Rehab in Tustin, California

The city of Tustin, nestled between Santa Ana and Irvine, is a small city of just over 11 square miles (11.08) with approximately 80,000 people (80,276 as of the April 2020 census). It’s only the 14th largest city in Orange County and the 109th largest city in California. Still, it faces big-city problems such as homelessness and substance abuse.

Demographics of Tustin, California

Tustin has a population of about 80,000, a small fraction of Orange County’s 3 million and California’s population of more than 39.5 million. Tustin’s population density is around 7,150 per square mile, making it only the 14th most densely populated city in Orange County and the 117th most densely populated city in the state.

Tustin’s population is younger, at a median age of 34.4 years, compared to Orange County (38.6), California (37), and the U.S. (38.5).

Tustin is also racially and ethnically diverse:

• The Hispanic population is about 40% in Tustin, slightly more than Orange County as a whole (34%) and about the same as California (39.4%). In the United States, it’s 18.4%.
• Only 31.9% of the Tustin populace is White (non-Hispanic), less than Orange County’s 39.7% and California’s 36.3%. In the U.S., it’s 60%.
• Another 22.2% are Asian (about the same as OC’s 21.2% rate but greater than California’s 14.6%). In the U.S., it’s 5.61%.
• Only 2.37% are Black (non-Hispanic), more than Orange County’s (1.64%) but less than California’s (5.5%). In the U.S., it’s 12.4%.

With less than one-third of its populace non-Hispanic White, Tustin is a majority-minority city.

Economics of Tustin, California

In Tustin, California, in 2019:

• The poverty rate was 11.4%, higher than Orange County (10.9%) but lower than California (13.4%) and the U.S. (12.3%).
• The percentage of the population that was employed was 53.5%, higher than Orange County (51%), California (45%), and the U.S. (46%).
• The median annual household income ($84,697) was higher than the U.S. ($65,712) and California ($80,440) but still lower than Orange County ($95,934). OC has the seventh-highest median income in California.
• Educational achievement, an important factor in economic success, is higher in Tustin than in Orange County as a whole. Only 15.3% have no high school diploma, compared to 15.5% in Orange County overall. A higher percentage (40.1%) have a bachelor’s degree than Orange County (38.4%). The same holds for advanced degrees such as an MBA, Ph.D., or MD. (4.7% in Tustin, 4.3% in Orange County).
• The median property value was $647,500, lower than Orange County ($725,100) but higher than California ($568,500) and much higher than the U.S. ($240,500).

Problems Facing Tustin, California

Tustin’s motto is the City of Trees, although development has deforested much of it. It has some small-town charm but is not a major tourist destination. Its largest single employer is the Tustin Unified School District.

Its proximity to Disneyland in Anaheim (10 miles away) means its economy has probably been hurt by the COVID-19 shutdown. As of Sept. 28, 2021, 62.61% of Orange County was fully vaccinated.

Wildfires are still a problem, at least to air quality. Average wildfire smoke exposure per year from 2016 to 2020 was between two to four weeks in Tustin, slightly better than the four-to-six weeks in Orange County overall.

Homelessness

The estimated homeless population of Tustin was 359 in 2019, up from about 70 in 2017. (In Orange County, it was 7,000 in 2019 and was estimated to be 12,000 in March 2021. In 2019, California was estimated to have 108,400 or 53% of all homeless people in the U.S.)

In response, the city added the 50-bed Tustin Temporary Emergency Shelter in 2019.

Tustin Veterans Outpost’s recent expansion more than doubled its beds (from 26 to 71), providing additional transitional housing for homeless or formerly homeless veterans in Orange County.

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Substance Abuse in Tustin, California

Substance abuse is:

• Using illicit drugs.
• Using legal prescription drugs other than as prescribed.
• Using legal prescription drugs without a prescription.
• Using legal non-prescription substances such as alcohol when underage.

Substance use disorders are severe cases of substance abuse such as dependence and addiction.

In 2016, 8.5% of Californians, or 2.75 million people—lower than the national rate of 10.6%— met the criteria for a substance use disorder in the past year, including:

• Alcohol – 6.4% (2,088,000)
• Illicit drugs – 3.3% (1,068,000)
• Pain medication – 0.6% (206,000)

While it’s not always possible to separate Tustin drug abuse statistics from Orange County and other parts of California, Tustin may be doing better than most.

Rates of drug and alcohol hospitalization (based on 2015 data):

• Tustin: 14.8 per 10,000 (133 out of 80,621), or 28th highest in the state.
• Orange County: 17.5 per 10,000 (5,481 out of 3,118,717).

Student Substance Abuse in Tustin, California Colleges

Schools, both secondary and college, should be prepared to deal with substance abuse because that’s when substance use disorders often begin: between ages 10 and 19.

Substance use disorders almost always begin before the brain stops developing, usually around age 25. Alcohol and drug use can impair that development.

According to 2016 data, about one-third (33%) of 11th-grade students (ages 16–17) in California had used alcohol more than four times—8.85% of all California teens—and more than a fourth (25.1%) marijuana. For any drug use by any teens, it was 10.37%.

• From ages 12–17, an illicit drug use disorder was twice as likely as an alcohol use disorder.
• At ages 18–25, Californians in 2020 were 24.46% more likely to use drugs than other Americans.
• Post-secondary school, however, was the most common time for SUDs in California. Californians were nearly twice as likely (15%) to have an SUD at ages 18 to 25 than those 26 and older (7.7%) and close to three times as likely at ages 12 to 17 (5.1%).

Orange County has more than 25 accredited college and university campuses, in-person and online, including several in Irvine and Santa Ana, but only one in Tustin: a regional campus of Massachusetts’ Springfield College graduate school.

If needed, students may have access to rehab in other cities, such as an Ontario, California, rehabilitation center.

There are 35 colleges and universities within 25 miles of Tustin and another 74 within 50 miles. Many may offer substance abuse assistance for their students.

Overdose deaths in Tustin, California

Rate of deaths due to drug or alcohol overdose:

• Tustin: 15.3 per 100,000 (15 out of 80,621), or 33rd in the state.
• Orange County: 21.9 per 100,000 (716 out of 3,118,717).

According to the report 2017 Opioid Overdose & Death in Orange County, 70% of overdose deaths in the OC involved opioids, and 55% of opioid-involved deaths involved prescription opioids as opposed to heroin.

California as a whole reported only 348 overdose deaths in 2015, including:

• Prescription Drugs – 176 (51%)
• Illicit Drugs – 84 (24%)
• Alcohol – 19 (6%)

An additional 67 (19%) deaths involved more than one substance.

Despite its low overdose death rate, alcohol is the most abused substance and the most common SUD. Binge drinking—consuming five or more standard drinks (for men; four for women) in two hours—was an entire percentage point higher in OC (35.5%) than in California as a whole (34.4%).

Opioid abuse and overdose deaths

Since 2017, overdose deaths have dramatically increased. Orange County alone had 668 overdose deaths in 2020. California had 5,363.

About 70% of drug overdose deaths in Orange County involve opioids, both legal prescription drugs (oxycodone, hydrocodone) and illicit ones (heroin, fentanyl). In total, in 2020, there were 501 overdose deaths involving opioids (15.4 per 100,000 residents), almost twice as many as in 2018, of which 432 (86%) were caused by fentanyl (12.5 per 100,000, five times the rate at the beginning of 2018).

There are two main reasons for all the fentanyl deaths:

• Fentanyl, a synthetic opioid, is 50 times stronger than heroin. A slight miscalculation in dosage can easily cause death.
• Dealers often substitute fentanyl for other, harder to obtain or more expensive drugs, so drug users don’t know they are taking fentanyl.

Along with the considerable rise in overdose deaths attributed to fentanyl (and other synthetic opioids), there was a slight decrease in heroin overdose deaths.

Not all substance abuse indicates a substance use disorder (SUD) such as addiction. Whether an individual has an SUD or not (and its severity) is determined by 11 diagnostic criteria, including being unable to stop use despite the substance’s destructive effect on the individual’s life.

Only 10% who need treatment for an SUD receive it, however.

Substance Abuse Treatment

At the same time that overdose deaths were going up in Orange County, the use of one of the most effective methods to control drug abuse was going down.

Buprenorphine, a low-dose opioid, helps people overcome addiction without suffering the worst withdrawal symptoms but does not cause euphoria. In its Suboxone formulation, it is tamper-resistant because it is combined with an opioid antagonist that is activated if crushed for snorting or dissolved for injection.

From 2018 to 2020, however, the prescription of buprenorphine declined 22%, from almost 16 per 1,000 residents to less than 12 (11.45).

At the state level, California is the fifth-worst for the number of adults who need substance abuse help but don’t get it. It’s also fifth for having the fewest number of substance abuse rehab facilities per 100,000 drug users.

 Choosing From Rehabs in Tustin, California

Not all rehabs are alike. In the past, many were fly-by-night operations designed to take advantage of insurers and perpetuate their so-called clients’ SUDs.

Among the things to check to ensure a rehab is legitimate are:

Accreditation

This shows that an independent body has checked that the rehab meets the minimum requirements or standards for behavioral health and opioid treatment programs (OTPs). The Substance Abuse and Mental Health Services Association (SAMHSA) recognizes these three bodies:

• CARF International (originally the Commission on Accreditation of Rehabilitation Facilities)
• The Council on Accreditation (COA)
• The Joint Commission

Also, Google and Facebook require certification by LegitScript that rehabs meet the requirements to advertise on their platforms.

The California Department of Health Care Services (DHCS) licenses and certifies substance abuse treatment facilities, also.

Client-to-Staff Ratio

While there is no official standard, the fewer clients (or patients) per staff member is generally preferable. That includes all types of staff, not just nurses, physicians, and therapists.

Some states and rehabs consider a 3-to-1 client or patient-to-staff ratio (three clients for each staff member) ideal, but 8-to-1 or 10-to-1 is acceptable. The American Nurses Association recommends 5-to-1 for rehabilitation and 4-to-1 for psychiatric.

Treatment Options

Before deciding on a substance abuse treatment program, clients or their representatives should make sure it meets their needs.

In 2015, less than half (48.5%) of California treatment programs covered co-occurring disorders.

In 2018, Orange County had less than half as many treatment slots for narcotic replacement therapies such as methadone (5.5 per 10,000 residents) as California (12.8), though nearly half the counties did not offer NRT.

Orange County did have the highest residential detoxification capacity in the state (6.9 per 10,000), and its overall residential capacity (4.2) was greater than the state as a whole (3.0).

The Orange County Health Care Agency lists behavioral health services offering:

• Alcohol & Drug Abuse Outpatient Clinics
• Perinatal Treatment
• Residential Treatment
• Social Model Detoxification Services
• Medication-Assisted Detoxification Services

Treatment Options at Rehab Centers in Tustin, California

There are many types of treatment available—programs, treatment approaches, and levels of care—with some overlap.

In Orange County, Medi-Cal provides for these levels of care:

• Outpatient. The client visits the treatment center (which need not be a medical facility) for up to nine hours—usually three three-hour sessions—for drug education classes and therapy.
• Intensive outpatient program (or IOP program). Like standard outpatient, except the client visits the center for nine-to-19 hours weekly. (Partial hospitalization, sometimes referred to as Day Hospital, is similar, except it takes place for at least 20 hours a week in a facility with medical services.)
• Inpatient drug rehab treatment. Also known as residential because the client stays at a treatment center 24-7 with medical services available (though not necessarily on-site) so their health and behavior can be monitored. Food, recreation, therapy, and a bed are provided on-site for up to 90 days at a time.
• Luxury rehab. A type of high-end rehab facility which has better accommodations, food, views, and even virtual offices so that business owners and executives can continue to work so long as it does not interfere with their therapy and recovery. If luxury rehab is unavailable locally, consider seeking out a treatment center in Eureka, CA.

What to Expect During Inpatient Drug Rehab in Tustin, California

All inpatient treatment begins with the intake process, the initial screening, and assessment as the client checks into rehab. This is when the client’s substance use disorder is evaluated and the individualized course of treatment is planned.

Services included in treatment may include:

• Detoxification. If the client is still actively using substances at the time they enter rehab; a medically monitored detox may be needed (in rare cases, withdrawal can be fatal) before they begin inpatient treatment.
• Behavioral therapies. Cognitive-behavioral therapy and related types of talk or psychotherapy help people with SUDs ignore or transform negative thoughts and learn healthier coping behaviors. Similar or related therapies include dialectical behavior therapy, rational emotive behavior therapy, motivational interviewing, contingency management, and the Matrix Model.
• Medication-Assisted Treatment (MAT). The use of drugs plus therapy and counseling to treat substance use disorders. This can involve narcotic replacement therapy (NRT) while the client undergoes rehab. The use of methadone or buprenorphine (Suboxone) can manage withdrawal from opioids and maintain sobriety without the opioid high or rush. Other forms of MAT include
  • Naltrexone (Vivitrol, Revia): Blocks euphoric effects of alcohol or opioids; does not prevent or mitigate against withdrawal effects.
  • Disulfiram (Antabuse): Causes alcohol to make the drinker sick.
  • Acamprosate (Campral): Lessens alcohol withdrawal symptoms.
• Mental health care. Substance use disorders frequently co-occur with mental health disorders—sometimes called a dual diagnosis—but are occasionally undiagnosed because the symptoms are similar. Substance use sometimes begins in an attempt to self-treat symptoms of the mental health issue. In these cases, collateral treatment is needed. A qualified dual diagnosis rehab will check for this during intake.
• Holistic rehab treatments. Exercise, yoga, meditation, art or music therapy, and equine therapy are sometimes included to reinforce mindfulness.

Aftercare Planning Procedures

Treatment for substance use disorders is not a total cure. The best current science suggests that once an SUD develops, it can only be controlled. Relapse will always remain a risk, even after decades of abstinence and sobriety.

So, a well-designed treatment plan will include aftercare, a continuing plan to help maintain sobriety after inpatient and outpatient treatment ends.

Aftercare or continuing care is part of a continuum of care, not an afterthought. Aftercare helps clients retain and reinforce their resolve to stay sober. The best rehabs will begin planning aftercare when treatment begins.

Support groups

While exercise, diet, hobbies, and avoiding the people, places, and situations that can trigger a relapse are essential to ongoing recovery, they can’t cover every eventuality. For that, one needs a team of experts, people who have experienced substance abuse and recovery, who can listen without judgment and offer advice.

That’s one of the advantages a mutual aid fellowship or support group offers. There are two main types: 12-step faith-based and non-12 step secular. Always check if meetings are in person, online, or on hiatus.

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12-step rehab

The Twelve Steps of Alcoholics Anonymous and Narcotics Anonymous are often valuable tools in bringing people to alcohol rehab or drug rehab. Working the steps—acknowledging one’s helplessness with addiction, seeking help from a higher power, attempting redress, and helping others—and attending meetings helps many maintain sobriety after rehab.

Twelve-step rehab is among the most common treatment types, so consider seeking out rehabs all over the state—such as a rehab center in Moreno Valley, California.

• Alcoholics Anonymous. Meetings of people with alcohol use disorders (AUDs) to offer mutual support as they try to stay abstinent and work the Twelve Steps. Those with long-term sobriety sometimes act as sponsors to newer members—more than 50 meetings weekly in Tustin, CA alone, plus meetings in other cities and online.
• Al-Anon and Alateen. Mutual support groups For the family and friends of those with AUDs. Only five Al-Anon meetings are listed in Tustin, CA, but there are more than 200 within a 25-mile radius (15 Alateen), plus electronic meetings.
• Adult Children of Alcoholics. Twelve Step group for people who grew up in families that were dysfunctional due to an AUD. There don’t seem to be any face-to-face meetings in Orange County, but there are nearly a dozen Zoom meetings.
• Narcotics Anonymous. Like AA but for those with narcotic use disorders. There are no meetings listed for Tustin, CA but more than 100 throughout Orange County, plus ten virtual meetings.
• Nar-Anon and Narateen. Like Al-Anon/Alateen but for the family and friends of those with narcotic use disorders. No Nar-Anon meetings are listed in Tustin, but 15 within 25 miles of Orange County, plus virtual meetings (Narateen, too).
• Cocaine Anonymous. No meeting is listed in Tustin, plus 16 meetings in Orange County.
• Dual Recovery Anonymous. Twelve-step program for those with a dual diagnosis/co-occurring disorders. No meetings are listed in Tustin, but three in Orange County, plus virtual meetings.
• Marijuana Anonymous. No meetings in Tustin, but six throughout Orange County plus seven Zoom meetings.
• Local Celebrate Recovery groups. All 12-step programs are at least quasi-Christian but Celebrate Recovery is a Christ-centered 12-step program based in Calvary Chapel in Santa Ana. There are no meetings listed in Tustin but 19 throughout Orange County.

Non-12-step rehab

The Twelve Steps are based on faith, not evidence, which may make them a poor fit for some people. Non-faith-based alternatives may serve a similar purpose without reference to God. The Twelve Steps also teach that people with SUDs are helpless in their addiction. Non-12-step programs say they do have the power.

• SMART Recovery. Self-Management and Recovery Training has trained facilitators who teach scientifically validated tools and techniques to change addictive behaviors. Although there are no meetings in Tustin, there are several meetings based in other Orange County cities that have moved online.
• LifeRing Secular Recovery. Members share experiences to help them design their recovery plan. Unfortunately, there are no meetings in Tustin and only one face-to-face meeting in Orange County (Huntington Beach), but there are online meetings.
• Women for Sobriety. A support group of women and for women in recovery. No meetings listed in Tustin and only two in Orange County (Los Alamitos and Newport Beach).
• Moderation Management. This group aims to curtail problem drinking, not necessarily all drinking. There don’t seem to be any face-to-face meetings in or near Orange County, but there are phone and video meetings available.

Veterans Affairs Addiction Treatment

Orange County’s veteran population is somewhere between 107,000 and 130,000. As of 2019, about 2,400 lived in Tustin, CA. Many of them have or will experience physical and mental health issues due to their time in service.

Illicit substance abuse among military personnel increases when they leave the service and become veterans. Marijuana and alcohol are most used, but opioids—both prescription and illegal—and cocaine send more to substance abuse treatment centers.

One reason is pain, seizures, diseases associated with unprotected sex or sharing needles (HIV/AIDS, hepatitis), mental health issues associated with readjustment to civilian life (anxiety, depression, stress, trauma), and severe mental illnesses such as bipolar disorder and schizophrenia.

There are no VA outpatient clinics in Tustin, CA, but there are several throughout Orange County, plus the VA Long Beach Healthcare System.

Other resources for veterans in Orange County include:

• OC4Vets. A program that assists veterans and their families in obtaining treatment for substance abuse, behavioral and mental issues, and other available services.
• Orange County Veterans Service Office. Local resources.
• California Department Veterans Affair (CalVet). Assistance finding local healthcare providers and obtaining federal benefits and services.
• U.S. Department of Veterans Affairs. Federal help from finding a VA location to refilling prescriptions, including:
  • Substance use treatment for Veterans
  • Psychological Health & Traumatic Brain Injury
  • Post-Traumatic Stress Disorder

Suicide is also a risk for mental health and substance use disorders. Veterans or their loved ones who exhibit severe mental illness or talk about taking their lives can call the Veterans Crisis Line (800i273i8255 then press 1) or text message 838255.

Paying for Rehabs in Tustin, California

In the U.S., more than half of all health insurance comes from employer-provided plans. In 2014, businesses with 50 or more employees were required to provide mental health and substance abuse treatment as essential health benefits.

There are other exceptions. Even when there aren’t, that doesn’t mean they cover all the costs of luxury rehab.

In California, some people qualify for substance abuse treatment under Medi-Cal, the state’s Medicaid program. Check eligibility and apply for benefits.

The federal Medicare program also provides people 65 and older some coverage for mental health and substance abuse treatment.

Traveling to Tustin, California Rehab Centers

There are three large airports—and two medium-sized—with regularly scheduled flights within 50 miles of Tustin, plus another seven without scheduled flights. However, there is only one with strong connectivity to other airports: Los Angeles International Airport (LAX).

Tustin, CA, is within easy driving distance of Los Angeles, just 35 miles away. Other nearby cities include Anaheim (10 miles), Newport Beach (12 miles), San Clemente (28 miles), and San Juan Capistrano (21 miles).

For travel by train, bus, and taxi, Tustin is close to seven major freeways and the John Wayne Airport. There is a Tustin Metrolink Station and four Orange County Transportation Authority (OCTA) bus routes, and there is a Metrolink Parking Structure.

Tustin, California Addiction Treatment Resources

• NAMI WarmLine. 877i910iWARM (877i910i9276). The National Alliance for Mental Illness operates a non-crisis phone line for mental health and substance abuse issues. 9 a.m to 3 a.m.weekdays, 10 a.m. to 3 a.m. on Saturday and Sunday.
• 24 Hour Suicide Prevention Line. 877i7iCRISIS (877i727i4747). Immediate, confidential over-the-phone suicide prevention services.
• OC Links: 24-7 information and links to the Orange County Health Care Agency’s Behavioral Health Services. Call 855i625i4657 (855 OCiLINKS).

The Orange County Health Care Agency has many resources online, including:

• Adult and Older Adult Behavioral Health (AOABH) Services. Provides a range of outpatient and residential treatment programs designed to reduce or eliminate the abuse of alcohol and other drugs within the community. Lists of outpatient clinics and specialized services.
• Behavioral Health Services. Which mental health and substance abuse services are available to eligible Orange County residents, including prevention, early intervention, and treatment services.
• Downloadable brochures