As the previous article suggested choosing an alcohol rehab can be very expensive, somewhere between £4,000 and £40,000 for a 28 day stay. So, if you are paying out that sort of money, make sure that you have enough information to be sure that you have chosen the right one. Here are 10 points to consider when choosing a detox for yourself or for your drinker.
- The first thing to consider when choosing an alcohol rehab is safety, so look at the medical cover available. Is there a doctor available 24/7 or at least is there one on call? A severely dependent drinker who has been drinking steadily for weeks or months can suffer badly from withdrawals, they can sweat, shake and feel extremely anxious. This can develop into full blown DTs (Delerium Tremens) which is a heightened withdrawal characterised by confusion and hallucinations, anxiety and raised heart rate, which can lead to cardiac arrest. Detoxing from alcohol can be a dangerous process, it can even be fatal. Because of this, many drinkers will need medication to stop drinking. Therefore, make sure that you are satisfied with the medical expertise and cover that the rehab provides.
- The actual detox will usually take a week or two, depending on the drinker’s physical and mental state, how long and how much they have been drinking and their level of dependence. However, it is what comes after the detox that is critical. Getting sober is a two stage process, getting sober and then staying sober. Getting sober is the only the first stage and, some would argue, the easiest stage. So, make sure you know what kind of aftercare they offer.
- What does the treatment program consist of? Does the facility follow a 12 step plan or is there a different type of program in place? Make sure that the treatment ethos is one that sits comfortably with you or your loved one. If their approach is not one you feel you can agree with, then there is will be little motivation to engage in it. Also find out how often do they have group meetings and how often do they have individual counselling?
- What training have the staff had? Are they in recovery themselves or are they from a medical background or is there a mixture of both? If there is a mixture, then the drinker can be exposed to a number of therapeutic influences, which may be beneficial. Alternately some individuals can feel conflicted by more than one approach. If there is individual counselling, what qualifications do the counsellors have?
- Will there be a follow-up plan and what would it consist of? Here are a couple of questions you might want to ask when you are choosing an alcohol rehab. Is it passive? That is, are there meetings that s/he can attend if s/he wants? Or is it more active – they will actively seek them out if they fail to attend? For example do they do home visits?
- Something people can overlook when choosing an alcohol rehab is – What is their relapse rate and how do they measure it? How do they manage relapse? Is there a contingency plan to deal with relapse?
- How long does the aftercare program last? This is a very important point. Statistics show that the relapse rate immediately after discharge is high and can continue high for at least three months. After that the relapse rates level off most clinicians regard two years as the beginning of real stability in sobriety.
- Will there be a named case worker who will be responsible for him/her, or will that task be shared with a team? Obviously the first is better as there is a clear channel of responsibility, whereas with a team, responsibility can be dissipated, and it is possible for the drinker to get lost in the cracks.
- Another important issue to consider when choosing an alcohol rehab is – Can the family be involved in any way? Will the facility offer help and support to family members and offer advice about how to give the drinker effective support? Is there a provision for the family to meet with the rehab team and ask all the burning questions they will have? Is there a hotline you can call in case of relapse? What support do they offer the family if there is a relapse?
- I’ve saved one of the big questions till last – How much does the facility cost? The reason I left it to the end being that there are some very important issues to be considered when choosing a rehab. Cost and quality are not always directly related but neither should you just choose the cheapest either. When you are quoted a price an important question to ask – Is that an all-inclusive figure or are there extras (eg medication, food, snacks, individual therapy). If the facility runs an A la carte approach costs (that you may not have factored into your budget) can mount up rapidly. So you will want a written estimate of what you are likely to pay. Finally, what guarantee, if any, do you get for that money? The facility may point the issue that outcome will depend on the drinker following the treatment regime but you should nevertheless ask the question and also ask if there is a refund if the drinker leaves the program early.
It is important to ask these, or at least some of these, questions so that you know not only what your money will buy you, but also to ensure that this is a safe and therapeutic environment. As the climate surrounding alcohol treatment changed (see part one of this article) most rehabs came to be organised on a more of a business footing. They became more independent and more competitive, which brought large differences in ethos and quality of care between them. Some really focussed on the latest scientific research of what is effective, concentrating on follow-up and outcomes. Others just plain got it wrong, as they concentrated more on the premises and providing a 5 star luxury experience with swimming pools and spas. There is nothing wrong with a bit of luxury, who doesn’t enjoy it? Provided that they don’t forget about the important stuff – safe detox, effective therapy and maintaining sobriety afterwards. So, make sure they get this bit right before you part with your savings.
You can use these 10 points as a tick list when you are choosing an alcohol rehab. The more of these questions you ask, the more confident you will be that you are getting value for money. But more importantly, the more likely that the detox will result in a successful long term sobriety. Hope this helps.