This is the third article in the “25 secrets of sobriety series.” The last secret exposed the idea that the spiritual approach to recovery is not optimal.
The “secret” of this article is simply that rehab is not a cure, but rather is just a mere starting point in the process that is recovery.
This can be learned on at least two different levels. One level is that the outsider who is not involved with addiction needs to realize that rehab is not an instant cure, and the other level is that the addict himself needs to realize this as well.
Usually in any given situation, the addict himself is slightly less than realistic, and the friends and family of an addict or alcoholic are usually completely misinformed about how the recovery process actually plays out in real life. Mainstream media is actually helping to correct this now with shows such as A&E’s “Intervention,” but there are still many people who do not understand the harsh realities of addiction (for example, a big one of these harsh realities is the entire point of this article, that a single trip to rehab may not cure a person forever, though we all hope and expect it to in most cases).
The outsider perspective
We have a tendency to put quite a bit of faith in modern medicine. Our general belief is that if someone is willing to seek help then surely we have the technology and the means to cure this person fully of their problems. Unfortunately, addiction seldom works that way.
Working in the rehab industry for over five years like I did, I got a chance to see this “outsider perspective” in action, over and over again. It was really quite sad to see. Family members of addicts and alcoholics would bring people in and expect that the person would be changed magically overnight, that they would certainly never drink or use drugs again, and so on. They expected and even demanded a magic cure.
Unless you have already had direct experience in dealing with an addict or an alcoholic in your life, it is easy to see why you might assume that we have the problem of addiction all figured out. It might be easy to believe in the power of medicine and technology, and just assume that we have made all sorts of advances in the field of addiction treatment, that we probably have pills now that cure addiction and fight cravings for every conceivable drug, and so on. It is understandable to see why the outsider would think this way, that they would have this hope that modern medicine has it all figured out now, and that a cure for addiction should be well within our reach these days. But of course this is not the case.
It is also very common to see another thought process from “outsiders,” and that is the “money solution” idea. Naive people generally believe that if they had millions of dollars and could send their addict or alcoholic to any rehab in the world then surely they could be cured, simply based on the obscene amounts of money they could pay for treatment. You pay more for rehab, you get better results, right?
This idea is another fallacy that is easy to understand why people think this way, but the real truth is that recovery rates are pretty flat across different rehabs. Going to the most prestigious and best rehabs in the world is not going to give you a huge advantage over going to the cheapest rehab you can find, or even one that is set up by the government to provide free addiction services to homeless people.
Just think about it: if spending more money on rehab could insure success, then we would essentially have the cure figured out, and it would simply be a matter of scaling that up to help other people in terms of affordability. There is no cure for addiction and throwing millions of dollars at the problem of helping just one person is not going to get you any closer to this imaginary “cure” that does not even exist. At best we can arrest the disease of addiction and be vigilante enough to keep it held in check, sometimes for years and sometimes for a while lifetime, but this is a painstaking process and a long journey, not a simple 28 day stint in a nice rehab.
No, recovery is not an event. It does not happen in a short 28 day span, and then everything after that is nice and easy. That is a fantasy.
No, recovery is a process, one that unfolds over decades of time, with much learning and growth to be had at all stages of the game.
It is not:
Check into rehab, learn to be sober, go live a sober live.
Rather, it is more like:
Check into rehab, learn about the process of recovery, go relapse, go back to rehab, learn some more, try to apply it in your life, experience some sobriety for a while, go through more growing pains, find a healthy path in recovery and stay clean and sober for years and years, continue to learn about yourself, continue to work hard on recovery, etc.
The second example may not be your exact experience, of course, but it is almost always going to be closer to the truth than the first example that is so neat and clean and tidy.
The outsider expects that recovery is a tidy little event that is all wrapped up and over with when the addict goes to rehab.
The truth is that recovery is a messy and complicated process, not an event, and it actually doesn’t even really start until the addict has left rehab and entered into the “real world” again.
Recovery is a process, not an event
Part of the reason that recovery is such a process is because breaking through denial is a process.
You might initially think that it is all about the learning, and that people in recovery have to go through this learning process, and those who fail to learn certain things will end up relapsing, only to have to learn them over again the next time that they try to get clean and sober.
This is pretty much exactly true–although not usually for the reasons that we think it should be true.
For example, take my first trip to rehab as an example. I had been drinking alcohol and smoking marijuana leading up to this point, and I had firmly decided in my mind that alcohol was my real problem. “If I could just stay away from the booze I would be OK,” I thought.
So what did I do? I went to rehab and I attempted to learn about how recovery might work for me.
There I “learned” 2 things that I failed to apply in my life:
1) I learned that a drug is a drug is a drug, and that if I was going to avoid alcohol then I would have to give up ALL mood and mind altering substances, including marijuana. This was not what I wanted to hear.
2) I learned that if I was going to stay clean and sober, I was going to have to let go of all the unhealthy relationships in my life (my friends who did drugs with me) and find a new support system that encouraged positive growth (the solution proposed to me for this was to dive into AA or NA). Again, not what I wanted to hear.
So did I fail to “learn” these two things? In a way, yes. But it was really all about denial.
The learning process that is recovery is all about peeling away layers of denial. Later on in my life I was able to clearly see that marijuana was just another way to self medicate, and that it would always lead me back to other drugs (like alcohol) if I continued to use it. When I first tried to get clean and sober, it was denial of this that kept me stuck. I believed that I might be different, that I might be the one person in recovery who could successfully use marijuana and avoid other drugs. It was not so much that I had failed to really learn this fact about “a drug is a drug is a drug,” it is that I was in denial about it.
In the same way, I was terrified of 12 step meetings and sitting in them and speaking in them made me really uncomfortable. I was furious that there were really no other solutions offered for people in recovery other than to go to these meetings. But all of the counselors and the therapists that I spoke with basically said the same thing to me, that they were going to be an important part of my recovery if I was ever to really get serious about staying clean and sober. It was a fact that I wanted to keep denying out of fear.
Eventually I became so miserable in my addiction that I no longer cared about my fear of meetings. I was so beat up and miserable due to my disease that I overcame my fear of meetings. It was not that I was determined and ready to take on the world and overcome any fear, it was that I was defeated, completely miserable, and no longer valued my life at all. This is known as “hitting bottom” and I had to get to this point in order to move past this last stage of denial. I had to accept 12 step meetings as my solution (at least in the short run) in order to make any kind of progress in recovery. This was my last lesson I had to learn and thus it was also the last stage of my denial that I had to break through.
Recovery is a process because breaking through denial is a process, and you have to break through all of your denial before you can get started on a new life in recovery and start making positive changes.
If you try to start on recovery while still hanging on to a piece of your denial, then these will become “lessons that you still need to learn” and you will eventually relapse in order to be able to try again some day with recovery and be able to “learn it” this time around. In fact what you are doing when you learn these lessons is to let go of all of your denial, surrender fully to your disease, and finally be willing to accept a solution in your life.
With some rare people this surrender process and breaking through their denial seems to happen all at once. With some rare people, they will surrender fully and go to rehab and then they will live happily ever after and never use drugs or alcohol again. This is going to be the exception though rather than the rule, because breaking through denial is such a long and clunky process for most people.
It is possible for a person to go to rehab just once and stay clean and sober forever. But it is not necessarily healthy for anyone to expect this to happen with the addict or alcoholic in their particular situation. Breaking through denial is a learning process and most people do not get the whole picture their first time through the grinder. In other words, the process of breaking through denial and finding “permanent” recovery can take years or even decades, and many false starts may be needed by a person in order to get through parts of their denial. It took me three trips to rehab before I had finally let go of all denial completely, and surrendered fully to the disease.
Rehab treats the immediate problem of detox and little else due to a short timeline
The idea behind addiction treatment is this:
* Check into rehab and go through a medical detox. Remove all drugs and alcohol from the system in a safe manner.
* Stay in a residential unit that is tightly controlled with no chemicals allowed and no chance for immediate relapse.
* Teach the addicts and alcoholics about addiction and why they might self medicate. Also teach them about recovery and things like relapse prevention techniques.
* Expose the addicts and alcoholics to a long term support solution such as the 12 step programs of AA or NA.
* Plan for aftercare and possible outpatient treatment, counseling, therapy, or some form of continued treatment after the person leaves rehab.
This is generally crammed into 28 days or less. These days most people who attend rehab for drug or alcohol addiction stay less than 28 days due to financial and insurance constraints. In fact most people who attend rehab do not have insurance at all and are using either government insurance such as Medicaid or Medicare or they are using government funding to be able to attend treatment. Most stays in rehab generally last about ten to fourteen days.
Part of this stay in rehab has to include detox at the beginning of it. This is unfortunate in a way because during the detox process most people are not able to attend groups or lectures and therefore cannot really learn anything about recovery until they are well enough to attend residential classes. So even though they may stay for two weeks at treatment they may only get about nine or ten days of actual learning about recovery.
What I want to point out here is that this is an incredibly short timeline, and even a 28 day program is just going to fly right by for most people. What they are so desperately trying to learn is how to live a clean and sober life without relapsing.
This cannot be taught in a month and in fact you cannot even teach it in a full year. It is a lifelong process of learning and “peeling the onion” that is more and more layers of our own selves that need to be explored in recovery. To think that we can get a real start on this lifelong process in 28 days or less is pretty crazy really.
Rehab makes a good starting point for this process but it is just that–a starting point. We do not walk out of a 28 day program anywhere near “cured” of our addiction. In fact we are not even crawling yet at this point, much less learning to walk.
Even long term rehab is a drop in the bucket compared to lifelong recovery
Going to a short term residential treatment program of 28 days or less is not really enough to “cure” someone of their addiction.
But what about a long term treatment program that can last up to 2 years?
I lived in a long term rehab program for 20 months.
Looking back, I can see that this, too, was merely a drop in the bucket. It was not a “cure” by any means, even though it helped me a great deal.
In fact, what long term rehab did, to some extent, was to simply “delay the challenge” of living in real world recovery.
I still had to, at some point, leave the comfort and safety and accountability of the rehab and go live in the real world. I still had many more lessons to learn about living in recovery, I still had to learn how to overcome addiction and cravings on my own, in the real world, without the safety net and the accountability of being in rehab.
You see, at some point, every addict and every alcoholic is faced with a test. Probably many tests if they continue to live in recovery. They will be having a bad day, a bad week, or even a bad month. And they will come face to face with their drug of choice and no one will be watching. They will be all alone, facing their drug of choice head on, and if they chose to use it, no one will know about it except for they themselves.
Every person in recovery is tested like this at some point, it is really just a matter of time.
And you cannot live in rehab forever. At some point, you have to spread your wings and fly and make your own decisions and hold yourself accountable.
At some point you are going to have to do the right thing, even when no one is watching, even when there is no accountability left in your life.
That is why they say that this is a patient disease. It will wait for years until it there is an opportunity to tempt you like I am describing here, and that is when your recovery will truly be tested.
A trip to rehab is not a “cure” for such a test in the future. Living in long term rehab is no defense against it either. These things can help you, but they are not going to save you when you are eventually tested in your recovery.
At some point in your recovery journey, you will have to “cure yourself.” It will be just you and your drug of choice. And it is then that you will understand that we are never really cured of our addiction.
Not that you will be tested and relapse, because many people who face such tests can do remain sober. But the fact that they are tested after years or decades of recovery should illustrate that we are never really cured, and that a trip to rehab is merely a starting point for our journey.
Rehab may not be a cure but it is still the best start you could give yourself
The bottom line is that there is no cure for addiction, but rehab is still the strongest starting point for most people.
Be realistic though. Realize that the journey does not even really start until after you have left treatment.
In some ways the real journey does not start until long after you have left rehab. There is always another layer of your self to discover.
The journey never ends.