Choosing the Right Rehab

Some researchers and medical professionals are suggesting that America’s most neglected disease is drug addiction because of the steadily increasing number of deaths by drug overdose. In 2015 alone, drug abuse contributed to over 47,000 deaths triple the number of deaths in 1999. The problem is not a lack of treatment programs, as there are well over 14,000 drug treatment locations all over the country. One of the major contributing factors is a lack of information.

Between the overwhelming number of treatment options and the less-than-helpful information often provided by treatment center’s websites, deciding on a rehab program can be overwhelming for some. That’s why we created a practical, step-by-step guide to understanding your options and choosing the right rehab program for your unique situation.

Step 1: Know Your Options

When it comes to choosing a specific rehab, there are many different options, but two basic factors separate rehab programs from one another:

  • Setting: Depending on what setting you choose, you will either be attending rehab part time or full time.
  • Length: Some programs allow you to stay as long as you want, while others have specified program lengths from one to twelve months.

Regardless of the location, setting, or drug being treated, complete rehabilitation needs to include the following four stages – stopping after just one or two puts you at a much higher risk for relapse.

To learn more, read our guide, "The Addiction Rehabilitation Process

Treatment Settings

The two main types of treatment settings are inpatient rehab and outpatient rehab

Inpatient means the patient stays in a facility full-time and overnight with most of their time devoted to treatment. Those who opt for outpatient treatment will attend therapy for part of the day but return home at night.

Inpatient provides a higher level of care but is more expensive and time-consuming

Inpatient programs are a one-stop rehab option with all of the necessary services in one location, which makes them ideal for severe addictions. They also provide 24/7 care for the residents living there.

However, some find the cost of inpatient rehab too prohibitive as it is the most expensive rehab option. Likewise, the time commitment of staying in a center full-time is sometimes impossible for people with families or other commitments.

Outpatient is cheaper but isn’t as intensive

Compared to inpatient rehab, outpatient centers are typically quite a bit more affordable and offer more flexibility, and therapy is stretched out over a longer time period. Outpatient treatment is not usually recommended for severe addictions, but it may be a good choice for those with moderate or slight addictions.

Overview of Treatment Settings
Type of Treatment Description Time Commitment Duration
Inpatient Short-term residential Intensive treatment, sometimes in a hospital setting. Therapies offered are extensive. Medical treatment is available to those who qualify. Hours per Day: 24 14-30 days
Days per Week: 7
Long-Term Residential Intensive treatment in a non-hospital setting, most often a therapeutic community facility with other patients. Therapies offered are extensive. Medical treatment is available to those who qualify. Hours per Day: 24 3-12 months
Days per Week: 7
Partial Hospital-ization Intensive treatment in a hospital setting. Patients do not stay overnight. Referred to as “inpatient” due to the hospital setting, extensive services provided, and the near full-time commitment every week. Medical treatment is available to those who qualify. Hours per Day: 6-8 14-30 days
Days per Week: 5
Outpatient Intensive Day Treatment Patients receive the extensive services of an inpatient program, but return home after. After completion, patients often transition to less intensive counseling. Therapies offered are extensive. Medical treatment is available to those who qualify. Hours per Day: 2-4 3-4 months
Days per Week: 3
Counseling Both individual counseling and group counseling focus on short-term behavioral goals to develop coping strategies. Therapies offered are moderate. Medical treatment is not available. Hours per Day: 1-2 As long as desired
Days per Week: 1-3
Support Groups Self-help groups are recommended to help maintain abstinence after another form of treatment. Typically meet one day a week for 1-2 hours. Hours per Day: 1-2 As long as desired
Days per Week: 1

Source: National Institute on Drug Abuse

Program Length

Program length is most important when considering inpatient programs. Inpatient programs typically have a shorter length than outpatient programs because their intensive programs with a full-time commitment to treatment can accomplish more over a shorter length. Inpatient programs usually require a commitment of one to six months, with the most common lengths being 30, 60, and 90 days.

Outpatient programs can be as short as a couple of weeks (like in the case of a detoxification center), or as long as a lifelong practice of going to therapy or attending a support group. Generally, outpatient programs are flexible across all criteria: length, duration, and setting.

Ways to Complete Rehab

Generally, there are two basic approaches to completing rehab that can also be mixed and matched. The first approach is to enter a full-service rehab center where you will complete all of the steps at the same facility (with the exception of aftercare, which will be coordinated at the facility, and then may take place elsewhere).

The second approach is to complete each step at a different facility. For example, you may be assessed by a therapist, detox at a hospital, complete intensive outpatient treatment, and then utilize a 12-step program for aftercare.

Step 2: Choose Your Rehab Path

To determine which approach (or combination of approaches) is right for you, start by considering three main criteria:

  • Your Level of Addiction
  • Your Budget
  • Your Availability

Your Level of Addiction

Your level of addiction determines what level of care you need and what programs are available to you.

Addiction is a spectrum ranging from mild to severe

Addiction is not a two-sided coin with people either being fully addicted or not at all. Rather, it exists on a spectrum from very mild to very severe with some drugs that are more dangerous than others, and some people are at a higher overall risk of addiction.

Determine what your level of addiction is

To determine what your level of addiction is, you can obtain a professional screening or decide for yourself.

If you opt for a professional screening, your level of addiction will be determined using the ASAM Criteria. During the screening process, therapists consider each criterion, or category, when determining your level of addiction. Once your level of addiction is determined, recommendations for the appropriate type of rehab programs will be made.

The National Council on Alcoholism and Drug Dependence created two quizzes to help you determine where you may fall on the addiction spectrum: Am I an Alcoholic? and Am I Addicted to Drugs?

To help you self reflect and get a head start on determining your level of addiction, you can review the questions listed below. While they are based on the ASAM criteria, these are in no way a comprehensive approach, and only a trained professional can use the criteria to provide a concrete recommendation. The more questions you answer “yes” to, the more severe your addiction may be.

Note: Insurance companies do not have to cover your rehab choice. Depending on the screening process’ recommendations, insurance may only cover a certain treatment setting and length – that’s why it’s important to get a screening before committing to any program.

The ASAM Criteria

Section 1: History with Substance Abuse
    • Do you ever use more alcohol or drugs than you intend to?
    • Do you get physically sick if you stop taking drugs or using alcohol?
    • Do you experience emotional or mental symptoms if you stop using drugs or alcohol (such as anxiety, depression, etc.)?
    • Have you ever experienced life-threatening withdrawal symptoms?
    • Do find yourself having to take a higher dosage of drugs or drinking more alcohol to get the same high?
    • Does your family have a history with alcohol or drug abuse?
Section 2: Medical Conditions and Complications
    • How many diagnosed medical conditions do you have that interfere with your day-to-day life?
    • Do you have any severe or potentially life-threatening medical conditions?
Section 3: Mental and Emotional Health
    • Do you ever have symptoms of mood disorders such as depression, hopelessness, or loss of pleasure or interest?
    • Do you ever have any type of anxiety?
    • Do you ever struggle with symptoms of psychosis such as paranoia, delusions, or hallucinations?
    • Do you ever have suicidal thoughts?
    • Do you ever think about harming others?
    • Are you ever in an abusive situation (emotional, physical, or sexual)?
    • Have you ever been diagnosed with an emotional or mental disorder?
Section 4: Desire and Readiness to Change
    • Does your alcohol or drug use have any negative impact on your life, such as your job/school, family relationships, or finances?
    • Do you continue to use alcohol or drugs even though it has a negative impact on your life?
    • Have you received treatment or help for alcohol or drug abuse in the past?
    • Are there any significant obstacles for you if you needed to go to rehab?
Section 5: Current Usage and Relapse Potential
    • How often have you experienced severe cravings, withdrawal symptoms, or undesired side effects of usage?
    • Do you spend a significant amount of time trying to obtain alcohol or drugs or recovering from withdrawal symptoms?
    • Do you feel that you will either relapse or continue to use abuse drugs or alcohol if you don’t get help?
    • Are you unaware of your personal “triggers?”
    • Do you lack a plan of action if you are “triggered?”
    • Have you tried and failed to quit using drugs or alcohol in the past?
Section 6: Living Situation and Recovery Support
    • Do you lack relationships that will support your recovery?
    • Are you currently homeless or underhoused (more than one family living in a single-family house)?
    • Do others use drugs in your home?
    • Do you live in a situation where you feel that your safety is ever threatened (by circumstances or relationships)?
    • Are there any other reasons why your current living situation would make your recovery more difficult?
    • Are you unemployed, or have you dropped out of school?
    • Are you currently involved with the legal system such as probation, facing jail time, etc?

Use your level of addiction to help determine what type of rehab program is best for you

More intensive programs (like residential treatment centers) are for people who have strong or dangerous drug addictions, are struggling with other mental illnesses and lack strong support systems like family and friends. Conversely, someone who has a very supportive home environment, lacks a history of rehab programs, and is not strongly addicted to dangerous drugs may be better off with less-intensive options like support groups or individual counseling.

Below is a table showing what treatment options each level of addiction typically is typically paired with.

Level of Addiction and Treatment Settings
Treatment Setting Level of Addiction
Outpatient Support Groups Low
Counseling (Regular Outpatient) Low – Moderate
Intensive Day Treatment (Intensive Outpatient) Moderate
Inpatient Short-Term Residential Inpatient Moderate
Long-Term Residential Inpatient Moderate – Severe

Your Budget

While the cost of rehab shouldn’t be your primary consideration, it still plays a role in determining which type of rehab program will be best suited for you. Overall, you have two options if you can’t pay for rehab out of pocket: Limit your choices based off of how much you can pay, or find a way to offset rehab’s cost.

There’s a huge variance between rehab costs

Rehab program costs can range from completely free to upwards of $30,000 per month with many options in between. The cost depends on the intensity of the program, with higher intensity and more frequent services resulting in higher overall costs.

Cost of Treatment
Treatment Setting Cost (without insurance)
Outpatient Support Groups Usually Free
Counseling (Regular Outpatient) $50-$240 per hour session
Intensive Day Treatment (Intensive Outpatient) $3,000-$9,000 3-month program
Inpatient Partial Hospitalization $6,000-$10,000 8 days
Residential Treatment Center $5,000-$20,000+ 30-day program

Sources: The Cost of RehabJournal of Addictive Disorders, and Health Cost Institute

You can choose less expensive option

If finances play a significant role in which rehab you will choose, you can use the following tips to keep your rehab costs down.

  • Choose a Less-Intensive Setting: While we don’t recommend just choosing the cheapest rehab option out there, there may be less-expensive outpatient rehabs that still provide the level of treatment that you need.
  • Choose a Location Closer to Home: While this tactic means limiting your selection, those opting for outpatient treatment can keep their costs lower if they find a quality rehab center that doesn’t require them to commute or find alternative living arrangements during the program.
  • Choose a Shorter Length: While you should choose the treatment length that matches the severity of your addiction, a shorter program does result in lower costs.
  • Choose a Less Luxurious Center: Residential treatment centers range from luxury and business retreats to facilities that only provide the necessities. Factors like the quality and selection of the menu, privacy in sleeping arrangements, and recreation amenities can make a huge difference in the overall cost of the program.

You can offset the cost of rehab

Though rehab is expensive, there are ways you can get help affording it, like the following:

  • Public and Private Insurance: The Affordable Care Act (ACA) requires insurance to cover certain measures like screening for substance use disorder (addiction), detoxification, and therapy; however, you need to make sure the rehab or counselor you go to is in your network. Then, either call your insurer to see how much they cover versus what you need to pay out-of-pocket, or ask for a benefits check from your rehab program of choice, in which case they would get insurance coverage information for you.
  • State-Funded Centers: These centers are partially funded by federal money, which allows them to provide sliding-scale (or income-based) fees for those with limited income. Some even offer payment assistance if you qualify, making their treatment more budget-friendly than comparable options.
  • Payment Plans and Scholarships: Other payment options include payment plans and scholarships, which are sometimes provided by the rehab program itself. You can find out if they are available by calling or looking at their website.

Get more information about paying for rehab in our guide The Cost of Rehab

The cost of addiction sometimes outweighs the cost of rehab

Overall, the cost of addiction can outweigh the monetary cost of a program. Damaging personal relationships, lower performance at a job, and reliance on a substance all take a toll and have their own costs to your well-being – not to mention the legal ramifications. Also, if you choose the wrong rehab and it doesn’t work for you, you may just have to pay for a more expensive rehab option down the road. That’s why it is just as important to choose a program based on your addiction and needs, as it is to base your choice on how much you are willing to pay.

Your Availability

Your personal, work, and family life all impact your schedule and, therefore, what rehab programs you can choose from. However, each schedule-driven decision may also limit how many rehab options you have available.

Availability is based on location, length, and duration

Rehab is not convenient for anyone, but you can still take your schedule into account when selecting the most sustainable rehab option. The more difficult you make it on yourself to attend rehab, the more likely you are to drop out.

You can narrow down your options by considering if you want to go to rehab near or far from home, the length of the program, and the duration of the program.

Decide if you want to go to rehab near or far from home

Going to rehab close to home may be best for people who:

  • Can’t escape job or personal responsibilities
  • Benefit from their support group of family and/or friends
  • Need the flexible schedule that outpatient rehab provides

Going to rehab away from home may be best for people who:

  • Have many negative influences near home that may trigger their addiction
  • Do not have financial concerns about going and living away from home
  • Don’t live in or near a major city with numerous rehab options

*Note: Many people who choose to go to rehab away from home go to a residential treatment center; however, you could still go to an outpatient program away from home, you would just need to locate housing.

Decide how long you can stay in rehab and how frequently you can go

Remember that you can either stay with one program like an inpatient center, or you can mix and match – you can go to an intensive program for a short while before entering an outpatient program that doesn’t require as much time per week.

Below is a table showing the average time requirement and length for different rehab settings.

Overview of Time Commitment for Rehab Programs
Treatment Setting Hours per Day Days per Week Length
Outpatient Support Groups 1-2 1 As long as desired
Counseling (Regular Outpatient) 1-2 1-3 As long as desired
Intensive Outpatient 2-4 3-5 3-4 months
Inpatient Partial Hospitalization 6-8 5 14-30 days
Residential Treatment Center 24 7 1-12 months

Source: National Institute on Drug Abuse

If you need time off work to go to rehab, programs like FMLA may make that possible

If you decide that you need to go to an inpatient, or full-time, rehab program, there may be options for you to take time off work. There are three possible options:

  • Paid Time Off: Use paid vacation and sick days if you have any available.
  • Mandated Medical Leave: FMLA is available once every 12 months to qualified employees. With FMLA, the employee can take up to 12 weeks of protected, unpaid leave from work for medical or family reasons. Rehab would qualify as a medical reason.
  • Non-Mandated Personal Leave: Even if your company isn’t required to provide you leave, Employee Assistance Programs are offered by some employers to allow their employees get the help they need for personal issues.

Step 3: Determine if You Need Specialized Care

After narrowing down your rehab options based on cost and time commitment, you can consider what types of therapy are most beneficial for the drug(s) you are addicted to and decide if a specialized rehab is right for you.

Some rehab therapies treat specific drug addictions

While many therapists use similar behavioral therapies for different drugs addictions, medication to help with withdrawal symptoms and detox vary based on the drug. Even if medication has been proven to help detox from a drug, some treatment programs may not have the capability to offer medications. To make sure that you are receiving the right treatment, read our guides about rehab for your particular drug addiction (such as alcohol, meth, heroin, and cocaine), then ask potential rehab programs if they can provide the medications you may need.

Women and New or Expectant Mothers

Women can find rehabs that cater to them. Sometimes, women feel more comfortable in group therapy when they are with those of the same gender, possibly sharing more and moving forward with the therapy process in ways they might not have if men were present. However, research done on the topic does not show significantly higher success rates among women in women-only centers versus co-ed ones.

You can use the filter function in our database (below) to find rehabs that offer specialized programs for women and new or expectant mothers.

LGBTQ

People in the LGBTQ community can also find rehabs specifically for them. These programs often create an inclusive environment and can create more beneficial group therapy opportunities as there is typically less judgment. Unfortunately, there have not been any conclusive studies done on how effective these treatment programs are compared to their counterparts.

You can use the filter function in our database (below) to find rehabs that offer specialized programs for members of the LGBTQ community.

Veterans

Veterans can receive substance abuse treatment at the VA. Additionally, some private rehab centers offer treatment specially designed to meet veterans’ needs. For more information, read our guide to “Substance Abuse Rehab for Veterans,” and use our database (below) to find rehabs that offer special treatment programs for this demographic.

Teens

Teens have rehabs that are designed to help them overcome the unique challenges that they face. However, some personal accounts and researchers argue that placing teens in rehab that only includes peers their age can worsen substance abuse rather than help it.

You can use the filter function in our database (below) to find rehabs that offer specialized programs for teens.

Step 4: Find Rehab Programs

Simply using an online search engine to find a rehab program is time-consuming, and it doesn’t always include every option that’s relevant to your unique situation. Likewise, many websites that list rehab programs only include advertisements for certain establishments.

Our Directory

Our directory of rehab programs includes a comprehensive list of available treatment centers and programs as provided by the Substance Abuse and Mental Health Services Administration (SAMHSA). In the directory, you will find tools to filter the programs by many of the categories listed in the steps above including setting, price, and location.

How to use our directory:

  • Determine what factors are most important to you: location, type of setting, etc.
  • Click your state from the list below, and input your zip code
  • Use the available filters to find the programs that will best fit your needs. Because there are a limited number of programs, you may want to start with fewer filters, especially if you are looking for programs in a particular area.
  • Search through the available options, using the steps above to help you narrow down to 2-3 options.

Click your state from the list below, and input your zip code to get started

  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • District of Columbia
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York State
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming

Step 5: Verify Programs’ Credibility

Once you’ve narrowed your list down to a small handful of companies from our directory, check that each one is credible by making sure they use evidence-based therapy, have trained and certified professionals for your treatment, and include support systems and aftercare. Rehab is a large time and financial investment for your future, so you want to be sure that the program you choose gives you the best chance at overcoming addiction in the long-term.

Evidence-Based Therapy Approaches

Evidence-based therapy approaches are the only ones proven to work

One of the most important qualities of a credible rehab program is having programs that implement evidence-based treatments. Evidence-based treatment means the treatment itself has been tested and proven to work for its intended purpose. On the other hand, some rehabs still use treatment methods rooted in the past – approaches are used that work for some people, but haven’t been scientifically proven to be effective for a majority of people.

Government agencies and nonprofits have programs like NREPP and others that rate and test old and new treatments to gauge their outcomes. Some widely-accepted and beneficial substance abuse therapies include Cognitive Behavioral Therapy (CBT), Motivational Enhancement Therapy (MET), and Motivational Interviewing.

Credible programs provide a variety of evidence-based therapies, not just one

Credible programs should offer a wide selection of evidence-based therapy options. Using one process, like only implementing a 12-step program, will work for just a small amount of the population. The more options, the better chance you have of being successful in a program.

Medical therapies can be just as beneficial as behavioral therapy

Not only is it important to have a range of behavioral therapies available, if you are recovering from a severe addiction to a dangerous drug (including alcohol and opioids), make sure the treatment program offers medication therapy to help with the withdrawal process. Using medication to recover from addiction is shown to have more positive and longer-lasting treatment outcomes than detoxing without.

Trained and Certified Professionals

Rehab centers lack oversight or regulations that make sure everyone is highly qualified

Registered therapists are required to pass exams and have a high amount of schooling, but there are very few state or federal regulations for addiction counselors. In the U.S., 20 states don’t have any requirement for certification or licensing for counselors, 14 only require a GED or high school diploma, and 10 only require an Associate’s degree. In addition, rehab centers have no regulatory oversight that makes sure their treatment is effective or that the recovery numbers they publish are accurate. This makes it even more important for patients to ask the right questions and make sure they are receiving the best treatment possible.

All therapists and counselors should have a college degree and be certified in their field

Not everyone working at a rehab center needs to have an advanced degree, but therapists and counselors who give advice and provide therapy should have ample training and certification in the form of a bachelor’s or master’s degree. Likewise, physicians or therapists, who can prescribe medication, should be certified by the American Board of Addiction Medicine.

Note: Many insurance companies won’t cover the services of a rehab center that doesn’t employ certified therapists and counselors. Be sure to check with your insurance company before making a final decision about which rehab center to attend.

Support Systems and Aftercare Preparation

Residential treatment centers should have a full support staff

Having a complete support system while in treatment is paramount to a successful program. Treatment centers should have at least one licensed medical practitioner for any medical needs that arise. Also, having a social worker on staff to help with any additional family, occupational, or other living problems is beneficial. Some outpatient programs will understandably only provide therapy as they are inexpensive and less-intensive.

Creating a strong aftercare plan during treatment is essential

Before returning home, the treatment center should create an aftercare plan with you, outlining resources and programs you have in your hometown as well as helping you and your loved ones prepare for post-treatment life. This process is crucial because patients who enroll in aftercare programs are more likely to maintain abstinence than those who don’t.

Step 6: Make Your Final Decision

After narrowing down your rehab options to three or fewer top picks, call and vet them to make sure they are credible and knowledgeable. To get you started, you can use the list of questions below. Additionally, consider what other concerns or questions you have based on your unique personal situation and your expectations for the program itself. When speaking to a representative, take notes on their answers so that you remember who said what.

Questions for Treatment Providers
If You Are Calling: Questions to Ask Answer Should Include
Any treatment program What will my treatment plan look like? How is it created? Your treatment plan should be designed with you one-on-one and be completely based on your needs. It should not be a standard, stock document.
What does a typical day include? (if looking into outpatient programs, “a session” instead of “a day”) Evidence-based therapies, individual or group. It should not include lectures and videos as part of its core treatment plan since they are proven to have one of the lowest treatment impacts
Is there a waiting list, and if so, how long would it take to enter? Depends on your needs and the urgency of your situation
(If applicable) What financing do you offer? Do you have scholarships, and if so, what are the requirements for applying for them? Depends on your needs and expectations
How do you help to facilitate aftercare programs? Aftercare preparation should include setting up a plan for you to go to a program once you get home and providing your loved-ones with information on how to best help you. Should be more extensive than a follow-up phone call.
A residential treatment center What licenses or certifications do your therapists have? Your counselors? Therapists should have at least a Master’s degree and be certified, counselors should have at least a Bachelor’s degree and be trained
Is individual therapy part of the program? Different people have varying needs, but some individual therapy should be included in the program.
About special needs (If you do, or might have, other mental health needs) Is this program equipped to address other mental health needs as well? Speak honestly about what your needs are to find out if they are ready to help you with those.
(If you will be recovering from alcohol or opioids) Do you provide medication to help with withdrawal or detox for alcohol or opioids? If you will be recovering from a dangerous drug, make sure the program you enter has medical capabilities and staff to help you.
(If you smoke and are going to a residential treatment center) Is smoking allowed on the premises? Ideally, the answer would be yes, unless you are quitting smoking as well.

What’s Next

Once you’ve made your final decision, the only thing that’s left to do is set a date and take care of any last-minute responsibilities. A word of caution: the longer you delay, the easier it will be to convince yourself that you don’t need to go to rehab. It’s wise to start rehab as soon as you possibly can.

Before going to rehab, make sure you have:

  • Spoken with your employer about time-off (if necessary)
  • Contacted your insurance provider to verify how much they are going to cover and/or determine how you will pay for the rehab program otherwise
  • Made plans for your loved ones or other responsibilities
  • Contacted your rehab program to answer any lingering questions (can use some of the questions above to get you started)

You can also prepare for rehab by reading our guide to the Addiction Rehabilitation Process