If you’re affected by drug addiction, it can be a very frightening and isolating experience. Statistically, however, substance use disorders affect many millions of people worldwide – including addiction to opioids, cannabis, cocaine and amphetamines, as well as the most prevalent addiction to alcohol.
According to the World Health Organisation, an estimated 27 million people suffered from opioid use disorders in 2016.  A study published in 2018 in the Lancet analysed data from 195 countries and territories between 1990 and 2016. Researchers identified 22.1 million cases of cannabis dependence in 2016, as well as over 100 million people with alcohol use disorders. 5.8 million people were dependent on cocaine. 
Access to Drug Rehab Worldwide
Despite the scale of drug addiction, most people don’t get the treatment they need. The World Health Organisation estimates that less than 10% of opioid addicts get specialist help or drug rehabilitation.  In England in 2018-19, less than one in five alcohol dependent people received addiction treatment. 
According to Jason Shiers, Psychotherapist at UK Addiction Treatment, there are several key reasons why people who want addiction help can’t or don’t access it. “Firstly in many cultures and countries, addiction is still highly stigmatised and criminalised. What this means is that many addicts try to hide, play down or self-manage their condition – sometimes for years or decades.
“Then there’s the question of cost. In countries where addiction treatment is readily available, often access comes down to affordability. Typically, when Government policymakers prioritise funding for addiction treatment, then pathways to effective and affordable care open up. When public investment is cut back, however, fewer people get meaningful help.
“Lastly, for patients with private medical insurance or the ability to self-fund, their engagement can depend on whether there is a choice of well-regulated drug rehabs that are responsive to their individual needs. Drug treatment should never be a one-size fits all approach – it’s about treating the whole person rather than the addiction.”
How to Choose a Drug Rehab – 10 Treatment and Recovery Essentials
1. Drug rehab regulation, licensing and staff qualifications
When choosing a drug rehab, it’s essential to choose a provider that is properly regulated and/or licensed. The staff team should have specialist qualifications and training in addiction medicine and/or therapies.
In England, the Care Quality Commission is the independent regulator of health and adult social care services. They monitor and inspect CQC-registered services, publishing reports about whether services are safe, effective, caring, responsive and well-led. For this reason, you should only consider CQC-registered drug rehabs in England.
In the US, accreditation by The Joint Commission can offer some reassurance to patients about the standards of healthcare providers. Licensing requirements in America differ between states but you can request information from drug rehabs about their current status.
2. Professional addiction assessment
At the start of your drug rehab programme, you should expect to have an assessment with a qualified addiction treatment professional. Depending on the facility and your circumstances, you might be assessed by a psychiatrist, a doctor, a nurse and/or an addictions therapist.
A thorough assessment is necessary, not only to identify the addictions you have that need treatment (including drug detox requirements), but also to gain a complete picture of your health, background and personal preferences. Understanding these individual factors from the start can make the difference between successful and unsuccessful completion of your drug rehab programme – so it’s important that a trained professional carries out your assessment, to gather the right information.
3. Dual diagnosis expertise
Are you suffering with an addiction and a mental illness? If so, it’s important to seek drug rehab treatment from a provider with dual diagnosis expertise.
In the USA, for example, a 2019 SAMHSA report found that 9.2 million adults aged 18 or older had a mental illness and at least one substance use disorder in the previous year – with 3.2 million adults having a co-occurring serious mental illness and substance use disorder. 
Whether you have a common mental health condition like depression or anxiety, or you have a severe and enduring condition such as schizophrenia, advanced anorexia or a personality disorder, it’s important that the drug rehab centre you choose has the expert knowledge and training to treat and support you effectively. This includes having specialist medical, psychiatric and therapeutic care as you recover from your addiction.
4. Residential v. non-residential drug rehab
There are a variety of treatment options for people with drug addictions – including day programmes, quasi-residential schemes and residential drug rehab. It’s important to consider factors around your own addiction and personal history, to give yourself the best chance of recovery. For example, will you recover well whilst living at home, attending a local drug rehab centre? Or do you need some time away from your family, work or local area, to receive more intensive rehabilitation and establish your recovery?
With a day programme, typically you live in your own accommodation while you attend scheduled sessions and appointments at a local drug rehab centre. Depending on the drugs you’ve been using, you may be required to stop taking drugs altogether or to take prescribed substitute medications (if you’re withdrawing from opioids, for example). Facilities may carry out drug testing to ensure compliance.
Quasi-residential drug rehabs offer their clients housing in the community, whilst they attend a drug rehabilitation programme in a nearby facility. This enables people to attend out-of-area treatment programmes, as well as living along side people who are also seeking addiction recovery.
Residential drug rehabs provide accommodation and treatment within the same facility. This is the best option for people who require medically managed detoxification to achieve abstinence. There is round-the-clock support from qualified professionals, to respond to the needs of clients as they occur. Typically, residential rehabs have the most intensive drug therapy too, offering patients the most comprehensive care.
5. Medical detoxification with qualified healthcare professionals
If you’re physically addicted to substances including opioids, benzodiazepines or alcohol, then you will need a clinically managed detoxification. Stopping these drugs abruptly without medical assistance can be unpleasant or even life-threatening, due to physical and psychological withdrawal symptoms. Going ‘cold turkey’ is not recommended because of the risks of relapse, accidental overdose or serious health complications, so please don’t go it alone.
The safest way to detoxify from addictive substances is within a residential drug rehab centre, where you have day and night care from nurses, doctors and support staff. You may be prescribed medication to ease your withdrawal symptoms, as the drugs and/or alcohol leave your system. If you feel unwell or distressed at any point, you will have support on hand to manage the situation.
6. Drug Therapy
While detox is an important beginning to drug recovery, detox won’t cure or resolve your psychological symptoms of addiction. This is where drug therapy or rehabilitation comes in – this is the support that is needed to uncover and address the reasons why people use drugs addictively, as well as developing healthier ways to cope.
Whether you need help to manage difficult emotions or improve your self-esteem, face up to challenging life events or past trauma, skilled addictions therapists will guide you through a process of discovery and change. The aim of drug therapy is for you to feel increasingly confident about managing your life in recovery – without the need for addictive drugs or other harmful behaviours.
There are a number of effective therapies used in drug rehabs across the world – some are based around the disease concept of addiction and others focus more on goals and strengths. You can read much more about the disease model of addiction, as well as alternative psychological perspectives about addiction and recovery on the UK Addiction Treatment website. 
One of the most prevalent treatment modalities, 12-step therapy, centres on the disease model of addiction. It is abstinence-based – a fundamental principle being that moderation or controlled use of addictive drugs and alcohol is not possible for people with a substance addiction. 12-step drug rehabs guide clients through a process of recovery. Firstly, they are supported to identify and accept the nature and harmful consequences of their addiction. Then, they move on to identifying and turning to healthy sources of support. The 12-step programme also helps recovering addicts to develop tools and techniques for personal examination, growth and transformation. Depending on how long people stay in their drug rehab programme, they may complete some or all of the 12 steps.
Other therapies used in drug rehab centres are goals-based, including cognitive behavioural therapy. Methods like these help people to challenge recurring thought patterns and beliefs that are causing mental distress or feeding into addictive habits. The goal is to reframe thinking, drawing upon positive characteristics or abilities.
Family therapy can also be very beneficial – it’s a good idea to choose a provider that offers 1-2-1 and/or group sessions for relatives, partners or close friends. Family involvement can improve addiction awareness amongst your close support network, as well as addressing some of the conflicts within the family that may influence your recovery process.
There are also completely bespoke therapies for addiction, developed in leading addiction treatment centres. For example, UK Addiction Treatment offers a unique Strengths programme at their Oasis clinic. The Strengths model focuses from the outset on people’s assets and skills, in order to apply these positive attributes to overcoming addiction. The treatment combines cognitive behavioural therapy, SMART recovery approaches and other therapeutic techniques such as dialectical behavioural therapy, as well as holistic treatments that promote health and wellbeing. 
Along side conventional therapies, many drug rehabs take a holistic approach – offering therapies and information that contribute to a healthy mind, body and spirit. Sessions might include meditation and mindfulness, art therapy, music therapy, yoga and nutritional guidance, as well as complementary therapies like acupuncture or massage. You can ask drug rehabs to provide full details of everything they offer, to inform your choice of facility.
7. Aftercare and recovery support in the community
It’s a good idea to choose a drug rehab that offers an aftercare programme, which follows on from your main treatment programme. Typically, aftercare takes the form of therapeutic group sessions on a drop-in basis. People can attend for a period of time after they have successfully completed their drug rehab programme. This helps to maintain support and continuity, as you adapt to your new life without drugs.
Good quality addiction rehabs offer free aftercare sessions, as a means for their clients to continue receiving specialist support. Aftercare also provides the opportunity to strengthen relationships with peers in recovery.
Many drug rehabs also recommend attending addiction recovery groups in your local community – these include 12-step groups such as Narcotics Anonymous, Alcoholics Anonymous and Cocaine Anonymous, or SMART Recovery meetings. For people with a dual diagnosis, it’s useful to build connections with local mental health support groups too.
8. Extended care
For some people with addiction, primary treatment in a drug rehab for a period of weeks or months provides a good foundation in drug recovery – but there is also a need for further structured support.
Secondary care facilities offer a continuation of professional therapy and support, to build on the progress made in primary care. It’s also an opportunity to look in much more detail at life circumstances that may be holding you back – such as issues with health, housing, employment, education, debt, life skills and relationships. There’s also the benefit of ongoing daily contact with peers in recovery, learning together in a supportive environment.
9. Personalisation of addiction treatment
If you’re a pregnant woman, addicted to opioids, you will need a drug rehab facility with specialist knowledge of drug detoxification during pregnancy. You will be best supported in a residential facility, where doctors and nurses can monitor your physical and mental health and proper measures are in place to facilitate your antenatal care.
If you’re a father of young children, you may prefer a residential drug rehab where your children can visit you during your stay. You might want your partner to attend family therapy sessions with you, so a facility close to home will make this more possible.
If you’re a busy executive, you may need a drug rehab with options for shorter residential stay with ongoing drug therapy and aftercare sessions in the evenings.
If you’re an older drug user with mobility problems and cardiovascular disease, you’ll be better served by a residential drug rehab with an accessible layout and on site medical staff.
Perhaps you’ve tried many drug rehabs before and they haven’t worked out – if so, it’s essential to understand why treatment hasn’t been successful and what facilities can offer you something different.
In your addiction assessment, it’s helpful to give as much information as possible about your health, background and preferences for treatment
10. Your commitment to addiction recovery
There is also no substitute for your own commitment to treatment and recovery. Arriving in drug rehab with a willingness to take on board new ideas that you learn, as well as asking for help when you need it, can vastly improve your chances of achieving and sustaining recovery.
Don’t underestimate your own agency in determining your health and wellbeing going forward – even if you arrive in drug rehab feeling physically and mentally broken, after many years in active addiction, you can start your life over with the right support to change.
Sources: https://www.who.int/substance_abuse/information-sheet/en/  https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(18)30337-7/fulltext  https://www.who.int/substance_abuse/information-sheet/en/  https://www.gov.uk/government/publications/substance-misuse-treatment-for-adults-statistics-2018-to-2019/adult-substance-misuse-treatment-statistics-2018-to-2019-report  https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf  https://www.ukat.co.uk/is-addiction-a-disease/  https://www.ukat.co.uk/strengths-model/