There used to be a lot less hope in the world of alcoholism. There were no rehabs. There was no 12 step program of AA.
So when alcoholics lost control (which they always invariably did) they were basically locked up. Locked up in jails or locked up in mental wards. But either way, society had no answer for what to do with the alcoholic. They had no way to try to treat the condition. Society did not know that there was a solution, that recovery even existed.
These days we know better than this. Today we know that change is possible. We know that people can go to rehab and get a fresh start on life. We know that a person might go to AA and turn their life around.
So obviously it is possible for an alcoholic to overcome the disease without any help at all. It can be done, and it has been done. In fact, it was done in many different instances before AA or rehabs even existed (just not very often!).
So an alcoholic certainly could sober up with treatment. But is it a good idea?
Two major concerns: safety and success rates
There are two major concerns with getting sober on your own.
The first concern is safety. Alcohol withdrawal is very serious.
Most people believe that because alcohol is legal that it must be much safer than illegal drugs to detox from.
This is not true. Alcohol is one of the most dangerous substances to try to detox from. In fact, the withdrawal process can be fatal. You can actually die from stopping drinking. That is quite severe!
Now there are also some drugs that can prove to have a dangerous withdrawal as well, but alcohol generally tops the list because the abuse of it is so prevalent. Many people die each year from alcohol, and percentage of those deaths include people who quit drinking cold turkey. Their body does not know how to transition to being off of all of that depressant all at once, and their adrenaline goes absolutely crazy. They have seizures. Their blood pressure goes out of control. And some of them actually die.
Now imagine that you are detoxing from alcohol and you are in your own home. Who is there to help you if your blood pressure hits a danger point? Who is going to be taking your blood pressure every few hours? Probably no one. Would they even know that this is important to do during alcohol withdrawal? To keep checking vital signs?
This is what a medical detox is for. Pretty much any treatment center that you go to is going to have a fully staffed medical detox. So there are nurses there who take your vital signs several times each day. Furthermore, they administer medication that can help to prevent the worst withdrawal symptoms. So if you have ever been visibly shaking based on the fact that you have not taken a drink in a while, then you probably need a medical detox if you try to quit drinking.
Remember, alcohol withdrawal can actually kill you. Not taking a drink can be fatal. It is nothing to mess around with. This is a good enough reason as any to seek professional help when you are ready to stop drinking.
Second of all your concern in seeking treatment has to do with the success rate.
Let’s say that you detox on your couch at home and decide to just “do it all on your own.” So maybe you get lucky and you make it through withdrawal without any seizures or complications. What now? Do you suddenly start living a different life just because you got all of the alcohol out of your system? What is your plan? How are you going to cope with stress and anxiety? How are you going to have fun in life? Where will you go, who will you associate with?
There are really two points to rehab:
Think of the medical detox as the “disruption.” You are interrupting your pattern of drinking or using drugs. In a medical detox you do this safely.
But then what? What happens after detox?
I used to work in a rehab facility and there were always a few people each month who came in who were only set up to go to detox. That’s it. They just had to go through detox and then instead of going through the residential program (where all the meetings and groups and lectures happen) they just had to leave and go home again. For whatever reason, certain people were not authorized or able to get funding for residential treatment.
These people nearly always came back in the future for more help. I mean really, what good is detox all by itself? You disrupt the disease, then you walk right back into the storm, with no new defenses. Of course you are just going to get drunk again. This is because you have not learned anything.
Detox is for disrupting the pattern. Residential treatment is for learning.
If you want a shot at remaining sober then you are going to have to learn something new about addiction, recovery, and how to live your life.
You can’t just walk out of detox and then conquer the world just because you are now dried out.
Every alcoholic had reasons that they drank. Every alcoholic and drug addict was self medicating because they felt driven to do so. It was not just a little bit of fun. It was not just an innocent experiment. At some point they got hooked, and then it became a way of life.
Alcoholism is how you deal with fear. It was the answer to boredom. We drank for many reasons, not just one reason. Alcohol became our answer for everything in life. It was our reason for existence.
You cannot just remove the alcohol with a quick detox and then expect for the alcoholic to steer clear of alcohol forever. It doesn’t work that way.
They need a solution. They need help. They need to learn how to live their life without the crutch of alcohol.
And to be honest you cannot get all of that in detox. There isn’t time. Detox is quick. For alcohol it lasts roughly 3 days time. Maybe 4 or 5 days in an extreme case but the vast majority can be safely detoxed in just 3 days.
And then the alcoholic can start to learn something. This is why residential treatment exists.
They have a saying in AA: “If nothing changes, nothing changes.” Profound wisdom, right? But it makes perfect sense to anyone who has relapsed after trying to sober up. They can look back at their actions and realize that they never changed the important stuff (and therefore they drank again).
You only remain sober if you make massive changes. In fact, you have to “change everything.” That sounds like a tall order, right? It is a tall order. It’s tough. And you really do have to change everything.
And if you go through detox and get spun dry from alcohol and then walk back into the real world after 3 or 4 days then guess what? Nothing really changes. Unless of course you make it change.
But there is a problem.
You don’t know what you are doing.
The reality of quitting drinking without a rehab facility
If you are an alcoholic then you have tried many times to quit drinking on your own.
Or perhaps you have never tried to quit entirely, but only to control your level of intake, so that you do not get into trouble with your drinking.
Every alcoholic has struggled with this. They always fight for control and then ultimately fail.
So when they go into detox and are magically “cured” of their drinking (temporarily anyway), what is the solution when they leave the detox center? How can they maintain sobriety?
They have to learn.
Recovery is a learning process.
Why is this the case?
It is the case because the alcoholic lacks information. They don’t know what they need to know in order to remain clean and sober.
If they did know then they would not have needed help in the first place. They could have just sobered up on their own, with no real issues or consequences.
So it is possible to get sober without treatment, but it is not possible for an alcoholic to get sober without learning something new.
So you have to ask yourself: “If I am not going to go to rehab, where am I going to learn how to get sober?”
You can learn the process of recovery outside of treatment, but in my opinion it is fairly difficult to do so.
Many people would suggest that you can simply go straight to AA. There are at least a few problems with this, though technically it still may work for a select few:
1) Going straight to AA without any treatment introduces the risk of detox. Remember, alcohol withdrawal is dangerous and can be fatal even.
2) Going straight to AA without any treatment causes you to miss opportunities of learning that you miss out on in rehab. For example, in rehab you will see professional therapists or counselors who may be able to diagnose or point out deeper problems in your life that will be completely missed or glossed over in AA. So it is a more thorough and professional level of help at rehab than what you might receive at AA alone.
3) The educational aspect of going to rehab may be deeper and more professional than the “education” that you can get from AA meetings. For example, if you go to rehab then they will probably make it very clear what cross-addiction is and why you need to avoid all addictive drugs. If you simply start going to AA you may hear brief mention of this concept but it will probably not be clearly explained to you like it will be in a rehab center. So the teaching in rehab is thorough and complete, whereas in AA you don’t know how thorough it will be necessarily.
This is not to say that AA is bad in any way. This is just to point out a few reasons why you may be short changing yourself if you skip rehab altogether. Going straight to AA meetings can have you miss out on a lot of important stuff, and besides it may be physically dangerous to boot.
How will you find support if you don’t go to rehab?
Alcoholics who are recovering need support.
This is a fundamental aspect of early recovery. You cannot do it alone. If you could then (by definition) you would not be alcoholic.
You need support. Where are you going to get that support if you do not go into rehab?
There is the AA argument as discussed above. This is possible and in the very old days when AA first started this was really the only way. Treatment did not exist yet so people would go straight from their couch to AA meetings. They needed support and they got it by going to meetings.
When you go to rehab you get support in a number of different ways, and on several different levels.
First of all you get the protection and insulation from the outside world while you are in rehab. The idea is simple, if you “lock yourself up in rehab” for a few weeks then you won’t drink. (Of course you are not really locked up in rehab and you can leave at any time if you so choose if you went in voluntarily, it is nothing like jail or prison!). But you get this protection from being in rehab that you would not get in the outside world. There is no temptation of alcohol or other drugs while you are in treatment. It is a controlled environment and you are protected from the threat of relapse, at least while you are checked in.
Second of all you get professional support from counselors and therapists. These are people who have been trained specifically in how to help you rebuild your life. This is a slightly different level of support than what you would get simply by attending AA meetings.
Third of all you get peer support. This is not worth as much as you may think, though everyone who is actually in rehab believes this to be very important. In other words, you will meet new people in rehab who are also trying to get clean and sober. There is power in meetings these new people (your peers) but it is less power than you initially believe.
There is a tendency in rehab to believe that the people you got sober with will be your friends forever, and that all of you are going to “make it.” This feeling is very strong while you are in rehab with a group of peers. The reality is that most of them are going to relapse. In fact nearly all of them will. Therefore the peers that you meet in rehab are sort of a distraction. You can enjoy their company and learn from them, but it is important to quickly move on when you leave treatment and find support in the outside world. Do not rely on the peers that you meet in rehab for ongoing support. Doing so is a mistake because their stability in recovery is highly questionable.
How will you learn to live a new life if you do not learn it at rehab?
Getting clean and sober is a learning experience. If you do not go to rehab then you put a really high demand of learning from other sources. It is possible that you might learn how to live a new life in recovery entirely from AA meetings, but why would you try to when there is an easier way?
Think about the purpose and the setup of any rehab. They have done everything that they can in order to give you the information that you need to remain clean and sober. This is the most concentrated form of help that you can possibly get.
For example, most treatment centers have lectures about relapse prevention. They talk about what skills you need to learn in order to prevent relapse. They may have a class about having a balanced lifestyle. This is important because most alcoholics and addicts do not even realize how obsessive they can be at times. Reintroducing balance into your early recovery can be the whole key to success for some people.
Some rehabs have a class about meditation and relaxation. This is a real eye opener for some people in early recovery. They may have had so much anger or anxiety inside and not even realized it at all. They may learn how to calm down and get a huge amount of relief from such an exercise. This may be the key thing that allows them to remain clean and sober.
Every rehab and treatment center has a variety of classes like this. They don’t just tell you avoid alcohol and then send you on your way. The approach is actually more holistic than that. Some rehabs may even have classes on nutrition, spirituality, and so on. The topics can be diverse.
You don’t get this diversity at AA. And it can be important. People respond to different things in recovery.
Not everyone stays sober in exactly the same way. Not everyone “clicks” by hearing the same exact information. We all learn differently, and at different paces.
This is another reason why treatment is so important.
One of my therapists used to push me to exercise. He thought it was so important that I start lifting weights or using the gym that was attached to the long term treatment center.
At the time I did not get it. I thought he was wasting his time. I was too busy trying to recover from a “spiritual perspective.” I did not want to exercise.
At some point in the future I started to exercise anyway, in spite of myself.
My whole world changed. It turned out that regular exercise was the single most important aspect of my recovery process. It opened up a whole new world of health and fitness to me. It became the biggest pillar of my recovery.
And here I was being resistant to it for so long!
Next time you sit through a dozen AA meetings, take note of the number of times that someone tells you to exercise. It will be precious few, if any.
This is another reason why treatment and rehab is so important. You just don’t get the same level of diversity and knowledge by going to AA.
There is nothing wrong with AA, don’t get me wrong. I am not bashing what they do. But AA is very concentrated, very specific in how they attempt to help people.
You may need a different kind of help.
I needed to be pushed to exercise. I needed to look the idea of a “balanced lifestyle.” I needed to learn about topics that they just were not discussing at AA meetings.
This is the role that treatment filled for me.
I credit AA with giving me some amount of support in early recovery. But I credit rehab with teaching me many important lessons for recovery, most of which were not to be found in 12 step meetings.
AA is a spiritual approach, not a holistic approach. Think carefully about that. Going to treatment exposes you to MORE of the solution. The solution is holistic. It is bigger than just spirituality alone.
Rehab does not cure anyone but it can set you up for success
We all know that treatment is not a “cure” per se. But it can set you up for success.
I was lucky enough to go to rehab and learn a new way of life. I could not have learned this without professional help.