Do the Benefits of Addiction Treatment Programs Really Outweigh the Costs?

Patrick
  • Many people have asked me in the past if the benefits of going to an addiction treatment program really outweigh the costs involved?

    After all, the cost of treatment can include many things, including:

    1) Monetary cost. Treatment is not free and a typical 28 day program can run into the tens of thousands of dollars very easily. Insurance can pay for this but a huge portion of struggling addicts and alcoholics may not have insurance, or their insurance may not cover much (or any) treatment depending on their circumstances. No big surprise there: Treatment costs money. Not everyone can afford or pay for this cost.

    2) Time cost. I used to obsess about this constantly when I was still drinking and using drugs every day. I could not see past my denial and I thought that going to treatment for 28 days would be like throwing away 28 perfectly good days that I could never get back. I believed that those days were “lost” forever and that I was missing out on potential happiness from getting drunk and high all the time. How little did I know at the time…..

    In addition to this, some people will argue that they are missing out on time spent with family or friends or time worked at a job. But really if the quality of your life is suffering because of your addiction (and you are just blind to this fact) then you are not really missing out on anything when you go to rehab–you just think that you are. This is your disease trying to convince you not to get healthy. Another form of denial.

    3) Opportunity cost. This is similar to the above, but I used to play this card in terms of my job. At the time when I was still drinking every day, I was also a pizza delivery man. Now I am not trying to knock that job because in many ways that can be a great career, I know one guy who makes a very, very good living delivering pizzas believe it or not! (He is an accountant by trade but chooses a life of simplicity delivering pizzas).

    But I was using this job as an excuse to say that I did not want to go to rehab and sober up because if I did then I would surely lose my position at that particular company. Again, I am not knocking pizza delivery but can you see how obvious the denial is there? When I was living through it I could honestly not see it, I thought that this particular job meant the world to me and that it would be foolish it jeopardize it by going to rehab for 28 days. How incredibly short sighted of me. Of course, having gone to treatment eventually (and leaving the pizza delivery business) I have since realized many jobs since then that had far more meaning and impact in my life. Today I am extremely grateful that my horizons were expanded so greatly when I finally got clean and sober. TL;DR = You will have many more opportunities in recovery than you can ever imagine while you are still drinking or using drugs. Stop fooling yourself. You are in denial!

    4) Fear factor. This may not really be a true “cost” but for me it sure felt like one. I had to be willing to pay the “cost” of going to rehab in terms of facing my fear of sobriety. I was terrified to face life without alcohol and I knew that as soon as I set foot into rehab that I would be going cold turkey from alcohol. So I was scared. From the perspective of the alcoholic, this is a cost that must be paid if you want to get clean and sober.

    Money, time, opportunity, and fear. Plenty of costs to pay when you finally decide to surrender can check into rehab.

    Is it all worth it?

    Let’s dig deeper.

    Unfortunately, recovery is entirely pass/fail

    One of the reasons that it can be difficult to gauge the value of treatment is because recovery is entirely pass/fail.

    This has been my experience anyway and it also lines up well with my observations that I made while working in a rehab facility for 5+ years.

    What do I mean by this concept? That recovery is entirely pass/fail?

    For example, let us assume that someone is an alcoholic and their life is out of control. They are drinking a case of beer every day and they lose their job eventually. Their spouse leaves them as a result and they are left with nothing and no one in their life. So they go to rehab.

    Now if rehab and recovery worked like most other things in this world, then you might expect that this person would show “average” results. In other words, maybe they would leave rehab and go to a few AA meetings here and there, then they would get a job back and maybe start living a little better life. Maybe they would drink a 12 pack of beer every day instead of a full 24 pack. Their spouse had left them before so maybe they find a new boyfriend or girlfriend. They manage to recover a little bit. They find a middle road in life and get their drinking basically under control. Maybe a year or two later they cut down further to a six pack of beer each day instead of a 12 pack. And then they get a better job of course. And so on…..

    Does this sound even a tiny bit realistic?

    Of course not! It’s completely impossible and it would never happen that way in a million years. And this is entirely the point.

    Most of our lives are dominated by scenarios like the one I just outlined above. We put in a little effort, we get a little bit of results. We make a modest effort, we get modest results.

    Recovery does NOT work that way.

    At all.

    This is what I mean when I say that recovery is “pass/fail.”

    There are only two real possibilities when an alcoholic leaves rehab:

    1) They follow through with their recovery and their life gets better.
    2) They don’t follow through and things get worse, going back to the way they were before or even getting more chaotic and destructive.

    There is no in between. You cannot get a C+ grade in recovery. It’s impossible.

    If you think you are getting a C+ in recovery then just wait a few weeks. You will be at F- before you know what hit you. Recovery is pass/fail. You either succeed or you relapse.

    They have a saying in AA that summarizes this concept quite well:

    “You are either working on recovery or you are working on a relapse.”

    Just try to stand still in recovery. Try to stand still in your life and do nothing to get clean and sober but also do nothing to go back towards addiction and drinking.

    If you try to do that then you will relapse for sure. It happens every time.

    I watched this happen over and over again with (mostly young people) who were in treatment. It always played out the same way:

    They got to rehab and they started to detox and maybe they even made it through detox and started attending groups. At some point they were struck with the idea that they did not need rehab and that they wanted to leave treatment right now, this very minute. Once this switch was flipped in their mind nothing could talk them out of it.

    Now at first I believed that these people wanted to go get drunk or high. But after watching it happen over and over again and trying to talk them into staying I came to realize that this was not accurate. These people actually believed that they were going to leave rehab early and stay sober. Call it “true believer” syndrome if you will. They had it in their minds that they did not want to drink alcohol or use drugs, but they just did not want to be in treatment either. It was like a switch was flipped in their minds. And so they could not be reasoned with. You could not possibly talk such a person into staying using logic. They were leaving no matter what.

    And the results were always the same. You bail out of rehab early, you relapse. It is a given. Anyone can see it coming from a mile away. Expect for the person who is leaving rehab early.

    And this has a great deal to do with the fact that recovery is always pass/fail.

    You are either in “full surrender mode” or you are doomed to sabotage your efforts and relapse. There is absolutely no in between. I have watched at least a hundred alcoholics try to find that middle ground, and they fail every single time and relapse. The person who is leaving rehab early is trying to find that middle ground. They are saying, in effect, “I know I am alcoholic and I know I need help but I don’t want to drink any more so I will just leave rehab now and do it all on my own and I will be FINE.” They are in self sabotage mode and they cannot see it for themselves. They are doomed to fail and they cannot figure it out. They have to go out there and fall flat on their face again and go through more chaos and misery before they can surrender in the future and take another shot at recovery (if they even get another chance, some don’t).

    And so what will happen later is that hopefully they will realize that they cannot do it on their own. That they don’t have the answers. That their way of living did not work. And that they cannot just walk out of treatment (leaving early) and go about their way and do it all on their own. This will not work because they don’t know how to live a sober life, even if they want to live a sober life they don’t have a chance of making it work at this point. They have no clue.

    No, what they need to do at this point is to sit down and listen and get out of their own way. They need to put their life in someone else’s hands entirely. And that takes guts. It takes serious guts to really surrender at that level. Most people have to fall on their face a few times before they will finally do it.

    Unlimited upside to lifelong recovery

    Now that I have convinced you that the cost of recovery is never trivial, what are the benefits like?

    The benefits of recovery are always immeasurable. They are infinite in comparison to the alternative. The benefits of recovery are boundless.

    Keep in mind that recovery is pass/fail. You are not going to “sort of recover.” You will either relapse or you will stay sober and grow. If you relapse then you will have to try again at some point in the future to make another run at recovery. But you either succeed or you fail, there is no in between.

    So when you fail we know what the deal is: chaos, misery, depression, anxiety. Your life is a downward spiral and everything just keeps getting progressively worse.

    The inverse of this is true in recovery as well.

    Everything gets better in recovery.

    A very long time ago I was in a rehab center, this was before I was ready to really get sober but I was in rehab anyway for the wrong reasons, and I was listening to this guy talk about recovery. He was an H&I person who had brought an AA meeting into the rehab from the outside. And he was talking some pretty good stuff so I really listened to him. In fact he was a very talented speaker and he was also speaking his truth so it rang very genuine to me. And the essence of what he said to us in that AA meeting was “It just keeps getting better and better.” Every day he wakes up and he is grateful. And he would just walk around in recovery, amazed that his life could suddenly be so good. And not only that, but that it would keep getting even better still! And the way that he spoke about this was truly energizing and it really moved me.

    Now at that time I was not ready to be sober. But I never forgot what he said, and I still think about it to this day. Because if I am honest with myself, I am really living the life that he described to me in that speech. I have achieved that gratitude that he spoke of. This very morning, over 12 years into my recovery, I woke up and was truly grateful for another day. Just grateful to have another day to walk around and explore life. This is a really long way for a hopeless alcoholic to have come. I used to be disgusted with myself and with the whole world and I was sick and tired of everything. Today I would be grateful for a simple walk in the park.

    It is difficult to describe this to the newcomer who is struggling to get sober. It is difficult to illustrate to them just how much upside there is if they can make it in sobriety. You can sit there and tell them that it gets better and better, you can tell them that they will be far happier sober than they ever were while drinking, but they it may all fall on def ears. Not because they don’t want to believe it, because trust me, they do want to believe it. But because their addiction won’t let them believe. Their addiction tells them that they are different, that those promises and benefits can never come true for them, because they are unique and for some reason they require alcohol or drugs to be happy. This is how my brain worked and so I really was sad after hearing that man tell his story in rehab, because I wanted what he had but I knew that I could never have it. I was different. I loved alcohol and drugs too much.

    At that time I just wasn’t ready. I had not had enough pain. So I went back out to get some more.

    Is it worth it to save one alcoholic? The ripple effect

    I have a sponsor in recovery even though I don’t really do the 12 step program or anything. He is in NA and he has about 20 years clean.

    He also has a sponsor and that guy has about 33 years clean. And they both talk to me at times because they think my brand of recovery is sort of different and unique. Not that I am special or anything but just that I am walking a different path.

    And so they grand sponsor has this theory that he keeps talking about that means a lot to me the more I think about it: “Healed people heal people.” It sounds kind of funny when you say it out loud and so people have to stop and think about what it means. And it really just sort of means “people pay it forward.” If you can get one alcoholic to sober up and start helping people then that person will create a ripple effect in life that will create massive currents downstream. Just one alcoholic who is doing this sort of work could potentially affect dozens of people within the next year (for instance) and those people may effect others and even after several decades that healing power may still be reaching out to touch new lives. It is a pretty profound idea and it is worth thinking about.

    If you can save one alcoholic then you are potentially affecting hundreds or thousands of lives. Not just his drinking or the alcoholics that he may in turn reach out to, but also for all of the friends, family members, and coworkers that the alcoholic comes into contact with. Everyone’s life will get a tiny bit better if there is less chaos and misery in the world. So this ripple effect is not just limited to one saved alcoholic reaching out and saving another struggling alcoholic. It can involve the “regular people” that are not alcoholics that have to come into contact with this person on a daily basis. And even those “regular people” (read: Not alcoholics) are all fighting their own battles too. They all have lives and struggles and they may be setting the example for someone else as well. I don’t think you could ever measure the effect of this directly because there so many ripples out there that just keep getting deeper and deeper. Healed people heal people.

    So this should, at the very least, show you the value of saving just one life in recovery and teaching someone how to overcome addiction. When you heal one person and teach them how to reach out and help other people you are creating a powerful ripple effect. And this has an implication when you are considering the costs of treatment, because you are not just saving one alcohol necessarily, but you are also working on that giant ripple effect that fans out into the future and touches countless lives.

    Living a better life at any cost

    The problem of course is that you need to surrender first, and you cannot “buy” that surrender at any price. It is not for sale. It must be paid for with misery.

    But once you have had enough misery, you can finally break through denial and then ask for help.

    At that point, no cost is too high for the rewards of recovery. Do whatever it takes to seek professional help after reaching the point of surrender, because your life will just keep getting better and better. It’s worth it!

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