Drug rehab & addiction treatment centers: what aspect do you value?

[Alfa]

I have no experience with rehab centers and drug addiction treatment centers. I would like to know what a qualities good rehab center would have to have?
What should it not have?
What aspects are important when evaluating or choosing a rehab center?

EDIT:

Originally Posted by Alfa

The reason I started this thread is actually that I need criteria to rate rehabs on.

Once the International addiction treatment center index is nearly complete, I will add criteria members can rate centers on. So what criteria should these be? Please post your list.

[~lostgurl~]

I think the quality of the therapists is the most crucial point to consider. Psychiatrists, psychologists, psychotherapists, counsellors, specialist adddiction counsellors etc. Although similar they often use different techniques in their therapy.

Also what programs/treatment options are provided ie cognitive behavioural therapy (CBT), Emotive behavioural therapy (EBT) Relapse prevention education, AA/NA programs etc.

Whether the treatment facility allows or provides any drugs/medications for the detox period.

$$$$ Cost and whether the cost is subsidised by the government or covered with medical insurance.

[Lucidity]

In the UK, as I guess in US, Rehab is expensive, I had a 1 week just detox, and it was 2000 pounds 4000$. Just to sit about on a bed for a week. I had an NHS one too, which wasnt great, exactly the same format for the way they speak to you and treat you. I actually think there a bit of a rip off, because its a last hope, they know people will pay absolutely anything to save themselves, or there son/daughter , I think thats why there so pricey, obviously doctors are expensive, but there never at them, have to be called, so that cant be expensive, just to have a doc on call and maybe visit once a week to access everyone. Maybe some have more, and ones that are on the premises full time, I dont know, that would be one side to look into.

All Substance Misuse/Abbuse, is treated like were absolute scum
I guess they've been taught thats what were like, by media or whatever
Were not the first person youd give your bank card to, to hold but some people have gotta come down off there high horses, there no better, at least we took the risk to have a bit of fun in our lives, it just went wrong and we admit the mistake and feel very stupid because of it, whats risks have they ever taken to maybe get a better quality of life, or just for 1 day, see absolute paradise, I actually feel very sorry for people that go through life without ever once experincing a drug, it can be life changing, or just make you see things a bit clearer, for good or bad. Its like an exerience, if you miss it, you've only lived 2/3's of the world
At my NHS detox I wasnt given my sleeping pills, that I was prescribed on a repeat prescription (didnt have to hardly ever see the doctor), so it was just a routine drug that I'd been on for quite a long time. I was in the detox for a completely diffeent reason, but they "decided" not to give me my sleeping pills, as they thought I shouldnt have them. However it had already been discussed, what I was going in for, all my meds would be the same, just the one Iwanted ti give up was supposed to be taken away. But when I arrived in there opinion I shouldnt be on the sleeping pills, so wouldnt give them to me, this wasnt even discussed with me. I am actually now off of them as I decided to give them up, they dont seem to realise that if you dont want to give up something, you wont, whatever treatment they use. I wanted to give up the drug I was in there for so had mentally prepared myself for it. The no sleepers was virtually a joke, why didnt they decide I needed to get a bit fitter, give up smoking, have my hair a bit longer than they decided was best, lol.
The first one I in was initially for an alcohol detox, but my GP doctor had prescribed me a sedative to deal with that a month earlier (waiting list time is a thing to look into as well), I didnt drink for a month before I went in to the detox but was now addicted to these sedatives, my doctor knew all about it etc, that I hadnt drunk, the reason to go in was now to give up this sedative but they just assumed it was alcohol, when they had been told it wasnt. I expained that it must have been mis communication etc, but of course they just treated me like any addict and gave me treatment for alcohol as that was what was written in there diary perhaps and I was too thick, I'd explained it to the doctor and everythnig when I arrived, as they said alcohol and I said no, hemaneverin (sedative). Of course, they just ignored me, gave me stuff for alcohol, a few librium and then went and watched tv, whilst I went through the worst experience of my life just cause they didnt really care. Believe me, I've been through heroin cold turkey quite a few times and that is an easy ride compared to that. I had been taking near death amounts of it every day for about a month, as it was stopping me drinking and I was assuming all was in safe hands and they would treat me for the sedative addiction once I arrived. A clucking Heroin addict was having to help me walk about everywhere, as I could hardly see cause of the withdrawel. The reason for saying that is - keep in constant communication with them before you go in, I now know that if I'd had made a few phone calls first, all would probably have been ok. I kind of assumed it was all being taken care of and all was in safe hands.

I also dont like looking for someone else to solve your problem for you, but they do have tonnes of experience at it, so are obviously far better than doing it alone I guess.
People often get rehab and detox confused, not thinking what the word rehab is short for. So you want a nice relaxed enviroment. Yeah in detox if they want to be all strict with you, fair enough, at that point your pretty much still out of control.

Empathetic workers, from the highest up doctor down to the cleaner.
Too many rehabs use the method of treat the losers like shit, till they prove themselves, I think this is totally crap, I have only been at one and visited another and thought they were appaling, were all human beings, we just made a few stupid choices.
So non judgemental, empathetic, obviously as highly qualified isnt always the best, its the way they apporoach it that I think makes or breaks it.
If you feel there understanding you, your understanding them, you have equel respect for each others, doctors dont expect to be treated like gods, as there not, and Iwould be the first to ttell them that as Ipacked my bag to leave. That idea of me leaving may stick in that doctors head, the next guy through the door might get treated better. I can just find somewhere else.
They've used the same format, the whole sale set up in most rehabs, amybe one with a twist would be differrent, memorable. You gotta remember that even the colour of the building is gonna effect for a relapse, you'd see that building in your head, youd remember someone being rude to you there, or all of them. Think Fuck them, wheres the off licence or my dealers number. My councillor told me that the other day, its called passing the buck, you blame them fro you buying that drink, so you are blameless- no guilt

[Lucidity]

Sorry to post again
f you've never waked into a rehab and seen how they work, you maybe are thinking like millions of people, that there like hospital/hotels (although US might be different from UK)

there often not, the decoration may be nice, but that isnt anything, if you look at a rehab leaflet/book i.e advertising, probably more than 50 % of it is pictures of lovely rooms and cosey lounges.

Look at the ones that give you hard facts, not just tryin to rip you off.

Who pays for there lovely rooms, and there very professional advertising. We do, cause were being way over charged. Thats not a bitter angry comment, just a true fact

[beentheredonethatagain]

this is a good topic, and just as there are many different members here, I would bet that the answers will be as diverse. I would look first at their program , what do they base their recovery on, is it the 12 steps of alcoholics anonymous, is it based on the 12 steps of narcotics anonymous,
do they have meetings there , do they have open meetings allowing in recovering addicts from outside the facilitys. How about their reputation, their overall success rate.

Is the treatment set up for you to stay 30, 60, or 90 days, do they just turn you back out upon completion or is their sober living facilities available.

Things like is it co-ed or men only or women only, how much time clean does the staff have. is it a clean well kept enviroment, costs, is it approved by the county or state.

I wouldnt want to go to a facility that was men only , I wouldnt like it if they allowed weekend passes home either. And it wouldnt be much use if afterwards they didnt have a sober living dorm or apartments (flats) available.

Too much chance of relapsing .

[rocksmokinmachine]

The UK (SWIM's native country) have the best rehab centres. SWIM was made subject to a DTTO (drug treatment and testing order) 4 and a half years ago. The chemist was around the corner where the clients could pick up thier methadone/buprenorphine, or chlorodiazepoxide/diazepam.

He was a little sceptical at first, but found it very comforting. There was a 'chill out room' covered in beanbags and other comfy items. There was also a kitchen with a fridge with chocolate spread, jam, and butter. There was also a fresh loaf of bread every day, aswell as the usual tea bags and coffee. The 'group room' as it was called had sofas all around and a television and DVD player that all could see. It also had an interactive 'smartboard' for presentations. There where seperate rooms upatairs for one to one 'key work' with SWIM's personal worker. There were also computer rooms and teachers who would come in from the local college to help people gain qualifications in maths and english. This was known as the 'skills' room. There was a doctor who would come in once a week, who would write prescriptions as needed and monitor people on thier medication or reduce as necessary. There was a testing room, where SWIM would give two tests a week. SWIM would be tested for opiates, methadone, cocaine, benzodiazepines and amphetamines, as would everyone else attending. The good the thing was, the staff were really great. SWIM was never penalised for giving positives tests, and so was SWIM's probabation officer. The courts commended SWIM even though he had only given one negative test for opiates in 6 months.

SWIM would usually arrive at around 10:00am, make a cup of tea and 2 slices of toast and chill out in the group room watching TV. Then at 10:30 we would watch as drug related educational video (actually quite good, don't think reefer madness...infact i've found a few one this forum). Afterwards The staff would come in an we would do some work on harm reduction, such as safer injecting, personal hygiene etc. It was always interesting to learn something new. Then later on towards the end of the session SWIus would go to the chillout room and lay down on the beanbags. A member of staff would come through and do auricular accupuncture with clients, believe me SWIM was always the first one asleep. It was so relaxing. It really reduced cravings. Health workers would also come in often and offer advice on smoking cessation along with other things. There was always a clinical nurse specialist around ask for advice. They offered a needle exchange, with clean needles, barrels, citric acid, vitamin C, pans, sterile water and isopropyl alcohol swabs.

Overall SWIM found it fantastic, he actually misses it.

I think the centre should be free to start off with, as almost all services are in the Europe, it should be an outpatient type clinic. These inpatient clinics are too expensive and no good IMO. One will find that the staff have been there and done it all before, and are perhaps recovering addicts themselves and can become part of SWIYour support network. This is probably the most important aspect when choosing a rehab centre.

[Lucidity]

Note: Sorry if this posts slightly long at all, icludes some bits about SWIM (he really doesnt know kind of the do's and the dont's yet, although has read it), SWIM is new to this, and also sometimes cant just shut up for a while lol. Any advice of any kind is totally appreciated. He should maybe just write all his stuff down in Word or something regularly, it might help a bit.

SWIY worded that post very well about his friends experince in the rehab, SWIMs never very good at putting down what he thinks into writing often, he feels he never has been much good at in IHO.
It sounds like that rehab that SWIY went through was absolutely perfect, thats the kind of rehab that he would love, and he imagined didnt even exist in his native country UK, as both Swimmers come from UK, SWIM guesses he just hasnt seen even 0.1% of them. SWIM actually thinking about it now thinks to have see one and briefly another as well and to judge them all by the same is a pretty silly thing to do. Its like seeing one girl and saying, "ah so all girls look like that then", lol. Maybe even SWIY could point SWIM in the direction of that rehab, as both of our friends are UK based. SWIM has been pointed in the direction of a rehab that is supposed to be the best in UK, and it would all be funded. But as we know, one person or even a million other peoples opinion of what helps or is good about anything can be totally different to our own. Thats what adverts are for lol "oooh, everyone goes there, it must be good, and it costs a fortune, it must work for everyone that ever goes!". Thats why I also think this thread is good, as its personal opinions, rather than advert type things. Maybe rehabs should publicise there known relapse %, after the peoples stays, then that would be a good way to see how succesful one was.

It sounds like SWIYs rehab had some great things going on and sounds like a really great, relaxed atmosphere. It sounds totally ideal. SWIM isnt quite ready for rehab yet, as has been doing an outpatient style detox, its now been a year on Methadone, without one dirty sample He's always pleased to be able to say that, it reminds him that he is doing well, although he did use one of these legal high things lastnight for the first time, thats mainly because of a health matter, as his way of coping has often been alcohol so far, so the livers giving SWIM evil stares at the moment lol, and giving threats that it will refuse to work under these conditions soon . But SWIMs keeping an eye on that one, and it will just be occasionally for health to give his liver a break, but to not sit totallly depressed, just thinking about drink or gear. Legals I'm sure are no way safer than illegals
Also has cut from 60ml's to 20ml's methadone in the first 9 months, so now on 20ml and comfortable. SWIM asked about it cause he's not sure if that is good, as he hasnt really had much feedback about that from anyone, whether its good or not from SWIMs key workers opinion and experience, I think the keyworkers idea is not to tell him so that he just kind of does what he thinks is best and comfortable with (not comparing himself to others), so he guesses she is probably doing what works best, she's seen it a million times I guess, so knows what works a lot better than SWIM does. maybe someone can let SWIM know, is that pretty normal? or is it quite a big step? or small step? any relevant info will be passed onto SWIM and he will really appreciate it, as at the moment he has absolutely no idea, as the whole previous set of friends has been cut off, for the best SWIM thinks, too many temptations lay there. So nobody to compare it with or even ask them about there opinion. He's even gone to the trouble of totally dry cleaning his mobile phone lol, just to make sure that there is no possible way, I think that was a really hard thing for him to do, but also very much dealing with his problem, as now the option isnt even there. Anything would have to be searched for amonst the general public (which as SWIM is UK, UK residents probably know this, is a damn hard thing to try to find very often, in SWIMs area anyway, luckily)

all in all, SWIM totally agree's with the post from SWIY about SWIY's rehab and what to look for in one, sounds like the one SWIY was at was great, SWIMs not suprised that they miss it. Was there ever any chance to go to secondary or anything? or can SWIY still use that centre as somwhere to go sometimes? like drop in type thing, SWIM thinks that would be an ideal thing, if you can pop back to a rehab centre whenever you want, just to kind of hang out there if needed, perhaps on a difficult day, so that its not a massive change when leaving, and your kind of left totally alone again with your problem (big chance for relapse I'd think). You'd feel there was somewhere you could go that was 100% safe, and 100% clean, and people that you can so easily relate to. One of SWIMs detoxes, he was actually asked not to come back for visits, as he would then begin to rely on it, he thniks that was a damn horrible thnig to say to him, even though I guess it wasnt totally enforcable in there rules and stuff, he never went back. He thinks that re-visitng was an ideal thing, and really helped him when he'd obviously just been through a very tough thing going there for the detox. But had made some good friends there and felt it was perfect, he never saw why they didnt see that, maybe it was kind of down to resources or something, or even personality (he hopes it wasnt that ).

SWIM doesnt really know that much about rehabs, only detoxes, but of course that was all SWIM needed lol, as he is always convinced, very stupidly that he can do the rest by himself, that and money, so is gonna keep an eye on this thread, and SWIM hopes you dont mind SWIM maybe asking a few questions about them, will try not to waffle as its gonna be time for SWIM to go to a rehab soon if he chooses to. SWIM wants the rehab for the actual rehabilitation, as the detox is kind of going along real smoothly as it is at the moment.

Oh one other quick thing, SWIM is about to go onto Subutex, and is really looking forward to it as he see's it as very positive progress, as he is now down to a low enough does or methadone to be able to switch to it. Sorry, SWIM is waffling a bit about SWIM, he doesnt mean to, as you can see, its about SWIMs 3rd post or somethnig, so kind of just getting the hang of it. is there maybe any threads that would be helpful for SWIM to get involved in? I havnt looked at all that many of them yet. SWIM will really appreciate any help or guidance towards threads or whatever that anyone can give.

If this post about SWIMs experiences and rehabs and detoxes etc here is too off topic (its not purely about rehabs, although that is the general reason for the post), then if anyone can guide SWIM to the right area, I'm sure he would really appreciate it. He tells me he's been looking for this kind of support network for ages, and he is pleased to have found this one. SWIM for the last 8 months has been using Second Life (not sure if you've heard of it), building businesses, making a bit of cash, and totally given SWIM something to concentrate on. SWIM feels he's ready to kind of leave that now, feels strong enough. Although will keep the investments etc in there. SWIM has even been asked to do media interviews about it even!! because of some of the big successes, but hasnt done any as yet, he thinks when it came to the question of drive, that would be a very difficult one to answer honestly lol, also because of SWIM's attitude at the moment, he would just play it down a lot, as he is not ready to accept being at all a success at anything. Also SWIM is 100% sure of the reason for his drive and so why perhaps the success, he just kind of turned all that previous energy and drive to somewhere else. If he was to give a true answer to that question in an interview it could maybe make people think, oh I'll do it the way SWIM did it, perhaps a year first and then join Second Life, it worked for him! lol, not a very good message or encouragement to be giving to people.

Thanks
SWIM
------------

Theres nothing you ever "should" do, everything in life is your choice - 'SWIMS keyworker'

P.S. if SWIM is not very good at swimming, sorry, he's just learning (lots of editing lol), he hopes his use is ok, maybe in the future he will give his more regular name (the one he usually uses for the internet) and so a bit more of his personality type thing, that and its actually a bit of fun swimming, he will have to think of some ideas and pass them onto me, a bit of fun, and also I think this type of thing totally takes your mind of what is probably often in it, even if you dont actually realise it, sometimes totally ignoring the issue and thinking about something else can really help, not for long term I guess, but for the start when it all seems impossible. Any advice about SWIM use or any other things, useful criticism or whatever, please let him know.
Also mods, if you think this post should be moved to a different section then thats no problem, is just this is the thread I've been most interested in so far, but I know I've gone slightly off topic in places

[Perception Addict]

I think this is a really valid thread. Is it reasonable to start a rehab rating system, and could that be done due to the need to reference the name of the center? If this is doable, perhaps a rating scale similar to that which was developed for book reviews could be used so that people could compare based on the qualities that are most important to them (ie treatment, atmosphere, effectiveness, cost, etc.) These categories could be chosen from the statements above, as well as other member suggestions.

If this is a viable option swim would be happy to get it rolling. She's just not sure if it already exists (but doesn't think so, she searched) or if it would be kosher, since the names of facilities would probably have to be mentioned.

[rocksmokinmachine]

These out-patient style rehab centres are all over the country in every city and every town. The only problem being one has to be a prolific offender committing drug related crime to get there (i.e shoplifting, theft from vehicles, burglaries etc.)

That is the great thing about the British justice system when it comes down to drug related crime, keeping addicts out of prison (where we all know drugs are available) and into rehabilitation where they can get the help and treatment they desperately need.

On a side note, SWIY should wait till he down and comfortable with 10mg/ml of methadone before going on to buprenorphine. SWIY will quite like it when he does, it does not make ones head feel cloudy like methadone does.

The only way, after that is to cut off all ties with the drug world. Which was prevelant where SWIM lived. So he moved as far away as possible (abroad infact) and is as happy as larry

[beentheredonethatagain]

As I get ready to face the day, I am remembering this thread, and have some more to say:

As many of d-f 's memembers take an opposite view than mine in reguards to AA & NA, I must remind myself that the members of those groups have something I want, the ability to not use " one day at a time ".

When I used to attend , I made friends with people who knew and understood my story. I made aquantances with people who are my peers, some higher and some lower. But I good lot of them were staying clean.

How ever they do it , with a higher power or no higher power, at the end of the day it wasn't them doing it alone, they have a phrase " I can't but we can ".

Sure are there those who are fronting or posing? of course, there is always going to be that in any group. The druggies arent the least flakiest people on the planet either.

That raps up my rap on the subject, the mess NIK has been doing has him re-thinking his steps. ONLY the best I pray your way BTDTA

[jerbles]

When I was 17 I went to a juvenile rehab. More of a youth center or some shit really. The minimum stay was 4-6 months, which is just ridiculous. I myself had been feeding a nasty junk habit since I was 15, and my right before my mom took me, I had scored some shit and was nice and high when I got there. I remember thinking, "this can't be that bad". It was. The first day was fine up until about 9pm, an hour before "lights out" and I was starting to have mild withdrawls. I managed to get to sleep, but was woken at 7AM for a morning group discussion and was feeling horrible.

The thing about this place was that every other kid there was there for smoking weed or doing a little coke or eatin a few pills. The staff there was bent more on changing the kids' lifestyles rather than just get them off drugs (which I don't even consider weed a drug). So here I was, only the second kid to have ever come in there for heroin, NO meds, not even a fucking sleepaid, and they expected me to sit through 2 hour group sessions on these hard ass seats. The thing was, once you started a group or something, they had these strict ass rules where you couldn't get up until it was over, even if you needed to piss/shit, and they didn't seem to realize that swim had diahrea out the ass. You also had to work your way up from level 1 to 4, lvl 1s having absolutly no privelages, lvl 2s being able to sit on the couches (lvl1 had to pull up a foldout chair), lvl3 get a pass and like a soda a week or someshit and so on.

this was the worst rehab I could ever imagine. One of the big things I would do in the "real world" when I was dopesick was smoke ciggarettes/weed, lye around, watch tv, take sleeping pills when needed etc. And here I was, stuck in this lame ass place, the whole day was filled with shit from 7am to 10pm (none of it leisure stuff), expected to discuss what he's feeling all day long?? I was always getting in trouble for stealing food and shit from the cafeteria, or from the fridge, but the motherfuckers wouldn't didn't let me eat any other time than the 3 daily meals.

they pretty much banned everything you would be used to on the outside. No snacks, soda, tv (lvl3-4s could watch tv at select hours), computer (again,lvl3-4). So you see all these lvl3 and 4 kids doing this shit but you're expected to just sit there and do whatever the hell they tell you? Needless to say, I only stayed about 27 days before I couldn't take it anymore. I had even gotten over all my withdrawls/cravings and still couldn't do it. I did manage to stay clean up to a month after that though.

I'm sorry, this post really has no input on the topic, this was just a horrible experience I had when I was younger. I really just couldn't believe they thought that place would help any one of those kids.

[Fight Club]

NIK went to rehab March - April 2006 at Father Martin's Ashley, Havre de Grace, MD USA.

Father Martin believes that all people are entitled to be treated with dignity and respect, and that attitude was reflected in every aspect of the facilities program for the 28 days NIK was there.

The center had beautiful, comfortable rooms, great food, and sat on a cliff overlooking the Cheasapeake Bay with a 20-mile vista. There were cousellors, physicians, and psychologists on staff and on-site Monday to Friday during the day, and counsellors and nurses on on-site 24/7.

The treatment protocol was primarily Twelve-step facilitation (TSF) and the disease model of addiction, but borrowed heavily from Cognitive Behavioral Therapy (CBT) and Relapse Prevention Therapy (RPT) as well.

Community members (as they were called) participated in lectures, group counselling, individual counselling, and in-house 12-step meetings from 7 AM to 9 PM daily, and outside AA / NA meetings at least once a week.

The program cycle was 28 days, and the staff began preparing NIK to return to the outside world after about about 18 - 21 days.

NIK had the opportunity to participate in weekend workshops with his wife, workshops for his kids, spiritual retreat workshops, and 1 and 2-day Sobriety Enrichment Training workshops.

NIK participates in an alumni group that makes contact with and guides new graduates, and returns to the facility at least once every 3 months as a speaker at their 8 PM 12-step meeting.

NIK is sorry for those of you that have had a less than ideal experience in rehab. He received everthing he could have asked for; including a program that works for him, (one day at a time) in the 18 months since he left the Ashley inpatient community.

FC