Fast facts about some obstacles to heroin sobriety

The death of actor Philip Seymour Hoffman underscored a troubling development: Heroin, long a scourge of the back alleys of American life, has spread across the country. A special series.

Treatment facilities are packed. Inpatient rehab is costly. Insurance companies have refused coverage. Addicts looking to get clean from heroin often face an uphill battle. A quick look at the process, and some of the obstacles to getting sober:

Withdrawal

Once in withdrawal, users feel like their bones are breaking. Fluids leak from every orifice. They sweat and get the chills and shakes. The withdrawal itself doesn't kill, but if addicts can't persevere, they often go back to heroin, with lowered tolerance, and many overdose.

Lack of beds

The number of people using heroin in the U.S. nearly doubled from 2007 to 2012 to some 669,000 people, and more people are also now seeking treatment. But of the 23.1 million Americans who needed treatment for drugs or alcohol in 2012, only 2.5 million people received aid at a specialty facility. There simply aren't enough beds at treatment facilities to meet the demand. There are about 12,000 addiction treatment programs nationwide, according to the nonprofit Treatment Research Institute in Philadelphia. Of those, about 10 percent are residential facilities, about 80 percent are outpatient programs and about 10 percent are methadone clinics.

Insurance battles

While most insurance policies state that they allow coverage of up to 30 days in a residential drug treatment center, nobody actually gets those 30 days, said Tom McLellan, CEO of the Treatment Research Institute. The average duration in residential care is 11 to 14 days.

The cost

A 30-day inpatient stay can cost as little as $5,000, but the average cost is about $30,000. The cost of heroin detoxification alone, which usually takes three to five days, is around $3,000. Most clinics require payment upfront if insurance can't be used.