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Is it Better to Go to a Private Alcohol Detox?

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Many factors go into making an informed decision as to what type of alcohol detox treatment best fits your unique set of circumstances, including the extent of your alcohol use, your history of withdrawal and detox, your risk of withdrawal delirium, your insurance coverage, and financial situation. Choosing a private alcohol detox program has many advantages, including confidentiality and privacy and upscale amenities and features.

In this article:

Private Alcohol Detox vs. Public Detox Centers

Choosing a private alcohol detox center or public detox center has advantages and disadvantages that you should consider.

Funding Sources

How a treatment facility is funded plays a role in how the facility is run and maintained and which services are distributed. Public substance use disorder treatment centers, for example, are changing as their funding sources, like Medicaid, change too.1 Some evidence suggests that publicly funded substance use disorder treatment centers lack technical proficiency and are also less responsive to making and integrating changes compared to their privately funded counterparts.1

However, although it appears that private agencies have some leverage over their public counterparts, the reality is that substance use treatment facilities across the board receive little assistance in the form of grants or resources from federal or state agencies, which creates a barrier to instituting changes.1 Because substance use is cast as a public health problem, a majority of funding for public treatment facilities comes from local, state, and federal sources.2

Benefits of Paying for Private Alcohol Detox

Now that you know where funding typically comes from, you can better understand how this may impact your financial contributions to your treatment (i.e., cash-pay, private insurance). Private pay cost ranges from modest to expensive, but it also provides you with some major advantages:1,3,4

  • More control over your treatment
  • Same-day admission, if not shortly thereafter
  • Some provide transportation to bring you to the facility
  • Different amenities (nutritional IV therapy, hydrotherapy, dry sauna detox, prolotherapy and naturopathic detoxification, swimming, hiking, yoga)
  • Detoxification and treatment are at the same location
  • Fewer total number of patients are admitted, so you can get more personalized care

Insurance

Under the ACA, 1.6 Americans with substance use disorders now have access to insurance because of the Medicaid expansion.4 With the expansion, adult children up to the age of 26 years old could remain on their parents’ insurance.5

In 2013, only 7% of those 12 and older with a substance use disorder were insured and receiving treatment from specialty treatment providers.6 This idea of insurance cannot only predict which facility you can go to, but it can also restrict the length of stay at a residential facility.

For example, if you have state-funded insurance, such as Medi-Cal or Medicaid in California, you will most likely be referred to a public alcohol detox center, which accepts government insurance. This facility will provide you with the care you need to withdraw from alcohol under medical supervision but it may not have the upscale facilities or exclusive feel of a private alcohol detox.

Because public facilities are impacted more significantly than private facilities, this reality can also be felt in the way in which services are delivered, resulting from you having state-funded insurance. Public facilities have some inherent added barriers due to how inundated they are, including:6

  • Although some clients are readily accepted into a detoxification program, they then are having to be waitlisted to get into the treatment part of the recovery process.
  • Care is not as personalized (i.e., “no extras”).
  • Because of the increase in the number of clients being served, treatment focuses on the group more so than the individual.
  • There are fewer accommodations.
  • Fewer staff are available.
  • Patients may share rooms with 4-6 other people.
  • Because of budget restraints, family therapy may not be offered.
  • Level of commitment varies due to circumstance (e.g., many clients are court-ordered).

Pros and Cons of Entering a Private Alcohol Detox Program versus Public

Choosing whether to go to a publicly or privately funded alcohol detox center and reviewing a pros and cons list is no different than when making other big life decisions. The list will help you make the best decision you can for yourself or a loved one. Generally speaking, whether it is a private or public detoxification center, the care is the same as any other facility, which includes step meetings and counseling.1,4,6

Once accepted into an alcohol detox program, it has three goals:7

  • To help you safely withdraw from alcohol and help you get all substances out of your system
  • To help you withdraw in a humane manner that preserves your dignity
  • To prepare you for ongoing treatment of your alcohol use disorder

Public Alcohol Detox Pros and Cons

Pros:8,9

  • Cost: It is cheaper than private detox—sometimes even free.
  • Quality of care is generally quite good, and staff have deep knowledge and experience in the fields of addiction and recovery.

Cons:8,9

  • Waitlists: Public resources are inundated, so often waitlists can be months long, which, depending on the severity of your circumstance, could exacerbate symptoms or put you at further risk.
  • Limited personal care: Often, because of minimal funding and limited physical space, this, in turn, can result in programs discharging clients sooner than anticipated to fit the need to get more people admitted and treated. Of course, then, this also means some are discharged sooner than is necessary.
  • Dated techniques: Because of the intimate relationship between state-funded and programmatic existence, this also means that these facilities are only permitted to provide state-approved treatment methodologies. Inherently, this is not bad, but it can take longer for a new treatment to become state-approved.

Private Alcohol Detox Pros and Cons

Pros:8,9

  • Quality of care: You will get the best care you are paying for.
  • Quality of comfort: Private rehab can likely afford perks other rehabs could not.
  • Treatment methods: In these settings, facilities are permitted to offer any treatments that they find are most effective; therefore, treatment methods are broad.

Cons: 8,9

  • Cost: Costs of operations are passed onto you, the consumer, since the facility is to be burdened with all the cost; although this sounds daunting, payment options are available.

Is Private Alcohol Detox or Public More Effective?

It is generally accepted that private alcohol detox facilities are more effective than public, state-funded rehabilitation centers. However, ultimately, the determining factor is which facility will fit and accommodate your medical, psychiatric, and substance use needs.

There is also the notion that a successful program results from the competency and longevity of its staff. A study found that 58.1% of its attending staff served at their respective rehabilitation centers for 1-5 years, 23.2% were there for 11-15 years, 10.5% for 6-10 years, and 8.2% served for over 15 years.10 Finding an alcohol detox program, either private or public, that has staff with significant experience in treating alcohol withdrawal is always a good sign.

The evolution of alcohol detoxification from the once-accepted gradual weaning schedule to the now-standard use of benzodiazepines (e.g., diazepam, chlordiazepoxide, or lorazepam), indicates an increase in effectiveness.7 Effectiveness, in part, is predicted by the intervention (i.e., medications such as benzodiazepines), rather than the treatment environment.

For example, the effectiveness of benzodiazepine treatment for alcohol withdrawal takes one of three forms:7

  • Fixed tapering dose regimen (FTDR), which requires you to receive fixed doses of a benzodiazepine at scheduled intervals regardless of if you are experiencing severe or mild alcohol withdrawal symptoms. Initial dosing is dependent on the severity of symptoms. This is best suited for outpatient settings.
  • Symptom-triggered regimen (STR), which structures benzodiazepine administration around the severity of withdrawal symptoms when using a rating scale such as the CIWA-AR. Ratings are conducted on a fixed schedule and dosing is administered per withdrawal severity. Overall, this method results in less total medication being administered, a shorter duration of treatment, and reduces the risk of over-or-under medicating you and is therefore preferred. However, the efficacy of this method is intimately tied to the validity of the initial assessment.
  • Loading dose regimen (LDR), which reduces the risk of complications like seizures and delirium by utilizing long-acting benzodiazepines. The clinical condition and level of withdrawal severity need to be monitored before each dose.

Choosing a Private Alcohol Detox Clinic Over a Public Detox Clinic

Although it would be nice if one category of treatment, private or public, were superior to the other, the reality is that a treatment center or detoxification center is only as effective as the quality of its staff, floor and administrative, and treatment methodology.

Both private alcohol detox and public alcohol detox options offer you the opportunity to undergo alcohol withdrawal in a safe and comfortable environment, under professional medical care. And once you complete alcohol detox, you are ready to begin your alcohol addiction treatment plan, which may involve behavioral therapies and addiction medication. Ultimately, the decision to enter alcohol detox is a great one—regardless of which type of program you use.

Call 800-996-6135(Who Answers?) to find a private alcohol detox center near you or to get more information about private alcohol detox clinics. We are available 24/7 to take your call.

Resources

  1. Substance Abuse and Mental Health Services Administration (SAMSHA) & Office of the Surgeon General. (2016). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health.
  2. National Institute on Drug Abuse. (2018). Drug Addiction Treatment in the United States.
  3. Substance Abuse and Mental Health Services Administration (SAMSHA). (2014). Integrating Substance Abuse Treatment and Vocational Services.
  4. Abraham, A.J., Andrews, C.M., Gorgan, C.M., D’Aunno, T., Humphreys, K.N., Pollack, H.A., & Friedman, P.D. (2017). The Affordable Care Act Transformation of Substance Use Disorder Treatment. American Journal of Public Health, 107(1), 31-32.
  5. Substance Abuse and Mental Health Services Administration (SAMSHA). (2020). Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Results on Drug Use and Health.
  6. Smith, J.C., & Medalia, C. (2015). S. Census Bureau Health Insurance Coverage in the United States: 2014.
  7. New 8: Sachdeva, A., Choudhary, M., & Chandra, M. (2015). Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond. Journal of Clinical and Diagnostic Research, 9(9), 1-7.
  8. Rural Health Information Hub. (2022). Opioid Treatment Program (OTP).
  9. National Institute on Drug Abuse (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (3rd Ed.).
  10. Amimo, F.A., Ouma, P., & Ondimu, T.O. (2019). An Assessment of Effectiveness of Drug Rehabilitation Programs in Kisii County- Kenya. Journal of Health Education Research & Development, 4(1), 1-20.
  11. National Institute on Drug Abuse (2020). Drugs, Brain and Behavior: The Science of Addiction.
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