addiction treatment definitions Archives

The addiction treatment industry is a multi-billion dollar industry that is supposed to help people overcome their addiction and lead a healthy life. However, there are many unethical and illegal practices that are prevalent in this industry. These practices not only harm the patients but also tarnish the reputation of the industry as a whole. In this article, we will discuss some of the unethical and illegal practices in the addiction treatment industry and six ways to find the best addiction treatment option for you.

Unethical and Illegal Practices in the Addiction Treatment Industry

1. Patient Brokering: Patient brokering is a practice where addiction treatment centers pay a commission to third-party marketers for referring patients to their facility. This practice is illegal and unethical as it puts profits over the well-being of the patient.

2. Insurance Fraud: Some addiction treatment centers engage in insurance fraud by billing insurance companies for services that were not provided or were unnecessary. This practice not only defrauds insurance companies but also puts patients at risk by providing them with unnecessary treatments.

3. Over-Medication: Some addiction treatment centers over-medicate their patients to keep them sedated and compliant. This practice is unethical and can lead to serious health consequences for the patient.

4. Lack of Qualified Staff: Some addiction treatment centers hire unqualified staff to save money. This practice is unethical as it puts the patient’s well-being at risk. (Any company that bills itself as a “concierge” or “premiere” service should not be filling it’s ranks with interns and inexperienced staff while still charging you top rates).

Things to Look for in a Good Treatment Program

1. Accreditation:

If you are looking at higher level care like residential / in patient or even intensive out patient services it’s good to start by looking for treatment programs that are accredited by a recognized organization such as the Joint Commission or the Commission on Accreditation of Rehabilitation Facilities (CARF). (If you are looking at out patient groups or individual sessions, look at the credentials of the individual, how long they have been in practice and what their peers in the community think of them.)

2. Evidence-Based Treatment:

Look for a treatment program that uses evidence-based treatment methods such as cognitive-behavioral therapy (CBT) or medication-assisted treatment (MAT). Ask them what specific training their staff have in these methods and how often they are retrained/updated in their training. I look for it in writing – in an email response or listed on their website. A reputable facility won’t have any hesitance in providing this – in fact, it should be a point of pride for them.

3. Qualified Staff:

Look for a treatment program that has qualified staff such as licensed therapists, doctors, and nurses. Ask them who is actually leading the groups, are those staff seasoned or are they intern-level, are these staff licensed in addiction only or do they also have licenses in emotional/mental health as well and how often do patients see the doctor, for how long are their sessions and are they in person?

4. Real Individualized Treatment:

Look for a treatment program that provides individualized treatment plans based on the patient’s needs and preferences. Beware of “cookie cutter” programs that think one type of approach works for all – ask them to explain how they adapt their program for different needs of their clients.

5. Aftercare Support:

Look for a treatment program that provides aftercare support such as counseling and support groups to help patients maintain their sobriety. And yes, ideally there should be Family Services while in the program and ongoing family support afterwards.

6. “Glass Kitchen” Approach:

Patiently and openly informing you of your complete financial costs and what your insurance may or may not cover. Clearly explaining if there are any additional charges such as alcohol / drug testing and physician fees that might not be covered. Ethical programs will be up front and concrete about the charges for these and whether or not they are included or will be additional charges you will be responsible for.

7. Personalized and Accessible Discharge Plan:

You should be included in the discharge planning from the very first week. In Texas, a facility is required to provide no less than 3 referrals to the next appropriate level of care and thee referrals are to be “accessible” to the client. This means that if you must use your insurance, than the three referrals must be ones that accept your insurance. If none exist, they must provide the next most accessible and appropriate options they can find. A facility can’t magically make options appear out there. But in a big city, there are so many options and no excuse for not providing them. This is about what is best for you, individually, not necessarily who the facility likes to work or partner with in the service area.

One last point on avoiding financial “scam” behaviors:

If you are using your in network insurance (INN) benefits then you should know exactly what this will cost from the very beginning. It’s also important to know what is really going on. When using your in network coverage you should owe nothing after your copay/deductible/out of pocket – beware balanced billing. If something seems wrong, call your insurance company and ask them to review it with you. (Some facilities do not bill for the physicians you see and those doctors bill separately. They should tell you this from the beginning. Always ask, if physicians or any other service is not included.)

If you are using your out of network (OON) benefits you are responsible for what your insurance company does not cover. However, some facilities inflate the charges on billing sent to insurance companies. In these cases, they may inflate the amount the insurance is asked to pay out and consequently what you will owe, as well. Ask them for their full cost and make a note of date, time, amount and who you spoke with. It’s unethical for a company to charge you one price and someone else another for the same service.

When You Need Help With Claims

If it happens and you can’t get the facility to correct it – file a complaint with your insurance company. If your insurance company doesn’t act in your best interests within an appropriate amount of time, consider filing a complaint against them with your state’s Department of Insurance. It can be incredibly effective and it’s not hard to do. Unfortunately, too many people don’t realize the support they have in these and end up with insurmountable costs that they should not be facing.

Unfortunately, the addiction treatment industry is plagued by unethical and illegal practices that harm patients and tarnish the reputation of the many honest and trustworthy professionals in the industry. It is important to be aware of these practices. Look for a treatment program that is accredited, uses evidence-based treatment methods, has truly qualified staff, provides individualized treatment, and offers aftercare support. By doing so, you can ensure that you or your loved one receives the best possible care and support to overcome addiction.

Remember – You and your loved one are the client (ie the customer). You have every right to ask questions and a have clear, complete understanding of what to expect.

To learn more – check out our Addiction Recovery 101 seminars for parents, partners and spouses.

Below you will find some quick definitions and facts on addiction treatment in Texas. I hope this helps to make things a little clearer. I’ve also included some personal opinions on what I believe good treatment should be in hopes of making it a little easier for you find the best option for you or your loved one.

Alcohol Addiction Treatment in Texas

Addiction, in the past, has incorrectly been thought to be a question of will power or choice. “If you really wanted to stop drinking, you would.” – we now know just how wrong and even damaging this belief was.

Alcoholism, like all addictions, is a disease. (A disease is an illness or affliction of a primary organ and in the case of addiction it’s the brain.) Alcoholism is genetically oriented, progressive in its destruction and path, chronic and requires a lot more than just “willpower” to overcome. (*you can find some quick statistics on Alcoholism at the bottom of this page)

A well known addiction physician in Houston was fond of explaining it like this: Addiction is biological, like diarrhea, so if you think you can simply choose to overcome it – the next time you have diarrhea, try to think your way out of it. (a bit over simplistic and graphic for some folks – but you get the point). Addiction is a challenging disease because it has psychological, emotional, relational and other challenges, but at it’s core, it is still a disease. You cannot successfully out-maneuver your own biology; at least not alone.

It’s important to note that some substances can kill you outright when you are using them, few are likely to do this when you are detoxing off of them. Alcohol (and Benzos) are two of the definitive and very dangerous exceptions. Many people have died trying to detox at home. Even if you have succeeded in doing this before it is not worth doing – luck doesn’t last forever. By the time you are in crisis, an ambulance may not be able to make up the time needed to get you into medical care and safety.

When it comes to alcohol detox – always seek the help of a physician and personally, I would opt for a medical detox level of care. Your life is too precious to gamble. Again, you will not win against biology. Please, don’t do it alone. Get help.

Benzodiazepine Addiction Treatment in Texas

Benzodiazepines are a commonly prescribed medication for sedation. Also called ‘tranquilizers’, benzodiazepines come in a wide range of varieties – amounting to 2,000+ different kinds. Benzodiazepine is a silent but potentially deadly drug that’s often used in combination with a range of other substances to produce its effects. Considered an accomplice in thousands of drug-induced deaths, benzodiazepine dependence and addiction is a serious health problem that poses a threat to an individual’s quality of life. It is especially lethal when mixed with other substances like alcohol.

Benzodiazepine detox, like alcohol detox, is very dangerous to undertake on your own. It is highly encouraged that you do not attempt this outside of a medical detox with physicians and 24/7 nursing available.

Chemical Dependency Education in Texas

This should be part of any level of treatment and is needed for both the person struggling with addiction and their family/loved ones. Sometimes exhausted and scared families will contend that they are not the one with the addiction so why should they “have to go” to classes/counseling. As many recovery communities teach; you are not healing and growing in your recovery until you change your mindset from “I have to go” into “I get to go”.

Chemical Dependency Education and support are a benefit and gift – don’t waste it or let it go by. CD Education helps to relieve the strain everyone has been feeling, support the hard changes needed to sustain healing for everyone and make sure that all members in the family and support system have accurate information and understanding of what is happening. I often tell families, “It’s not your fault that we are here at this point, but you are able to make the healing easier or harder going forward.” Your actions can mean more than your words. Get informed and get involved.

Any reputable Residential, PHP or IOP treatment program will have education and support services specifically for family and loved ones as part of it’s program. Make sure you get the details and take advantage of it. It’s a good start and they will often be able to connect you with other resources for ongoing support.

Cocaine Addiction and Treatment in Texas

Cocaine is an addictive stimulant drug that’s made from the leaves of the coca plant which grows native to various areas in South America. Cocaine is the second most commonly trafficked illegal drug in the world, with an estimated 1.9 million people aged 18 and over using the drug in the United States alone.

One of the most difficult aspects of cocaine addiction is that the high first achieved – when the body has never before been introduced to cocaine – can never again be achieved to the same degree. The cocaine addict is essentially condemned to chase something that biochemically is no longer achievable. Yes, they can use more, but the pleasure will never reach the same point.

The greater risk of death is during use, not typically during deto, unless other serious medical conditions are present. But, detox can be very unpleasant and for many difficult to complete. This is where going into a medical detox facility can be helpful.Following detox, residential or partial hospitalization is necessary for any chance of sustained recovery. And like with all addiction, immersion in a recovery community is paramount to success.

Intensive Outpatient Programs (IOP) in Texas

The best Intensive Outpatient Programs (IOP) will likely offer a holistic & evidence-based approach supporting long-term recovery for the client and the family. An IOP should include individual, group, & family therapy and all therapy should be conducted in a discreet, uplifting environment. If it is punitive or lacking privacy – go somewhere else. Beyond alcohol & drug addiction specific programming, the better programs tend to offer a range of therapies to support issues surrounding anxiety, depression, grief/loss, shame, trauma, family systems, process addictions and more.

Some programs are heavily weighted in favor of a particular recovery community’s philosophies; like Alcoholics Anonymous (AA). More contemporary programs understand that there are different paths to recovery that may best fit individual needs. These will support clients being involved in AA, NA, Refuge Recovery, SMART Recovery, Life Ring, Celebrate Recovery and more. Many programs say they use evidenced-based approaches and individualize treatment. It’s okay to ask them to be specific and explain how this is achieved. A reputable program will welcome your interest and happily share what they do.

In Texas, an IOP should be at least 10 clinical hours (9 in group and 1 individual) each week and run 8 to 12 weeks. Groups should be run by Masters level therapists. Some will also employ Masters level intern therapists and they are required to tell you this up front. Some interns can be phenomenal, so don’t let that turn you away. But ideally there should be a balance so find out how much of your face-to-face clinical service is being provided by interns versus seasoned clinicians. Any IOP (or PHP) who has a majority of their clinician service hours being provided by interns should be up front about this and in our opinion, should also be ready and willing to negotiate a significantly discounted rate for clients without insurance.

Any reputable IOP will seek to involve family/loved ones in the treatment process and will provide a robust, specific and detailed Discharge Plan no less than 7-10 days before you leave that level of care. Make sure you let them know you want to be included in the development of this.

Marijuana Addiction Treatment in Texas

Marijuana is the most used psychotropic drug in the United States. Although the likelihood that a person might abuse and then become addicted to marijuana are slim, there are more cases in recent years where dependence has developed. One argument for this is that the THC levels in marijuana commonly accessible today can be 15 times more than what it was 10-20 years ago. (“It’s not your Momma’s marijuana anymore”).

Another difference is that a notable amount of longer term marijuana users experience significant increases in anxiety during withdrawal, some to the point of having panic attacks. These points, and others, are part of the reason that more centers around the country have developed specific programs for this and are accepting admissions for marijuana abuse. Some insurance companies are now supporting coverage for this treatment, too.

Methamphetamine Addiction Treatment in Texas

A highly addictive stimulant drug, methamphetamine is used by an estimated 12.3 million U.S. citizens. Over the long term, recurrent, frequent meth use can lead to addiction and dependence. The longer that a person uses meth, the stronger the dependence becomes. It isn’t uncommon for meth addicts to fall into financial turmoil as a result of their addiction. At a certain point when all monetary resources have been exhausted in pursuit of the next fix, abusers may turn to theft and other illegal activities in order to sustain their expensive habit.

Meth is particularly hard on the body and brain. Some treatment programs are cautious to admit long term users due to frequency of bizarre behaviors during early recovery. Healthcare needs and a longer duration of brain recovery are very common with longer term methamphetamine abuse.

Opioid Addiction Treatment in Texas

Considered a health crisis or epidemic, opioid addiction can cause serious dangers to a person’s health, social, and financial problems. The class of drugs are typically prescribed in healthcare settings to treat pain, but their strong potential for abuse has become a major problem worldwide.

The treatment for opioid abuse is twofold: opiate recovery counseling and withdrawal management. The first focuses on the social, mental, and emotional aspects of the addiction while the second works to ease the system into a drug-free state.

There are medications available to assist with opiate withdrawal and early recovery – there is some controversy around some of these. Speak openly with your addiction-savvy physician and counselor and get clear information. Even the most widely known medication for this has shown their highest success rates only when medication and treatment/counseling were used in tandem. There is no “miracle pill” cure. Treatment and a recovery support community are still necessary for any chance at sustained recovery.

Partial Hospitalization Program (PHP) in Texas

PHP level of care should give our clients the strongest foundation possible upon which to build independence in an out-patient setting. It’s an highly-focused program, with groups meeting 5 days a week, for 5 hours a day, plus individual therapy and psychiatric visits. It is most often used in lieu of Residential Treatment (when combined with Sober Living) or as the first “step-down” post discharge from Residential.

PHP gives clients the knowledge, tools, support, and structure to start building strength and confidence in their sobriety. PHP should be seen as the first step of an extended treatment program that also includes Intensive Outpatient Programming (IOP) and possibly Sober Living. Any reputable PHP will seek to involve family/loved ones in the treatment process and will provide a robust, specific and detailed Discharge Plan no less than 7-10 days before you leave that level of care.

Process Addiction Treatment in Texas

Addiction comes in all sorts of forms. A common misconception is the physical over-reliance on substances, in which an individual would often fall in physical, emotional, and mental pitfalls. But this reliance on substances is just one type of addiction. Process addiction, or behavioral addiction, deals with the compulsive nature connected to the actual act of abuse on substances and other triggers that cause addiction. Some examples of behavioral addiction can include gambling addiction, porn addiction, shopping addiction, gaming or social media addiction, and food addiction.

Similar to other types of addiction, help is always available for the individual. Identifying the problem, addressing the different triggers, and creating solid treatment strategies are some of the best ways to help with this disorder. Addiction is nearly impossible to treat if the person won’t accept that they have an addiction.

A behavioral addiction can be present alone, as a co-morbid condition along with a mental health disorder or even cross-addiction with substance. (It is important to mention that the presence of any addiction with the absence of any emotional or mental health disorder is extremely unlikely. At minimum, anxiety and depression are a common part of early recovery and whether that is solely due to the process of addiction recovery or fueled by emotional health is something that time and a seasoned professional should help to determine).

Recovery Coaching in Texas

Professional recovery coaching is an invaluable step in the sobriety journey, as these experienced coaches provide continued guidance and accountability for clients either discharging from a Sober Living House, or after IOP, or for those who can manage a lower level of structure. Clients typically work with a recovery coach for 90-180 days. The best recovery coaches have been professionally trained, extensively, in addiction treatment and recovery, have experience working within the field and are immersed in their local treatment community.

In Texas, they should hold a professional certification and/or license. Personal or “life experience” does not make someone a professional recovery coach. While that can be helpful, that is what refer to as a peer not a professional. A professional has formal training, along with experience. You can think of it this way: having had heart problems may give you valuable insights but doesn’t make you a cardiologist. Likewise, personal addiction experience doesn’t make you an addiction treatment professional.

Sober Living in Texas

Sober living program provides structure and support in early sobriety, and is designed for individuals in need of that structure and accountability during the transitional period back to normalcy and independence. There is a world of difference in the quality and support levels provided by various sober living homes across the state. Do your research. Ask your physician and counselor for recommendations and whenever possible, go and visit/tour the facility.

A reputable sober living will arrange for you to tour the property and answer your questions. You should expect that most will not allow family and others to visit or enter the property except at the initial tour – this is to protect the privacy of the other residents. Many will want you to have completed RTC, PHP or IOP before coming. Most will support your employment schedule, to a point.

Strong sober living homes have behavioral expectations, some type of curfew, house meetings and a required number of recovery community meetings each week. Rather than fight it, try to embrace it. If you’re headed to sober living then your way of staying sober wasn’t working anyway. So maybe it’s time to listen to someone else?

Synthetics Addiction Treatment in Texas

While drugs used to be made from natural ingredients, many of the drugs of today are synthetic or completely man-made. The roster of synthetics includes notorious names like methamphetamine, LSD, and ecstasy, all of which cause significant effects on both mind and body. Because of the nature of these substances, it’s highly likely for individuals to get hooked and addicted to their use.

Although the ever changing nature of synthetics can make it a challenge to understand the drug, synthetic drug abuse is treatable. The ideal treatment is a residential treatment center in which a patient is sent to live in a facility for the duration of the process. Typically, 35 to 45 days or more may be needed, followed by at least 2-3 months of IOP. This is because synthetics can take many forms, and the emotional and psychological effects can be bizarre and lingering which can be scary and confusing for caregivers and the client. So, in some cases it can even be a safety issue. Also keep in mind that caretakers in a private home setting might not be able to identify whether the patient is using synthetics or not.

QUICK FACTS ON ALCOHOLISM IN THE US

(from the National Center for Drug Abuse Statistics)

1 in 10 Americans over the age of 12 have an Alcohol Use Disorder.
140.557 Americans die from the effects of alcohol in an average year.
Of these, alcohol-related liver disease is the leading killer, causing 19.1% of all alcohol-related deaths.
53.7% of alcohol-related deaths are due to chronic misuse.
52.4% of chronic misuse deaths are attributable to alcohol alone; 47.6% include additional factors, such as other chronic health issues or drug abuse.
Alcohol poisoning is another leading killer, causing 32% of acute alcohol-related deaths.
Over half of Americans (roughly 60%) report increasing their alcohol use during COVID-19 lockdowns.
Each year, 97,000 sexual assaults among American college students involve alcohol.
22.5% of acute-alcohol related deaths are due to suicide.
(Suicides involving alcohol kill more people than car accidents involving alcohol).

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