If you or a loved one has a substance use disorder and wants to get better, you may have wondered if a rehab center is the answer. It is a treatment center for people who have an addiction disorder related to alcohol or drugs. Some people go daily (or even less frequently) to an outpatient facility for care, while others live in a facility for a period of residential care.
Some people with a substance use disorder really need residential care. But there are many facilities to choose from, and they may not all have your best interests in mind.
“The ethics issue is really important,” says Marvin Ventrell, executive director of the National Association of Addiction Treatment Providers (NAATP), “because as treatment centers have grown, there are some charlatans out there. They’re not the majority, but they’re out there.”
But quality treatment does exist, and there are ways to find reputable centers and avoid scams. Here’s how to get started.
There is a wide range of treatment for substance use disorders. Not everyone needs to start out by going to a residential program, which is the most expensive option, says Margaret AE Jarvis, MD, DFASAM, chief of addiction services at Geisinger Addiction Medicine and Geisinger Neuroscience Institute.
Paul H. Earley, MD, DFASAM, agrees. He is the past president of the American Society for Addiction Medicine (ASAM), a professional medical organization that creates widely used guidelines to improve the addiction treatment system. He may be familiar with your ASAM criteria, a set of guidelines to help determine the best course of action for a person with addiction.
Some people who don’t have serious and pressing physical or psychiatric problems can achieve “remission” by getting regular care from an addiction specialist, such as a therapist or recovery coach, Earley says. Remission is when you go a certain number of months without meeting the medical parameters for a substance use disorder, other than cravings.
If that doesn’t work, the specialist can work with your primary care doctor to gradually increase the level of care. A residential rehab center may be an option to consider in the future.
If you decide to find treatment centers right away, an addiction specialist may be able to recommend a program that fits your needs. You can also ask for recommendations from people you know who are in recovery.
“If you have friends who have been through one type of program, ask them what worked and what they thought of that program,” Earley says.
Jarvis and Earley recommend using the ATLAS online tool (Addiction Treatment Locator, Assessment, and Standards Platform) on the nonprofit Shatterproof.org. It can help you get an idea of the level of care you might need and where you can find a facility that provides it.
Proceed with caution if you decide to search the Internet for a drug or alcohol rehab center.
“Online can be a dangerous place to be,” Jarvis says, especially when it comes to advertisements for treatment centers. “If it seems too good to be true, then it is. If there are promises of cures, [addiction] It is not a disease that can be cured. It can be managed.”
Be skeptical of advertisements that emphasize the amenities a center offers, such as a detox diet, yoga, or equine therapy. Those things are fine in and of themselves, Earley says, but there’s no research showing they’re specifically helpful for treating the core of someone’s substance use disorder.
“The things that tend to have glamor around them tend to be things that don’t have an evidence base around them,” he says. They are expensive, too.
Some ads claim that you can get treatment in your area, but the advertiser doesn’t actually have a treatment center there.
“If you’re anywhere, you don’t have to fly 500 miles or 1,000 miles to get treatment. There’s probably a good treatment program in your area,” he says. “This idea that you have to go to Florida or Southern California if you’re not there is not accurate.”
Ventrell also suggests that you consult the NAATP Industry Directory. The association is a nonprofit professional membership group of addiction treatment providers, including treatment centers.
“All NAATP members are licensed and accredited for everything they do at all locations. They follow our quality control guidance and follow our code of ethics.”
Rehab centers that are members of the NAATP are prohibited from posting deceptive or deceptive advertisements. They must also deliver the services they promise and follow a host of other ethical rules designed to protect the health, rights, and finances of patients.
“There are people in this world,” says Jarvis, “who are hired by rehab centers simply to get patients. And they get some kind of financial compensation for every body they turn in to the rehab center.”
This is patient brokering and not an ethical business practice, he says. Ventrell agrees.
“A broker is bringing in a patient based on the treatment provider’s promise to pay, not a clinical assessment of what the patient needs,” he says. “It’s fundamentally problematic and not allowed in any area of medicine.”
The NAATP prohibits its members from offering or receiving financial rewards, gifts, or other types of compensation for patient referrals.
So how do you know if you might be talking to a patient runner? For starters, they may seem much more eager to make a sales pitch than to talk about their health and needs.
“If it’s a high-pressure sale, that’s something to worry about,” Jarvis says. “If the person you’re talking to doesn’t start asking you enough to make some sort of [health] evaluation, that’s also a problem.”
Ventrell recommends:
- Ask the person you are talking to who they work for. Make sure they are employed by the treatment center you are considering.
- Be suspicious if they try to tempt you with perks like plane tickets to an out-of-state facility or offer to waive your insurance deductible.
- Call a treatment center directly. If you find a phone number online, check it against the number listed on the center’s official site.
Once you know you are speaking with a representative at a treatment center, it is important to have your health and life circumstances evaluated. Jarvis says that a reputable facility would ask him things like:
- How severe is your substance use disorder
- What other physical or mental health conditions do you have
- If you have a place to live, transportation, and resources to manage your life
“If those kinds of things aren’t being considered, then that’s a sign that something may not be right,” she says.
And if the representative says that “everyone who calls needs to go to residential treatment, that’s not credible,” Ventrell adds.
Whether you’re visiting a facility or speaking with a representative on the phone, ask questions like these:
Are you licensed and accredited? The center must be licensed to provide addiction treatment, Ventrell says. It must also be accredited by an outside organization that ensures that its staff meet certain standards of care and performance.
What evidence-based treatments do you use? These are science-backed treatments for substance use disorders. Some of them are:
- Cognitive behavioral therapy (CBT), which can help you spot and change negative thoughts
- Dialectical behavior therapy, which can help you manage strong emotions
- A type of counseling called motivational interviewing
- Drugs that treat alcohol and opioid use disorders
If a representative from a residential rehab center tells you they don’t believe in using FDA-approved drugs for alcohol or opiate addiction, that’s a red flag, Jarvis says.
Do you have special programming for me? “Ask about their specific circumstance and how they would handle it,” Earley says.
For example, if you are a young adult who began abusing drugs or alcohol in your teens, your treatment needs will be different than a 50-year-old who has had a substance use disorder for 30 years. says. Or, if you have depression or anxiety, it’s important for the center to have an addiction psychiatrist on staff.
Make sure the center can meet your specific needs and has experience treating people whose age and life circumstances are similar to yours, Earley says.
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