Is Residential Treatment Really Necessary for Drug or Alcohol Addiction?

Is Residential Treatment Really Necessary for Drug or Alcohol Addiction?


When someone asks the question: “Is residential treatment really necessary for alcohol or drug addiction?” what they are really saying is “Do we really have to resort to this extreme measure?”

Do we really need to go to inpatient rehab for 28 days just to get off of drugs or alcohol?

What if we did something easier, such as going to therapy or counseling a few days a week? Maybe hit a few AA meetings?

In other words, the person asking this question is minimizing. They are trying to minimize their disease to some extent. They might say things like “It’s not that bad really. I’m fine.”

The real solution to this problem is to turn the question around and ask the alcoholic: Are you really and truly happy?

Because if a person is really and truly happy then that is fine, they can go on about their business and live their life and be happy. But if they are upset, anxious, miserable, angry, sad, or full of self pity most of the time, then are they really happy just because they get a tiny window of “happiness” every once in a while when they are drinking?

In my experience, the alcoholic is fooling themselves. This is denial. They are in denial about the fact that they could potentially be happy again if they were sober, because they don’t believe that this is even possible for them. The idea that they could be clean and sober and experience happiness is foreign to the alcoholic. They don’t believe it. It is like a myth that does not apply to them, because they are unique and different.

Withdrawal is a problem, of course. The second the alcoholic stops drinking, their body starts to nudge them because it wants more. Eventually the body is screaming at them to give it more alcohol. Many people who are physically dependent will begin to shake or tremor because their nervous system is so confused during cold turkey withdrawal. This can actually be very dangerous and the alcoholic should seek medical attention if they are shaking visibly. At inpatient treatment they have medical staff and medications that can help you get through the detoxification phase safely. If you are at home then it is likely that you will succumb to temptation and just return to drinking at some point.

I went to rehab three times. The first time I was still in denial to the extent that I wanted to get out of rehab and go back to using marijuana while leaving the alcohol alone. But I was not ready to start attending AA meetings or anything. After two weeks or so I got out, tried the marijuana maintenance program, and quickly reverted back to full blown alcoholism. But I suppose that some seeds were planted at this point.

The second time I went to rehab it as because my family and friends did a massive intervention. I walked into a room and without warning, everyone was there (they hid the cars). They convinced me to attend rehab but I really wasn’t ready to surrender fully. I went to treatment but I relapsed immediately.

Timing is everything.

The third time I went to rehab was different. This time I was completely alone, completely miserable, and I knew that I was beaten. I could not figure out how to make myself happy any more, even when I had plenty of money and drugs and booze. At this point I realized that I did not know how to be happy, period. I was miserable. And, I had been miserable for a long time. I was sick and tired of being so miserable.

That is the point of surrender, when you realize that you do not know the answers, that you do not know how to find happiness any more. So you agree to go to rehab, you agree to get help, you agree to do whatever it takes.

I knew that I needed more than just detox. I knew that I needed long term treatment or a halfway house. I knew that I needed to go “all in” on recovery and completely immerse myself in the program.

So that is what happened the third time around for me. I knew that I was done, I had that moment of clarity when I truly surrendered. I even felt a sudden frustration because I could not convince my family that it was different this time, because I had “cried wolf” too many times in the past. But they would see, in time. And over 16 years later now and counting, they definitely see that the third time was very different for me.

It is not that rehab is a cure–that is not it at all. Instead, it is more that when you are truly ready to change your life, then you need to be willing to go “all in.” If you are not willing to dive into recovery completely and thoroughly, then you are not ready yet. Period.

I would say to the hesitant alcoholic or addict: Yes, you need to go to rehab. Of course you need to go to treatment. That is just the tip of the iceberg. Doing 28 days in rehab may sound like a lot, but it is nothing compared to the total effort that an alcoholic makes in terms of turning their life around. That 28 day rehab program is just a little starting block compared to rest of your life in recovery.

Recovery takes a great deal of work, and quite honestly, that work largely begins when you get out of the 28 day rehab program. Going to rehab is easy. Sure, it takes courage, and you need to make a decision first, but after you decide to go to treatment everything happens easily and almost effortlessly. Once you surrender and decide to seek help, things will just start happening for you.

No, going to a 28 day inpatient treatment center is not as big a deal as you think it is. If you are really going to dive into recovery and do this thing right, then that is just the starting point. One day when you have ten years sober you will look back at the entire first year or two of your recovery and see it all as one big process. The stay in rehab is just a blip, a minor detail.

What I am really saying is, get over yourself and just go to rehab already. It is the single best decision that you can make for yourself–not because the 28 days will magically cure you, but because it will set you up for a lifetime of success and recovery.

Rehab may not be an absolute necessity, but if you have zero willingness to attend rehab, I highly doubt your chances for success in recovery. My advice would be to open your mind and give inpatient rehab a chance–even if you have tried and failed in the past.