How Effective are Long Term Treatment Centers for Addiction?

How Effective are Long Term Treatment Centers for Addiction?


I have to admit that before I ever got clean and sober, I assumed that there was some sort of cure available.

I mean, I really believed that there was probably a way that you could purchase your sobriety. That if you could pay enough money to the right treatment center then surely you could find a way to escape from alcoholism and drug addiction. It was all a matter of finding the best treatment in the world and simply handing over a check. I guess in the back of my mind I assumed that this was how it worked.

In much the same way I think I assumed that going to long term rehab would produce much better results than going to short term rehab. If 28 days is good then 18 months must be better, right? This was my assumption that I made because I really did not have much experience or first hand knowledge of the issue. So at one point I sobered up and I went to rehab and I also lived in long term treatment. I learned a great deal by these experiences. Later on I did some research and I learned a lot more. What I learned was pretty surprising to me.

The surprising data and some possible causes for it

First of all, while I was living in long term rehab I noticed that nearly every one of my peers relapsed. I probably lived with about 30 to 35 different recovering alcoholics and drug addicts over a span of 20 months (the facility housed 12 people total). So people would leave the rehab and a new one would come in and take their place. It was supposed to be a six month to two year commitment but many people relapsed and left long before the six months was up. So the turnover rate was surprisingly high and the success rate was also not very hopeful. This was just based on my observations at the time.

After leaving rehab and starting to write about recovery, I learned that from a statistical standpoint, there was really not much difference in the success rates of short and long term rehab. Some studies showed a slight increase for long term rehabs but then in other studies there was no difference at all in the success rate. Why was that? And on top of this shocking data, it also seemed to jive with what I had observed while living in rehab myself. Most of my peers relapsed while being in long term treatment.

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One of the reasons for this surprising data is that far less people go to long term rehab, while huge amounts go to short term. Of course we are looking at percentages and not absolute numbers so this should not really make a huge difference, but I think ultimately it does somehow. I think there is a belief that if someone checks into long term treatment then they must really be serious about recovery. The fact is, I watched a lot of struggling alcoholics check into long term rehab who had not yet hid bottom.

Another reason that the data might be so surprising is because many people who enter long term rehab are doing so for the wrong reasons. They see an opportunity to rest and relax and take a break from the storm of addiction. I met several people in long term rehab who were doing exactly that, whether they realized it or not. This is because they kept relapsing and then coming back to long term treatment later in their life. Essentially they were using it as a “flophouse.” They would crash and burn in addiction and then they would simply check back into rehab to get on their feet again. They found themselves in a vicious cycle involving long term rehab. They were still in a cycle of relapse but they had found a way to stretch it out a bit. I met several people who were in this sort of cycle.

Recovery is entirely pass/fail. You either remain sober or you relapse. There is absolutely no area in between those two extremes. And so it all boils down to surrender and the amount of willingness that a person has in early recovery.

I think this is the real reason why the success rates of short and long term rehab are so similar. It is because it has nothing to do with the length of treatment and everything to do with the state of surrender of the individual. If you reach a point of total surrender then it doesn’t matter what you do for treatment, the individual will succeed. If the alcoholic or addict has NOT reached a point of total surrender, then it doesn’t matter what you do–they are going to relapse. And that is what it all boils down to in the end. That goes back to what I said in the beginning, about how I believed that you could probably buy a cure for addiction if you had all the money in the world. It doesn’t work like that. Going to long term rehab does not give you this huge edge over short term rehab. In fact it does not make one tiny bit of difference because ultimately it all comes down to surrender. You have either surrendered to the disease or you have not. Recovery is pass/fail. So if you have surrendered and you go to short term rehab, you will stay sober. If you have NOT surrendered and you go to long term rehab, you will relapse. It is as simple as that. Where you go to treatment and how long you stay has nothing to do with outcomes. It is only a reflection of your level of surrender and your willingness to change.

This may be reflected in some studies (and some data you may see) because those who have reached a point of full surrender are slightly more likely to embrace long term rehab as a solution. But do not confuse this with causation. It is not the long term rehab that is causing them to stay sober more frequently than short term rehab. It is the fact that more of those people going to long term have fully surrendered to their disease. Send them all to short term and you would get roughly the same success rate. It is all about surrender.

Subjectively I have to say that long term rehab is the best solution (it worked for me)

Long term rehab worked for me when all other solutions had failed. But I really believe that this is because I had finally reached a point of complete surrender.

Previously I had not surrendered fully, and yet I still made some half hearted efforts to get clean and sober. So I went to counseling. I went to therapy. I went to a few short term facilities. Nothing worked because I had not really surrendered to my disease. I was not ready to stop drinking.

But eventually I became desperate enough that I really wanted to change my life. I wanted something different than what I was getting. I was fully miserable and I realized that it was all my own doing and it was based entirely on my alcoholism. I could no longer point the finger of blame at other people. This is the turning point, where I finally surrendered.

I happened to check into long term rehab at that point, based on the suggestion of many. In the past this was something that I was never willing to do. But now that I had reached a point of true surrender I was willing to go live in long term rehab. This action was a reflection of my willingness. I truly wanted to be sober at that time so I was willing to do whatever it took. The therapists and the counselors were telling me (and had been telling me for over a year) that I needed long term rehab in order to get sober. So I finally listened to them and followed through with their suggestion because I was desperate to change. I wanted the pain and the misery and the fear to finally end.

The problem is that long term rehab cannot change your desire to be sober

What you need to understand here is this one important point:

Going to long term rehab cannot change your desire to be sober.

If you don’t believe me then go get a job at a rehab center, preferably one that includes both a short term and a long term unit. Work there for several years and just observe what happens. I can tell you what will happen because I did this myself after getting clean sober.

What you will see is that people come and go in rehab. And many of them will relapse and eventually come back for more treatment. Some will go to short term, some will go to long term, some will go to both. A few will stay clean and sober and become a success story. Many of them will relapse and you will hear about it from others who come into treatment. Or you will learn that they relapsed because they will come back into rehab later on again. And so over the years you will get a feel for this cycle of addiction and you will start to pick up on who is at a level of full surrender and who is not. It is very hard to distinguish and predict this though.

And ultimately you would learn that most people who come into rehab simply aren’t ready yet. Including those who check into long term rehab. Many times they are secretly hoping that “this will work for them” because nothing else has worked and they don’t know what else to do. They are at their wit’s end because they don’t know how to stay sober on their own. And they are hoping for a magic solution.

I cannot fault people for hoping but you need to be crystal clear about something here:

Going to long term rehab cannot change your desire to be sober.

In other words, you can’t buy sobriety. And you can’t force yourself to go to a more intense or a longer treatment in order to produce better results. It doesn’t work that way. You can’t just say: “Well, I went to a 28 day program and I relapsed, so I will force myself to go to a 2 year program and surely that will lead me to sobriety.” It doesn’t work that way. Signing up for more treatment is not the secret solution. Signing up for better treatment is not the secret. Finding the best rehab in the world and paying more money is not going to save you either. None of that stuff really matters. You cannot buy your sobriety at any price.

Instead you have to really want it first. No, really. You do. Deep down you have to want to change your life more than anything else in the world. And once you reach this point then you will suddenly stop thinking like I was thinking, where I imagined that you could buy your sobriety if you only had enough money. Or that if you just found the perfect rehab that it would cure you. Or that if you just forced yourself to attend rehab for a few years rather than a few weeks then that would surely cure your problems. All of that thinking is wrong. None of that thinking reflects reality.

The truth is that going to a certain rehab, going with a longer rehab visit, or spending more money for the “best” treatment in the world cannot overcome a lack of surrender. Recovery is entirely pass/fail, and that is all determined by your true level of surrender. Either you have surrendered fully to your disease or you have not. And if you haven’t, then none of that stuff is going to matter. Going to the perfect rehab is not going to change your surrender. It will not give you an edge in staying sober. You will still be doomed to relapse because you failed to surrender fully.

Going to long term treatment cannot cause you to surrender. It cannot convince you to want to be sober. It doesn’t work that way.

If you are motivated to change for yourself then long term rehab gives you a ton of support

The good news is this:

If you are motivated to change (i.e., if you have surrendered to your disease) then long term rehab can give you a ton of support.

I lived in a facility with eleven other recovering alcoholics. We went to meetings every single day because that was required of us. We met twice a week for therapy groups and hashed out our problems. We dug deep into our feelings and learned how to communicate them.

And we were held accountable. We were drug tested on a regular basis. We had to use a breathalyzer randomly each week to make sure we had not been drinking. And if someone relapsed they were kicked out immediately. So there was a definite element of accountability.

On the other hand, you would be surprised at how much this level of accountability really did not help. People still relapsed while living there. People still screwed up, sabotaged their own recovery, relapsed, and then left.

This was so shocking to me because these people had every opportunity with which to remain sober. They were surrounded by a support system. They were already going to meetings every day and getting professional therapy and counseling. They had everything going for them but they still ended up relapsing. It was so frustrating to watch it happen over and over again. This is what will eventually cause you to realize that you cannot force sobriety on anyone, even on someone who thinks that they want it. Deep down they have to want it more than anything else in the world.

There are always two forces competing in every alcoholic. One force is simply wanting to get blasted drunk. The other force is the desire to change and build a better life. It is just like the two wolves, the one that wins is the one that you feed every day.

And that is why recovery always comes down to your daily habits. Long term treatment is good at one thing: helping you to establish a daily practice.

Finding your daily practice in long term rehab

There is no magic in recovery, just as there is no magic in long term treatment. But you can create your own magic by building a new life for yourself. You can do this if you are in rehab just as well as you can do it while you are outside of treatment.

You become what you do every day. Fast forward your life 3 years from now, and where will you be? In 3 more years, what will:

….your emotional health be like?
….your relationships be like?
….your physical fitness be like?
….your dependencies on drugs and alcohol be like?
….your spirituality be like?

Where will all of these things be in your life 3 years from now?

I can tell you how to figure it out:

Simply add up what you do every single day for the next three years. That will tell you exactly where you will end up in each of those areas in the future.

Reality does not lie. There are no magic shortcuts to achieving optimal health in any of those areas. If you want to build something positive in your life then you simply need to start laying bricks down, one at a time. Each day is another brick to be laid. Each day is another opportunity for positive action.

If you want to build a new life for yourself in recovery then you must be persistent. It doesn’t happen overnight. Your first few weeks in recovery may actually be somewhat miserable. This is because you just cut yourself off from your “best friend” and you are trying to learn how to live a “normal life” again. That is understandable.

Give yourself a break. It takes time. You are not going to be happy, joyous, and free overnight. It will take some time to get there, to build it up. But build it you will if you are determined to take positive action every day.

This is what should give rise to the daily practice. Should you work on your spirituality? Should you work on your physical fitness? Should you improve your relationships?

Yes. All of it is important. And it all takes time. And you can’t do it all at once.

So the solution is to do what you can. To take positive action every single day, and keep pushing yourself to get to that next level.

What you must do is to find the daily habits that help you to become the person that you want to be.

One way to figure this out is through modeling. Sponsorship can work this way as well. Find a person in recovery who has what you want to achieve. Find someone who is living the life that you want to live. Find someone who has the character and the traits that you would like to see in yourself.

Then, find out their PROCESS.

The daily practice is all about process. Think back to the idea of 3 years in your future. How will you become the person that you want to be 3 years from now? Only by following the right process.

And that means you need to identify the daily habits and the daily practice that will lead you to the life that you really want.

This is modeling. I found a few people who had what I wanted. These people all exercised on a regular basis. So I started doing the same thing.

Another was living the kind of life that I wanted to live. So I started writing every day. I modeled what they were doing in order to get similar results in my own life.

And in doing these experiments I found things that really clicked for me. These became my daily practice. The habits that engage in over and over. These are the habits that have determined what I have now become.

Today I have a vision for the future. I have a vision for where I want my life to end up. So I now have a responsibility to make sure that my daily practice will lead me to that place.

This is how to grow in your recovery. You become what you do every day.

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