Home » Blogs » Addiction of any kind, be it to alcohol or drugs, is a dreaded affliction. Not only does it tend to destroy the individual who is addicted, but also impacts everyone in his network – friends or family. Many rehab or addiction treatment centers have effective substance abuse treatment programs that can help the individual overcome his/her addiction and restore a semblance of balance and normalcy to their lives.
With the presence of so many rehab facilities and addiction treatment programs, it is often difficult to figure out which one fits the individual’s needs; and one that also increases the chances of staying sober post-treatment. The right program is crucial to entering recovery successfully and maintaining sobriety. SO, it is important to make the right choice.
Rehab or addiction treatment centers follow a variety of approaches to addiction treatment and their results vary. Sometimes their success may be measured differently. Therefore, before you choose a rehab facility, be cognizant of your strengths and weaknesses and know your needs. You definitely want to choose an addiction treatment center that believes in Medication Assisted Treatment (MAT), because multiple have proven it to be more effective in sustaining sobriety.
In MAT, buprenorphine, naltrexone or methadone is utilized to address withdrawal symptoms and cravings (see suboxone withdrawal) in order to alleviate physical discomfort and enable a person suffering from a substance use disorder to engage in therapy needed to effect lifestyle changes.
To help you, we have listed down five aspects you should consider while choosing a rehab center.
Access from Home
Traditional wisdom held that the addiction treatment facility should be far from the patient’s home so that the patient is removed from the environment that enabled his addiction. It was deemed safer for the individual suffering from addiction, as it removed triggers to substance abuse such as usual haunts, toxic family relationships and enabling friends. The major flaw with this approach is that it treats addiction as a behavioural problem and not as a chronic disease that it is.
In this approach, treatment equals incarceration. Patients are sent away to learn to modify their behaviors in a sterile environment. However, individuals suffering from addiction resent this treatment as they feel they are being punished for being addicted. While other chronic diseases such as diabetes, hypertension and even contagious HIV are treated in an outpatient setting, addiction treatment has remained an exception.
Even today over 95% of detoxification, the most acute phase of addiction treatment, is performed in an inpatient setting. Besides, many people, especially women, hate to be torn away from their home environment in order to access treatment as they feel guilty about abdicating their responsibilities at home. Over the past decade or so, the availability of medications to treat addiction have expanded and MAT has proved effective.
Consequently, Outpatient detoxification, rehab and other treatment should be preferred over inpatient treatment, as it allows the integration of the home environment into treatment and helps to deliver better results. Outpatient or Ambulatory Detoxification has grown in popularity over the years as it has delivered far better results that inpatient detoxification.
Ambulatory detoxification is now offered for all substances of abuse – alcohol, benzodiazepines, opiates, painkillers, suboxone, kratom, anesthetics, ketamine and for poly substance abuse. Unless the patient’s living environment is compromised or the patient suffers from acute medical conditions that require 24-hour monitoring, it is always preferable to choose outpatient detoxification, rehab and other levels of treatment.
Length of Treatment
Addiction has been proven to be a chronic disease, and generally, the longer the length of treatment, the better. As explained below, changes in the brain take years to correct. While treatment usually does not last for a long time, self-help groups are important to maintain sobriety and provide a sense of community and shared values in order to stay on the path to sobriety.
A common marker utilized is 90 days of sobriety – after which it is said to become increasingly easier to maintain sobriety. However, the brain changes when a person gets addicted – the brain gets used to a rush of dopamine (the feel good neurotransmitter) due to stimulation from drugs and literally produces less than needed dopamine in response to usual stimuli such as food, sex, hobbies, or games. This change in the brain takes years to correct and individuals recovering from abuse of drugs or alcohol do not feel “normal” for 2-3 years after they stop using.
Having said the above, detoxification, the most acute phase of treatment, is key to putting people on the path to recovery. This is because individual suffering from withdrawal symptoms and cravings need to feel physically stable and comfortable in order to continue to engage in therapeutic treatment to effect lifestyle changes.
Longer length of stay in detoxification assures a much greater level of physical comfort at the end of detoxification, allowing individuals to be physically comfortable enough to engage in other levels of therapeutic treatment. Most inpatient programs offer detoxification for only 5 or 6 days because health insurance companies do not cover that level of treatment after that.
However, health insurance companies allow 12-14 days of stay in Ambulatory or Outpatient detoxification because of lower costs. This is beneficial for the patient, as the medication taper can be much more smoother eliminating the withdrawal symptoms and cravings patients experienced at the beginning of the process.
Approaches to Treatment
Basically there are two approaches to addiction treatment, whether inpatient or outpatient. One utilizes medication to assist with withdrawal symptoms and cravings, and the other is cold turkey with only talk therapy to assist. While the utilization of medication to assist with withdrawal symptoms and cravings was looked down upon as “drug-for-drug” substitution for a long time, it has now become the norm as studies have proved it to be vastly superior in delivering favourable outcomes.
Advances in medication have made a huge difference in addiction treatment. They have provided a useful tool in managing physical symptoms associated with quitting drugs and/or alcohol, enabling the individual suffering from the disease of addiction to become physically comfortable in a relatively short period of time and be able to engage in therapy to effect the lifestyle changes needed to maintain sobriety.
Consequently, it is recommended that medication assisted treatment be chosen over the alternative. The other major option in treatment is to get treated on an inpatient or outpatient basis. This has been discussed previously and we clearly prefer outpatient detoxification and rehab.
Expertise In treatment
While most of the higher quality facilities offer detoxification and other levels of treatment from all substances, some offer only detoxification from opiates. Since most people who are addicted to drugs or alcohol rarely abuse just one drug, it is preferable to pick a facility that treats addiction to just one substance. Worse is that some facilities without the broader expertise needed to detox individuals off of multiple substances, just detox the individual off of one substance, and completely ignore the abuse of other substances. This can be dangerous as it could lead to negative medical events.
Needless to say, a facility that can deal with the abuse of multiple substances should be preferred over ones that focus on only one substance.
Medical treatment can be expensive and out-of-pocket cost is a major factor. As a rule-of-thumb, addiction treatment facilities that enjoy in-network status with major private health insurance companies offer the most value. This is because treatment for addiction is almost always covered and deductibles and co-pays are the lowest possible.
There are many facilities that accept the same private health insurance but are in an out-of-network status with the same private health insurance companies but they cost more because the health insurance providers cover a smaller portion of the cost of treatment at these facilities. The remaining cost almost always fall on the patient, and adds to the stress.
Consequently, it is better to access treatment at facilities that enjoy in-network status with your health insurance provider.
Dr. Cidambi is a leader in addiction treatment and innovator of safe and effective ambulatory (outpatient) detoxification level of care for alcohol, benzodiazepines, opiates, and suboxone. Prior to founding the Center for Network Therapy, she completed her residency in Psychiatry at Maimonides Medical Center in Brooklyn and an Addiction Medicine Fellowship at NYU/Bellevue Hospital in New York. Due to the successful detoxification program, Dr. Cidambi was featured frequently by media outlets, including NPR, CBS, NY Times, and Wall Street Journal.