In 1956 when the AMA declared alcoholism a disease it became eligible to be treated as a medical condition. Health insurance companies jumped on the bandwagon and developed programs of treatment. Traditional inpatient rehab is based on the Minnesota Model utilizing 12-Step indoctrination. Over the past few decades, inpatient treatment for substance abuse and behavioral addictions has become a multi-billion dollar a year business. Don’t get ripped off by thinking that the more you spend on rehab the better the treatment will be.

The Betty Ford center is well known as a haven for celebrity clients, with a price take of over $50,000 a month. Luxury treatment centers will run $65,000 plus for a 30-day stay. Private pay can range from about $7,000-15,000 per month. A county treatment center may be free for low income or on a sliding scale for residents.

Engage due diligence when researching facilities. Ask a lot of questions and take a tour if possible. Speak to several members of the staff, not just the intake person who answers the phone and will do the hard sell. Ask for a detailed description of the daily schedule, classes, one-on-one counseling, family program, activities, and costs not covered (so there are no surprises).

It is easy to be nickel-and-dimed when specialist appointments, psychiatry, medical treatment, holistic treatment, and prescription medications are not covered in the quoted price. Also ask about step-down treatment, sober living and aftercare costs.

COMPARING

It is difficult to compare treatment centers because they offer different treatment types, specialties, integrated or dual-diagnosis treatment, and 12-step or non-12-step programs. Some have detox centers, as well as different levels of treatment and lengths of stay.

Amenities seem to push the price ever upward. Luxury treatment centers have private chefs, spa-like locations, high thread count sheets, large swimming pools, and hot tubs, fire pits, sea views, private rooms, equine therapy, massage and acupuncture, gyms, and personal concierge. There are group activities off campus, business centers, affluent clientele and home comforts galore.

Also factored into cost are the size and location of the facility and how many client’s they serve at one time, the ratio of staff to clients, amount of one-on-one time, specialists and program expertise.

Facilities are staffed 24 hours a day at any location. Doctors, psychiatrists, therapists, case managers, and group facilitators will be involved in daily programming. Most locations will offer some form of family program.

PAYMENT AT TIME OF ENTRY

A common refrain from expensive rehab facilities is that you would spend anything on your substance of choice, that the cost of years of addiction and negative consequences is nothing compared to spending $50k on rehab to ‘save your life.’ Although there is truth in this statement, I’m pretty sure that most people needing treatment still don’t have that amount of money lying around. Addicts are notoriously broke.

Then the argument goes to conveniently finance treatment through an affiliate lending institution, who may or may not be totally legit. This gets family members involved because you personally are unable to apply for any type of credit.

Now loved ones on the hook. You have a family either paying out of pocket or financing treatment at some exorbitant interest rate that will take years to pay off. You will conceivably have relapsed numerous times prior to the loan repayment.

Even if you or your loved ones have that kind of money laying around, is it sensible to spend it on someone who has blown up their life with no guarantee they will stay clean and sober after the 30 days? Not very sensible.

HEALTH INSURANCE

Most health insurance policies have provisions for intensive outpatient, if that fails then inpatient is the next level of care. They will contract inpatient with regional facilities and will cover a major portion of the cost. They will not pay for a ridiculously expensive luxury rehab; you get what you get, which is usually a traditional 12-step, 28-day program.

Private pay facilities will have affiliations with several health insurance providers. Always check if your insurance is accepted before committing to a particular program.

Check your county resources for inpatient programs. County programs cover the basics and use 12-Step programming. The groups will be larger but the schedule and types of groups will be similar to private pay.

County case managers are usually really busy. It is worth arranging counseling through your health provider as an additional resource.

SOBER LIVING & OUTPATIENT

Another option is to move into a sober living home. Here you are able to continue school, work, or outpatient in a structured environment. House requirements will vary; there will be weekly house meetings, support group meeting requirements, assigned chores, and curfews.

You will be free to go about your day as needed while being in a safe, supportive environment as you learn how to live clean and sober.

Sober living plus an outpatient program is a really cost-effective early recovery choice.

LUXURY IS NOT ALWAYS BETTER

Obviously, luxury rehab facilities attract enough wealthy clients and perhaps celebrities to stay in business. Knowing myself, had I been put into something like this, I would have been blowing off treatment to bask in the luxuries. For a lot of people, this kind of exclusiveness may not be hard hitting enough to enact change.

There has been a huge shift away from 12-step treatment to behavioral-based treatment. The 12-step protocol is falling out of favor. Research advocates for integrated treatment and behavioral therapies where symptoms of all co-occurring disorders are treated together.

If there are too many distractions and other activates available, the treatment time will be compromised. It is very important to have as much time to gain knowledge, find solutions, develop self-awareness and coping mechanisms, and to plan for your future and aftercare plan. Making an environment so comfortable and luxurious takes away from the seriousness of substance abuse. Inpatient is not a hotel where you have gone on vacation. Inpatient is the highest level of substance abuse treatment there is.

TREATMENT OPTIONS

I do not believe that people deserve to be punished either. Whatever location and type of program, it needs to be a safe place to face substance abuse and the consequences head-on.

Under no circumstance do I recommend any program, at any price point, that uses any form of hazing, ridicule, or attack therapy.

County, on the other hand, can be pretty rough around the edges. In my experience, they are more sterile and institutional. The programs are solid though. The information, education, case management, assignments, and schedule are very similar across the board with other 12-step facilities.

In the middle, is your suburban facility that is often a converted residence. Client load will be smaller and there will be a more intimate environment. Services tend to be more limited, with professionals such as psychiatrists and doctors being available, but not on full-time staff. Smaller residential facilities may not have dedicated detox either. You need to see a medical professional to get evaluated and cleared to enter treatment.

It is common to see programs in Thailand, Mexico or other warm locations offered as an alternative to treatment in the U.S. Cost is variable, and it is difficult to really evaluate the program unless you know someone who has been there or through word of mouth from trusted sources.

All of the facilities should be State or county certified. If they cannot provide certification, walk away. There are legislative bodies that monitor rehab facilities.

FOR THE RIGHT REHAB FOR YOU

It comes down to personal preference. But I can say without a doubt, I will never advocate top of the line luxury rehabs without personally knowing who, what, why, when, and how they operate. They will espouse their success rates as 85-95% because that is how many people stick out the 30 days, not how many stay clean and sober after leaving.

Anything paid for by your health care provider should be taken advantage of. You are going to get the standard 28-day bio-psycho-social 12-step program in a controlled environment. Generally, out of 100 people, only 1 will remain sober at 12 months. Relapse rates are as high as 70% in the first few months.

If you have no financial means, then county will work just fine for you. The program will be basic but worthwhile.

In order to get started on recovery, getting through detox and the first few weeks in a controlled environment where the focus is solely on recovery is where you should be.

You will get as much out of it as you put into it. Your participation after you return to the community is up to you. If you want to be in recovery, you will go to any lengths to keep it.

DON’T JUMP TO COMMIT

Don’t make any commitment before you talk to credible references, check certification, or do further research into the facility.

Ask a lot of questions about the types of treatment why offer, how many clients are there, how many hours of individual counseling you will get, whether they have on-site medical staff, on-site detox facilities, family programs, what their phone call and visiting policies are, assessment and intake procedure, waitlist, refund or partial refund policy, aftercare, alumni and anything else you can think of.

Ask for a tour before committing. You may not have the luxury of time; do what you need to do to get into treatment. You can always move on to another program if this one doesn’t suit.

Any amount of time you have away from the people, places, and things that fuel your substance abuse in an environment that starts you on the journey to recovery is priceless. Even a few short weeks of program can set you up for life.

It is up to you to maintain your recovery.

Don’t wait to hit rock bottom. The time to get help is now.

Prepare for rehab armed with the facts. Know before you go.

11 Early rehab lessons. Take your time.

RESOURCES

• Luxury rehabs: //drugabuse.com/luxury-rehab-centers/
• Information to help you: //www.rehabs.com/how-much-does-rehab-cost/
• Very expensive rehab choices: //www.projectknow.com/the-10-most-expensive-luxury-drug-rehabs/
• How to choose a facility: //rehab.help.org/choosing-the-right-rehab-facility/