If you think your child, spouse, friend or family member might need help combatting their alcohol or drug use, you’re probably right.  Whether someone is an alcoholic, has an opioid addiction, a cocaine addiction, or an addiction to any other substance, the fact is that they aren’t likely to be able to get clean on their own.  They need help and they probably needed it yesterday.  Drug and alcohol addiction is a disease that will not correct itself and if you have found and are reading this blog post, chances are that you are past the point of believing that you and your family can handle this alone.  The good news is, there are numerous rehab treatment options available.  The bad news is, it can be a challenge to wade through the options and find one that is best for your family.  One size does not fit all.  Here is a beginner’s guide to taking that first step towards formal addiction recovery treatment.

If you don’t already belong to Al-Anon, consider joining.  Sort of like the airlines’ instructions to put on your own oxygen mask before helping others with theirs,  Al-Anon can provide tons of emotional support and practical advice for you with this very difficult life-situation you find yourself in.  Find a meeting with a group of people, who “click” with you.  Help groups like Al-Anon are only as good as the relationships they develop within the group.  Just because a meeting is conveniently located and scheduled doesn’t mean it’s a good meeting for you.  If it’s filled with people you don’t particularly like, you’re unlikely to go and if you don’t go, you’re not getting the help you need.  Shop around.  The Al-Anon website is a good place to start. There is a meeting out there for you, you just have to find it.

Next, get your loved one to agree to go to treatment.  If he or she is your minor child, then you can likely mandate that they go.  Not pretty, but effective.  If your loved one is an adult, you may need to do some work to convince them that they need help.  Al-Anon can help with advice and, if you don’t think you can confront them on your own, an interventionist and help with action. 

Interventionists can be independent professionals or they can be affiliated with individual rehab facilities.  They generally will have a certification as an addiction interventionist, equipped with the skillset to effectively navigate the emotional gauntlet that your loved one (and you and other family and friends) will experience as you all try to convince your loved one to acknowledge their affliction and accept help.   If you select an interventionist who is affiliated with a specific rehab facility, then you will have to commit to using that facility for treatment.  Do some research and make some calls to find someone you feel will work well with your family.  Ask a lot of questions about the person’s experience and the overall process they envision before you hire someone.  It’s also okay to seek references while seeking an interventionist.

At the same time,  do your research on treatment options.  A good place to start is through family or friends who have had to go through this process of sending someone to rehab.   Not all treatment is based on the 12-step model so familiar for alcoholism treatment and drug treatment.  More and more, primary care physicians are becoming involved in treating the neurological disease of addiction.  A number of medications have recently become available that have proved effective at curbing the pull of addiction.  If you feel like treating a drug addiction with other drugs is somehow incongruous with the concept of sobriety, consider one likely alternative:  multiple relapses over a lifetime if you’re lucky, and an early death if you’re not.  The treatment drugs of today are not like the methadone treatments of yesterday:  they are more effective and are less addictive.  Obviously, every situation is different, but a conversation with your family physician is a good place to start.  He or she may also be able to tell you if your health insurance covers alcohol rehab or other treatments for your loved one.

Your insurance company can also be a good resource for rehab options.  Depending on your individual policy, your insurance company may have a list of recommended and approved addiction treatment providers.  Generally, an insurance company has done some vetting of providers before they are approved for use by policyholders, so you should have some sense that a treatment provider is on the up-and-up.   Make sure to ask what your coverage is, if any.   Many insurance plans will cover a broad range of addiction recovery services, including residential rehab.  Certainly, using a treatment provider recommended by your insurance company can make the payment process much easier. 

One popular option for treatment is to check into a residential rehab facility.  Residential rehab facilities have the benefit of being “one-stop-shops” that generally offer both detox and behavioral modification services (i.e., individual and group therapies).  Many residential rehab facilities will also take care of all of the logistics of physically getting your loved one into treatment. 

Be aware, though, that the addiction rehab industry has a bad reputation and deservedly so, particularly when it comes to residential rehab facilities.  The relapse rate for patients discharging from a residential rehab treatment facility is high.  The industry accepts that 80% of “graduates” will relapse within one month of discharge.  More than 90% will relapse within three months.  Rehab facilities have little incentive to improve the efficacy of their treatments.  Long-term sobriety cuts off the revenue stream from readmitting patients and there are plenty of providers out there living the “lifestyles of the rich and famous” funded by addicts who relapse again and again. 

Due to lax or non-existent regulations, California and Florida have become havens for the shadiest of sobriety providers.  Stories of insurance fraud, criminal drug use, sex abuse and just plain mean treatment abound.  Don’t be fooled into thinking that paying $60,000 for high-end canapés, “equine therapy” and a view of the ocean will somehow work better to get your loved one sober than will a lower cost facility without a view.  (You could spend a month at the Ritz-Carlton for less and the food is likely better – but hire a sober companion to keep the drugs and alcohol out of reach.)

And beware of the offer of a plane ticket to come to a facility.  While it may be a tempting and expedient method for whisking your loved one away the moment they have agreed to enter treatment, a treatment facility will not pay for them to get home again.  The truth of the matter is that many of these places make so much money from insurance payments that they will do anything to get patients with benefits into their facilities and keep them there.  Hence the plane ticket and, in the most egregious cases, facilitating continued drug use during treatment.  When the insurance benefits run out, the “hospitality” ends – often unceremoniously, with a couple hours’ notice to the patient that they must pack up and get out.

Not all rehab facilities are bad – far from it.   There are many good, honest people running businesses that truly want to help.  The good businesses will have honest conversations with you up front, answer all of your questions, give you an idea of what you can expect and talk about the importance of following a relapse prevention plan after discharge.  Residential rehab is just the beginning.  Long-term recovery is a long-term endeavor.  Talk to people you know, people you meet at Al-Anon, your insurance company, your doctor and even your employer’s EAP provider for recommendations for residential rehab providers.  If you find a good one and can afford it, residential rehab is a great way to start the road to recovery. 

A second treatment option is stand-alone detox treatment.  The physiological effects of detoxing from drugs or alcohol are generally enormously difficult to endure and can be fatal (hence the addiction – anything to avoid withdrawal).  Depending on the substance(s), detoxing from drugs or alcohol takes 3-5 days and if not done as part of a residential rehab program, is generally done in a hospital.   There are also physicians out there who provide home-detox services which come complete with 24-hour nursing or home health care during the detox period.  While you and your loved one may feel that, if he or she can just get detoxed, they can stay sober, you should know that detox treatment without follow-up behavioral treatment (such as residential, intensive outpatient or other recovery care treatment) is overwhelmingly ineffective:  less than 1% of people will remain sober for more than a month.  And, depending on the provider, a stand-alone detox treatment and can cost as much as a residential program, so if you choose this option, be prepared to follow it up with an intensive outpatient program or a home-based addiction recovery service.  Again, there is no easy fix for the disease of addiction.

Many outpatient options are also available.  The most common model is called “intensive outpatient” or “IOP” and consists of individual and group therapy at a treatment facility for about three hours a day, no fewer than three times a week.   You live at your own home.  Often, people discharging from a residential facility will transition into an IOP while they reside in a sober living home.  The combination of costs for this pair of options can have a wide range and, while your insurance might pay for IOP services, insurance will almost never pay for a sober living home. 

A shared bedroom in a sober living can cost you $5,000 per month.  Sober living homes can provide support in the form of other residents who are also struggling to stay sober, but the facility itself is not in the business of providing any sort of therapy or follow up care.  And you can’t pick your housemates.  Don’t take any valuables with you if you choose this option and don’t be surprised when one of your housemates is unceremoniously tossed out in the middle of the night for using drugs or drinking.   

A good alternative to IOP or sober living is in-home recovery care.  Home-based recovery treatment uses the same types of behavioral therapy as does a residential or IOP facility but does so at home.  The cost can be significantly less than an IOP and/or sober living home and, because the home-based nature of the services means that the treatment plan (every place has a treatment plan) is tailored to the specifics of your loved one’s life.  Sessions at home can not only help an individual confront and conquer their addiction, but it can also help heal family dynamics that have been damaged by this disease.  A therapist or certified drug and alcohol counselor has the opportunity to witness triggers to relapse that can occur in the home environment and help the addict or alcoholic deal with the issue effectively, in real time.  It’s one thing to listen to a therapist at an IOP tell you how to address a problem at home; it’s another to have a therapist at home with you when you are faced with the problem.  And because in-home care is less expensive than most other options, you’re more likely to be able to afford a longer term of service.  And it’s a well-known fact that the longer someone can stay sober, the more likely they are to avoid relapse. 

Plan on at least a year for the physiological effects on the brain of drug and alcohol addiction to abate sufficiently so that your loved one is not in imminent danger of relapse.  But even after that, it can be a life-long struggle to stay sober and your loved one will always need your emotional support and understanding.   This doesn’t mean that you will have to live like you did before treatment, but it does mean that you, too, need to educate yourself about addiction, its impact on the brain and body, understand that it is a chronic disease and should be treated as such.  And a little sensitivity goes a long way.  Just like you wouldn’t push a piece of pecan pie on diabetic Uncle Joe who just had to have his foot amputated, don’t serve wine at Thanksgiving dinner if someone at the table is trying to stay sober!  Be thankful that they ARE sober and have a glass of wine another time – when they’re not around.  This doesn’t have to be forever but in the beginning of sobriety the temptation or feeling of remorse from not being able to drink is heightened.

So, now you’ve done some soul searching, a lot of research, talked to professionals, friends and family and have decided on a course of treatment.  Now, plan for an intervention.  Whether you use a professional or not, pick a day and a setting and make arrangements, in advance, to get your loved one as soon as possible, to the chosen place where rehab will begin.  Don’t be surprised if your plans fall through because your addict got drunk or high and didn’t show up.  Don’t give up.  Be prepared to try again as soon as possible.  If they are defiant and not open to a rehab option, they are just in a serious episode of their addiction.  Wait and try again.  There will be a window of opportunity in which they will want to seek treatment, but these timeframes come and go quickly, so it’s important to act fast.  Deep down, addicts and alcoholics don’t want to live the way they do any more than you want them to live this way.   

And if you have a question, feel free to call us at 877-219-9212.

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