Consumer Treatment Guide

Whether you are seeking help for yourself, a family member, or a friend, finding the right treatment for a substance use problem or addiction can be overwhelming and confusing. Our partners are working tirelessly every day to address the many factors that are contributing to this uneven and chaotic treatment landscape. Our goal is to give you the all the necessary information to help you find the right starting point for you or your loved one.

There are numerous people and places who stand ready to help you—and our hope is to connect you with options that have your best interests at heart. We want to help you move from anxiety and fear to stability and hope.

This guide has been assembled to help you find and contact the right first resources for addiction treatment. Specifically, we are talking about treatment for alcohol or drug addiction. We try to do this in plain language and there are a few important terms we need to acquaint you with as we go. Importantly, this guide is not meant to replace any advice from a health professional. And we cannot guarantee, in any way, that you will receive quality treatment or have a positive outcome.

Let’s begin by showing you the treatment resources available in your area. You can select topics below the map display to help you select the right resources for your situation.

Let the questions below be a blueprint to help guide you or your loved-one to high-quality addiction treatment.

What type or level of treatment do I, or my loved-one need?

There are four levels of addiction care established by the American Society of Addiction Medicine (ASAM). Level one is the least intensive, with level four being the most intensive, in terms of time and resources. A comprehensive evaluation by a trained medical provider can help guide you in determining which level of care is most appropriate for you or your loved one.

What are the things I should look for when searching addiction treatment programs?

Research has identified elements that quality substance use disorder treatment facilities should possess. These range from personalized treatments, to national accreditation, to assertive linkages to continuing care.

The 11 Indicators of Quality Addiction Treatment:

1. Assessment and Treatment Matching (Identify)

Finding effective help for an alcohol or other drug use disorder begins with reliable and valid screening for a range of substance use disorders and related conditions, as well as any physical or mental health conditions. This is followed by a more comprehensive assessment of substance use history and related disorders, medical history, psychiatric history, an individual’s family and social networks, and assessment of available recovery resources (“recovery capital”). These assessments help uncover the many interrelated factors affecting the patient’s functioning, life, and readiness to change. This careful and comprehensive assessment finds important aspects of a person’s life, such as trauma or chronic pain, which aids in long-term recovery success.

2. Comprehensive, Integrated Treatment Approach (Treat)

As discussed above, patients in treatment may have co-occurring psychiatric disorders, like depression and anxiety, as well as other medical problems like hepatitis C, alcoholic liver disease, or sexually transmitted diseases. Programs should incorporate comprehensive approaches that directly address these additional concerns, or otherwise assertively link patients to needed services. Treating the whole patient will improve the likelihood of substance use disorder recovery and remission.

3. Emphasis and assertive linkage to subsequent phases of treatment and recovery support           

Continuing care is defined as the ‘ongoing care of patients suffering from chronic incapacitating illness or disease.’ Ongoing care provides essential recovery-specific social support and necessary recovery support services after the patient leaves or transitions away from the initial phase of treatment. Programs that strongly emphasize this continuing care aspect will provide more than just phone numbers or a list of people to call, but instead, will provide assertive linkages to community resources, on-going health care providers, peer-support groups, and recovery residences. This ‘warm hand-off’ or personalized introduction to potential peers and resources in the recovery community, produces substantially better outcomes.

4. A dignified, Respectful, Environment

The treatment program should possess at least the same type of quality environment as one might see in other medical environments (e.g., oncology or diabetes care). You don’t need palm trees and luxury mattresses, but you should expect a clean, bright, cheerful, and comfortable facility. It is important that the program treats substance use disorders with the same professionalism and allocates similar resources for patient care as other chronic conditions. Creating a respectful and dignified environment may be particularly important for addiction patients because those suffering from substance use disorders often feel as if they’ve lost their self-respect and dignity. A respectful environment helps them regain it.

5. Significant Other and/or Family Involvement in Treatment

Engaging significant others and loved ones in treatment increases the likelihood that the patient will stay in treatment and that treatment gains will be sustained after treatment has ended. Techniques to clarify family roles, reframe behavior, teach management skills, encourage monitoring and boundary setting, re-intervention plans, and help access community services. All family involvement strengthens the entire family and helps family members cope with the family changes that occur in recovery.

6. Employ strategies to Help Engage and Retain Patients in Treatment

Dropout from addiction treatment within the first month of care is around 50% nationally. Dropouts leads to worse outcomes, so it is vital to employ strategies to enhance engagement and retention. These include creating an atmosphere of mutual trust through clear communication and transparency of program rules, regulations, and expectations. Treatment programs can also work to retain patients by providing person-centered, empathic, counseling that works to build strong relationships. They also can use motivational incentives to reward patients for continued attendance and abstinence.

7. Use of Evidence-based and Evidence-informed Practices

Programs that deliver services founded on scientific research and principles and that are delivering the available “best practices” tend to have better outcomes. In addition to psychological interventions, these should include accessibility to FDA approved medications for addiction (e.g., buprenorphine/naloxone, methadone, naltrexone/depot naltrexone, acomprosate) as well as psychotropic medication for other types of psychiatric conditions (e.g., SSRIs etc.). This is typically combined with qualified staff (see below).

8. Qualified Staff, Ongoing Training, and Adequate Staff Supervision

Having multi-disciplinary staff (e.g., addiction, medicine, psychiatry, spirituality) can help patients uncover and address a broad array of needs that can aid addiction recovery and improve overall functioning and psychological wellbeing. Staff with graduate degrees, and adequate licensing or board certification in these specialty areas are indicators of higher quality programs. In addition, clinical supervision and team meetings should take place at least once or twice a week for outpatient programs and three to five times a week for residential and inpatient programs.

9. Personalized Approaches that include Specialized Populations, Gender and Cultural Competence

Stemming from individualized comprehensive screening and assessment, programs should treat all patients as individuals attending to their needs accordingly. One size does not fit all, and neither does one treatment approach work for every individual. High-quality treatment programs identify the potentially different needs of men and women, adolescents versus adults, and those from different minority communities (e.g. LGBT) or cultural backgrounds, creating in turn, treatment and recovery plans that address their specific needs and acknowledge their available strengths and recovery resources.

10. Measurement of Program Performance Including During-treatment “Outcomes”

A further indicator of quality treatment is having reliable, valid measurement systems in place to track patients’ response to treatment. Similar to regular assessment of blood pressure at each check-up in treating hypertension, addiction treatment programs should collect “addiction and mental health vital signs” in order to monitor the effectiveness or ineffectiveness of the individualized treatment plan and adjust it accordingly when needed. Without any kind of standardized metrics, it is difficult to document and demonstrate patients’ progress.

11. External Accreditation from Nationally Recognized Quality Monitoring Agencies                             

Accreditation from external regulatory organizations such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO; aka “the Joint Commission”), the Commission on Accreditation of Rehabilitation Facilities (CARF), and the Council on Accreditation (COA); and other programs licensed by the state are required to offer minimum levels of evidence-based care. These licensing and accreditation requirements serve as quality assurance that the treatment program is incorporating a certain level of evidence-based care in its model and is open to random audit of its clinical care.

What should I watch out for when searching for addiction treatment programs?

Unethical addiction marketing practices take advantage of vulnerable patients and families in desperate need of medical treatment and care. Awareness is the first step in combating unethical addiction marketing practices and protecting you and your loved ones. When looking for addiction treatment, it is important to be able to identify some of the more prominent forms that these corrupt practices have taken.

Here are the most common:

  1. PATIENT BROKERING

Lead Selling: Paying brokers a per-head finders-fee or kick-back for referring patients to their treatment facility (e.g. financial compensation ($500-$1000 per patient) or special future consideration. This type of patient brokering is not only happening with patients new to treatment, but also in agreements made between recovery residences (e.g. sober houses) and treatment centers, or between two separate treatment centers.

Lead Buying: When treatment centers bid for patient referrals and leads. Call centers are set up to generate commission based on their number of placed referrals, with call center agents posing as caregivers, and unbeknownst to the patient, auctioning off the patient to the highest bidding treatment center. Treatment facilities that appear as separate actually may all route to the same call center.

*Patient Brokering often entails what is called “Addiction Tourism,” which is the practice of sending a patient out of their home state to receive treatment at a facility in a different state.

  1. PATIENT ENTICEMENT

Unethically incentivizing patients to enter, stay, or switch addiction treatment facilities through money, gifts, free rent, flights, food, or other amenities.

  1. LISTING THEFT

The hijacking of Google business or Google Maps listings through the suggested edits feature. Unaffiliated individuals can go into an organization profile and change listed phone numbers to reroute calls and online correspondences to other treatment programs or call centers, and change listed addresses to deceive patients of actual location.

  1. MISREPRESENTATION OF SERVICES

When treatment facilities deny their affiliations to other facilities or organizations or inaccurately portray the services they provide, their status of accreditation, the types of conditions they treat, the credentials of their clinical staff, what insurance providers they accept, or misrepresent their facilities, locations and amenities in any way.

  1. PATIENT PRIVACY VIOLATIONS

The common practice of a patient’s health information, such as their treatment plan or diagnosis, discussed in a sales or marketing context, and shared with individuals outside the patient’s care team, without medical necessity or the patient’s consent. This is in violation of HIPAA and other patient privacy protection laws that work to protect sensitive health information of the individual.

  1. INSURANCE OVER-BILLING

The process of billing insurance companies excessively for unnecessary treatment or services. This was commonly seen in urine drug screens, where $10 drug tests were being conducted every 2 days and billed at $1000 or more to insurance.

  1. INSURANCE FRAUD

Under the guise of free insurance or care, patients, sometimes multiple at a time, are enrolled in insurance plans utilizing false addresses to take advantage of the “change in address” exception, which allows for year-round insurance enrollment. Patients are often unknowingly signed up for premium plans with generous coverage (e.g. out-of-network coverage and low out-of-pocket costs) available in states that the patient does not live in, nor has ever lived in, but serve to reimburse the ultimate treatment center at a higher rate than other plans or providers.

How do I find addiction treatment providers near me?

You can use the Addiction Resource Hub to find providers near you:

-You can search by treatment provider name to learn more about the facility and get detailed contact information.

-Or you can select different service options to see resources in your area that meet criteria for publication.

You can learn more about searching for resources and creating collections in the Addiction Resources Hub at: resources.facingaddiction.org/find-it

How do I find out if a treatment program is covered by my insurance?

You should start by calling your insurance company to ask specific questions about treatment coverage. Be sure to have your insurance card ready. We suggest asking:

-What type of plan do I have? Is it a Preferred Provider Organization (PPO), Health Maintenance Organizations (HMO), Exclusive Provider Organizations (HMO), or Medicare.

– Based on your plan type, do I need prior authorization, assessment, or referral for substance use disorder treatment coverage? Be aware that the requirements may be different depending on whether you are looking for detoxification services, inpatient or residential treatment, or outpatient or partial hospitalization.

Once you have this information, tell the insurance company representative that you are looking for an eligible treatment provider within a particular area. Then, ask your insurance company to pull a list for substance use disorder facilities, and another list for opioid (insert primary substance) treatment programs, or co-occurring disorder treatment programs. Have your insurance company email you the different lists. Ask which programs on the list are in-network and out-of-network based off your plan type. You may want to ask about the costs and co-pays associated with in or out-of-network status.

When you have this information, you can use the treatment resources map located above to help you find the best treatment option for your situation.

How do different people recover, or does everyone recover the same way?

There are many different ways that people recover from a substance use disorder. It is important to recognize that as every individual is different, so is their recovery. While certain interventions may work well for some, these same interventions may not work well for others, or not work well at that particular time in their recovery journey. There are three broad categories that group multiple different interventions together to form three distinct pathways to recovery:

Clinical Pathways to Recovery: Recovery processes aided by the services of a healthcare provider, clinician, or other credentialed professional. Including: Pharmacology or Medication Assisted Treatments, Holistic-based Recovery Services, various forms of psychosocial talk therapies and counseling (e.g. cognitive behavioral therapy, 12-step facilitation, relapse prevention).

Non-clinical Pathways to Recovery: Recovery processes that do not involve a trained clinician but are often community-based and utilize peer support. Including: Recovery Residences, Recovery Community Centers, Peer-based Recovery Support, Education-based Recovery Services, Employment-based Recovery Services, Faith-based Recovery Services

Self-managed Pathways to Recovery: Recovery processes that involve no formal services, sometimes referred to as “natural recovery”. In other words, people are able to successfully stop or cut down to non-harmful levels of alcohol/drug use without external help.

 

This guide was developed with the guidance of the Recovery Research Institute. Please visit their site for more evidenced-based information on treatment and recovery.