substance abuse

Can’t afford treatment:

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Can’t afford treatment? Need to know cost of treatment? Low cost treatment?

Does treatment have to cost a lot?
Addiction crosses all education level “from Yale to jail.” IQ has little to do with it. Some of the lucky ones recognize the problem early, swallow their pride, and seek help. The majority, though, are like me. By that I mean they have an attitude–an attitude that says, “No one is going to tell me what to do!” One person may need only a few counseling sessions. Another might need a few months in a residential setting. Many centers offer outpatient and intensive outpatient treatment as well as residential treatment.

Inpatient or residential treatment is one option, though it is the most expensive. Even at discounted rates many families cannot afford a 28- day program. However, this isn’t necessary for every drug-dependent person. In fact, more than half of all recovering people didn’t have the inpatient experience. As I make this point, please bear in mind that I’m not suggesting that inpatient treatment isn’t beneficial. It would be wonderful if this was available to everyone; but it’s not. There just aren’t enough facilities for the demand. Even if there were, many people can’t afford it.

Let’s talk about a few other ways to begin recovery. Determining which treatment is appropriate will depend on the drugs the addict has been using, how much, for how long, and his or her level of motivation. We will start with the simplest and work our way up.

Counseling
For those who experience intervention early, before the addiction has become severe, the recovery process might be less complicated. It may involve only a couple of counseling sessions with an addiction counselor and then committing to attend recovery group meetings. There will be some who commit to recovery sooner than others, and the sooner, the better. Some people are lucky enough to not have to hit a low bottom (see chapter 18).

Outpatient Treatment
For those with a moderate problem, outpatient treatment may be appropriate. This works well for the high-functioning addict/alcoholic. By high-functioning I mean the user still has a job and a home, pays his bills on time and is generally responsible, yet knows he has a real problem. Maybe a spouse or a friend has noticed his excessive drinking and mentioned something about it. If the dependent person is doing well on the job or in school and just can’t leave for a month, outpatient treatment may be the answer. This candidate would attend group meetings, typically in the evenings and maybe also see a counselor a few times a week.

Intensive Outpatient Treatment
The next level of treatment is what is called intensive outpatient treatment. This usually consists of two-hour group meetings three to five nights a week. A professional addiction counselor facilitates the meeting. Again, the advantage here is that the addict can continue going to school or work and return to his or her home at night. This is a long day, but is an ideal solution for some who need daily support to be successful in recovery. It also is much less expensive, than residential treatment because the treatment center does not have to provide housing and meals. This option usually lasts four to six weeks and tapers down to whatever is best for the individual.

Inpatient/Residential Treatment
For serious cases, inpatient or residential treatment may be the best option. Residential treatment is what worked for me. I believe it is exceptionally effective for several reasons. First, it pulls the patient completely out of their environment, removing them from their friends, who are usually other substance abusers. A family may also want to consider sending the user out of state to really move them to a different environment (at this point, we are talking about only a few hundred extra dollars for traveling expenses).

Inpatient treatment is very structured. The first few days are often referred to as detox, which means going through some physical withdrawal. This phase varies quite a bit from person to person. Believe me, this experience is not fun, but I made it through. The severity of a person’s detox experience depends on the drug or drugs a person has been using. I’ve heard a few people say it was no big deal at all. Others have described it as four or five days of living hell. There are some drugs available now that can help ease the discomfort of the first few days of withdrawal.

When I arrived at the treatment center in Atchison, Kansas, the intake person asked me about my drug use history. Along with everything else, I had been taking a high dose of Valium every day. I didn’t think it was going to be a big deal to give up. But stopping this drug all at once, after years of use, was a shock to my system. I had a couple of very difficult days. The feelings I had are not easy to describe. Along with the insomnia came some hallucinations. In some ways it was like having a nightmare while being awake. The rational part of my brain knew I needed to quit using, not just Valium, but everything else as well. But my body and part of my mind still wanted and needed that drug. There was a battle going on. A real fight. Had I tried to do this on my own, I seriously doubt that I would have stuck it out. Treatment centers want to move everyone through this stage as quickly as possible and get them involved in recovery work.

Most facilities post their regular schedule on their website. The lectures and groups that take place throughout the day shed light on every aspect of drug and alcohol dependency. The person learns in great detail what will happen (or has already happened) to them physically, mentally and spiritually. In addition to participating in groups, each person meets one-on- one with a professional counselor. Many facilities have a chaplain on staff. Few, if any, chaplains will get into debating religion or suggest that a person must adopt any certain belief-system. Regardless of this, people often come into treatment looking for answers to spiritual issues, and centers have found it beneficial to have a professional available to meet the spiritual needs of their patients.

I will always remember how meaningful it was to spend time during the evenings and weekends with others who shared the same struggles. There is a special bond among those who have been there. People are encouraged to take walks and to experience their feelings on a deeper level through journaling. Time allotted for reading, reflecting, prayer, and meditation are luxuries the addict did not have (and did not care about having) in his home environment. This experience can be a real turning point in a person’s life.

Specialized Treatment
Gender-specific (all-men or all-women) centers have recently be- come a great option. A patient who is in a gender-specific facility has the advantage of speaking more openly and gaining a more complete understanding from group members who share the same life experiences. There are certain issues that apply to men more than women, and vice-versa. When addiction issues are dealt with in a specifically male or female context, a very therapeutic and powerful camaraderie forms.

Men, for example, find it difficult to admit weakness and accept defeat. But if they are with a group of other men who have also had their lives destroyed by drug abuse, they are more likely to be humble and honest in a group setting. Having to admit to brokenness in a mixed group is much more difficult (it’s that whole macho thing). Even the reason men and women become users can be different. Men seem to take illicit drugs to get a high and as an adventure, whereas women take them more often to relieve stress and to self-medicate.

Women in treatment often have been taken advantage of by men, so they may be more likely to open up without men in the room. They are more sensitive to the social stigma of addiction, and therefore may have been more private about their substance use than men. Women also are more likely to be dealing with parenting issues. Lately, more and more inpatient treatment centers are opening their facilities to children so they can stay with their mothers for the duration of their treatment.

Depending on the severity of a person’s addiction, longer treatment can be more effective than a typical twenty-eight-day stay. Sixty-day and ninety-day treatments are becoming more common. Someone who was using large amounts of methamphetamine, cocaine, or heroin over a period of years may need ninety days of treatment. But regardless of the drug the person has been using, there can be varying reasons why extended treatment may be to their advantage. For example, some people will need more time to work on ways to resist drug use and develop replacements for drug-using activities. There are many factors to consider before a person leaves treatment; the center itself will make recommendations. I can’t think of any cases where a few extra weeks in treatment turned out to be a bad idea. There is a lot at stake here.

Cost of Treatment
In today’s unstable economy, the financial strain of recovery is a real issue for families. How much does treatment have to cost? Who pays? The average cost for a one-month program is about $20,000. Prices usually begin around $10,000 and go up to $40,000 or more. This is a lot of money seemingly out of reach for most families. But when you consider how much money the addict has blown on drug and alcohol use in the past, and how beneficial this treatment program will be, it may be well worth it.

There are ways to defray the cost of treatment. First of all, some employers are willing to help cover the cost; all you have to do is ask. Some insurance companies will cover the cost as well, so families need to find out what their insurance plan will and will not cover. However, many treatment facilities unfortunately do not accept insurance. Dealing with insurance companies is often a paperwork nightmare, and some centers do not have the staff to keep up with what it requires. Moreover, some insurance companies try to dictate just what type of treatment they will cover and for how long, and this may not fit with a treatment center’s philosophy or diagnosis. However, there are centers that do take insurance, and usually they will make all the phone calls concerning coverage and handle the details for you.

If the employer won’t help cover the cost of a treatment program, and the insurance plan doesn’t cover it or if it does but the treatment center won’t accept insurance money you should know that many facilities will take people for less than the standard fee–sometimes much less. Occasionally, patients are able to get ten to fifty percent off of the normal rate. Some centers will even let you make payments on a discounted price. In these cases, they are essentially loaning you the money in spite of credit history. How do you find out about these discounts? Ask. That’s right, simply ask if there is any way to get a reduced fee.

How are they able to charge less? There may be some scholarship money available, or sometimes a hospital or a graduate of the treatment program will help cover the cost. If a treatment center sees that a person is able to pay only a portion of the cost, and if it is obvious that the person is motivated to begin recovery, those at the center will be motivated to help as well. For people working in this field, drug treatment is both a business and a passion. A high percentage of counselors, staff and owners are also recovering people. For most, it’s not all about the money. Call around. Ask a lot of questions. You just might be surprised what you find out.

So far we’ve covered the more formal, structured treatment methods. So, what other forms of treatment or support are available?

Twelve-Step Programs
Probably the most obvious are the twelve-step programs. AA (Alcoholics Anonymous) and NA (Narcotics Anonymous) are literally everywhere, all the time, across the world, and they are free. Al-Anon is also available to the family member who needs support or information. These groups all have listed phone numbers and will give you information twenty-four hours a day.

Sadly, within the Christian Community there are some who see a conflict with The Twelve Steps (of AA and Al-Anon) and biblical principles. I’ve studied this at length and I have found none. For those who are followers of Christ, we can simply know that He is our Higher Power–our understanding of God.

As I mentioned earlier, many churches are now adding addiction counselors to their staff. Some churches even refer to themselves as Recovery Churches. Things are changing. An important point to keep in mind is that the addict or alcoholic must have daily support as they begin this road to recovery. In the beginning, a person in recovery is high-maintenance and needs daily support. This is why I believe that a twelve-step program must be part of early recovery. Are there rare exceptions to this? Yes. But remember how much is at stake. I personally know of many Christians who took advantage of what AA had to offer and are now glad they did.

Is AA or NA appropriate for everyone? This is a tough question. You can surely check it out for yourself. Discourage your friend or family member from making a judgment too quickly after visiting just one group. Each group has its own personality. Sometimes it takes visiting several to find a group that the addict will feel comfortable with. There are different meetings in all parts of town, including: men’s, women’s, open meetings (where a person doesn’t have to be an alcoholic to attend), and speaker meetings.

Some people in certain professional fields might not feel comfortable attending AA or NA meetings, even though the names of those attending, and the content of such meetings, are confidential. Why? Some people are very visible in their community. If a person is a doctor, dentist, police officer, city official, pastor, judge, lawyer, school-teacher, swim coach, school counselor, CEO, pharmacist, pilot, or bus driver, it might be very difficult to stay anonymous. Most people wouldn’t want to jeopardize their career to get support in such a potentially public manner. I wouldn’t want to meet my surgeon at an AA meeting! Some people may need to find a different resource, but more often than not, twelve-step groups are very beneficial.

Spin-offs of the traditional twelve-step groups include faith-based groups like Celebrate Recovery, Christians in Recovery and the Salvation Army. The Salvation Army also offers free in-patient recovery programs in some cities. There is help available for almost everyone. People that need recovery have choices, ranging from those that cost absolutely nothing to a multitude of deluxe high-priced options. Help is out there. Just ask.

Over the past two decades I’ve seen addicts and families recover from both mild and severe addiction problems. Sadly, there are others who give up the fight before they even get started. Finding a good support group or counselor doesn’t always happen overnight. Get referrals, talk to others who had similar problems, and be persistent. Determination always pays off.

“There is help available for almost everyone.
People that need recovery have choices.”

“We can’t afford treatment. What now?”
excerpted from revised edition (pg. 101) of
Why Don’t They Just Quit?
What families and friends need to know about addiction and recovery.
(click on title above to purchase)

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