By Susan B. Ramsey, R.N., ESQ


According to the Substance Abuse and Mental Health Services Administration (SAMHSA), it is approximated that at least 20 to 23 million Americans age 12 or older needed treatment for substance abuse and addiction. Unfortunately, only about 4 million out of those 23 million received it. It is also estimated that alcoholism causes 500 million lost work days a year.

Treatment centers for drug and alcohol abuse is a blossoming industry. While there are many exemplary facilities, there are also facilities that are ill equipped at best and dangerous at worse. Moreover, with the advent of more recovery residences (sober homes) there are lots more questions to ask.

The National Institute on Drug Abuse (NIDA) created a brief guide containing these initial inquiries:

1. Does the program use treatment backed by scientific evidence? Ask the facility what the scientific rationale for their programs is. Do they utilize medical management, medications or other types of interventions? You will find that there are a number of different treatment modalities and each one needs to be analyzed separately and on its own.

2. Does the program tailor treatment to the needs of each patient? Specifically, is the treatment “one size fits all”, or do they have different programs or tracks. Does the facility address the needs of patients with “dual diagnosis” or “co-occurring disorders”; such as, eating disorders, or hypertension, and other medical or psychiatric conditions.

3. Does the program adapt treatment as the patient’s needs change? How does the treatment facility do these assessments and make these referrals. For example, if it becomes evident that a patient is in need of additional medical or psychiatric services, how do they ensure that happens in a timely and appropriate manner?

4. Is the duration of the treatment sufficient? Specifically, different programs have different ideology regarding this issue. There are some programs that are many months in duration. Others are much more short term. This again will depend on the specific needs of the patient and needs to be discussed and addressed.

5. How do 12 step or other similar recovery programs fit into their substance abuse treatment? There are different programs that have different ideologies and philosophies as to what best works. Again, each individual needs to be evaluated for their suitability to a specific program.

6. How does the facility address a patient/client who is experiencing a recurrence of their substance abuse disorder (relapse)? The answer to this is critically important particularly for recovery residences (sober homes). Is there a documented plan that is reviewed with the patient/client and family members or emergency contacts at the time of admission? Consider having a loved one sign a Release of Information so there is absolutely no question as to who needs to be contacted if this unfortunate event occurs and have a plan.

These are general overview questions that will hopefully educate the prospective patient/client and/or family member. Once you have gotten to this point, if the facility is well run and above aboard, they will answer these questions without hesitation.

1. Has the facility had any complaints lodged against them? In Florida, the State Agency that licenses Substance Abuse Facilities is the Department of Children & Families. If the facility is in another state, ask them who licenses them and whether there have been any complaints (and then check yourself). As to recovery residences – in Florida check with the Florida Association of Recovery Residences (farronline. org). Other states have associations as well (Pennsylvania- PARR, Arizona- AzRHA etc.…) If the facility tells you they have other types of accreditation, for example JCAHCO (joint commission, accreditation, health care, and certification) or CARF (Commission on Accreditation of Rehabilitation Facilities), you may want to check.

2. Where am I or my loved one actually going to be sleeping, eating, etc.? While the marketing brochures may look fabulous, reality may be quite a different thing. Ask to see the actual places- particularly with recovery residences (sober homes). There have been fire code, health and sanitary concerns.

3. Is there a safety plan? Is there a procedure for ensuring safety in the event of a hurricane, or other disaster? Will transportation be provided to safety? Who will determine this? What options would I or my love one have?

4. Who are the patients/residents going to stay with? Meaning is the facility co-ed and how does the facility maintain boundaries.

5. Ask what the “success rate” of their program is? According to the SAMHSA National Survey on Drug Use and Health estimates that relapse rates for addictive diseases usually range in the range of 50% to 90% and there are numbers of different factors relating to this. So you want to ask what this particular facilities follow-up studies are, follow-up information is and how they base it. If you are told some very high number for a “success” rate – ask them about the SAMSHA statistics.

6. Ask about the staff. How many professional licensed staff members are there versus non-professional? Specifically, who are the people that are going to be interacting with your loved one on an hour to hour – day to day basis? There are certifications and license requirements for para-professional and professional staff members who work in this field in most states. While 12 step programs encourage peer to peer support- utilizing other people in recovery as the main therapy model has a number of pitfalls.

7. More about the staff – Do not be afraid to ask the hard questions, what the backgrounds of these folks are, have any of these individuals had any complaints, felony charges, criminal complaints etc. It is not uncommon in this industry to have recovering substance abusers help those just beginning their own recovery, and some of these people have difficult pasts. These individual can be wonderful and truly help others but there are those who have no business working with vulnerable patients. Ask about the supervision of those caring for your loved ones or yourself.

Substance Abuse Treatment Facilities and Recovery Residences have enabled millions of people to get back to productive effective lives. It is our hope that if you or your loved one is in need of such treatment that you do the homework and investigate and find the right facility!

Ms. Ramsey’s professional experience began as a Registered
Nurse at Yale New Haven Hospital. She graduated from CUNY
Law School, and is admitted in several different state and federal
bars. She is a Florida Licensed Health Care Risk Manager. Ms.
Ramsey assists families whose loved ones suffer from the disease
of substance use disorders. Ms. Ramsey actively litigates cases
involving serious and catastrophic injuries on behalf of victims with
Gary Roberts and Associates.