If there is one thing that residential treatment does well, it is to disrupt a pattern of addiction or alcoholism.
After all, this is what treatment is designed to do. The whole idea is to help someone to break free from a life that has enslaved them.
Many alcoholics and drug addicts would prefer to avoid treatment if they can, however….especially inpatient rehab. There is a stigma associated with the idea of “checking into rehab” and admitting that you have lost all control over your life and your happiness. Yet this is probably the most powerful step that any alcoholic could possibly take in terms of overcoming their addiction. While it does not offer a guaranteed cure, it is still the best approach to a very difficult problem.
After all, if you spend 28 days in rehab, then that is 28 days of sobriety under your belt, where you did not drink or use drugs at all. Not a bad way to kick start your recovery. Disruption is key. Those who fail to disrupt their pattern will never even have a chance at real recovery.
Why residential treatment is so powerful at disrupting addictions
In order to change your life you have to do something different.
Checking into rehab is your chance to do exactly that, in a very big way. At least for the next 28 days (or however long you are in rehab) your life will be completely under someone else’s control. This is probably the biggest thing that turns so many alcoholics off to the idea, while also being the most important part of the solution.
Just take a look at the success rates for outpatient rehab and you will realize that this is not a very powerful approach to recovery. Going home from the rehab each day is a recipe for disaster. I am sure that it works for some people, but the numbers are just not that impressive to me (of course, the success rates for inpatient rehab are not all that great either, but they are typically better than what you get with either counseling, therapy, AA meetings, or outpatient therapy by themselves. In other words, while inpatient rehab is not necessarily a sure-fire cure, it is still better than all of the alternatives. This is largely because it is so effective at disrupting the pattern of abuse. At the very least the alcoholic or addict will walk away with some clean and sober time under their belt, and have the ability to decide if they want to pursue sobriety further.
There is a reason why they call it “surrender.” When you check into an inpatient treatment facility you are handing over the control of your life. This is by design. If you are not willing to do that just yet then you are probably not ready to get clean and sober. If so then that is OK, your time will come and that time will arrive after you have finally had enough misery and chaos in your life. When you have had “enough” you will be ready to give up control and let someone else (the rehab) tell you what to do and how to live. This is the point of surrender that you must reach in order to learn how to live a new life of recovery.
A discussion of cost/benefit analysis
Rehab is not free, even if it is covered by someone else or paid for by insurance. There is always a cost and as it is the cost of health care in general just keeps climbing and climbing. Therefore treatment is generally expensive.
This does not mean that treatment is a rip off. Of course if you go to rehab and then you leave treatment and you relapse over and over again you can certainly try to claim that rehab is a rip off. But the truth of the matter is that rehabs all around the world are doing the best that they can in order to help people. In the end it comes down to the individual and the fact that you cannot force someone to help themselves.
Many, many people end up in rehab when they have to fully and truly surrendered yet. I know this for a fact because:
a) I went to rehab myself, 3 times. Obviously 2 of those times I did not “get it.”
b) I worked in a detox and residential unit for over 5 years straight, watching many alcoholics and addicts go out and relapse and come back for more treatment. Some eventually “got it.” Many others did not.
c) I lived in a long term rehab center for 20 months. Again, I made lots of observations and learned much about addiction and recovery.
So the bottom line is that no one who enters into rehab really, truly knows if they are at their rock bottom and are in a state of total surrender. You can never be 100 percent sure. I felt like I was sure the last time, and I have stayed sober even since, but trust me when I say that it is really easy to fool yourself. For example, the first two times I was in treatment I was not really sure if I was at my bottom, or if I would ever drink again. I had no idea, quite honestly. And obviously both of those times I relapsed.
Watching other people in recovery will help to illustrate this concept as well. No one really knows for sure that they are at full surrender. They might tell you that they are, and that they are 100 percent committed to recovery, but then they end up relapsing. Perhaps later they come back to rehab and finally “get it,” and then they can look back and say “yep, I was just fooling myself before. Shucks!”
So you never really know. And I don’t think it is fair for the typical alcoholic to attend rehab once, come out and relapse, and declare for it to be a giant scam. Sure, they tried to get well and they failed at it, and you can either blame the rehab or you can blame yourself. But when you do this you have to realize that most rehabs have about 5 to 10 percent of people who leave and stay clean and sober for the long run. So it does work, it just doesn’t work for everyone. And that most definitely might not be the fault of the rehab itself. Because everyone who eventually “gets it” in recovery can look back at their previous attempts and say: “Nope, I just wasn’t ready yet back then, I was not serious, I was not at full surrender, I had not hit my bottom yet, etc.”
If you go to treatment and then you relapse then it is obviously expensive. But it is probably not much more expensive than if you just keep drinking or using drugs. Stop and think about that for a moment.
For example, I lived in long term treatment for 20 months. I had many peers who lived with me. Nearly all of them were in better shape financially when they left long term treatment than when they first entered it to get help. This was true even for the people who relapsed when they left. Because they had lived in treatment for 6 months, 12 months, 18 months, they were not wasting money on their addiction and most of them returned to the workforce as well. So even though treatment has a cost the net effect of this decision for many people is a net gain in the financial department.
Not to mention the fact that you cannot really put a price on sobriety itself, especially if it leads to happiness.
If you are drunk or abusing drugs then you are miserable. If you are not miserable yet then as your addiction progresses you will become extremely miserable. The “fun” that you once had with your addiction will all but completely fade away. In the end stages, the alcoholic is either blacked out or they are miserable and desperately trying to black out. They used to have “fun” when they were drinking but now it is simply an on/off switch. They come to or wake up and they are miserable so they start drinking. They remain miserable and never have any fun until they reach blackout. Then they cannot remember what happens after that. Then they wake up miserable. They try to tell themselves “phew! I know I must have had fun last night because I can’t remember a thing!” After a while that game gets pretty old. You will miss the days when you could be drunk and still have fun with it and be social and experience real joy. Those days are gone forever unless you sober up.
The reason that this happens is due to something called tolerance. The alcoholic and drug addict do not have a choice in this matter. Their tolerance is going to change over time and there is nothing they can do about it. If you take a year off and then start drinking again your tolerance will be back to these horrible levels by the end of one week, possibly by the end of one day for some people. Seriously, I have tested this out when I was still drinking and it is ridiculous. You can take some time off and “have fun again” for about a few hours when you go back to drinking but then suddenly you are miserable again and you cannot get enough. This is no way to live, folks, trust me! There is a better way.
That way is sobriety, and the way to start it out right is by disrupting your pattern by going to treatment. There are other ways to get started in recovery, but none of them work as well IMO.
Can you disrupt your addiction without rehab?
Sure, you can go through the disruption process without checking into treatment.
Let’s consider some of the alternatives:
Cold turkey on someone’s couch – this is just plain dangerous and in fact you can die from going through alcohol withdrawal. If you have the least bit of tremor when you stop drinking then I would strongly advise you to seek medical attention, as this can be a life threatening condition. Not drinking can kill you. Get to a medical detox, a rehab center, or even a hospital.
Jail – if you have done this before then you probably know how truly awful it is. No one ever says that they would like to detox in jail. Ever.
Hospital – This is better than nothing but it is still not optimal. Alcoholics who go to the hospital start drinking when they leave. Why? Because they don’t learn anything! And they don’t get any sort of real support. It may be a safe detox but it is also a dead end path. You need something more in order to recover.
AA meetings – These can help in the long run but if you need detox then we are back to square one. Rehab facilities generally have a medical detox built into them, as well as having AA meetings in house.
Counseling or therapy – Maybe good for aftercare but if you are struggling with sobriety then you need more help than this, at least initially.
Mental institution – Again, better than nothing and probably safe from a medical standpoint but not as specialized and helpful as an alcohol treatment center or drug rehab would be.
So it is certainly possible to find alternatives to inpatient residential treatment, but honestly none of them make much sense if you are serious about getting clean and sober. Why mess around when you could go straight to the optimal solution?
I know this probably sounds like I am trying to push people into rehab but that is really the best choice in nearly every case. I tried many of these alternatives at different times in my life and none of them came even close to working for me. Of course, I may be biased because when I tried these alternative I was not really at a point of true surrender, so obviously they were not going to work for me anyway.
Keep in mind too that inpatient rehab is really a combination of most of these alternatives listed above. So in other words, you are combining the best of most of these treatment methods under one roof. For example, at most rehab centers you will have:
* A medical detox.
* 12 step meetings such as AA and NA on a daily basis.
* Counseling and therapy of some sort.
* Group therapy.
* Aftercare support and possibly lead into outpatient therapy, counseling, recommended AA meetings, or even long term rehab.
In effect going to an inpatient rehab is the most comprehensive form of recovery that you can find.
How to prevent relapse after leaving treatment
All of this does not do much good if you walk out of treatment and start drinking again immediately.
I know that this is possible because it happened to me twice. The third time I was able to do things right and avoid relapse.
So what is the key to preventing relapse post-treatment? I would say that it is a combination of:
1) Following through with aftercare recommendations. They have done studies that show that the people who ignore the suggestions from the rehab center nearly always relapse after they leave. It is almost a perfect correlation. No aftercare, no sobriety.
2) Taking massive action in your recovery. I personally lived in long term rehab for 20 months, and was fully immersed in recovery while I was living there. This was enough “massive action” to carry me through this tough transition. By the time I moved out of long term rehab (and in with a fellow recovering addict) I was actually fairly stable in my recovery. But living in long term treatment does not insure success, because quite honestly most of my peers relapsed while living there. The key is in actually taking action and following through with things.
3) Personal growth. This is the big one, and it is also what is critical for the “final stage” of your sobriety that most people never really consider or think about. For example, you go to rehab and this may be thought of as the “first stage.” It is actually pretty easy to stay sober through this part if you are willing to check into treatment (takes guts though, I know!). Second of all you leave treatment and now you start going to AA meetings and you find some stability in early recovery. Maybe this is the “second stage” of sobriety. You find a sponsor and you get lots of support at the meetings and you hang on dearly to your new found sobriety. Finally you reach a third and final stage, and this is where you are now fully stable in recovery and you have adjusted to this new life in sobriety.
Now here is the kicker: You can still relapse at this point! And many people do. This is because they become complacent. They get lazy. They stop pushing themselves to learn and to grow in recovery. And most of them cannot help it because they are just doing what they were told, going through the motions, hitting their meetings and so on. But they still get lazy and they still may end up relapsing without really knowing what hit them.
So the key is that you must learn how to keep growing in recovery, how to push yourself to keep achieving more personal growth.
You must improve yourself and your life, continuously. If you don’t then you just might relapse. Even if you are engaged in the “basics” and going to meetings every day, etc.
It can happen.
So how do you prevent it?
Why the recovery process lasts for the rest of your life
In order to stay sober forever you would have to keep improving your life forever.
There is no such thing as standing still in recovery. If you try to stand still then you are actually sliding backwards. Maybe we are all on a hill or something. But if you sit still and get lazy and stagnate then eventually your addiction will jump and take a big old bite out of you again.
If you stop growing then you relapse.
Therefore the key is personal growth. Continuous reinvention of yourself.
So how do you do this?
How do you keep “reinventing yourself” in a practical way?
You do it through improvement. You must improve your life and your life situation (two different things).
In order to do this well you may have to seek help from others. There is no weakness in doing this as seeking feedback and guidance from others is like a massive shortcut to wisdom. They can see flaws in us that we cannot see in ourselves.
So the basic idea here is:
1) Identify flaws in your life (negative stuff that holds you back or drags you down. Both internal and external stuff).
2) Prioritize those flaws in terms of the benefit you would receive by eliminating it.
3) Attack the negative stuff, one thing at a time, and start improving your life.
4) Don’t ever stop this process. Go back to step one and start over with identifying the negative stuff again.
If you do this consistently then your life will improve dramatically over time. In order to do this well you have to be really honest with yourself to the point that you will be uncomfortable at times. But being uncomfortable and facing some of your negative issues is a small price to pay for the massive rewards and benefits that this method will yield you.
Plus the icing on the cake is that doing this keeps you sober.
How can you argue with that logic? Improve your life AND stay clean and sober?