Rehab 101: How "The System" Really Works

One year ago today, my husband began his journey to sobriety.  This past year has been a new roller coaster of experiences and emotions that I certainly never thought I would be riding.  And this is where the more significant stumbling often occurs in our life...at those times when we're tossed into the unknown and forced into unfamiliar territory.

I started writing this post shortly after he was admitted for rehab because I was completely disgusted with the process of finding and securing help for my husband.  I never finished or posted it because I didn't want to seem ungrateful.  Or entitled.  Truth is, we got the help we needed.  It took some wrangling, some persistence, multiple phone calls and good connections with the right people.  But we got help.  I realize that our situation, although far from ideal, is better than many struggling with addiction. 

Most of us know that if you break your leg, you go to the emergency room and they'll fix you up.  How many of us know where to go to get help with addiction?

We certainly didn't know what to do, and it turns out there's no quick, easy answer.  At least not in this corner of semi-rural northern California.

Here's how it went for us.

Day 1:

1.  First, you have to hit rock bottom.  The disease of addiction is a funny thing.  It's something you can cover up, avoid or deny.  Until you hit rock bottom. Someone doesn't typically have one horrible night of binge drinking and become convinced they are an alcoholic.  It's a process.  A long process.  Unlike cancer that can identify itself early with a small, treatable tumor, you can't really diagnose addiction until you see a pattern and it begins to affect your relationships, your job, your financial situation, your memory, your health, or all of the above. But eventually it all culminates into the perfect storm and you bottom out and realize you need help.  This is the beginning.

2.  Google "Alcohol Rehab facility". Call the only local option and say you're ready to be admitted.  They tell you to call back tomorrow. 

Day 2:

3. Call back the next day, leave a voicemail and wait hours for a return call.

4.  Finally get a return phone call, talk about your situation with a counselor.  Mention that you are a veteran and they tell you to contact the VA.

5.  Call the VA.  Nobody answers.  Leave a message.


6.  Wait 2 hours and call the VA again.  Nobody answers.

7.  Call the national VA crisis line.  They refer you to the local VA clinic (that isn't answering your calls). No joke.

8.   Call the rehab facility again and ask if you can just work with them directly since you can't get a hold of anyone at the VA clinic.  They tell you to go the emergency room and ask the physician to refer you to rehab.  (Ummmm.  What?)

9.  Show up in person at the VA clinic as a walk-in and hang out until someone will see you.

10.  Someone finally speaks with you to let you know that the person who does intake/referrals for addiction is out of the office for the next two days.  And not one single soul in that whole place is able to do that function in his absence.

11.  Contemplate drinking.

12.  Call therapist.  Get an appointment that evening.  She tells you to get out of town for treatment.

Day 3:

13.  Next day.  Call new, out-of-town treatment facility.  They do a phone intake interview.

14.  Wait a few hours for them to call you back.

15.  Treatment facility calls back to let you know that your insurance coverage looks good, but it doesn't look like there is "enough" for you to be admitted for inpatient care.

16.  Seriously consider getting drunk to improve your chances of being admitted.

17.  Curse the system.  Repeatedly.

18.  Finally receive a call indicating that you have been approved for inpatient care and you can be admitted tomorrow (Hallelujah!).

Day 4:

19.  Travel 200 miles and admit yourself to a 28-day inpatient treatment program.

20.  Receive notice from your insurance company that you are approved for 7 days of inpatient care.

For us, the process felt way too long and cumbersome.  People have told me that we are lucky he got in so quickly.  But when you're critically ill and need help, anything less than lightening speed feels too slow.  It seems ludicrous to wait three days on pins and needles before anyone can help you.  Three days is 72 hours (4,320 minutes) of time to reconsider, talk yourself out of it, do something stupid, forget you wanted to get sober, walk away, give up on the system, get drunk or whatever.  We had a hard enough time navigating the system while we were both sober.  I can't imagine trying to do it when you're half drunk or high.  Or uninsured.

So when you see people strung out on the street and wonder why they don't just "clean up"....you can stop wondering.  They don't clean up because it's not easy.  Just getting your foot in the door is a challenge. And then your insurance company kicks you when you're down.  And then the real work of sobering up actually begins.  It's no picnic.

I share this not to offer an excuse for those that remain lost in their addiction, but as a tool of understanding to the sober bystanders.  And as a word of encouragement to those that might serve as an advocate for someone trying to get treatment.  It's a tricky system to navigate.  A team effort stands a much better chance of success.   

Addiction is complicated.  Messy. Hard.  On top of the insurance hassles, red tape and chaotic order of operations you must navigate, there is the need to prove you are sick enough to warrant care, the logistics of how you will arrange to skip work for 30+ days, who will take care of the kids, how to file for disability without a phone or Internet access, and then the wondering if it's really going to be worth it in the end.

Looking back a year later, I am glad we made it this far.  In hindsight our struggles seem petty. But the truth is, these inconveniences, road blocks and bureaucracy could have easily derailed my husband's path to sobriety. He could have changed his mind and decided it was too much of a hassle.  Or too expensive.  Or too inconvenient.  But he didn't.  He persevered with his mission to get sober.

And for that I am hugely grateful.

For those in need of inpatient addiction treatment, St. Helena Recovery Center in the Napa Valley accepts self-referrals and offers confidential intake interviews over the phone.