The Cost of Drug and Alcohol Rehab
If you’re on a medical aid or hospital plan, they’ll cover the bulk of the costs of drug and alcohol rehab primary care costs.
The Cost of Active Addiction Vs. The Cost of Drug and Alcohol Rehab
The size of the addiction problem in South Africa is immense. I’d say that it’s the pandemic of our time, yet it’s so misunderstood and access to quality care is poor. The truth is that money spent on going to rehab and the time invested away from your life while in treatment is a great investment. It’ll cost less than continuing to use drugs or alcohol.
Money aside, active addiction isn’t worth your family and your health. Treatment gives you the chance to take responsibility for restoring your life.
Recovery delivers everything that drugs and alcohol promised.
The Human Cost of Active Addiction
We know the prevalence of alcohol and drug abuse and mental illness imposes a substantial financial burden on those affected and on society. However, it’s difficult to place a value upon intangible costs.
- How do we value the average welfare loss of a household, the pain and suffering of families and victims of crime?
- What’s the economic value assigned to loss of life, injury, reduced quality of life, and early death?
- What about the loss of taxation income from a non-functioning workforce and an increased burden on the public healthcare and law enforcement system?
- How well are the children of these households faring?
- Are they engaging in education and sports well?
- Will their current quality of life mean an inability to break their family’s cycle and end in the further perpetuation of addiction and toxic dysfunction?
The Link Between AUD/SUD and Mental Health
Having both a substance abuse problem and a mental health issue such as depression, bipolar disorder, or anxiety, is called a co-occurring disorder or dual diagnosis. Dealing with substance abuse, alcoholism, or drug addiction is never easy, and it becomes more difficult when patients are also struggling with mental health problems.
In co-occurring disorders, both the mental health issue and the drug or alcohol addiction have their own unique symptoms that may get in the way of `people’s ability to function at work or school, maintain a stable home life, handle life’s difficulties, and relate to others.
To make the situation more complicated, the co-occurring disorders also affect each other. When a mental health problem goes untreated, the substance abuse problem usually gets worse. And when alcohol or drug abuse increases, mental health problems usually worsen too.
Co-occurring substance abuse problems and mental health issues are more common than many people realize. According to reports published in the Journal of the American Medical Association:
- Roughly 50% of individuals with severe mental disorders are affected by substance abuse.
- 37% of alcohol abusers and 53% of drug abusers also have at least one serious mental illness.
- Of all people diagnosed as mentally ill, 29% abuse alcohol or drugs.
AUD & SUD problems and mental health issues don’t get better when they’re ignored, they are likely to worsen.
What Comes First: Substance Abuse or the Mental Health Problem?
Substance abuse and mental health disorders such as depression and anxiety are closely linked, although one doesn’t necessarily directly cause the other. Abusing substances such as marijuana or methamphetamine can cause prolonged psychotic reactions, while alcohol can make depression and anxiety symptoms worse.
Alcohol and drugs are often used to self-medicate the symptoms of mental health problems. People often abuse alcohol or drugs to ease the symptoms of an undiagnosed mental disorder, to cope with difficult emotions, or to temporarily change their mood.
Self-medicating with drugs or alcohol may provide temporary relief and be someone’s only option to cope. Unfortunately, in the long run, the symptoms they were trying to relieve are made worse by the alcohol and/or drugs.
Alcohol and drug abuse can increase the underlying risk for mental disorders. Since mental health problems are caused by a complex interplay of genetics, the environment, and other factors, it’s difficult to say if abusing substances ever directly causes them.
However, if someone is at risk for a mental health issue, abusing alcohol or drugs may push them over the edge. For example, there is some evidence that those who abuse opioid painkillers are at greater risk for depression and heavy cannabis use has been linked to an increased risk for schizophrenia.
Alcohol and drug abuse can make symptoms of a mental health problem worse. Substance abuse may sharply increase symptoms of mental illness or even trigger new symptoms. Abuse of alcohol or drugs can also interact with medications such as antidepressants, anxiety medications, and mood stabilizers, making them less effective at managing symptoms and delaying recovery.
The Cost of Not Seeking Treatment
Factors Affecting the Cost of Drug Rehab
The cost of drug rehab can vary greatly depending on several factors. These factors include the type of treatment, the length of treatment, and the location of the facility. Let’s take a closer look at each of these factors.
What we do know is that most people who remain in treatment and stop using drugs show a reduction in criminal activities and improved mental, family, social and career performance. This is according to research by NIDA (According to the National Institute on Drug Abuse).
Type of Treatment
The type of treatment chosen can have a significant impact on the cost of drug rehab. Inpatient treatment, where the individual stays at a facility for a set period of time, is typically more expensive than outpatient treatment, where the individual attends therapy sessions while living at home. Additionally, the level of care provided, such as medical detox or specialized therapy, can also affect the cost.
Length of Treatment
The length of treatment can also impact the cost of drug rehab. The longer an individual stays in treatment, the higher the cost will be. However, it is important to note that longer treatment periods often result in better outcomes and a lower risk of relapse.
Location of the Facility
The location of the facility can also play a role in the cost of drug rehab. Treatment centres in urban areas or popular tourist destinations may have higher costs due to the demand for their services. On the other hand, facilities in more rural areas may have lower costs.
Different Types of Drug Rehab
There are several types of drug rehab programs available, each with its own unique therapy costs. It is important to understand the differences between these programs to determine which one is the best fit for you or your loved one.
Inpatient Treatment
Inpatient treatment, also known as residential treatment, involves staying at a facility for a set period of time. This type of treatment provides 24/7 care and support, making it the most intensive and expensive option. Inpatient treatment is typically recommended for individuals with severe addiction or those who have relapsed multiple times.
Outpatient Treatment
Outpatient treatment involves attending therapy sessions while living at home. This type of treatment is less expensive than inpatient treatment and allows individuals to continue working or attending school while receiving treatment. Outpatient treatment is often recommended for individuals with less severe addiction or those who have completed inpatient treatment.
Partial Hospitalization Programs (PHP)
Partial hospitalization programs (PHP) are a middle ground between inpatient and outpatient treatment. Individuals attend therapy sessions during the day and return home in the evenings. This type of treatment is often recommended for individuals who have completed inpatient treatment but still require a high level of care.
Intensive Outpatient Programs (IOP)
Intensive outpatient programs (IOP) are similar to PHPs, but with a lower level of care. Individuals attend therapy sessions a few times a week and are able to continue living at home. This type of treatment is often recommended for individuals who have completed inpatient treatment and are transitioning back to their daily lives.
Additional Drug Rehab Treatment Costs
In addition to the cost of the treatment program itself, there may be additional costs to consider. These costs can include medication, transportation, and aftercare services. It is important to discuss these potential costs with the treatment facility beforehand to ensure that there are no surprises.
Paying for Drug Rehab
Paying for drug rehab can be a daunting task, but there are options available to help cover the costs. Some individuals may have insurance coverage that includes addiction treatment. It is important to check with your insurance provider to see what is covered. Additionally, many treatment facilities offer payment plans or financial assistance for those who cannot afford the full cost upfront.
The Importance of Understanding the Costs of Drug Rehab
Understanding the costs of drug rehab is crucial for individuals seeking treatment. It allows them to plan and budget for the expenses and avoid any unexpected costs. It also helps individuals make informed decisions about which type of treatment is the best fit for their needs and budget.
The Size of The Problem and Personal Costs
Numbers have a way of focusing our attention and sobering the mind.
| South Africa – Health & Social Issues | Statistics or Facts |
|---|---|
| Patients in trauma units testing positive for alcohol | Between 22% and 57% |
| Mortality cases testing positive for alcohol | Between 40% and 67% |
| General hospital admissions testing positive for alcohol | 30% |
| Violence-related injuries linked to alcohol | 73% |
| Motor vehicle-related injuries induced by alcohol | 46% |
| Drownings related to alcohol | 40% |
| FASD (Fetal Alcohol Spectrum Disorder) rate | An average of 111 children per 1,000 – 14 times higher than the global average |
| People living with HIV | Highest in the world at 7.5 million |
| Gender-based violence | Five times the global average |
| Children in child-only households | 55,000 |
| Malnourished children and stunted growth | Gauteng (34.2%)‚ Free State (33.5%) and KwaZulu-Natal (28.5%) Children who were stunted. The North West (12.6%) and Western Cape (11.9%) had the highest percentage of children who were underweight. |
| Daily rape incidents | 115 every day, one of the highest in the world. South Africa has been named the “Rape Capital of the World” by Interpol, even surpassing some countries at war. |
The above figures are all caused, contributed to, or exacerbated by AUD/SUD (Alcohol Use Disorder/Substance Use Disorder). They show that addiction is not a major public health concern, but the pandemic of our time. Yet AUD/SUD and their impact are poorly understood, and access to treatment is limited.
The COVID-19 pandemic has claimed 102,595 deaths (WHO: World Health Organisation) on 4 June 2023. We shut down our worlds for Covid-19. Surely the South African people deserve an appropriate response to these mental health issues? How else can we move our country forward?
What Does the Problem Cost Us?
The burden of disease attributable to substance/alcohol misuse in South Africa is significant. The economic, social and health costs associated with alcohol and drug-related harms are important measures with which to inform strategies around treatment, management policies and laws.
Estimates fall into two categories: tangible (health and crime expenditures, in which resources are allocated to address alcohol-related harms; labour and productivity costs, in which the effect of alcohol results in reduced economic output and production) and intangible (non-financial welfare costs, such as pain, suffering and loss of life or of ‘quality of life’, which do not have a monetary value).
Another important distinction is between costs borne by drinkers themselves and those borne by the government or society at large. These complexities make it difficult to not estimate the true costs to the SA economy and our people.
In 2003 conservative tangible estimates were R8.7 billion, or 1% of the GDP and an estimated R17 billion was allocated by national and provincial government for expenditures related to addressing alcohol-related harms.
The latest figures we have from 2009, estimate the tangible cost to the SA economy of harmful alcohol use at 1.6% of the GDP, or 37.9 billion. With intangible costs included this increases to 10-12% of the 2009 GDP.
These costs are related to harmful alcohol use alone, they do not cover legal and illegal drug use and abuse. The cost of drug and alcohol rehab is worth every cent.
Health Care Providers
The enormity of the problem coupled with SA’s overstressed and under-resourced healthcare system has resulted in dedicated professionals having fought valiantly to stem the tide, and provide emergency services and a small proportion of therapeutic care but had a marginal impact in bringing tangible long-term solutions.
Hospitals and the medical fraternity are hard-pressed to cope with the day-to-day treatment of their communities.
Substance abuse patients historically are difficult to treat, require long-term care and supervision and are characterised by anti-social behaviours, a marked disinterest in their own welfare and a high incidence of relapse. As such, traditional healthcare institutions are unprepared and understandably reluctant, to deal with the problem.
The Cost of Drug and Alcohol Rehab Versus Benefits
Despite advances in treatment and technology, successfully treating those addicted to alcohol and drugs and helping them maintain abstinence remains a challenge. Cost-benefit ratios for addiction treatment in South Africa don’t exist.
As we can see above, the human costs are difficult to measure. So tangible data is monetary.
Even without considering the direct value to clients of improved health and quality of life, allocating money to substance abuse treatment may be a wise investment, whether taxpayer Rands, medical aid funds, or private funding. Due to the lack of South African data, we’ll use American figures to help clarify this.
American studies have found that substance abuse treatment more than “pays for itself”. There’s a greater than 7:1 ratio of benefits to costs. These benefits were primarily because of reduced costs of crime and increased employment earnings. For every $1 spent on substance abuse treatment, $4 is saved in health care costs and $7 is saved in law enforcement costs. Addiction treatment not only saves lives – but it could also save billions of ZAR as well.
Substance/alcohol misuse (e.g. binge drinking) and SUD/AUD (addictions) have a direct and negative effect on millions of South Africans every year. The research shows that:
- The problems caused by substance misuse are not limited to substance use disorders but include many other possible health and safety problems that can result from substance misuse even in the absence of a disorder.
- Substance use has complex biological and social determinants, and substance use disorders are medical conditions involving disruption of key brain circuits.
- Prevention programs and policies that are based on sound evidence-based principles have been shown to reduce substance misuse and related harms significantly.
- Evidence-based behavioural and medication-assisted treatments (MAT) applied using a chronic-illness-management approach have been shown to facilitate recovery from substance use disorders, prevent relapse, and improve other outcomes, such as reducing criminal behaviour and the spread of infectious diseases.
- A chronic illness management approach may be needed to treat the most severe substance use disorders.
- Access to recovery support services can help former substance users achieve and sustain long-term wellness, and
- Embedding prevention, treatment, and recovery services into the larger healthcare system will increase access to care, improve the quality of services, and produce improved outcomes for countless South Africans.
| Research Findings | Implications |
|---|---|
| Problems extend beyond substance use disorders | Substance misuse can lead to a variety of health and safety issues, even without the presence of a disorder. |
| Complex biological and social determinants | Substance use disorders are medical conditions that disrupt key brain circuits. |
| Efficacy of evidence-based prevention programs and policies | Programs and policies grounded in evidence-based principles have demonstrated significant reductions in substance misuse and related harms. |
| Benefits of evidence-based treatments (Behavioural and MAT) | Utilising a chronic-illness-management approach with evidence-based behavioural and medication-assisted treatments can facilitate recovery, prevent relapse, and improve other outcomes like reducing criminal behaviour and the spread of infectious diseases. |
| Necessity of a chronic-illness-management approach for severe disorders | For the most severe substance use disorders, a chronic illness management approach may be essential. |
| Importance of access to recovery support services | Providing access to recovery support services can assist former substance users in achieving and sustaining long-term wellness. |
In a cost-cutting environment, public funding for substance abuse treatment competes more broadly with other uses of limited societal resources for improving population health. Private funding competes with shareholders’ profits – medical aids will likely do what they can to reduce benefits.
Given the stigma associated with substance abuse and perhaps an underlying scepticism about the value of rehabilitation, financing for substance abuse treatment may not be readily provided in the current policy climate.
Pressure, therefore, exists for advocates to demonstrate that the benefits of substance abuse treatment can be explained not only in human terms but also in monetary terms. Policymakers are generally more inclined to support treatment programs if they “pay for themselves” through reductions in other types of costs, e.g., health care, criminal justice costs, etc.
The literature in this area has consistently suggested that substance abuse treatment is associated with net benefits.
Traditional USA health services research on these topics has focused on the effectiveness of treatments and access to treatment. In recent years, however, there has been a greater focus on assessing the societal impact of addiction and substance abuse treatment.
A substantial body of empirical evidence suggests that in addition to the cost of substance abuse treatment itself, drug and alcohol abuse are associated with increases in a wide range of costs. These include costs associated with crime and the criminal justice system, medical care, especially hospital and emergency room admissions, infectious diseases such as HIV/AIDS, hepatitis, and tuberculosis; pre and postnatal care; mental disorders; and government social programs, including unemployment benefits, welfare payments, and disability benefits.
We know that the effects on unemployment and impaired work productivity is worse for substance abuse than alcohol abuse.
| Aspect | Cost |
|---|---|
| Alcohol Abuse | The combined tangible and intangible costs of alcohol harm were estimated at 10 – 12% of the 2009 GDP.
Tangible financial costs alone reached R37.9 billion, or 1.6% of the 2009 GDP. Nearly 60% of all murders and 30% of all rapes occur under alcohol’s influence. One in four South African children resides with an alcohol-abusing parent. Individuals with alcohol issues often face higher risks of health problems like cancer, liver disease, and heart disease, as well as death by overdose or suicide. |
| Drug Abuse | In South Africa, drug abuse imposes a high cost on health, families, friends, and society.
Financial burdens can be overwhelming, leading addicts to engage in criminal activities for funding. The human cost includes job loss, homelessness, and broken relationships. Illicit drugs are pricey, often necessitating criminal acts like robbery or prostitution for purchase. |
| Rehabilitation | Approx. 21-day inpatient cost is R51,000 (medical aids pay around R30,000 or more depending on your scheme). Outpatient costs are around R18,000. |
Conclusion
Drug addiction can have a significant financial impact on individuals and their families. Seeking treatment through drug rehab can help individuals overcome addiction and avoid the long-term costs associated with it. While the cost of drug rehab may seem high, it is important to understand the different types of treatment and the factors that can affect the cost. With the right knowledge and resources, individuals can find a treatment program that fits their needs and budget, and ultimately lead them to a healthier and happier life.