Frequently asked questions

No, Houghton House only treats adults; the minimum age of admission is 18. We usually refer parents of younger patients to Akeso for adolescent-specific services.

Akeso has facilities across South Africa and provides specialised age-appropriate care for young people between the ages of 12 and 18 who are struggling with mental health, substance abuse, and addictive behaviours.

Yes. Houghton House is licensed as both a private psychiatric hospital and a rehabilitation centre. This dual licensing is significant — it means that medical treatment, including detox, is provided by HPCSA-registered medical professionals. It also means the facility can claim from medical aid schemes under both psychiatric and rehabilitation minimum prescribed benefits.

No, Houghton House only treats mental health conditions like burnout and stress that present alongside addiction. Depending on the patient’s circumstances and location, we have a network of psychiatrists, psychologists, and psychiatric hospitals to which we refer patients.

Houghton House treats all forms of substance addiction, including, but not limited to: 

• Alcohol
• Opioids – Heroin, nyaope, whoonga, prescription painkillers like morphine, codeine, oxycodone, fentanyl, etc.
• Stimulants – Cocaine, methamphetamine, tik, cat (methcathinone), prescription stimulants like Ritalin, ecstasy, MDMA, etc. 
• Novel psychoactive substances or ‘designer drugs’ – synthetic cannabinoids, research chemicals, bath salts, synthetic cathinones, etc.
• Sedative-hypnotic drugs / depressants / ‘tranquilisers’ – benzodiazepines, z-drugs, barbiturates, sleeping pills, GHB, mandrax (methaqualone), etc. 
• Inhalants – Poppers (nitrites), whippets (nitrous oxide), aerosols, gases, solvents, etc. 
• Dissociative drugs – Ketamine, PCP (phencyclidine), DXM (dextromethorphan), salvia divinorum, etc. 
• Cannabis 

In addition to substance use disorders, we also treat gambling disorder, as well as co-occurring mental health conditions.

No, medical detox is always part of the full inpatient programme at Houghton House.

The duration of medical detox varies by substance and severity of the dependence — how much, how frequently, and how long the patient has been using it. You won’t know exactly how long a detox is needed until the doctor has consulted with the patient. In South Africa, medical aids typically cover 3 days of hospital-based detox.

Not everyone requires detox, but it is clinically indicated for substances where withdrawal carries physical risk, including alcohol, benzodiazepines, opioids, and mandrax. The admissions team will assess whether detox is needed as part of the intake process.

For some substances, yes. Alcohol and benzodiazepine withdrawal can cause seizures and, in severe cases, can be fatal without medical intervention. Opioid withdrawal is rarely fatal but can be severe enough to cause dehydration and other complications that can be fatal. Supervised detox significantly reduces these risks and manages discomfort with medication.

Discharge from the primary programme is not the end of treatment. Houghton House offers an aftercare programme, and patients whose home environment is not yet stable enough for independent living may be suitable for the halfway house. Continuing care significantly improves long-term outcomes.

Relapse is common in addiction recovery, and the response matters more than the relapse itself. Contact the Houghton House admissions team as soon as possible to discuss returning to treatment.

Depending on the circumstances, that might mean returning to a full inpatient programme, a shorter stay, or stepping up to a more intensive outpatient or aftercare schedule. The admissions team can help you work out what level of support makes sense.

In our experience, relapse often signals that the aftercare commitment wasn’t maintained long enough. Recovery demands consistent effort over months, not weeks, and most people who reach twelve months of continuous abstinence go on to do well over the long term. 

Yes. Several patients have completed more than one programme at Houghton House. The admissions team can discuss what a second or extended treatment programme might involve.

No. You can contact Houghton House directly — no GP or psychiatrist referral is required. The admissions team will conduct an initial assessment and guide you through the process. However, if a psychiatrist or GP is currently treating you, it can be beneficial to bring along a referral.

Here’s what happens when you contact Houghton House:

1. 1. The admissions team conducts a confidential phone call to understand your situation and the level of care needed. 
   2. During the phone call, we’ll discuss the patient’s history, drug(s) of choice, psychiatric conditions, and any current treatment. We’ll also collect your medical aid information and discuss your treatment options.
   3. Following the phone call, we’ll send through an information pack and submit your details to your medical aid for pre-authorisation.
   4. Once we receive feedback from your medical aid scheme, we’ll contact you and book a bed for you or your loved one.

Admissions timelines vary depending on bed availability, but we always do our best to facilitate rapid admission when the situation is urgent.

Yes, during busy months we do have a waiting list, but it’s important to keep in mind that beds usually open up daily, so it wouldn’t be too long of a wait.

Yes, we do admit patients on weekends and public holidays.

We frequently treat international patients at Houghton House. The admission process for international patients is very similar to our standard admissions process. Remote assessments are available if needed, but a phone call is usually sufficient to determine whether admission is suitable.

On travel arrangements: 

• Houghton House does not assist with international travel arrangements. However, we may be able to assist with collection from the airport if our driver is available.
• We are more than happy to provide international patients with a treatment confirmation letter for Visa purposes.

On settling accounts: 

• For patients using an international medical aid we work with, the pre-authorisation is much the same as for patients with local medical aids. Our admissions team will conduct a confidential phone call to understand the patient’s case and gather the relevant medical aid information, after which we will submit the details to the medical aid for pre-authorisation.
• For private patients (i.e., international patients not covered by medical aid), payment can be made either via an electronic fund transfer (EFT) to our bank account or by card machine at reception.

See our standard packing list below. Please note that any sharp objects — razors, nail clippers, etc. — will be kept at the nurse’s station.

What to bring with you:

• Toiletries: Soap, shampoo/conditioner, toothbrush, toothpaste, roll-on deodorant
• Documents: ID and medical aid card (if applicable)
• Any current medication
• Towels (bath and/or face towel)
• Comfortable clothes for both cool and hot weather
• Walking shoes/tekkies
• Swimwear (optional)
• Plastic hangers
• Tuckshop money (cash or card)

Optional:

• Cigarettes or vapes (Vapes must be sealed)
• Literature (can only be read on weekends)

What NOT to bring:

• Cigars
• Rolling tobacco or pipe
• Radio, iPods, or other MP3 players
• Spray deodorant, perfume, cologne, or aftershave
• Foodstuffs
• Alcohol-based mouthwash 

If you bring the following items, they will be locked in the safe on admission:

• Cellphones
• Smart watches
• Laptops or tablets
• Wallet/purse
• Cash and bank cards

The cost of treatment varies depending on factors such as duration and level of care. 

• The cost of 30 days of inpatient care typically falls in the range of R92,000-R102,000. 
• Outpatient treatment typically costs between R17,000 and R26,000. This is dependent on whether the patient is doing the 4-week programme or the 6-week programme.

Yes, there is. Our standard primary programme’s duration is 30 days. Should you choose to extend your stay, you (or your medical aid) would be charged the standard ward fee per additional day, as well as the fees of any professional services used during your extended stay.

No, Houghton House does not offer payment plans. For inpatient and outpatient treatment, 50% of the total fee is payable on admission, and the remaining 50% is due 14 days later.

There is a once-off admission fee of R1,850. This is separate from treatment costs. Please note that the admission fee cannot be claimed back from medical aid or gap cover.

In most cases, yes. Substance use disorders are prescribed minimum benefits (PMBs) under South African law, which means all registered medical aids must fund addiction treatment regardless of your plan tier.

The specific benefits may depend on your scheme and some medical aids may charge a co-payment at out-of-network facilities — but Houghton House typically waives such shortfalls.

Note that while treatment shortfalls are waived, any co-payments for medication remain the patient’s responsibility. This typically doesn’t exceed R2,000.

PMBs are a set of medical conditions that all registered South African medical aids are legally required to cover. Substance use disorders are included, as are certain psychiatric conditions.

This means your medical aid cannot refuse to fund addiction treatment — though the number of days covered and whether co-payments apply depends on your specific scheme.

Our admissions team will help you verify your available medical aid benefits and obtain pre-authorisation before you get admitted — so you’ll never be in a position where you run out of medical aid benefits during treatment at Houghton House.

Houghton House bills at scheme rates and typically waives any shortfalls or co-payments beyond the once-off admission fee.

When treatment is pre-authorised, most members pay nothing beyond the R1,850 admission fee.

Note that any co-payments for medication remain the patient’s responsibility. Medication costs can vary considerably, but this co-payment —if it applies — typically doesn’t exceed R2,000.

Gambling addiction is not currently classified as a prescribed minimum benefit, so it does not receive the same mandatory medical aid coverage as substance addiction. However, it may be covered under your psychiatric care benefit, particularly if you present with a dual diagnosis covered by PMB, such as major depression or bipolar disorder.

Houghton House works with all major South African medical aids, including Discovery Health, GEMS, Bonitas, POLMED, Momentum, Bestmed, Medihelp, Fedhealth, Profmed, CAMAF, and several international schemes. If you don’t see your medical aid mentioned, chat to our admissions team; even if we don’t have a formal agreement in place with a particular scheme, we can verify your benefits and help you get pre-authorised.

Most medical aids apply a 3-month general waiting period for new members, and up to 12 months for pre-existing conditions. However, PMB-covered conditions may still be funded during waiting periods in certain circumstances. The admissions team can verify your specific situation directly with your scheme.

As a dual-licensed psychiatric hospital, Houghton House can claim under both addiction PMBs and psychiatric PMBs for patients with co-occurring conditions that qualify under psychiatric benefits. This can result in broader coverage for eligible patients. The admissions team can confirm what your specific scheme covers.

Houghton House’s admissions team manages pre-authorisation directly with your medical aid. You do not need to contact your scheme yourself. Pre-authorisation must typically be secured before admission.

Yes, this is normal with pre-authorisation. Once admitted, the admitting doctor will complete a diagnostic form (DSM form) and submit  it to your medical aid, and your approved length of stay will be updated.

If you don’t have medical aid and can’t afford treatment, consult our free and subsidised recovery resources page and reach out to some of the public and non-profit treatment facilities we’ve listed there.

The standard inpatient treatment programme at Houghton House is 30 days. This can be extended to 42 days when clinically necessary and approved by your medical aid or funded privately. 

Thirty days is the minimum time needed to do three things: clear the substance from the body, stabilise the patient medically and emotionally, and begin meaningful therapeutic work. None of those can be rushed.

The first week or two is often dominated by detox and stabilisation. Withdrawal from alcohol, benzodiazepines, or opioids can be physically dangerous without clinical supervision, and managing that safely takes time.

Once a patient is medically stable, the work of building a daily routine begins, because structure is part of treatment. Patients at Houghton House are engaged in therapeutic activity every hour from 06:00 to 20:00, because consistent engagement accelerates change in a way that a shorter stay cannot.  

Thirty days also gives the clinical team enough time to understand what they are actually dealing with. Addiction rarely presents in isolation, and most patients have a co-occurring condition, whether depression, anxiety, trauma, or something else. Assessing that properly and beginning to address both conditions takes time. 

There is also a neuroscience case for the duration. Prolonged substance use changes brain chemistry and alters neural pathways. After someone stops using, full cognitive function can take up to 90 days to return. The 12-step fellowship’s longstanding recommendation of “90 meetings in 90 days” drew on lived experience, but addiction medicine now explains why: the first three months are when the brain is most vulnerable to relapse and least equipped to make sound decisions. Thirty days of inpatient treatment covers the most acute phase of that window.

In our experience, patients who reach twelve months of continuous abstinence are far more likely to maintain long-term recovery. Thirty days is a solid start. Houghton House recommends building on those 30 days with secondary care, structured aftercare, and ongoing support. The goal of inpatient treatment is to get you stable and into the therapeutic process, but the work continues well beyond that first month.

No, we do not offer shorter inpatient programmes, with the exception of a 14-day relapse programme that is reserved for former Houghton House patients who need to be readmitted.

From 06:00 to 20:00 daily, patients at Houghton House are engaged in therapeutic activity with almost no gaps. Group therapy, individual sessions, psychoeducation, and 12-step work fill the day. Mealtimes and evenings are the only real breaks.

The pace is deliberate. Keeping patients occupied and engaged from morning to night is part of the treatment, not incidental to it. The daily programme at Houghton House is one of the most rigorous in the country, and the clinical team considers that a point of distinction.

At Houghton House, our primary mission is to provide a safe, supportive, and focused environment that promotes healing and long-term recovery. To ensure this, we have established a clear policy regarding the use of electronic devices during treatment. We do allow limited access in specific cases. This can be discussed before admission.

Phones, laptops, and tablets are collected and stored securely on admission. For the first 7 days, there’s a complete blackout on calls, and any device use is strongly discouraged for the first seven days. 

Continuing to work during inpatient treatment isn’t compatible with the programme. The daily schedule runs from 06:00 to 20:00 with therapeutic activity throughout, and the device restrictions exist for the same reason: recovery requires full presence. Staying connected to work obligations during that time undermines the process. 

If work commitments make a full break from work impossible, the outpatient programme may be a better fit. Outpatient programme patients attend for a few hours a day and manage their own time outside of sessions. Speak to the admissions team before coming in to discuss which option suits your situation.

Within the first 7 days of treatment, a family session is arranged with the patient’s treating psychologist. During this period, no other visitors are allowed. 

After the first 7 days of treatment, family (including partners if unmarried) is allowed to visit on Saturdays (14:00-17:00) and Sundays (10:30-17:00) for a maximum of 2 hours per day.

Patients may video call children under the age of 10 in exceptional circumstances, subject to the child’s best interest and confirmation with family. The admissions team can make arrangements upon admission.

For children over 10, the standard call allowance applies: three calls per week from the landline in the counsellor’s lounge.

No phone calls are allowed to be made within the first 7 days of admission. Thereafter, patients may make 3 phone calls per week: 

• 1 weekday call (Monday–Friday)
• 1 call on a Saturday
• 1 call on a Sunday

Phone calls are only allowed to be made from the landline in the counsellor’s lounge, and according to the call list.

Any device use is strongly discouraged throughout the entire duration of inpatient treatment, and phones, laptops, and tablets are collected and stored securely upon admission.  Patients and families should arrange for essential phone use or communication needs prior to admission. 

In the few exceptional cases where patients are granted personal device access, the following restrictions apply:

• No device use for the first 72 hours after admission
• After 7 days, patients who have received special permission have limited windows for personal device use:
  • Weekdays: 20:00–21:00
  • Weekends: 14:00–16:00, for one hour only

Outpatient treatment allows patients to attend therapy and group sessions at Houghton House while continuing to live at home.

Outpatient treatment is suited to people with a milder substance use disorder, significant work or family commitments that make residential treatment impractical, or as a step-down option after completing an inpatient programme.

Houghton House’s outpatient programme runs for 4-6 weeks. The duration of outpatient treatment is usually determined by the programme coordinator before you enter the programme. However, if a patient needs more time, the programme may be extended from 4 to 6 weeks.

Outpatient treatment runs Monday to Friday from 17:00 to 19:00. For the duration of the programme, outpatient programme patients attend one group therapy session and one lecture per day. There is also one individual session per week with a therapist.

No, outpatient treatment is not covered by medical aid. In some cases, it can be claimed back from medical aid savings.

The decision between inpatient and outpatient treatment depends on three factors: the severity of the addiction, whether withdrawal requires medical supervision, and how much support and stability exists at home.

Outpatient treatment suits people who are genuinely self-motivated, prepared to be open with those around them, and have a stable home environment. If the addiction hasn’t reached the point of requiring medical detox, outpatient treatment can be effective.

Inpatient treatment is appropriate when the addiction is severe, when previous attempts at outpatient haven’t worked, when the home environment is too unstable or full of triggers, or when withdrawal requires clinical supervision. Alcohol and benzodiazepine withdrawal, in particular, can be physically dangerous and requires management in a hospital setting.

Addiction makes honest self-assessment difficult, and an instinct to choose outpatient often reflects a desire to keep the problem hidden from family or colleagues rather than a genuine clinical fit. Our admissions team can help you work out which option suits your situation.

Outpatient treatment typically costs between R17,000 and R26,000. This is dependent on whether the patient is doing the 4-week programme or the 6-week programme.

A halfway house is a supervised, sober-living facility for people who have completed inpatient treatment but aren’t ready to return to their home environment. Houghton House’s halfway house offers stable, substance-free accommodation while residents rebuild their independence.  

Unlike inpatient treatment, there’s no daily clinical programme. Residents are expected to work or study during the day, return to the house by curfew, attend 12-step meetings, and undergo regular substance testing. Sunday evenings include a compulsory house meeting and NA meeting. The structure keeps residents accountable without replicating the intensity of primary care. 

The halfway house is open to anyone who has completed a treatment programme, not only those who did their inpatient stay at Houghton House. There’s no minimum or maximum length of stay. The cost is R11,500 per month, which covers accommodation, breakfast, dinner, and laundry. Medical aid does not cover halfway house costs. 

The halfway house is open to anyone who has completed a treatment programme, not only those who did their inpatient stay at Houghton House.

There is no minimum or maximum length of stay in the halfway house. You can stay for however long you need.

No, it is a co-ed house. However, the men’s and women’s rooms are separated. Male and female residents may not enter each other’s bedrooms at any time whatsoever.

Yes, we absolutely encourage our residents to work or study while staying in the halfway house.

The following curfews apply: 

• 22:30 – Sunday to Thursday
• 00:30 – Friday and Saturday 

Extensions are available, within reason, if requested from a House Manager at least 24 hours in advance.

The cost of staying at the halfway house is R11,500 per month, which covers accommodation, breakfast, dinner, and laundry. Medical aid does not cover halfway house costs.  

Yes, we expect all residents to have a sponsor. It is further expected that residents engage with their sponsor regularly.

Residents are required to attend at least five 12-step meetings per week during their first month, reducing to three per week after that. Aftercare, group therapy, and religious meetings don’t count toward this.

Residents are also expected to complete a minimum of two pages of written stepwork each week, which the house manager checks regularly.

Breakfast and dinner are provided Monday to Friday. Lunch and weekend meals are the residents’ responsibility. Residents have access to a shared kitchen for lunches and weekend meals. Sunday evenings include a communal braai as part of the weekly house meeting.

Weekend sleep-outs are introduced gradually. Residents can’t sleep out during their first month. From the second month, one sleep-out per weekend is permitted, increasing to two in the third month, and unrestricted from the fourth month onwards. Sleep-outs cover Friday and Saturday nights only, and residents must be back for the Sunday evening check-in at 15:30. At least 48 hours’ notice to the house manager is required.

Residents are responsible for keeping their own rooms tidy and cleaning up after themselves in shared spaces. On top of that, everyone is assigned a rotating set of house duties each week. The details are posted in the house. Failing to meet these expectations can result in curfew restrictions and, in serious cases, suspension.

Yes, but visitors must be reported to the house manager before entering. They may not bring drugs or alcohol onto the property or arrive under the influence. Any 12-step members visiting must have at least 30 days of continuous sobriety. Visitors are not permitted in bedrooms at any time and must leave by curfew.

Yes. A house meeting takes place every Sunday at 15:30, combined with a braai and NA meeting. Attendance is compulsory, with no exceptions.

Halfway house residents may not visit nightclubs, bars, or lounges at any time during their stay.

Gambling in any form — including the Lotto — is not permitted.

Energy drinks and beverages containing stimulants such as taurine or guarana are not allowed on the premises, and this includes non-alcoholic alternatives to alcohol, such as 0% beers. New tattoos and piercings are also not permitted for the duration of your stay.

No, we only admit dual diagnosis patients — patients who present with mental health conditions alongside addiction.

While we’d love to help everyone in need of psychiatric care, we currently do not treat psychiatric conditions in the absence of substance use disorder or gambling disorder. This is so we can help more of the people who will benefit the most from our highly specialised treatment services (i.e., people in recovery).

Dual diagnosis refers to the simultaneous presence of addiction and a co-occurring mental health condition — for example, alcohol addiction and depression, cocaine use and ADHD, or compulsive gambling and bipolar disorder. The two conditions are treated together because addressing one without the other significantly increases the risk of relapse.

The only times we won’t admit a psychiatric patient is if there is no accompanying substance use or addiction, or if they are actively psychotic. In such cases, we will usually refer the patient to a specialised facility first to stabilise before we can admit them for addiction treatment.

Yes. Houghton House has an on-site psychiatric team that assesses patients at admission, prescribes and monitors medication where indicated, and provides ongoing psychiatric care throughout treatment.

The rehab programme uses various therapy modalities, including cognitive behavioural therapy (CBT) and dialectical behaviour therapy (DBT) for both individuals and groups.

You can’t force someone into recovery, but there are concrete steps you can take. Acting early, before the situation deteriorates, tends to be more effective than waiting for a crisis.

Houghton House’s admissions team works with families in this situation regularly and can advise on how to approach the conversation, whether a formal intervention makes sense, and what to do in the meantime. Our blog, What to do when someone won’t get help, covers the practical options in detail.

Voluntary admission is strongly preferred. However, in South Africa, a Section 33 court order allows for involuntary admission to a treatment centre when a person poses a risk to themselves or others.

While Houghton House accepts Section 33 patients for addiction treatment, we do not admit patients who are an active danger to themselves or others.

For immediate assistance in such cases, patients can be admitted to an involuntary psychiatric ward with a Form 4 (MHCA 04) for stabilisation.

A Section 33 order is a South African legal mechanism that allows a magistrate to compel a person to enter treatment when they’re unable or unwilling to seek help voluntarily and their condition poses a risk to themselves or others. 

The process runs through a social worker, who assesses whether a Section 33 is appropriate before making an application to the Magistrates Court. The application must include supporting documentation such as an affidavit, witness statements, medical records, police reports, and/or photographs. The magistrate reviews the application and issues the order if the case warrants it.

Within the first 7 days of treatment, a family session is arranged with the patient’s treating psychologist. During this period, no other visitors are allowed. 

After the first 7 days of treatment, family — including partners if unmarried — is allowed to visit on Saturdays (14:00-17:00) and Sundays (10:30-17:00), for a maximum of 2 hours per day.

All visitors need to be approved by the patient’s therapeutic team in advance to ensure that visits support rather than disrupt the recovery process.

Yes, family involvement plays a big role in treatment. Within the first 7 days of treatment, a family session will be scheduled with the patient’s psychologist. Follow-up sessions are encouraged if the patient and family are on board.

You don’t need a diagnosis or a confirmed addiction to reach out. The admissions team can help you make sense of what you’re observing and whether it points to a problem worth addressing. The conversation is confidential and carries no commitment to proceed.

Consistent family support in the period after treatment has a significant bearing on long-term outcomes. The most practical things you can do are encouraging your loved one to attend aftercare, recognising that relapse is part of recovery for many people (rather than a definitive failure), and avoiding behaviours that make it easier for them to sidestep accountability.

Families in this position also carry a significant strain of their own. Support groups like Al-Anon exist specifically for families of people in recovery and are worth considering alongside whatever your loved one is doing.