Expert Insights
Although medications like buprenorphine and methadone are safe and effective at treating addiction and preventing overdose and death, regulatory hurdles have prevented these treatments from being widely utilized. A recent national study estimated that 87 percent of people with opioid use disorder never receive any medication treatment.
Those who do receive treatment often have to manage long-distance travel, inconvenient hours, stigma, and strict rules that can seem impossible to follow. Joan had lost hope that she would get the care she deserved.
She was able to get help at a neighborhood pharmacy because of a study we conducted in which pharmacists in Rhode Island got special training to directly provide patients with buprenorphine. That meant patients could walk in and ask to start treatment, and the pharmacist could initiate the process. The pharmacist did this in consultation with a physician, but the patient did not have to see the physician first. We wrote about this research, known as the MATPharm Study, this week in the New England Journal of Medicine.
We found that pharmacies offer a safe and accessible starting point for treatment and keep patients engaged better than is typical. Of 100 people who started buprenorphine treatment at a pharmacy, 58 stabilized and were randomly split into two groups. Twenty-eight of them continued to receive their addiction care at a pharmacy, while the other 30 had the usual follow-up care with a doctor or an opioid treatment program. One month later, 25 of the 28 patients in the pharmacy group were still proceeding with their assigned treatment. Only five of the 30 patients in the doctor-treatment group were doing so.
A third of the patients in our study identified as Black, Indigenous, or persons of color; almost half were homeless.~ Rita Milios
How Expensive is Drug Rehab in Boston?
Many factors can affect the cost of addiction treatment in Boston. These can include the type, the length of your stay, and the facility of your choice. In Massachusetts, the average cost of a residential stay in Boston was $56,725 per individual, with the average cost of outpatient being $8,386 in 2016.2
Are There Low-Cost and Free Drug Rehab Centers in Boston?
Many low-cost and free treatment centers are available in Boston. Most will even work with your insurance, whether it is private insurance or Medicaid, the federally and state-funded program that helps with healthcare costs for those with a low income.
Facilities funded by the state are treatment centers that use government money to help pay for care for those who need it but don’t have the income or insurance to pay.
If you do have insurance, using it to pay can greatly reduce the cost of care. According to the Affordable Care Act and the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008, health insurers and group health plans must cover mental health and substance use help.
Does Insurance Cover Rehab Center Costs?
Private Insurance
Every insurance provider is required by law to cover substance abuse and mental health services to some extent. Contact your provider to learn about the specific coverage they offer, which varies by company.
Medicaid
In Massachusetts, Medicaid and the Children’s Health Insurance Program (CHIP) are rolled into one program, called MassHealth. MassHealth members may be able to cover the cost of rehabilitation services through this government-funded option. Massachusetts residents must apply for benefits, and the provider must accept MassHealth as a method of payment.
Medicare
Massachusetts Medicare is a program funded by the government to provide coverage for Massachusetts residents who are 65 or older, have been on Social Security Disability Insurance for two years, or have end-stage renal disease or Lou Gehrig’s disease. Medicare covers the cost of addiction treatment services; however, some rehab facilities and detox centers in Boston don’t accept Medicare methods of payment, so always check before enrolling in care.
TRICARE
Massachusetts TRICARE (North region) is a program funded by the government to provide health insurance coverage for military personnel, veterans, and their families. TRICARE covers addiction services for these individuals.
How Do You Pay for Addiction Treatment in Boston?
If you find that free addiction treatment centers are full or you don’t have insurance, you still have options.
You can always seek out faith-based organizations, non-profits, and/or government-funded programs. You may also qualify for medical loans or scholarships to help pay.
Choose a Program That Offers Payment Plans
Choose a Program That Offers Payment Plans: Certain places may offer payment plans. Payment plans are an easy way to get the rehab you need without having to have a lot of money to pay for the costs of rehab upfront.
Apply for a Scholarship: A scholarship is a financial award that you can receive if you don’t have the financial means to pay yourself. Scholarships can pay for the full cost or help fill in any gaps in funding from your insurance.
Free and Sliding-Scale Options: A sliding scale fee is a type of payment method that many programs employ. This type of payment option involves a flexible fee schedule in which your payment would change based on your ability to pay.
How Does Boston Compare in Alcohol and Drug Use?
Like so many other major cities, Boston is facing the opioid epidemic head-on. In 2020, more than 2,000 Massachusetts residents died from an opioid overdose.1 As the capital and most populated city in Massachusetts, there are more than 140 drug rehab centers in Boston.2 With plenty of high-quality options for you to choose from, finding help and getting yourself on the road to recovery is within reach.
The total number of admissions into drug and alcohol rehab in Boston in 2017 was 14,780. Of these admissions, 74.2% were among cisgender males. Cisgender female admissions comprised 25.6%, and transgender admissions comprised 0.3%.1
At 56.8%, the majority of individuals admitted to clinics were white. Black people made up 21.1% of that population, and multiracial individuals who identify as “other” comprised 9.2% and 12.9%, respectively, of the total number of people admitted to Boston drug rehabs.1
The majority of admissions, or 56.9%, were due to heroin. Alcohol admissions were the next highest reason at 29.9%. Crack/cocaine and marijuana drug admissions were at 4.5% and 3.0%, respectively.1
In the greater Boston area, 18.3% of the admissions were due to intravenous (IV) drug use. In Massachusetts as a whole, the average age of drug admission for those who used opioids was 34 years old.
Alcohol and Drug Laws in Boston
9-1-1 Good Samaritan Law: In 2012, Massachusetts passed the 9-1-1 Good Samaritan law. It provides that anyone who calls 9-1-1 during an overdose emergency won’t be charged with possession of a controlled substance. This law was created to encourage more people to call emergency services during overdoses.13
Naloxone Standing Order: Massachusetts state law allows for an individual to obtain naloxone (Narcan) with the intention to administer it to another person in the event of an emergency overdose. Further, anyone can administer naloxone as emergency care for an opioid-related overdose without fear of legal repercussions.14
Marijuana Decriminalization: In 2016, Massachusetts legalized marijuana for recreational use by adults 21 years and older. Adults can legally possess up to one ounce of marijuana in public and up to 10 ounces in their own residences.15
Zero Tolerance Law: In Massachusetts, the legal BAC for drivers under 21 years of age is 0.02% instead of 0.08%. Violation of this law can result in up to three years of license suspension, 2.5 years in prison, up to $5,000 in fines, and a suspended license.16
Drug Classes: The state of Massachusetts has created five classes of controlled substances. Class A includes opioids. Class B includes cocaine. Class C includes some narcotics. Class D includes marijuana. Class E includes narcotics that contain additional substances. 17
Choosing the Right Level of Care
Several levels of care are available at drug rehab centers in Boston, based on your specific needs.
Medical Detox
A Detox usually occurs under medical supervision at a hospital or other treatment facility. It is the process of safely and comfortably removing drugs or alcohol from your system. Once detox is complete, you can transition to the next step.
Inpatient
Inpatient, also known as residential treatment, involves staying at the facility to receive round-the-clock supervised care. Getting cared for in this setting typically includes individual and group therapy, recreational therapy, nutritional counseling, and medication.
Partial Hospitalization Programs (PHPs)
Massachusetts residents who participate in a PHP live at home while receiving treatment services at a hospital. This often includes many of the same methods as inpatient care, but instead of staying at the facility, you return home.
Intensive Outpatient Programs (IOPs)
IOPs allow Boston residents to attend counseling sessions several days a week. However, they are allowed to spend the rest of their time at home, at work, or fulfilling other obligations.
Standard Outpatient
The least intensive option is standard outpatient. It involves just a couple of hours of treatment per week. This is best for highly motivated people with a strong support system.
Aftercare
Aftercare is for Boston residents who have completed a program. It is also referred to as relapse prevention. It includes ongoing support like 12-step groups, SMART recovery, and therapy.
Finding Specialized Drug Rehabs in Boston
Many types of drug and alcohol rehabs in Boston offer treatment based on varying principles and styles ranging from holistic to faith-based and luxury.
Holistic
Holistic programs use both conventional and alternative therapies. Some of the therapies offered in holistic rehab include expressive therapy, art therapy, acupuncture, osteopathic treatments, and spiritual and/or religious interventions.
Christian and Faith-Based
These use religion and spirituality as a central theme of the recovery process. The programs often incorporate Christian and faith-based teachings into the treatment model itself. These programs help encourage you to strengthen your faith in a higher power on your road to recovery.
Luxury
Luxury facilities feature upscale amenities, such as private bathrooms and bedrooms, individualized therapies, and alternative methods like yoga and acupuncture. Some also offer equine therapy and nutrition and fitness counseling.
Executive
These drug rehabs allow access to computers, phones, and sometimes private conference rooms so that you can still get your professional work done while working on your road to recovery.
Dual Diagnosis
A dual-diagnosis program works with individuals who have been diagnosed with both a substance use disorder as well as a mental illness, such as anxiety, depression, or bipolar disorder.
Types of Addiction Therapy Used in Boston Drug Rehabs
Cognitive Behavioral Therapy (CBT)
CBT focuses on helping patients identify their own problematic thought patterns and actions, and to increase their understanding of how these behaviors impact their substance use. CBT is based on the idea that psychological problems are often rooted in cognitive distortions or faulty ways of thinking.
Dialectical Behavior Therapy
Dialectical behavioral therapy is a form of psychotherapy intended to help people change problematic thoughts and behaviors by learning to manage and change negative emotions, rather than trying to escape from them.
Motivational Enhancement Therapy (MET)
MET is a form of therapy that helps individuals strengthen their internal motivation and create a plan for change. Individuals with SUDs are often ambivalent about changing their behaviors, even when they are aware of the damage caused by their addiction.
Contingency Management
Contingency management uses positive reinforcement to help build positive habits. This approach uses strategic rewards or incentives to encourage behaviors such as attending treatment sessions and engaging in recovery-focused activities.
Group
Group therapy can be highly beneficial to individuals in a drug or alcohol treatment program. Group counseling provides a safe environment in which patients can build their interpersonal communication skills and learn from others who have been in their situation.
Family
Family therapy is integral to many programs. Research shows that when combined with individual counseling, family therapy can help reduce stress, improve mental health conditions, and help prevent relapse.12
Should You Travel for Drug and Alcohol Rehab in Boston?
You may wonder whether you should travel to Boston for your addiction treatment. The city has a wide array of accredited drug rehab centers to fit your unique needs. To determine whether you should travel, you should consider whether you have the financial means to travel and how leaving your current environment would impact your alcohol or drug use.
For example, if you live in a more rural part of Massachusetts, then you may choose to travel to Boston for a wider range of treatment options.
Resources
- Fighting the Opioid Crisis | Mass.gov. (n.d.). Www.mass.gov.
- FindTreatment.gov. (n.d.). FindTreatment.gov.
- Geographic Sheets [Ebook]. Bureau of Substance Addiction Services. (2018).
- Drugabusestatistics.com. Average Cost of Drug Rehab [2022]: by Type, State & More. NCDAS.
- Di Lorenzo, R., Galliani, A., Ferri, P., Landi, G., & Guicciardi, A. (2014). A retrospective analysis focusing on a group of patients with dual diagnosis treated by both mental health and substance use services. Neuropsychiatric Disease And Treatment, 1479.
- Substance Abuse and Mental Health Services Administration. (2019). Key Substance Use and Mental Health Indicators in the United States: Results from 2019 National Surgery on Drug Use and Health.
- Quello, S., Brady, K., & Sonne, S. (2005). Mood Disorders and Substance Use Disorder: A Complex Comorbidity. Science &Amp; Practice Perspectives, 3(1), 13-21.
- Bushnell, G. A., Gaynes, B. N., Compton, S. N., Dusetzina, S. B., Olfson, M., & Stürmer, T. (2019). Incident Substance Use Disorder Following Anxiety Disorder in Privately Insured Youth. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 65(4), 536-542.
- Brady, K. T., Haynes, L. F., Hartwell, K. J., & Killeen, T. K. (2013). Substance use disorders and anxiety: a treatment challenge for social workers. Social Work in Public Health, 28(3-4), 407-423.
- VA.gov. Veterans Affairs. ptsd.va.gov. (2022).
- Stokes, P., Kalk, N., & Young, A. (2017). Bipolar disorder and addictions: The elephant in the room. British Journal of Psychiatry, 211(3), 132-134.
- Parmar, A., & Kaloiya, G. (2018). Comorbidity of Personality Disorder among Substance Use Disorder Patients: A Narrative Review. Indian Journal of Psychological Medicine, 40(6), 517-527.
- General law. (n.d.). Part I, Title XV, Chapter 94C, Section 34A. Retrieved November 16, 2022, from https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXV/Chapter94C/Section34A
- The Board of Registration in Pharmacy. (2018). Massachusetts Executive Office of Health and Human Services. https://www.mass.gov/doc/policy-2018-04-naloxone-dispensing-via-standing-order/download#
- Massachusetts law about recreational marijuana. (n.d.). Commonwealth of Massachusetts. Retrieved November 16, 2022, from https://www.mass.gov/info-details/massachusetts-law-about-recreational-marijuana#
- Altman & Altman LLP. (2018, July 17). Boston Criminal Lawyer Blog. https://www.bostoncriminallawyerblog.com/zero-tolerance-laws-for-underage-oui/#
- General law. (n.d.). Part I, Title XV, Chapter 94C, Section 31. Retrieved November 16, 2022, from https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXV/Chapter94C/Section31
