Genesee Orleans Council on Alcohol SA Atwater Home Community Residence
(585) 343-8330
www.gcasa.net
424 East Main Street
Batavia NY 14020

Rehab and Insurance Services

Substance abuse treatment services
Services Provided: Substance abuse treatment, Halfway house
Type of Care: Residential long-term treatment (more than 30 days)
Special Programs/Groups: Persons with co-occurring mental and substance abuse disorders, Women, Men

Nicotine

Nicotine is a powerful drug that is a physical addiction on par with cocaine. As with any chemical dependency, there can be both physical and psychological addictions that develop, serving to promote addiction. The most common forms of nicotine addiction are smoking and using chewing tobacco. When consumed, the user feels the effects of these products within 10 seconds as the nicotine enters into the blood stream and reaches the brain. However, as soon as a user ceases nicotine use, the effects can wear off quickly. The body expels over half of the nicotine in it in a little as 60 minutes. This leaves individuals addicted to nicotine craving another cigarette as withdrawal symptoms like irritability, agitation, anxiety, headache and hunger set in. Chemicals in the brain, which are "neurotransmitters," are responsible for regulating how the mind thinks and feel. Once nicotine is present in the body, it alters the natural state of chemical balance (known as homeostasis) in the brain and the body requires a constant intake of nicotine in order to feel normal. Nicotine creates a physical addiction by primarily affecting the levels of three neurotransmitters: acetylcholine, dopamine and glutamate. Nicotine increases levels of acetylcholine that make nicotine users more alert and temporarily heightens concentration ability. When natural acetylcholine levels decrease, users need to smoke, chew or otherwise introduce nicotine to the system in order to rebalance the levels of acetylcholine in the brain. Additionally, nicotine has an extremely short half-life, requiring repeated intake in order to stave off withdrawal. Smoking increases the level of dopamine in the body, which stimulates reward centers in the brain. This process reinforces the smoking behavior, so that each cigarette makes smokers desire yet another. In addition, habitual intake can trigger addiction, as the reward centers of the brain come to associate the act of smoking or chewing with pleasure and reduced tension. Glutamate is responsible for creating and storing memories in the brain. Each time a nicotine dependent individual smokes or chews, the sense of alertness (from the acetylcholine) and the feeling of pleasure (from the dopamine) reinforce the desire for continued nicotine consumption. The two primary signs of nicotine addiction are the habitual use of nicotine products and experiencing withdrawal when use ends. Other signs of nicotine addiction include possession of cigarettes or copious amounts of lighters, ashtrays, cups for spitting chewing tobacco residue into or pipes and tobacco pouches. Nicotine addicted individuals also tend to display stained teeth, gums and fingers, as well as signs of premature wrinkling due to the drying out of the skin and lack of oxygen the skin receives.

Paying for Drug Treatment

Finding ways to pay for treatment to recover from dependence on alcohol or drugs takes some research. Addiction treatment can be quite costly and the wrong program can be ineffective. The severity and duration of the substance a person abuses and the type of treatment the person requires all contribute to the costs.
Some treatment for drug and alcohol dependence costs more than others. Residential treatment is more expensive than outpatient treatment. The location of the facility, amenities offered and staffing also influence treatment costs. Chronic alcoholism or drug abuse may require longer-term treatment and that can become very costly depending on the treatment facility.

Private Insurance

The most commonly used payment for drug and alcohol treatment is through private insurance. The insurance coverage may pay for some or a great portion of the drug and alcohol treatment program. The websites of some addiction treatment centers may mention specific insurance carriers, particularly if the facilities are preferred addiction treatment centers for national insurance companies such as Blue Cross, Aetna, Cigna and others. Whether or not private insurance covers any portion of drug and alcohol treatment depends on whether the facilities are ERISA or non-ERISA plans. The Employee Retirement and Income Security Act (ERISA) is a federal law that sets standards for certain health plans offered by employers. If the plan is ERISA, it may or may not cover drug and alcohol treatment, as it is not required to. Non-ERISA plans and other group health plans, are required to provide at least four inpatient detox admissions (of up to 7 days each) in a lifetime, at least 30 days per year (lifetime 90 days) of non-hospital residential treatment and at least 30 days a year of partial hospitalization or outpatient services.

Military Insurance

Members of the armed services who need alcohol or substance abuse treatment may have some or most of the costs paid for through military insurance.

Medicare, Medicaid and Medical

Many treatment facilities advertise that accepting Medicare, Medicaid and Medical. Medicare Part A covers some drug and alcohol treatment received at a hospital (including room, meals, nursing and some other services), while Part B covers some services provided by alcohol and drug professionals (inpatient or outpatient), lab tests, partial hospitalization and outpatient therapies. Be aware that Medicare does not cover the total cost of most treatment and services and patients pay deductibles and co-payments.

Self Payment

The two major things to consider when evaluating self payment for addiction treatment are that the first attempts at drug and alcohol treatments do not always work. Ongoing addiction usually has high mental and financial costs as well as increased risk for other problems.

Personal Savings

It may come down to the having to tap into personal savings to pay for rehab treatment, especially if a person has a high insurance deductible, no insurance at all, does not qualify for scholarships or does not want to take out a loan. Again, be sure to find out exactly what the cost break down is to estimate if it will exhaust a savings account.

Family Assistance in Paying

Asking family for assistance to pay for the drug and alcohol treatment can be an option. If a person is genuinely committed to quitting the abuse, family members may be willing to help. If the aunt or uncle says that rehabilitation treatment will be a loan, be sure to draw up a loan agreement and make good on the promise to pay them back.

Creative Payments

One-Time Pay Assistance

Some treatment centers offer some type of financial assistance on a one-time-only basis.

Scholarships

Several drug and alcohol treatment centers in California offer scholarships to those individuals who cannot afford to pay for treatment out of pocket or who do not have insurance. In fact, some of these treatment facilities may be required to make a certain number of beds available for scholarship recipients as part of state licensing requirements--depending on what type of license the facility has. If a person qualifies for a scholarship, it will pay for the entire cost of the treatment. Scholarships are for those individuals who really have no other option.

Self-Pay Sliding Scale

Another popular payment method for drug and alcohol treatment is one where a patient pays what he or she can, according to a sliding scale. This assures that the patient will get the necessary treatment to kick alcohol and/or drugs, but will not break the bank.

Loans

Some facilities may offer loans that patients can take out to pay for the treatment. Be sure to find out everything that the loan covers in the treatment and understand exactly what the terms of the loan are. No one wants any hidden fees or surprises. Ensure that someone explains anything there is a fee-for-service, as this would be in addition to the treatment costs.

Facility that Meets Needs and Budget

The next step seeking treatment is to locate the right treatment facility to meet the needs and budget. Whether an inpatient hospital or residential treatment center specializing in addiction treatment or outpatient treatment, determine which treatment facility can best address the particular addiction situation.

The following step is to contact each of the treatment providers on the list and ask a series of questions. Some people may visit the clinics that seem well-matched in order to see firsthand how these facilities operate and to get a better sense of the kind of care a patient will be receiving at the facility. Ask for literature and inquire about all costs associated with the treatment and various treatment options each may offer. Some residential treatment facilities, for example, offer outpatient treatment, aftercare treatment and other services.

In order to shorten a long list of possible treatment facilities it is best to examine in-depth exactly what the costs of the programs are. Some facilities require an initial assessment first, in order for professional staff to determine the best and personalized program for a patient. In fact, whichever treatment facility ultimately chooses, no treatment can begin without a comprehensive assessment. This assessment involves an interview to learn about patient background, family history, type of substance and duration of abuse and other issues important to the treatment. Some treatment centers require patient detoxification in order to be admitted to the treatment program. This will be determined at the time of the assessment. No one can enter treatment without being free of traces of drugs or alcohol.

Don’t Let an Inability to Pay Defer Treatment

Employer-Sponsored Programs: Find out if an employer has a substance abuse program. This may be a part of the employer-paid insurance coverage or it may be separate.
Federal, State, County or Local Assistance: Check with the Department of Health, county or local organizations to inquire about assistance with treatment programs or treatment at a sponsored facility. There may be citizenship, residency and income limits applicable before treatment.

The best advice anyone can give is to fully explore all the options to getting treatment to quit drugs and alcohol. Be honest and upfront about the financial and insurance situation and ask for help to get the treatment need.