Navigating treatment options for opioid addiction
PHILADELPHIA (WPVI) -- Treatment for substance abuse disorder can take a long time and carry a hefty price tag.
That means families need to enroll in any program with their eyes wide open.
"I came in here beaten, I came in here hopeless, and I came in here with a really serious drug addiction," said Zac Clark.
He became addicted to opioids after surgery to remove a brain tumor. Zac went into a 28-day treatment program, but as is often the case he relapsed and went from pills to heroin.
"Where one Oxycontin might be $50 to $60, a bag of heroin, a bag of dope on the streets of Camden is $10," he said.
Zac hit rock bottom before ending up at a different in-patient treatment center where he spent four-and-a-half months.
At the non-profit center, Zac was put in a comprehensive, personalized program that included his family.
Health experts say all of these elements are things to look for: a non-profit with a comprehensive and personalized, individualized approach that is family-focused.
"If a facility does not have a piece of the family involved in the whole treatment program, I would say run in the other direction as quickly as possible," said Bert Alicea of Health Advocate. Alicea helps employees navigate their health benefits and options.
Also look for a gender and age-specific program with free continuing care after treatment, data to prove results, and a small patient-to-counselor ratio.
"We become the eyes and ears for the consumer and letting them know what the costs may be in going into that facility," Alicea said.
So once you know you or your loved one needs help, ask if you have an employee assistance program.
And be aware: under the Affordable Care Act, insurance companies must provide coverage for substance abuse disorder, but the facility you need may be out of network or your insurer may disagree with you on the right level of care.
"That is frustrating and families have to proceed with caution, because if they think the person needs a residential level of care and they pursue that, they could end up with significant expenses if it's not covered down the road," said Dr. Raffi Terzian of Health Advocate.
"We have a lot of uneducated consumers out there, and sometimes people will see an advertisement on television for a drug and alcohol facility and see something in Florida," Alicea said. "They have no idea that the facility that they are walking into may be in excess of $50,000-$60,000 for a 30-day stay."
Experts say that's on the high end for a 30-day stay, and there are good local facilities on the low end of $10,000. But no matter what program you're considering, ask for all costs up-front.
"You just don't want to be blindsided by any of these ancillary services," said Alicea.
Extras may include psychiatric evaluations, detox, blood work, and urine samples.
State Resources and Guides for Opioid Addiction Treatment:
Pennsylvania: Pa.gov/Guides/Opioid-Epidemic
New Jersey's ReachNJ.gov
State of Delaware Opioid Info
Caron.org/Understanding-Addiction/Opioid-Overdose
HealthAdvocate.com
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