So They Have Been to Drug Rehab or Addiction Treatment Several Times,...

So They Have Been to Drug Rehab or Addiction Treatment Several Times, and they Know it All, but Continue to Relapse. What Next?


A reader writes in and asks:

“My son (or daughter, or wife, or husband) has been to drug rehab before and they say that they “know it all,” and yet they continue to relapse or struggle to stay clean and sober. What is the next step for me, and what can be done to encourage them to get the help that they need?”

I see this situation over and over again, actually. In some cases, the struggling alcoholic or addict is still using every day, with no real intention of quitting anytime soon. In other cases, the person may be trying to abstain, but they still end up trapped in a cycle of relapse.

Either way, the core of the problem is this:

The alcoholic or addict has been to treatment before, and they believe that there is nothing new that they can learn. Therefore, they refuse to seek professional help for their problem.

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So, what can be done about this? Let’s take a look.

Possible argument: you obviously missed something critical in treatment

This is the most important part of the issue, because it is the truth that they are refusing to see: they believe that they “know it all about recovery,” and yet they continue to relapse, self medicate, etc.

So you need to call them out on this. The way that you do this could very easily lead to an angry blow-up, or it might lead to the person taking a genuine look at their life. But either way, it is better than nothing. Even if it leads to an angry fight, it might actually sink in a bit later on, when the person cools down.

They think that they learned all that their is to learn about recovery, but they did NOT. If they did, they would be clean and sober today. Period.

Maybe the person actually had significant clean time in recovery. Maybe they were clean and sober for several months or even for several years.

It does not matter though. They missed a critical lesson in their recovery. They failed to learn something, which they are learning now (the hard way).

Maybe they failed to learn you have to keep pushing yourself in recovery, or you may become complacent and relapse.

Maybe they failed to learn that you can forget how miserable you were in your addiction if you are not helping others to recover.

Maybe they failed to learn that you are never cured, and that your recovery is contingent on continuous effort.

Maybe they failed to learn that, even though there is a transitional period where they may get depressed, that they will learn how to have fun in recovery again some day.

But ultimately it does not matter. You don’t have to diagnose their recovery or find the holes in it. The fact that they relapsed after treatment means that they missed an important lesson. And now they have an opportunity to go learn it.

Now they have an opportunity to change their life for the better, if they are willing to swallow their pride and admit that they have more to learn about how to live a sober life. Because obviously, they do not know everything that there is to know about recovery.

Talking the talk does not equal sobriety. Quoting the Big Book of AA does not insure that you know how to live sober. Actually living sober means that you know how to live sober. Big difference. Anyone who relapses or struggles to get sober has already proven that they do not yet know how to live sober.

Treatment or rehab may not be the perfect learning environment for this, but it is generally accepted as being helpful, better than nothing, and pretty much the best chance that most people have for getting a clean start in recovery. It’s not perfect but it does work (if they want it to work).

The need for confrontation and possibly boundaries

So the key here is that you see a need to confront the person.

If nothing changes, then nothing changes. It is easy for the addict or alcoholic to continue with what they are doing in their life, especially if they are in a cycle of self medicating.

Addicts and alcoholics do not change their whole life and get clean and sober when things are going good for them. That will never happen if things in their life are going halfway decent. That is not how addiction and recovery work at all.

No, the alcoholic will only change when they are absolutely miserable. They will only give sobriety a chance to work in their life when they are completely fed up with drinking, or if they have no other options. And even if they run out of options, they might not be finished drinking and drugging yet. They might just be broke and have no resources to continue the madness, but have full intentions of returning to a life of chaos just as soon as they get “back on their feet.”

As such, many alcoholics will ask for help at times, even though they might not be ready to quit drinking. Or they may ask for money, or for a place to stay, and so on. But are they really ready to make a positive change in their life? How can you know for sure?

You will know for sure when they are willing to do exactly what you tell them to do. That is the point of surrender. When they start taking direction without trying to manipulate people. If they are not at that point, then you should probably NOT try to help them.

So how do you set this sort of boundary? It’s pretty simple. Offer to take them to rehab, or offer to help them make calls to get professional help, and that’s it. No rides to work, no money, no nothing. They either accept help on your terms, or you do not help them.

If they get to a point where they are bouncing in and out of rehabs, but seem to have no intention of staying sober, then you may have to withdraw all support entirely, until they can prove themselves. “Go get 90 days clean and sober, and then come talk to me.”

Set your boundaries so that you can only help them, without enabling them. If they abuse your trust anyway, then move your boundary line again. Step away from them and protect yourself. Force them to deal with you sober or not at all. If they choose to keep abusing drugs and alcohol, their bottom will come that much quicker. If they are already at their bottom, then they will take any help that you suggest for them.

Tactical suggestion: plead with them to try a different rehab (which is beside the point but might still work)

Another tactic that you might try is to switch rehabs.

Now ultimately, this is not really the magic trick that people believe it is. No rehab center actually has an edge over the others. But people are constantly misled, and think that they do, because they finally surrendered to their disease, checked into a certain treatment center, and said “Wow! That rehab knows their stuff, and all the other places are worthless. They saved my life! Everyone should go there!”

The truth is, it is all about surrender, not about some magical treatment process that only certain rehabs know about. There are no shortcuts to sobriety. Pretty much all rehabs have the same basic tools to try and help addicts and alcoholics, and even the different treatment philosophies pretty much produce the exact same success rates.

In other words, if you go to rehab A and you relapse, then go to rehab B a year later and stay sober, it is not because rehab B is superior. It is because you finally surrendered when you checked into the second rehab.

But people do not know this, nor do they always believe it. So use this to your advantage, and try to convince the struggling addict or alcoholic to try a different rehab.

Perhaps, if they have truly surrendered, they will actually stay clean and sober this time around.

For someone who claims to “know it all” because they have been to rehab, it is worth a try. Convince them to go to a different treatment center this time.

Another suggestion: push them directly toward 12 step meetings and skip treatment

So the alcoholic in your life claims that they have learned all that rehab has to offer them. So confront them with this argument instead: They have been to rehab before, but they just failed to follow through.

So tell them that they just need to follow through. Go to AA, get a sponsor, and start working the 12 step program. That is the typical follow-through that most treatment centers suggest.

There are plenty of examples out there that prove that this path actually CAN work. You can skip rehab and go right to the meetings and build a new life for yourself.

And if you already know the basics, if you have experienced any sort of significant recovery in your life, then you should know that the support that you can get from 12 step meetings is sufficient to help you to sustain recovery (if you want it).

If they already “know what they have to do to stay sober” then tell them to DO IT. Tell them to take action, to take the bull by the horns, and go get their life back on track. So maybe they really would not learn anything new in rehab, OK. Fine. But go do what you have to do to stay clean and sober. Again, if they balk at these arguments, consider setting stricter boundaries, and eventually removing them from your life if you have to.

Help yourself too: get to an Al-anon meeting

It should go without saying that if you are struggling because of an alcoholic or addict in your life, that you should check out an Al-anon meeting or two. It is there that you can get pinpoint advice for your situation, as well as support from others who are going through (and have been through) what you are going through.

If you are overwhelmed with the addict or alcoholic in your life, or if it is negatively affecting you in a big way, then you owe it to yourself to at least go check out Al-anon.

In some situations, getting help for yourself in Al-anon meetings might be the start of change–not just for you but also for the alcoholic in your life. Depending on how much enabling is really going on, this could be the sort of decision that forces the alcoholic to really take a look at their own behavior, and eventually get honest with themselves.

If you can learn to stop enabling someone, then they will probably be forced to look at what they have really become. And drug addicts and alcoholics generally don’t like seeing themselves for the selfish beings that they really are. It is then, when they are confronted with the truth about themselves that they consider the idea of actually doing something about their problem.

If they still feel halfway decent about themselves, if they can still justify their own behavior in their minds, if they can convince themselves that others self medicate just as much as they do–then they will not change and they will not stop drinking and drugging. But if you withdraw your support from them, they might have to face how twisted their behavior is, how selfish they are, and how damaging their drinking or drugging is to other people. They will not “wake up” to their addiction if they never have any negative consequences because of it. They will not “wake up” to the possibility of change if they are still getting by OK in their everyday routine.

Go to Al-anon and learn how to get out of their way, so that they can find their bottom and start to heal again. If you try to help them, in many cases, you are only delaying their bottom and possibly prolonging the process. Help them by allowing them to crash and burn, by withdrawing your support, and by setting boundaries that show how serious you are.

Help them only if they will help themselves first. The change must come from them, from their decision. All you can really do is get out of the way.

Still need help? Come get support from real people in the addiction recovery forums.

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