Tell me about rehab

[Anonymous]

Anonymous wrote:Thank you! These are some really good leads.

None of the places have any ballpark on cost though.
I know it's all about insurance but is it $10K a month or something like that?

My spouse went to Father Martin's Ashley and is sober today because of it. It's a beautiful place on the water with excellent staff. Insurance covered all but a couple thousand dollars. My spouse is now active in AA but says AA meetings before rehab were like white-knuckling it and that sobriety never would have stuck without rehab.

[Anonymous]

Father Martin's runs about 24,000 to 28,000 a month. Have heard very good things about them from people who have gone. Caron is more like 35,000. Have personal experience with Caron for a teenager and would not recommend to my worst enemy. May be better for adults. Good insurance tends to cover rehab pretty well, at least the first time.

If this person has a therapist and a psychiatrist, he is at least trying his own rehab, but it is not working so well. Going to a lot of AA meetings is often helpful, but I have known people who find it quite depressing and discouraging to hear so many stories of relapses.

It is a myth that rehab, while helpful for many, is the only way to go here. It is a myth that AA is the only way, as helpful as it has been to hundreds of thousands. It is also a myth that a person has to hit bottom before he can finally be successful at overcoming his addiction. Addicts court ordered to rehab have just as good success rates as those who go voluntarily, albeit few programs have good success rates.

Google "Inside Rehab," a book by someone (I think a former alcoholic) who did a lot of research on this. Most places do not use anything like cutting edge therapies and treatments and are spectacularly unsuccessful. I haven't bought the book, but I understand it has many useful checklists for deciding on a rehab strategy, as well as which rehab program to choose. Since you are not in an emergency situation, order the book off Amazon and take a little bit of time to do good research.

Many rehabs do not encourage/know about a medication that has been very successful with alcoholics. It is naltrexone, a nonaddictive medication, that comes in pill form or in the form of a once a month injectable formulation called Vivitrol. The latter is vastly preferred as the person cannot decide to stop taking it as he can with the pills so he can go on a bender. Naltrexone blocks the ability of the person to feel the effects of alcohol. If this person's psychiatrist has not suggested it, he should get a new one. Father Martin's strongly suggests Vivitrol for its patients with alcoholism, as well as opiate addiction. Getting him there may be the push he needs to get on this medication so he can live his life. Or he can just go on Vivitrol locally and continue with therapy--it will put him in a place where he can be more receptive.

[Anonymous]

If his mental illness is intertwined with his addiction - as many use substances to self medicate symptoms of mental illness, then you need to make sure that any program has a dual focus on mental illness as well. It could be that it is the mental illness that isn't as well treated or managed as it could be.

[Anonymous]

PP with previous experience of Caron, which claims dual diagnosis expertise. Definitely not! And the reason I cannot un-recommend Caron enough. So many of these places say they do dual diagnosis but their real belief is that the MH problems are caused by the addictive substance, so if they get the person off that they have solved the MH problem. But many fall into addiction because of a pre-existing MH problem, and that is not going to magically disappear once the person is no longer abusing. (Though of course use of addictive substances often greatly worsens the MH problems.)

A definite caveat emptor here. People are routinely taken off SSRIs and other MH meds precipitously once they enter into rehab. Could anything be worse? It is elementary these drugs must be tapered off. Also, at most dual diagnosis rehabs, the person is lucky to get individual therapy once a week, even at the really pricey celebrity rehabs. Do not believe what they say on their websites, over the phone, or in their marketing materials about addressing MH problems. Get a commitment in writing as to how much individual therapy will actually be provided, as well as what the qualifications of the "therapist" will be. Many times the little individual therapy provided is done by recovered addicts with little training.

[Anonymous]

A local outpatient option is Aquila Recovery near Friendship Heights metro. They offer Vivitrol, perhaps the only local outpatient place that does.