Addiction treatment considerations: Which rehab is best for me?
Admitting you have a problem with alcohol and drugs is the first and most important step you can take toward getting better, but then the question becomes, “Which rehab is best for me?”
There are two schools of thought when it comes to selecting the drug and alcohol treatment facility that will best meet your needs: One is that beggars can’t be choosers, meaning that addiction and alcoholism are deadly — there were 85,516 reported drug overdose deaths between August 2019 and August 2020, according to the Centers for Disease Control, which also reports that “excessive alcohol use is responsible for about 95,000 deaths a year in the United States.”
If your back is against the wall because of a drug or drinking problem, then sometimes the best thing you can do is commit to getting help, whenever and wherever you can get it. Asking “which rehab is best for me?” isn’t nearly as important as finding a facility that can help you avoid becoming a statistic.
On the other hand … if you’re an addict, then you have a drug of choice. If you’re an alcoholic, you have a preferred beverage. What do we mean by that? While you probably will take/drink/smoke/shoot/snort anything to get drunk or high, there’s always a drug or a particular brand of alcohol that you would use, each and every time, if it was readily accessible and affordable. It’s what you prefer, and there’s nothing wrong with being discriminatory about the help you get, if you have certain preferences that will make your rehab experience more meaningful.
So in that regard, yes — asking “which rehab is best for me?” is an important question, and it’s one that should be given some serious thought. Just don’t wait too long, and don’t let indecision prevent you from making a decision, because if you know you need drug and alcohol treatment, it’s all too easy to come up with excuses to avoid getting help because you’re afraid.
Which Rehab Is Best For Me: What Do You Want?
According to the National Institute on Drug Abuse (NIDA), there are three primary objectives that should be achieved by addiction treatment (meaning, treatment for addiction to any substance, including alcohol): It should help those seeking it
- “stop using drugs
- “stay drug-free and
- be productive in the family, at work, and in society.”
If you recognize you have a drinking or a drug problem, asking yourself what you want out of treatment is the best step toward answering the question, “Which rehab is best for me?” If you want to simply stop using, then what you really want, instead of treatment, is a medical detox program — and there are many of facilities, including those that offer residential inpatient treatment for addiction and alcoholism, that offer detox only.
According to the NIDA, “Detoxification, the process by which the body clears itself of drugs, is designed to manage the acute and potentially dangerous physiological effects of stopping drug use.” However, the organization hastens to add, “detoxification alone does not address the psychological, social, and behavioral problems associated with addiction and therefore does not typically produce lasting behavioral changes necessary for recovery.”
By this point, you may be wondering: “Psychological problems? Social problems? Behavioral problems? I just wanna figure out which rehab is best for me so I can stop shooting dope or make it through the day without drinking a handle of liquor!” That’s understandable, and definitely a worthy aspiration — but, and this can’t be overstated, getting clean and sober involves so much more than just putting down the drugs and alcohol. Why, you ask? Because those substances have essentially hijacked your brain, according to the National Institute of Health’s monthly newsletter:
“A healthy brain rewards healthy behaviors — like exercising, eating, or bonding with loved ones. It does this by switching on brain circuits that make you feel wonderful, which then motivates you to repeat those behaviors. In contrast, when you’re in danger, a healthy brain pushes your body to react quickly with fear or alarm, so you’ll get out of harm’s way. If you’re tempted by something questionable — like eating ice cream before dinner or buying things you can’t afford — the front regions of your brain can help you decide if the consequences are worth the actions.
“But when you’re becoming addicted to a substance, that normal hardwiring of helpful brain processes can begin to work against you. Drugs or alcohol can hijack the pleasure/reward circuits in your brain and hook you into wanting more and more. Addiction can also send your emotional danger-sensing circuits into overdrive, making you feel anxious and stressed when you’re not using the drugs or alcohol. At this stage, people often use drugs or alcohol to keep from feeling bad rather than for their pleasurable effects.
“To add to that, repeated use of drugs can damage the essential decision-making center at the front of the brain. This area, known as the prefrontal cortex, is the very region that should help you recognize the harms of using addictive substances.”
So There’s More To It Than Just Quitting?
Most definitely. That’s why determining what your needs are is going to play a big role in answering the question, “Which rehab is best for me?” Because drugs and alcohol have affected you physically (if you’ve ever tried to stop on your own, then you know you’re already physically dependent), but they’ve also affected you mentally — meaning, the circuitry in your brain has been compromised by your drug and alcohol use.
On top of that, we haven’t even touched on other psychiatric issues that often coincide with addiction and alcoholism. Take, for example, the stress of psychological trauma: grief, abuse, sexual assault or any number of issues that happen to us throughout our lives. A great many people impacted by those issues turn to drugs and alcohol as a means of dealing with them, according to author Gabor Maté, speaking in 2018 to the British newspaper The Guardian: “‘The primary drive is to regulate your situation to something more bearable.’ So rather than some people having brains that are wired for addiction, Maté argues, we all have brains that are wired for happiness. And if our happiness is threatened at a deep level, by traumas in our past that we’ve not resolved, we resort to addictions to restore the happiness we truly crave.”
Needless to say, that’s only a short-term solution, because it doesn’t resolve anything; it only provides a temporary anesthesia that fades with time, leaving the afflicted with both a psychological issue and a substance abuse issue.
And hey, there are also those individuals who turn to alcohol and drugs because of undiagnosed psychiatric conditions. According to the National Alliance on Mental Illness, “Substance use disorders — the repeated misuse of alcohol and/or drugs — often occur simultaneously in individuals with mental illness, usually to cope with overwhelming symptoms. The combination of these two illnesses has its own term: dual diagnosis, or co-occurring disorders. Either disorder (substance use or mental illness) can develop first. According to the National Survey on Drug Use and Health, 9.5 million U.S. adults experienced both mental illness and a substance use disorder in 2019.”
As you can see, it’s easy to dismiss everyone with a drinking or drug problem as garden-variety addicts and alcoholics who don’t know when to quit, but nothing could be further from the truth. And if you find yourself in such a predicament, then you’ve got to evaluate all of these things in order to answer the question, “Which rehab is best for me?”
Which Rehab Is Best For Me: What Do You Need?
By this point, you’ve hopefully begun to see that simply quitting might not be good enough. If you’re at least open to the possibility of needing (and maybe even wanting!) more than just detox, here are other types of treatment to consider, according to the NIDA:
- Long-term residential treatment, which focuses on the “‘resocialization’ of the individual and use the program’s entire community — including other residents, staff, and the social context — as active components of treatment. Addiction is viewed in the context of an individual’s social and psychological deficits, and treatment focuses on developing personal accountability and responsibility as well as socially productive lives.”
- Short-term residential treatment, designed to “provide intensive but relatively brief treatment based on a modified 12-step approach … the original residential treatment model consisted of a 3- to 6-week hospital-based inpatient treatment phase followed by extended outpatient therapy and participation in a self-help group, such as AA.”
- Outpatient treatment programs, which “cost less than residential or inpatient treatment and often is more suitable for people with jobs or extensive social supports. It should be noted, however, that low-intensity programs may offer little more than drug education. Other outpatient models, such as intensive day treatment, can be comparable to residential programs in services and effectiveness, depending on the individual patient’s characteristics and needs. In many outpatient programs, group counseling can be a major component.”
Those particular frameworks are fairly common across the drug and alcohol treatment field, so if you’re wondering, “Which rehab is best for me?,” then whichever facility you consider will likely have programs built around these models.
But of course, not all treatment facilities are the same, and ideally, you’ll select one that meets both your needs and wants. For example, does the facility you’re considering offer trauma therapy? Is there a dedicated psychiatric services department designed to provide dual diagnosis treatment for co-occurring mental health disorders? Are there other psychotherapies used, like Cognitive Behavioral Therapy, that have an evidence-based track record of success?
And of course, there are also other amenities that may be important to you, which is understandable and perfectly reasonable — if you have the financial means to be selective. For example, the pricier drug and alcohol treatment facilities are basically luxury spas, with private rooms, indoor pools, equine therapy and more. Government-funded facilities that provide grant beds to patients in need may be spartanly furnished with little to offer beyond clinical therapy — but the work staff members accomplish there can be just as effective as more expensive treatment.
Amenities may make you comfortable, but they won’t make you better, so keep that in mind as you make your decision.
Whatever You Decide, Make a Choice
Regardless of what your needs are, time is of the essence. That doesn’t mean you should drive to the nearest addiction treatment facility before you finish reading this article, but spending too much time wondering “which rehab is best for me?” can also lead to a paralysis of indecision.
Some other tips, according to U.S. News and World Report staff writer Ruben Cataneda:
- Get a professional assessment: “Before you decide on an inpatient treatment facility for yourself or a loved one, obtain an evaluation from a doctor certified by the American Society of Addiction Medicine, a licensed clinical social worker or a psychiatrist experienced in treating substance use disorders.”
- Find out if the facility you’re considering has the ability to meet your needs: “Check the website of any rehab center you’re considering to see if they have resources, such as counselors, to deal specifically with a dual-diagnosis … call the facility and ask them about each of the resources listed on the website; some facilities list services they don’t have.”
- Find out if the facility uses Medication Assisted Treatment, which can make a difference in whether you’re able to detox comfortably and have some necessary medical tools to stay clean and sober permanently.
- Make sure the facility you’re considering has an established track record: “Shy away from rehab centers that haven’t been in business for at least five years … some of these facilities may be fine, but others could be opportunistic, trying to take advantage of the high demand for such services.”
- Don’t confuse luxury, and therefore a higher price tag, with quality. And finally:
- Avoid facilities that guarantee success: “It’s impossible to guarantee success for an alcoholic/addict. It’s up to the individual to follow the treatment plan once he or she leaves the center.”
“OK,” you may be wondering, “but I still don’t know: Which rehab is best for me?” You’re likely going to find several that meet your needs, and you’ll need to evaluate your financial situation, as well as the availability of beds at those facilities, before you make your choice. The most important thing: Make a choice, because the longer you wait, the more your compromised and addictive thinking is going to convince you that maybe you don’t need rehab after all.
Trust your gut: Those who don’t have a drug or alcohol problem don’t sit around wondering if they do, so if you’re already trying to figure out “which rehab is best for me?,” then you’re already aware that you need help. Figure out what kind of help you need, and then work toward getting it.