Are inpatient treatment centers a scam?

I’ve read numerous things saying that inpatient treatment centers are a very expensive scam. But I also know people who have gone to rehab and are still sober. What do you think? Is there a way to distinguish between good rehabs and scammy rehabs?


Just Curious

This is a good question, and — as with many things in recovery — there’s not a simple, straightforward answer. But I’ll do my best! If you’re asking if inpatient treatment (also known as rehab) is always necessary for a person to get sober, the answer is no. Many, many people get into recovery with the help of support groups like Alcoholics Anonymous (or SMART Recovery, Refuge Recovery, etc.), without ever setting foot inside a traditional treatment center. It is absolutely possible. There are also people who get sober without a support group, though I do think that approach can make the endeavor unnecessarily difficult.

It’s also true that inpatient rehabs can be extremely helpful for some folks. It was for me. I had made attempts at quitting drinking on my own and when those didn’t work, I tried a few 12-step meetings. Again and again, before, after, and occasionally during the meetings, I drank. Sometimes, I would leave meetings and still drink. I needed to be somewhere I couldn’t do that — I needed to be forcibly removed from alcohol. But what that really means is that I had the luxury of being forcibly removed from alcohol. Because, by and large, rehab is expensive as shit. The one I went to certainly is, and it’s more reasonable than most. And while health insurance is much better about covering mental health and addiction treatment as a result of the Affordable Care Act, there are still some limitations on what certain plans will cover — for example, an inpatient facility with more than 16 beds isn’t eligible for Medicaid reimbursement. (There is proposed legislation to change this.)

If rehab is going to cost a bazillion dollars and insurance companies don’t cover all of it, one would at least hope that it’s because you’re getting quality, 24/7 care. As you note in your letter, this is sometimes but not always the case.

The rehab industry is getting an increasingly bad name, often with good reason. There’s no universal accreditation or standard for rehabs, so there are a significant number of “treatment centers” that operate more like really nice spas than medical facilities. This also means there are no less than a kabillion rehabs in the United States alone, making it even harder to distinguish the quality from the scammy.

That said, here are two big red flags that indicate a treatment center is bullshitting you:

  • They claim to have a success rate statistic. If the rehab you’re considering says anything like “97% of patients are successful in their recovery after leaving Tranquility Falls” or whatever, they’re lying. That’s an impossible thing to know for a million reasons that I’ll save for another time because it’s long and ranty.
  • There are no licensed medical or mental health professionals on staff.

The main thing to understand about treatment centers is that even the best ones can only take you so far.

If I hadn’t had the privilege of going to an inpatient treatment center, would I still have gotten sober? I hope so. But the last day of my drinking ended in a real close call in the “staying alive” department, and me getting another shot at sobriety wasn’t a sure thing. I believe rehab saved my life.

But it saved my life because it allowed me to get sober. The sober part is what does all the real work — it’s where all the good, not-dying stuff comes from. For me, rehab was like really expensive, shiny training wheels. It allowed me to learn how to be a sober person and practice that for a couple of weeks before heading back into the real world. But kids do learn how to ride a bike without training wheels. It’s just a matter of getting back on the bike again and again, grimacing through the skinned knees and elbows until they get the balance and steering just right. Then, it’s just a matter of staying alert and pedaling forward.


Every other week I’ll answer one recovery/addiction related question posed by Anxy readers, based on my experience. This isn’t meant to diagnose or provide medical advice — that responsibility lies with physicians. The author is not a licensed medical professional.

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