I've recently added a series of blog posts to the blog for my half-time job, Lawyers Concerned for Lawyers of Massachusetts (no, I'm not a lawyer, but I've learned a great deal about them) on the subject of alcohol/drug rehabs, and thought I would highlight here some of the points I made there. I know that many of those (especially family members) who come to see me (or visit my blog) are thinking about trying to get their loved ones into rehab. Here are some of the important things to know:
- The term "rehab," in the alcohol/drug field, refers to an extended inpatient stay, usually around a month, that begins with detox (withdrawing the individual from his or her substance while preventing the most serious withdrawal symptoms) and proceeds to a structured daily routine of group therapy, some individual counseling, medical/psychiatric evaluation, often some family contact, and usually exposure to self-help groups. Aside from the treatment per se, being away from one's usual habitat and immersed in the culture of recovery, while bonding with others in more or less the same situation, can provide a nice inspiration and jump-start to establishing a life free of bondage to addiction (though there is no guarantee and rehab is only one stage of movement toward recovery).
 |
| Lindsay Lohan |
- With few exceptions, health insurance no longer covers rehab -- usually the only inpatient treatment it will cover for alcohol/drug addiction is the "detox" phase, generally a few days, more or less depending on the severity of withdrawal symptoms. This means that most of the time at rehab (often payable in advance) must be paid out of pocket, and exceeds $30,000 or $40,000 for the month. There are some less expensive options, which I can discuss with you, which are achieved by cost-cutting means such as (a) a lower percentage of doctoral-level staff; (b) less medical/nursing coverage; (c) locations in areas where it is less costly to operate, including outside the U.S.
- There are some options that emulate aspects of rehab which are often covered by insurance -- mainly, day programs ("partial hospital") offered in such a way that the patient attends daily but lives at home, or pays a reasonable fee for room and board on the facility's grounds. For those of us without wealth, this is the main intensive kind of option to be considered.
- Hundreds of rehabs have glossy web sites or brochures -- they are profit-making enterprises and they
 |
| Robert Downey, Jr. |
want your business. It is very difficult to know what facility to choose. Generally, the more grandiose their claims (very high success rates, "cures" for addiction, no need for abstinence or self-help programs, disparaging other approaches) the more likely they are to be bogus (much like late night infomercials about getting thin with a pill, getting life insurance in old age for pennies, or making a killing in real estate). Though expensive and by no means perfect, two of the oldest and best known facilities are probably also the most reliable: Hazelden in Minnesota and Caron Foundation in Pennsylvania (both have satellite programs in other locations as well). I have also heard positive reviews for Mountainside in Connecticut, which may also be a bit more affordable. Many facilities will also claim to be covered by insurance, yet demand the up-front payment of a large deposit. Be wary.
- Rehab can be a great start for those with plenty of money. It is almost never worth the money for
 |
| Amy Winehouse |
families that must struggle or borrow to pay for it. The fact is that, no matter how wonderful the treatment, alcoholism/addiction is a condition characterized by relapse, and there is no magic. Regardless of their claims, less than half of those graduating from rehab will still be completely alcohol/drug free a few months later, but your poverty will persist. Inpatient rehab, or some facsimile, becomes more worth considering when other, less intensive measures have repeatedly failed, and when the individual's addiction becomes quite serious. Even then, however, recovery takes a lot of motivation on on the part of the addict. I've seen too many people go to a long string of even the finest facilities with no lasting impact, and I've also seen many people who seemed "hopeless" get sober at unpredictable points in time in ways that cannot be attributed to treatment.
- While it can be extremely helpful to be removed for a time from the environment in which the addiction has developed, what makes the biggest difference in the long run is ongoing involvement in a non-addictive lifestyle. The components of that lifestyle often include: (a) outpatient therapy/counseling; (b) self-help groups; (c) healthy activities not associated with drinking or drugging; (d) daily structure and routine; (e) frequent contact with healthy friends/family; (f) connection to community and sense of meaning, which can come in many forms; (g) exercise and meditative activities. (That's not to say that all of these are essential for any individual.)
Some people come to meet with me (in Newton or Boston) just once or twice to brainstorm about all these options. I have no obligations or financial connection to any particular facility, group, or treatment, and I respect your ability to make your own decisions (even better when more more informed).
