Finding the Right Addiction Treatment Provider After an Assessment

Comparing providers after an assessment

With an assessment done by a doctor, counselor, or other professional, many people move on to choosing a treatment provider. According to NIAAA, the services programs offer can vary widely. The NIAAA Alcohol Treatment Navigator Toolkit describes a 3-step “Search-Ask-Choose” process for finding alcohol treatment, with worksheets for each step: a Choices Chart, a Notes Page, and 10 Questions to Ask Providers. The worksheets are written for alcohol treatment. If you’re finding the right addiction treatment for other substance use, you may find most of the questions useful, too.

Which level of care you need is a question for the professional who did your assessment. A medical professional can also help you figure out whether your plan should include withdrawal care. You can also read Do I Need Detox?

Call 911 if you’re having a medical emergency.

Notes to have ready before calling

Before you talk to providers, NIAAA’s Notes Page has you jot down notes on health insurance, past treatment history, and individual needs and preferences. Be specific, since these are what you’ll check each provider against.

• The name of your insurance plan, your member ID, and the phone number printed on your card
• Past treatment, with rough dates and a note on what helped and what didn’t
• Hours you can’t do appointments, such as a work shift that runs late or an afternoon school pickup
• Which relatives want to take part, and how much involvement the person in treatment is comfortable with
• Any care you already get, such as seeing a psychiatrist once a month or taking a medication every morning
• The language you’d want sessions in, if it isn’t English

Assessment and treatment plan questions

A good first topic is how the provider puts a treatment plan together. NIAAA’s Q&As for alcohol treatment programs say a comprehensive assessment is a long, structured interview done by a professional clinician. It should cover the person’s drinking, other substance use, mental health, physical health, family dynamics, employment, criminal justice involvement, and need for social services or other support. According to the same page, only a medical doctor can fully assess a person’s physical health and any medical conditions.

• Will you do a full assessment of your own, or can you use the one I already had?
• How will my assessment results be used to build a personalized treatment plan? How involved will I be in putting it together?
• Can you tell me about your treatment approach and the counseling techniques you use most often?
• Which levels of care do you have? If I need something you don’t provide, where would you refer me?
• What size are your groups and who runs them? How often would I meet individually with my primary counselor?
• Can you arrange for someone to prescribe a medication if it’s appropriate?

NIAAA suggests asking about the size of the groups and what formal training in group therapy the clinicians have. It also suggests meeting with a primary counselor at least weekly.

How the provider handles other health needs

According to NIAAA, as many as half of all people with alcohol use disorder also have another mental health issue, such as anxiety or depression. The 10 Questions worksheet includes a question on this: “How do you help people address other mental health or medical issues if needed?” A program may not have every resource onsite. But a good program should still be able to refer patients to other qualified providers and coordinate a full plan with therapists, medical doctors, and social service agencies, NIAAA says.

Whether doctors are available depends on the level of care. Per NIAAA, outpatient programs aren’t required to have doctors on staff but should be able to refer patients to local doctors. Hospital-based inpatient programs will have a medical team on staff. Residential programs based outside a hospital should have a medical doctor there on certain days or on call. If you already see a doctor or psychiatrist, ask whether and how the program would coordinate care with them. It may also help to ask your own doctor whether a program’s medical or mental health support fits your situation.

Family involvement, schedule, and access

Expectations differ from one program to the next, according to NIAAA. Ask each provider what it expects of patients and their families during treatment. The basic schedule is a good place to start. Find out how many sessions there are and how long each one runs, how many days a week they meet, and how many weeks or months treatment lasts in total. Some programs may also expect participants to get involved in a mutual-help group. Others may ask them to use a recovery support app on their smartphone.

NIAAA notes that the primary focus of treatment is the person in treatment. Even so, it says there should be some kind of counseling or program for the family as well, if they’re open to it. You’ll want to know what the family program includes and whether the person in treatment can decide which relatives take part.

• Are you accepting new patients? If we choose your program, how soon could treatment begin?
• Do you only schedule intake appointments on certain days or at certain times?
• Are any sessions held in the evening or on weekends?
• Are sessions available in my language, or with an interpreter?

If you’re on Medicaid, ask your plan whether it covers transportation to appointments. For example, Health First Colorado members who don’t have a way to get to a covered appointment may qualify for a free ride. Substance use disorder visits are among the services members may be able to get a ride to. Plan to schedule the ride at least 2 business days before the appointment.

Cost questions and written estimates

Treatment costs can vary widely, according to NIAAA’s What About Costs and Insurance? page. What you pay depends on the provider, the setting, the services offered, and your specific needs. For comparing prices when you’re finding the right addiction treatment, NIAAA’s advice is to look at options “apples to apples.” Individual doctors and therapists bill by the hour, or per office visit or therapy session. Treatment programs may instead charge by the day, week, or month, depending on the type of services. The most expensive option isn’t always the best, NIAAA adds, and neither is the cheapest.

• What does a typical course of treatment cost here, and how long does it usually last?
• Do you and all of the program’s providers accept my insurance?
• What gets billed separately? NIAAA gives copayments, medications, specialized tests, and family therapy as examples.

If you aren’t using insurance, the CMS page What is a good faith health insurance estimate? says your provider usually must give you a good faith estimate of expected charges if you request one or schedule services at least 3 business days in advance. You can ask before you schedule, and the provider must give it to you within 3 business days. Each estimate lists charges for a single provider or facility, so it might not include care from another provider. If you have questions about this, the No Surprises Help Desk is at 1-800-985-3059.

If you have insurance, call the number on your card or look over your schedule of benefits, as NIAAA suggests. From either one, you can learn how many inpatient days and outpatient sessions are covered, what copayments (if any) you’ll have, and whether you’re limited to in-network providers. According to HealthCare.gov, all Marketplace plans must cover substance use disorder treatment as an essential health benefit. The specific benefits you get will depend on your state and which plan you pick. You can also read Does Insurance Cover Substance Abuse Detox?

Relapse and support after treatment

It can feel early to ask about life after treatment. NIAAA recommends asking now anyway, so you have an idea of what to expect when it’s time to move on from treatment. Look for a program that treats relapse as a likely part of the recovery process, NIAAA says, and that would respond by offering more intensive care or other support. When someone completes treatment, the program should work with them on a discharge plan with recommendations for ongoing recovery support. A good program helps people move to the next level of care, such as from inpatient to outpatient. Some programs may also do periodic phone check-ins.

• If I drink or use again partway through, what changes in my plan?
• At what point do you begin the discharge plan with patients?
• If I need outpatient care after a residential stay, will you arrange it, or is that up to me?

Licenses and credentials

Checking qualifications can be a short part of each call. Online directories can be out of date and incomplete, so NIAAA suggests making sure a program’s license is valid. NIAAA also recommends asking if the program is accredited and about the qualifications of its counseling staff. There are questions for individual clinicians on the 10 Questions worksheet as well. The worksheet has you ask a therapist to briefly describe their background and credentials. For an addiction doctor, the question is whether the doctor is board certified in addiction medicine or addiction psychiatry.

A directory like Find a Detox Near Me can be a starting point for your list of providers. Then confirm license and staffing details with each provider. If a credential is unfamiliar, ask a medical professional what it means for your care.

A provider comparison table you can reuse

Fill in one column per provider as you make calls. NIAAA’s Choices Chart starts as a place to collect names and contact information for the providers you find in your search. After your calls, you fill in what you learned and see how the options compare on signs of quality.

After each call, NIAAA suggests writing down your overall impression along with the answers. You might mark the programs you felt most positive about with a checkmark or star, then add a few details to remind you why.

Red flags in unclear answers

One vague answer may simply mean the person you’re talking to needs to check with a colleague. Go ahead and ask again. If the answer is still unclear, note that in your table.

• You ask what a typical stay costs and hear “we’ll go over that after admission,” with no range and no estimate in writing.
• Nobody can say whether every provider in the program takes your insurance.
• Staff say “we don’t believe in medications” or that medications “just substitute one addiction for another.” NIAAA advises steering clear of programs that reject medication.
• They call patients drunks or addicts, or describe a confrontational, “tough love” approach.
• Someone who relapses would be discharged instead of offered more help.
• Every patient seems to get the same schedule and the same plan, whatever their assessment found.
• The call feels rushed, your questions get treated as dumb, or you’re just sent to the website. NIAAA says that’s useful information, too.
• Questions about discharge planning get “we’ll figure that out later.”

Making the choice

Step 3 of the NIAAA Navigator is choosing: comparing your options on signs of quality and picking the best fit for your situation. It can help to bring your filled-in table back to the professional who did the assessment and ask what they make of the differences. You can also visit our Resources page, and if cost is the main obstacle, see How to Find Free Detox Centers.

You can spread these calls out over whatever time you need and compare as many providers as you’d like.

Frequently asked questions

What should I ask an addiction treatment provider?

Start with NIAAA’s 10 Questions to Ask Providers worksheet. Its questions cover availability, costs and insurance, credentials, a full assessment and personalized plan, treatment approach, medication, support for other mental health and medical issues, what’s expected of patients and families, managing relapse, and recovery support after treatment. It’s available as a PDF download, and you can use it to capture each provider’s answers as you ask the questions.

Does a state license mean a program is accredited?

No. Every treatment program has to be licensed by the state it operates in, according to NIAAA. Because states vary in how rigorous their licensing requirements are, NIAAA generally recommends looking for a program that’s also accredited. About half of all U.S. treatment programs are accredited. The Joint Commission and CARF issue the two most common types of accreditation for addiction treatment programs. That said, NIAAA notes it’s possible to find a non-accredited program that offers higher-quality treatment. If you’re interested in one, see how it responds to your other questions.

Should a treatment program offer medication?

NIAAA suggests asking whether a program can arrange for someone to prescribe a medication to treat alcohol use disorder if it’s appropriate. It notes medications may not be needed, but says the option should at least be on the table. Whether a medication is right for you is a question for your doctor.

What if a provider I’d like to use doesn’t take my insurance?

NIAAA’s advice is to ask that provider for a cost estimate for a typical treatment episode and whether there’s a payment plan or sliding fee scale. If your financial resources are limited, NIAAA also suggests looking into Medicaid eligibility (in most states, Medicaid covers some form of addiction treatment), contacting your local or state health department, and looking for therapists or programs that offer payment assistance or a sliding fee. Veterans and people covered by veterans’ health benefits can search for nearby VA services with the VA Substance Use Disorder Program Locator.

Who decides what level of care I need?

You work that out with the clinician who does your assessment. NIAAA says a complete assessment will help determine the appropriate level of care. If you don’t have an assessment yet, NIAAA mentions paying for one session with a health professional who can do an assessment and recommend next steps, which may cost up to a few hundred dollars.