How Can I Find Good Treatment?

by A. Thomas McLellan, Ph.D.

It is not hard to find treatments and services for addiction treatment. The phone book is full of therapists and counselors who offer "addiction-focused therapy." There are also over 13,000 licensed addiction treatment programs in the country. But it is hard to find addiction treatment that is appropriate for your problems, that is professional and effective, and that is available in the location and at the price that you can afford.

One of the reasons good treatment is so difficult to find is that there have not been published standards for "effective addiction treatment." Thus, virtually any therapist, program or service can claim expertise and effectiveness. Second, addiction treatment is poorly covered by most private health insurance plans. Most plans offer very limited benefits. Most addiction treatments are quite time limited - 21-30 days for residential care and 30-90 days of outpatient care. However, most cases of serious addiction require extended periods of care.

Things to Know About Addiction Treatment and Questions for a Treatment Provider

1. There is no cure for serious addictions - though addiction can be effectively managed. Question providers about their approach to care. Be wary of those who say they have had extraordinary successes or been able to return individuals to controlled use patterns.

2. There are effective medications for the treatment of nicotine, opiate, and alcohol addiction.

  • Question providers about the availability of medications. Do they approve of medications? Do they offer them?
  • Be wary of medications offered for the treatment of cocaine, marijuana, tranquilizer or methamphetamine dependence (the FDA has not approved any medications for these problems) - ask to see the evidence for the effectiveness of these medications.

3. There are effective individual therapies for the treatment of virtually all addictions. Question providers about which therapies their counselors and therapists have been trained in. Ask whether individual therapy is available and how many sessions. Be wary of programs that only use group therapy.

4. Family therapy is an effective component of care. Couples therapy and family therapy improve post-treatment function of the patient and the family.

  • Ask if family are involved in the treatment process - and in what ways.
  • Ask how the family will be prepared when the affected member returns home

5. Effective treatment involves monitoring of substance use throughout treatment. Ask if the program tests urine for substances of abuse.

6. Not all treatments work for all patients. Better treatment providers offer more than one approach, medication, therapy and service; and they monitor patient performance regularly to modify the treatment plan.

  • Ask how a provider can tell if a treatment is working and what they do if it is not?
  • Ask how many types of therapy, counseling, medications and other services are available for changing a treatment plan?

7. There are no short forms of treatment (medications, therapies or services) that are effective for individuals with serious addiction. Most forms of serious addiction require extended care beyond any formal period of treatment.

  • Ask about continuing care options available to patients. Ask how long the continuing care continues and what form it is (home visits, telephone).
  • Ask about formal efforts to link patients with AA or other mutual help groups.
  • Ask about linking the patient with their primary care physician to assure continuity of care.

Payment for addiction treatment can be a complicated matter. Learn some keys to navigating the complex maze of funding used to pay for private and public insurance coverage.

Prepare to advocate for your interests if your health insurance plan balks at covering treatment.









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