Common Questions about Residential Drug Rehab

What are the different kinds of drug treatment programs?

There are several different kinds of treatment programs, including residential drug rehabilitation, outpatient programs, inpatient programs, therapeutic or emotional growth boarding schools, wilderness programs, and methadone clinic programs.

Residential drug rehabilitation refers to comprehensive programs where people stay overnight and work their programs full-time, usually for one to six months. These programs are usually connected to a detoxification unit where people first undergo withdrawal from drugs under medical supervision. Detoxification usually takes a few days to a few weeks, depending on the individual.

After detoxification, clients remain at the center to undergo counseling and classes to learn to live a drug-free life. This is the most expensive treatment plan, but usually achieves the best outcomes.

Therapeutic or emotional growth, boarding schools are residential programs for young people (usually students between the ages of 11 and 24). Clients enroll not only for drug abuse treatment but also for help with alcoholism, depression, psychological and behavioral problems, eating disorders and related challenges.

Some schools specialize in particular problems, such as boys with Attention Deficit Hyperactivity Disorder or girls who are struggling with alcoholism. Therapeutic boarding schools have an academic component that allows students to keep earning credits toward high school or college while they are completing the program. Depending upon the structure of the therapeutic boarding school, students may remain enrolled anywhere from a few months to more than a year.

Wilderness programs are usually designed for young people. Experienced counselors guide clients on camping and hiking trips, living together in a challenging yet safe environment that facilitates personal growth and allows for significant professional intervention. Wilderness programs allow young people to get away from the environments in which they were having problems, and give them a dramatic opportunity to start living a healthy, drug-free lifestyle. Wilderness programs are intense, short-term residential programs that students usually attend for no more than a few months.

Inpatient programs are usually connected to a hospital or large medical center. People who are abusing drugs can become patients within special units, where they work with psychological counselors and doctors on a 24-hour basis. These programs were more common in the past, but have become less commonplace because insurance companies are less likely to pay for them.

Outpatient programs are usually connected to a hospital, medical center, or drug clinic. After detoxification is over, people attend classes at their centers every day as if it were their nine-to-five job, and then go home at night. Some programs require people to attend only a few days a week. While this alternative is usually less expensive than full time enrollment in a residential program, it is hard for some people to remain in their old environments -- near their drug dealers and drug-using friends -- and still remain abstinent. These programs work best for people who had been abusing substances, but had not developed a dependency or addiction.

Methadone clinics provide access to counseling services as well as professionally supervised medically assisted addiction treatment. Heroin addicts go to methadone clinics every day in order to take oral doses of methadone, which allows them to stop using heroin without experiencing withdrawal or cravings. Some methadone clinic clients eventually choose to go into a program that gradually weans them from their dependence upon methadone.

How do I find out which residential drug rehabilitation program is best for me?

It is important to think about what you want to achieve and to set new goals for yourself as you work through your drug rehabilitation program. Drug rehabilitation is not just about ending an addiction, but about pursuing a healthier lifestyle.

Do you want to develop a new sport or hobby that requires a certain geographical setting? For example, let's say you always wanted to take up skiing -- you may opt to go into drug rehabilitation in Utah or some other area that is home to winter sports. If privacy and discretion are among your top concerns, you may choose a luxury or executive program located a distance from where you currently live and work.

Some people want to find a center located near their homes and others look at it as their chance to get away from home and try something new. Some centers specialize in certain cultural traditions, some are gender-specific, some provide specialized services for lesbian, gay, bisexual and transgendered individuals, and some are equipped to serve clients with physical or emotional disabilities.

Visit the websites of centers that you are considering to find out what each one offers, or discuss your choices, options and questions with one of our counselors at 866-784-8911. All calls to this number are free, all conversations are confidential, and there is never any obligation to enroll in any program or purchase any services.

I’ve been ordered into drug treatment by a court system. Does that make a difference regarding which type of program I should select?

Some treatment centers do not accept clients who are under court order to get treatment, while others specialize in treating clients whose have been ordered to attend a treatment program. Your legal status is one of the issues you should discuss with representatives of any addiction rehabilitation centers that you are considering.

How can I tell if a program is any good? After all, they all have great looking websites.

It is an excellent idea to visit the center in person before you enroll. This will give you the chance to look over the program and facilities, and to chat with counselors and administrators. Ask the administrative staff about their outcome studies. What percent of their clients remain drug-free? What percent have to return for more treatment?

Ask about payment plans. Is everything included, or are their special fees to participate in certain sports or classes?  How much does it really cost to go back and forth from your house (including shuttles, taxis, plane tickets and related expenses)?

When you look over a program, pay special attention to the ratio of counselors to clients. It should be low enough so that you get plenty of individual attention. Here are a few other areas to research:

• Do the program’s counselors hold advanced degrees in relevant subjects such as psychological counseling?
• Are they certified professional drug rehabilitation specialists?
• Drug counselors should be licensed and certified according to the requirements of their states, established by organizations such as the Certification Board of Chemical Dependency Counseling or the Certification Board for Addiction Professionals.
• Are the clients at the center all enrolled for drug rehabilitation or does the center accept people with a variety of problems, such as eating disorders, bipolar disorder and other mental health issues?

The center should screen out people who may become dangerous to others. Sometimes you are better off in a program that specializes in drug treatment, but it depends on the facility and the number and quality of staff. Some centers that do not specialize in drug abuse still have great programs in that area.

Check out the food service, where you will sleep and eat, and the cleanliness of the facility.

What types of accreditations or certifications should I look for in a drug treatment program?

The program should be licensed and inspected by the government of the state in which it is located. Look for accreditation from the Joint Commission on the Accreditation of Health Care Organizations (JCAHO). Another lesser-known one is CARF, or the Commission on the Accreditation of Rehabilitation Facilities. The center might also be a member of the National Association of Addiction Treatment Providers.

If the program includes an academic component, the school should be accredited and licensed, and students should be able to earn credits that can be transferred to the high school or college they attend upon completion of the program.

What happens in a drug rehabilitation center?

There are three phases of residential drug rehabilitation.

1. The first phase is detoxification or the chemical ridding of drugs from your body. Chemical withdrawal can take a few days or several weeks depending on the amount of drugs you abused and how long you abused them. Some people can start Phase Two of drug rehabilitation immediately because their withdrawal symptoms are very mild. Others are too uncomfortable with flulike symptoms, and have to wait until they recover to start Phase Two.

2. The second phase involves learning the skills you will need to live a new life without drugs.

• One component of Phase Two is cognitive behavioral therapy, a short-term process that focuses on setting goals and changing behavior, achieved through individual sessions with a personal counselor.
• Group therapy helps you understand how you function in groups, whether it’s at home, school or work, and how to have better relationships with other people.
• You also may participate in art, drama or music therapy as a way to help you get in touch with your feelings and find healthy new means of expressing them.
• Participating in sports, physical exercise and recreational activities and eating healthy meals will help you achieve your top physical condition.
• You may also have activities such as journaling and yoga to teach you how to relax and handle stress without drugs.
• Finally, you attend classes to learn how to recognize what triggers drug use and how to cope with such triggers, and how to find new interests to fill up time formerly spent using drugs.

3. The third phase of drugs rehabilitation is follow-up care. When you return home, you continue in individual and family counseling, and may attend local support meetings to help you remained drug-free.

I don’t see the point of doing paintings or drama or music as a way to treat drug addiction.

Many times people object to one aspect of drug rehabilitation and use that as an excuse not to enter treatment. The truth is that art, music and drama therapies are very effective in helping people get in touch with their feelings and find new ways to express them. Some people are unable to express anger or other negative emotions openly, not even to their therapists, but will express them in drawings or music. The fine arts also help people relax.

Talking to psychologists, doing yoga, keeping a journal or participating in some other aspect of a drug rehabilitation program may not make sense to you at the moment, but it’s important to remember that the rehab process is about changing attitudes and behaviors, and that the professionals with whom you are working are experts in putting people in the best possible position to pursue lifelong recovery.

I don't like Narcotics Anonymous or any 12-step program that involves a higher power. Will I be forced to attend these meetings?

Most aftercare programs include a support meeting component because these groups are a proven way to stay drug-free. You usually will work with a sponsor, someone who has already been through the program successfully, and who is willing to work with you on a one-to-one basis. Usually, you can phone your sponsor any time of the day or night when you are experiencing problems. At the meetings you and others in the same situation can support each other’s efforts and share stories and problems. These meetings are free and anonymous.

However, if you do not like the idea of surrendering to a higher power or admitting that you are powerless over your addiction, non-spiritual recovery support groups do exist.

What happens once I get home?

One of the most important aspects of drug rehabilitation is after-care or follow-up care once you get home. Aftercare is a crucial part of recovery. It is easier to stay drug-free at a rehabilitation center, and it becomes harder when you go back into your old environment.

Your old environment will be full of stimuli or “triggers” that will make you think about re-using drugs. You may pass a house where you used to abuse drugs, or get phone calls from your old pusher. You will need support from your counselors and family to resist these triggers to drug use.

The follow-up care should include family and individual therapy, and support meetings in your local area. You should get periodic follow-up calls from your counselors at your residential center. Some centers have Internet support. Some teenagers and others will have to undergo random urine tests. Follow-up support should last a year or more.

I just can’t bring myself to enter a drug treatment center, even though I know it would be the best place for me.

You are not alone. For every person in a treatment program, there countless others who need to be there but aren’t One government study found it takes seven years of indecision and drug abuse before the average person enters treatment. Because of this inability to commit to treatment, many people lose many valuable years of happy, healthy living.

Remember: Entering drug treatment isn’t an admission of failure. If anything, it is evidence that you are willing to take responsibility for your life and develop the skills and strategies that will allow you to live a happier and more successful drug-free life.

I have responsibilities at home or at work. I'm worried that I'll lose my job or my family will fall apart if I enter residential drug rehabilitation.

The truth is you are more likely to be fired from your job, get a divorce or be an ineffective parent to your children if you keep using drugs. To be the best worker, parent, partner or person you can be, you need to address your drug abuse problem.

If you decide attend drug rehab, you are actually more likely to voluntarily change careers than get fired from your job. One study found that many people change career paths after working through a drug rehabilitation program, because they have experienced significant changes in their values, priorities and beliefs. Some no longer feel driven to work all the time, or they decide that they would enjoy some other kind of job better. They develop better relationships with their families and decide to spend more time at home. They become freer to pursue the lives they really want for themselves.

Just as workaholics tend to find more balance in their lives after working through a residential drug rehabilitation program, those who had little drive or ambition before drug rehabilitation discover that there are plenty of worthwhile pursuits that they would like to explore.

Many former addicts tell their counselors that enrolling in a residential drug rehabilitation program was the smartest decision they ever made.

How successful are most drug rehabilitation treatment programs?

Drug addiction and alcoholism are classified as chronic diseases, similar to diabetes, high blood pressure or cancer. Treatment programs for these diseases do not necessarily cure them, but they do keep them from getting worse or causing death. For example, if a diabetic follows a treatment program by using insulin as prescribed and following diet and exercise recommendations, the person will remain well.

This is true of drug addiction, too. If addicted individuals complete their drug rehabilitation program and follow the advice of their medical professionals, they can recover and remain drug-free.

The outcomes for drug addiction treatment are similar to those of other chronic diseases. Whether you are successful at your program depends upon whether you follow the advice of your medical professionals and comply with the protocol prescribed for your particular case.

If I've tried and failed in the past, how can I be sure I'll make it this time?

About half the people in residential drug treatment programs are there for the first time. The others have tried at least once before, and still others may be on their third or fourth attempts. Sometimes it just takes more than one try to achieve a drug-free life.

The current philosophy of recovery is that relapses are part of the recovery process. Most people “fall off the wagon” a few times before they achieve sobriety – but your time in treatment can help you to minimize the consequences of those slip-ups, and can prepare you to resume your recovery without a complete backslide into drug abuse.

People who stay in treatment for at least three months or longer are more likely to succeed. People who are employed, who have some higher education and who have good support systems are also more likely to have a successful recovery experience.

Common Questions about Drug Rehab, Careers and Finances

How do I talk to my employer or school about entering drug rehabilitation?

If you work for a large organization or government entity, your employer may have a policy on drug abuse treatment in place. Some employers pay for all or part of the costs for substance abuse treatment. Read your employee handbook or check with your human resources officer.

If you are reluctant to talk to your employer about your treatment, check with your doctor, a lawyer or the staff at the treatment center and ask for their advice on how to handle the situation. You need to be aware of your legal rights too before you enter treatment. For example, you may have the right to take a leave of absence and the right to be re-employed when you finish your treatment.

Is there a way that I could talk to a professional counselor right now?

Yes. If you have any concerns about drug addiction or which center is best for your needs, professional counselors ready to answer your questions at 866-784-8911. The call is free, your conversation will be confidential, and you will be under no obligation to enroll in any program or purchase any services.

Your Questions about Money and Employers

How much does substance abuse treatment cost?

The cost of treatment is hard to estimate because it depends on several factors, including the nature and severity of your addiction, the presence of any co-occurring disorders, the type of treatment program you select, and where you are located.

Some treatment costs can be covered by insurance or employers, and many programs will be happy to work with you to establish a payment plan or help secure an alternative means of funding your treatment.

How do insurance policies pay for substance abuse treatment?

The good news is that most insurance coverage of substance abuse treatment is improving. According to the Bureau of Labor Statistics, 37 percent of insurance policies covered drug abuse treatment in 1982, but that number had increased to 74 percent in 1988 and 96 percent by the mid-1990s. Usually, detoxification is fully covered as a medical expense.

Most policies limit the number of days you can spend in treatment. Some cover only inpatient treatment; others cover only outpatient treatment. Some policies place a lifetime limit on the amount you can spend on drug abuse treatment, while other insurers limit the amount you can spend on any one treatment program.

If you are considering substance abuse treatment, contact your insurance agent to find out exactly how your policy works, what it will pay for, and what you need to do to ensure that you receive the maximum benefits that are available to you.

Are there other ways to pay for substance abuse treatment?

Some companies or employers will pay for substance abuse treatment for their employees, and many substance abuse treatment centers are willing to work with clients to establish an affordable payment plan, or to help them secure a loan to pay for their treatment.

Is there a way that I could talk to a professional counselor right now?

Yes. If you have any concerns about drug addiction or which center is best for your needs, professional counselors ready to answer your questions at 866-784-8911. The call is free, your conversation will be confidential, and you will be under no obligation to enroll in any program or purchase any services.