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Who is an online addiction program good for?

This is the second of a 3-part series about online addiction programs:

  1. 14 Reasons why online addiction programs work
  2. Who is an online addiction program good for?
  3. Technology can either replace relationships, or unlock them


Here we’ll focus on how to determine who an online program is the right fit for.

What we know about studies on improving health is that there are many ways to skin a cat. In general, you’ll improve the most when you pursue an approach that you’re interested in and ready for. That way you’re not fighting like hell to stick to a plan.

It’s kind of like dieting, where the same diet works for one person and not another because of their individual circumstance, level of commitment, characteristics, and so on. Among treatment options shown to help, you need to find what suits your particular time and place in life.



You’re in the 90% majority if there’s something that gets in your way of engaging in treatment. While the headlines talk about the need to expand access to treatment, the silent problem is that for the most part people already have access… they just don’t engage for several valid reasons.

What that means is we need to change access, not expand access. This is what gets me up and working hard everyday.

The most common barriers are:

  • Shame (stigma)
  • Logistics (time or distance from obligations and responsibilities)
  • Cost
  • Not wanting to completely abstain from alcohol or drugs
  • Low motivation (this can be on its own or an effect of the other barriers)

Given that 9 in 10 encounter these barriers, let’s use them as our lens to look at the factors that point towards in-person treatment or an online program.


SHAME (Stigma)

Benefits of in-person treatment:

Usually therapy is provided in group settings. I’ve run plenty of groups, and it can go either way for people. When it goes well, it can really help people open up and be cathartic after years of bottling up their experiences and feelings. A group of accepting, considerate, and helpful people can help heal wounds you’ve hidden from the world.

Benefits of an online program:

It’s really scary to speak to a group about the most shameful, sad, and scary parts of your life. Putting yourself on display and expecting that you’re comfortable enough for that to be productive can be unrealistic. It’s also common that groups introduce unhealthy people into your life at the most vulnerable time, causing relapses or initiating people into new substances. The safety and privacy of an online program is what some people need before exploring themselves in front of others. There will always be plenty of people to practice your improved health with when you’re ready for it.


LOGISTICS  (Time or Distance from Obligations and Responsibilities)

Benefits of in-person treatment:

Some people are not tied to work or family, and are easily able to go to intensive treatment. It’s also helpful to go away for treatment to a serene and protected setting if you have toxic relationships actively trying to bring you down. If you require inpatient or complex medical care/detoxification then you will want to be at a facility with 24 hour medical attention. If you have a court-ordered treatment or legal issue, more often than not they will require an in-person treatment. Other factors to consider are whether you’re able to take care of basic daily needs (food, shelter, hygiene), or are acutely suicidal.

Benefits of an online program:

If your situation is more chronic, you might be suitable for online care. It’s incredibly practical to be able to do a program from the comfort of your own home, at any time, and make it fit your work and family life. Beyond that, it can make getting help possible and sustainable. You also get to practice implementing changes in your real life setting so you can recognize what’s going on in your environment and avoid surprises.



Benefits of in-person treatment:

If you have good health insurance, you may not pay out of pocket for high intensity care. You do need to do your homework to avoid unexpected out of pocket costs, copays, and deductibles. Medical bills are the number one reason for bankruptcy. There are plenty of financial horror stories, so check with your insurance yourself to make sure what you are being quoted is accurate.

Benefits of an online program:

Because online programs don’t have the high property and personnel costs of in-person care, it is much more affordable even without insurance. While you don’t want to put a price tag on your health, keep in mind that a $90,000 rehab is still going to only be effective 5-10% of the time on average. An online program can be a practical way to see whether you are successful before incurring debt or spending hard-earned savings.



Benefits of in-person treatment:

There are very few programs that allow you to enter treatment not already sober, and almost all will kick you out if you use or drink at all. Urine drug screens are used to ensure you follow rules, and some people like that type of punitive accountability. MAT (Medication-Assisted Treatment) clinics offer harm reduction treatment usually with an opiate called buprenorphine (Suboxone is an brand name of one) which is a safer alternative to other opiates, and are obliged by law to drug test and ensure compliance.

Benefits of an online program:

You can start and continue an online program whether you start sober, prefer to challenge yourself as you become more equipped to, or are simply looking to moderate your addiction to a tolerable level. You don’t need to lie or hide anything, or deal with added pressure to be perfect with your addiction from the moment you start. You can focus on your underlying process and not become distracted by the games we all play when we have rules imposed on us.



Benefits of in-person treatment:

If you really don’t care to get better, whether for yourself or people around you, then it might be best to have as much “hand holding” as possible. Recognizing you are not as interested in getting help as you’re expected to can be difficult to explain and handle, and it can increase your chance of success if you enlist as much live support as possible. If you are highly irresponsible or reckless, people are there to take over responsibilities and choices to help you function.

Benefits of an online program:

Online programs are more suited for people who already recognize the need to get healthy. They work well for people who might have low outward motivation, but are curious, insightful, reflective, enjoy learning psychological concepts, and want to explore themselves. It’s a great fit for people who want to develop self reliance and responsibility rather than rely on others indefinitely.



As a psychiatrist who likes addressing deep issues, I almost never find it useful to tell people what to do. With rare exception, I believe in allowing people to work through difficult life choices as long as there is sufficient safety, guidance, and wisdom being offered.

If you feel overwhelmed as you consider treatment options, I would guess you get that same feeling in response to all kinds of life issues. It’s no coincidence that feeling defeated or overwhelmed when dealing with life challenges or negative feelings happen to be common in addiction (where the object of your addiction can serve as a way of escaping or numbing that bad feeling). Challenging yourself through that feeling is your source of growth, and to avoid it is to avoid growth.

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