Modified: 15th Oct 2019

Signs You May Need Rehab

People often exhibit signs that they may need drug and alcohol rehabilitation. These signs reveal their behavioral patterns with substance use. People may hide their drinking from close friends and family. They may overconsume alcohol for more extended periods. They may even spend all their day seeking and obtaining drug and alcohol. These signs suggest that people have been suffering under classical conditioning where drug and alcohol use activates the reward centers of the brain, making it easier to tolerate addiction and harder to abstain from substance use. 

Also, signs that you may need drug and alcohol rehab include dual diagnosis where patients who are diagnosed with a substance use disorder may also present with a co-occurring mental illness condition. In this case, the drug and rehabilitation therapist will diagnose a patient who may have a primary psychiatric illness condition comorbid with a substance use disorder. The reverse can be true where the patient has an alcohol use disorder that is comorbid with bipolar disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the criteria for comorbidity. 

The following are standard signs that you may need drug and alcohol rehabilitation:

  • Substance use leading to clinical impairment
  • The daily seeking drug and alcohol substances 
  • Intense cravings that make the detox process harder to complete 
  • Tolerance as a result of prolonged use 

Patients who have tried to abstain from using drugs and alcohol report unsuccessful attempts that lead to further risky behavior and legal troubles. 

If you need a drug or alcohol rehabilitation program, contact CareFirst BlueCross Blue Shield District of Columbia to determine your drug rehab needs. Coverage will depend on your treatment plan and insurance.

For more information on your coverage and plans or access to resources, contact CareFirst BCBS District of Columbia. 

Do Blue Cross Blue Shield of District of Columbia Plans Cover Drug & Alcohol Rehab?

CareFirst BCBS District of Columbia offers drug rehab coverage. Patients can choose from various health plans that cover drug rehab. CareFirst BCBS District of Columbia behavioral health plans require out of pocket expenses of non-network providers and treatment plans that exceed the minimum depending on your insurance coverage. 

To receive drug and alcohol rehab treatment, you must obtain authorization through your primary care physician. You will need to get a physician referral to a network provider. Once you receive the referral, you can set an appointment to speak with a therapist, who will conduct an initial assessment of your substance addiction. The goal is to determine the appropriate treatment for your substance addiction. The therapist will use the guidelines of the DSM (2013) and drug and alcohol rehabilitation preferred practices. 

You may be subject to a dual diagnosis if you present with both substance use symptoms and mental illness condition. 

For more information on your coverage and plans or access to resources, contact CareFirst BCBS District of Columbia.

The History of Blue Cross Blue Shield of District of Columbia

CareFirst Blue Cross Blue Shield District of Columbia is a healthcare insurance provider that offers medical and dental plans for individuals and families, employers and employees, and Medicare. CareFirst BCBS District of Columbia serves the Mid-Atlantic region with 3.3. Million members. In its 82nd year, CareFirst BCBS District of Columbia provides coverage for Maryland, the District of Columbia, and Northern Virginia. 

CareFirst Blue Cross Blue Shield is a nationally accredited program that offers congressional employees’ coverage. The CareFirst BCBS mission is to provide affordable and accessible healthcare, assist public and private initiatives, and promote the integration of a healthcare system that meets the needs of its members. 

For more information on your coverage and plans or access to resources, contact CareFirst BCBS District of Columbia.

Why Do We Need Rehab Coverage?

Statistics on drug alcohol addiction are rising. Men are reported to binge drink more than women (CDC, 2016). Women are more likely to be diagnosed with an alcohol use disorder than men (NIAAA, n.d.). Opioid use disorder has become prevalent as healthcare providers continue to write more prescriptions. Adolescents and youth are increasingly becoming addicted to prescription drug medications (Monitoring the Future, 2016). 

The National Institute on Drug Abuse (NIDA) reports that in 2017, there were 244 overdose deaths, involving opioids and at a rate of 34.7 deaths per 100,000 persons. Washington, D.C. healthcare providers wrote 28.5 opioid prescriptions in 2017 (NIDA, 2019). The U.S. rate for opioid prescriptions is 58.7 prescriptions (NIDA, 2019). 

The need for drug and alcohol rehabilitation coverage is increasing as drug and alcohol addictions are considered chronic diseases are needing medical coverage and treatment. Patients can receive drug rehab coverage under the provisions of the 2010 Affordable Care Act and guidelines under the Mental Health Parity and Addiction Equity Act of 2008, which requires insurance providers to offer comparable coverage for drug and alcohol addiction treatment as they do for medical and surgical procedures. 

CareFirst BCBS District of Columbia will help you locate an in-network drug rehabilitation provider. 

For more information on your coverage and plans or access to resources, contact CareFirst BCBS District of Columbia.

How Does Blue Cross Blue Shield of District of Columbia Rehab Coverage Work?

CareFirst BCBS District of Columbia offers drug rehab coverage for pre-authorized addiction treatment. Plan members must seek pre-authorization before setting an appointment with a drug and rehabilitation. CareFirst BCBS District of Columbia requires customers to follow all guidelines for drug rehab coverage. Out of pocket expenses might apply for non-network providers and addiction treatment not authorized by a primary care physician. 

For more information on your coverage and plans or access to resources, contact CareFirst BCBS District of Columbia.

What is Detox?

The medical detoxification process allows patients to undergo the chemical withdrawal process where the body rids itself of toxins. Patients experiencing severe withdrawal symptoms may need prescription medication to lessen the severity of symptoms. Medical detox typically runs seven full days under medical supervision and monitoring. Patients are expected to complete the detox process before enrolling into inpatient treatment, which is the step-down level of treatment.

For more information on your coverage and plans or access to resources, contact CareFirst BCBS District of Columbia.

What are the Differences Between Inpatient and Outpatient Treatment?

Inpatient treatment is the next level of addiction treatment after medical detox. Patients with severe addiction are typically enrolled in an inpatient residential program where they share a room with another client and are expected to live on-site for the duration of their treatment. Patients must complete individual and group therapy. Patients are also required to participate in related activities. 

Outpatient treatment may be for less severe addiction treatment. Patients are required to visit a drug and rehabilitation center according to a determined schedule. They can, however, return home each night, work, and attend school. They must participate in individual and group therapy. 

CareFirst BCBS DC offers the following treatment options:

Inpatient Treatment

  • 30, 60, or 90 days inpatient residential treatment 
  • Medical detox, supervised by clinical and licensed physicians
  • Individual and group therapy 
  • Shared room and board 

Contact CareFirst BCBS District of Columbia for more information about coverage and out of pocket expenses. 

Outpatient Treatment

  • Daily visits to the drug and alcohol rehab center 
  • Home returns, work, school attendance 
  • Individual and group therapy, counseling

For more information on your coverage and plans or access to resources, contact CareFirst BCBS District of Columbia.

Get the Help You Deserve Today

If you or a loved one needs drug and alcohol rehabilitation treatment, contact CareFirst BCBS District of Columbia to discover your healthcare options. 

Resources

CareFirst BCBS District of Columbia Company Overview

CareFirst BCBS District of Columbia

CareFirst BCBS District of Columbia Individual and Family Health Plans

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th edition. Washington, D.C.: American Psychiatric Publishing.

Beronio, K., Po, R., Skopec, L., & Glied, S. (2013, February 20). Affordable care act expands mental health and substance use disorder benefits and federal parity protections for 62 million Americans. Retrieved from https://aspe.hhs.gov/report/affordable-care-act-expands-mental-health-and-substance-use-disorder-benefits-and-federal-parity-protections-62-million-americans

Centers for Disease Control and Prevention. (n.d.). Fact sheets—excessive alcohol use and risks to men’s health. It is retrieved from https://www.cdc.gov/alcohol/fact-sheets/mens-health.htm.

Centers for Medicare & Medicaid Services. (n.d.). The mental health parity and addiction equity act (MHPAEA). The Center for Consumer Information & Insurance Oversight. Retrieved from https://www.cms.gov/cciio/programs-and-initiatives/other-insurance-protections/mhpaea_factsheet.html

National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol use disorder. It is retrieved from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders.

National Institute on Drug Abuse. (2019, March). Washington, D.C. opioid summary. It is retrieved from https://www.drugabuse.gov/opioid-summaries-by-state/washington-dc-opioid-summary.

Schulenberg, J.E., Johnston, L. D., O’Malley, P., Bachman, J. G., Miech, R. A., & Patrick, M. E. (2016). College students and adults ages 19-55. Monitoring the Future, National Survey Results on Drug Use, 1975-2016. Retrieved from http://www.monitoringthefuture.org/pubs/monographs/mtf-vol2_2016.pdf.