Increasingly, I receive desperate emails from parents who have adult children who are quite literally only a short time away from dying from addiction.
The letters are all similar. They say something like, "My child is suffering from addiction and has been using opioids/heroin/benzodiazepines/other prescription meds for somewhere between five and ten years. S/he has been in short term (30 days or less) treatment programs several times." In at least 1 in 3 cases, the child is on Suboxone, a "medically assisted treatment" (MAT) to help wean them from opioids. Around 50% of the time, the addict has a co-occurring psychological disorder, the most common being depression, anxiety, ADD/ADHD or trauma. Every single one of these family members who writes me is sincere and frantic - and every single one ends their letter with, "We are almost/completely out of financial resources."
I have absolutely no idea how to reply.
The truth is that unless your loved one responds to the 12 Step program, which has saved millions of people over the years from the ravages of addiction, but has only a 5-8% success rate overall, or something like SMART Recovery, which is a non-12 step support group, there are no other nationally recognized programs that are free. And 12 Step programs are abstinence-based, meaning that anyone using MAT will not be accepted as "sober" in those groups. All health care, including mental health care, costs. Sometimes dearly.
I am not a medical doctor and cannot give anyone advice on a particular case, but I can share some important information that is very clear from the research and data on addiction.
1. Keep naloxone on hand. If your loved one uses any opioid medication or heroin, or has a prescription for longer than 7 days, s/he is at real risk of overdose. Naloxone (sold under several brand names) is a drug that temporarily reverses opioid overdose in most cases and gives you time to get your loved on to emergency medical care. Have it in your home, your purse, your car, and make sure you and every person in your household, including your addicted loved one's friends, knows where it is and how to use it. This drug saves lives.
2. Find quality treatment. The New York Times reports that people spend more time researching a new car than they do researching where to send a loved one for addiction treatment. That's hard to comprehend, but it is true.
In medical care, not all programs are the same, nor do they have the same treatment outcomes. If you had cancer, you would research the doctors, treatments, and facilities available and choose the one you felt could best save your life. Addiction treatment is no different. You must do your due diligence from the start, because if you use up all your insurance benefits on a sub-standard facility, you leave yourself and your loved one with few options.
3. Seek out longer term care. The National Institute on Drug Abuse is clear that both for residential and outpatient programs, treatment of less than three months' duration, in a high quality program, is generally of limited success. Why? Because we are dealing with a disorder that is neurological and psychological at its core. In treatment, we both have to get a new brain pattern established and deal with the underlying reasons why a person needed to drink/use in the first place. That's not something that can be resolved in a few weeks.
4. Keep fighting. While I completely understand the inability to throw good money after bad, you have to keep looking for resources for your loved one. I get that it is discouraging to see treatment centers advertised on television that feel financially out of reach, but once you have found the type of treatment you want for your loved one, call the facility. A lot of people are surprised to find when they call the treatment center where I work that we have many different treatment options available, not just the luxury flagship facility. Some treatment centers also make referrals and the vast majority work with your insurance to obtain the maximum benefits available.
Lack of resources, though very real, cannot be a reason to give up on your loved one. You have to keep looking for help and leave no stone unturned in your efforts. Do not give up hope.