Why Is Rehab So Intimidating?

The Psychiatry (Edgmont) journal stated in 2007 that shame and discrimination can motivate addicts to take extreme measures to hide their substance abuse disorder. Many addicts resist admitting to a problem because it implies they now have to do something about it, and for many, entering rehabilitation can be intimidating. Treatment professionals understand the potential intimidation, apprehension, embarrassment and even denial that a person might feel entering rehab, and every effort is made to make patients feel more comfortable. By gaining a better understanding of what makes rehab seem intimidating, however, prospective patients can help themselves feel more comfortable and confident about their rehab admissions.

Misinformed Addiction Stigma

Arguably the primary factor that makes rehab intimidating is stigma about addiction and treatment. The headline-hungry media sensationalizes stories about celebrity substance abuse and rehab, and films and television often characterize rehab in an unflattering light. Misinformed stigma portrays addiction as a sign of weakness and moral compromise, and a study published in the Journal of Social Work found that people who believe the stigmatizing stereotype are less likely to help addicts. Individuals can help defend against such ignorance by becoming better informed about addiction. As detailed by the American Society of Addiction Medicine (ASAM) in 2011, addiction involves significant genetic and biological issues, including the following:

  • Addiction is a disease of the brain reward system that involves changes to dopaminergic pathways, motivational hierarchies and neural transmissions
  • Desensitized neural receptors, reduced neurotransmitter production and physical dependency can cause physical and emotional pain when substances are withheld
  • Affected areas of the brain include the frontal cortex, white matter connections, the nucleus accumbens, basal forebrain, amygdala and related circuitry
  • Genetic factors make certain people more susceptible to the neurobiological dysfunctions and account for 50% of the likelihood that addictions will occur

During rehab, patients typically learn the neurobiology behind addiction, and it reveals stigma for the misinformed and damaging discrimination it is. Going into treatment, stigma might make rehab seem intimidating, but gaining a better perspective on the disease helps diminish any stigmatizing effects.

Fear of the Unknown

As with any new situation, a fear of the unknown can make rehab intimidating, especially for older adults with more established daily routines. What are the therapies like? How will the other patients be? Is rehab tough, boring, intense or difficult? Most patients quickly adapt to the positive, healthy and productive setting, but it can help to know what to expect when you enter. Therapists customize recovery plans for each patient based on his or her specific needs, but examples of potential treatments include the following:

  • Cognitive behavioral therapy (CBT) aimed at reshaping negative thought patterns that foster maladaptive responses and adverse behavior
  • Dialectical behavioral therapy (DBT) that adapts CBT principles to help patients balance personal self-acceptance and their need to change
  • Motivational interviewing (MI) using reflective listening and open-ended questions to guide patients toward finding their own motivations to change
  • The development of strong coping skills to manage anger and stress, resolve conflicts and avoid or neutralize substance-craving triggers
  • Integrated screenings, diagnosis and treatment for co-occurring mental health and personality disorders

Regarding the latter point, a study published in The American Journal of Psychiatry in 2005 stated that 72% of drug abusers have at least one co-occurring mental health disorder. The study also suggested that addiction and mental health disorders might share similar genetic vulnerabilities and be different expressions of related neurobiological issues. As the statistic might suggest, many addicts have some level of mental health dysfunction that can also make rehab seem more intimidating. This is particularly true for addicts who also suffer from social anxiety, major depression or avoidant personality disorder.

The Financial Cost of Rehab

For some addicts, the intimidating factor might be the potential cost. At the most fundamental level, it is important to note that an investment in treatment is typically more cost-effective than allowing the addiction to continue. This applies both to the cost of drugs and alcohol and the potential consequences that often arise from their abuse. However, it is equally important to know that financial support options are often available, including the following:

  • Every insurance policy on the Affordable Care Act (ACA) exchanges must offer benefits for addiction and mental health treatment
  • Many facilities accept Medicaid, Medicare, federal military insurance and state-financed health insurance
  • Most insurance policies must, by law, provide the same measure of benefits for addiction and mental health that they provide for physical health issues
  • Several rehab facilities offer financing and reduced treatment rates based on the patient’s ability to pay

The National Survey of Substance Abuse Treatment Services (N-SSATS) collects data on rehab centers across the country, and its 2013 report found that 62% of facilities utilized a sliding fee scale based on the patient’s personal finances. While upfront costs can be intimidating, most potential patients will be surprised at the support options available to them to make rehab more affordable.

Rehab and Treatment Information

If you want more information on rehab facilities, treatments and methods, our admissions coordinators can speak with you any time of day or night. If you have health insurance, we can even check the policy for rehab benefits. Our helpline is toll-free so please give us a call now.