Addiction Treatment | What It Takes To Stay Sober
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Addiction Treatment

What will it take for your loved one to stay sober?

Follow the Full Process

1. Detox : Medical Stabilization, Detoxification

Your loved one has to get drugs and alcohol out of their body. Detox relieves withdrawal symptoms, reduces cravings and prevents complications.

What it’s like.

Detox starts with an evaluation of physical and mental health, including how long, how much and how often different substances were used. The assessment estimates the types and amounts of medications to be used to keep them safe and comfortable.

For 3-10 days, medications with similar properties as the abused drug are given in minimum doses and continually decreased based on progress. Additional medications help manage specific withdrawal symptoms — such as a beta-blocker to curb a fast heart rate.

Vitals and well-being are monitored by medical professionals the entire time. Detox keeps them relaxed, hydrated, nourished and attended to.

Does my loved one need it?

Cocaine, meth, amphetamines and marijuana don’t usually need detox. For other drugs — including alcohol, heroin, benzos and prescription pain pills — trying to quit on their own can be life-threatening.

The body becomes physically dependent on these drugs. A “cold-turkey” approach can lead to vomiting, muscle aches, seizures, hallucinations, blood pressure issues, delirium tremens, panic or heart attacks. Risks are higher each time the drug is started and stopped.

Also, without supervision and encouragement, relapse is hard to resist. The body’s tolerance decreases during even brief sober periods, so using the same amount of the drug to get rid of withdrawal symptoms can cause overdose.

With detox, your loved one is comfortable rather than feeling miserable, so they want to continue the treatment process.

Why it’s not enough.

While your loved one may be physically free from the substances after detox, they are still just as mentally addicted and spiritually beat-down. They need to go directly to rehab to learn to stay drug and alcohol-free.

2. Residential Treatment : Inpatient, Rehab, Rehabilitation

Residential treatment provides around-the-clock clinical, medical and social support. It has the highest rate of long-term success.

What it’s like.

A typical day is carefully and personally scheduled. The majority of time is spent in therapy — whether group, 1-on-1 or family sessions. Specialized therapies — like art and music — or advanced therapies — like EMDR for trauma — may also be part of their day-to-day schedule.

When not in therapy, they may participate in relaxation activities like massage, acupuncture, meditation or working out. They may attend lectures from experts like nutritionists and successful alumni. They should have worksheets and self-reflection journaling to do during downtime. 12-steps meetings are usually required as something to easily continue when they leave. If needed, life skills should be part of treatment — from resume writing to cooking and budgeting. Whereas, an executive would take time for work-related matters instead. They should see a medical doctor regularly and learn to have fun and socialize with peers without drugs or alcohol.

Does my loved one need it?

Most people try support groups, a regular therapist or after-work options first — usually several times. But, sobriety is always going to be short-lived without getting to the core of the issue. While rehab may seem “extreme”, it’s just a few weeks of the rest of their life. Rehab allows them to completely focuses on getting well without the distractions of everyday life and under 24/7 supervision.

There are always plenty of excuses (like work, kids, school or finances), but nothing is more important. Across the world, in study-after-study, residential treatment has the highest rate of success.

Why it’s not enough.

The addiction took longer than a month or two to develop, and it’ll take longer than that to heal. While treatment lays the critical foundation, they still have to go into the world and continue to make healthy choices every day.

3. Outpatient Treatment : IOP, OP

Outpatient treatment is therapy that happens while living in the “real world.”

What it’s like.

Outpatient treatment works around other obligations (like job schedules) to provide a “lighter” level of therapy while addressing the same underlying issues as residential treatment.

Intensive Outpatient (IOP) requires at least two-hour sessions for three or more days a week — 9 hours a week minimum — with a commitment of 1-6 months. IOP may also require drug testing and support group attendance and may include medical components like medication evaluations.

Outpatient Program (OP) involves anywhere from 1-9 hours a week. OP can be through an addiction treatment facility or one-on-one sessions with any local therapist. It can be a simple as what you think of “normal” therapy.

Does my loved one need it?

Everyone transitioning out of the shelter of residential treatment needs some form of outpatient treatment. Hold your loved one accountable for a minimum of 5 months of outpatient treatment at least weekly, starting immediately after they leave. The positive reinforcement allows them to learn to voluntarily abstain from drug or alcohol use without constant supervision — until the risk of relapse decreases.

Meeting regularly with a therapist is the best way for anyone to remain in a good place mentally and think clearer about their life and issues. When emotional situations come up — such as a death in the family or marital struggles — look to resume outpatient treatment right away. Therapy should be like going to the gym. It’s something we can do regularly (weekly or bi-weekly) forever as a safety net.

Why it’s not enough.

Many families try outpatient before looking at residential treatment. A local therapist or after-work program is a natural place to start. It’s possible to end addiction with only outpatient treatment, it’s just much more likely this only prolongs the struggle.

If you’re reading this, your loved one has probably tried outpatient options in the past (maybe more than once) or their addiction has escalated quickly. In that case, follow the full process. They’re five times more likely to recover long-term with residential treatment.

4. Sober Living : Halfway Housing

Sober living is a house specifically for those coming out of drug or alcohol treatment.

What it’s like.

Sober living is an ideal blend between treatment and the “real world.” They generally have normal responsibilities and freedoms, but with accountability measures like required meeting attendance, random drug testing and sober live-in mentors.

Does my loved one need it?

Even if you plan on your loved one moving back in, sober living is almost always a better next step. The same triggers and opportunities to use still exist at home. The longer sobriety is maintained, the more natural it becomes. Plus, you may have your own feelings of anger, distrust or co-dependency to work on. You both may be anxious to get them back home, but taking a little extra time can make all the difference. Most relapse occurs within the first six months.

Depending on where you live, options may be limited, but they can always stay an extra month (or more) in FL/CA. Structure and accountability are critical in the beginning, and it’s not healthy for your relationship if you’re serving that role.

Why it’s not enough.

Sober living is not treatment, it’s accountability. If your loved one has relapsed, they need to go back to a few weeks of residential or at least outpatient treatment (and maybe detox) — no exception.

5. Support Meetings : 12-Step, AA, NA, Alumni

Support groups offer a free place to come together, get advice and stay accountable.

What it’s like.

Support groups are full of normal people that meet regularly to use their story and experiences as a lesson and reminder for others. There are groups just for young adults, women, executives, etc. Meetings are available daily, open to the public and free.

Does my loved one need it?

Addiction doesn’t go away when they’re sober. While they may not benefit from everything said, they can take something away each time. Even just the effort of attending is something to feel good about. The meetings provide emotional support, reduce isolation and serve as a reminder to remain active in their sobriety.

The standard is 30 meetings in the first 30 days after residential treatment. Since support groups are free, there’s no good reason not to attend at least once a week forever. Eventually, your loved one’s story becomes an inspiration to others.

Why it’s not enough.

Support groups are not designed to treat addiction or underlying mental health issues. It’s about the daily maintenance of sobriety. Your loved one thought about addiction every day, so breaking that cycle also requires a daily commitment.

Utilize Medications

Though not a “cure” for addiction, medications can be life-changing in the beginning by removing physical cravings and rebalancing the body. You don’t need to come in knowing what medications will be best. That’s the physician’s job. You just need to encourage your loved one to be open to medications and bear with the process until they get a medication (or combination) that help.

Everyone


Naltrexone (Vivitrol, Revia, Depade) is non-addictive. The medication blocks the positive effects of alcohol and drugs to discourage relapse, while also reducing cravings. It can be started day 7-10 of sobriety and has no serious side effects. Naltrexone could theoretically be taken forever.

In shot form (Vivitrol), it’s administered once a month by a medical professional, eliminating the option to skip or mistake the dose. The drawback is cost. If not covered by insurance Vivitrol is $1,000 per monthly shot, though they offer a savings card. The other options are Revia and Depade. These oral pills are closer to $112 a month, but require your loved one willingly take the medication every day.

Two other addictive medications are more rarely used. Gabapentin (Neurontin, Gralise, Horizant) can be used for cravings and Baclofen (Kemstro, Gablofen, Lioresal) can be used “off-label” to give a calming effect during withdrawal.

Alcohol


While Naltrexone is usually the first choice, the following medications are also FDA-approved for alcoholism:

  • Acamprosate (Campral) reduces symptoms of long-lasting withdrawal and cravings, such as insomnia, anxiety, restlessness and generally feeling unwell. It must be taken three times a day.
  • Disulfiram (Antabuse) interferes with the body’s ability to absorb alcohol. Instead of feeling “good”, alcohol will cause unpleasant reactions such as nausea and possibly be dangerous. Those who have shown the ability to stay sober for an extended period with recent relapse are ideal candidates.

Topiramate (Topamax, Qudexy) is an FDA-approved medication for seizures that is used “off label” to also reduce alcohol cravings due to initial promising research.

Opiates


In addition to Naltrexone, these medications are FDA-approved to treat heroin/pain pill addiction:

  • Buprenorphine/Naloxone (Subutex, Suboxone, Probuphine, Bunavail, Cassipa, Sublocade, Zubsolv) helps prevent withdrawal symptoms by replacing the effects of opiates with a lesser effect that does not produce a “high.” This is typically administered for 7-10 days, though those with chronic relapse may be recommended for a longer maintenance program. This medication is addictive but poses a much lower risk than the abused drug.
  • Methadone (Dolophine, Methadose) is a more dangerous version of the above medication almost never recommended.

Additional medications help manage withdrawal symptoms during detox, including Clonidine (Catapres, Duraclon, Kapvay, Nexiclon), the most common, and Methocarbamol (Robaxin), a muscle relaxer.

Underlying


All other physical and mental health issues (like depression and anxiety) need to be treated too – whether they helped fuel the addiction in the first place or came as result of the addiction.

Common mental health prescriptions include:

  • Fluoxetine (Prozac, Sarafem) or Bupropion (Wellbutrin) for depression
  • Aripiprazole (Abilify) for mood and bipolar
  • Trazodone (Oleptro) or Hydroxyzine (Vistaril, Atarax) for sleep and anxiety
  • Paroxetine (Paxil, Pexeva, Brisdelle) or Sertraline (Zoloft) for major depress, PTSD, OCD
  • Oxcarbazepine (Trileptal) for mood stabilization

Pay for Treatment

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Find the Best Facility

Residential treatment facilities usually offer detox and help with all outpatient planning, so focus on finding a good rehab and getting your loved one to go.

Accreditation

Accreditation

The Joint Commission gold seal is the highest standard in healthcare. The non-profit organization investigates the quality of care during an initial evaluation and demands continuous improvement through random check-ins. Only the top 10% of treatment centers meet this standard.

Location

Location

If there is a quality treatment option near you, staying close to home makes sense. But, if they’ve already tried treatment before locally, getting away helps eliminate triggers and increases the focus on recovery. Florida, California and Arizona are known to have the best treatment in the country.

Insurance

Insurance

You’re better off going out-of-network if their policy covers it. You get more time and more advanced treatments because the facility isn’t locked into a standard (low) contract. If only in-network is covered with your policy, start your search using your insurance company’s list. For help with any insurance questions, call (888) 492-1633.

Reviews

Reviews

A reputable facility will have plenty of positive reviews on multiple websites. Instead of perfection, look for a consistent history of positive feedback.

Is it easy to find reviews for this facility? Do the reviews seem real? Is the average review score 4 stars or higher? Do they provide alumni references?

Treatment

Treatment

Ensure the facility has a “dual-diagnosis” license, so underlying mental health issues (like trauma, depression and anxiety) can be properly addressed. Also, confirm that the facility is authorized to prescribe medications like anti-cravings. Without both elements, treatment is unlikely to be successful.

Staff

Staff

Therapists should have plenty of formal education and certifications in fields like psychology or social work. At least half should be masters-level, coupled with actual experience in the field.

Look for therapist-to-client ratios of at least 1:8 to ensure they get enough attention. (Ambrosia’s ratios are 1:2-6).

Family

Family

You need support and guidance throughout the process too. And, your involvement increases the likelihood of their permanent sobriety. Look for a facility that offers direct support and engages you in the treatment process, but with policies to ensure interactions are not destructive.

Presence

Presence

Only trust a facility with an established reputation. Look for places backed by at least a decade of experience rather than a fly-by-night. The best facilities go above-and-beyond the standards in ways that are hard to categorize — from having research departments and partnerships with universities to shaping better laws and offering community support (like HopeTracker 🙂 ).

Our Stories

Toni C Family Story
Parent
Spouse
Adult Child
Sibling

If you don’t have insurance, expect to feel desperate, hopeless and angry even when they’re asking for help and willing to change. Around us, there’s nothing. My daughter would be put on waiting lists for weeks. By that time, she left the house. Only God knew where she’d go, but I wouldn’t see her again for a month or so. Other than phone calls asking for money, I’d hear nothing.

By the time she came to me the last time looking to get clean, I had done hours and hours (and hours) of research. My plan was to take her to all the 12-step meetings I could and go to a place four hours away that operates on a first-come-first-serve basis every day. As soon as we pulled up, I could tell we weren’t going to make it. We waited in line but were turned away a few hours later as expected. While not getting in was disappointing, I actually felt hope that this could work. Instead of driving back, we went to a meeting together and then slept in my car. Well, I didn’t actually sleep. I was so paranoid she was going to run away in the middle of the night and excited that she might get in treatment in just a few hours. I set my alarm for 4AM to be in line, and she got in. I cried the whole drive back. She was 32, and she had two kids. It was long past time for her to make a change.

She seems to be on the right track so far. She lives in public housing with six other women in addiction recovery, and she’s required to go to a 12-step meeting every day. The social worker even helped her get a job at a gas station. It’s not glamorous, but she’s really trying to get back on track. If you don’t have money or insurance, you have to help yourself. Do your research. Be your own advocate. I never thought this day would come, but it did. She’s sober.

- Toni C.

I was resistant to the idea that my husband needed to go to rehab. I pretended for years that he was “OK.” I didn’t realize at the time, but my biggest fear was what I’d do without him. My whole life was taking care of him. It had been that way forever. I heard that a lot of rehabs cut them off completely from their family. How would I watch and protect him in rehab? What if he didn’t want to be with me when he got sober? I was caught up in the unhealthiness of his disease.

The truth was Ambrosia kept me engaged and involved the whole time. I had someone I could text when I was feeling anxious, and I talked to his therapist every week. We did several marriage counseling sessions together too, but it was family weekend that was transformative. I addressed the fears that I had and the pain I’d been hiding. Ever since then, we’ve been rebuilding our relationship – replacing bad habits with healthy ones.

If you’re living in pain right now because of addiction in your house, get them to rehab. If you’re saying, but we have kids or they have to work – so what?! Seriously, you’ll never regret it. I can’t believe all the excuses I had. I can tell you that since then, everything has changed for the better. Our relationship is stronger. He shows up more for our kids. He probably would have lost his job by now if he was still drinking.

- Dallas S.

I had known for months about my dad’s addiction to painkillers. He would come home from work and just disappear into what seemed like a black hole. Every night was the same. What made it unbearable though, were the mood swings; I don’t know how my mom tolerated him.

Every time I tried mentioning treatment to him I felt uncomfortable as if I was overstepping my boundaries. Sometimes he would shrug me off and say he had to get to work, other times he got annoyed and started to become violent.

Seeking help was the best thing I could do, not only for myself but for my parents. I learned how to communicate and to not give up no matter how hard and hopeless things may seem. After I opened the line of communication with my mom, she even admitted to me that she was attending therapy sessions herself, but she was just too embarrassed to admit it. After that, we felt a new bond and confronted my father together. We were two people who loved him, and no matter how uncomfortable the conversation might be we were ready to tackle whatever may come to help him.

- Tim W.

Jenny was always too clever for her own good. I still can’t believe the manipulation and how many lies we believed, and how long we believed them for! Every time I think about it, it brings me right back to the insanity of it all.

My sister started sneaking our parent’s booze pretty early in life. By the time she was in 9th grade, she was using heroin. Money would go missing and we always believed all her excuses. She was so manipulative and convincing that she managed to cheat drug tests constantly and even though she looked high, we couldn’t get the proof we thought we needed to confront her. She was always in and out, running the streets and only coming by the house when she needed to steal something because she ran out of money.

Once she got into treatment, my parents and I quickly realized that we had to become involved in her treatment. We learned what to do and what not to do, which allowed us to support her the right way until she broke the cycle and we started seeing actual progress. I guess we were contributing to her addiction more than we thought. The best thing we did for her was to get educated about addiction and stick to our guns together, as a family.

- Steph D.