With addiction on the rise in the United States, we need a cultural shift in the way we view and treat it. According to a report from the Attorney General’s office, 27.1 million Americans suffer with addiction and only 1 in 10 seek treatment.
The reasons are plenty: managed care, individuals not knowing their options, providers polarizing treatment with a one-size-fits-all approach, and unfortunately the system is not an honest one.
I have been in the field of addiction for 20 years. We teach patients how to be honest about their addictions and the causes behind them. If we expect honesty from our patients, then we need to run our industry with transparency and truthfulness.
The addiction industry has always been on the fringe; ever since hedge fund companies learned that it’s a $35 billion industry. They started buying out treatment centers with little to no knowledge of the business. Heads in beds has replaced quality care.
Since money has become the main goal, there has been an increasing amount of deaths, kickbacks, overcharging, fraud, and patient brokering, which is when rehabs and sober living homes pay kickbacks to one another or to therapists referring clients to them without regard for whether or not a facility or provider is appropriate for the patient.
One of my clients, a mother seeking treatment for her bipolar 25-year-old son who suffers from heroin, marijuana, alcohol, and cocaine abuse, has put her son through treatment eight times in three years. Along the way, she—like many others—ran into dishonest marketers claiming their programs were dual diagnosis and trauma focused when they were not.
Her son spent between five and ten minutes with a part time psychiatrist; she was promised he’d receive a minimum of two individual sessions a week and on-going group therapy. She reported that most of the programs did not deliver and many had hidden fees. This is a common problem.
My client became so depressed due to her son’s addictions and the lack of honesty in these facilities that she started self -medicating. When we discussed getting her treatment, she said she no longer had the energy to sift through all the scams and hassles.
Eventually, she agreed to attend a family owned dually licensed treatment center that provided a warm and nurturing environment. She was put in touch with the medical director so she could ask the questions that needed answering.
Upon admission, she was given a complete physical. She saw the psychiatrist every day, had individual and group sessions, too. Not once did she feel like a number. As her therapist, I received weekly progress reports. I’m happy to report she’s doing well.
So what can you do to protect yourself or a loved one seeking treatment?
Ask these questions:
1. What type of accreditation or licensing does your program have?
You need to know about their national accreditation because
licensing laws and regulations vary from state to state. The Joint
Commission and the National Committee for Quality Assurance
are two national accreditation programs. You also want to know
if the facility has a primary mental health license and a primary
addictions license. If it is a true dual diagnosis program there
should be a full time psychiatrist and medical director on staff.
2. What level of education, training, and licenses does the
program’s clinical staff possess? Look for a minimum of a
master’s degree of education for all clinicians. The different
licenses for clinical staff are:
LCADC (Licensed Clinical Drug and Alcohol Counselor)
LCSW (Licensed Clinical Social Worker)
LPC (Licensed Professional Counselor)
An LSW (Licensed Social Worker) and LAC (Licensed Associate Counselor) are social workers or professional counselors who have met the educational criteria and passed the first licensing exam, but have not met all of their clinical hours so they need to work under the supervision of a fully licensed counselor or social worker.
3. Is the program centered on evidence-based practices and how do they measure how effective their services are?
4. How much will this cost? Ask about hidden fees. Get everything in writing.
5. What is the patient to counselor ratio in all of their programs? How many private and group sessions will you receive each week?
6. Is the program gender specific? If not, is there access to gender specific programs?
7. What is the treatment center like? Does the program treat a full range of your needs, including medical and psychological? Is it spiritual? Does it address family issues? You may have to visit in order to see for yourself.
8. How tailored are the programs to your needs? Will they work with your individual needs and history?
9. What types of services are available to families? Can they visit or call? Can you contact them during your stay? Will they educate your family on how to work with you once you return home? Are there private family counseling services available?
10. Is there a medically managed detoxification program provided on site as part of the inpatient program and if not, will they transport you from detox to the facility? What types of medical stabilization are provided? Are medications provided, and if so, which ones?
11. What about aftercare? A 28-30 day stay in an inpatient facility is not enough to maintain recovery. How will this program support you after you leave? Does the program actively participate in assisting clients to obtain quality care treatment close to home? Do they help set up appointments with medical, psychological, and all other out patients’ needs?
12. Will the program provide a Vivitrol injection prior to discharge and arrange for the patient to have their next appointment already set? Vivitrol injection is used in some treatment programs for drug or alcohol dependence.
As a patient or a family member it’s your right to ask questions. If your questions go unanswered, trust your gut and move on.