Nearly 7% of adults who drink alcohol develop alcohol use disorder (AUD), the term doctors use to diagnose alcoholism. Heavy drinking can hit you in the pocketbook in many ways. For example, a man who drinks heavily averages 14 drinks per week, according to the CDC. Multiply that by a conservative $7 per drink, and that’s at least $5,096 spent on alcohol each year.
Also, crunching figures from the American Psychiatric Association and Center for Workplace Health shows people with AUD may average a startling 29 lost workdays each year. Let’s say you were carrying 10 sick days and 3 personal days at work, and also could apply 5 vacation days. That still leaves 11 potentially unpaid days, meaning 4.2% of your annual pay is on the line.
And drinking problems can drive up auto insurance premiums (due to accidents) and legal costs (DUI defense, etc.). Plus, an AUD diagnosis will disqualify you with some life insurers.
These losses, in addition those you cannot put a dollar amount on (your health, your family, your friends), may weigh on you enough to compel you to seek help for a drinking problem. A wise decision, indeed: Every day, 261 Americans die over excessive alcohol use, according to one study.
You should anticipate and manage the costs of treating an alcohol dependency. Doing that will let you focus on your recovery with greater peace of mind.
First, See Your Doctor
Your road to treatment of your alcohol problem probably will begin with your primary care doctor, who may be qualified to evaluate your drinking and suggest a treatment plan. If not, your doctor can refer you to an AUD specialist after asking about your drinking habits, giving you a physical exam, running lab tests, and maybe giving you a psychological exam.
Many new approaches to treating alcohol problems have been created in recent years. You may be advised to start your recovery with up to 28 days as an inpatient at a rehabilitation center that specializes in alcohol treatment. If you choose this option, you will pay more than for outpatient treatment.
Inpatient treatment begins with 2 to 7 days of detoxification, or “detox,” a period when you withdraw from alcohol use under medical care. You may need to take sedatives during detox to prevent withdrawal symptoms. After a successful detox, some people go home and return to the rehabilitation center after work in the evenings, while others continue at the center full-time.
Your time as an inpatient also is spent developing life skills and behavior changes suggested by alcohol treatment specialists during counseling and therapy (sometimes involving your partner or family members). Some people also are prescribed medication that reduces alcohol cravings or triggers a negative reaction to drinking.
Inpatient alcohol treatment is very expensive, anywhere from $5,000 to $30,000 or more, depending on how many days you stay full-time at the rehabilitation center, according to online sources. If you have private health insurance, the federal Affordable Care Act fortunately requires coverage of substance abuse treatment, just as it does with other health conditions. (Though your deductible or copay may be steep.) Also, Medicare covers “reasonable and necessary” inpatient treatment; Medicaid coverage levels vary by state.
But if you don’t have insurance or if it will be hard for you to afford your deductible, here are some tips:
- Research the costs of rehabilitation centers and if a facility charges by the day, week, or month.
- Call your insurance company and verify how many inpatient days and what medications it covers, and if it has a time limit on inpatient treatment.
- Ask the rehabilitation center if it offers a sliding fee scale to people without health insurance.
- Ask your state or local health department if an inexpensive government treatment program might work for you.
A facility that treats alcohol problems on an outpatient basis will evaluate whether your detox can be done safely at home or needs to be supervised on-site. After detox, you come to the facility in the evenings for counseling and therapy sessions. If your need for outpatient help is intensive, you may spend four evenings a week for several months in treatment.
Outpatient treatment typically costs from $1,400 to $10,000 in total, after $250 to $800 per day for detox, according to a review of fees online. Private insurers and Medicare should cover outpatient treatment, although the coverage level may depend on the specific medical and therapy services you receive.
Doctors advise some people to continue taking medications for alcohol dependence for a while after inpatient or outpatient treatment ends. The FDA has approved three medications for this purpose:
- Naltrexone (Vivitrol, Revia), which blocks receptors in your nerves that respond to alcohol so you want to drink less
- Acamprosate (Campral), which affects a chemical in your brain that produces a substance that makes you crave alcohol
- Disulfiram (Antabuse), which triggers nausea and other unpleasant reactions if you drink
A prescription for naltrexone is priced online for as little as $22.86 with a coupon (meaning a 30% copay, if you are insured, is $6.86). Acamprosate can be found priced online for $74.50 ($22.35 copay), and disulfiram for $41.54 ($12.46). It’s always smart to research the best deals for your medication.
Overcoming an alcohol dependency is very difficult, especially if you try to go it alone. A support system doesn’t have to hit you in the pocketbook. Alcoholics Anonymous is perhaps the best-known 12-step program, and its meetings are free; but it’s easy to find others in your community.
The doctors, counselors, and others helping your recovery also may recommend you seek ongoing behavioral therapy (sessions led by a professional to change behaviors that led to heavy drinking). These sessions might focus on identifying and overcoming your “cues” to drink, motivational techniques, or brief one-on-one interventions. Marital and family counseling also may be part of your recovery, as you will rely on those relationships.
You could find free or low-cost counseling from a local government agency, social service organization, or church. Otherwise, in the U.S., a therapy session typically costs $100 to $200. Check whether your insurance plan covers any or all of the cost. Marriage or family counseling typically costs from $75 to $200 per session, according to one online directory. Most health insurance doesn’t help with that cost.