this is that those who “fail” frequently do so by overdosing and dying. Can you imagine what you would say if your insurance company required that your loved one with cancer “fail” a treatment known to have a very low success rate before providing a treatment with a higher success rate…all the while the cancer is growing and progressing? This is one of the hidden financial repercussions of addiction. Treatment costs money, and the family, just as it paid for the addict’s addiction, will need to find a way to pay for his or her recovery. 

What to Look for in a Residential Addiction Treatment Facility

It is estimated that people spend more time researching what kind of new car they want to buy than they do researching which addiction treatment center they will send their loved one to. This may be due in part to not knowing what to look for in an addiction treatment facility.

The most important aspect of an addiction treatment facility to consider is its treatment protocol. Inexpensive or high-end, the best treatment facilities offer evidence-based treatment protocols. 

Evidence-based treatment means that research has been done into the various therapies the treatment center uses. The research has usually been done at universities and published in peer-reviewed journals. These therapies are then used by treatment centers. These are therapies that are proven by outside sources to be effective at helping people maintain their sobriety. Evidence-based treatments are generally used in low-cost treatment facilities that rely on grants and donations to keep their doors open and in a handful of high-end treatment facilities. 

Be wary of treatment centers that do not track or do not give their long-term success rates. Some treatment centers make a business of repeat clients. They promise results in 30 days and keep patients coming back for 30 day stints at every relapse. This is not recovery. You want to send your loved one to a treatment center with a proven success rate, a treatment center that wants you or your loved one to get a solid grasp on recovery the first time, then free the bed up for someone else. There are enough addicts in this world that no treatment center needs to rely on repeat business to keep its doors open. 

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Constance Scharff has a PhD in Transformative Studies, specializing in addiction recovery. She is the Senior Addiction Research Fellow and Director of Addiction Research with a private treatment center and coauthor of the bestselling book, Ending Addiction for Good You can find Constance on Twitter and Linkedin.