Someone recently asked me these questions, so I thought I would answer them here publicly:
What are your thoughts of the cost to properly get enough help for young adults whom have no access to funding?
Tough situation, one that can probably never be self sufficient.
I really like the idea of self sufficient concepts like the Oxford House movement (the residents all work and they cover all rent and expenses to run the house). That is tough to do with younger people because they are not yet working, and most are going to be too young too work.
In such a situation I think it is gonna come down to:
1) Parents – putting up the funds to see their kids get help.
2) Government – using tax dollars to try to help the kids who need help.
So maybe the ultimate solution for adolescent treatment is to find a way to set it up such that it is cheap, since it can probably never be free or totally self sufficient. I like the idea of “wilderness recovery” for adolescents too, taking them out into the woods on an extended survival trek, having one or two “therapist rangers” as the guides, and just getting them out there, doing stuff, safe environment, getting experience, etc. Plus the cost of this type of “rehab” is much cheaper than the traditional, 28 day, watch videos and do group therapy with expensive therapists all day stuff.
My understanding of the data is that current methods don’t work so well anyway. Why not get radical, try some new models, try some cheaper models, etc.?
The trend right now is: less and less money to pour into substance abuse. Less for rehab, less for prevention, less all around. So I say, let’s explore some cheaper, more sustainable ideas. Let’s get radical, try new things. Try them on a massive scale.
What would you like to see happen so that those whom want the help can get that help?
Like I said above, I am leaning toward self sufficiency in treatment models. Using tax dollars is just so wasteful. Let me explain though:
I worked in a non profit rehab for 6 years. I did the money. I was the insurance guy. So I handled the funding for every single client. And I watched the incredible amount of repeat business that we got there. And the scary thing? Probably about 80 percent either state funded or government insurance clients. Only about 20 percent private insurance. Actually it was worse than that, I am sure of it. Probably more like 90/10.
I would not have a problem with this, believe me. I got clean and sober myself on state funding. Call me a hypocrite if you will, but what I saw happen over six long years cannot be erased. I cannot forget that pile of data that I watched accumulate.
It doesn’t work. Our basic model of 12 step based inpatient rehab is just plain broken. It works so, so rarely. It is so incredibly costly and expensive.
Now trust me, I do know how large the payoff is when someone “gets it” and they stay clean. But this is rare. Very, very rare. Relapse is the norm.
With younger folks, the numbers are even worse. Relapse is even more common. I was working with 18 and up. But I know that the numbers are even worse for kids.
Do you feel the cost of rehabilitation could or should be lowered?
Not necessarily. Rehab has a “cost,” and that is based on all the overhead. It costs money to keep the lights on and buy the food and feed the clients and pay the therapists and so on. Like I said, I worked at a rehab and I was the money guy.
It would be nice to say “everyone should be entitled to the best treatment available” but I understand the costs very well. I also pay taxes. And I have seen how effective our tax dollars are at trying to help the addicted. Not very well to say the least.
But I am not without hope. I want to see treatment work more than anything. I want to see it become more affordable, more practical, more accessible.
At the same time I am realistic. I know we have a long way to go. I know that our current system is broken, and is not very effective. And it might be a very difficult, or impossible, problem to solve. Maybe this is the best we can do.
But I think we can do better.