Finding the Best Fit for Out-Of-State Rehab
They say the first step to recovery from drug or alcohol addiction is admitting there is a problem. The next step? Selecting an addiction treatment program to enroll in. Committing to a treatment program will be one of the most important and life-saving decisions an addict will make in their life.
Many start their search for a rehab facility close to home, seeking out treatment centers in their local community. But experts say patients shouldn’t rule out the possibilities out-of-state rehab facilities may offer.
“Contrary to popular belief, traveling out of state for rehab is incredibly common,” said Jon Eisenberg, Executive Vice President of Advanced Recovery Systems, a network of substance addiction treatment facilities spanning the U.S. He said in 2016 more than half of ARS patients chose to attend rehab out-of-state.
Why Choose Rehab Out-Of-State?
Choosing to attend rehab and where to enroll is a personal choice. There are positives and negatives to both in-state and out-of-state treatment. Despite their diverse backgrounds, most addiction treatment professionals agree the main benefit to traveling out of state for rehab is a change in environment — both physical and social.
“Speaking on behalf of my patients — which is where I get a lot of my research from — many families tell me that taking the patient out of their everyday life and removing them from their people, places and things is a huge benefit,” said Lena Wooten, clinical director at Next Generation Village, an adolescent drug rehab facility in Sebring, Florida. “Traveling out of state for treatment provides a different mindset to treatment, it gives them seclusion to get healthy. They feel like, ‘This is a time to go and focus on myself.’
Greg Plakias, Regional Outreach Director for Advanced Recovery Systems, which owns seven recovery facilities across the U.S. including The Recovery Village, said attending out-of-state drug rehab “sets up patients to be successful.”
“The biggest advantage to out-of-state rehab is a change of environment for the individual seeking help,” he said.
“A big thing I hear people talk about is being triggered for relapse in early recovery, especially within the first 30 days. Going out of state for rehab is not the end all, be all, because ultimately the patient has to change themselves, but it’s a lot easier to do that when you’re not distracted by your environment.”
As with anything, there are drawbacks to traveling out of state for drug rehab. Wooten said many of her teen patients initially find the removal from technology and social media as a negative. For some, it’s also their first time being away from home.
This removal from family can be disadvantageous in some aspects. For example, family therapy sessions have to be held over the phone or using a video conference instead of in person, which is preferable according to Wooten. But she said the separation can also be a boon for the families, eliminating parental temptations to pick up their child early.
“That way if their child calls them and says ‘I’m ready’ or ‘I want to go home,’ they have that distance, they are removed from the emotions and can remember that our therapists prepared them for this reaction. In this case, we are building a healthy boundary that helps these parents be patient and encourage their children to fulfil their commitment to a full course of treatment,” Wooten said.
Plakias made a similar point. He said while patients may miss their families, traveling out of state for rehab can eliminate a patient’s opportunity to call a friend or family member asking for a ride home if they want to leave treatment early.
Out-of-State Rehab by the Numbers
In the first 10 months of 2016, 1,907 people were admitted to six treatment facilities across three states.
Of those, 57.2%, or 1,091 of 1,907, attended out-of-state rehab.
Out of 1,907, 89.6%, or 1,709, used insurance to pay for rehab.
During this time, 96 adolescent patients aged 13 – 18 were admitted.
The oldest person admitted during this timespan was 74 years old.
Where to Look for a Rehab Facility
Many people facing drug or alcohol addiction choose to look outside of their own communities for a treatment facility because some states and cities across America are renowned for their quality of care. Florida is at the top of this list.
Industry experts have long considered Florida — especially along the southern coast — the recovery capital of America for decades. While the climate may afford addicts in treatment the opportunity to spend more time outdoors and in the sunshine, Florida has mostly gained popularity for its recovery capabilities because of the accepting community. Year after year, Florida cities such as Delray Beach make it onto national lists of “most sober” or “best recovery” communities.
“Florida is one of the best places on Earth to go for addiction treatment,” Eisenberg said. “Cities like Orlando are amazing recovery communities because they are non-judgemental. Most people who live there have been through treatment themselves. There is a limited stigma surrounding addiction.”
These recovery communities have no shortage of support. For example, in Delray Beach alone there are 300 different Alcoholics Anonymous meetings each week that draw more than 5,000 people.
Eisenberg said Florida communities are also an excellent place to seek treatment because of the strong tourism-related job market. Patients who seek outpatient treatment in these communities have a plethora of job opportunities from which to begin rebuilding a sober lifestyle. He listed Colorado, Washington and Texas as other ideal states to look for a addiction treatment program for these same reasons.
And these reputations for exceptional drug and alcohol treatment programs has only brought more authority to these communities, attracting world-class researchers, doctors, clinicians and nurses who all specialize in addiction science. The end result is an elite class of recovery communities that many choose to seek out when investing in their recovery from addiction.
How to Prepare for Rehab Out-Of-State
Regardless of how far a patient travels to attend rehab, every person seeking treatment for their addiction to drugs or alcohol must take some steps to prepare. Most quality facilities will offer patients a checklist or other resources, but this preparation involves more than just packing a suitcase.
“It can be very difficult for the patient to understand the commitment they need to make when going away for treatment, whether that be in their state or out-of-state,” Wooten said. “Sometimes they come in super scared, feeling like this is incarceration and it’s the worst thing they will ever endure. But this is a misconception because treatment is your time to focus on you. It’s a mental retreat.”
Wooten said while some of her teen patients may arrive scared or unsure, they always leave with a different perspective and true appreciation for the addiction treatment process.
“We do a celebration of success when patients go home and it’s always so awesome to hear the feedback our adolescents give to other patients when they make their speech,” she said. “Almost all of them say, ‘Please take this time to be here in the moment, to be present. This is the best thing I’ve ever done, to talk about me and work on my feelings, my thoughts, my emotions.’ And these are just adolescents! I can’t imagine what more insights adults may express.”
In his professional opinion, Plakias said preparation for out-of-state rehab comes from inside the patient.
Wooten said especially when working with children, there are a few simple things patients and their families can do to get ready for the recovery journey ahead. For example, she recommends new patients and their families take a tour of a few rehab facilities “to get comfortable and see it’s not like incarceration.” According to Wooten, this can be especially helpful when the patient ends up choosing rehab out-of-state where they may be unable to visit in person.
To truly understand what rehab will be like, she also recommended prospective patients and their families work with an interventionist or therapist — addiction professionals who can help the patient truly understand what treatment will be like and that there’s nothing to be afraid of.
All patients, regardless of their age, should also inform key people or groups in their life that they will be going away. It’s especially important to inform an employer or school of this change so the organizations can help the patient through their treatment.
Maintaining a Job or Education
According to Eisenberg, one of the biggest fears patients have is telling their employer or school about their addiction problem and a plan to get treatment. But he said, on the contrary, most schools and places of employment are happy to help.
He explained, “Most people forget that a human resources department is designed to support employees, especially when it comes to their health. Your HR professional will know your insurance the best and, in my experience, will even go so far as to recommend treatment facilities. They are definitely a resource prospective patients shouldn’t be afraid of using.”
Human resources professionals will also be able to determine if the employee is eligible for leave under the Family and Medical Leave Act. According to the federal law, which was enacted in 1993 and is under the purview of the U.S. Department of Labor, certain employees are entitled to up to 12 weeks of unpaid medical leave per year. Alcohol and drug addiction treatment is an admissible use of FMLA leave. Employees who take medical leave under the FMLA are guaranteed job security and continued maintenance of their group health benefits.
There are less clear-cut rules regarding adolescents, according to Wooten, which is why it’s important to have educational staff at teen drug treatment facilities. She said Next Generation Village works very closely with schools to make sure the patient’s privacy and their educational opportunities are both protected. After filing a letter of presence with the educational institution, the facility’s teaching staff keeps in contact with a student’s teachers at home to receive work packets or lesson plans.
What to Look for in Out-Of-State Rehab
Above all else, experts say the most important characteristic to look for in any addiction treatment center — in-state or out-of-state — is the quality of care.
In addition, Wooten said patients should look for addiction treatment programs that work with a patient’s family, establish an aftercare plan, value safety and education, and whose clinicians offer an eclectic mix of expertise. Together, she said, all of these qualities point to a treatment facility with above-average care.
“All of these points are important, but especially so when you’re working with a patient who is out-of-state,” she said.
A commitment to work with a patient’s family is important, according to Wooten, because “addiction is a family disease.” Treatment programs should offer family therapy and should educate loved ones on addiction.
Establishing an aftercare plan to help the patient once they return home from rehab is also an essential piece of recovery. She said Next Generation Village’s business development team works across the U.S. to identify aftercare providers in patients’ home communities.
“They evaluate primary care physicians, therapists, outpatient facilities and even AA or NA meetings to find the best of the best and then give us recommendations,” Wooten said. “Then our team puts together an aftercare plan and makes appointments for our kids who are going home so they never have a lag in treatment.”
When working with adolescents, the clinical director said an out-of-state rehab facility should also show they value a patient’s safety by transporting to and from the airport. An educational staff is also key.
And above all, she said, the center’s clinical staff should have a “therapeutically eclectic” team of therapists. “You want the therapists to have different treatment modalities so they can treat different types of conditions,” Wooten said, “like if the patient has a dual diagnoses of substance use disorder and anxiety or depression.
“It’s these little things that make a huge difference.”
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