The nights before my brother’s rehab admission were long and sleepless.  My brother was still maintaining his addiction schedule with prime activity hours being between 5 pm and 7 am.  Every time the door open and shut for my brother’s frequent cigarette breaks, I would wonder if he was coming back or if he’d try to make a run for it.  Ultimately he stayed and I could only hope that this meant that maybe this time would be different.

The rehab facility, located on a ranch, looked like a peaceful environment.  The rural landscape and the 70 degree temperatures made me almost want to go for a pleasant stroll.  Then I looked to the residential dorms and thought about the people housed inside.  This was anything but a peaceful place for the residents.  I was sure about that.  So many of the recovery ranch residents had to be experiencing such tremendous discomfort and unhappiness even at that very moment.  The atmosphere was clearly designed to evoke a sense a peace, but it brought me none and I’m sure that my brother felt the same way.

We had talked about his upcoming trip to rehab.

“I’ll fake it until I make it,” my brother had said to me when we talked about the 12-step programming.

My brother and I were raised under strict religious conditions as children.  Neither of us believe in God or adhere to any types of spiritual rituals, so needless to say, the 12-step program has not held much appeal to either of us as an effective method of treatment.

The bottom line was that my brother had to go to rehab to avoid having a felony heroin possession charge on his record.  As a result of the Affordable Care Act, substance abuse treatment is now covered by health insurance unlike ever before…but not for us.  Insurance companies generally will not fund court mandated rehab, they will not fund rehab for someone who has had a recent unsuccessful treatment (like my brother), and they will not fund rehab if it is not considered a medically necessary treatment.  Because my brother had not used heroin for more than sixty days and had not taken suboxone for more than thirty, there would be no detox and hence the insurance companies did not consider inpatient treatment to be medically necessary.

I say all that to get to the point that out-of-pocket rehab, with no assistance from any type of insurance coverage, is a huge expense and the non-twelve step programs are often only available at an even more premium rate.  When it came down to it, it was either pay ~$30K for three months of treatment or triple that for a non-twelve step treatment program.  Seeing as how we were already borrowing the money, it just didn’t make sense to us to pay a ridiculous rate for a non-twelve step program.  Twelve-step or not, most rehabs have a success rate around 15% so I personally could care less about which program we throw away our money on.

“Try to get something out of it,” I said to my brother as I hugged him goodbye.  He smiled and I continue to hope.