In the good old days, when you went to rehab, you went for a full 28 days. That was perfectly normal and insurance companies were apparently glad to pay for it.
These days, things have changed. A lot. No one generally wants to pay for 28 days in rehab any more.
Maybe you know someone who needs to go to rehab. A friend, family member, or loved one.
One of the problems is that the success rates based on 28 day programs are not very impressive. They work at times but they also fail for quite a few people. The rate of failure is not very encouraging given the high costs of inpatient rehab.
When I worked in a non-profit rehab facility, most people were allowed to stay for about 12 days total. But that included their detox period as well.
So you get into rehab and you are alcoholic. So in most cases you are a complete mess and you are still drunk. So how long does it take for you to detox from that condition?
The average is 3 days or so. So you will generally spend 3 days in a medical detox unit before you are even ready to start attending groups and lectures and meetings and learning about recovery.
So your average stay of 12 days is now shortened to more like 8 or 9 days of actual learning about recovery.
Can you really learn a new way of life in just 8 or 9 days?
Furthermore, some people (depending on their insurance or funding source for rehab) will only get authorized to stay in treatment for more like 3 to 5 days. So the rehab center has a choice at that point–they can either turn the person away completely, or they can take them in for a few days and consider that to be better than nothing.
I mean, it would probably be nice if a rehab center could put down their foot and say “if you can’t get funding for the full 28 days, then we can’t help you.” But in the end they can’t really do this. One, they need the money, and two, all of the health care cuts have forced them to shorten treatment lengths anyway. So they have had to go through this painful process by which all of their clients get less care, less days in rehab, and so on.
Of course it all depends on how someone is funded. If you are paying cash and you have lots of money then none of this is an issue. Simply find a rehab center and tell them you want to stay longer. If you are paying cash they are not going to refuse you.
If you are funding with health insurance then it becomes much trickier. It all depends on what your health insurance is willing to pay for, and how much money you will have to kick in. When I worked at a rehab center, my job was to handle funding and insurance on new clients who were coming in. My feeling over the years was that private health insurance companies are covering less and less, and they are requiring higher and higher copayments. So the people who have private insurance used to be in a very good position to get the help they needed (like 10 plus years ago) but recently that trend has reversed. I used to tell clients “it’s funny, but having private insurance can actually make it more expensive these days to get help.” Of course that also depends on which treatment center you are trying to attend.
Generally speaking, if you have private health insurance, you should not be shocked to find that you have a significant copayment upon checking into rehab. Due to this trend, I believe a lot of treatment visits have become shorter and shorter over the years. It is simple economics; people will pay for what they can afford. You have to have really outstanding coverage to get 28 days in rehab fully covered with no copayment.
That said, even if you have no insurance and no money to speak of, you might be able to get help to get the treatment you need. Make the calls and ask questions and you might get the help that you need, just because you asked. There really are no excuses unless you have already done all the footwork.
Is it possible to get clean and sober in only 3 to 5 days?
I suppose it is possible to get clean and sober in only 3 to 5 days, but that is a bit misleading.
When I finally got clean and sober, I basically dedicated my life to recovery for the first 2 years. Now you are probably wondering, “OK, what exactly does that mean?”
It means that I lived in a long term treatment center for 20 months. I lived and breathed recovery for the first 2 years. I focused entirely on building a new life in recovery.
During that time I observed a lot of people who were also struggling to get clean and sober. Later on I worked in a treatment center and I had the opportunity to watch more people try to get clean and sober. I watched many people who stayed about 12 days in residential treatment. I also watched people who just stayed 3 to 5 days in detox. And the rehab I worked at was also connected to the long term program where recovering alcoholics lived for 6 to 24 months. So I had the opportunity to observe a lot of data. And, I stayed there for over 5 years so I got to see a lot of stories unfold. People would relapse, come back to rehab later, tell me their stories. I watched how their recovery evolved over time. I got to see the results of different people’s efforts in recovery.
So when I say that it is possible to get clean and sober after only 3 days of detox, that comes with a huge string attached. In order to pull it off, you don’t just go to rehab for 3 days and then go back to your old life. That completely misses the point.
What has to happen is this:
Everything has to change.
That may sound like a cliche but it is absolutely true. If you want to stay clean and sober for the long run then you have to change everything. This means that you can’t just make a 3 day effort in recovery and expect for things to magically get better. If you only try hard for 3 days then you will relapse for sure.
Now the important thing to realize here is that your length of stay in treatment is NOT the most important thing. The most important thing is your commitment to recovery. This is dictated by your depth of surrender. The deeper your surrender, the more likely it is that you will remain sober….regardless of how long you stay in treatment.
You have to change everything. So your 3 days in rehab is just the tip of the iceberg.
Shoot, looking back at my own recovery (starting over 12 years ago), the 20 months that I spent living in rehab was only the tip of the iceberg. When I left that rehab center I was only getting started in my journey. That 20 months was like nothing. It flew right by. I cannot even imagine leaving rehab after only 3 days. That is insane.
So if you do go to rehab for a week or less, here is what you have to keep in mind:
You need to take massive action. I am not talking about 3 days of action. I am talking about 3 years and beyond of taking action. Every single day.
In other words, you may only go to treatment for 3 days, or 7 days, or 12 days, but your recovery is going to last for the rest of your life.
And it takes much more than a week or even a month to start living a new life in recovery.
Shoot, you have to realize something first. You have to BUILD a new life in recovery before you can even start to live it.
This takes time.
I am sorry, but this is just how it works. Recovery is a process. And that process takes time.
You can try to rush it if you like, but reality will show you who is boss. Some parts of your journey cannot be rushed. You have to learn everything in its own time. You have to be willing to learn as you go along. It is like peeling back the layers of an onion as you learn more and more about yourself in sobriety. You can’t just peel them all off at once. If you do you will miss subtle lessons. This will be evidenced by the fact that you have to learn some of the same lessons over again, because you missed something important the first time around.
Therefore you should not rush the process. You can’t rush the process, even if you try. Recovery takes time.
And so what I am saying here is that you need to be prepared for this epic struggle. It takes massive action. It takes a supreme effort. It is hard work and in the end it will pay off handsomely. But you have to do the work. And it takes a lot of work over a period of years. You have to keep pushing yourself to improve your life for a long, long time.
It is one thing to go to rehab and sober up over 3 days. It is quite another thing to live for the next 3 years (or the next 10+ years) and not be tempted to go back to the bottle. How are you going to accomplish this long term goal? Of course we all do it one day at a time, whether we realize it or not, but ultimately it is based on the positive actions that you take. This is why I say that you have to take “massive action.” It is not only that you have to make this huge effort, but also that this effort must be sustainable. You have to keep pushing. You can’t let up.
Bottom line: If you go to a 3 to 5 day rehab program, go into it with the knowledge that this is just the tip of the iceberg, and that you have a ton of follow up work to do if you have any hope of staying clean and sober in the long run. Realize that the real learning process in recovery never ends, and that you are going to have to work very, very hard at it when you leave detox.
What if you are not ready to leave treatment after a few days?
Sometimes you can find a way to stay longer.
This is worth exploring if you are already in rehab. For example, they will probably assign you a counselor or a therapist, even if you are only in treatment for as little as 3 days.
During that time, your job should be to try to schedule time to talk with this counselor. When you do that, you can ask them if they can help to find you placement at another facility. Maybe they can help you find something that will accept different funding options. For whatever reason, you only have a short time authorized at the rehab you are already at, but maybe there are other options.
Specifically it is the case many times that there will be different funding for long term treatment centers. In other words, after you go through detox you may be eligible to get into a longer term facility. Not only that, but the way the long term center is funded may be completely different than the detox. So it is possible that you could work with your counselor or therapist and get placed at a long term facility. This is essentially what happened to me and I have watched it work out well for other people.
You never know if you don’t ask. In general, it makes sense to try to stay longer in rehab if you are serious about recovering.
Is it really much better to stay in rehab for 28 days?
If you are looking at really good data that shows relapse rates for various lengths of stays in rehabs, then “yes,” it is almost always better to go for 28 days rather than a shorter period of time. The numbers indicate that longer stays are almost always better when you look at the overall data.
Just consider the idea of pattern disruption when it comes to alcohol abuse. If you go to treatment for 3 days and then you go home immediately afterward, you have not really had much of a chance to disrupt your pattern of drinking. Your last drink is still very fresh in your mind. The temptation is still quite near after only 3 days. Not much has changed in terms of your thinking either after only 3 days. Your mind still justifies a drink just as easily as it did 3 days ago. You haven’t had time to learn any new coping skills either.
Now consider someone who has been in rehab for a full 28 days instead. They are over 4 weeks away from their last drink now. So the memory of taking that drink, the memory of getting drunk is faded quite a bit. They have more thoroughly disrupted their pattern of drinking. That immediate need to self medicate is no longer as strong. Their thinking is quite different now because they have been going to meetings and groups and lectures about recovery for 4 weeks straight. So when they get tempted to take a drink they can step back and look at the temptation objectively. They can label that thought as their disease, and realize that they have options for how to deal with it (such as calling a peer in recovery, calling their sponsor, going to a meeting, meditating, etc.). They no longer automatically justify the idea of taking a drink. They don’t automatically say “Oh yeah, a drink sounds good right now, and I deserve it.” They might have said that in their mind after only 3 days of detox, but after 28 days in rehab they know that this is self defeating. The thought might still pop up, but they have since learned how to label it more accurately, how to see through the deception. They have learned that their mind can be the enemy, that it can try to trick them into relapse. So their defenses are up and they have learned that they have to watch out for this. You can’t learn this sort of detail about recovery in just 3 days of detox, when you don’t even have your bearings yet. But you can learn this sort of detail if you stay in rehab for 28 days.
Therefore it makes more sense to stay in rehab for 28 days than it does to stay for just 3 days. In the shorter time frame you almost don’t even have time to get fully detoxed. You may still be physically dependent to some degree when you walk out of the door. But after 28 days in rehab you will have had time to actually learn about recovery, and you will have had time to deal with some actual cravings yourself (while being in a controlled environment).
Think about it: If you are only in rehab for a few days of detox, then your first craving is going to hit you when you are back out in the real world, fully vulnerable to relapse. If you are in treatment for 28 days then you will have cravings while you are in a controlled environment. Something to consider anyway.
Follow up and aftercare is the key regardless of time spent in rehab
No matter how long you are allowed to stay in treatment for, the whole key is aftercare.
Being in a controlled environment is a mixed blessing. On the one hand, you don’t have the ability to relapse. Period. While you are in treatment, there is pretty much zero chance of relapse. On the other hand, you are extremely vulnerable to relapse the second that you walk out of those doors to go home. Sweet freedom, but it is so dangerous. Because now you answer to no one, and can go drink to your heart’s content if you want. Once you leave treatment it is all up to you again. This is why aftercare is so critical.
To some extent it does not really matter how long you stay in treatment, because the whole key is going to be your level of dedication and the amount of effort you put in for the first few years of your sobriety. You are probably not going to be in treatment for longer than a month, so the whole key is in your follow through. What happens after you leave rehab? How much effort do you put into building this new life for yourself? This is what will determine your success in long term sobriety.
Why longer treatment is generally better
My best advice to you is to seek longer treatment times.
Or rather, my advice is that you seek high intensity recovery for as long as possible. This doesn’t necessarily have to take place inside of a residential rehab facility.
For example, you may go to a short detox session and then leave rehab to start going to AA meetings every day. Maybe you will go to several meetings each day and get really involved in the program. If so, then you might do just fine in recovery. The key, again, is in the follow through. It is possible to do well after rehab if you are serious about taking positive action every day.
To be honest, most people don’t follow through real well after treatment. They have good intentions but they tend to get lazy. They don’t want to do the work.
If you are willing to do the hard work that recovery requires, then nothing else matters quite as much. With the right attitude you will naturally try to seek out as much treatment as possible. In the end it is not only about the treatment, it is about what you do after treatment that really counts.
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