Finding Good Drug Treatment
Finding the right alcohol and drug treatment center for you or a loved one is no easy task. If you are like most people, you did not learn anything about drug abuse or alcoholism in school. You may have caught a news story on television about the latest celebrity checking into “drug rehab” or athlete charged with impaired driving. However, these stories do little to inform the general public about what people actually do while they are at an alcohol and drug treatment center, how long they stay, or what you as a family member, partner or employer can do to help.
A lack of public knowledge is not the only challenge you may encounter as you try to locate an alcohol and drug treatment center that is a good fit. You will also find that virtually no two treatment centers are the same.
While the great variety of alcohol and drug treatment centers may be confusing, it also provides an opportunity for families and individuals to find a treatment center that is a good fit.
At Sunshine Coast Health Center, there is one thing that all of our callers looking for treatment have in common: they need help now. It’s an emergency. While approaching an emergency with a sense of urgency is entirely appropriate, it can leave families vulnerable to deciding on a treatment center before getting all the facts. Your first choice may not be the right choice.
In the end, your decision choosing the right alcohol and drug treatment center is based on three questions:
- Will he be happy there?
- Will he be safe there?
- Will this work?
Chances are you will not find a treatment center that is a perfect fit but if you do your homework and follow some of the suggestions provided below, you should be able to find the right fit.
No treatment center is going to guarantee you or your loved one’s happiness and safety while in treatment. Be wary of any treatment center that claims “miraculous” success rates or promises a clean and sober life following treatment. Here are some of the tell tale signs that an alcohol and drug treatment center may be a good choice for treatment:
A good treatment center should have nothing to hide and be candid about their strengths and weaknesses.
An alcohol and drug treatment center can demonstrate transparency by providing:
- actual photos of their facility (grounds, lounge area, bedrooms, meeting space, fitness center, etc.)
- detailed staffing information (name, job title, qualifications, etc.)
- a weekly schedule of client activities
- the price of the program (with details on what is included/not included in the admission fee)
A treatment center can easily provide this information on their website, via e-mail or by mailing a brochure.
While families frequently want to know success rates, very few alcohol and treatment centers have the resources, time or inclination to conduct science-based, objective outcome studies. For more information, contact the Sunshine Coast Health Center Admissions department toll-free 1-866-487-9010.
A simple phone call can tell you a lot about an alcohol and drug treatment center. The financial viability of a treatment center is dependent on converting inquiry calls into actual admissions (especially private facilities). Since your call is so important, treatment centers typically staff their phones with individuals with their best people who have the right combination of people skills, expertise and program knowledge. It stands to reason, therefore, that if the person answering the phone is courteous, candid, patient and helpful, the odds are increased that you or a loved one will have a similar experience while in treatment.
An alcohol and drug treatment center can demonstrate customer service by providing:
- A live person instead of a voice recording when you call for information
- Phone service evenings and weekends
- Constructive suggestions on how to make life better for or your loved one
- Names and phone numbers of other treatment centers if their treatment center is deemed inappropriate due to age restrictions, wait times, cost, etc.
- Sufficient time to get your questions answered
- Emotional support if fear, anxiety and fatigue overcome you during the phone conversation
- Travel assistance to facilitate an admission (booking flights, shuttle service, flight layover assistance, etc.)
If you find that a treatment center is interested more in your ability to pay than your predicament, you may want to look elsewhere.
During the phone conversation, an alcohol and drug treatment center that has good customer service practices will be working as hard as you are to make sure you or your loved one is a good fit. Here are some of the questions that an alcohol and drug treatment center may ask:
- Drug(s) of choice (quantities, length of use, date of last use)
- Treatment history (where/when rehab was provided, length of abstinence following treatment)
- Legal history (critical to maintaining safety in a peer group)
- Psychological history (to ensure adequate treatment for individuals with mental illness can be provided)
- Medical history (other concurrent medical conditions or high drug/alcohol toxicity may first necessitate a hospital admission prior to admission)
While nobody likes paperwork, spending a half hour completing an admission form will help the clinical staff at a treatment center ensure that their program will meet your treatment needs. A treatment center that is not selective does a disservice to you, the peer group and the staff.
Effective alcohol and drug treatment cannot be delivered if clients do not feel safe. Fortunately, determining if a treatment facility is safe is not difficult.
An alcohol and drug treatment center can help assure clients and their families that they are committed to client safety by:
- Confirming their facility is licensed with the local provincial health authority
- Obtaining legal, medical and psychological histories from prospective clients prior to admission
- Disclosing their policy on accepting direct referrals from correctional facilities
- Discharging clients that use drugs or alcohol during their stay
- Having on-site medical staff
- Being within reasonable driving distance to a hospital for medical emergencies
- Maintaining a safe distance from bars, liquor stores and convenience stores (often frequented by drug dealers)
- Drug testing when staff has reasonable grounds to suspect clients of drug or alcohol consumption
Formal licensing by a provincial health authority that includes regular unscheduled inspections of medical facilities, kitchen facilities and living quarters can ease concerns about a treatment center’s level of safety. Accrediting agencies such as the Canadian Council on Health Services Accreditation (CCHSA) and the Commission on Accreditation of Rehabilitation Facilities (CARF) can provide an added level of confidence. Ask potential treatment centers about the licensing and accreditation they maintain. If a facility is not licensed or accredited and they are unable or unwilling to schedule a site tour, you may want to consider another facility.
Individuals in treatment need clear boundaries as well as guidelines so that they can focus on their own recovery rather than worrying about whether individuals around them are using alcohol or drugs. Not all treatment facilities are abstinence-based so be careful to ask if rehab programs are abstinence-based (have a zero-tolerance policy) or follow a harm reduction approach (will make accommodations for possible use of mood-altering substances or unexplained absences).
It is important that a treatment center be able to demonstrate that policy is in place to maintain client safety and respond decisively when client safety is at risk.
The best program in the world will have no impact on clients if it is not delivered by capable clinical staff. When evaluating the abilities of a clinical team, look for:
- Experience (specifically with alcohol and drug counselling)
- Diversity (medical, mental health, and addiction expertise)
- Supervision (Program Director, Clinical Supervisor, etc.)
Be aware of programs that employ recent graduates or individuals in early recovery from alcohol or drug addiction. A good rule of thumb is that staff should have a minimum of 10 years in their personal recovery before working in the field.
A good treatment center will staff counsellors with a strong educational background specific to addictions, current certification with a nationally recognized counselling association and a minimum of 5 years residential treatment counseling experience.
5.a. Programming Qualities
Although there are as many approaches to alcohol and drug treatment as there are treatment facilities, a quality program will have sufficient:
- Intensity (sufficient to keep clients engaged)
- Focus (trying not to do too much, too soon)
- Variety (therapy, education, recreation, nutrition, etc.)
- Flexibility (adjusting the program to meet the needs of a client)
- Portability (the ability to apply curriculum to life after treatment)
Intensity can be determined by a review of the weekly client schedule. Note that some treatment centers are highly intensive with little flexibility while others are less structured and more individualized. One approach is not necessarily better than the other. However, just as grade school is different from university, high functioning clients may prefer less supervision and more time for reflection.
Focus is often a challenge for treatment centers that try to treatment too many varieties of disorders. While there are similarities in drug and alcohol addiction, eating disorders and other process addictions, group dynamics often suffer when focus is not maintained. A program that is focused on one addiction will have an easier time discussing issues that are relevant to the whole group and not just certain individuals.
Some alcohol and drug rehabs will provide counseling for sex and gambling addictions as a secondary focus but only if the client is primarily suffering from drug and alcohol addiction.
Another challenge for treatment centers is trying to cover too much, too soon. Since primary treatment is typically less than 60 days, a treatment center needs to build a foundation for a client’s long-term sobriety. Trying to cover too many Steps (going beyond Step Three) or advanced relapse prevention techniques may dilute the program and lead clients to believe that attaining information rather than self-awareness and fellowship is the key to long-term sobriety.
Variety is an important factor in keeping clients engaged in motivated, especially in primary treatment where access to off-site services is limited or not permitted. Variety is reflected in everything from program curriculum to nutrition and is consistent with encouraging clients to “sample” all that life can offer as they begin to make plans for their lives post-treatment. All treatment centers recognize the tendencies of clients to leave early. A program has an obligation to provide content that will engage a client and create a sense of progress and hope.
Flexibility is the ability of clinical staff to adjust to the needs of a client and will often be determined by the clinical staff-to-client ratio. A counsellor should have no more than 12 clients assigned to his/her caseload. Generally speaking, a counsellor with a smaller caseload will be more flexible around customizing a client’s treatment plan since there will be more time to be creative, to meet individually with clients and consult with the rest of the clinical team.
Flexibility is also required during the intake process. A window of opportunity exists when an individual decides to get help. A good treatment center recognizes this and will offer medical detoxification so that a client does not have to have “clean time” prior to admission.
Portability is the ability of clients to replicate in their home community what they learned in treatment. One of the more obvious examples of portability in a program is the amount of AA or NA meeting participation. Programs that encourage and practice AA or NA participation during treatment (especially off-site meetings) will naturally build portability into their program. While going to meetings can be an important antidote for the isolating tendencies of all clients in post-treatment, it is especially true for clients with limited financial resources or access to addiction counselling in their home communities.
5.b. Programming for Families
One of the more daunting realities for individuals completing treatment is that, while they may have changed, nothing has changed back home. While clients try to adjust to being home away from the safe environment of a treatment center, partners, family workers and co-workers may not fully appreciate how a client has changed. As a result, they may either wait to see signs that he/she is returning to old habits or they may assume that the individual is somehow “cured” of their addiction. Neither of these responses is constructive.
Family programs offers participants a better understanding of the nature of addiction and the recovery process and an opportunity for family members to begin their own healing from the days and nights of living with a loved one’s alcohol and/or drug use. Family programs can run anywhere from 3 to 7 days in length.
The result of family program participation is a shift in the home “dynamic” away from reaction and panic to constructive support for the client and self-care for partners and family members.
5.c. Programming for the Whole Person
Modern treatment centers are now promoting the concept of “wellness” that encourages physical, social, emotional and spiritual health in addition to the more traditional goal of being clean and sober.
When people stop using drugs and/or alcohol they need to deal with problematic emotional issues. Long term recovery from mood-altering substances occurs best when people develop a healthy lifestyle that supports recovery. Thus, individuals need to care for their:
- Biological needs (exercise, nutrition, physical therapy)
- Psychological needs (depression, anxiety, low self esteem)
- Social needs (estrangement from family, friends)
- Spiritual needs (selfish internal focus, having a purpose in life)
With nutrition, exercise programs and alternative therapies (massage, relaxation) to help combat physical stress, clients can develop healthy new lifestyles to strengthen their recovery. Mental health specialists, such as psychologists and psychiatrists, can work in conjunction with addiction counsellors to help clients address longstanding emotional issues that are holding them back from their potential to live a full life. Clients are encouraged to find greater purpose in life and an understanding of spiritual lifestyle principles such as compassion, gratitude, thoughtfulness and humility.
Be careful of treatment centers that offer quick solutions, techniques, or medications for quitting mood-altering substances without providing the necessary therapy needed for long term sobriety.
Follow-up is critical for staying connected and providing the necessary ongoing support after discharge.
The amount of Follow-up (also known as after care or continuing care) an alcohol and drug treatment center provides to alumni can be demonstrated by the provision of additional services such as reunions, cake nights, aftercare groups, telephone support, etc.
One of the more favourable changes in recent years has been a shift in attitude debunking the belief that a stay in “rehab” needs to be some form of punishment. As a result, treatment centers are now often located in comfortable, home-like settings that provide clients with the opportunity to experience the benefits of getting in shape, eating well and sharing life’s ups and downs with supportive, motivated staff and peers.
Don’t assume that a quality treatment center has the amenities that you consider important. If a treatment center concludes that a facility amenity has little therapeutic value, chances are it will not be available.
A quality facility may feature amenities and a location with:
- Private or semi-private rooms (as opposed to dorm-style accommodation)
- On-site medical detoxification
- A fitness center
- Outdoor or off-site recreation
- Proximity to nature
While a program may prefer to focus on the clinical aspects of an individuals treatment stay, a good treatment center recognizes that clients have other needs such as a desire for physical health and recreation.
No location, however, will be suitable to all individuals. You will have to decide if your loved one needs to be close to family or far away from “friends” and “old haunts.”
It is more challenging for a person to stay clean and sober after they have completed treatment and returned to their home community. Most, if not all, of the aspects of treatment may no longer be there including:
- Supportive, “sober” friends
- Daily, accessible access to counsellors
- A focus on recovery and healing
- A regular routine of healthy meals, rest and exercise
Instead, clients will eventually experience:
- Unresolved issues at home and work
- People, places and things associated with past alcohol or drug use
- Stresses associated with daily life (traffic, deadlines, bills, etc.)
Individual aftercare plans developed by a client and their counselor offer a meaningful “roadmap” in the recovery process. Typically, an aftercare plan will include regular support group attendance and counselling.
Finding the right program is critical when individuals and families are looking for an alcohol and drug treatment center. Finding the right program will help ensure you or your loved one is happy and feels safe while in treatment. Treatment centers recognize that treatment cannot work if a client leaves early so a good treatment center will strive to attain a balance between effective treatment and an enjoyable stay.
While alcohol and drug treatment is not a cure, practicing due diligence before you decide on a treatment center will greatly improve the odds of you or your loved one effectively managing the disease of drug and alcohol addiction.