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I think stuff like methadone and/or suboxone works, but rehab is sort of a scam. Maybe because I live in what's termed the "rehab capital of the world" but it has a piss-poor success rate and it just seems like a way to extract as much money as possible from insurance companies by unscrupulous companies.
and sure, fuck insurance companies, but we're talking about real people here. people from all across the country come here, end up meeting a bunch of other addicts, get a bunch of connections to find drugs and end up addicted here in south florida. it's a very common story
I have a friend of mine who ended up working as a therapist in a rehab, had a master's degree in psychology and all that - he had gone to rehab over 10 times and was still struggling. He relapsed and lost his job last year.
My 2¢ as someone who has been volunteering to run some outpatient stuff in a large not for profit American HMO for a decade.
These days, inpatient recovery (what most people consider classic “rehab”) often deals with people who have the most severe disease. And with any disease, you typically have the poorest treatment outcomes when you’re dealing with the most severe cases. It’s not the treatment that’s the problem - it’s the disease progression and its level of severity.
These days the research has shown that the standard of care should be to start with outpatient care, then to dial up the level of care if the patient needs something more intensive. The hospital that I’ve been volunteering in has a spectrum of treatment options. Support groups, weekly outpatient stuff, once-a-night outpatient, all-day outpatient (IOP), all the way up to full on inpatient care and or living in an SLE.