Jason Cherkis: Dying To Be Free

...To enter the drug treatment system, such as it is, requires a leap of faith. The system operates largely unmoved by the findings of medical science. Peer-reviewed data and evidence-based practices do not govern how rehabilitation facilities work. There are very few reassuring medical degrees adorning their walls. Opiates, cocaine and alcohol each affect the brain in different ways, yet drug treatment facilities generally do not distinguish between the addictions. In their one-size-fits-all approach, heroin addicts are treated like any other addicts. And with roughly 90 percent of facilities grounded in the principle of abstinence, that means heroin addicts are systematically denied access to Suboxone and other synthetic opioids.
On average, private residential treatment costs roughly $31,500 for 30 days. Addicts experience a hodgepodge of drill-instructor tough love, and self-help lectures, and dull nights in front of a television. Rules intended to instill discipline govern all aspects of their lives, down to when they can see their loved ones and how their bed must be made every morning. A program can seem both excessively rigid and wildly disorganized.

Heroin Addiction Treatment in America - Willpower Over Chemistry