Choosing a drug or alcohol rehabilitation facility for a child often is a decision guided more by emotion than reason.
But because of the number of programs from which to choose, state and local authorities who monitor the facilities say selecting the proper treatment center should be made with care. They say the parents must find the exact program for their child, and that each child must be judged as an individual case.
"You must proceed in a methodical fashion, because that is the only way to go," said Chauncey L. Veatch III, director of the California Department of Alcohol and Drug Programs.
So where do you begin with a multitude of programs ranging from private, state-of-the-art facilities that charge several thousand dollars a week for treatment, to public-run centers that charge a minimal fee depending on a family's income?
Veatch suggests that parents talk to friends, physicians and state and county agencies that deal with treatment centers before deciding which facility is best for their specific need.
For example, some teen-agers may need inpatient care in which they live at the facility. Others may need a strong outpatient program in which they spend part of the day in treatment but otherwise continue their daily routine.
Dr. Max Schneider, a Santa Ana physician who treats drug and alcohol patients, said there is no magic potion for recovery. An 18-day program may work for one person; another individual may need six months or more.
Schneider said the model facility should be located close to a person's home so no one in the family has an excuse not to attend counseling sessions. He said it should have certified drug-alcohol abuse counselors, physicians who have shown expertise in the field of chemical dependency, and a psychologist, psychiatrist and recreational therapist available.
The treatment program also should have a strong family treatment plan so that all members of the family will be involved in the therapy.
"We will not take the kid without mom and dad, because we feel if we're going to restructure the kid's life, we have to do it with mom and dad there," said Tim Allen, executive director of Break Through Clinic in Costa Mesa. "And in order to treat anybody, you've got to uncover all those family secrets."
Schneider also said that after-care treatment programs are essential. He said patients must attend group meetings such as Alcoholics Anonymous or Cocaine Anonymous for a long time after they complete their recovery program.
"A 10-day, 21-day or 30-day program is just an artificial arrangement," Schneider said. "You must go for a period of at least six months (including after-care treatment). Kids will require longer professional involvement than adults.
"It is most important of all once you are hooked on a mind-altering drug. The propensity to get rehooked to that drug or some other drug will be embedded for life."
Treatment really is a re-education that emphasizes fighting temptations for the rest of their lives, Schneider said.
"I've been in the AA program for a few months," said Deanna de St. Paer of Irvine's University High School. "Through it, I've learned a lot about people's problems, teen-age alcoholism in general and not to judge people too quickly. I don't think it's OK to drink or get stoned because drinking causes more problems than it's worth."
Typically, life at a recovery home or hospital is mundane and structured. Patients attend group therapy sessions, lectures on the effects of drugs and alcohol, meditation sessions and AA meetings at night. Those who must first go through detoxification are slowly weaned off the drugs through medication.
At Break Through, an outpatient clinic, therapists spend about 10 1/2 hours a week with the teen-agers and their parents for anywhere from 16 to 20 weeks. They usually attend meetings four times a week. They are given family therapy and group therapy and are tested for drugs. Then they are put into an after-care treatment program such as AA meetings to help assimilate them back into society.
Schneider's model is one followed by most facilities, state officials said.
But one state official, who asked not to be identified, said about 10% of the private facilities are not up to industry standards. One of the reasons, he suggested, was that private facilities do not have the kind of stringent licensing laws that public-run programs have. The laws vary because government-funded programs often receive more scrutiny, he said.
Bill Edelman, division manager of drug programs for the Orange County Health Care Agency, said his office has heard complaints that as soon as insurance money runs out, patients have been dropped from programs. Other officials stated concerns that some doctors will convince parents that their children need hospitalization when the kids may not.