Not All Addiction Treatment Programs Are Equal

If you’re looking for a rehab program for yourself or someone you love, it can be helpful to think of treatment programs as existing on different tiers, or levels of quality. The higher you move up the ladder, the better your quality of treatment.

Rehab Tiers

Bottom Tier — Recovery Support Groups

These include 12-step meetings like Alcoholics Anonymous as well as groups like SMART Recovery and Women for Sobriety. Though recovery support groups all have different philosophies, one thing you can count on is that most of these groups do not feature accredited professionals who can provide daily or regular guidance.

Recovery support groups are put together and led by the addicts themselves, or community leaders like pastors, usually without the involvement of trained therapists and counselors. While it is admirable that these people are willing to help others, many experts don’t believe these groups are as effective as evidence-based programs.

Second Tier — Public Rehabs

Operated by state, local and tribal governments, these programs run on taxpayer funding. Because money is tight, they’re operated as cheaply as possible. They rely on group therapy and the 12-step meeting model, not necessarily because they’re most effective, but because they cost the least. Trained counselors are available, but they struggle to meet the overwhelming needs of their patients. Counselor-to-patient ratios are often terribly disproportionate.

Going to one of these publicly funded rehabs is like going to the DMV, but for addiction treatment. You’ll wait a long time for help and you’ll be treated like a number, not a

person. These programs were created to help people on the fringes of society — criminals, the homeless and the severely mentally ill — and you or your loved one would live with these marginalized people while in treatment.

For these reasons, publicly funded programs are really not ideal if you have other options. They should be considered as a last resort only so that you or your loved one can get the best possible care, and so beds in public rehabs are left open for those who need them the most.

Top Tier — Private Not-For-Profit Rehabs

Seventy-four percent of these receive some amount of government funding, and because they’re charity organizations, more than half (58 percent) offer treatment based on ability to pay. While the quality of treatment can vary from one facility to the next, many not-for-profit rehabs do offer high-quality, personalized, holistic or evidence based treatment. Many not-for-profit organizations are larger than private programs and have many excellent facilities to choose from. There is a growing number of people who believe that going to a facility that is not based on a business model of profitability gives an experience that can’t be found elsewhere.

Top Tier — Private For-Profit Rehabs

These are the most expensive, but around 21 percent of them will offer discounts for treatment. Private for-profit rehabs offer whatever the market desires, including excellent doctors, holistic treatment options, nutritional supplements, acupuncture, yoga, etc. Anything that is designed to address all the mental, physical, emotional and spiritual components of addiction can be delivered. Many times their treatments are evidence-based and personalized, and their facilities tend to be the most luxurious. From a purely practical standpoint, these programs may be cost-prohibitive for some people.

Substance Abuse Treatment Facilities, by Whether Facility Offers

Some Type of Payment Assistance:

  • 4.0% All free
  • 10.5% Partial free without a sliding fee scale
  • 23.7% No free without a sliding fee scale
  • 24.0% No free with a sliding fee scale
  • 37.8% Partial free with a sliding fee scale

Note: Percentages may not sum to 100 percent due to rounding.

Source: 2008 SAMHSA National Survey of Substance Abuse Treatment Services (N-SSATS).