A Goodbye Letter to My Drug Addiction

Substance use disorders impact over 21 million Americans each year, but only 10 percent of people get the life-saving treatment they need. One of the major barriers to treatment is stigma. I was so ashamed of my addiction, but I was equally so stuck in denial that it took ten years of failed attempts for me to say goodbye to drug addiction and fully embrace recovery.

Fortunately, at the bitter end of my addiction, I made a smart choice to go to treatment. That decision saved my life. And the guidance and support of addiction recovery professionals is why I remain sober today.

How I Denied My Drug Addiction for Years

For years, I told myself that I had control over my substance use. My typical drug use and denial looked something like this: I’d go out to a bar after work, telling myself I’d only have one drink and then head home. Four hours later, I’d find myself in the bathroom lining up. Recalling the earlier promise, I’d made to myself, I’d say “You’re fine. You can stop whenever you want.” The reality is that I’d end up getting home in the early hours of the morning and calling in sick to work the next day.

This scenario played out for years. Recognizing those failures wasn’t enough though, my denial ran much deeper. I’d tell myself that my stress validated my drug use. I’d also surround myself with people who used more than me, so I could plausibly deny that my addiction wasn’t that bad.

That’s the thing about drug addiction: it’s the one disease that tells us we don’t have it. I truly believed that I couldn’t possibly have a problem like a drug addict. In reality, my internalized stigma about addiction, coupled with my denial, kept me from seeking the help I desperately needed — like so many other Americans.

Fortunately for me, my world crumbled when I lost a close family member. That led to a massive binge where I used more drugs than ever over a week-long period. Needless to say, I felt emotionally and physically destroyed. I couldn’t take any more. I was violently sick, and, in a panic, I searched online to see if I was experiencing some kind of poisoning.  I came across a blog on an addiction website that told me I had to get immediate medical attention. Thank God I called the number on the blog and got help.

Taking the First Steps Toward Rehab

I’ll never forget how I felt walking through the doors of the addiction treatment center. I felt utterly defeated and I hated myself for letting things get so bad. I expected that rehab would be like going to the doctor and that I would be shamed and reprimanded for my addiction. I couldn’t have been more wrong.

Every single member of staff, from the moment I arrived at the moment I left, treated me with dignity and respect. I wasn’t treated like a drug addict that had made so many poor decisions. I was treated like a human who had a medical condition. It was how I was treated that led me to think that I should pay attention to what they ask me to do. Thankfully I did, and I believe that’s what made treatment successful and led to long-term recovery.

For me, the most impactful part of treatment was writing a Dear John letter (aka a goodbye letter) to my drug addiction.

What is a Dear John Letter?

A “Dear John” letter is an activity that’s commonly used during rehab. It is an expressive medium to communicate your thoughts and feelings related to your former drug or alcohol use. There is no right or wrong way to write a Dear John letter; it’s simply a therapeutic way to express your feelings without having to talk.

Therapists say this tool is effective because it allows you to connect to your innermost thoughts and feelings that might not come out in talk therapy. Second, it is a way to process your experience with addiction in a way that allows you to also accept that it is a part of your past.

Again, there is no right or wrong way to write a Dear John letter, but here are some helpful suggestions to get started:

• Write about what happened during your drug addiction.
• Talk about the fun parts as well as the dark moments.
• Include the things you feel shame about, like making decisions that you wouldn’t have made sober.
• Once you’ve covered the extent of your addiction, then move on to break up with drugs or alcohol.
• List the reasons why you’re choosing to move on and how you envision your life without substances.

Here’s the bonus: not only do you get to process a difficult part of your life, but you also get to dream about the future. Plus, you don’t have to share this letter with anyone, you don’t need to read it out to your group or even your counselor. It’s yours to keep. However, you are more than welcome to share the letter with a trusted professional if you think it would be helpful to your recovery.

The part I liked the most about writing my letter is that I knew it was private and for my eyes only. I think that helped me open up more and dig deeper into my memories and feelings. While it wasn’t easy, it gave me the most insight of all the things I did in treatment!

Now that I have so many years of recovery under my belt, I am accustomed to telling my story to others if it helps them choose to get the treatment they need. So I’m totally open to sharing my Dear John Letter. It was a big part of my journey that helped me feel like I closed a chapter and took a leap into my life in recovery.

My Goodbye Letter to Drug Addiction

Dear Addiction (Specifically Drugs and Alcohol),

Our time here is done. I say “our” because the truth is, neither one of you were my favorite. You were both kind of mediocre.

While I once found you a soothing tonic to a stressful day, you became a monster inside of me that I needed constant attention. Sure, we had fun. Summer nights after work on the patio: there was laughter, joy, and you provided the social lubrication to make socializing easy. It’s like you shimmied up beside me as a smart, handsome person at the bar who offered me this magic elixir. “Everyone around me was drinking it, so why shouldn’t I?” I wondered.

What you never told me, though, is that you’re insidious like a cancer that ravaged my body until it was unrecognizable.

What hurts the most is I thought I could trust you. You told me that you were a part of normal life. “It’s how people unwind,” you said. But we both know that isn’t true. In just one year of listening to you, my mind was utterly consumed with urges to use…every-single-day. But at the time, it felt like you were a coping strategy that made sense.

For more than ten years, I tried to break up with you. But like a toxic ex, you’d creep back in reminding me that I couldn’t cope without you. We danced like this over-and-over. Until that fateful night. Remember that tragedy that I faced? I desperately needed support, but you just pushed me into a deeper depression. You nearly killed me.

Thank God, even in the midst of a crisis, I woke up to your toxicity. That clarity gave me the strength to pick up the phone and save my life.

Life today is a dream compared to life with you. I have more clarity than I’ve had in twenty years. I see that I never needed you. You weren’t a coping strategy at all — you were a crutch I leaned on. And in the end, you were a negative force in my life set on a path of destruction.

It is with the clarity of recovery that I can tell you with complete certainty that we are broken up. Delete my number, get out of my head, and never ever darken my doorstep with insidiousness again.

From here on out, I have effective ways to cope that don’t involve obliterating my reality and slowly killing myself.

Goodbye forever.

And good riddance!

12 Evidence-Based Therapies for Individualized Addiction Treatment

Finding individualized evidence-based therapies for treatment can be the key to long-term recovery from addiction. Everyone’s experience with addiction is different, so the type of addiction treatment you choose is a vital key to recovery success. Simply put, it’s critical to find a therapy that works best for you.

When I got sober ten years ago, I lived in the U.K. The only options in my area were Alcoholics Anonymous (AA) or very limited private treatment. I was out of work and there were no programs that could fund treatment. It felt like I had no choice but to get sober in AA.

I’d tried to do it alone multiple times, but I couldn’t get more than a few days of sober time. I kept relapsing using the “cold turkey” method. But as I grew, so too did my revelations about recovery and the kind of support I needed.

AA has this analogy that recovery is like peeling back layers of an onion to get to the core of who you are. That was my experience in navigating different therapies throughout my recovery journey. The more I revealed, the more I was able to meet my needs for healing.

Determining Your Needs for Treatment

A critical part of the recovery process is being able to get in touch with your needs. Even in the midst of addiction, you can determine that you need to find and pay for treatment or housing, for example.

To determine the right kind of addiction therapy for you, consider:

• Severity of use: The duration and intensity of use will help you to determine if you’ll benefit from inpatient treatment and/or detox. It can be dangerous to stop using certain medications so it’s best to speak to a treatment specialist who can advise you on the best course of action.
• Dual-diagnosis: If you have any other medical conditions, including mental health diagnoses, you may also benefit from treatment under medical supervision in an inpatient facility.
• Commitments at home: If you have responsibilities, like children, and can’t leave home, you may want to opt for outpatient treatment options or partial hospitalization.

Evidence-Based Therapies for Addiction

There are a range of clinical and non-clinical therapies available for addiction treatment. We’re going to focus on evidence-based therapies. These treatments fall into the clinical category.

Treatment Programs

When we’re talking about treatment, we usually think of rehab. But addiction therapies are not limited to inpatient addiction treatment.

They also include:

• Detox: As the name suggests, this therapy provides physical detoxification from substances that can be dangerous to stop alone. Generally, this type of treatment is for people on the acute end of the substance use disorder spectrum and have a physical dependency on a substance.
• Inpatient Treatment Programs: Otherwise known as rehab, inpatient programs involve staying at a facility staffed with nurses, doctors, techs, and psychologists or counselors. They help you achieve a sustained period of recovery. Typically, stays are 30, 60, or 90 days in duration depending on the severity of addiction and any co-occurring disorders. Think of inpatient treatment as a one stop shop for treating your addiction and providing you with the tools you need to sustain sobriety. Note: some inpatient programs also provide detoxification services.
• Intensive Outpatient Programs: As the name suggests, it is outpatient (meaning you can stay at home), but also intensive enough to sustain recovery. Intensive outpatient programs typically require a person to attend nine to 20 hours per week of treatment over the course of two months to a year. This type of program is best suited to those who have a strong family support system, a stable home environment, access to transportation, and a willingness to attend regular treatment sessions.
• Outpatient Addiction Treatment: Like inpatient rehab , but you attend less intensively, during evenings or weekends. Outpatient is best suited to people who have work or school commitments and each facility will have different expectations as to the frequency of visits per week.
• Partial Hospitalization: This involves staying at a stand alone clinic or hospital for 4-8 hours per day, but returning home at the end of the day. These programs last around 3 months and are best suited to people with a stable and supportive home environment.
• Residential Programs: These provide a sober living environment together with treatment services. Stays can be anywhere from a month to a year or longer. These programs have various phases of treatment to assist the person in establishing and maintaining recovery. These types of programs are great for people who don’t have stable living or employment, and/or limited social support.
• Medication-Assisted Treatment (MAT): Otherwise known as pharmacology or pharmacotherapy, this is the use of medications, together with behavioral therapies, for the treatment of opioid use disorder and alcohol use disorder. MAT is now considered the gold standard of therapies for opioid addiction because it reduces cravings, improves patient survival rates, and increases retention in treatment programs. MAT is best suited to those with opioid use disorder or alcohol use disorder.

Behavioral Evidence-Based Therapies

There are a range of behavioral therapies that can be used alone or in combination with the above treatment programs. Typically, any kind of formal treatment program will involve some kind of behavioral therapy, of which there are many (see below).

Some of the most effective evidence-based therapies include:

• Eye Movement Desensitization and Reprocessing (EMDR) is an 8-stage therapy that uses eye movements, light, and psychotherapy to help individuals overcome trauma.
• 12-Step Facilitation is a semi-structured program that is led by a facilitator over the course of four to 12 sessions. Ultimately, the goal is participation in the 12 Step program like Alcoholics Anonymous to help people abstain from drugs and alcohol. The facilitation sessions also offer the opportunity to discuss attendance at AA and to discuss anything that arises.
• Cognitive-Behavioral Therapy (CBT) includes a range of approaches that work on the premise that behavior is influenced by a cognitive process. The belief underpinning CBT is that addiction is a maladaptive coping strategy, therefore the therapy focuses on developing new behavioral skills for coping. The therapies involved under the umbrella of CBT include:
  • Dialectical Behavioral Therapy (DBT) also includes skill-building to positively influence behaviors, with the addition of mindfulness strategies to regulate emotions and cope with stress.
  • Contingency Management also works on behavioral modification, but with an incentive-based approach to positively reinforce change. Participants may be given vouchers, financial incentives, or other privileges to reward positive changes.
  • Rational Emotional Behavioral Therapy (REBT) is an action-oriented therapy that identifies negative or irrational thought patterns that lead to negative thoughts or emotions. By identifying these thought processes, the idea is that you can use REBT to interrupt these patterns and create healthier and more productive beliefs and behaviors.
• Behavioral Couples Therapy: As the name suggests, this type of therapy involves both partners in therapy i.e., the person with substance use disorder and their partner. The goal of couples therapy is to overcome addiction and to improve the relationship through better communication, acceptance, and change.
• Family Therapy: Like couple’s therapy, family therapy involves anyone in the immediate family of those struggling with addiction. Similarly, it also works to improve family communication, create lasting change, and improve relationships.
• Motivational Interviewing (MI) This is a technique used to explore and resolve ambivalence around substance use by motivating the individual to make positive behavioral MI involves empathetic listening, reinforcement, and supports the individual in their ability to meet their goals.
• Acceptance and Commitment Therapy (ACT): This works on the principles of acceptance, mindfulness, tolerance and personal values. ACT’s goal is to develop the flexibility to tolerate difficult emotions and experiences while maintaining recovery.
• Community Reinforcement Approach (CRA/ACRA): This therapy uses group-based behavioral interventions that provide responses (or consequences) and rewards in response to certain behaviors, like addiction or sustained recovery.
• Relapse Prevention or Mindfulness Based Relapse Prevention (RP/MBRP) This utilizes strategies and skills-building to help promote recovery and decrease relapse.

How My Needs Changed Throughout My Recovery

As I mentioned earlier, 12-step recovery initially helped me get sober. But as I progressed in my journey — or revealed more layers of the onion — I found that I had other issues to deal with: unresolved trauma, depression, and ADHD.

Ultimately, that led me to seek out a trauma therapist to help work through my traumatic childhood. Once I had gained some healing, I could then move on to developing solid coping strategies and emotional regulation techniques through dialectical behavioral therapy.

The combination of evidence-based therapies during sustained recovery has been life changing. No longer do I feel like I’m on an emotional rollercoaster and I haven’t had a desire to drink or use for years. These coping strategies have been essential to me not only in sustaining recovery, but also in my ability to take on challenges in life, like buying a house, getting married, and going back to school.

Whatever you choose in your pathway of recovery, know that there are always options available to you as you progress through your journey.

If you or someone you love is experiencing a substance use disorder, help is available. Call 800-914-7089 (Who Answers?) today.

Why is There a Stigma Associated with Rehab?

Research shows that despite 21 million Americans struggling with addiction, less than 10 percent of people get the help they need. The stigma associated with rehab can prevent people from seeking treatment.

People suffering with addiction are often blamed for their disease. Others label them as making poor choices, or as weak of character. But stigma doesn’t just impact the public’s view of people.

It also permeates through families, and even medical providers. It reduces not just the quality of care, but access to quality addiction treatment.

It is no surprise that people avoid seeking life-saving treatment because they’re worried about what other people will think of them. They may even have internalized that stigma into the belief that they have failed in some way.

We don’t stigmatize those with other chronic conditions, like diabetes. So why do we stigmatize people struggling with addiction? People struggling with substance use disorder don’t need stigma.

They need empathy, compassion, and to receive specialist treatment for a medical condition.

What is Stigma?

According to the Recovery Research Institute, “stigma is an attribute, behavior, or condition that is socially discrediting.” Researchers have found that illicit drug use disorder is the most stigmatized condition in the world. In that same study, researchers found that  alcohol use disorder ranked as the fourth most-stigmatized condition.

Stigma varies depending on the perception of the condition. For example, substance use disorders are often perceived to be due to someone’s choices and receive a higher level of stigma. Whereas if a condition is not believed to be a person’s fault and that they have less control over the condition, the stigma is lower.

Stigma has two parts: the negative perceptions or beliefs about a person and their addiction, and the discriminatory behavior or actions that result from that negative perception.

For example, if someone with an addiction to heroin is viewed as untrustworthy and dishonest, you may be less likely to offer them help if they ask for it. The same is true for medical providers.

Is There Proof of Stigma Associated with Rehab?

There are several studies that highlight the stigma associated with rehab and addiction which can have real-life consequences, these include:

• Until recently, insurers did not reimburse addiction treatment at the same rate as other mental health disorders
• The language used to describe people with substance use disorders, like “addict,” or “alcoholic” can negatively impact the patient in terms of access to care, quality of care, and their morality
• Researchers interviewing participants about the descriptor “substance abuser” found that participants believed this person is:
• Less likely to benefit from treatment
• More likely to benefit from punishment, like jail
• More likely to be socially threatening
• More likely to be blamed for their addiction and related difficulties, and less likely to believe challenges were a symptom of a condition over which the person had no control
• Has control over their substance use without professional help
• Black individuals are less likely to receive buprenorphine prescriptions than white individuals
• Being thrown out of the emergency room, even if in mental health crisis, because of intoxication or withdrawal symptoms
• People with substance use disorder end up stigmatizing themselves
• First responders may be less likely to reverse an overdose due to a lack of available medication

What Are Some of the Ways Stigma Shows up in Addiction Treatment?

The language used to describe people with substance use disorders can elicit more negative attitudes and punitive behavior. For example, physicians may believe that a person struggling with addiction is less likely to benefit from treatment.

Stigma affects individuals on a personal level too. Research shows that individuals with alcohol use disorder who felt their condition was highly stigmatized were less likely to seek treatment.

The larger effects of stigma are that a very treatable condition is under-diagnosed, under-treatment, and misunderstood. The consequences are fatal as thousands of Americans  die from untreated substance use disorder every year. And figures are only worsening.

According to the Centers for Disease Control and Prevention, deaths from opioid related addiction have quadrupled to over 500,000 since 1999!

However, it’s worth noting that addiction professionals are well aware of this stigma. They are working towards reducing stigma by highlighting that addiction is a chronic brain condition worthy of compassionate medical care. As such, addiction treatment facilities are non-stigmatizing facilities that pride themselves on providing individualized medical care to patients to offer the best possible chance of success.

How to Overcome Stigma Associated with Rehab

There are a variety of ways we can reduce the stigma associated with rehab and substance use disorder. These include:

• Changing our language, by dropping the use of words like “abuser” and using the Recovery Research Institute’s Addiction-ary
• Writing to publications that have used these labels and reminding them of the guidelines by the Associated Press and the International Society of Addiction Journal Editors
• Seeking help when we need it instead of avoiding it because of stigma
• Telling our friends and family we are struggling with substance use disorder
• If you’re a loved one, you could educate yourself on substance use disorder and actively seek to change any negative perceptions you hold
• Advocating for ourselves at the doctor, that might include using the words substance use disorder
• If you’re a physician or medical person, treat patients with dignity and compassion above all else, and ensure you are up-to-date on your medical education about the treatment of substance use disorders
• Reviewing the overwhelming evidence that treatment is effective, that medication-assisted treatment works, and that millions of Americans have resolved an alcohol or drug problem
• If you are in recovery, consider sharing your story so that people can see addiction affects everyone, not just the stereotypical person.

If you or someone you love is experiencing a substance use disorder, help is available. Call 800-914-7089 (Who Answers?) today.

Images Courtesy of Canva.

Paying for Rehab: Will Medicare or Medicaid Cover Treatment?

Can Medicare and Medicaid help with paying for rehab? The short answer to this question is yes, there is some coverage under Medicare and Medicaid…but it can get complicated.

So we’re going to uncomplicate things for you right here, right now.

I remember being so confused about each program, and it felt like I hit a brick wall. When you’re looking for the right treatment facility, the last thing you want is to do a ton of stressful research. Trying to understand your eligibility in the midst of an addiction crisis is exhausting!

I’ll start by providing a brief explanation of both insurance programs, how they work, and who is covered. That way you can focus on what’s important: finding the addiction treatment you deserve.

What is Medicaid?

Medicaid is a federally and state funded program that provides healthcare coverage. Medicaid is the largest payer of mental health services in America, accounting for 21 percent of the nation’s substance use disorder treatment.

But it hasn’t always been this way…

Not too long ago, health insurance providers actively denied addiction treatment, while covering the cost of care for many other chronic conditions. That’s why The Mental Health Parity and Addiction Equity Act was passed. These acts legally ensure Americans with mental health and substance use disorders aren’t discriminated against for behavioral health treatments.

In order to get coverage under Medicaid, you’ll need to meet certain requirements. The important thing to keep in mind is that Medicaid can help with paying for rehab. But the extent of Medicaid coverage depends on your unique circumstances.

Who Qualifies for Medicaid Coverage?

Typically, Medicaid eligibility is based on financial and other eligibility requirements.

Medicaid generally provides coverage for:

• Older adults (over the age of 65)
• People with disabilities
• Children
• Pregnant women
• Parents and/or caretakers of children
• Those who need nursing home care, long-term care, and home health care services

Generally speaking, if you qualify for Medicaid, you’ll also qualify for Medicare. Cost of care is generally covered by Medicare first, then Medicaid.

People who are considered low income or belong to certain groups tend to qualify for Medicaid.

Does Medicaid Cover Addiction Treatment?

You can expect Medicaid to cover part of your addiction treatment costs in most states. However, the extent of coverage depends on whether you have other forms of health insurance and state requirements.

Most treatment centers now accept Medicaid, with little to no co-pay.

Coverage typically includes:

• Intervention
• Screenings and assessments
• Inpatient and outpatient programs, including residential programs, partial hospitalization, and detoxification
• Mental health services
• Medication-assisted treatment, including: methadone, buprenorphine, and naltrexone
• Addiction counseling and therapy for individuals and families
• Outpatient visits
• Activity-based therapies
• Lab tests

Most states cover a range of addiction treatment services. Just be sure to verify your coverage and confirm how much (if any) you’ll have to pay out-of-pocket for treatment.

What is Medicare?

Medicare is available to people over the age of 65 or those who experience disabilities. You may be expected to pay a monthly premium for Medicare, which is based on your income. There are two types of Medicare: original Medicare (Part A, B, and D) and the Medicare Advantage Plan (Part C).

Does Medicare Help with Paying for Rehab?

In terms of paying for rehab, Medicare may cover the costs of both inpatient and outpatient programs.

There are four parts of Medicare coverage:

• Part A: Covers hospital stays, including inpatient treatment for up to 60 days
• Part B: Covers outpatient care at up to 80 percent, including therapy, medication, mental health disorders and co-occurring conditions like PTSD and substance use disorder
• Part C: This is essentially Medicare-approved private insurance for folks who want more extensive benefits than they would get with Medicare alone. It’s known as the Medicare Advantage Plan. Coverage includes prescriptions, hearing, vision, dental. Members can apply for four different options under the Medicare Advantage plan:
  • Medicare SNPs: For people with a specific disease or condition, including addiction
  • Medicare HMO: Covers in-network coverage, but medication coverage may vary
  • Medicare PFFS: Offered by private insurers and they determine what is covered and how much you pay for healthcare services
  • Medicare PPO: Provides a network of healthcare providers both in and out of network
• Part D: Covers medication, such as medication-assisted treatments like those used to treat opioid use disorder (buprenorphine, naltrexone, and methadone).

It’s possible that you can qualify for Medicare and Medicaid, particularly if you are over the age of 65, if you are considered low income, or if you have a disability. Keep in mind, however, each state has different eligibility requirements.

How to Verify Coverage for Medicaid

There is a specific application process when you apply for Medicaid, but it differs slightly from state to state. In some states, the Medicaid office may be referred to by a different name, like the Department of Health, the Department of Social Services, or the Department of Insurance (among other names).

While the best way to verify coverage is to contact your state’s office, here’s a step-by-step guide for what you need to do:

• Find out the name of your local Medicaid office, then contact them to find out how they receive applications. Some offices require in person applications, while other states accept applications online, by mail, by telephone, through a local health center, or via a community organization.
• Before sending in your application, you need to have some specific documents ready. The Medicaid office may ask for any of these documents:
  • Proof of U.S. citizenship or other lawful residence, such as a driving license, passport, green card, birth certificate, employment authorization card
  • Proof of date of birth, such as a birth certificate or driver’s license
  • Proof of income, such as paycheck stubs, Social Security income, or retirement benefits
  • Proof of financial resources, like bank statements, life insurance policies, and any other financial assets
  • Proof of residence, such as a lease agreement, rent receipt, statement from a landlord, or deed to your home
  • Insurance cards for any other health insurance you currently hold (including Medicare)

It’s important to note that Medicaid coverage is available regardless of citizenship status, pregnancy, or if you require emergency treatment for a medical condition. You simply need to provide a doctor’s note to certify a medical condition requiring treatment.

How to Sign up for Medicare

You can sign up for Medicare via the Medicare website within three months of your 65th birthday or if you have a disability. You must sign up during what’s called a “general enrollment” period, which runs from January 1 to March 31 every year.

However, there is a special enrollment period. It can extend the enrollment period up to eight months under certain circumstances, such as having coverage under a group health plan, if your spouse has a health insurance plan that covers you.

The Pitfalls of Using Medicare or Medicaid When Paying for Rehab

There is no doubt that Medicare and Medicaid can increase accessibility when it comes to paying for rehab. But there are also a number of qualifications you’ll need to meet in order to qualify:

• You must be eligible
• Your doctor must determine addiction treatment is medically necessary
• Government programs generally cover up to 80 percent of the total cost of treatment
• Some treatment providers may not take Medicare and/or Medicaid
• Medicare will only cover inpatient addiction treatment for a duration of 60 days

Call the Treatment Center to Ask About Paying for Rehab

Along with determining your eligibility for coverage, it’ll be important for you to find a rehab that accepts Medicare or Medicaid. Use the Rehabs.com directory to search the nation’s best treatment facilities, make a short list of rehabs that provide the services you need, then call the treatment center to ask if they accept Medicare or Medicaid.

Yes, Medicare and Medicaid are certainly valid options to help you pay for rehab…you just have to do a little bit of pre-planning and know what to look for.

Get help today at 800-914-7089 (Who Answers?) to learn more about the addiction treatment programs available in your area.

What’s a Typical Day in Rehab Like?

Rehab is a 24/7 inpatient program where you live at an addiction treatment facility. Rehabs are standalone buildings in which medical and behavioral experts help people recover from addiction. 

We’ve outlined what a typical day in rehab might look like, as most facilities follow the same kind of structure throughout the day.

Goals of Inpatient Rehab Treatment

You can expect your stay in inpatient rehab to be anywhere for 30-90 days depending on the severity of your addiction. While programs do vary depending on the facility and patient needs, there are a standard set of goals for addiction treatment will seek to achieve, including:

• Ensuring that you have comfortably detoxed from your drug of choice and remain stable
• Undertaking a comprehensive medical assessment
• Identifying and managing any medical conditions
• Conducting a behavioral evaluation, which includes a biopsychosocial assessment
• Establishing a care plan for any co-occurring conditions
• Helping you to develop healthy coping strategies which you’ll practice in rehab
• Creating social bonds with people in recovery and helping you establish your own social support network
• Developing a structured aftercare plan that includes a detailed relapse prevention strategy

With this set of goals, you would be right in thinking that your days in rehab will be full. While there is downtime, most of your day is spent focusing on some kind of recovery-related activity.

Approaches Used in Inpatient Rehab

Inpatient rehab programming uses a combination of different therapeutic approaches throughout the day, including the following.

Individual Therapy

During individual therapy, you’ll discuss the circumstances that led to coping with substances and work with the counselor to develop solutions. 

In your first session you can expect to have a detailed session lasting up to 90 minutes during which the therapist will take a detailed biopsychosocial assessment. Think of it as a sort of zooming out to look at the bigger picture surrounding your drug or alcohol use. 

You can expect the therapist or social worker to take a full medical and psychological history, look at your family history, and establish your social support structures as well as social issues that might be influencing your use of substances. 

After your initial session, you’ll work together with your therapist to:

• Identify thought patterns that might lead to substance use
• Determine relapse triggers
• Develop a more comprehensive coping strategy that encourages well-being
• Create a comprehensive relapse prevention plan
• Identify and develop a solid support network
• Develop a robust aftercare plan

A therapist may use a variety of different methods and techniques to support your recovery process, including: 

• Cognitive behavioral therapy (CBT)
• Dialectical behavioral therapy (DBT)
• Motivational interviewing
• Contingency Management
• Eye Movement Desensitization and Reprocessing (EMDR)
• Seeking Safety
• 12-step facilitation

Group Therapy

These sessions include talking about your history, developing relapse prevention strategies, giving feedback to peers, or even working through a program of recovery.

Group sessions are intended to build community and social support by showing you that other people are walking this path with you, and that they experience similar struggles. 

Group therapy also helps you develop a supportive network of people in recovery that you can rely on and reach out to when you’re having a difficult time.

Family Therapy

Family therapy sessions are attended by family members and allow you to talk about how addiction has impacted your family. 

A therapist will facilitate the session and allow everyone an opportunity to speak without interruption. 

Once everyone has been able to talk, the therapist will guide the family to developing strategies that promote recovery. 

Alternative Therapies

Most treatment centers have some sort of alternative therapy to support the recovery process, such as:

• Massage therapy
• Yoga and meditation
• Art therapy
• Equine or dog therapy
• Neurofeedback
• Music therapy
• Exercise programs
• Nutrition therapy
• Adventure therapy

These supplemental activities and therapies can offer a new level of healing that can’t be achieved with behavioral therapy alone. 

People who have been through traumas with their addiction may find difficulty expressing themselves verbally, but find the use of art of music an effective way to process your experience. 

The takeaway here is: be open to new ways of supporting your recovery — you might enjoy it! 

Mornings During a Typical Day in Rehab

Most rehabs will expect you to get up around 7am, during which nurses make their rounds and provide patients with their medications. You may have around 30 minutes before breakfast to get yourself ready for the day and may even have time to meditate, or go to a meditation class depending on the facility.

You can expect breakfast at the same time every day. Most facilities serve this around 8am. You’ll be joined by other residents and there will be some sort of communal seating arrangement.

Therapy

Following breakfast, you’ll either meet with a therapist, counselor, or therapist individually or in a group setting. These are credentialed professionals with extensive experience in treating substance use disorders.

Personal Time or Activity

After therapy, you can expect to have some free time. That might be described as recreation time — which is a great way to integrate after therapy — or relaxation time. You can expect to do some kind of exercise, some downtime, and lunch. You’ll then return to the afternoon session. 

Afternoons During a Typical Day in Rehab

Therapy

After lunch, if you met with a therapist in the morning, the afternoon session will be group therapy, during which you’ll sit with peers in treatment and process your experiences. 

Personal Time

After the afternoon session, you should have some more free time before dinner. You should be able to unwind, watch a movie, complete a recovery assignment, and socialize. 

Dinner is usually around 6pm.

Evenings During a Typical Day in Rehab

Group Support

Evenings in rehab are typically filled with some kind of recovery support meeting, like a 12-step or SMART Recovery meeting. During these meetings, people share their experiences, strengths and hopes, or work through developing specific recovery skills. 

Weekends During Rehab

Weekend programming may vary slightly in structure from a typical weekday in rehab. For example, more adventuring activities, peer support, socializing, or reflective activities such as journaling may be encouraged as opposed to formal therapy sessions.

If you or someone you love is experiencing addiction, help is available. Call 800-914-7089 (Who Answers?) today.

How I Qualified for a Drug Rehab Scholarship

I’ll never forget the sheer desperation I felt at the end of my addiction. I knew I needed help, but I couldn’t afford to pay for rehab. I lost my job, and I was completely broke. I thought my situation was hopeless.

If I sank much into my addiction, I knew I’d be dead. But I didn’t know where to turn. I drank all day, every day. Even my friends were sick of my addiction. I wanted to stop, but I couldn’t.

I still don’t know if there’s a “Higher Power,” but I was desperate enough to get on my knees and ask the universe for help.

Whether my prayers were answered or the Internet’s algorithm stepped in, I found the answer I needed:

Treatment may be accessible through a rehab scholarship.

What is a Rehab Scholarship?

A scholarship provides part or all of the funding for addiction treatment services. And when I started searching for scholarships, I found out some important facts:

• Scholarships can be used with private insurance, Medicare, and Medicaid.
• Scholarships cover a range of treatments (see the section below, What Do Scholarships Cover?), but they don’t cover what’s considered “luxury” treatment, which may include massages and acupuncture.
• They are available through both non-profits and private treatment centers.
• Individuals eligible for scholarships include:
  • People unable to seek funding elsewhere
  • Individuals not covered under Medicare and Medicaid (although scholarships can be used alongside this coverage)
  • Underinsured people
  • Individuals with co-existing conditions, such as a mental health concern
  • People committed to completing the program
• Scholarships are fairly easy to apply for. Do your research and apply for multiple scholarships. Remember, scholarships are in high demand.

What Do Rehab Scholarships Cover?

Scholarships are generally awarded by non-profit organizations, along with outpatient and inpatient treatment centers. Depending on the applicant’s financial needs, a scholarship could cover a significant portion of your out-of-pocket costs.

Since the cost of inpatient treatment is usually more expensive — usually anywhere from $3,000 to $20,000 — an inpatient facility may provide more financial assistance than outpatient treatment centers. And specific treatments covered by the funds from scholarships will vary by the treatment program.

Scholarships generally do not cover treatments that are optional or considered luxury, which may include acupuncture, massage therapy, fitness training, spa treatments, salon services, etc.

4 Important Considerations For a Rehab Scholarship

Before I share my experience applying for a treatment scholarship, there are four important considerations to keep in mind:

1. Rehab scholarships are generally need-based. Essentially, they are only offered to people with absolutely no other alternative — no insurance, no credit, and no resources or assets.
2. Treatment centers offer a limited number of scholarships. Most rehabs set aside a certain portion of their income to offer scholarships every year. If that money has not already been used up, and if you qualify, you may be in luck.
3. The facility may offer some financial assistance. For example, if your insurance covers 75 percent of the treatment’s cost, the rehab facility may be willing to pick up the other 25 percent.
4. Not all rehab programs offer scholarships. You’ll need to do your homework by calling multiple treatment centers and researching online.

Other financial options include a sliding-scale payment plan. These plans are designed for people unable to pay the full costs of treatment. They’re often referred to as “income-based” payment plans.

How to Apply for a Rehab Scholarship

I’m always interested in hearing about another person’s personal experience when making major life choices. And addiction treatment is certainly one of those major life choices, right? It’s a major investment in yourself – and your life!

With that said, here’s how I applied for (a lot of) addiction treatment scholarships and was lucky enough to earn one:

• I Started with Research
  • Search the scholarship website 10,000 Beds. The organization has awarded millions of dollars in treatment scholarships over the past eight years. You can apply online on the first Monday of the month from March to November.
    • Please note that you must meet the following criteria:
      • You’re ready to commit to at least 30 days of residential treatment.
      • You don’t have the resources to cover the costs of treatment.
      • You need treatment for substance use disorder.
      • You’ve exhausted all other options.
  • Research private rehabs, then call them and ask if they have scholarships available. This may involve calling a lot of treatment centers in your area. Be prepared with a set of questions, including:
    •  How much of the treatment is covered (partial or full-funding)?
    • How many scholarships are available?
    • When will you receive an answer to your application?
    • If partially funded, what other financing options are available?
    • If they don’t offer scholarships, do they know of other treatment centers that do?
  • Ask for scholarship information from local recovery community organizations and other community resources, such as churches, social workers, and charity organizations.
• Apply Apply Apply: Because of the high demand, you’ll need to apply for multiple addiction treatment scholarships.
• Follow-up After Applying: Treatment centers may receive hundreds of scholarship applications. After around 30 days or so, call them to make sure they received your application. Ask the facility when you may receive an answer.
• Be Ready: When a bed opens up and they have a spot for you, the call could come at any moment. You need to be ready to go when that call comes. Have a bag packed. Be ready to tell your close friends, family, and employer.
• Don’t Give Up: There are other options available if you can’t find a scholarship.

If You Can’t Find a Rehab Scholarship…

While there are certainly a lot of scholarships available, demand is still enormously higher than the supply for this type of financial assistance. If you’re unable to secure a scholarship, it isn’t the end of the road. Please don’t give up.

Consider these options:

• Some state-run facilities offer free treatment. But these treatment facilities are generally smaller with limited space for clients.
• You may qualify for coverage under Medicare or Medicaid. Check out our recent blog, Paying for Rehab: Will Medicare and Medicaid Cover Treatment?
• Grants are available in every state via Substance Abuse Prevention and Treatment Block Grants, which cover the cost of treatment. You can find out more by visiting the website GrantWatch.
• Many rehabs have financing options available. That means you may be able to pay for treatment over a period of time. All those treatment centers you called earlier asking about scholarships? Call them back and ask if they have financing options available. Don’t give up until you get the answers you need.

A Note On Recovery

While I was lucky enough to get a scholarship, I’ve got to be real with you: I applied for 38 different scholarships and got one acceptance letter.

I literally spent days on my phone and computer. And it was beyond stressful to keep calling over and over again, asking questions and trying to find someone else I could speak to about financial help. It was like having a full-time job! But the effort I put into finding a treatment scholarship was worth every second.

At the end of the day, it was that one single rehab scholarship that saved my life. There’s no way I could have afforded to go to treatment otherwise. I spent 60 days in rehab before I came home with a brand new outlook and a mindset committed to my recovery. That was five years ago, and I haven’t used (or wanted to use) since I finished treatment.

If I could give myself one piece of advice back then — back when I could feel myself getting discouraged and my addiction tried its very best to convince me there was no hope — here’s what it would be:

Do not give up. Keep calling, applying, asking for advice, reapplying, and researching. You’re worthy of treatment, and you deserve a life of recovery. You’ve made it this far…hang in there just a little longer and your life will improve in ways you can’t yet imagine.

For information about treatment options for you or a loved one, get help at 800-914-7089 (Who Answers?) today.

What to Know Before You Go: 7 Tips for Preparing for Rehab

Once you’ve made the decision to seek treatment, the next step is preparing for rehab. You may be feeling anxious and be focused on just getting there. 

While those feelings are completely normal, there are things you can do to prepare whether you’re traveling to rehab or attending in your home state. Preparation is the key to easing that pre-rehab stress and setting yourself up for success when you return home.

We’ve put together a guide to help you know what to expect from rehab and how to prepare. 

How Rehab Works

Many people entering rehab have little to no idea what to expect from their stay, which can make people feel anxious or fearful. There’s no need to be worried. Addiction treatment has a fairly defined process. Here is what you can expect throughout your stay.

Intake

Just like when you visit your primary care doctor, you will complete intake paperwork, provide your ID, and your insurance information.

Part of the intake process is assessment by a medical professional. They’ll need to know your drug use history and a detailed medical history, including details of medications and any co-occurring conditions. 

The reason they take such an extensive history is to build a complete picture of your medical needs and how to support you during your stay. You can also expect to meet with a psychologist, counselor, or clinical social worker to talk about your psychological well-being — this process is often referred to as a biopsychosocial assessment.

Getting Settled

Once you’re admitted, or after completing detox, you’ll be taken to your room. Some facilities have single rooms and some are shared with other residents. You can expect your own bed, nightstand, and a place to store your belongings. 

If having your own room is important to you, then you’ll need to inform the treatment center of this before intake to check if they have that option available. 

Note that your belongings may be searched for restricted items, like drugs and paraphernalia. 

Some treatment centers also take away electronics for a few days to the duration of your stay to help you focus on treatment without distraction. 

Treatment

Treatment in rehab involves several stages and approaches, including:

• Detox: The first part of your stay in treatment may include detoxification under medical supervision. This process will manage withdrawal symptoms, help you to feel comfortable, and provide any medical support you need.
• Group therapy: Group therapy sessions are little different to an AA meeting—although you may be asked to attend those too—in that you participate in sessions led by a licensed therapist. You may be asked to share your story, or contribute in some way that helps to support your recovery process. 
• Individual therapy: A therapist or counselor will meet with you on a regular basis to establish a relationship in which you can process your addiction. You can also expect to work with the therapist to come up with healthier coping strategies and to develop a relapse prevention plan.
• Developing coping skills: in addition to developing these skills with your counselor, you may also attend workshops, training sessions, and group therapy to learn coping strategies with your peers. The idea is to find something that is useful and effective that you can maintain when you’ve left rehab.
• Family therapy: Many treatment programs involve inviting your partner and/or family into the facility to process how addiction has affected the family and how they may have also contributed towards it. As a family, you’ll all be given an opportunity to speak without interruption and a trained facilitator will help guide the family toward a resolution and more effective coping strategies.

Aftercare

After you complete your treatment program, you can expect to be enrolled in some kind of aftercare program or plan. Whether that’s attending an outpatient facility, checking in with the treatment center at regular intervals, going to sober living, or engaging with a therapist, the rehab will help to find you the most appropriate options that will help sustain long-term sobriety.

Knowing what to expect should hopefully have allayed some fears so that you can focus on preparing for rehab.

Preparing for Rehab

As you’ve gathered already, addiction treatment is a process and one way to ease you into that process is to prepare for it. Here are seven top tips that people attending rehab have found helpful in preparing for treatment.

#1. Make Childcare, House Sitting, or Pet Sitting Arrangements

One of the first steps to take while preparing for rehab is to make arrangements for your loved ones (and fine furry friends). Making your arrangements official can make your treatment entry date feel more real and reduce anxiety you may feel about what will happen while you’re away.

#2. Tell Your Loved Ones You are Preparing for Rehab

In addition to arranging for your loved ones to be taken care of while you’re receiving treatment, decide how to tell them you’re preparing for rehab. You don’t have to tell them detailed information, just the basics, (e.g., that you’re going away for mental health treatment and that you’ll hope to be back at a certain date). You can ask for their support, too.

#3. Take Care of Your Work or Financial Obligations

Pay bills in advance, ensure you have enough money in your bank account to cover regular expenses, and inform your boss or HR department that you need to attend rehabilitation.

Connect with your rehab facility and insurance company so you understand treatment costs.

#4. Pack Essentials (and Some Home Comforts)

Essential items include: 

• Grooming and hygiene products
• Comfortable clothing
• Your ID and insurance cards
• Prescription medications
• A credit card 

Home comforts might include your favorite blanket or sweater, or perhaps one of your children’s items. Check with your rehab about any restrictions on what you can bring.

#5. Make a List of Your Medications

When creating your medical history, ensure to make a list of your medications, noting the dosage amount and when you take them. This is helpful information to complete your intake paperwork.

#6. Be Mindful of How You Nourish Yourself

Sleep, nutrition, and social connection can affect your rehab experience. Before and as you enter rehab, be mindful of how you care for yourself.

Eating nutritious foods will help your body recover more quickly. 

Nourishing yourself also means choosing who you surround yourself with in rehab. Hanging out with residents who aren’t taking rehab seriously, or are looking to cheat the program, isn’t in your best interests. It may feel fun at the time, but it’s essentially wasting your time and money.

#7. Don’t Overthink It

Hard to do, we know. However, there is only so much you can prepare for before rehab. You won’t know how you’ll feel until you go through the treatment process so don’t overthink what you can’t anticipate.

Start Now

While you’re waiting to go to rehab is the perfect opportunity to start focusing on recovery. Consider practicing meditation and relaxation techniques. Start with just five minutes a day and it may help ease some of that anxiety and fear you’ll be feeling.

You may decide to begin attending peer support groups, like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), ahead of entering treatment.

For information about treatment options for you or a loved one, call 800-914-7089 (Who Answers?) today.

Where To Get Fentanyl Test Strips And How To Use Them

I never thought I’d need a reason to use Fentanyl test strips. Like many, when I first started taking opioids, I had a legitimate reason. I fell off my bike, broke my arm, and needed surgery. While I’d heard about the risks of taking opioids, I knew I’d be able to manage the prescription.

I was in my late 20’s, really active, and had no substance use problem. Heck, I could take or leave a beer, and the hardest drug I’d ever tried was weed in high school. But that all changed after I fell off my bike.

If I could go back to that moment, I’d tell myself what I know now: You may think addiction isn’t possible, but these drugs are powerful and can ruin your life.

The Crash That Changed Everything

Just like any other Saturday, I’d been hanging out with my friends. We’d meet at the park, shoot some hoops, or go to the skate park. We then usually headed over to our favorite burger joint for lunch. A few hours later, I rode home on my usual route, but I was distracted by my phone which kept buzzing.

Instead of ignoring my phone until I got home, I took it out of my pocket to make sure it wasn’t anything important. In that brief moment, while glancing at my phone, everything changed. I was hit by a driver that I veered into because I was distracted. The impact threw me off my bike. I flipped over the hood of the car and onto the side of the road. I fell at a funny angle and landed on my arm.

After the initial adrenaline rush, I felt a searing pain in my arm. I looked down and it was pretty obvious that I’d fractured my arm — I’ll spare you the gory details. Before I knew it, first responders had arrived. They checked me over telling me I needed to go to the ER.

While I was in pain, I was grateful that I was still alive. I’d broken small bones as a kid, so I felt optimistic about my prognosis. What I didn’t expect was the extent of my fractured arm. It was broken in multiple places: the radius, ulna, and humerus — all three bones in my right arm. The doctor took one look at me and recommended I be admitted to the hospital for surgery as soon as possible.

I had surgery later that night. The surgeon placed multiple fixation devices in my arm to hold it together. I didn’t feel pain when waking up from surgery, but two hours later, I was in agony. The next thing I remember is a nurse giving me something before I drifted to sleep. Every few hours, after that, I needed more medication to induce the same effect.

Prescribing My Future Addiction: A Common Story

When I was discharged from the hospital a day later, they gave me a prescription for Vicodin — a highly addictive narcotic containing hydrocodone. I didn’t expect to need it for much longer, but before I knew it, I’d emptied the bottle.

When I had a follow-up appointment with the surgeon, I told him I was still experiencing pain and asked for more medication. He gave me a 30-day supply.

Fifteen days later, when I tried to get more, the doctor refused to give me a prescription and told me that I shouldn’t need it. Taking his advice, I tried Tylenol and ibuprofen, but they didn’t work. Before long, I was sweating, feeling nauseous, had a stomach ache, and couldn’t sleep. When I looked up my symptoms online, I saw that I was in opioid withdrawal. I was in agony.

Instead of riding it out, I called a friend who I knew would be able to help me. When he came over, he explained that he didn’t have pain pills. Instead, he had heroin and showed me how to use it. I didn’t hesitate in trying it. Instantly my pain went away. I felt that relief and drifting feeling I had experienced in the hospital.

We all know what happens next: I became addicted to heroin. Even though the signs of addiction slowly became clear, I still didn’t see it coming.

Heroin’s Secret Ingredient

I continued to buy heroin from my friend. One day, unexpectedly, my friend’s supplier changed the drug’s potency. I didn’t know nor did my friend. Just like millions of other Americans, we were both duped into believing we were buying heroin. We had actually bought heroin mixed with fentanyl.

Fentanyl is 50 times stronger than heroin and 100 times stronger than morphine. It is singularly responsible for killing 150 Americans every day. Just 2 milligrams of fentanyl can kill you, and yet drug cartels are increasingly using it to make drugs more potent and, ultimately, make more money.

Once he realized what was happening, he quickly administered Narcan to reverse the effects of the overdose. I can’t imagine that I would be here to tell you this story if my friend hadn’t been there.

The overdose and my second chance at life were the wake-up calls I needed. I knew I needed to stop and get into recovery. After spending 90 days in rehab, I’ve since dedicated my life to harm reduction by educating people about overdose prevention, promoting the use of naloxone (Narcan), and how to test your drugs for fentanyl.

Where to Find Fentanyl Test Strips and How to Use Them

To curb the dramatic spike in overdose deaths attributed to fentanyl infiltrating the drug supply, the Substance Abuse and Mental Health Services Administration has provided federal funding to purchase rapid fentanyl test strips (FTS).  Fentanyl test strips can be used to test any street drugs.

Due to the increase in funding and the advocacy of harm reduction organizations, people who use drugs now can test their drugs for fentanyl and make informed choices about drug use.

In my work, I often meet with people who use drugs other than heroin who think they don’t need FTS. They couldn’t be more wrong.

Fentanyl is making it into the whole drug supply, including methamphetamines, cocaine, benzodiazepines, and illicitly manufactured opioids. I say to them, just as I’m explaining to you, that everyone who takes any illicit substance should use fentanyl test strips.

A quick “How to” for using fentanyl test strips:

1. Dissolve a small amount of the drug in water.
2. Dip the test strip into the liquid for 15 seconds.
3. Place the FTS on a flat surface for 5 minutes until the results appear.
4. Read the results: One line indicates fentanyl. Two lines indicate a negative result.

Please note that FTS are incredibly sensitive to fentanyl. The strips can even detect the drug in a bag with drug residue.

You can find fentanyl test strips at local harm reduction agencies. Simply search online for “fentanyl test strips” and your city. You can also purchase FTS by mail via these organizations:

• DanceSafe
• DoseTest
• Bunk Police

Overdose Prevention Tips

In addition to fentanyl test strips, there are various other ways you can use drugs safely and reduce the risk of overdose. The Harm Reduction Coalition outlines the following strategies:

• Use slow and less.
• Never use alone. If you do, let someone know that you are using.
• Try snorting instead of injecting.
• Always carry naloxone.
• If using in a group, stagger drug use so that one person is alert while others are using.

If you or someone you love is experiencing a substance use disorder, help is available. Contact our helpline at 800-914-7089 (Who Answers?) and get help today.

Photos courtesy of Shutterstock.