How effective is drug rehab really, and does the cost matter? Many of us are conditioned to believe that when a product or service is expensive, it is of a higher quality. Of course, this is true in many cases- but what about in the case of drug & alcohol rehab? There are a number of alternatives for addiction and drug abuse treatment. Different programs serve different individuals best under specific circumstances. But when it comes to drug rehab success rates, do you necessarily get what you pay for?
According to Drugabuse.gov, the problem of addiction and substance abuse in the United States costs patients and taxpayers more than $600 billion every year. The average cost for one full year of methadone replacement therapy is $4,700 per person. We also know that different programs offer similar treatments at different prices depending on a variety of factors such as location, state regulations, and availability. But we want to know how much does the cost of a program contribute to the quality of patient outcomes.
There are roughly four different models for addiction treatment. Some programs offer only one, while others offer a mixture of two or more. They are:
- Detoxification – Detox programs range in price between $1,000 and $1,500. Most rehab facilities offer this form of treatment, and it requires strict medical supervision which contributes to the cost.
- Inpatient Rehab – These drug treatment centers come in a wide price range and can cost anywhere from $6,000 to $20,000 per month. For a 60 or 90 day program, the costs can range between $12,000 and $60,000. Often times patients are paying for atmosphere, much in the same way one would pay more at a luxury hotel.
- Outpatient Rehab – For graduates of an inpatient program and those whose addiction problem is considered mild, outpatient programs are an option. They tend to run 90-day programs and cost between $5,000 and $10,000. The price varies depending on the facility itself and on how frequently the patient visits.
- Medication Treatments – As mentioned above, medication treatments cost an average of $4,700 for one year of methadone replacement. Other replacement drugs are available, such as Suboxone, but methadone is used most frequently. This type of treatment is most often given to those with severe alcohol or opiate addiction- both of which have very high rates of relapse.
All told, the total cost of addiction treatment for one year ranges roughly from $12,000 to $100,000 for one year of treatment. So, do you get more effective treatment when you pay more? Let’s consider the variables.
You’ve probably seen news stories about a celebrity going to rehab- often repeatedly and with poor outcomes. Invariably, these are expensive facilities that cater to the expectations of the famous and the well to do. Often they will feature world-class chefs, large campuses, AAA facilities and very low accountability for patients- and sometimes even for staff and medical personnel. When it comes to a mismatch of price and quality, this might be a worst-case scenario. Many of these facilities are extraordinarily insular and can be very difficult for the outside world to audit.
Of course, not all “celebrity rehabs” trade quality for luxury for. Some, offer very high-quality drug abuse and addiction treatment, for which you would expect around $9,000 a week. But as we will see, not all high-end treatment centers deserve the bad reputation attributed to celebrity rehab. In so many cases, it is the patients themselves- and celebrity culture- which contribute to high profile relapses.
While we know very little about some of these high-end, boutique facilities, it can be difficult to avoid the impression that they actually incentivize relapses. Suffice it to say, programs that focus on providing luxury for profit over quality addiction treatment do not meet high standards of addiction treatment.
Often times, the more expensive treatment centers are located in remote and beautiful locations. They will have newer, more architecturally appealing buildings, more activities, and more robust staffing. More expensive programs often feature better privacy as they are not located in the middle of busy metropolitan areas. It is a matter for debate as to whether or not luxury equates to better recovery outcomes- but it certainly makes spending time at such a place a more enjoyable experience.
What Makes Drug & Alcohol Rehab Expensive VS What Makes it Effective?
A study published in the International Journal of Psychological Rehabilitation cited a list of factors which the authors believe are key to success in addiction treatment. They write;
“[…] factors, which are most commonly employed by mental health professionals: Readiness (recognition, taking steps, ambivalence), Self-efficacy, Expectation about the therapy outcome, Satisfaction by the therapy treatment, Perceived Social Support, Depression/Anxiety/Stress levels of the client (clinical profile), Positive and Negative Emotions and the way in which clients realize the Meaning of Life.”
We have distilled their list as follows:
- Readiness for treatment
- Expectation about the therapy outcome
- Satisfaction by the therapy treatment
- Perceived Social Support
- Emotional wellbeing
- The way in which patients find meaning in life
Readiness for Treatment & Self-Efficacy
You’ve probably noticed that these are by and large perceptual aspects of the patient’s experience with rehabilitation. The patient must arrive ready and willing to succeed in recovering from addiction, and he or she must believe recovery is possible.
Expectation of a Positive Outcome
The patient must believe that a good outcome is possible. This requires both a sense of self-efficacy and confidence in the program. The perception that recovery is attainable can be aided by high-quality facilities and qualified, professional staff. These factors contribute to cost, but not so much so that one must necessarily attend a $100,000 a year clinic to benefit from them.
Perception of Social Support
It is key that patients believe that they have the support of friends, family, loved ones or other valued compatriots in their efforts to recover. Clinics with a robust group therapy component score well in this category. Those which employ social workers can also offer the patient access to additional social support programs and opportunities. Location also plays a factor in terms of what kinds of support are available- and whether or not such support is desirable.
Those suffering from depression, anxiety, or stress or are experiencing high sensitivity to negative emotions will have worse outcomes. Clinics that offer counseling and psychiatric help can help, but for those without co-morbid conditions, social support is usually enough.
What we can learn from this is that all of these factors can be made more robust by seeking more expensive treatment. More luxurious surroundings and better-funded programs can help boost confidence in treatment outcomes, promote a sense of well-being, and offer more opportunities to find social support. However, it is clear that programs falling along the lower end of the price range can also offer these kinds of human-oriented assets.
Finding Meaning in Life After Recovery
We are all aware of the importance programs like AA and NA place on a belief in a higher power. This has become a tradition for the mere fact that finding meaning in life is an overwhelmingly positive factor in promoting good treatment outcomes.
Other factors that predict success rates include:
- Variety of available treatments
- Mental health care
- Long-term treatment
The Value of Patient-Focused Drug Rehabilitation
What we find is that perception and motivation are key elements of a successful recovery. The real and meaningful support of professionals and peers is all but indispensable in most cases. Less luxurious rehab facilities might offend the sensibilities of those who are not used to living modestly. But being comfortable in rehab is not always a good thing.
Many clinicians will agree that rehab should feel like a challenge, not a soft place to land after a dramatic bout with substance abuse. Unfortunately, striking the right balance for every individual is not an exact science. What we can say for certain is that any rehabilitation program that is complete with a variety of available treatments, mental health care, and long-term treatment have a very high rate of success when paired with a patient who is both confident and determined.
The good news is the likelihood of a positive outcome does not depend on paying for the most expensive treatment. No matter how much you pay for qualified treatment, determination and confidence are your finest assets.
For many, even programs falling into lower price brackets can be difficult to pay for. Fortunately, Medicare, Medicaid, and private insurance usually help to cover much of the cost of treatment. Those who cannot access insurance may find clinics which accept payment along a sliding scale. Non-profit treatment centers and government subsidized facilities are also able to fill in the gaps in many instances. Many faith-based organizations offer free or low-cost alcohol/drug rehabilitation services.
Those seeking treatment, whatever the price range, should research the facility they are considering fully. Be sure the clinic offers evidence-based treatments. There are poor addiction treatment programs at both ends of the price spectrum. To avoid them, read up about the clinic, find patient reviews (not on the clinic website), and trust your instincts when it comes to choosing the right place to take a stand against addiction.