Are Long Term Rehabs Effective or Are they Just a Scam?
Long term rehab sure sounds like it could easily be labeled as being a scam.
Generally it is very expensive. Staying in treatment for 28 days is pricey enough. But staying in long term rehab can be anything from 90 days to 2 years. So the cost is obviously a lot higher.
Combine this with the fact that many people relapse during or after long term treatment, and you have to raise your eyebrow a bit. Is it really worth it?
Let’s find out.
Consider the data: success rates for long term treatment are not that impressive
First of all we should consider the data. If you look at government statistics here in the US, you will find that the success rates of long term treatment are only slightly better than that of short term rehab. This has always been extremely surprising to me.
I mean, after all, if you are willing to check into long term rehab and commit several months to the recovery process, shouldn’t that indicate that you are more serious about your recovery? Shouldn’t that indicate that you are willing to make a greater amount of change in your life, if you are willing to go to rehab for 3 months or more rather than just one month?
Apparently not. The data does not really support that. In some cases the success rates are not even different enough to show statistically different. Short term rehab seems to fare just as well as long term rehab.
I have a few theories as to why that might be, based on the time that I spent living in long term rehab (as well as 3 trips total to short term treatment centers).
When I was in rehab, I paid attention. I watched people. I wanted to see who stayed sober and who relapsed. This was important to me because I was trying to “figure it all out.” I did not want to relapse myself and so I wanted to know the secret of how to stay sober forever. So I paid close attention to people.
What I found was that the people in long term rehab were stuck in a pattern. Many of them had been to long term rehab in the past, often several times. So they were using the long term rehab as more of a flophouse.
When I first went into long term treatment, that was it for me. It was the end of the road, so to speak. This was a commitment that I had never been willing to make in the past. So checking into a long term facility represented the ultimate in surrender for me. I believe that this is absolutely critical in terms of your final outcome. If you want to predict whether someone stays sober or not in the long run (regardless of what treatment they attend) then you need to look at their level of surrender. Everything flows from that state of surrender.
What I learned is that many people who check into long term rehab are NOT necessarily in a state of full and complete surrender. They have other motives. They need a place to stay. They want a break from the chaos of addiction. But they are not all necessarily at the state of total and complete surrender that is required for someone to rebuild their life and stay sober.
My belief is that the people who stay sober after long term rehab actually needed the long term treatment process
I needed long term rehab really badly.
This was a theme that had come up over two years prior to my actually going to a long term facility.
For example, I was seeing a counselor at one point about my addiction, and they were trying to convince me to take action and get more help. They told me that I needed rehab. But even more than that, they were telling me that I needed to go live in a rehab center for the long run, and I here I was–stuck in denial, not even willing to go to a 28 day program! Of course at that point I was still stuck in my disease and I was not at a point of surrender yet. But the seed had been planted for me that I was going to need to take massive action if I ever wanted to fix my problem.
Later on in my addiction I attended a 28 day program. I felt like it had been a great sacrifice on my part to agree to 28 days in treatment. I felt like I was “wasting my life” being in treatment for that long. Of course I was still a total wreck from alcoholism and drug addiction and I tried to be honest with the counselors at the rehab. When it got time to plan my aftercare, they told me that I was a strong candidate for long term.
I was angry at this. I was upset with this. I did not want to go to long term treatment. I was still stuck in my disease and I wanted to get treatment over with and get on with my life. I did not realize that recovery is your life. I did not realize that recovery was entirely pass/fail. I did not realize that you cannot just slap a cure on your disease and then move on and pretend that it never happened.
Why do you think that people in AA meetings identify as alcoholics every single day when they say “My name is so and so, and I am an alcoholic?” If we could just forget the whole thing and move on then surely everyone would want to do that, right? No one wants to dwell in their past mistakes. But alcoholism is not like having a toothache. You don’t just go to the dentist and get it patched up and then go back to your everyday life again. You can’t fix it like that.
And this is what I was missing when I was in a 28 day program and I was resisting the idea of long term treatment. I was angry at the counselors and I resented the fact that they believed I should go to long term. Why me? Why did they want to punish me?
What they were doing of course is to listen to my story. They were hearing what my routine was, how often I drank and used drugs, and thus they were determining how much help I needed. They realized that I had no friends in my life other than people who drank or used drugs heavily. They realized that I was totally trapped and that I was resistant to AA meetings. So they knew that I did not have a prayer in the world of walking out of a 28 day program and making it work. They knew this and they could see it clearly. Recovery is pass/fail. It takes a whole lot of effort in order to “pass” and remain sober. And the counselors and therapists knew that I was in big trouble if I tried to do it on my own. I had too many factors working against me in my life.
So at my moment of surrender I finally accepted the fact that I needed long term rehab. But I decided this based on the fact that I was truly sick of chasing more drugs and alcohol. I was burned out by it. So I was willing to do whatever it takes. This is the most important part of my attitude. This willingness is what actually made the difference. In fact, the long term treatment itself may have been beside the point. The point was that I finally reached a point in my life where I surrendered fully to my disease. So I was willing to take action. I was willing to follow directions. I was willing to accept the huge amount of structure that you get while living in rehab. In the past I had never been willing to do those things. I lacked willingness. Because I had never been so desperate to change my life in order to escape misery.
My misery had boiled over to a point where I just wanted to escape. And drinking and using drugs was no longer doing the trick for me. It was failing to work. I could not get happy. And so I realized that I had to try something different.
This is the only mindset that can produce long term sobriety. You must surrender completely to the fact that your addiction is getting you nowhere, that it only gives you more misery, and that deep down you want something different for your life.
It is only then that you can start to heal.
Consider the potential upside of successful treatment as opposed to failure
My logic was so twisted when I was stuck in my addiction. Thus is the power of denial.
Here is how my logic actually went:
“I don’t want to go to rehab because that is a waste of my time. I could be using that time instead to get drunk and high every day and thus be happy. If I go to rehab not only will I be unhappy, but I will also miss out on those days in which I could have been drunk and high.”
That was seriously my logic in life.
People tried to explain the inverse of this to me in order to convince me to go to rehab and get the help that I needed. But I could not hear their arguments because I was stuck in denial. I believed that their arguments did not apply to me.
Now that I have gone through the process and I am clean and sober, I know the truth now. And the truth is this:
When you are stuck in addiction you are miserable every single day. Your only hope is that some day you have enough personal freedom and resources to be able to properly medicate yourself and finally be happy. But this never comes because such “happiness” is fleeting even if everything lines up the way you want it to. You also believe that the discomfort of withdrawal will last for the rest of your life if you stop drinking or using drugs. You project the misery of withdrawal on to the rest of your life. This is untrue.
The real truth is that anyone can go to detox. They can go through the recovery process and learn to start living a health life again with drugs and alcohol. Within a few short weeks they will return to being happy much more frequently than they were in their addiction. This is a critical point to understand. Within the first 30 days of sobriety you will actually be happier in sobriety than you ever were in addiction. Most alcoholics and addicts do not believe this as they are stuck in denial and they are clinging to the idea that they can only be happy with their drug of choice.
The truth is that anyone can become happy in sobriety. It happens naturally, on its own, as you start to heal and become healthy again. Life will take on new meaning for you if you give it a chance. And you will be able to look back and see that you were never really happy when using your drug of choice. You were only happy to be avoiding the discomfort of withdrawal. Going from day to day and “feedings” so that you could keep yourself medicated. But this medicated state was not really happiness, it just became your normal everyday state of being. It was not truly happiness or elation like you thought it was in the beginning. Remember your first drink? The first time you got really drunk or high? And it was a lot of fun? Yeah, those days are long gone. But have you admitted that to yourself yet? Has the addict or alcoholic realized that the good times are over with?
Getting past denial is when you realize that it is not fun anymore, and never will be again.
This was my own moment of truth. It was a flash of insight. Perhaps it was divinely inspired. I don’t honestly know. But what I do know is what my “new logic” was in that moment. I finally saw the truth. I realized that I was on a hamster wheel, and that it was never going to get any better.
That is what I said to myself. I said “here I am chasing that next high, and yet I am still miserable for 90 percent of the time, and it is just never going to get any better.”
I could clearly see a way to make it better. Go sober for a week and then get loaded all at once. If I did that I would be happy for a day (maybe half a day). Then I would be miserable again. This is the problem with addiction, when you drink or use drugs every day then it no longer becomes fun. You can make it fun again by depriving yourself for a while. But that is too high a cost for any addict or alcoholic to pay. You will be miserable while you deprive yourself and wait for your next drink.
Figure out how much of the time you are really “happy” when you are trying to live this way. Going from drunken episode to drunken episode. If you drink once a week then you will be miserable 90 percent of the time while you are abstaining. Then try to drink every single day. Notice that you are now miserable 100 percent of the time. You never really get “happy” at all when you are constantly drinking because there is no “peak.” You have nothing to compare it to so being drunk constantly becomes your new normal. No happiness.
With alcoholism or drug addiction you always come to this point in the end. Your tolerance builds and you reach a point of misery. You can no longer get that “happy buzz” going unless you first abstain for a while. And while you are abstaining you will be miserable. After that your “peak buzz” will only last for a few hours at best. Then you are back to being miserable again.
If you don’t believe this then I encourage you to test it out for yourself. Start keeping a journal and writing down how happy you are each day. Try to check in maybe two or three times each day to indicate how happy you truly are. Keep drinking. Try different strategies with your drinking. But make sure you keep measuring how happy you are.
If you do this you will see through your denial. Because you will realize that it is not worth it, that you are miserable nearly 100 percent of the time.
When you get clean and sober, you get to create happiness in your life each and every day. Heck, you will experience real joy at times. True bliss. Higher than you ever got when you were drinking.
Don’t you want to take a shot at that? Don’t you want to see what it is like to be genuinely happy, rather than just chasing happiness?
This the potential upside of treatment (whether it is long term or short term).
Recovery is pass/fail.
If you fail and relapse then you already know what to expect. You know exactly what you will get and what your life will be like. There is no question about that. You know exactly what your addiction is like to live through.
But if you succeed and remain sober then the upside is unlimited. We are talking happiness, joy, unlimited potential. We are talking about being excited each morning when you wake up because you are so excited about what the new day might bring to you. We are talking about real joy in life.
Who wouldn’t want a shot at that? What kind of price could you put on that?
You see, when I was stuck in denial I was looking at it all wrong. I was worried that if I went to treatment I would be wasting my life and wasting my time–when I could be drinking instead!
This was insane. I really thought that I was “happy” when I self medicating, even though for 99 percent of the time I was miserable.
In recovery, I made this “sacrifice” (which really wasn’t) and lived in long term treatment. Because of that time investment, my life is a million times better today than it ever was in my addiction. And I have been sober now for 12 years+ and counting.
Has it been worth it? You bet it has. It was worth it even after the first 30 days in long term rehab! It was worth it right from the beginning, though it took me maybe 6 months to look back and realize it. Now that I am at 12 years you can imagine how much this has multiplied. It has been more than worth it. It was the best decision I ever made. It was the smartest thing I ever did.
And all I had to do was to surrender, and get out of my own way. I had to agree to live in rehab and let other people tell me what to do. I had to be willing to change everything.
They say that there is only one thing you need to change in recovery, and that is “everything.” If you surrender and then go to long term treatment, you are making a heck of a good effort at changing everything. Just remember that the surrender part is what is most important (even more so than living in rehab!).
Long term treatment is not a scam, but it may appear so to people who have failed to surrender. It cannot force you to want sobriety.
An important point that you should understand:
Long term treatment cannot make you want recovery.
This may be the very thing that trips people up in recovery. This may be why the success rate of long term rehab is nearly the same as that of short term. Because people who agree to go to long term believe that it will cause them to be successful. They have the wrong attitude. They are looking for a shortcut. They are saying “Well, I am not sure if I really want to be sober, but if I agree to go live in long term rehab then that will help to push me into successful recovery.”
Doesn’t work that way. Going to long term does not make you want recovery.
This is a problem that happens over and over again. Doing anything does not necessarily make you want recovery. You can’t just snap your fingers and surrender.
Real surrender comes out of pain and misery and suffering.
And if you don’t truly surrender then going to a certain rehab or taking certain actions is not going to help you to magically stay sober.
This is why some people believe that rehab (in general) is a scam. Because it does not force people to want to get help.
Obviously this is not realistic. We are not a society that would allow such manipulation anyway. We don’t allow brainwashing. We value our freedom to highly.
So don’t expect rehab to be able to manipulate someone into wanting to change against their will.
Rehab is not a scam. You just have to want it to work. That does not invalidate the help that they can give a person.