Most recovering addicts – or “ex-addicts” as some choose to term it – prefer to keep their personal struggles with addiction as quiet as possible when dealing with the general public. In the interest of drawing an important example, however, I will disclose one key element pertaining to my own previous struggles with substance abuse. Looking back from when I first reached the point in my addiction that required admission to rehab, to my very last treatment center not too terribly long ago, one consistency boldly stands out. As the years and numerous trips to rehab went by, the level of posh & luxury progressively diminished. From private accommodations and 5-star cuisine to skid row shelters and army cots in a gymnasium-type setting, my affluent upbringing and formal education became nothing more than a distant memory.
Today, I have the fortune of not only living a life beyond my wildest dreams, but the experience of having had numerous opportunities to work in various formal and informal addiction treatment settings, all of which have played an integral role into who I am today. Over the years I have been approached by many friends and family members of addicts that often pose the same question which is, and I paraphrase; “what type of treatment program works best?” And before I go any further let’s just get one thing very clear. The reasons as to why I did not remain sober following my initial trips to the nicer rehabs had absolutely nothing to do with the quality of care. My reasons for going in the first Alcohol rehabs place were based upon nothing more than to get back in my family’s good graces, or to get the girl back, or to get the job back, or anything else along those self-serving lines. I had no intention and no desire to apply myself whatsoever toward a life of sobriety and hence, the long, arduous & painful road of active addiction lay ahead.
There are many variations of treatment, most of which will integrate a variety of elements which are often referred to as the treatment “modality.” Among the more common modalities out there are; 12 Step, Behavioral Therapy, Cognitive Therapy, Holistic, Faith-Based, Work Therapy and others. The growing trend in recent years has been to incorporate a multi-disciplinary approach in which the facility will utilize certain elements of each treatment type in order to come up with their own modality and often market it as resulting in a higher level of success. The question then becomes, “what is their definition of success?”
Looking first at those treatment centers which are state, county and charity funded, they essentially offer what they offer and that’s about it. If you like it then great and if you don’t like it then leave, because there are likely 30 people standing in line behind you whom are desperate to get your bed. These are the types of programs that will usually provide an extremely “core-purpose” environment which, often begins with getting the addict off the streets and into a rigorous structure that involves group therapy, 12-step panels and meetings, work therapy in order to help the facility cover its costs, social-model structure that involves residents working with and overseeing each other’s day to day behaviors & actions, etc. These types of programs are also commonly offered by churches and religious non-profits which provide a religious “faith-based” format in conjunction with the other elements previously mentioned. In most cases the majority of the residents living at publicly funded facilities are either indigent or just coming out of jails and prisons and are mandated to the facility as a condition of their parole.
There is no evidence suggesting that the above treatment facilities are less effective, however, than span of treatment options available are definitely narrower. My personal experience with publicly funded treatment is that most of the clients have been struggling with addiction for many years and already have a good base of knowledge pertaining to recovery. Also, it is much more common to see a bit of a rougher client mentality in such facilities as opposed to those focusing on private-pay clients due to their history of incarceration, gang life or living on the streets & shelters. In most cases however, the staff is extremely diligent in their efforts to change these behaviors and not allow things like “prison talk” and gang-type clothing.