Are drug addiction and alcohol treatment programs truly effective at helping people?
You could be forgiven for asking this question if you are the loved one of a struggling addict or alcoholic. Because to be honest, much of the time it appears from the outside when you are looking at the treatment industry that it just doesn’t work.
This is because most struggling addicts and alcoholics who go to treatment do not walk out of treatment after going for the first time and never touch a drop of alcohol or an illegal drug ever again.
In our minds, we have set this to be the bar of success. Permanent abstinence from all mood and mild altering substances, to include alcohol. Anyone who goes to inpatient rehab and spends several weeks there should be “cured,” right? They should leave treatment and never want to touch drugs or alcohol again. At least that is how the general population perceives the issue. If treatment for addiction is going to work, then this is certainly how it should work (or so we believe).
If there is a struggling alcoholic and you send them to the best treatment center in the whole world for 28 days then surely when they left treatment they would not want to drink as much, right?
Wrong. This is not how it works at all, unfortunately.
And deep down I think we all realize this instinctively. We know that just going to rehab is not going to permanently alter someone’s motivation. We can’t process someone like a robot and turn their life around against their own will. We can’t force people to want to be become sober.
Sure, we can help them. We can do anything and everything that we can think of to teach them a new way to live. We can show them support systems that can help them to remain sober after they leave rehab. And we can encourage them to change their life, to take it in a new direction.
But we don’t have a way to force sobriety onto people.
We don’t have a “cure.” Not in the sense that the general population believes treatment should work. We don’t have a magic wand that makes alcoholics want to get sober. We have no way to affect motivation and internal willingness to change. Unfortunately, these are the things that really matter when it comes to success in recovery. People don’t just “get lucky” in recovery and somehow manage to slide by. If a struggling alcoholic is able to turn their life around, it is only because they were so thoroughly sick and tired of drinking that they had reached a bottom in their life.
Is it possible to design a recovery that will work for your life, rather than to rely on a structured recovery program? Absolutely. But this is not something that you can do after 5 days of detox. It takes time to find “your path” in recovery. Better to start out on someone else’s path. That takes humility.
Treatment is effective when all of the pieces are in place:
* Hitting bottom.
* Willingness to listen, to take advice, to take suggestions from other people.
* Action. Following through on advice, on getting help.
* Follow up. Consistent action. Rebuilding life through daily habits. Persistence.
These are some of the core fundamental principles of a successful recovery. Leave one of these elements out and it won’t matter where you go to rehab or what treatment program you are following.
For example, I have watched several struggling alcoholics who came into detox, went through a residential program, participated in groups and AA meetings, but then they relapsed shortly after leaving treatment. This happens quite frequently. So what happened?
The person will come back to rehab months or years later, and say “I just wasn’t ready yet” or something similar. So when they left treatment, they did not follow through. They did not take the actions that they needed to take. Maybe they went to one or two meetings but then they slacked off and stopped following through.
It is usually about a lack of action, which can be traced to a lack of willingness, which can be traced back to a lack of total and complete surrender.
“I thought I was at my bottom but I guess I wasn’t. I had more pain and suffering to go find out there before I was truly ready to stop drinking.” This describes the problem perfectly. The alcoholic thought they were ready to change their life but for whatever reason they had reservations. They lacked full willingness because they had not truly hit bottom yet.
Surrender to the disease must be “total” surrender, or it won’t work. If you hold something back when you attempt to surrender and turn your life around then you will get tripped up and go back to addiction.
Recovery is pass/fail
If you were to look at the evidence in my life then you could conclude “treatment must work, this person has been sober for many years now.”
But if you looked at my life 13 years ago (or more), then you could conclude the exact opposite. You could say “Treatment doesn’t work at all, this person has gone to two different rehabs and he is still drinking every day and struggling a great deal.”
Notice that there is no room for a middle conclusion. This is because, in the world of addiction and alcoholism treatment, there are essentially only two outcomes (this is my opinion of course):
Pass or fail.
Sober or relapse.
There is no middle ground. Now actually, there are some radical treatment programs out there that attempt to define a middle ground, and some of them even attempt to teach people how to moderate their drug or alcohol intake. Such programs have not experienced wild success and in fact one of the founders of those programs got into a very bad drunk driving accident (thus increasing my skepticism of the whole “moderation movement”).
No, recovery is pass/fail. You are either sober and hanging on for dear life, or you have jumped off the cliff and you are back to a life of drinking.
Oh sure, you can trick yourself for a few days when you first relapse (maybe). You can do this by deliberately forcing yourself to hold back, to drink as conservatively as possible when you first relapse. This will last for a day, maybe a week. But at some point you will lose control again. This is alcoholism. This is how addiction works, people. You might fool yourself for a while and seem to be in control, but eventually the alcohol will take over and you will go absolutely nuts. You will get hammered and lose all control of yourself. The beast will take over in the end and it will have consequences in your life. Again.
It would be quite a different world if you could send an alcoholic to rehab and they could “graduate” from treatment, come home, and then start drinking 2 beers a day for the rest of their lives. That would be a very different world that has no resemblance to the world we actually live in. Because recovery just doesn’t work that way. You are either sober or you are a raging alcoholic. That is what alcoholism is at the core, it is a disease of extremes. If we could moderate there would be no problem.
Recovery is pass/fail. So when you judge someone who has left a treatment program, there is really only question:
“Is the person sober and improving their life, or are they drinking and allowing their life to spiral out of control again?”
If you think there is a middle ground for an answer then alcoholism has you fooled. You are under the spell of addiction. There is no middle answer, which is why the question is phrased in such a way as to eliminate it. You are either working on recovery or you are working on a relapse. Which is it?
The unlimited upside to successful sobriety compared to the waste and expense of instant relapse
Because recovery is pass/fail, the stakes are high for someone who is going to a 28 day (or longer) rehab program.
The stakes are this:
A) Remain sober and improve your life every day, experiencing true joy and contentment, or
B) You relapse back into chaos and misery.
There is no middle option “C” that can give you a middle path between these two extremes.
Sobriety has unlimited upside. If you remain clean and sober and you start putting in effort to change your life for the better then guess what? Your life will get better and better every day. This can continue for years or even decades. You cannot possibly imagine how incredible your life can become after a decade of taking positive action every day. The upside of successful recovery is truly unlimited. Your life will overflow with joy if you are persistent in taking positive action.
The benefits of recovery don’t just come to you, they accumulate over time. They multiply. Life gets better and better if you are putting forth the right kind of effort.
And what effort is that? It’s not too complicated really. I would say following these three rules would get you there:
1) Don’t drink or use addictive drugs no matter what.
2) Strive every day to improve your life (eliminate fear, anger, guilt, shame, self pity). Work on the internal stuff. Ask for help in this. Get support.
3) Strive every day to improve your life situation (eliminate toxic relationships, get a better job, career, lower stress, etc).
It’s pretty simple. You stick to sobriety, then you work hard to improve your life and your life situation.
If you do this consistently then your life will start to get better. If you do this consistently for a full year then your life will really start to show dramatic improvement. And if you do this consistently for the next decade and you are taking positive action every day then you will be truly amazed at what the outcomes are.
Most rehab centers focus on 3 things as part of their program guide for recovery:
1) Abstinence. “Don’t drink or use drugs no matter what.”
2) Learning. “Here are tools to help you avoid relapse.”
3) Support. “Go to meetings every day, get a sponsor, call your peers.”
If you do these things then you can definitely build a strong foundation in early recovery. The problem is that many people who leave rehab do not follow through and do these suggestions consistently. They slack off and they stop going to meetings, they don’t seek out support, they don’t try to learn more about how to rebuild their life.
You cannot go to treatment and get “partial results.” You don’t go to rehab and then leave treatment and then six months later tell your friends “yeah I am glad I went to rehab because now I only drink a six pack of beer instead of a twelve pack.” That isn’t how it works. You might fool yourself for a few days or even a few weeks by drinking that six pack but eventually you will return to your old level of consumption. Treatment doesn’t give partial results. It is only pass/fail. And so this can make it seem like it is pretty worthless when someone leaves rehab and they relapse immediately.
How to maximize your treatment expense: Waiting for “true” surrender
How can you maximize the value that you get from treatment?
There is only one way to do this.
The trick is to go to treatment only after you have truly surrendered.
Go to treatment only when you hit your true rock bottom.
There is one problem with this: It is not always possible to know when you have hit rock bottom.
It is definitely possible to fool yourself into thinking you are “truly ready” for recovery. I worked at a rehab center for 5 years plus and I definitely met many people who thought that they were ready to change, only to later realize that they were not truly at their bottom yet.
Was their trip to rehab wasted? Not entirely.
Sometimes you have to try and fail in order to realize just how serious the situation is. I had to do this myself, apparently. I went to rehab 3 times. Obviously the first two outcomes were bad. The third outcome has resulted in 12+ years of sobriety and still counting.
So what was different?
My level of surrender. The first two rehabs I was willing to attend treatment, but I wasn’t willing to change my whole life, to surrender completely, to “go to any lengths.”
If you want to get the most that you can out of rehab then it is all about your frame of mind when you attend. If you are in a state of complete surrender then you will get much more help from rehab than if you are still planning and scheming more ways to drink or use drugs.
Again, it goes back to the idea of “pass/fail.” You are either ready to change your life, or you are not. If you are not then it doesn’t matter where you go to rehab or what attitude you try to adopt. Deep down inside you have to be totally done with drinking. Sick and tired of your disease. That is the way to go to rehab and find success–when you have reached your rock bottom.
Why you should “risk” going to rehab even if you think it might not work for you
I believe it is still worth it to attend rehab even if you are not sure if you are at your bottom.
There are benefits to doing so. One benefit is that you get exposure to treatment and so you know what to expect. You learn what you are up against. Even if you are not ready to stop drinking yet, at least you will know what to expect if and when you finally surrender.
Does that seem wasteful? No one really knows for sure if they are in a state of total surrender, so if you have the willingness to attend treatment, my recommendation is to go.
Treatment for alcoholism is not a cure. I don’t think it ever will be. But it is the best thing we’ve got. It is our best solution.
So take advantage of it. Use treatment to help you rebuild your life. If you are not ready then you will fail and you will relapse. So what? You were drinking anyway.
Think of it this way:
It is better to go to rehab and to fail then to not go at all and just continue to drink or use drugs every day.
The opportunity cost of continuing to drink is just way too high.
The annual opportunity cost of staying drunk
If you continue to drink alcohol and you don’t even try to sober up then you have lost the game entirely. You have no chance of winning. None whatsoever.
You are not going to suddenly get lucky and just randomly stop drinking and turn your life around.
Think about this for a moment because many alcoholics and addicts have this fallacy in their minds.
They are secretly hoping that one day their addiction will just melt away and they will become happy.
It doesn’t work that way!
For true alcoholics (you will have to decide if you are one or not, no one can make this diagnosis for you), you are not going to improve your life unless you make a deliberate plan to do so.
A plan such as:
* Ask for help.
* Surrender completely.
* Go to rehab.
* Do what they tell you to do at rehab.
* Follow through, take action.
* Rebuild your life.
If you continue to stay drunk then you will be miserable forever until you die. That is alcoholism. That is addiction. There is no happy ending.
But you can change all of that if you are willing to go through those bullet points. Surrender. Ask for help. Go to rehab. Start taking action. This is how you rebuild your life in recovery. One positive action at a time.
I believe that in the long run you need to use a holistic approach to recovery. Long term sobriety requires continuous effort. But that is no problem because that effort is continuously rewarded. You just have to give yourself a chance to rebuild your life and start enjoying these benefits. It takes time to heal your whole world. But if you take the proper actions then it will definitely turn around and you will be rewarded for your efforts. Life gets better and better.
Take a look at this holistic relapse prevention guide and consider if you are moving towards a path of greater health or not in your recovery.
What about you, do you believe that alcohol treatment is effective? Have you had a positive or a negative experience in going to rehab? What has your experience been like? Let us know in the discussion forums. It only takes a second to register!