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Learn why virtually all addiction treatment programs spend a great deal of time and energy teaching relapse prevention strategies. Why they do it, what they teach and what you need to learn.

Anyone can quit…it’s staying quit that’s hard.

That's why any addiction treatment program worth its salt spends a great deal of time teaching you how to avoid slipping back to your old ways.

You need to work to prevent relapse, and you do this by:

1. Learning to identify situations, (physical, mental and environmental) that increase your risk of relapse
2. Trying to prevent the occurrence of such situations

3. Learning coping skills that help you to handle such situations when they do occur¹

Relapse is common so relapse prevention efforts are vital. Read on to discover more about what you can expect to learn in drug rehab relapse prevention classes.

Does Relapse Just Happen?

No!

Although on the day of a relapse it may seem like it just came out of nowhere, relapse is actually a process that begins long before you drink or use again.

The process of relapse begins when you start slip-sliding back into old habits of behavior and thought, such as:

• Getting overconfident – you stop trying to minimize your exposure to the people, places and situations that trigger cravings
• Letting stress and problems build up to a crisis point
• Isolating
• Failing to take steps to counteract negative emotions, such as anger, boredom or loneliness
• Forgetting to take care of your nutrition, get enough sleep or sufficient exercise
• Letting your recovery plan and activities slide²

Relapse Statistics

You don’t have to relapse, but you need to understand that addiction is a chronic disease and that many people experience multiple periods of relapse and remission over a lifetime.

According to the National Institute of Drug Abuse (NIDA) drug addiction relapse rates range between 40 and 60% and of people that relapse, about 2 in 3 will relapse within the first 6 months of recovery³

So a significant percentage of people will relapse. Don’t feel discouraged, but accept that:

• You don’t have to relapse, and the best way to avoid relapse is to get treatment and to work hard on changing your lifestyle and on relapse prevention efforts
• If you do relapse, it doesn’t mean that your recovery process has to end; what it really means is that you need to get back to what was keeping you clean and sober before and that you likely need a refresher addiction treatment intervention

So treatment isn’t a magic cure to addiction, but if you pay attention and work hard, treatment offers you the knowledge and tools you’ll need to avoid backsliding.

But of course, tools alone won’t do much, unless you use them, every day.

What Causes Relapse?

According to the Substance Abuse and Mental Health Administration (SAMHSA), typical causes of relapse include:

• Lacking skills to deal with social pressures to use or drink
• Over-exposure to temptation and triggers
• Lacking skills to handle negative emotions or interpersonal conflict
• Testing your readiness to drink or use with moderation
• Lacking skills to manage recurring cravings⁴

So to avoid relapse you need to learn a few important skills; you learn these skills in relapse prevention classes.

Relapse Prevention Programs

A typical relapse prevention program consists of the following components:

1. Learning from Your History

If you don’t understand how you got in this mess, how can you expect to avoid repeating your past mistakes?

When looking back at your past you’ll focus on:

• Making a detailed history of your drug and alcohol use
• Listing the problems that caused you to seek treatment
• Listing reasons why previous treatment efforts or self-efforts at abstinence failed – what led to relapse? What situations got you into trouble?
• In past recovery efforts (if any), it’s important to identify which recovery exercises and tasks you completed and which you ignored or failed to follow-through with. It can be helpful if you can link your failing to complete a recovery task (like going to meetings) with your relapse.⁵

2. Learning about Relapse and Its Typical Causes

The more you know about relapse and its causes the better. A typical relapse prevention program will include education on some typical causes of relapse, such as uncontrolled anger or over-exposure to temptation, and an overview of some general protective strategies.

3. Making a List of Dangerous Situations

In your recovery plan you will need to prepare for high-risk situations, but before you can prepare you must first identify what threatens your recovery process.

By looking back at your history and by looking within you’ll develop a list of situations to avoid – and then later you’ll develop a plan for how you’ll deal with each situation, should it arise.

4. Learning about Warning Signs That Warn of Imminent Relapse

Relapse doesn’t come out of nowhere and the process of relapse begins some time before you drink or use.

Some example warning signs of imminent relapse include:

• Thinking you’ve got addiction beat and that you no longer need help or support
• You’ve started lying to those closest to you
• You stop making conscious plans for the future and for recovery success
• You start feeling really irritated with friends and family members and you start avoiding their company
• You start feeling resentful or self pitying
• You start entertaining ideas about drinking socially
• You stop trying to keep a structure to your daily activities⁶

If you can recognize relapse warning signs you can correct yourself before you stray too far off the right path.

To facilitate this, most relapse prevention programs teach daily or regular inventories, so you can make sure, every day, that you’re doing your healthy recovery activities and avoiding high-risk activities/situation/thoughts.

5. Learning and Practicing Coping Skills

1. You will face cravings and difficult situations and you will have to deal with anger, frustration and stress.
2. Since you know what’s coming, it’s a good idea to get ready
3. You prepare yourself by learning and practicing coping strategies

Some examples of coping strategies you might learn include:

• Urge surfing techniques
• Getting involved with community self-help organizations
• Getting rid of drug and alcohol paraphernalia/reminders
• Limiting your contact with people you used to use/drink with. Changing your phone number
• Cutting up your ATM and credit cards. Having someone take control of your finances for you
• Trying new drug-free recreational activities
• Scheduling free time

6. Developing a Structured Recovery Plan for Dealing with High-Risk Situations

You make a list of personal high risk situations and warning signs that warn of imminent relapse and then you make a plan for what you’ll do, specifically, when you experience any of these warning signs or high-risk situations.

You match each warning sign or risky situation to a specific and appropriate coping strategy or activity.

For example:

• If I start entertaining thoughts of social drinking – I will go to an AA meeting and I will call my sponsor to talk about this option.

You also make a general schedule to integrate recovery activities into your daily/weekly routines. By sticking to your schedule you increase your odds of recovery and when you deviate from your schedule you’ll know that you’re increasing your odds of relapse.

7. Involving Close Family Members

Getting people close to you involved in relapse prevention planning and maintenance decreases your odds of relapse.

8. Making a Post-Relapse Intervention Plan

You hope and work for the best but plan for the worst.

The truth is, you may relapse – but not all relapses wreak the same destruction – not all people spiral back to full-blown out of control use.

With a post-relapse plan already made you won’t have to wonder about what to do after a relapse - you’ll already know - and by following the steps on your post-relapse plan, you’ll get back on the right track quickly.⁷

You may also work on a post-relapse plan with and for significant others, giving them instructions about what they need to do after a relapse. This way they’ll know what steps to take, without delay, and they’ll know they are following in your true best wishes.

9. Updating the Relapse Prevention Plan over Time

As your circumstances change throughout the early recovery period you need to keep-up by taking some time to regularly revisit and modify your relapse prevention plan, on an as needed basis.

Experts recommend updating your relapse prevention plan once a month for the first 3 months, once every 4 months after that for the first year, twice a year for the next 2 years and once per year after that.

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Will your health insurance pay for your rehab stay? Read on to find out how insurance companies make approval decisions and make sure you can prove that you need the care you’re entitled to.

Need coverage for rehab and wondering if you qualify? Well, unfortunately, there’s no way to condense the labyrinthine legalese of a thousand care policies into one comprehensible document.

But fortunately, provided your policy covers substance abuse treatment, all you really need to understand is the concept of Medical Necessity.

If you can prove that you have a medical need for residential substance abuse treatment (rehab), your provider should accept your claim.

But how do you prove that?!

Read on for a brief explanation of medical necessity and for some examples of the kinds of behaviors and situations that should qualify you for residential substance abuse treatment coverage.

The Concept of 'Medical Necessity'

Most insurance companies approve or reject treatment based on the principles of medical necessity.

According to the American Society for Addiction Medicine (ASAM), the core components of medical necessity are:

1. The requested treatment services are required to diagnose or treat a suspected or identified illness or condition.
2. The requested treatment services are appropriate for the condition and meet the standards of good medical practice (meaning that scientific evidence proves that the requested treatment is effective for the condition).
3. The requested treatment is required for more than just the convenience of the requester or provider (meaning, for example, that though you might find it more comfortable to go away to rehab, unless you can prove that you need it for a medical reason, you will likely get coverage only for outpatient treatment).¹

Although the ASAM identifies only these three core components, most insurance companies add a fourth component to the decision-making process, namely that:

4. The requested treatment is not more costly than any other treatment that is as likely to produce an equivalent result.²
   

Examples of What Qualifies You for Rehab Coverage

You’ll likely need to read the fine print of your policy documents to know for sure, but if your contract covers substance abuse treatment then read on for some general examples of the kinds of preconditions that generally result in a claim approval for residential treatment.

You’ll probably need to meet ALL of the following criteria:

• Your withdrawal symptoms can be managed at the requested level of care (you might need hospital detox, first, for example)
• You are cognitively able to participate in a treatment program and have no other medical problems which preclude your ability to participate
• You show evidence that you want treatment and that you are motivated to work toward recovery

You’ll need to meet AT LEAST ONE (and possibly more) of the following criteria:

• The severity of your self-harm or risk taking behaviors present a serious threat to yourself or to others and these self-harm or risk taking behaviors can’t be effectively managed outside of a 24 hour facility.
• You have acute medical problems that make it difficult or impossible for you to stay abstinent outside of a residential environment
• Your substance abuse is causing severe problems in at least 2 domains of life, such as school/work, family, social relationships, physical health etc.³
  
• There is evidence that a lower level of care wouldn't help (such as previous attempts within the last 3 months at a lower level of care, like an intensive outpatient program.)
• There is evidence that unless you get residential treatment your condition is going to continue to worsen, to the point where you’ll probably need hospitalization (a more serious level of care)
• There is evidence that residential treatment should help to ameliorate symptoms⁴
• Your current living arrangements are dysfunctional and endanger your recovery progress and there are no other clinically appropriate or available living arrangements

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Answers to your basic questions about getting into a treatment program rather then sent to a jail cell. How it works, why it works and where to find court approved treatment.

If you’re charged with a non-violent drug or alcohol related crime, there’s a reasonable chance that you can avoid prison by agreeing to get addiction treatment instead.

Rules vary by jurisdiction, but in general, the three basic ways you can get treatment instead of jail are:

1. The judge in a conventional criminal court may sentence you to some form of addiction treatment as a part of your sentence
2. Your lawyer may work out a deal with the prosecutor prior to your appearing in court so that you can complete a certain period of treatment as part or all of your punishment
3. You may have the opportunity to appear in drug court, instead of a conventional adult criminal court

Are You Eligible? Can You Avoid Prison by Getting Addiction Treatment Instead?

Maybe… - Alternative sentencing laws vary by jurisdiction, but you should talk to your lawyer about the possibility of getting diverted to treatment instead of jail, especially if:

• This is your first or second offense and you have no history of violence or sexual assault
• You are a non violent offender and haven’t committed a sexual offense
• You’ve been arrested on a drugs crime, were intoxicated or high when you committed your crime or your addiction to drugs or alcohol contributed to your committing of a crime.
• You are addicted to drugs or alcohol
• You are willing and able to comply with any mandated treatment
• You are willing to plead guilty to your crime (in many states, after successfully completing court mandated treatment your criminal record is expunged)

What’s a Drug Court?

You may also be given the option of appearing in a drug court, rather than a conventional adult criminal court.

Within the justice system, drug courts operate to divert appropriate offenders out of the prison track and into addiction treatment. As of May 2012, there were more than 2,600 drug courts in operation in America.¹

You cannot be forced to participate in drug court (participation is voluntary) but if you decide to participate you will have to plead guilty to your crime and agree to participate in an addiction treatment program. Some common components of a drug court sentence include:

• A sentence length of between 1 and 2 years
• Mandatory treatment participation
• No drug or alcohol use
• Frequent random drug and alcohol testing
• Frequent court appearances for progress updates
• Making restitution to victims (if any) by community service or payment
• Rewards for program compliance and sanctions for infractions, like failed drug tests (a weekend in jail, for example.)²

Drug court can keep you out of prison, but only if you live-up to your end of the bargain.

Can Forced Treatment Really Work? Don’t You Have to WANT to Quit?

Despite the popular belief that you must hit rock bottom before you can start to get better, people forced into treatment programs have similar outcomes to people who enter into treatment for other reasons.

For example: A California study on methamphetamine users found that both people coerced into treatment by the criminal justice system and people entering into treatment of their own accord had similar rates of methamphetamine use post treatment, similar rates of total abstinence post treatment and similar overall recovery rates at 24 months post treatment.

Interestingly, one factor that affected the success rates of both the coerced and voluntary treatment seekers was duration of treatment. Universally, people who stayed in treatment for longer periods had better outcomes than people who finished with treatment more quickly.³

Why Does Coerced Treatment Work Just as Well?

It seems like you’d have to want treatment to have any hope of benefiting from it – after all, though the courts can make you listen, they can’t force you to really change your thinking. So why does it work then?

No one knows for sure, but a common explanation is that though you might not want treatment at the beginning, you might also change your tune as you progress through the program, learn more, make gains and feel better and start to see that a life of recovery is not only possible – it’s desirable.  

Sometimes it’s just hard to see the possibility of a better future through the foggy thinking of drug or alcohol addiction.

In any case, one thing you can be sure of is that addiction treatment works a whole lot better than prison to reduce drug and alcohol use. Compared to non treated offenders, criminal justice clients who completed a drug court imposed sentence:

• Failed fewer drug tests (29% vs. 46%)
• Were less likely to get rearrested (52% vs. 62%)

Where Can I Find a Treatment Program that Accepts Court Ordered Clients?

To find out which facilities can treat court ordered clients:

1. Visit the Substance Abuse and Mental Health Services Administration’s (SAMHSA) state by state treatment locator
2. Choose your state from the drop down menu
3. Call the contact phone number you find or follow a link to visit your state’s substance abuse website

How Much Is Court Ordered Substance Abuse Treatment Going to Cost?

In virtually all cases, you are responsible for finding and funding your court ordered treatment.

The costs can vary greatly, depending on the type of treatment you need and on facility and program features and amenities.

A one day DUI course might cost a couple of hundred dollars, a multi-month intensive outpatient program a few or more thousand dollars and a 28 day residential rehab from $7,000 on the low end to a private care average of about $19,000 (and for an exclusive private facility, quite a bit more than this.)⁴

If you cannot afford to pay the full price of treatment you can likely find an approved facility that will offer treatment on a sliding payment scale that is related to your income and ability to pay for services.

To search for affordable care, visit SAMHSA’s treatment locator and search for treatment in your state by your area code. When you define your search, make sure to click on the required button for criminal justice clients and for treatment offered on a sliding scale basis.*

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Choosing the right drug rehab is no easy task, and since the right program can make the difference between success and failure, the stakes are high and making the right decision is pretty important. Here are 5 questions you need to ask and answer about any rehab under consideration.

Finding the right treatment program can be tough. Make the right choice and you’ve got an excellent chance at long term recovery. Pick the wrong one and you’re far more likely to exit before completion and far more likely to relapse back to substance abuse. The stakes are high, but how can you know what’s right for you?

To help with this difficult task, the experts at the National Institute on Drug Abuse (NIDA) came up with 5 questions you need to ask and answer about any addiction treatment program under consideration:

Does the program use evidence-based behavioral therapies and, if appropriate, medications?

Does the program employ proven effective behavioral therapies, such as cognitive behavioral therapy, motivational interviewing, motivational incentives and group therapy?

Behavioral therapies help people build and sustain motivation to change and teach the skills needed to maintain recovery, and they are an essential part of the treatment experience.

When appropriate, certain medications can also help those in recovery manage withdrawal symptoms and overcome cravings to use. Medications are most effective when they are combined with behavioral therapies.

Be wary of any treatment program which does not offer behavioral therapies. Some treatment programs may not make use of effective medications on philosophical grounds or due to a lack of staff expertise. Programs which do not or cannot incorporate effective addiction treatment medications into the treatment experience are not likely as effective as programs which make full use of these medications.

Is a personalized treatment plan developed around your individual situation?

You are an individual. Your combination of past experience, culture, health and mental health needs, gender, sexual orientation, motivation and age are unique to you and nobody else.

Because of this, you come into treatment with unique needs and require services adapted to meet your specific needs – there is no one-size-fits-all solution.

The best treatment programs will screen for mental illness and will evaluate your individual situation and develop a personalized treatment plan for you alone, and because addiction does not occur as a problem in isolation from the rest of your life, the best treatment programs will also help to coordinate other services you may need, such as child care, medical care, legal services, education, job training and others services.

Will treatment be adapted to your changing needs?

The types of treatment you need at day 1, day 15, day 100 and day 300 aren’t the same, and it can be difficult to predict the progress you’ll make and the services you’ll need in the future.

The best treatment programs adapt to your changing needs by periodically re-evaluating your situation and making changes as necessary.

Addiction is a disease of relapse and remission. Relapse does not mean that treatment has been ineffective but rather that treatment of a greater intensity is once again required. Because of this, effective treatment programs may try to monitor for drug use so that they can intervene quickly should relapse occur.

Is the treatment long enough?

Treatment should step-down in intensity over time but it should not be overly brief.

Research indicates that 3 months is about the minimum duration you should consider and ideally the program is set up to accommodate periodic stints of higher intensity treatment after slips or relapses.

Although treatment needs to be of sufficient duration treatment does not need to be residential for the entire stretch.

Are you introduced to the 12-Steps or a similar community based support group program?

People who continue to participate in community support groups and/or group therapy such as that offered in AA, NA and other group meeting programs have better recovery rates than people who do not continue to participate in group meetings after the end of a formal period of addiction treatment. Because of this, there is value to an introduction to such programs while still in an addiction treatment program.¹

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Information on the average costs of private addiction treatment and the program costs of many of the country’s best known rehabs.

I want to go to rehab…but how much will it cost?!

It’s a logical question that’s frustratingly hard to get answered.

So, to give you a better idea of the costs of drug rehabs in various locations across the country, this article contains the following information: 1) the results from a survey study on the average costs of private addiction treatment programs, 2) example prices from a number of the country’s best known facilities (as you will see, prices can differ dramatically), and 3) information about finding discounted, free or sliding scale payment programs.

Average Private Addiction Treatment Costs

Open Minds Consulting released a survey study in February 2011¹, on the average costs of services from 44 private treatment providers. They found that:

• Medical detox averaged $1,707 per day
• 28-day residential treatment programs averaged $19,067
• 10-week intensive outpatient programs averaged $6,863

Example Pricing for Drug and Alcohol Rehabs across the Country²

Prices are always subject to change and you should confirm pricing information with any individual facility you may be interested in.

Arizona

• Sierra Tucson: Tucson, Ariz. - $47,680
• Back2Basics Outdoor Adventures: Flagstaff, Ariz. - $8,500 per month
• The Meadows: Wickenburg, Ariz. - $44,000 for a 5 week program
• Prescott House: Prescott, Ariz. - $6,850

California

• Sober Living by the Sea: Newport Beach, Calif. - $42,000 for 3 months
• Alta Mira: Sausalito, Calif. - $50,000 per 35 day stay
• Authentic Recovery Center (ARC): Los Angeles, Calif. - $25,000
• The Beach House: Malibu, Calif. - $10,000 per month
• Beit T'Shuvah: Los Angeles, Calif. - $5000 (for residents of California)
• Betty Ford Center: Rancho Mirage, Calif. - $32,000
• Casa Palmera: Del Mar, Calif. - $30,000
• Cliffside Malibu: Malibu, Calif. - $53,000 per month
• Cri-Help: Los Angeles, Calif. - $6,000 per month
• The Hills: Los Angeles, Calif. - $40,000+
• Michael’s House: Palm Springs, Calif. - $23,500 for a 30 day stay
• Morningside Recovery: Newport Beach, Calif. - $28,000 for a 30 day stay
• New Method Wellness: San Juan Capistrano, Calif. - $18,700 for a 30 day stay
• Newport Academy (Adolescent): Newport Beach, Calif. - $30,000 per month
• Northbound Treatment Services (NTS): Newport Beach, Calif. - $21,500 for a 30 day stay
• Passages Malibu: Ventura and Malibu, Calif. - $50 000 to $80 000 per month
• Pasadena Recovery Center: Pasadena, Calif. - $8000 to $11 000
• Promises Malibu: Malibu, Calif. - $57,000
• Reflections: Novato, Calif. - $32,500 per month
• SOBA Recovery Center: Malibu Cali. - $28,000 for the first month and $14,000 for every additional month thereafter
• Sure Haven: Costa Mesa, Calif - $16,500 for 30 days

Colorado

• Jaywalker Lodge, Carbondale Colo. $12,000 per month

Connecticut

• Mountainside:  Caanan, Conn. - $13,600
• Silver Hill Hospital: New Caanan Conn. - $30,000

Florida

• Wellness Resource Center: Boca Raton, Fla. - $14,250 for 30 days
• Behavioral Health of the Palm Beaches: Across Florida - $12,000 to 20,000
• The Florida House Experience: Deerfield Beach, Fla. - $17,500 per 30 day stay
• The Hanley Center: West Palm Beach, Fla. $24,600
• Palm Partners Recovery Center: Delray Beach, Fla. - $19,500 for a 30 day stay
• Recovery Road: Palm Beach Gardens, Fla. - $18,000 for a 30 day stay
• The Treatment Center: Lake Worth, Fla. - $21,000 for a 30 day stay
• The Watershed: Boca Raton and Boynton Beach, Fla. - $16,000 for a 30 day stay

Georgia

• Talbott Recovery Campus: Atlanta, Ga. - $18,000

Maryland

• Father Martin's Ashley: Havre De Grace, Md. - $22,000

Minnesota

• Hazelden: Center City, Minn. -$28,300
• Pride Institute (LGBT): Eden Prairie, Minn. $19,600
• The Retreat: Wayzata, Minn. - $4,700 for a 30 day stay

Nevada

• Las Vegas Recovery Center: Las Vegas, Nev. - $750 per day

New Jersey

• Alina Lodge: Blairstown, NJ. - $58,500 for a 6 month stay
• Seabrook House: Bridgeton, NJ - $26,000

New York

• Saint Jude Retreats (non 12 step based): Upstate New York – from $13,000 to $30,000 for a 6 week stay

Pennsylvania

• Caron: Wernersville, Pa. - $30,000
• Marworth: Waverly Pa. - $28,000

South Dakota

• Tallgrass: Sioux falls, SD - $6000 for 30 days

Tennessee

• Cumberland Heights: Nashville, Tenn. - $700 per day
• The Ranch: Nunnelly, Tenn. - $18,000 for a 30 day stay

Texas

• Austin Recovery: Austin, Texas - $8,850 per month
• Benchmark Recovery Center: Manor, Texas: 6 months for $36,000
• Burning Tree: Kaufman and Elgin, Texas - $33,000 for a 3 month stay
• Santé Center for Healing: Argyle, Texas - $23,000
• Serenity House: Fredericksburg, Texas - $12,600 for a 30 to 35 day stay

Utah

• Cirque Lodge: Sundance, Utah - $30,000

Virginia

• Williamsville Wellness: Hanover, VA. - Starting at $25,000

Washington

• Olalla Guest Lodge: Olalla Wash. - $225 per day
• reSTART (internet Addiction): Fall City Wash. - $20,000 for a 45 day stay
  

What About Discounted Addiction Treatment – Does It Exist? How to Find It?³

Here are 2 facts:

1. Quality addiction treatment costs a lot of money (doctors and therapists and all the other staff required don’t come cheap)
2. Investing in quality addiction treatment saves you money in the long run (decreased health-care costs, better performance and productivity at work, decreased spending on drugs and alcohol, etc.)

So from an economic point of view, paying for treatment makes sense, even if it costs a lot.

But what if you don’t have insurance coverage and you don’t have enough money?

Well, you can probably still find a quality program. Consider the following facts, taken from the 2008 National Survey on Drug Use and Health

1. 60% of all people who got addiction treatment in 2007 had no health insurance of any kind
2. More than three quarters of substance abuse facilities offer discounted or even free treatment to people unable to pay full price. (76.3% of all substance abuse treatment facilities offer at least some form of payment assistance)

Of more than 13 000 American substance abuse treatment programs surveyed:

• 4% offer free treatment to all clients
• 10.5% offer free treatment to some clients
• 37.8% offer free treatment to some clients and also offer treatment on a sliding cost scale related to your income
• 24% offer no free treatment but offer treatment on a sliding cost scale related to your income
• Only 23.7% offer no free treatment and no sliding cost scale (no discounted treatment at all)

If you lack health insurance and cannot afford full-price treatment, to search for free or sliding scale substance abuse treatment services:

1. Visit SAMHSA’s Substance Abuse Treatment Facility Locator
2. Make use of 'Payment Assistance Options' when searching for treatment

The Price of Sober Living Homes (Transitional Housing)⁴

Sober living homes can be an attractive option for people in certain situations, such as:

1. Those completing a stay at a primary care facility (rehab) and looking for a safe and supportive environment to continue recovery
2. People attending addiction treatment on an outpatient basis
3. People leaving the corrections system

The cost of a sober living can range from a few hundred to a few thousand dollars per month, depending largely on the amenities and services of the house.

Inexpensive houses, such as those following the Oxford House model, work as non-profit rent-sharing alcohol free zones, and as such these types of housing can provide among the most affordable living arrangements available anywhere.

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Think you need rehab or some form of addiction treatment but struggling with ambivalence and indecision? Take 10 minutes to try this cognitive behavioral technique called decisional balancing and you might find it easier to evaluate the pros and cons and to choose the best course of action.

One minute you know it’s the right decision and a minute later you feel like you’re overreacting.

Going to rehab: it’s a huge decision, it’s going to disrupt your life and the lives of those close to you in significant ways, it can cost a lot of money and you’re probably not even sure it’s what you need…what do you need?!!

Well, no one else can tell you what’s right for you. You know your body and you know your addiction best, but if you’re having trouble weighing the pros and cons of going to rehab, try this easy exercise to structure your thoughts.

Decisional Balancing

One tool that substance abuse counselors and other mental health professionals use to help their clients make difficult decisions about behavioral change is an exercise called decisional balancing.

Making a decision to change the course of your life is rarely simple, and although one big part of you probably wants treatment, another part of you might wonder if you’re ready, or if you even can achieve lasting change.

• Ambivalence to change is normal and life is rarely black and white, which is why making major decisions about behavioral change, like about going to rehab to quit drugs or alcohol, can be so hard
• Structural barriers (like financial difficulties) can further complicate the decision making process

Decisional balancing exercises help you to identify and structure all the shades of grey – both pro and con – that weigh down the balance of any major decision.

And once you’ve identified all the pros and cons of both action and inaction and written them down in an easily comparable arrangement, you’ll have a more structured framework to base a decision upon.

What was an impossible decision sometimes becomes an obvious choice by the end of a decisional balancing exercise.

An Example of a Simple Decisional Balancing Chart

Write out rough table of 4 squares and label the squares with the titles:

1. Benefits of Going to Rehab
2. Costs of Going to Rehab
3. Benefits of Not Going to Rehab
4. Costs of Not Going to Rehab

And under each title, brainstorm for examples of likely costs/benefits. For example:

Ready to Try a Decisional Balancing Exercise for Yourself?

So are you grappling with a decision about rehab or addiction treatment – or about any type of major behavioral change? If so, why not sit down with a pencil and paper and take 10 minutes to write out the pros and cons of both sides of your dilemma.

If it doesn’t clarify things then you’ve wasted nothing more than a few minutes of your time, but you’ll likely find it easier to choose a course of action once you’ve structured things to enable a side by side comparison of the costs and benefits of both action and inaction.

And if it does work and it does transform ambivalence and indecision into motivation for action, then it is 10 minutes very well spent indeed.¹

Image Copyright: Shreyans Bhansali

For Christian men and women, especially those with financial need, the Adult Rehabilitation Centers (ARC's) run by the Salvation Army can offer needed access to long term and comprehensive residential treatment.

The Salvation Army is a faith based Christian organization with a mandate to helping the unfortunates of society, including the homeless and those suffering with addictions to drugs or alcohol. An international organization, the Salvation Army boasts more than 4 million members in 100 countries throughout the world.

Salvation Army residential drug rehab programs are free for those with financial need, and may require some payment from those that can afford it. The program costs are subsidized through yearly charitable appeals (especially at Christmas) and as well through the proceeds of the Salvation Army stores, which are more often than not staffed by recovering addicts participating in the program.

Most participants in The Salvation Army's Adult Recovery Programs have already received some form of supervised medical detox and often a limited duration of inpatient rehab, but continue to benefit from a long and structured stay within a Salvation Army drug rehab.

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If you can afford it, private drug rehab is your best option, but for those that can't, any drug treatment is far preferable to no drug treatment and continuing abuse.

If you need help, even if you don't have much money, there are people who will help you. Learn how to find a low cost drug or alcohol rehab.

Getting Help Without Insurance

In the best of all worlds, you would have comprehensive private health insurance or you would have the means to self finance a needed stay at one of the best private drug and alcohol rehabs in the country.

There is no denying it, they are better and you do get what you pay for. Private drug and alcohol rehabs will provide a far higher level of personal comfort and privacy, will offer a greater variety of alternative and helpful programs, will boast tranquil meditative grounds and most importantly, will give you the intensity of private and one on one therapy you need for the best chance at recovery.

If you can afford private drug rehab, even if it's a bit of a financial stretch, it is well worth it; and sobriety always makes financial sense over time whatever the upfront costs.

But if you don’t have the money, you don’t have the money. For those of us without good credit, without reasonable health insurance, and with no hopes of self financing an expensive month of private care, is there anywhere we can go? Will anyone help us?

Affordable Drug and Alcohol Rehabs

If you cannot pay for private care, you have three options.

1) Get State Funded Subsidized Care

Even if you are not eligible for Medicare, you may qualify for full or partial coverage at a state funded rehab. Some of state funded facilities offer an exceptional level of care, and if you are eligible and the waiting list is reasonable, this can be a very good option.

Call your state social services office to find out about your eligibility and about waiting lists for care.

2) Find a Low Cost Rehab.

Which is easier said than done, but they do exist. There are rehabs that exist solely to provide services for people who cannot afford private care, but cannot qualify for state funded rehabs. These programs generally offer care with fees based on a sliding scale related to your income and ability to pay. These rehabs will work with you to ensure that you get the care you need, and in some cases, may even waive initial fees for those in real financial distress.

These rehabs can be tough to find. You should ask your local pastor or minister, your local doctor and even the people at the state social services office for good local options. Most will have web pages, but these web pages are often buried so deeply that you really have very little chance of finding them.

If you need assistance in finding a low cost rehab in your area, please contact us at ChooseHelp, we can help you find something that's going to work for you.

3) Find a Totally Free Rehab

For those in real financial need, and for those unable to pay for any portion of their care, charity rehabs will take you in for nothing. The Salvation Army runs about 200 long term rehabs across the country, and the Baptist Missions run a similar number. There is no charge for those in need.

Another option is a sober living environment. These sober living homes do not offer intensive therapies, but most will take you in for nothing or nearly nothing, and only ask that once you can get a job that you contribute your fair share towards the house expenses. These are very affordable, supportive and long term options, and can be an excellent sobriety resource.

Get the help you need

Any rehab or drug or alcohol treatment is better than nothing, and when you make the decision to get help, you need to get help fast. Don’t delay needed care because you don’t think you can afford what you need. There is someone somewhere waiting with a bed and a concerned heart, waiting to take you in.

You can get better. Get the help you need and look forward to a far better life of sobriety.

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Addiction is a complex disease that affects the mind, body and soul. To beat addiction for good you’ve got to be ready to make some serious changes and improve yourself. Read on to find out how making improvements in your physical, psychological, interpersonal and spiritual functioning can help you to overcome addiction for good.

If you’re like most people who choose residential addiction treatment, you’re going to drug rehab because your life has become unmanageable, you know you need to quit using or drinking and you know you can’t do it on your own.

And if you’re like most people heading to rehab – you know you need to make some changes in life, but you’re not sure of how or even what to change, and since the drugs or alcohol are such an everyday presence in your life, it’s hard to even find the clarity of mind you need to think about these very important issues.

So, what do we go to rehab to do anyway and what kinds of specific changes and self improvement does a person in drug rehab strive to achieve?

Well, according to the experts at Hazelden, a person working to overcome addiction needs to focus on self improvement in four basic areas of life:

1. Medical/Physical
2. Psychological
   
3. Interpersonal
   
4. Spiritual
   

Addiction is a disease of the body, mind and spirit and it damages functioning in all of these areas. Recovery of the mind or the body or the spirit alone is rarely sufficient, so a good recovery program helps clients to achieve change and self improvement in all of these areas.

Medical/Physical Self Improvement

People rarely come into drug rehab in optimal physical health. They are often suffering direct health deficits from the toxic consequences of their drug abuse and they are often in ill health and in poor physical fitness from the neglectful lifestyles that typically accompany addiction.

Poor physical health affects cognition, mood and energy levels and so it very directly affects recovery efforts. For example:

• A person with dental pain that had been masked by opiates might find abstinence very difficult until the pain had been eliminated
• A person with very poor eating habits might find that learning healthier eating helps them to avoid relapse by moderating blood sugar spikes and valleys
  
• A very sedentary person might learn that physical exercise helps to reduce stress and thereby reduce relapse risk

So medical/physical self improvement is an important aspect in any drug rehab recovery program. Some of the changes a person might expect to make could include changes in diet and in exercise.

A person might also need medical attention and medication to deal with chronic illness or disease.

Psychological Self Improvement

Whether you use drugs or alcohol as a way to escape from past trauma, as a way to handle your anxiety or depression, because you lack impulse control or because of a thousand other possible causes, you will very likely benefit from individual or group psychotherapy to gain a better understanding of why you use – and to learn how to handle your emotions and impulses in healthier ways.

Working to improve thinking and emotional control is beneficial for every person who struggles with addiction, but for those who suffer a co-occurring mental health disorder, psychological self improvement is of paramount importance. You cannot hope to overcome addiction without bettering symptoms of mental illness, which if left untreated, will almost certainly lead to relapse and continued addiction.

Interpersonal Change and Improvements

Some of the most difficult changes necessary are interpersonal in nature:

• If your friends or family like to use drugs then you will have to consider limiting your exposure to these people. This is obviously a very difficult thing for most people to do.
  

But in addition to changing who you spend your time with, you’ll also have to overcome the tendency for those in recovery to slip into isolation. You need peer contact; you just need to find ways to make friends who support your continued recovery.

Learning how to have fun without drugs and alcohol, learning how to handle boredom and free time and meeting people who will support your recovery are all very important aspects of an addiction treatment program.

Spiritual Change and Improvement

Spiritual need not mean religious or faith based (though it can) but for the best odds at lasting recovery you need to find and understand your place in the universe.

Spiritual improvements can help a person to overcome a negative outlook or a sense of hopelessness and can help a person to find peace and centeredness within themselves, without having to resort to an artificial or chemically induced serenity. 

Only you can explore and define your own spirituality, but it’s important that you spend some time and effort in the process, since gains made here reap huge dividends across the battlefield of recovery.

Because spirituality is so important, virtually all rehab programs will devote some attention to facilitating change and self improvement in this area.¹

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When you decide to get help you need to get help fast...but you also want to make sure that you receive care in a quality facility, offering you a legitimate chance at sobriety. Here are ten quick ways to evaluate the quality of any drug or alcohol rehab under consideration.

If due to your financial circumstances you do not have the luxury of choice between many available treatment facilities, you can rest assured that any treatment is far preferable to no treatment, and entering into a period of enforced sobriety and therapeutic guidance offers a lot towards a better life of abstinence.

If you do have the luxury of choice between available facilities, you need to evaluate which options offer the highest quality of care and offer the best chance at sobriety; and since many of us considering rehabs have never been in treatment, have no idea what's important and can only access information from a website or from a sales call, we feel very uncertain about how to make the best choice.

There are no guarantees, but here are some tangible and quantitative evaluation measures than may help you to decide which available option offers the highest quality of care, and the best chance of success.

1) Does it enjoy a good reputation?

If possible ask for references and ask around. Better rehabs should be able to provide you with contact information for graduates of their program, and talking with these people can give a better idea of the quality of care and the suitability of the program for you. You should also consider calling your local better business bureau to inquire about any complaints, and ask your doctor or health services provider if they have heard anything good or bad about the rehab.

It only takes a few minutes, and it may save you from a costly mistake.

2) Is it clean and organized?

Running a successful and comprehensive rehab is tough, and not everyone does it well. It can be hard to evaluate how well the staff do their jobs therapeutically, but if the staff do not keep the facilities clean and well maintained, they are likely performing poorly in other areas as well.

Ideally, you don’t want treatment at a facility where staff are overwhelmed, overworked and underpaid. If you have difficulty getting basic information on the phone, if staff do not return your phone calls in a timely matter, or if you do not feel as though you are being treated with respect, you may want to think twice.

If staff cannot provide you with information you need in a courteous manner before treatment starts, you cannot hope to receive care and information once in treatment in a manner any different. You are sick, you deserve respect and compassion, and you deserve treatment at a facility that will treat you well.

3) Is the facility accredited?

You may not have the luxury of deciding between facilities, but if you do, try to find an accredited facility employing professional addictions staff.An unaccredited facility is not necessarily poor quality, but without accreditation you have no way of knowing how well they perform therapeutically, and whether or not they meet basic governmental regulations on therapeutic care. Accredited facilities will need to offer services with proven effectiveness, need to employ qualified and licensed professionals and will receive regular evaluations from governmental agencies to ensure that standards are being met.

Accreditation does not necessarily signify a very high standard of care, but it does protect against a very low standard of care.

4) Does the facility offer a number of distinct forms of therapies?

No one form of treatment works well for all addicts in recovery, and better residential rehabs will generally offer a few very distinct forms of programming to better ensure that at least one therapy works for most.

If you go to a rehab that offers only 12 steps programming, and you find that you cannot relate to the 12 steps, you are not likely to receive much of value from your stay. Look for rehabs that offer a range of therapies including, 12 steps based, group recovery, individual therapy, cognitive behavioral therapies, and ideally, peripheral therapies such as equine therapy, yoga, karate, meditation and others. The more that's offered; the better the chances.

5) What does the daily schedule look like?

You have a big job to do and not much time to get it done, and you can’t afford to waste your days in a leisurely manner while in treatment. Ask to see the weekly schedule, and look for a program of therapies and events that fills each and every day. Beware of rehabs that offer too much private reflection, free time or personal meditation time. In small amounts these are all beneficial, but in greater amounts simply indicate a low intensity of more valuable therapies.

6) What's the completion rate?

Relying on so called success rates can be misleading. Facilities measure success differently, and some may not make much of an effort to really find out about relapse so as to keep their success statistics high. Treatment completion rates tell you a lot more. In general, the longer you stay in rehab the better your eventful prognosis, and a facility that boasts a very high completion rate likely offers a high success rate as well.

You don’t want to enter in to a rehab where most people won’t stay until the end of programming. No rehab can offer 100%, and adults are always free to leave if they wish, but rehabs with very low completion rates may have fundamental problems with the staff or programming, and may not be a good choice for your recovery.

7) Can family get involved?

Family participation in the therapies of rehab proves very beneficial to long term sobriety, and if possible you want to get your family into the rehab facility, and actively participating in education and therapies that are proven to work.

Some longer term rehabs may limit family participation for the first period of care, which is fine; but if possible, you should select a facility that will at some point involve your family in a meaningful way.

8) Do they medicate?

No one therapy works well alone, and for the best chance of success you need to have access to a comprehensive range of tools against relapse. No medications currently available against relapse work well on their own, but when combined with therapies and education, these medications do offer additional assistance towards sobriety. If possible, look for a facility that can offer you pharmacological therapies when appropriate.

Medications may also help to alleviate the physical and psychological pains of withdrawal, and are especially needed for patients with even minor forms of dual diagnosis.

9) How much aftercare is offered?

Nothing keeps recovering addicts sober better than a long and intense participation in therapies of aftercare following the graduation from a residential facility. The initial weeks and months of freedom offer great temptations, and the success rates for people who do not maintain aftercare therapies are low.

The longer the aftercare is offered, the better.

10) Does the philosophy of care match your beliefs?

If you're not a Christian, even the most comprehensive and high quality Christian based rehab will not offer much of therapeutic value. You need to ensure that you get into treatment that matches you beliefs, that resonates with your cultural background, and that treats you with respect, regardless of your race, gender or sexuality.

Get the best you can

If you have insurance or money to pay for private care, you should ensure that any facility under consideration satisfies all concerns, and answers all of the preceding questions well. If you can pay, you can go anywhere, and you have no reason to settle for anything less than a perfect fit.

If you cannot pay, and are reliant on subsidized or charitable care, you will not enjoy the same number of options and you may be forced to make some compromises. Try to select a facility that answers as many of the preceding question criteria well as possible, and remember that any treatment is far preferable to no treatment.

Sadly, doctors remain near the top of the list of at risk professions for substance abuse, and the combination of long hours and professional stress, when coupled with easy access to intoxicating pharmaceuticals or the pleasures and release of alcohol, becomes too tough for many to resist.

Of course, practicing medicine while intoxicated or even while suffering the effects of the previous night's intoxication, is unacceptable, and as such doctors need access to completely confidential doctor's rehab facilities.

While some would argue that doctors who use and abuse drugs endanger public health, and do not deserve confidentiality or compassion, the fact is that doctor's are human, and to best encourage them to accept needed treatment, the price of this recovery cannot be set too high. Asking anyone to sacrifice a lifetime of work, and many years of education to get help is asking too much, and human nature ensures that without confidential access to rehab, too many doctors will continue to practice with debilitating, and possibly dangerous addictions.

Are you really addicted? Do you really need to go away to rehab?

Do You Need Rehab?

For some people and for some families, things have gotten to the point that a decision about treatment is clear, and when addiction makes life unmanageable, residential rehab is often the only way up from that dark pit.

But a lot of people may know that they have some degree of a problem with drugs or alcohol, feel unable to better the problem on their own, but aren’t sure just what to do or where to go to get help. Anyone who wonders about their drinking or drug taking very likely has some degree of an abuse or addiction challenge, as healthy substance users don’t often feel the need to evaluate their level of use.

Is it Addiction or Abuse?

There are two categorized levels of substance abuse problems, and although there can be a great range of severities within each broad category, in general, the treatments required for each are quite distinct. As a starting point, you need to know whether you have a substance abuse problem, or whether you face an addiction.

Here's an easy way to self diagnose, take the American Psychological Association's 7 question quiz on abuse behaviors. Answer honestly, and if you answer yes to three or more of the following questions about your behaviors over the last 12 month period, you are classified as addicted.

The American Psychological Association Addiction Test.

• Do you have a tolerance…does it take more than it used to to feel the same high?
• After you try to stop, do you ever feel withdrawal symptoms, or do you ever take a different drug to eliminate feelings of withdrawal?
• Do you ever use more that you had meant to in a session?
• Have you ever tried to quit or cut down, and found that you were unable to?
• Do you spend much of your time thinking about drugs or alcohol, using or recovering from drugs or alcohol (a preoccupation)?
• Have you stopped doing things you used to enjoy, because of your alcohol or drug use?
• Do you continue to use alcohol or drugs even after you notice adverse consequences of your use?

Abuse or Addiction

If you answered yes to three or more of the questions, you are medically classified as chemically dependant, if you answered yes to 2 or less, you likely suffer from a chemical abuse problem.

Abuse

If you suffer from a substance abuse situation you may well need professional help to change your behaviors and to better your health, but you may not require the intensity of a residential drug or alcohol rehab; and at the very least you may want to start the treatment process on an outpatient basis to see whether you can get healthier without suffering the expense and disruption of a residential rehab.

Addiction

Once addicted though, the treatment requirements increase dramatically. Once we become chemically dependant we lose some degree of control over our actions. Addiction manifests in an area of the brain beyond our conscious awareness, and although this area of the brain (the mesolimbic) does exert an enormous influence over our behaviors and actions, and although we appear to be making conscious and willful decisions, in many cases we are merely following the directions of a part of our brain over which we have no control.

With addiction we lose control over our actions and since our will to stay sober is rarely enough, we instead need to learn effective strategies to manage these pre conscious impulses. The brain does heal, and it will revert to a normal state of functioning, but it requires time for this healing process. Getting into rehab and away from access and temptation for a month or more can be enough to diminish the power of these preconscious influences, and allow you a better opportunity to exercise learned strategies to relapse avoidance.

There are no guarantees, and for any real chance at success a full and honest participation in the therapies of rehab, and a long involvement in therapeutic aftercare programming is required.

If You Are Addicted…

If you are addicted, you may find that outpatient therapies give you the tools you need to overcome your dependency, however, to have the best opportunity for success, a period of enforced sobriety and very intensive therapy and education offers a lot. If you are addicted, getting into a residential rehab program is likely the best chance you have at a better life of sobriety, health and happiness.

You may also want to consider seeking the advice of an addictions therapist or psychologist. A single session with an experienced professional can offer insight into the extent of the problem and leave you with concrete suggestions for individually relevant therapies.

Drug rehab aftercare refers to continuing treatment offered to the recovering addict after the completion of residential rehab. Aftercare programming can vary greatly depending on the needs of the addict in recovery, but at least some participation in aftercare must be considered a priority, and families should be very wary of considering a rehab facility that does not offer continuing care after release.

The initial period after release from a facility, and back into an environment of temptation and access to drugs and alcohol, is fraught with the risk of relapse, and continuing case management helps to guide addicts through this initially very dangerous period, and throughout the very risky first year of sobriety.

Drug rehab aftercare may mean 2 or 3 weekly group sessions within the rehab environment with other recovering addicts newly released into temptation, and it may also include weekly sessions with a psychologist or therapist to continue working through a recovery and relapse prevention plan, and to develop plans to best apply the lessons of rehab to the realities of life on the outside.

Some recovering addicts may have a need for more intensive and intrusive drug rehab aftercare programming, and for some, aftercare may mean access to safe and sober housing and some form of supervision and management in this housing (halfway house), it may mean work release or supervised employment opportunities or other forms of social assistance designed to minimize the life stresses that can increases the probability of relapse.

At the most intensive level, aftercare may mean a continuing live in presence within the rehab facility, and some patients have the opportunity to work as recovery guides within the facility; in exchange for room and board, a nominal salary, and continuing access to the therapeutic and safe environment of rehab.

Patients with dual mental health diagnosis' have the greatest need for continuing case management, and often the above described rehab aftercare programming will be combined with the efforts of a public health case worker, who checks in on the recovering addict to ensure compliance with medications, and to intervene should any problems arise.

The family is an unwilling participant in the descent into addiction, it only makes sense that they participate on the journey back out.

Family Participation Can Help

Additionally, family programs can help to heal a family harmed by the destruction and heartache of abuse; and bring back a healthier dynamic to the family as a whole.

No abuse happens without affecting the family, and as such families need to participate in the rehab process, as much to heal themselves as to learn how best to help the addict.

When thinking about what type of rehab facility best fits your needs and wants, make sure you consider how much family involvement you expect in the process. Family involvement can be very beneficial, and when working with trained addictions councilors and in group therapy sessions with other families of recovering addicts; families learn what they can do to help, and what they were never responsible for in the first place.

Healing Negative Emotions

Addiction generally brings out the worst in all of us, and the behaviors associated with addiction can be pretty terrible. You'd think that all the rage and anger of a family would be directed back at the creator of this behavior, but often the negative emotions spread through the family, damaging relationships and trust all the way through. A good rehab facility will begin to heal the family of the addict, as it also helps the addict recover from abuse.

Learn How You Can Help After the End of Rehab

Some of the specific programs to look for are family drug education programs, whole family sessions with a therapist or psychologist, and multi family peer group sessions. To really get the most benefit, these programs should be offered over at least a couple of days, and should ideally occur later in the rehab, after the addict has had time to work out some of their issues by themselves.

The period after rehab ends, and when the recovering addict is once again faced with the triggers to abuse and the access to drugs or alcohol, is a very high risk period for abuse; and a loving and supportive family, trained in how best to offer support, can be an outstanding tool for any recovering abuser. Through the education and family programs at a rehab facility, family members learn how to offer love and support without enabling the behaviors that can lead to abuse. Family memebers also learn the limits of their help, and learn that ultimately only the addict can change their behaviors.

Family sessions during rehab help a family to heal the damage too often caused by addiction, and a family therapist, trained in addictions, helps the family to resolve some of the issues created by the abuse, and maybe even some of the family dynamics that could promote further drug or alcohol abuse.

The peer family sessions are always illuminating, and families learn that their suffering is not unique, and the devastation caused by addiction is the rule and not the exception.

This family involvement heals the family, and increases the likelihood of a successful reintegration into society for the recovering addict at the end of rehab; and as such, family involvement should be a factor to consider when selecting a rehab facility.

A rehab facility that is too far away from the home, may limit the extent of family involvement, and as such may not be an appropriate choice.

Addiction affects everyone surrounding it, and since the family is affected by the addiction, it makes sense that the family participate in the road to recovery. A weekend will never erase all of the heartache of addiction, but it can put a family on the road to healing, and is almost always a very positive thing.

The life stresses in a celebrity's existence may be far removed from the personal stresses of our day to day existence, and while worries about making the rent may not bother a wealthy celebrity, everyone carries their own baggage, and financial independence and success do not isolate anyone from the burdens of life.

If anything, although generally very well off, celebrities lead more demanding lives than the rest of us, and especially so when battling with substance use and abuse. Having a crowd of paparazzi following you during your lowest moments, and having all of your shameful behaviors recorded for the world cannot be easy.

Additionally, although most of us don’t maintain a paid entourage, the massive salaries of so many celebrities enable the employment of a variety of aides whose livelihoods are entirely dependent on the celebrity's performance. These people may not be able to or even want to change the celebrity's behaviors, and as a result the celebrity can be surrounded with a group of people reluctant to say what is needed, and reluctant to intervene when addiction overwhelms.

Ultimately, whatever the causes of addiction, dependencies are not easily conquered without professional help, and when a celebrity decides, or is compelled to accept treatment, they may have some different needs from a treatment program than the average drug or alcohol dependent addict.