Free Rehab: Is it as Effective as Paid Treatment?

When you’re looking for treatment to overcome addiction to drugs or alcohol, cost is a huge factor. The media portrays many luxury rehabilitation programs as exclusive resorts for the rich and famous, but this isn’t accurate. Most programs focus on evidence-based treatment, which starts with detox, continues through therapy, and culminates in the development of an aftercare plan to reduce the risk of relapse and promote ongoing recovery.

If you cannot afford a drug rehab program because you do not have insurance and struggle with financial stability, you may qualify for free rehab programs. These approaches to treatment primarily focus on social support, but several offer other forms of assistance to those in need. 

What Are Free Options?

In considering free rehab options, it is important to know the difference between rehabilitation and detox. The first step to long-term recovery from addiction is often detox, which involves medical and social support to safely stop abusing drugs or alcohol, manage associated withdrawal symptoms, and end the body’s dependence on substances to feel normal.

Detox may involve medications to help individuals taper off substance abuse, like buprenorphine for opioid abuse. It may involve some prescription drugs to stabilize physical or mental symptoms, like anti-nausea drugs. It will also involve social support to overcome cravings and manage physical discomfort.

Rehabilitation programs are longer-term programs aimed at changing behaviors around drugs and alcohol, so individuals can stay sober. For many people, rehabilitation is the main focus of addiction treatment, although detox is often medically necessary. To be fully effective, the National Institute on Drug Abuse (NIDA) advises staying in a rehabilitation program for at least 90 days (three months).

Most free rehabilitation programs are run by charities or nonprofit organizations. Many of these are religious, but an increasing number are secular organizations inspired by the group therapy model. 

• The Salvation Army: This organization offers Christian charity to help impoverished, homeless, or otherwise struggling people get back on their feet. This includes those who struggle with addiction to drugs or alcohol, and have experienced legal, financial, and housing struggles because of their condition. The Salvation Army offers group and individual counseling, holistic approaches, spiritual direction, and life skills development to ease those struggling with addiction off drugs toward self-reliance and into stable, healthy lives. Reportedly, the nonprofit organization helps 150,000 people annually.
  
• Support groups: Starting with Alcoholics Anonymous, support groups in the 12-step model have long been a free approach to overcoming addiction to drugs or alcohol. There are dozens of programs now including support to overcome addiction to cocaine, crystal meth, marijuana, narcotics, and co-occurring mental health and substance use disorders. The original 12-step programs are based in the Christian faith, but there are also several secular programs, including SMART Recovery, Secular Organization for Sobriety (SOS), and LifeRing.
  
  While these are free approaches to treatment, and members can attend as many meetings as they want, there is no medication management or medical oversight. If you need physical treatment related to substance abuse, this may not be an appropriate approach to treatment at first.
  
• VA hospital treatment for veterans: The Veterans Affairs Administration manages several hospitals across the country. Health care is provided to veterans; they simply must be registered at a local VA hospital. After an intake assessment with a physician and counselor, veterans can get help for addiction to drugs or alcohol.
  
• Online support: Many online forums have sprung up over the years to offer scheduled meetings and general social support for those overcoming addiction. StepChat is one of the most popular, and About Alcoholism is also widely used.
  
• Medicaid: This federal health insurance program may help to cover the cost of detox and medically necessary inpatient rehabilitation, partial hospitalization, and counseling. As part of the Affordable Care Act (ACA) insurance programs all over the United States, including Medicaid, had to expand their treatment programs to cover mental and behavioral health options like substance abuse treatment. Coverage for treatment can vary by state, however. 

Free Options vs. Paid Options

Free rehabilitation programs tend to focus on group therapy. Unless the program is covered by state funding or a federal insurance program, there are typically no options for medication management, few options for individual therapy, and rarely long-term inpatient treatment. Additionally, free rehab will not accept clients unless they are in dire financial need, including being chronically unemployed, struggling with homelessness, or struggling with caring for young children.

In contrast, paid rehabilitation programs offer more specific options, including long-term residential treatment, medication supervision and management, and help from a case worker to keep clients on track once they complete the rehab program. If you can afford some insurance coverage, you have some support for at least one month in a paid program. From there, you may be able to step into a free or low-cost support option after getting your basic needs for focused behavioral therapy met.

Many rehabilitation programs also have sliding scale options, deferred payment options, or installment plans to help you get the treatment that will benefit you the most. 

Access to Treatment Saves Money in the Long Run

Everyone has different needs for treatment. Free options may work well for some who struggle with addiction; others may benefit more from paid options that offer a wider array of services, better accommodations, and more staff members. Access to many kinds of treatment programs is crucial to helping as many people as possible.

NIDA found that substance abuse costs the U.S. $600 billion every year. Drug and alcohol rehab, whether free or paid, alleviates a lot of this financial burden on society. For every $1 spent on addiction treatment by taxpayers, conservative estimates state that $4 to $7 are saved on drug crimes, criminal justice costs, and theft. When health care savings are included, like emergency treatment services, there is a cost savings of $12 to every $1 spent on treatment.

Paid rehabilitation tends to offer more focused programming to overcome specific addictions, but free rehab has an important place in the larger treatment world. Both can be very effective, depending on individual needs.