Substance Abuse Centers: Does Higher Cost Mean Higher Quality Treatment?

An addiction treatment center like Promises will probably remain out of reach for most of us. But does a lower price tag mean lower quality care? I can assure you that the answer is no.
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Time and time again, we hear about celebrities checking in and out of rehab. Last month, Whitney Houston and Amy Winehouse sought additional help after several earlier treatments. And they weren't alone. For anyone who reads People magazine, it would seem that the cycle of substance abuse, treatment, relapse and treatment again was a Hollywood rite of passage. Don't get me wrong, I applaud anyone who seeks treatment when the disease of addiction resurfaces; it's just a shame that celebrities have no choice but to have their relapses and stints in posh rehabs become front page news.

As an article on DailyFinance.com pointed out, celebrity relapses have not only provided constant tabloid fodder, but they've also been very good for the luxury treatment business. Residential treatment at Promises, where both Lindsay Lohan and Charlie Sheen have been clients, can cost up to $100,000 a month. Not a year -- a month! While respected treatment centers like Hazelden and Betty Ford are more reasonable ($28,300 and $27,400 a month, respectively), they might still be more than the average person can afford.

Sadly, cost can be one of the many reasons why more than 90 percent of those who meet the criteria for substance abuse or dependence in this country don't receive treatment. It might seem to regular folks that quality treatment is not within their budgets -- unless they become rich and famous or are willing to mortgage the house.

This isn't necessarily true, and fortunately, with health care reform, even more affordable quality care is becoming available to those who need it. Historically, consumers of mental health and substance abuse treatment services have faced inequities when it came to insurance coverage; treatment was limited to a small number of days or lifetime benefits were "capped" at 28 days or 30 visits.

However, the Wellstone/Domenici Parity Act now requires that insurers who cover addiction treatment do so at the same level of benefit they provide for other medical conditions. Additionally, the Affordable Health Care Act bars insurance companies from discriminating on the basis of pre-existing conditions, including behavioral health problems -- and requires substance abuse treatment and prevention services to be included in the minimum health care benefit packages of the individual market and small businesses. This legislation also provides incentives for treatment of substance use disorders to be integrated into the primary health care system; this integration will pave the way for improved and expanded services, such as brief interventions for individuals whose substance abuse has not yet reached an acute stage.

All this is to say that health care reform will make it possible for many more individuals and families to afford treatment. Still, a treatment center like Promises, which boasts spa-like amenities and beach-view private suites, will probably remain out of reach for most of us. But does a lower price tag mean lower quality care?

I can assure you that the answer is no. At Phoenix House, our residential treatment programs cost $12,000 or less, with over two-thirds costing $5,000 a month or less. We accept insurance and offer a variety of payment options. Like Promises, Caron, Hazelden and others, we use evidence-based methods, such as motivational interviewing and contingency management, to help our clients address their addiction or substance abuse problems and learn to live productive, sober lives. Our clients, like clients elsewhere, participate in group and individual counseling sessions led by credentialed staff. We also provide a full continuum of care -- from detox to residential treatment to outpatient, aftercare and recovery monitoring services -- in order to support the men, women and teens we serve throughout their recovery.

Many treatment centers -- regardless of whether they offer luxury accommodations -- focus on ensuring that those who seek help receive the best possible care, even though they don't provide high-end amenities like 1,000-count sheets. We take pride in our facilities, where we serve people from all walks of life -- including those who wouldn't otherwise be able to afford treatment. As anyone who's gone through the process will tell you, recovery is hard work, addiction is a chronic condition and relapse is common before a person achieves long-term sobriety. Any treatment organization that claims quick "cures" or near-perfect success rates is falsely advertising.

Time and again, our clients have shown us that lasting recovery is possible. The worst part about all the headlines about celebrities going "in-and-out" of rehab is that there are no headlines about the celebrities who are now able to successfully manage their disease. This perpetuates the stigma surrounding treatment, when the stigma should instead be placed on the illness and on people who do nothing to address their disease when it gets out of hand.

We need to shift our attention to the millions of people -- movie stars, schoolteachers, fashion designers, construction workers and others -- who have gotten their lives back on track. Your friends, neighbors and colleagues who are in recovery have all gained the tools they need to manage their disease, as have folks more well-known than them. And all of them are living the dream: a life without the shame, burden and stigma of addiction.

As many of our clients say, "Treatment works if you work it."

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