According to one camp, drug rehab is vitally necessary, it saves a ton of money over the alternatives, and it can work when other options for recovery fail.
On the other hand, our present addiction treatment success rates seem to be poor, and some go so far as to call the entire drug rehab industry a scam.
So how do we sort it out? How effective is treatment? Let’s break it down with some of the facts from the U.S. government. (NIDA)
First, let’s look at the positive side of the coin:
* The cost of treatment versus non-treatment. Even though most will not stay clean and sober, those that do make it all worthwhile, because their lifetime value that they provide while clean and sober outweighs the cost of incarceration by a factor of over 5 to 1. (In other words, it costs over 5 times as much to incarcerate as it does to rehabilitate). However, this does not factor in the increase of value that a clean and sober person will contribute to society versus being idle in prison. The difference then becomes more like 10 to 1 or even 20 to one in terms of their overall economic contribution while clean and sober.
But now let’s consider some of the negatives:
* 90 percent of people who need treatment do not get it. Period. That is 9 out of 10 addicts. Yikes.
According to several conservative estimates, every $1 invested in addiction treatment programs yields a return of between $4 and $7 in reduced drug-related crime, criminal justice costs, and theft. When savings related to health care are included, total savings can exceed costs by a ratio of 12 to 1. Major savings to the individual and to society also stem from fewer interpersonal conflicts; greater workplace productivity; and fewer drug-related accidents, including overdoses and deaths.
“The point at which risk of future lifetime relapse drops below 15%) is not reached until after 4-5 years of sustained remission.”
In other words, the person needs to get to a point where they can get at least 4 years sober in a row, without any slips. I did this successfully after finally attending long term treatment and living there for almost 2 full years, though I could easily tell that this is by no means a cure all solution that works for everyone (it doesn’t!).
“64% of persons entering publicly funded treatment in the United States have already had one or more prior treatments.”
This was painfully obvious to me when I worked in a rehab center for 5+ years. After working there for a year or so, nearly everyone who showed up in treatment seemed like they were a “repeat visitor.” Actually when we went over the day’s admissions we took note of who was coming in for the first time ever, and it seemed like it was quite rare. People who had never been to any treatment at all were rarer still. This did not speak well to the effectiveness of treatment! (at least in my opinion).
“Long-term studies of clients treated for substance dependence in publicly funded programs reveal that the majority of those who achieve stable recovery do so after 3 to 4 episodes of treatment over multiple years.”
Again, this is proven out to me to be true based on my own experience. I went to rehab 3 times before it finally “stuck.” When I talk to others in recovery they typically tell me that they had to go to rehab several times before they finally were able to make it stick. The average that I found in my own experience and talking with others was usually 3 times. Though I have to admit that I did meet a few people who had been to significantly higher numbers of rehab centers (one guy was in the high teens. He later relapsed and died from it).
“The longer the participation in recovery support groups in the three years following primary treatment, the greater the probability of remission at 15+ years following treatment.”
This is a very interesting concept and it sort of validates my ideas about reducing dependency on recovery programs in the long run.
Perhaps this has to do with the idea that people who stay in AA are keeping themselves plugged into that “disease concept” of addiction, telling themselves over and over again that they are never really cured. So perhaps this becomes a self fulfilling prophecy? Hard to say for sure. But I realized early in my own recovery that I was going to quickly burn out on the daily meeting circuit and that there had to be something more to recovery. So I pushed myself to reduce dependency on meetings even though my peers were cautioning me that I was playing with fire and headed for relapse. Funny that these same people who were trying to warn me later ended up relapsing themselves (turned out to be true in nearly every single case).
Treatment is not perfect but it is the best solution we have currently
Alcoholism treatment and drug addiction rehab is definitely not perfect. It’s not even close. The success rates are certainly nothing to write home about.
But on the other hand they are the best solution we have right now. They are our best chance at helping someone who is struggling with addiction. If nothing else, we can at least arrest the disease temporarily so that the person has a chance at recovery.
I think the key is that the individual must realize at some point that they are ultimately in charge of their recovery. No one can evade the personal responsibility that comes along with sobriety. You either put in the work and the effort or you do not. If you fail to put in the work then you are doomed to relapse eventually, it is simply a matter of “when.”
Treatment is not perfect but the alternative is a non-starter. You go through life as a miserable alcoholic or drug addict and things just continue to get worse and worse. Nothing can justify that existence. If there is even a tiny sliver of hope for change then you must seize that opportunity and run with it. So your chances of success with treatment are very slim–so what? The alternative is miserable anyway. You are not a statistic, nor do you have to settle for becoming one. If you want to change your life and be happy then you can do it.
No one who has surrendered 100 percent to their addiction has ever relapsed. No one. How is that for a hopeful statistic? The problem is that most alcoholics and addicts do not fully surrender when they are trying to sober up and get clean.
Ever heard of the term “half measures?” This is what AA cautions people about when they are starting out in their program. If you do it halfway then you will fail. If you put in only a modest effort then you will relapse. The key is to go all out, to dedicate your life entirely to recovery. Most people do not understand the true depth of this commitment.
Ultimately long term sobriety is a bit of a paradox. In early recovery you have to find a ton of support. Rehab is helpful though it is not a cure. Going to meetings every day is probably much better than doing nothing at all.
But then later in your recovery the equation changes. You become stable and you get a bit too comfortable. Daily meetings become a way to vent. But you are not growing any more. Even though you remain sober, this is not enough. If you stand still on this treadmill eventually it will kick you off. And yes, you can be going to AA every single day and still be standing still. This is called “complacency.”
So the paradox is that you want to embrace support, you want to embrace meetings, but then later on you want to set yourself free. If you depend on AA in your first year of recovery that is probably a good thing. But if you depend on AA after ten years sober then you are in the danger zone. Why? Because you should have grown far past this group dependency by now.
I am not saying that AA is bad for you. I am saying that dependency on AA (in the long run) is bad for you. Sure, in the first year or so it is vital. Get all the support you can find. But then later you need to learn how to spread your wings a bit and fly. Personal growth is the key to long term sobriety. If you can get that out of an AA meeting each day then good for you. I could not hack it this way. I had to find a way to grow outside of the daily meeting grind.
Are rehabs setting people up for failure by sending them to AA?
Yes and no. The paradox is that they need the support at first, but if they depend on it for life then they are probably headed for complacency. So it is a fine line.
I have a friend in AA who is walking the right path. He is heavily involved in AA but he keeps it healthy. He sponsors people and he really gets into it with them and works with them. None of this superficial stuff. He is doing the real work. He continues to challenge himself and to learn and to grow. This is not how most people end up in AA.
Most people kick their feet up and relax. They decide that going to a meeting each day is their salvation. This is a mistake. The daily meeting can become a dependency. A false sense of security in your sobriety.
Learning to reduce your dependency on programs, treatment, and AA
I knew that something was not right when I was going to AA meetings every single day of my life.
Something was nagging at me. I felt a mixed message, but I could not put my finger on it at first.
On the one hand, people seemed to be telling me that “the solution was in the steps.” But then they were also telling me to come to meetings every day, and if I failed to keep coming to meetings that I was doomed to relapse.
Well….which is it?
Are the 12 steps really the solution? Or do you have to go to meetings every day for the rest of your life in order for the steps to really work? And if so, what kind of bum deal is that? If you have to do the meetings anyway, then why work through the steps at all?
In other words: If you are just going to show up to your daily meeting so that you can vent about your problems, then why go to the trouble of actually fixing your problems in the first place? Why not just accept the daily grind of meetings for the rest of your life?
This seemed to be the choice that I was being given.
I rejected the conventional wisdom. I thought to myself: “No. I am not going to settle for a lifetime of these meetings that aren’t really doing much for me. There has to be a better way to maintain sobriety than this.”
And so I started to test the waters myself. When I say “test the waters,” what I mean is that I started skipping meetings. So instead of going 3 times a week I just went twice a week. Then later on I went once per week.
People started asking questions. My peers in recovery warned me that I was slacking off. They told me that they were simply worried about my well being, and they did not want to see me relapse.
In the meantime, I was trying hard to figure out a solution for recovery.
I was piecing together my own recovery philosophy.
What actions did I have to take on a regular basis in order to stay sober?
Because if I was not going to go to AA meetings every day, then I had better do something instead.
What exactly was that “something” going to consist of?
Finding that out was a learning process that is still continuing to this day.
I am grateful to have taken this particular path though because I have learned so much about myself and been set free at the same time.
I have not been going to AA meetings for about ten years now. And yet I continue to push myself to learn, to change, to grow.
When I was being challenged by my peers in recovery after leaving the meetings, I knew that the answer was personal growth. I knew that this was the real secret of recovery.
I once heard the story of a Zen teaching about the “finger pointing at the moon.” The teacher asks the student “what’s that?” when pointing up at the moon.
The student says “That is the moon.”
The teacher says “NO! That is a finger pointing at the moon. Ha!”
Well, stop and think about it.
How often do we make this mistake in life?
How often do we mistake the finger pointing at the moon for the actual moon?
This is exactly what people do when they worship AA and the grind of daily meetings.
They are mistaking the process for the result, the outcome.
The outcome is a new life in recovery. One of the many processes that might get you there is to go sit in AA meetings each and every day.
But that process is not the thing itself. AA meetings might help you, but they are not recovery. They only point towards recovery. Just as a finger pointing at the moon is not really the moon.
And when I was at about 18 months sober I started to figure this out very slowly. I realized that AA was not recovery, and that it only pointed to recovery.
There was so much fear being bandied about where AA members tried to convince themselves that they were safe now, that as long as they stayed in AA and recited these 12 steps and came to these meetings every day that they would be just fine. That things would work out. They wanted a solution so they grabbed the process of AA and they declared it to be recovery. “This is it,” they were saying. Look no further, for we have found our salvation.
Wrong. What works for some may not work for all. And one process of recovery is but one of many paths.
And so the battle rages on.
Treatment is expensive and it works for some but certainly not all.
AA is “free” and is offered up as the best solution for alcoholism. Yet the success rate is downright scary, and I found a valid path to recovery through simple action and personal growth instead.
Recovery is very personal. The story unfolds in a unique way for each and every alcoholic, each and every drug addict.
My hope is that no one convinces you that their way is the only way.
Recovery is bigger than that. Salvation knows no boundaries.
If AA works for you, great. If you have a chance to go to rehab, take it. Go find a new path in life. It may or may not work.
When you are finally sick and tired of the madness, nearly anything will work for you.