Rehab is often seen as the go-to answer when someone is struggling with addiction. People assume that checking into a rehab facility and going through the program there will “cure” the patient’s addiction, but that’s an extreme oversimplification. For one thing, not all substance abuse disorders are equal, and treating opioid use disorder is not like treating, for instance, alcoholism. And in like manner, not all rehab centers are equal either. “Rehab” is a catch-all to describe residential programs as well as outpatient stints where you attend group therapy and 12-step meetings. There’s no standardization, and that’s a big problem, as many rehab programs for opioid addiction forgo evidence-based treatment using medication.
Making matters worse, rehab is often very expensive and offers very little return on investment for opioid users with minimal long-term benefits. According to international expert John Kelly, a Harvard Medical School researcher and professor of psychiatry, patients dealing with opioid use disorder spend an average of eight years and four to five attempts at treatment to achieve a single year of remission. Those repeated attempts at treatment can be demoralizing and incredibly costly. And in the meantime, some patients overdose and die.
How much does rehab cost?
Rehab centers charge a wide range of prices. Some community-based centers offer free grant-funded programs run by the county, but their resources may be limited by what donations and public dollars can cover. Meanwhile, private facilities with extensive resources charge hundreds or thousands of dollars per day. A key factor in determining how much someone pays for treatment in a rehab facility is the type of rehab they choose and, sadly, their insurance status.
The average cost of inpatient rehab, for example, is often anywhere between $20,000 and $40,000 for a 30-day program. Luxury facilities may charge even more for these programs. Outpatient rehab programs tend to be less expensive than inpatient rehab. The average cost for drug rehab in an outpatient facility is upwards of $5,000 for a 90-day program. Typically, the more time the patient plans to spend at the rehab center in an outpatient program, the higher the price tag.
It’s important to note that rehab often isn’t a one-time expense. Actor Matthew Perry, who has been very open about his struggle with opioid dependency, estimates that he spent around $9 million on visits to rehab facilities and other efforts to get sober over many years before he was finally connected with a physician who could prescribe Suboxone. Rounds of treatment repeatedly fell short, leading Perry to pay for additional rehab programs over and over while the costs stacked up.
Does insurance cover addiction treatment?
Paying for addiction treatment in a rehab facility can be a challenge for many patients and their loved ones, especially if they pursue multiple rounds of treatment. Some families go into incredible debt. Many hope to use their insurance to cover some or all of the costs of addiction treatment, but does health insurance cover rehab?
Health insurance does typically cover at least some of the costs of substance abuse treatment, including treatment for opioid use disorder (OUD). However, your insurance may restrict you to only certain in-network treatment centers or place other restrictions on your coverage.
What does that mean? Individuals and families are largely the ones footing the bill. Reporting from the Wall Street Journal shows that out-of-pocket spending on inpatient drug treatment has far outpaced total healthcare spending, even among people with insurance. We’re talking about an 80% increase between 2012 and 2016.
If you have health coverage through Medicaid, you may wonder whether Medicaid covers addiction treatment. It’s complicated, but in general, Medicaid does fully or partially cover inpatient and outpatient addiction treatment with some exceptions, like room and board.
Hidden costs of opioid addiction rehab
Rehab for OUD comes with a lot of costs people aren’t aware of until they’re in the thick of it, including. Just consider: Being in rehab takes time, often away from home, which can put one’s job security at risk. If a person finds that their job is no longer available to them when they get out, they often lose their access to employee-sponsored health insurance in addition to their income.
When families know their loved one needs help, and they’re eager to take care of them at any cost, they’ll dip into savings, retirement funds, and credit cards to find a facility with openings–even if it means shelling out tens of thousands of dollars to cover airfare and lodging at a private center out of state. And, according to the Wall Street Journal, that doesn’t necessarily include the upfront payments some centers require before admitting a new patient.
What is the rehab-relapse cycle?
The cycle of relapse, also known as the rehab-relapse cycle or chronic relapse, is one of the major contributors to the high price patients pay for treatment in rehab facilities. This occurs when someone repeatedly relapses after periods of treatment and recovery. Studies show this is a very common occurrence after treatment for opioid dependency. One study found 91% of patients relapsed after inpatient treatment; in 59% of cases, the relapse occurred within a week of leaving treatment. Another study examining abstinence-oriented rehab programs more broadly found that 85% of patients relapsed within their first year after treatment. Beyond that one-year mark, less than 35% of patients were considered abstinent from opiates.
Going through these cycles of treatment, recovery, and then back to relapse takes a significant toll on patients, both emotionally and financially. And yet, even with these discouraging results, many people remain in the mindset that rehab “simply hasn’t worked yet.” They continue to pay for rehab programs hoping for better outcomes, forgoing more effective alternative treatment for chronic relapse.
There is a better, and often less expensive, treatment option
Although most default to rehab, the gold standard of care is medication, like methadone and buprenorphine. Buprenorphine has the added benefit of being able to be picked up from your local pharmacy. The result is increased access, more convenience, and yes, lower costs. After all, you don’t have to trek to a clinic, spend excess money on gas or take time off from work to endure long wait times. Compared with traditional non-medication treatment, medication-assisted treatment (MAT) is associated with lower overdose deaths. Simply put, it doesn’t just save money — it saves lives.
Step out of the rehab-relapse cycle with evidence-based care
If rehab hasn’t worked for you in the past, a different treatment approach may be the right move. Leave the “rehab just hasn’t worked yet” mindset behind. You can start evidence-based MAT on your own terms through Ophelia’s private, personalized approach to treatment. Our clinical care team will meet with you to begin your naloxone-buprenorphine protocol on your schedule and offer ongoing support.