Residential alcohol treatment facilities: please hope us pick
November 10, 2018 11:17 PM   Subscribe

My wife is planning on entering a residential program for alcohol recovery in January. It turns out that finding the right facility is a nontrivial task. We found two locations that may work; are you familiar with The Haven at Pismo or Chapters Capistrano? Can you give us other recommendations or general advice? More info is inside.

Quality in the inpatient addiction seems to be pretty hard to assess and verify. Stories like this one make it hard to trust who we're working with, and online reviews haven't seemed to be helpful. Do you have particular advice you can share?

My wife has a somewhat complicated medical situation which has lead us to seek lots of doctors for a while now. It turns out that some things are more connected to each other than first thought. So, somewhat-to-fairly traumatic childhood (with a family history of alcoholism and abuse) led to intense insomnia (since she was five), which she began self-medicating with alcohol in her mid-twenties, which may have helped contribute to her fibromyalgia and chronic pain. It's a lot of things coming to a head for her this year. We finally found a highly recommended sleep psychologist, who told her that she would not work with her until she attended an inpatient rehabilitation program and stopped drinking entirely.

My wife has been uncomfortable about her drinking, which has not yet become a work or social issue, and is willing and actually excited to stop. It's very important to her that she does not wind up following the much darker paths of her relatives. It's vital, though, that she learns to sleep, and to do so without the drinks. If she keeps getting 3-4 hours of sleep a night, and crashing for 12+ hours on some days, she will not succeed in recovery. So we need a program that will help her break down the mental blocks that force her to stay awake, while also giving up alcohol for good.

The two listed above the jump have stood out to us after about three weeks of looking. They tick a lot of boxes, but it is hard to find a lot of reviews. It's also hard to know how their programs will really accommodate her needs; we know that they are selling us, which isn't bad, just sometimes a little disappointing.

Some criteria we're looking for:
  • Expertise in alcohol. My wife drinks and uses CBD oils, but does not use other substances.
  • Secular, non-12 Step options. She's an atheist and deeply uncomfortable with accepting a 'higher power', even one that is 'humanism' or otherwise spiritually. She feels strongly that her experiences with her mother in AA will not help her succeed her.
  • Strong psychological focus. My wife's insomnia predates and led to her alcoholism, not the other way around. We need them both treated.
  • Qualified medical staff. Not everyone needs to be (or could be) an MD, but we would rather have something fancy and professional than homespun. There are family history and class feelings here, but between us and insurance we can afford very good, if not obscenely expensive.
  • A healing environment. She has never had the opportunity to work on herself like this, so it would be nice if this was also, like, a yoga and massage kind of environment. Oceans are a particularly good thing.
  • We are West Coast dwellers, and would prefer to find somewhere west. We have not found anything we like in BC, WA, ID, or OR; we are planning on looking at MT and CO as well. Thank you so much for reading and chiming in! If there are a lot of important points I made, I will make a sockpuppet account to respond, so feel free to ask for any vital information and I'll try not to threadsit. We are ready to start a new chapter in our lives, but we need some guidance!
posted by anonymous to Health & Fitness (5 answers total) 1 user marked this as a favorite
I don't know about the cost, but I know that Promises was a place my family was looking at for a struggling family member in an extremely similar situation, but they (with major input of the person who needed the help) ultimately decided on a Hazelden location.

The family member in question had been in and out of three other inpatient rehab facilities over the course of a few years. Hazelden was the one that finally worked. However, by the time the family member went to Hazelden, there had been some severe interpersonal and career-impacting problems related to alcohol use.
posted by erst at 12:31 AM on November 11, 2018

Please be advised that Hazelden is most definitely 12-step; I believe it was the original 12-step inpatient rehab. I think they absolutely require not only 12-step meeting attendance, but that patients profess loyalty to the ideology. If your wife can't relate to the 12-step belief system (which is basically salvation theology), then Hazelden would not be a good fit for her. Promises is not 12-step, and promises "evidence-based" treatment. Here is a link to a list of some other non-12-step rehabs. Best of luck to you and your wife.
posted by RRgal at 5:48 AM on November 11, 2018

SMART recovery may be a good key word, it's the peer group approach that doesn't emphasize a spiritual component. Asking if it's an option instead of 12 step participation can give you some insight.

Though, 12 step real value is in community and shared experiecinces. The core spiritual belief component varies greatly between members. I have a low threshold for this stuff due to some PTSD with spiritual issues, and it was annoying but ultimately tolerable for me. The key is more not being in control of the addiction and looking for guidance elsewhere. If that's a therapist, that's perfectly fine. If it's a small component of a program, you shouldn't nessisarily disqualify it.

Any program where 12 step plays a significant role, avoid. 12 step is not an evidenced based practice.
posted by AlexiaSky at 6:07 AM on November 11, 2018

IANAD, but I work in the drug and alcohol treatment field. Couple thoughts -

- I looked at both the links you provided. Specifically, I was looking for the qualifications of the staff (MD, licensed clinical staff, etc.) . They both tick the necessary boxes.

- Because her primary issue is alcohol, you should expect the staff to recommend Medication Assisted Treatment (MAT.) This includes naltrexone (daily pill) and Vivitrol (monthly shot.) . Many people reject MAT because they think it substitutes one drug for another. This is not true. In fact, it improves the chances of recovery from something like 15% to 60+%. Read up on MAT for alcohol before she goes and ASK FOR IT. If they don't offer MAT, find another facility.

- About 12 step, the general belief in the field is that what makes AA work is the social support, not the focus on God. It is a place to develop relationships with people who will hold you accountable in a non-judgmental setting. Most 12-step based programs will offer non-religious social support programs. Focus on those.
posted by eleslie at 6:08 AM on November 11, 2018 [3 favorites]

Another medication that may be effective is baclofen. It's been studied in France and has been successful. Olivier Ameisen wrote a best-selling book about its effectiveness in his case. In the US it can't be prescribed specifically for alcoholism but it's FDA-approved as a muscle relaxant and can be legally prescribed by a medical professional. As with everything, YMMV.
posted by bendy at 4:44 PM on November 11, 2018

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