Expert: Peter L. - 12/11/2009

Question
Hi Peter,

Thanks in advance for any advice you can provide.  My 23 year old brother in-law has an addiction to heroin (possibly Oxycontin also).  He has been struggling with this addiction for probably about 5 years now.  He has successfully stopped using in the past, only to start again a few months later.  This last time, we discovered he is using again the day before a suprise party in his honor to celebrate 2 months of sobriety.  I don't believe an inpatient or 12 step program has ever been tried.  He does have a willingness to quit (as far as I can tell) and is a fundamentally good person.  He has a very loving family and a great girlfriend who puts up with all of his issues.  He has no money.  His family has no money.  I am willing to pay for him to enter a program but only if I can find something with a reasonable rate of success.  He is located in Janesville, WI but would be willing to travel.  I believe the "friends" he associates with in his hometown are a contributing factor to his continual relapses.  

Could you provide some information on the types of program that are most likely to succeed?  It is difficult to find unbiased information as most resources are trying to sell a particular product.  I'm willing to provide up to $20k and we could probably get some smaller contributions to a pay for an effective treatment program.  A faith based program may be particularly effective for this individual.  

Thanks for your help in this matter and thanks for all you to to help those with substance abuse issues.

Regards,

Justin

Answer
Hi Justin,

This is a revised answer -- additional content toward the end.

There are a number of treatment options for your brother-in-law.  Opiate dependence can be treated outpatient in many cases, but it is usually preceded by a short detox in a hospital or other facility that has the capacity for medical monitoring.  It is very difficult to treat opiate addiction in the long term without opioid replacement therapy, namely methadone or buprenorphrine.

If you look locally for a program, you may be better able to get a sense of how the program runs and possibly meet the staff.  Where I work, we occasionally have families who visit our site to get a feel for it.  Getting treatment locally means your brother-in-law will also have family resources for support.

It is difficult to connect treatment outcomes with the quality (or lack thereof) of a program.  The best program will fail with the least motivated client, and the worst program will generate success with a very motivated individual.  It is all about how much someone has "had it" and senses they are headed to even greater trouble.  Those "ready" will always get the most out of treatment.

I am not at my desk at this time, but will get some names of treatment programs in your area that ate state and federally funded programs.  I have no access to independent, private treatment programs with the exception of what you might find on the internet. Some of these are very expensive, and without being able to evaluate them first hand, it might be difficult to ascertain the quality of services they have to offer.  Substance abuse counselors should be certified and/or licensed.  Web sites might contain the backgrounds and credentials of the treatment staff.

It might be  helpful to start out with a substance abuse evaluation to determine level-of-care.  A local program should be able to do this.

Here are some programs in the Janesville area:

Alcocare, Inc./ New Dawn
608-754-2651

Mercy Options
608-756-5555

Rock Valley Addiction Services
608-741-4515

This information is from the National Directory of Drug and Alcohol Treatment Programs, and can be accessed for any area from the website www.oas.samhsa.gov/copies.cfm

Janesville is near Milwaukee and Madison, and there are probably many more options in those cities.

Certainly one of the most highly respected treatment programs is Hazelden, in St. Paul and Center City, MN.  http://www.hazelden.org/

I hope this helps get your brother the services he needs!

Best,
Peter