Questions to ask before booking rehab abroad

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Before You Book Rehab Abroad: 25 Questions to Ask

Before you pay a deposit on a rehab abroad, work through twenty-five questions covering licensing, medical safety, the clinical team, the programme, money and leaving. Each one comes with what a good answer sounds like and the red flag that should stop you, so you can judge the reply you get rather than simply asking.

How to use this checklist

You are probably reading this with a shortlist, a deposit request and possibly a flight date. These are the questions to ask before rehab abroad, and they work the same way whether the placement is an alcohol rehab or a drug and alcohol programme, and whether the centre sits in Spain, Thailand, South Africa, Portugal, Bali or anywhere else. Only the regulators change.

Detox and rehab are not the same service, and the difference between detox and rehab decides which of these questions matter most. If you are asking on someone else's behalf, supporting someone through the decision is its own task.

Every question carries three lines: why it matters, what a good answer sounds like, and the red flag. Ask, listen, then check the reply against the other two.

Put all twenty-five to every centre on your shortlist, including the one a friend or a therapist recommended: a well-run centre anywhere should answer them without preparation. Ask questions by email where you can, and write the replies down either way: a phone call is impossible to compare against another a week later. Print this page, or save it to your phone.

Licensing and legal status

Four things wear similar words: a registered company, a licensed healthcare facility, a licensed hospital, and a voluntary accreditation. The distinction applies to rehabs in Thailand and rehabs in South Africa as anywhere, and it decides what every later answer is worth.

1. Is the centre licensed to deliver healthcare, and by which authority?

Why it matters: A validly registered company is not a licensed healthcare provider, and a centre can be one without being the other.

A good answer sounds like: The regulator named without hesitation: Thailand's Department of Health Service Support, South Africa's Department of Social Development, Portugal's Entidade Reguladora da Saude or the regional health authority in Spain, with the certificate offered unprompted.

Red flag: "We are fully registered" with no regulator named, or a company-registration certificate produced as though it were a healthcare licence.

2. What is the licence number, and can you check it yourself?

Why it matters: A licence number nobody can look up is a claim, not evidence, and independent verifiability is the most reliable test here.

A good answer sounds like: The exact number and a pointer to the register: REGCESS, the national register of authorised Spanish healthcare centres, the Andalusian register that issues the NICA identifier or Portugal's ERS provider search. Where no public register exists, the certificate in writing, naming the issuing authority.

Red flag: Being told the number is confidential, or being given one that returns nothing when you search the register.

3. Is it a hospital, a clinic, or neither?

Why it matters: Hospital, clinic and neither are separate legal categories with separate obligations, and a great many centres offering residential treatment abroad are licensed as neither.

A good answer sounds like: The category named exactly as the licence names it: a private clinic under Thailand's Sanatorium Act, or a treatment centre registered under South Africa's Substance Abuse Act, not the phrase "medical facility". In Indonesia, ask registered as what and with which body: a social-welfare foundation registration is not a medical licence, and the national list of registered rehabilitation facilities does not distinguish them.

Red flag: "Hospital" or "clinic" used freely in the marketing but absent from the licence category when you ask directly.

4. Does any UK regulator have jurisdiction over this centre?

Why it matters: UK protections do not travel with the patient. The CQC regulates health and social care in England only, and the Mental Health Act 1983 reaches no further than England and Wales.

A good answer sounds like: A plain statement that no UK regulator has jurisdiction where the centre operates, and a pointer to the local equivalent. Question 22 covers what that means if someone wants to leave.

Red flag: Any claim to be "CQC-registered", "CQC-approved" or "CQC-compliant" for a facility outside England. That is not a real category.

5. If it claims CARF or JCI accreditation, can you verify it on the accreditor's own site?

Why it matters: Both accreditations are voluntary and paid for by the provider through a survey it commissions, so a badge proves nothing until it appears on the accreditor's public list.

A good answer sounds like: The exact accredited entity name and the year of the award, so you can search CARF's provider search or JCI's list of accredited organisations yourself. Accreditation means the provider chose to be measured against a published standard and passed, but it is not a government licence and says nothing about outcomes.

Red flag: A logo with no matching entry on the accreditor's register, or an accreditation that has lapsed.

What it isWho issues itWhat it actually provesWhat it does not proveHow you check it
Business or company registrationThe national companies registryThe company legally exists and may tradeAnything at all about clinical care, staffing or safetyThe relevant national companies register
Healthcare-facility licence or authorisationThe health regulator: the regional health authority in Spain, ERS in Portugal, DHSS in Thailand, DSD in South AfricaAuthorisation to deliver a named category of health serviceHospital status, detox capability or quality of care. Read the service categories listed, not just the numberREGCESS and the regional register in Spain, the ERS provider search in Portugal. We found no public facility-level lookup for Thailand or South Africa: ask for the certificate and contact the regulator direct
Hospital or inpatient licenceThe same health regulator, in a different licence classInpatient medical capability and emergency infrastructure appropriate to that classThat addiction treatment falls inside the licensed scopeThe same register, reading the licence class rather than the licence number
Voluntary accreditation (CARF, JCI)CARF International or Joint Commission International, both paid for by the providerThat the provider chose to be assessed against a published standard and passedA government licence, or any clinical outcomeCARF's provider search or JCI's public list of accredited international organisations

A separate guide for UK families looking at Spain covers how to read a Spanish health-centre record.

Medical safety

Withdrawal from alcohol and benzodiazepines can be dangerous, and a residential centre is frequently not a hospital. Two honest gaps shape this block: we found no regulator in these five countries requiring a centre to publish its escalation plan, and no aviation-medicine guidance on flying in acute withdrawal, so travel timing is a clinical judgement, not a rule you can look up. Medically supervised alcohol detox explains the term.

6. Who manages detox, and where does it happen?

Why it matters: Alcohol withdrawal can progress to seizures and delirium tremens, a medical emergency, so medical staff must lead detox, not counselling staff.

A good answer sounds like: A named doctor or nurse-led team running detox in a setting licensed for it, with a written escalation protocol. A centre that completes detox in a separate medical setting before admission, and explains the transfer, answers equally well.

Red flag: Detox described as something that happens "naturally" with peer support, or run by staff with no medical qualification.

7. What is the withdrawal protocol, and who is on site overnight?

Why it matters: Withdrawal symptoms and their complications do not respect office hours, and a centre running active detox on daytime-only cover has an unstaffed gap at exactly the wrong time.

A good answer sounds like: A protocol specific enough to repeat to your own GP: a medically supervised withdrawal plan, with clear arrangements for adjusting medication and monitoring symptoms, in line with NICE guidance on assessing and managing alcohol dependence. Then who is on site overnight, and the response time when the doctor is not.

Red flag: Being told the protocol is "tailored to the individual" and left at that, or any suggestion of stopping alcohol or benzodiazepines without a medically supervised taper.

8. What happens during a medical emergency?

Why it matters: No regulator here requires this plan to be published, so before admission is the only moment you can reliably get it.

A good answer sounds like: A written protocol naming who assesses, who authorises a transfer, how transport is arranged and how the family is told, handed over before you have to ask.

Red flag: "We call an ambulance" offered as a complete answer, with nothing in writing behind it.

9. Which hospital receives patients, and how far away is it?

Why it matters: In rural inland Spain, upcountry Thailand or on an island such as Bali, the nearest hospital equipped for a serious emergency can be far beyond the nearest town.

A good answer sounds like: A named hospital and a realistic transfer time, given freely. Check the drive on a map yourself.

Red flag: "Nearby" or "not far" offered in place of a hospital name and a number of minutes.

10. How will prescribed medication be handled at the border, and is the person fit to travel?

Why it matters: UK export rules, the destination country's import rules and the person's clinical state on the day of the flight are three separate problems. Some ordinary UK prescriptions are restricted or banned outright abroad.

A good answer sounds like: The centre asks about every current prescription weeks ahead and puts the requirements in writing: a doctor's letter for up to a three-month supply of lawfully prescribed controlled medicine leaving the UK, a Home Office personal licence beyond that applied for at least a month before travel, a Schengen Article 75 certificate for journeys of up to 30 days into Spain or Portugal, and whatever permit Thailand or Indonesia requires. Cannabis and CBD cannot lawfully be carried into either. It asks the clinician managing the person's treatment to confirm when they are medically fit to fly, rather than assuming that travel is appropriate while withdrawal is still active, and it covers the journey back into the UK.

Red flag: No mention of border medication rules, reassurance that "it will be fine" without paperwork, or encouragement to fly while already symptomatic.

The clinical team

Job titles are mostly not credentials, and prescribing authority comes from the country a doctor practises in, not from the UK prescription your relative arrives with.

11. Who will be treating your relative, by name and role, and how many people are in their care?

Why it matters: You cannot verify credentials until you know whose they are. No government or professional body publishes a staff-to-client ratio standard for these destinations, so the only real test is whether the centre will put its own figure in writing.

A good answer sounds like: Full names, roles and registration numbers for the people who deliver the therapy day to day, offered without being asked twice, plus a current ratio in writing and how it is counted, including whether night staff and part-time clinicians sit inside the number.

Red flag: Staff introduced only by first name or as "the team", or a round figure such as 1:3 presented as an industry benchmark, when no such benchmark exists.

12. What qualifications do they hold, where are they registered, and who can lawfully prescribe?

Why it matters: Registration is checkable in a way a CV is not. Clinician registers are searchable in Thailand and South Africa even though we found no facility register for either, so you can verify the people where you cannot verify the building.

A good answer sounds like: Named registration bodies and numbers you can search yourself: the Thai Medical Council's public doctor lookup, the HPCSA's iRegister, Portugal's register of doctors, or the relevant regional colegio in Spain. Plus a named local prescriber who explains how medication continues.

Red flag: Qualifications given as degree titles with no registering body, a registering body that does not exist, or an assumption that a UK prescription carries over abroad.

13. Is that job title a protected title, or just a description?

Why it matters: In the UK, "counsellor", "psychotherapist", "therapist", "addiction specialist" and "recovery coach" carry no legal protection: anyone may use them without training or registration, and how far the same holds elsewhere varies from country to country.

A good answer sounds like: The centre separates statutorily regulated roles, doctors and the nine practitioner-psychologist titles protected by the HCPC, from voluntarily registered ones such as a counsellor on a PSA-accredited register like BACP or UKCP, and says which is which for each person. Voluntary registration is not lesser: many highly skilled counsellors hold it.

Red flag: A title such as "addiction specialist" presented as though it carried the same legal weight as a medical or psychology qualification.

The programme

Ask these three before accepting anyone's description of what a month contains. If the setting is still open, how inpatient and outpatient treatment differ is worth reading first, as is treatment for co-occurring mental health conditions.

14. What is in the programme, how long does it run, and what is the evidence for both?

Why it matters: NICE identifies psychosocial interventions with a real evidence base, and NIDA's research-based principles find that treatment lasting under 90 days tends to be of limited effectiveness, so both content and length should have reasoning behind them.

A good answer sounds like: The centre maps its main components to a recognised evidence base, names the therapy behind each one, and is candid about which elements are supportive rather than primary treatment, and can describe a typical week hour by hour, including how often family are involved. Length is set by a full clinical assessment against the general evidence on duration: a principle about engagement, not a rule that every stay runs 90 days.

Red flag: A programme described entirely in marketing language, or one fixed package length sold to everyone regardless of clinical need.

15. Can the centre treat a co-occurring mental health condition alongside the addiction?

Why it matters: Treating mental health and substance use together, rather than treating one and referring out for the other, is what UK guidance on co-occurring conditions favours.

A good answer sounds like: An honest list of what the centre can and cannot manage on site, who provides psychiatric input and how often, and a plan for a condition that emerges mid-stay outside that list. Naming its limits is a strong answer, not a weak one.

Red flag: A blanket claim to treat "anything", with no detail on how psychiatric conditions are assessed or who assesses them.

16. How would you check an outcome claim or a testimonial?

Why it matters: A success rate with no methodology behind it is a marketing figure, and the CMA's guidance on fake reviews treats fake or undisclosed-incentive reviews as a breach carrying fines of up to 300,000 pounds or 10% of global turnover.

A good answer sounds like: The centre can tell you who was counted, out of how many, over what follow-up period, how people lost to follow-up were treated, and whether anyone independent verified the figure. Its reviews sit on third-party platforms and show a spread of experiences.

Red flag: A headline percentage with no denominator or follow-up period, testimonials that exist only on the centre's own website, or near-identical five-star reviews posted inside a few days.

Money

Payment method is the one part of this transaction you fully control. Set the quotation against what rehab costs in the UK and against a worked overseas benchmark such as what rehab costs in Spain or a comparable quotation from Thailand or Portugal, then ask these five.

17. What exactly is included in the price, and what is not?

Why it matters: Headline prices routinely exclude the expensive parts: medical detox, medication, psychiatric assessment, laboratory tests, transfers, family sessions, aftercare, and any stay beyond the initial rehab programme.

A good answer sounds like: A written, itemised breakdown of inclusions and exclusions, with the cost of an extended stay stated up front, sent to you before any deposit is requested.

Red flag: One headline number, exclusions that only surface after payment, or a refusal to itemise in writing.

18. How should you pay, and what protection does that method actually give you?

Why it matters: Section 75 of the Consumer Credit Act 1974 can cover a purchase from a foreign supplier costing more than 100 pounds and no more than 30,000 pounds, but the FCA's published analysis is that an intermediary in the payment chain, such as a booking agent or a referral broker, can break the debtor-creditor-supplier relationship the protection depends on, and that only a court can give a conclusive view in a disputed case.

A good answer sounds like: The centre accepts card payment, does not steer you towards a bank transfer, and confirms in writing that the money goes to the entity actually delivering the treatment rather than to an agent. It says plainly that paying at least part of the fee on a UK credit card keeps the strongest protection available to you.

Red flag: Bank-transfer-only terms, a discount conditional on transferring, or an invoice issued by a company that is not the centre.

How you payWhat protects youIs it a legal right?Limits and time windowWhat can break it
UK credit cardSection 75 of the Consumer Credit Act 1974Yes, a statutory rightPurchases over 100 pounds and no more than 30,000 pounds. Can apply to overseas suppliers. A disputed claim is ultimately decided by a courtAn intermediary in the payment chain, or a lender that is also the supplier
Debit card, or a card payment below the Section 75 floorChargeback, raised through your card providerNo. Chargeback runs on the card schemes' own rules, not on statuteNo minimum spend. Time limits apply and they are short, so contact the card provider as soon as a problem appears rather than waiting for the centre to resolve itThe scheme's own rules and the receiving bank's cooperation
Bank transfer to a foreign accountEssentially nothing once the money has goneNoRecovery depends on the receiving bank's goodwill, or on pursuing the provider under whatever law governs the contractThe transfer itself

19. Which country's law and which courts govern your contract?

Why it matters: Consumer Rights Act 2015 protections can survive a foreign governing-law clause only where the contract has a close connection with the UK, a fact-specific test rather than a guarantee. Which country's courts would hear a dispute is a separate question.

A good answer sounds like: The contract states governing law and jurisdiction in plain terms, and someone at the centre can explain what each means if things go wrong. For a sum this size, take independent legal advice rather than the centre's summary.

Red flag: A contract silent on governing law, or a foreign-jurisdiction clause buried in small print with no explanation offered.

20. What is the refund and early-departure policy, in writing?

Why it matters: Circumstances change clinically, financially, or because the placement turns out to be a poor fit. A written policy protects both sides; its absence protects only the provider.

A good answer sounds like: A clear, proportionate written policy covering the deposit, unused nights and clinically advised early discharge, handed over before booking rather than produced on request afterwards. Question 22 covers the practical side of someone leaving.

Red flag: "No refunds under any circumstances", or no written policy at all.

21. Is a referral fee being paid to whoever recommended this centre?

Why it matters: Referral and lead-generation arrangements are a documented feature of the addiction treatment market, recorded in reporting on patient-recruiter schemes and health journalism on patient brokering, and the UK advertising regulator has published guidance for the addiction treatment referral sector. Many "best rehab abroad" lists are paid placements rather than editorial judgement.

A good answer sounds like: Both the centre and the referrer state plainly whether a fee is paid, how much and on what basis, and a paid referrer says so before recommending anyone. Ask every referrer, including therapists, helplines and comparison websites: applying it to everyone is what makes the question fair.

Red flag: A referrer who will not say whether it is paid, or a directory presenting itself as independent where every listed provider happens to be a paying customer.

Leaving, and what comes next

The period after discharge carries real risk: tolerance falls during a stretch of abstinence, so a return to a previous dose, opioids above all, can be dangerous. And the crisis nobody plans for is someone deciding to go home early. The first steps to recovery and how addiction affects the whole family are worth reading before these four.

22. What happens if the person wants to leave, and can the centre hold a passport?

Why it matters: No UK detention power reaches overseas, a centre cannot lawfully compel someone to stay outside a formal local legal process, and withholding travel documents is treated as an indicator of coercive control under UK law.

A good answer sounds like: A clear line between a therapeutic agreement someone may choose to end and any form of physical or documentary restraint, plus a written plan for getting the person home safely if they do leave, including who pays for the flight. Asking someone to sit down and talk before they go is clinical practice, not restraint. If a passport becomes the problem, the FCDO sets out who it can support abroad, including emergency travel documents.

Red flag: Any policy of retaining passports, or any suggestion that someone can be stopped from leaving when they are legally entitled to go.

23. What happens on the day of discharge?

Why it matters: A centre that treats the discharge date as the end of its responsibility leaves the family to improvise in exactly the weeks when reduced tolerance makes a return to a previous dose dangerous.

A good answer sounds like: A written discharge plan produced days in advance covering ongoing medication and who will prescribe it at home, travel arrangements, relapse-prevention planning, a letter to the UK GP, and a named person to contact in the first weeks.

Red flag: No discharge plan until the final morning, or a plan that ends at the airport.

24. Is there aftercare in the UK, and who delivers it?

Why it matters: Twelve months of aftercare means nothing until you know what fills them, and engagement with continuing care is associated with better outcomes.

A good answer sounds like: A named format and frequency, group therapy or one-to-one, delivered by named people, with the country and the delivery method stated, and a clear answer on what happens if the person cannot travel back.

Red flag: "Lifetime free aftercare" with no detail on who provides it, how often, or from where.

25. Who holds the clinical record, and can a UK GP get a copy?

Why it matters: A provider in Spain or Portugal is bound by the EU GDPR while one in Thailand, South Africa or Indonesia is not, and either way the handover to a UK GP is what turns a stay abroad into continuous care.

A good answer sounds like: A clear statement of who holds the record and how the patient, or their GP with consent, requests a copy, plus how the transfer will satisfy UK rules on international transfers of personal data, and a commitment to write to the GP at discharge.

Red flag: No clear answer on who owns or can release the record, or a refusal to send anything to a UK GP.

The three answers that should end the conversation

A licence claim the centre will not let you verify on a source it does not control. A demand for payment by bank transfer only, or an invoice from a company that is not the centre. Any policy of holding a passport, or any suggestion that someone can be prevented from leaving.

None requires clinical knowledge to spot. All three can be established on one phone call, before a deposit leaves your account.

Take it to every centre on your list

Work down these twenty-five with each centre in turn, then read the written answers side by side. If it helps to talk it through with someone first, or you are making a referral on someone's behalf, both routes are open.

Use this checklist when comparing any rehab abroad, including Sierra Recovery.

Sources

UK government and regulators

  • Home Office and gov.uk, "Controlled drugs: personal licences" - www.gov.uk
  • gov.uk, "Travelling with controlled medicine" - www.gov.uk
  • FCDO, "Foreign travel advice: Thailand, safety and security" - www.gov.uk
  • FCDO, "Foreign travel advice: Indonesia, safety and security" - www.gov.uk
  • FCDO, "Who the FCDO can support abroad" - www.gov.uk
  • House of Commons Library, "The Care Quality Commission" - commonslibrary.parliament.uk
  • Crown Prosecution Service, "Modern slavery, human trafficking and smuggling" - www.cps.gov.uk
  • Information Commissioner's Office, "A guide to international transfers" - ico.org.uk
  • Mental Health Law Online, "Mental Health Act 1983" - www.mentalhealthlaw.co.uk

Clinical guidance

  • NICE CG100, "Alcohol-use disorders: diagnosis and management of physical complications" - www.nice.org.uk
  • NICE CG115, "Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence" - www.nice.org.uk
  • NICE CG51, "Drug misuse in over 16s: psychosocial interventions" - www.nice.org.uk
  • NIDA, "Principles of Drug Addiction Treatment: A Research-Based Guide" - nida.nih.gov
  • Public Health England, "Better care for people with co-occurring mental health and alcohol/drug use conditions" - assets.publishing.service.gov.uk

Registers and verification tools

Consumer protection and advertising

Independent journalism

  • The Philadelphia Inquirer, reporting on patient-recruiter schemes in addiction treatment - www.inquirer.com
  • MindSite News, reporting on patient brokering - mindsitenews.org

Frequently Asked Questions

Is rehab abroad safe?

There is no blanket answer. An overseas centre can be as safe as UK residential rehab or considerably less so, depending on its licensing, medical staffing and emergency arrangements. Verifying the specific centre, using questions 1 to 10 above, matters far more than the country it sits in.

Is a rehab abroad CQC-registered?

It cannot be. The CQC regulates health and social care providers in England only, so "CQC-approved" or "CQC-compliant" is not a real category for a facility outside England. Ask instead which local authority licenses the centre, and check that licence on the relevant national register.

Does the UK Mental Health Act apply if my relative is in rehab abroad?

No. The Mental Health Act 1983 applies in England and Wales, with narrow transfer provisions to Scotland, Northern Ireland and the Crown Dependencies. It has no reach into Spain, Thailand, South Africa, Portugal or Indonesia. Compulsory detention overseas would depend entirely on that country's own legal framework.

Can a rehab centre abroad hold my relative's passport?

We found no lawful basis for a treatment centre to retain someone's passport against their wishes in any of the jurisdictions covered here, and withholding travel documents is a recognised indicator of coercive control under UK law. Ask for the policy in writing before booking.

Will my UK prescription for controlled medication be honoured abroad?

Not automatically. UK Home Office rules govern taking it out: a doctor's letter covers up to a three-month supply, and a personal licence is needed beyond that. The destination country then applies its own entirely separate rules, and some ordinary UK medicines are restricted or banned outright.

Does Section 75 protect me if I pay a rehab abroad by credit card?

It can, for purchases over 100 pounds and no more than 30,000 pounds, but only where a genuine debtor-creditor-supplier relationship exists. The FCA notes that an intermediary in the payment chain can break that link, and that only a court can give a conclusive view in a disputed case. Pay the clinic, not an agent.

What is the difference between chargeback and Section 75?

Section 75 is a legal right attached to credit card purchases over 100 pounds and no more than 30,000 pounds. Chargeback is not a legal right: it is a dispute process run under the card schemes' own rules, on debit and some credit cards, with no minimum spend. Time limits apply and they are short, so contact your card provider as soon as a problem appears.

Are "counsellor" and "therapist" protected job titles?

Not in the UK. Anyone may use either with no mandatory qualification or registration. Only the specific practitioner-psychologist titles protected by the HCPC carry legal protection, so ask for a registration number and the register it sits on rather than relying on the title itself.

Can we get the clinical records back from a rehab abroad?

You should be able to, though the mechanics differ. An EU provider in Spain or Portugal is bound by the EU GDPR; one in Thailand, South Africa or Indonesia is not. The transfer back to a UK GP still has to satisfy UK rules on international transfers.

Publisher disclosure. This checklist is published by Sierra Recovery, a residential addiction and mental-health centre in Andalusia, Spain, authorised by the Junta de Andalucia under NICA 67331 and verifiable on the Spanish health-centre register. It was written to be applied to any centre in any country, including this one. Readers are invited to put all twenty-five questions to Sierra Recovery and to hold the answers to exactly the same standard as anyone else's.

This page is educational information about how to assess a treatment provider. It does not replace medical advice. Never stop alcohol, benzodiazepines or opioids without medical supervision.

Nerea Encinas SánchezLucy BrittonChester Page+

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