Dependence versus Addiction Medical

Terminology According to the Diagnostic and Statistical Manual, the clinical criteria for "drug dependence" or what laymen refer to as "addiction" include: compulsive drug use despite harmful consequences; inability to stop using a drug; failure to meet work, social or family obligations; and sometimes, depending on the drug, tolerance and withdrawal. Tolerance and withdrawal reflect physical dependence of where the body adapts to the drug, requiring more of it to achieve a certain effect resulting in specific physical or mental symptoms when drug use stops abruptly. Physical dependence can happen with the chronic use of many drugs even when the user takes a prescribed drug. Thus, physical dependence in and of itself does not constitute addiction, but often accompanies addiction. Dosages of prescribed pain medications can change to meet the need of the patient if there is increasing pain, but can also represent tolerance or the worsening of underlying problem like addiction. Because some psychotherapeutics have an associated risk of dependency, like benzodiazepine, which treats anxiety or sleep disorders and opioids that treat pain, it is important for patients to follow dosage instructions faithfully. Physicians must monitor patients carefully. To minimize the risk of dependency, a physician or other prescribing health provider should be aware of the prior or current substance abuse problems of every patient, as well as any family history of addiction.

12-Step Facilitation Therapy

Twelve-step facilitation therapy is an active engagement strategy designed to increase the likelihood of a substance abuser choosing to become actively involved in 12-step self help groups and promote abstinence. One aspect of facilitation therapy is acceptance: realizing that drug addiction is a chronic illness over which one has no control; that life is unmanageable because of drugs, that willpower alone is insufficient to overcome the problem and that abstinence is the only alternative. Another aspect of facilitation therapy is surrender, which involves giving oneself over to a higher power, accepting the fellowship and support structure of other recovering addicted individuals and following the recovery activities laid out by the 12-step program. The final ingredient in a facilitation therapy is active involvement in 12-step meetings and related activities. While studies support the efficacy of 12-step programs in treating alcohol dependence, the research pertaining to other drugs a person abuses is more preliminary but promising for helping drug abusers sustain recovery.

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Paying for Drug and Alcohol Treatment

Finding ways to pay for treatment to recover from dependence on alcohol or drugs takes some research. Addiction treatment can be quite costly and the wrong program can be ineffective. The severity and duration of the substance a person abuses and the type of treatment the person requires all contribute to the costs.
Some treatment for drug and alcohol dependence costs more than others. Residential treatment is more expensive than outpatient treatment. The location of the facility, amenities offered and staffing also influence treatment costs. Chronic alcoholism or drug abuse may require longer-term treatment and that can become very costly depending on the treatment facility.

Determine the Payment Approach

The goal of every drug and alcohol abuse treatment center is to help the patient to abstain from use, to be able to function again normally and re-enter society and to stay in recovery--clean and sober. In an ideal world, no treatment facility would turn any client away for lack of ability to pay. In reality, not every drug and alcohol treatment center can do this because of fixed costs. Still, there are various methods available for assisting clients pay for treatment.

Private Insurance

The most commonly used payment for drug and alcohol treatment is through private insurance. The insurance coverage may pay for some or a great portion of the drug and alcohol treatment program. The websites of some addiction treatment centers may mention specific insurance carriers, particularly if the facilities are preferred addiction treatment centers for national insurance companies such as Blue Cross, Aetna, Cigna and others. Whether or not private insurance covers any portion of drug and alcohol treatment depends on whether the facilities are ERISA or non-ERISA plans. The Employee Retirement and Income Security Act (ERISA) is a federal law that sets standards for certain health plans offered by employers. If the plan is ERISA, it may or may not cover drug and alcohol treatment, as it is not required to. Non-ERISA plans and other group health plans, are required to provide at least four inpatient detox admissions (of up to 7 days each) in a lifetime, at least 30 days per year (lifetime 90 days) of non-hospital residential treatment and at least 30 days a year of partial hospitalization or outpatient services.

Military Insurance

Members of the armed services who need alcohol or substance abuse treatment may have some or most of the costs paid for through military insurance.

Medicare, Medicaid and Medical

Many treatment facilities advertise that accepting Medicare, Medicaid and Medical. Medicare Part A covers some drug and alcohol treatment received at a hospital (including room, meals, nursing and some other services), while Part B covers some services provided by alcohol and drug professionals (inpatient or outpatient), lab tests, partial hospitalization and outpatient therapies. Be aware that Medicare does not cover the total cost of most treatment and services and patients pay deductibles and co-payments.

Self Payment

The two major things to consider when evaluating self payment for addiction treatment are that the first attempts at drug and alcohol treatments do not always work. Ongoing addiction usually has high mental and financial costs as well as increased risk for other problems.