Q. When surfing the web for alcohol and drug rehabilitation, why do all of the expensive and distant drug rehabs rank first in any search?

A. Money to advertise and optimize on a national level is best made in expensive, residential drug rehab settings. Often the highest ranked drug rehabs rely upon high, out-of-insurance-network charges, which help pay for extraordinary marketing campaigns and patient acquisition strategies, including paying for referrals.

Q. Is celebrity endorsement and fantasies of luxury and fame important considerations when selecting alcohol and drug rehab?

A. Recovery, especially long-term recovery is attained by learning to “check” your ego, not to defend ingrained feelings of shame and loss with flights into grandiosity. Endorsements from people successful with their recovery are important, especially when you can respect their humility.

Q. Why are so many of the exotic and luxury drug rehabs located in Hollywood, Los Angeles/ LA, and Malibu.

A. Los Angeles/ LA, especially Hollywood and Malibu are easy locations to advertise and acquire patients. Often people burdened with addiction fantasize about escaping their sense of defeat and humiliation with grand and exotic people, places and things. Recovery is actually based in authenticity and humility.

Q. Are all drug and alcohol rehabilitation centers (drug rehabs) in Los Angeles, Hollywood and Malibu based in fantasy and priced out of range of most people in need?

A. No. Los Angeles, just as any community has affordable and accessible drug rehabs which contract with HMO’s and MediCal. Go to the provider directory provided by your insurance carrier to find an affordable and reputable alcohol and drug rehabilitation provider.

Twin Town Treatment Centers is immediately accessible to all Los Angeles and Orange County residents, is accredited by The Joint Commission, and is certified by the California DHCS.
All network HMO/PPO/EPO insurance plans and Medi-Cal contract with Twin Town Treatment Centers to provide drug and alcohol rehabilitation.
Our phone is answered by real people. We can see people on the same day you call. (866) 594-8844

Science and medicine have determined that about forty percent (40%) of an individual’s addiction or substance use disorder arises from their genetic predisposition. Several genes are suspected in passing the “code for addiction” which creates and individual’s dulled response to the brain messenger (neuro-transmitter) dopamine. Family histories and twin studies have for years provided science strong evidence of the inherited addictive predisposition by one generation from the former.

What can I do if one of my parents or grandparents had a drinking or drug problem?

Start with reading more information about addiction/ substance use disorder. Becoming aware of the characteristics, signs and symptoms will help you in the event you begin to lose control over your drug or alcohol use.

Are there risk factors which can lead to or detect the development of a substance use disorder/ addiction?

Interpersonal conflicts and/or neglect within families and other relationships can coincide with addiction/ substance use disorder. Impulsive or emotionally reactive behavior, emotional instability, depression or anxiety are also common. Trauma, unresolved grief or shame often correlate with the development of substance use disorders. Using friends and access to drugs and alcohol enable increased use and the development of addiction.

Are their signs or symptoms that I should watch which can lead toward or indicate the beginning of a drinking or drug problem?

Behaviors indicating a problem or the development of a problem include: drinking under the influence; riding in a car driven by someone under the influence; drinking or using more than attended; forgetting or being embarrassed about drunken or drugged behaviors. One of the best indications of addiction/ substance use disorder is continuing to drink or use after encountering consequences from drug or alcohol use (i.e. shame, guilt, loneliness, illness, hang-overs, legal or career entanglements, interpersonal problems).

What can I do if I believe that a relative or child might be developing the “family affliction” of addiction?

Define addiction as an inherited disease. Take the shame and stigma out of it. Be open and honest, and talk about the family secrets openly. It is only by looking at the facts in the light of day do we start to develop a real understanding and plan. Don’t keep secrets but also be respectful and compassionate.

Can I or my family take steps toward preventing addiction/ substance use disorders from developing?

Many people who come from alcohol or addicted families avoid alcohol and drug use. If you don’t drink or use drugs, addiction can’t develop. (Watch for overeating, compulsive spending, sex or gambling, or excessive risk-taking). If you can’t drink or use in moderation, talk with someone in recovery or a professional.

Talk openly about your concerns and plans to keep track of your or other’s alcohol and drug consumption and related behaviors. Share your concerns and plans with loved ones and people with whom you share alcohol or drugs. If you are losing people with whom you can share these concerns, seek help.

Set a plan regarding drinking and using occasions and stick to them. If you can’t follow-through, ask for help from someone in recovery or a professional.

Addiction, otherwise known as “Substance Use Disorder” (SUD) is a relapsing, chronic disease which requires lifelong cognitive, behavioral, social and physiological change and maintenance. Outpatient treatment and “recovery management” are designed to prevent addiction related deterioration, morbidity, relapse, and death. Outpatient treatment and recovery management also provide solutions which guide addicted people toward resources designed to better meet their needs and away from inappropriate, costly, and restrictive levels of supervision such as residential institutions, hospitals, and jails.

Since the 1930’s it has been demonstrated that successful, lifelong recovery from the disease of addiction can be achieved by engaging in recovery promoting activity, social support and benevolent service. Attempts at providing professionally provided acute care medical and time-limited psycho-social interventions to this chronic disease as resulted in partial solutions and modest outcomes.

What appears to be missing in the current model of addiction treatment is long-term recovery follow-up and monitoring. Investments in thirty-day to nine-month courses of treatment in inpatient, residential or sober living settings are being lost when the patient returns home and/or over the course of time.

Cognitive and behavioral gains fail to generalize into normal life settings after discharge from a residential setting. Relapse often follows. In the absence of practicing recovery in real time, in real life, over time, recovery deteriorates. Recovery management aids to assess and supervise recover in the long-term.

The commercialization of addiction treatment and recovery has resulted in expensive services which result in occasionally good short-term outcomes. The motive for providing these services is too often fee-for-service profiteering. When the payor and payment for services is exhausted, there are no resource left for integrating clinical gains into real-life circumstances. Recovery management has been abandoned to “self-sustained” sobriety, sometimes with peer support.

“Shift by government and private sources from purchasing time, or session-limited units of service – to purchasing and integrated program of management and support for long-term recovery; shift in emphasis from treatment intensity (crisis stabilization) to treatment extensity (prolonged recovery maintenance).”(1)

Mutual support groups offer peer support on a voluntary basis. This has been an effective model for people who remain willing and open to recovery despite its challenges and demands for change. People who encounter periods of ambivalence, avoidance, defiance or other roadblocks benefit from professionally provided recovery management which is designed to anticipate and prevent incidents of recovery deterioration and relapse. Recovery management also offers professional contact, support and access to assistance regardless of the person’s level of willingness.

Outpatient treatment and recovery management differ from the “acute care model” in that a multitude of highly restrictive and costly resources is not required in the entry level of care, save medical detox in selective cases. Outpatient treatment and recovery management provides case management, coaching and support over the long-term, in the natural environment where the client resides.

The distractions, triggers and the wreckage from reckless drug/ alcohol influenced behavior must be encountered early in sobriety so that specific recovery skills are exercised in the context where they are needed. If a person new to recovery encounters these stimuli for the first time without the support and guidance of professionals and peers, relapse is likely.

Outpatient treatment and recovery management must be provided in “real time” during “real life”, to pursue “real life opportunities” and to cope with “real life events”.

“Treatment on an outpatient basis allows a more valid assessment of environmental, cognitive and emotional antecedents of drinking episodes and drinking urges on the part of the patient, and allows the patient to test new coping strategies while still within a supportive counseling relationship.

These conditions would be expected to foster greater generalization of learning in treatment to the patient’s natural environment” (2)

Learned ideas and behaviors are not applied in real life unless new skills are practiced and coached. (3) Studies reveal that didactic teaching provides participants no practical benefit. Didactic teaching which includes role-playing or in-class practice results in no lasting practical benefit. Only when teaching and practice are applied to real life situations followed by coaching and follow-up are behavioral improvements achieved. (4) (5)

Outpatient treatment of substance use disorders and recovery management allows for the practice and exercise of pro-recovery skills in the real world. Coaching and follow-up after real-world exercise allow for supportive, reinforcing and corrective steps toward strengthened recovery and guiding away from relapse towards greater resilience.

Patients develop the skills and self-confidence to cope with high-risk situations such as negative emotional states, interpersonal conflict, and social pressure to drink. The informal use of similar coping strategies may contribute to the success of 12-step self-help programs. (5)

References:

(1) White, W.L. & McLeallan, A.T. (2008) Addiction as a chronic disease: Key messages for clients, families and referral sources. Counselor, 9(3), 24-33.
(2) Annis, 1986, p. 183
(3) “Meta-analysis of Effects of Training and Coaching on Teacher’s Implementation in Classroom”, Joyce & Showers, 2002
(4) “Impact of Formal Continuing Medical Education- Do Conferences, Workshops, Rounds and Other Traditional Continuing Education Activities Change Physician behavior or Health Care Outcomes”, Dave Davis, MD, The Journal of the American Medical Association
(5) Kelly et. al. 2000
(6) “Evaluating Substance Abuse Treatment Process Models: I. Changes on Proximal Outcome Variables during 12-step and Cognitive Behavioral Treatment”, Finney, Moyes, Coutts, Moos, Journal of Studies on Alcohol, ‘98

You can pay $60,000 ($60K) per month in Malibu or West Palm Beach, $37K “Out-of-Network” from your insurance, $14K “In-Network” with your insurance coverage, or you can simply pay whatever your deductible and co-payment is for an average of twenty-five substance abuse/ addiction sessions at Twin Town Treatment Centers. Once an average of twenty-five billed sessions is complete, Twin Town provides four additional months of aftercare.

If you paid out of pocket, a five (5) month episode of substance abuse/ addiction treatment at Twin Town Treatment Centers would run approximately $4.5 K.

Optum Health, a nationally recognized behavioral health managed care organization published a white paper, which states the following:

“Sensing both demand for services and higher rolls of young adults on their parents’ insurance, entrepreneurs have opened new centers for treatment of substance use disorders. Many of these are in “destination” locales, in states far from patients’ homes. In our estimation, however, those are often not the most appropriate or effective settings for treatment for these reasons:

1. When individuals can be treated for a substance use disorder in or near their home communities, they often stand a better chance of long-term recovery. Their families and close friends can be part of their recovery, and the individuals in treatment learn how to be sober in the surroundings where they will continue their lives.

2. Close analysis of claims from some treatment centers bears witness to questionable practices in treatment protocols and in billing patients, families and their insurance companies. A particular area of abuse is in the use of and billing for drug screenings through laboratory tests that are being administered inappropriately, far more frequently than required, at rates well beyond the usual and customary charges.

CLAIMS COSTS FOR SUBSTANCE USE DISORDER TREATMENT IN FLORIDA

The costs of treatment in out-of-network facilities were, on average, three times higher than the costs of treating at in-network facilities.

Nearly 75 percent of the cases of young adults treated in Florida involved individuals who were not residents of that state.

Individuals from outside the state treated at out-of-network facilities were readmitted at higher rates — between 11 percent and 40 percent higher, depending on level of care — than Florida residents who used in-network facilities.

CLAIMS COSTS FOR SUBSTANCE USE DISORDER TREATMENT IN FLORIDA 18- TO 25-YEAR-OLD DEPENDENTS:

Out-of-Network (63% of members) per member $36,645

In-Network (27% of members) per member $13,692.”