Choosing the Right Rehab

Choosing the right rehab for treating your addiction is one of the most important decisions you will ever make. However, you may be feeling overwhelmed with choices, advertisements, opinions of friends and family, and be very unsure right now of which direction to go in. This guide is designed to help make that decision easier and to help you find the right rehab facility for your needs.

Choosing the Best Rehab for Your Needs

There are thousands of treatment facilities across the United States that offer a wide variety of services, including inpatient and outpatient rehab, which all take different treatment approaches. Some programs firmly believe in group-oriented treatment, while others are based on individual treatment. Some programs use medication, others limit the use of medication. Some are luxurious and offer amenities like private rooms, chefs, horseback riding, and yoga, while others offer basic lodging and few amenities.

Regardless of the approach, it is important to make sure the rehab facility is a good fit for you. Your best friend might have thrived in a spiritually based environment, while you cannot imagine staying in that type of treatment program and feel you need a more secular, less religious approach. Choosing a rehab based on people’s opinions is not always the best option. The main goal of a rehab program is that you complete it, leave the program sober, and maintain sobriety after returning to “real life.” Therefore, it is important that you get into the right program for you.  

Decide Your Rehab Needs and Goals

It is important to achieve your goal of getting sober and staying in recovery, so determining which program can do this for you is critically important. For example, decide how the treatment program fits the substance you want to recover from using. If you, for example, have a serious problem with alcohol, ideally, you should look for a rehab program with a special emphasis on treating alcohol use disorders. Likewise, if you have an opioid use disorder, you need to determine if you want to find a program that emphasizes medication-assisted treatment, which uses methadone or suboxone to help you taper off of opioids and continue on methadone or suboxone for a period of time. However, if you are adamant that you will not agree to such interventions, and prefer an abstinence-based program, do not go to a rehab program that encourages the use of medication-assisted treatment.

Also, if you are adamantly against religion and the concept of a Higher Power, you will likely feel uncomfortable in a program that facilitates 12-step programs as a main focus of treatment. Rather than spending your time in a program that clashes with your belief system, which is likely to sidetrack you from focusing on the real issues around your sobriety and recovery, locate a program that will not require you to be in a 12-step setting and uses other treatment modalities.

Speak with a Treatment Professional

While your friends, family, or people on the internet may not be the most objective and reliable sources of information, treatment professionals can be a valuable source of the information you need on the treatment programs that you are considering. They are likely to be familiar with the programming, treatment style of the staff, and other factors that you may not be aware of. Their knowledge can help you choose the right program for you, and even more so, if you are very honest and open with them about what you are seeking.

Consider Their Specialization

Many rehab facilities specialize in either the type of care they provide or who they provide it for. It is important to note that certain factors are common to most programs, mostly due to safety and also ensuring the program runs smoothly for everyone as a group. Therefore, you may not be able to find a program that offers unlimited phone calls, the freedom to come and go at will, or getting privileges that are not given to everyone participating in the program. Factors to consider include:

• The therapeutic approach, such as using group vs. individual sessions. Some programs are almost all group-oriented, and you may feel you need more one-on-one therapy, for example.
• Religious or spiritual orientation. You may feel strongly that you only want a faith-based program, or that you do not want any part of such emphasis.
• The use of medications, which is important in detox from opioids and alcohol. How are medications used, and are you comfortable with that approach?
• Single-gender programs, which may be important for people, such as women who feel uncomfortable sharing their issues in a group format where men are present.
• LGBTQ friendliness, if you are concerned about the program understanding your needs as a member of the LGBTQ community and are concerned about acceptance by staff and other patients.
• Cultural diversity, if you want to ensure that the staff of the rehab program can relate to your cultural identity and how this is part of your addiction and recovery.
• Dual-diagnosis, or co-occurring disorders. If you have both a substance use disorder and bipolar disorder, for example, you will want to look at programs that understand and are experienced in treating people with co-occurring disorders.
• Ability to be in contact with work. For some high-level executives, for example, some programs allow for contact with work for urgent situations, but at other programs, strict rules limit phone calls to certain hours and prohibit internet access or cell phone use while in rehab.

Treatment & Therapies Offered by Your Rehab Provider

There are thousands of different treatment models for addiction. These include behavioral treatment approaches, such as cognitive-behavioral therapy, which emphasizes changing thinking patterns to help people avoid drug use and relapse and family therapy approaches, such as multidimensional family therapy, to help families set boundaries to avoid enabling a person who uses substances. Medication is also a component of many treatment approaches, including medications designed to treat opioid use disorders or alcohol use disorders. Regardless of the treatment model, most programs follow a typical treatment pattern of:^{2 (green section near bottom of page)}

• Detox.
• Medication (mostly to treat alcohol or opioid addiction).
• Behavioral counseling.
• Evaluation and treatment of co-occurring disorders.
• Aftercare to prevent relapse.

Inpatient vs Outpatient Rehab

Inpatient rehab takes place in a facility where you are monitored continuously throughout your stay. Inpatient treatment may be necessary in some cases, especially if you have underlying medical conditions, are suicidal, or have several prior attempts at rehab.^{1(figure 2.1 pg 21)} Outpatient rehab lets you go home at night, and you may attend group therapy sessions for 2-3 hours per day, 2-3 times per week. Your treatment providers will assess your situation to determine whether you need inpatient or outpatient rehab.

Provider Specialties & Amenities

Providers and programs may focus on specific types of substance use treatment. For example, a physician may be a well-known provider who specializes in treating opioid use disorders, but your issue is with alcohol or methamphetamine. This is not to stay that you could not be helped in this provider’s care, but you may get better outcomes in a program that specializes in treating alcohol use disorder and stimulant use disorders. Likewise, if you are 18- or 19-years-old, you may benefit more from a program that works with young adults, rather than one where most people being treated are 55-65 years of age. If you are a veteran, for example, you are likely to benefit more from a rehab program that understands the needs and struggles of veterans through the experience of having treated many veterans, or by having veterans on staff who have also gone through their own recovery and rehab.

Amenities are probably the biggest factor in how rehab programs differ from each other. Some programs, which tend to be the most expensive, offer individually cooked meals prepared by gourmet chefs, yoga, massage therapy, acupuncture, and Jacuzzis, as well as private rooms that look like luxury hotel rooms. Other programs offer cafeteria-style meals and rooms that are similar to a hospital or college dorm. Some programs let you use your cell phone and offer free wi-fi and in-room televisions. Other programs limit you to watching TV in a communal area and do not allow internet access. Given the wide range of amenities available, you are bound to find a facility that meets your preferences.

Considering the Location, and Length of the Rehab Program

Location is often an important consideration in choosing a rehab program. Some people choose the convenience of going somewhere nearby. However, sometimes going far away can help you distance yourself from negative influences, such as family and friends who enable or encourage your substance use. However, you need to consider the costs of travel to the facility when thinking about where to go for rehab.

Your course of treatment and length of stay is determined by your treatment team, but most people spend several days to a few weeks in rehab. Ideally, though, longer stays work better, with research indicating that people who spend at least 90 days in treatment, whether inpatient, outpatient, or a combination of both, tend to maintain their recovery longer.^3(#4)

Figure Out Your Payment Method and Budget for Rehab

The cost of treatment varies tremendously, and it is dependent on many factors, including amenities, location, and length of stay. However, in many cases, paying for rehab is made possible through the use of private insurance or government-sponsored healthcare coverage. If you have health insurance, call the number on the back of your insurance card and find out what coverage and benefits you have to cover substance use treatment. You are likely to find that insurance covers a large percentage of the costs of rehab. However, if you do not have health insurance, you may be eligible to purchase low-cost coverage through the Affordable Care Act (ACA) that will provide coverage for substance use treatment. You can start the process to determine if you are eligible for an ACA plan here.

Typically, when you enter your information for the ACA plan, if your income is within certain thresholds, you may also be eligible for Medicaid. Medicaid is health care coverage for people who meet the requirements of having an income that is below a certain limit. In some cases, you may also be eligible for Medicaid if you are pregnant or if you are caring for a young child. You may also qualify for Medicaid if you have certain types of disabilities. If you have Medicaid, it will typically pay for rehab at no cost to you.

If you are 65 or over and have paid Medicare taxes for at least 10 years, or have a spouse that paid into the program, you are likely to qualify for Medicare. Medicare usually does not charge a premium or a fee to have coverage, although you may pay a copay for most services, similar to private health insurance. Medicare is also available to some people on disability and with certain medical conditions. Checking your eligibility for both Medicaid and Medicare is important to help you determine if you qualify.

If you do not have private insurance or qualify for ACA plans, Medicare, or Medicaid, your other options are to pay out-of-pocket for rehab or get a loan. You may be able to borrow money from friends or family or get a loan through a company such as Carecredit. You may be able to work out a payment plan with the rehab center. Some rehab programs offer sliding scales, which base charges on your income.

Compare Rehab Centers & Make a Decision

Now that you have information to consider in choosing a rehab that is best for you, it is time to compare facilities and weigh all the factors. Talk to treatment professionals and list the factors that you want to consider in choosing a rehab. You will probably not get everything you want but picking the best rehab for you requires that you determine what factors are most important to you.