Drug rehab in the United States is more important than ever. The ongoing drug epidemic has been called the greatest public health crisis in American history. Thousands of lives are lost to needless overdose deaths every year, and many millions more are struggling with an active addiction RIGHT NOW.
But there is good news – RECOVERY WORKS.
Evidence and experience shows us that drug rehab is the best way to successfully and safely return to long-lasting sobriety. With timely intervention, individualized care, effective treatment, and ongoing support, you CAN find a way back to your life.
Drug rehabilitation is a blanket term for all of the services a person with a Substance Use Disorder (SUD) may receive during their addiction recovery. It may be referred to as drug treatment.
By examining the data from a variety of sources, the shape of the US drug problem can be determined.
According to the most recent National Survey on Drug Use and Health, released by the Substance Abuse and Mental Health Services Administration, over 130 million Americans aged 12 and older have used an illicit drug at some point in their life. That means that nearly HALF of all US adolescents and teenagers have tried illegal drugs.
1 in every 9 people in this country use illegal drugs regularly, and an estimated 20.5 million meet the criteria for an SUD diagnosis.
But widespread drug use and addiction also means more overdoses. In 2017, there were an estimated 71,600 overdose deaths in the United States, reports the Centers for Disease Control and Prevention. That means that 2017 was the single-deadliest year in American history, in terms of illicit drug poisonings.
To put that number in perspective, that is more lives lost in just one year than during the entirety of the Vietnam War.
Within the last five years, the number of fatal overdoses in the United States has jumped by 63%!
Yet, even in the face of this crisis, too many addicted Americans are not getting the help they need. In fact, only about 1 in 10 people with a diagnosable SUD are receiving specialized drug addiction treatment.
This is unfortunate, because drug rehab and treatment saves lives. With the right combination of education, counseling, lifestyle changes, and medication, many people in rehab go on to enjoy drug-free lives.
For people whose lives have been impacted by drug addiction – whether theirs or someone else’s – one of their first questions is:
“How do I know if I/my loved one need drug rehab?”
To answer that, an understanding of the differences between use, abuse, and addiction is needed. They are similar – yet distinct – problems.
Drug use is an action. The person purposefully uses an illicit or legal drug for its pleasurable effects – intoxication, euphoria, confidence, energy, relaxation, etc. They like the way it makes them feel, so they consciously CHOOSE to take it, because it makes them feel good.
At this point, there substance use is still a CHOICE. They can still modify their behaviors on their own. However, chronic substance abuse causes changes within the person’s brain, putting them on the path to dependence and addiction.
Addiction is an illness. At this point, the user has lost control of their drug use – frequency, amount, situation, etc. They continue using despite those negative consequences. Even when they try to abstain, they experience extremely unpleasant symptoms of withdrawal so severe as to drive them back into active use. Because their brain has been hijacked by their disorder, they now compulsively take drugs to keep from feeling bad.
People with active addictions rarely quit on their own. They need the structure and support of specialized rehabilitation program.
Addiction is a process – a downward spiral that begins with experimentation, progresses to regular use, and worsens to abuse until it reaches the point of a full-blown illness.
To find out more ways to tell if a loved one is addicted, take this quiz.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, says an SUD diagnosis may be warranted when the person exhibits three or more of the following symptoms:
Similar to other chronic diseases, an SUD can be managed quite successfully. Drug treatment allows people to break free from addiction’s powerfully-disruptive influence on their brain and behavior and regain control over their own lives.
But as is also the case with other chronic illnesses, recovery from addiction is a lifelong process. The unfortunate reality is that without constant vigilance and adherence to a program of drug recovery, a relapse is possible.
Think about it this way – society doesn’t look down upon or give up on a diabetic who sneaks sweets and has high blood sugar. Taken in this context, it is clear that a relapse does NOT mean that treatment is a failure or that recovery isn’t possible.
Rather, it simply signifies the need for a rededication to or an adjustment of the drug treatment program. Just as a diabetic with tested high blood sugar can modify their diet and start exercising more, a recovering-yet-relapsing substance abuser can resume their sobriety efforts.
Significantly, recovering addicts are taught what to do if a relapse occurs. Having a relapse recovery plan in place means the difference between a brief “slip” and a full-blown relapse into active addiction.
There are literally HUNDREDS of addictive drugs, separated into several different classes. The best rehabilitation programs offer tailored strategies that address the specific challenges of each kind of drug addiction.
A treatment recommendation is typically made after an in-depth assessment by a medical or mental health professional. In drug treatment programs that are integrated and comprehensive, a recovery team of professionals works together to offer all needed services, without the need for multiple referrals.
This is another frequently-asked question:
“Why do I need to go to drug rehab?”
Answering this question requires a deeper understanding of the disease of addiction.
Virtually every person who has ever checked into a rehab program has tried to quit before. They make such statements as:
Some people will even try to manage their drug use by making deals with themselves:
MAYBE this kind of bargaining works in the beginning, when substance use is still a personal choice. But when the disorder has progressed to dependency and addiction, choice is no longer a factor. Drug use becomes an irresistible compulsion.
The idea that a person can easily and successfully quit drugs on their own relies on the misconception that true addiction is nothing more than a bad habit that someone can overcome with enough willpower. It ignores the decades of scientific research that has concluded that addiction is a medically-diagnosable chronic disease of the brain.
Also, safety is a factor. Certain substances affect the brain so profoundly that when they are discontinued, withdrawal symptoms can be so severe as to be potentially dangerous or even fatal. For that reason, close medical supervision and monitoring is an absolute necessity. Where appropriate, medical staff can administer FDA-approved medications to alleviate cravings and reduce symptoms of withdrawal.
Finally, addiction is typically associated with other problems – emotional, relationship, health, legal – that must be addressed if recovery is to be successful.
Evidence-based therapy utilizes those treatment approaches and strategies that are supported by actual evidence, rather than by personal beliefs or bias – generally-accepted science, statistics, clinical reviews, and measurable success.
Evidence-based therapy addresses the disease of addiction on several multiple fronts. Each specific strategy/approach is employed to address two things:
Generally, evidence-based addiction recovery involves several different behavioral therapies, which can be further supported by pharmacological options – medications to help with cravings, anxiety, and depression.
Behavioral therapy gives struggling substance abusers an opportunity to change their dysfunctional behaviors. The overall goal is to replace any bad/negative habits with good/positive ones. There are several objectives:
During behavioral therapy, service providers don’t just talk in generalities about addiction – they focus on getting the substance abuser to examine the specific ways that problematic drug use has affected them personally. In this way, the person practices using responses and strategies that they can then apply to their own life.
Whenever a struggling drug abuser acquires a positive new recovery technique, they actually gain a new tool that they can use whenever cravings, stress, or temptations arise in their life.
Behavioral therapy modifies the addict’s thoughts, so that they can change their behaviors.
The 12 Steps are applicable to any form of recovery.
Residential treatment, also referred to as inpatient rehab, is when the person physically checks into a facility to receive around-the-clock care and monitoring, 24/7. Because it is in an immersive therapeutic environment that is safe and secure from the stresses and temptations of everyday life, patients can turn their full attention to recovery and healing.
In fact, to completely remove themselves from temptation and stress, many patients choose to travel out of their local area – or even out-of-state – to go to residential drug rehab. Being away from home makes it harder to just drop out of treatment on a whim.
For most substance abusers, inpatient drug treatment is the preferred choice that gives them their best chance to successfully recover from their addiction and regain not just their sobriety, but also their emotional balance, serenity, and hope for the future.
The standard residential rehab program runs for 30 days, but it can be adjusted on an individual basis for those people suffering from severe addiction or who need more time to respond to treatment.
Some of the services offered at inpatient facilities include:
Inpatient programs give newly-sober addicts the kind of structure and support not possible during a chaotic addiction-driven lifestyle.
For those people with mild-to-moderate addictive issues, or who are unable to attend residential treatment, another option is an Intensive Outpatient Program (IOP). While participating in an IOP, clients can continue to live at home, work, go to school, and remain with their families.
IOP and other outpatient offerings are of particular benefit to those people who need drug treatment but who can’t get away for some reason, such as:
IOPs offer most of the same clinical services – counseling, education, drug screening – as inpatient rehab, over a longer period of time. Typically, IOP attendance is 3 to 5 sessions per week, 3 hours per session. Most programs are 12 weeks in length, again adjustable on a case-by-case basis.
For flexibility, most IOPS offer participants a choice of morning or evening sessions.
Most people who have recently “graduated” from an inpatient facility prefer to receive aftercare from an IOP in their area. This helps them by providing continued structure and accountability while they transition from the temptation-free residential program back to the real world.
People with mild addictive disorders may choose to participate in a regular outpatient rehab program. Again, although the therapy and counseling offerings are largely the same, the differences are mainly in time and intensity.
A regular outpatient drug program might only meet 1 or 2 times per week, typically in a group setting. Most programs also require 12-Step meeting attendance. Obviously, this infrequency does place some limits on how in-depth the treatment received really is.
Many people use a regular outpatient program as continuing aftercare following residential rehab and/or an IOP.
In between the highly-structured 30-day at an inpatient drug facility and the flexibility of an outpatient program is the partial hospitalization program, or PHP.
This is a good option for those people who cannot attend residential rehab, or who have graduated from such a facility but still feel that they need a great deal of help to remain sober. For example, a PHP might be the right fit for someone who still needs regular access to medical personnel, who but doesn’t require 24/7 monitoring.
A typical PHP might meet 6-8 hours per day, five days a week. At the end of the day, patients can return home, full of newly-acquired recovery information and skills.
Ultimately, the choice between an inpatient or outpatient program depends on the individual – their recovery needs, commitments, family situation, and budget.
Inpatient Treatment – Pros
Inpatient Treatment – Cons
Outpatient Treatment – Pros
Outpatient Treatment – Cons
There is room for discussion on two of those “cons”.
FIRST, current laws require insurance providers to cover drug rehab services. This could mean that the difference between the out-of-pocket expenses for inpatient versus outpatient treatment is essentially negligible.
SECOND, the ability to take off from work is a non-issue. Because addiction is a medically-recognized disorder, your employers are required by law to give you time off to seek treatment for a medically-diagnosed addiction. They are even legally-bound to protect your position, pay rate, and privacy.
One of the biggest challenges to receiving effective care for an SUD is the common co-occurrence of addiction with other mental illnesses. Without the right kind of treatment, recovery from both can be complicated.
Some of the mental disorders link with substance abuse include:
The best way to treat dual diagnoses is to create an integrative treatment plan that addresses both disorders simultaneously. Different service providers should work in cooperation using a shared strategy.
The best drug rehabs will have clinical teams that include both addiction specialists and mental health professionals working in tandem to create an individualized service plan.
The short answer here is NO.
Some people wonder if they can just go to a local counselor or therapist instead of checking into a drug treatment program. Unfortunately, that option usually isn’t sufficient to effectively address the issue of substance abuse, for a number of reasons.
On the other hand, the best rehab programs – both inpatient and outpatient – will have a combination of addiction specialists, mental health professionals, and medical doctors on staff, all working together under the cooperative umbrella of a shared treatment philosophy.
Medical drug rehab is a program that focuses solely on the addiction and its consequences to the physical and mental health of the addict. Most medical treatment programs are abstinence-based.
There are many pluses to this approach:
Holistic treatment, on the other hand, focuses on the “total wellness” of the individual. Because addiction affects so many areas of the victim’s life, holistic therapies also address the disease on multiple levels:
The best rehab programs incorporate both approaches, using medical drug treatment as the primary service, with holistic therapies being offered as additional adjunct options. Some of the most common holistic therapies include:
Not every rehab program will offer every kind of holistic therapy. But when both approaches are used, the results are improved happiness and health during recovery.
It’s hard to argue with over 80 years of benefits to struggling and sometimes hopeless substance abusers. While Alcoholics Anonymous was founded in 1935 as a supportive fellowship of problem drinkers, it wasn’t until 1953 when an AA member formed a mutual support society now known as Narcotics Anonymous.
Today, there are more than 67,000 NA meetings held every week throughout 139 different countries.
The philosophy behind 12-Step meetings has been referred to as the “kinship of common suffering”. This means that struggling substance abusers can find in each other what they may not be able to find elsewhere – unconditional acceptance and support from others who intimately understand their struggles and pain.
For many people lost to active addiction, a 12-Step meeting is the first time that they come to believe that recovery really is possible. When they see someone who was once as down as they are who is now clean, sober, and happy, they can begin to have hope for their own futures.
It is important to understand, however, that the 12 Steps do not, in and of themselves, constitute drug treatment. Advancements in addiction science have led to treatment approaches based in hard data and proven success. An example of this would be the development of anti-craving medications such as Vivitrol, buprenorphine, and methadone.
Modern addiction treatment takes many of the principles and philosophy behind the 12 Steps and then applies what science has learned about addiction over the years. This adapted model that combines both the 12 steps and evidence-based practices has proven to be the most-effective means of treating addictive disorders.
Accepted science forms the basis for treatment, and the 12 Steps are a powerful adjunct support.
Drug detoxification is when the addict refrains from use so their body can purge itself of the drugs. Habitual use resulted in a dependence, so during detox, the person goes into a kind of shock – withdrawal – because the drugs they are accustomed to are no longer available, they will start experiencing painfully-uncomfortable symptoms.
This process can take anywhere from a few days to a few weeks.
Put another way, detox is a way for the addict to break free of the physical effects of drugs so they can mentally prepare for the recovery process.
Although they can be harshly uncomfortable, withdrawal symptoms are not especially physically dangerous, with two definite exceptions – benzodiazepine tranquilizers and alcohol. Severely-dependent people can experience benzodiazepine withdrawal so severe as to be potentially fatal.
A person who abuses alcohol or benzos such as Xanax, Klonopin, or Valium should NEVER attempt to self-detox on their own. The ONLY safe way to quit these substances is under the close supervision of qualified medical staff. Where necessary and appropriate, they can administer medications to reduce strong drug cravings and alleviate withdrawal symptoms.
But, understand this – detox – merely “getting clean” – is NOT recovery. In fact, the National Institute on Drug Abuse says that detox alone “does little to change long-term drug use.”
Detox IS a necessary first step, however, because it is extremely unlikely that a substance abuser can achieve or maintain long-lasting sobriety while they are still physically dependent on addictive drugs.
Only when a person is free from physical dependency and past the worst of their withdrawal symptoms can they be clear-headed and open-minded enough to receive the lessons and message of recovery.
After detox, they can move forward on their journey of recovery from addiction.
For some people, the idea of getting clean can be so stressful that they avoid going to treatment out of fear of the pain of drug withdrawal.
There is an old recovery acronym – FEAR – “False Evidence Appearing Real”.
This means that the apprehension, worry, and fear of withdrawal can become so magnified and distorted in an addict’s mind as to be far worse than the actual detox process itself.
But there is another interpretation of that acronym – “Face Everything and Recover”.
This means that a clear expectation of what drug withdrawal is really like can help alleviate much of that fear. With that in mind, here are some of the common symptoms:
Some symptoms of severe benzodiazepine withdrawal should be treated as medical emergencies:
To be clear – drug withdrawal can be an uncomfortable process, but the addict doesn’t have to go through it alone. The horror stories of the past about agonizing “cold turkey” do not reflect the reality of today. Now, you can safely and privately detox in a clean and comfortable setting, all while receiving medical care and support.
Once someone has decided to seek treatment for their addiction, one of the first things they want to know – “How long does drug rehab take?”
One of the defining characteristics of addiction is an inability to delay gratification – the addict wants what they want when they want it. It is no surprise that people new to recovery want to hurry through drug treatment and be done with it as soon as possible.
But that’s not the way that addiction recovery works. Just as it took time for the addiction to develop to the point that it hijacked the person’s brain, so will it take time for brain chemistry to return to normal.
Keep in mind that recovery is a process – there are distinct stages that must be worked through and completed for progress to be made.
Because the disease of addiction manifests differently in every person, adjustments can be made on an individual basis. Most people in recovery achieve their best results by combining different levels of drug treatment.
Most addiction specialists agree that for substance abuse treatment to be truly effective, it has to last a MINIMUM of 90 days. Significantly, treatment link is an excellent predictor of how successful recovery will be. A Los Angeles Times article reported that people who stay in treatment for less than 90 suffer relapses at over TWICE the rate of those who stay in treatment longer.
Dr. Lisa Onken, Head of the National Institute on Drug Abuse’s Behavioral and Integrative Treatment Branch, said, “The more you have a treatment that can help you become continuously abstinent, the better you do. You have to figure out how to be abstinent. You still have cravings. You still have friends offering you drugs. You still have to figure out ways not to use. The longer you are able to do that, the more you are developing skills to help you stay abstinent.”
Following drug detox, your sober journey of recovery truly begins. Going to inpatient rehab can be a bit overwhelming and frightening, because you are entering a whole new phase of your life.
When you first arrive, there will be an intake process consisting of:
Depending upon the time of day you arrive, you may be able to get a meal or even attend a therapy session. Here’s a tip – try to get some sleep, because your first full day of rehab begins early tomorrow morning.
During your first week of residential drug treatment, you will have a pretty full schedule:
Boredom is the enemy of recovery. The busier you are, the less time you will have to wallow in negative emotions – shame, guilt, anger, drug cravings, etc.
Although you may not be used to such a structured daily routine, even that is part of the therapeutic recovery process. You are relearning how it is possible for you to have a productive day without the influence of drugs or alcohol.
There is an important consideration about the earliest phase of recovery—expect to have little to no contact with your loved ones in the outside world. At this point, your entire focus should be on YOURSELF and YOUR recovery. Until you have progressed, phone calls and visits will only distract you from your biggest goal—getting better.
Your treatment team will determine when it is appropriate for you to reestablish contact. As you progress in therapy, Family and/or Couples counseling may be recommended.
People who successfully complete a drug treatment program invariably leave with a changed outlook. You may have entered rehab angry, resentful, and scared, but you will leave:
Addiction is a disease that is by denial, deflection, dishonesty, distrust, and dysfunction. This is because each of these enable the substance abuser to hide their problem, from themselves and from everyone around them.
And the addiction continues.
Recovery, on the other hand, is best served by rigorous honesty. It starts at the beginning, because ADMITTING the problem is the first step in SOLVING the problem.
But just as active addiction can make a person unreliable and hard to trust, it makes it hard for them to rely on and trust others. And TRUST is a big part of recovery from drug addiction, because the process requires that a person gives up their old ways of thinking and reacting and tries something completely new.
But the biggest way that the top drug rehabs build trust is in their everyday practices – how the patients are treated and cared for on an everyday basis. When a person new to recovery – still suspicious, hesitant, and apprehensive – is welcomed into a clean, safe, and comfortable environment where every effort is focused on their well-being, it becomes a lot easier for the seeds of trust to grow.
The most important thing to do after completing a stay in a residential drug treatment program is to avoid becoming complacent in your recovery. Addiction has been referred to as a "cunning and baffling disease" that can strike again at any time.
Top drug treatment programs provide you with a solid foundation on which to build. Additionally, it gives you the tools you need to craft your own continued successful recovery.
No, rehab does not “cure” the disease of addiction. Precisely because there is no cure, you must continue to do those things that support your ongoing physical and emotional sobriety. This will take a lifetime of work.
If it sounds like staying sober is a lot of work, that’s because IT IS. But the arithmetic of recovery is wonderful, because you get back so much more than you ever put in – you get your life back.
One of the most powerful recovery savings is – “It works if you work it”.
The National Institute on Drug Abuse estimates that put together, all forms of substance abuse place an economic burden on the United States in excess of $700 billion a year – health care costs, lost productivity in the workforce, social services, crime, law enforcement, and judicial services.
To put that number in perspective, that is more than heart disease, cancer, and diabetes combined.
These amounts are for the substance only. They do not take into account missed work or unemployment, arrests and fines, lawyers’ fees, accidents, or medical costs. Obviously, these expenses can raise the financial costs of active addiction dramatically.
Looking at it that way, the question changes from how to afford drug rehab to how to afford NOT to.
Affordability is the biggest perceived barrier that keeps people from getting the addiction treatment they need. Struggling addicts and their families put off getting help because they think that quality drug treatment is far too expensive to even consider.
Make no mistake – rehab for drug addiction is not cheap.
Because the disease of addiction varies considerably from person to person – the substance abused, the length and severity of the addiction, etc. – it is difficult to give a truly accurate price without knowing specifics.
However, it is possible to give some “ballpark” estimates for the costs of professional drug addiction treatment, based on national averages. Keep in mind that every drug detoxification facility and addiction recovery program uses its own treatment approach and offers its own set of services.
These estimates should only be used as a starting point from which additional research should be conducted.
The consensus among addiction specialists is that 90 days of some combination of inpatient and outpatient services is the shortest length of treatment acceptable for it to be effective.
In some cases, it can be considerably longer.
For instance, the minimum recommended length for a methadone maintenance program is 12 months. Without the addition of specialized behavioral counseling, methadone maintenance can go on for years.
Per the National Institute on Drug Abuse, the typical costs are:
For most people, those costs are prohibitive. But here’s the good news – thanks to federal law, drug treatment may be far more affordable than you think.
Most people don’t realize is that their private insurance plan is REQUIRED BY FEDERAL LAW to cover substance abuse treatment. Right now, the Affordable Care Act requires insurance carriers to pay for qualified outpatient and inpatient addiction treatment services.
The best news?
Depending on the details of your individual plan, it may be possible to go to drug rehab with little-to-no out-of-pocket expense.
There is one important consideration when choosing a rehab facility, however—although every insurance carrier is required to cover substance abuse treatment, individual facilities are NOT REQUIRED to accept every insurance plan.
Sometimes, insurance coverage may not be an option. An active addict may be unemployed and without private insurance, or they may not be covered under someone else’s plan. This means that the cost of rehab is paid for by the patient or their families. This is known as self-pay.
By thinking creatively and outside of the box, many new patients employ a combination of several funding strategies until they raise enough money to pay for inpatient rehab. Remember this – where there is a willingness, there is ALWAYS a way.
As of 2014, there were over 14,000 addiction treatment centers in the United States, and the number was growing. But with so many choices in front of you, how do you know which drug rehab program is right for YOU?
Again, the best drug rehabs will use a combination of treatment strategies to address the addiction on multiple levels.
Once you have eliminated those programs that are not properly accredited or licensed, or that follow a non-science-based philosophy, you can start further refining your choices by looking for those programs that meet your needs as a unique individual. For example, some considerations might be:
When that is the case, you may have to open your mind to other possibilities. For example, many people do not realize that they can look outside of their immediate area when considering their inpatient rehab choices.
Best of all, in some cases, the cost of travel is either covered by your insurance carrier or can be handled through arrangements with the individual facility. But even if you have to pay travel costs out of your own pocket, the benefits of finding the perfect addiction recovery program outweigh that expense.
Northpoint Washington is a patient-focused inpatient drug detox and rehab center in Edmonds, Washington, part of the Seattle Metropolitan Area.
When it comes to drug detox and inpatient rehab, you have a choice, and when you choose Northpoint Washington, our goal is to show you that you made the RIGHT choice.
If you are ready to get help, contact Northpoint Washington today.