Why do People Who Undergo Drug Rehab Still Return to Taking Drugs...

Why do People Who Undergo Drug Rehab Still Return to Taking Drugs Later on?


One of the most frustrating things about the concept of addiction treatment is that it does not always “work.”

And by “work” I mean, of course, that someone will check into rehab and then after they leave treatment they will never ever use drugs or alcohol again. Period.

That is how we expect rehab to work. And of course the reality is that this is actually describing what we might refer to as being a “magic cure.”

Unfortunately there is no magic cure.

There is also the idea that many of us have tucked in the back of our minds that if we simply threw enough money or resources at a problem then surely we could fix it. If we assume unlimited wealth and the absolute best treatment resources on the planet then surely we could save any struggling alcoholic or addict, right? Wrong again. There is no magic bullet that is available to the super rich. This should be evidenced enough by the fact that addiction has destroyed plenty of celebrities who had access to money and the best treatment centers in the world. But ultimately “the best rehabs in the world” don’t really have any magic tricks up their sleeve that the other treatment centers are lacking. They may have a nicer lobby and they might serve more expensive food but in the end they do not have a magic bullet that gives celebrities a better chance at sobriety than anyone else has. We all go through the same struggle with addiction. We all have the same basic fight, the same hurdles to overcome, and the same challenges to face. You cannot buy your way out of this problem, unfortunately (but perhaps this is also a blessing for those with less money, as they have the same chance at recovery as anyone else!).

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No, if anyone really wants recovery then they could do it in many different ways. They could go to the top rehab center in the world, or they could go to a homeless shelter that doesn’t put up with drunks and forces you to attend free AA meetings. Are the success rates of these two options really any different? I am telling you that, surprisingly, they are not that different. In fact they are pretty much the same. Anyone who truly wants to change their life can do so if they are willing to put in the effort. There are many different levels of help and assistance and for the most part it does not matter so much where you choose to check in it. Just ask for help and start following advice from other people. Make a positive change and then do it again. Recovery is not rocket science. It’s hard work and the basic key is that you have to follow through. Get started, follow through. Mystery solved.

A cure for addiction recovery?

As the friends or family of a struggling addict or alcoholic, we hope for a cure. That is what we want–we just want the problem to go away and vanish entirely. No one can blame us for having such a hope. And there are times when reality will comply with this. But you can be sure that fate is going to take its time in giving us the outcome we are hoping for.

Consider, for example, the fact that most people who have achieved long term sobriety today have attended an average of 3 treatment centers, or have attempted to become clean and sober on no less than 3 separate occasions in their life. Because this is the average there are many people who have to try 5 or 6 times as well. Definitely shatters the idea that we have addiction anywhere close to being “cured.”

Some treatment centers actually promise a “cure” for addiction and alcoholism but really they are just using emotional language to manipulate people. One treatment center that advertises their “cure” on television has openly had to admit that many of their clients eventually relapse if they do not follow through and take the proper actions after leaving treatment. Doesn’t sound like much of a cure to me. Sounds more like manipulative advertising.

So do yourself a favor and realize that there is no cure, but there is still hope. Many people eventually move past addiction in some way, and some of them do it by finding a better life in recovery. But there certainly is no magic cure out there, and we should not expect one anytime soon. The drug industry is trying very hard to find a cure right now, but it is probably a distraction at best. Anyone who can take a pill for addiction and become instantly “cured” is probably going to have some underlying problems that the pill does not “fix.” Therefore many people are skeptical at the idea of a drug-based cure. Such a solution may come along with its own set of problems.

The long process of surrender

Here is an unfortunate truth:

* Many people who attend rehab have not fully surrendered yet.

What exactly does this mean?

It means that there is a tipping point in the life of every addict and alcoholic that will cause them to embrace recovery once they reach it. That tipping point is the point of surrender. It is the point at which they are completely miserable with their life, they don’t want to go on living the way that they have been, and they are still skeptical that recovery or abstinence will work for them. They are caught between addiction and abstinence and neither path seems acceptable. So they are forced to decide between fear or misery. Abstinence or addiction. Which is it going to be?

The addict who is still in denial does not see this choice yet. They stay blind to that choice even though they continue to make it every single day. If they choose to keep using their drug of choice then they are choosing misery. If they choose to go to rehab and try to change their life then they are turning away from the misery and facing fear instead. Those who are stuck in denial do not even see or acknowledge that there is a choice at all. They remain oblivious to it and just continue to self medicate.

Sometimes a person will attend drug rehab before they have made the choice to face their fear. Sometimes a person will agree to check into treatment before they have fully surrendered to their disease. Unfortunately this happens quite a bit more than you would think. By the numbers I would say that roughly 9 out of 10 people in rehab have not fully surrendered and made the choice to face their fear head on.

And what am I basing that on? The success rates of treatment centers everywhere. If you look at the long term success rates of any treatment center you will see a curve where most people stay clean the day that they leave treatment, a whole bunch have relapsed by the 30 day point, more have relapsed by 6 months, and nearly everyone has relapsed by 1 year. So after a full year after leaving rehab, maybe 1 out of 10 people will still be completely clean and sober. The rest will have relapsed. I am pulling these numbers out of thin air but if you go do some research you will find that this is pretty close to what the data shows. The vast majority have relapsed after a full year from leaving treatment. Those are just the numbers.

Out of those people who have relapsed post-rehab, many of them will eventually try again some day. And when they do, they have another chance at being one of the people who manage to stay clean for the long run. Or if you like, of being one of the people who are “cured.” (Of course we are never cured, but long term sobriety sure looks like a cure to the outsider looking in).

So what is really going on here?

People are stubborn. Addicts and alcoholics are stubborn. We don’t like to take direction from others. We don’t like to squash our own ego and listen to others tell us how to live.

Therefore the process of surrender gets stretched out over a long period of time. Depending on the person it may get stretched out over several years. For me it was several years.

Specifically, I went to my first rehab and I admitted that I was an alcoholic and a drug addict. I was no longer trying to deny this label. This was my first rehab. I relapsed very quickly upon leaving though because I was not ready yet.

Years later I attended a second rehab. I was closer to surrender and I was closer to breaking through my denial, but I still did not believe that the 12 step program could “fix” me. Therefore I rejected the solution they were offering me and I continued to self medicate. I refused to surrender and my excuse was that the treatment process was not a good fit for me (this much is true, but should not be a deal breaker for anyone. Just because 12 step programs are archaic and optimized for extroverts does not make them totally invalid).

Finally after another year from this second rehab visit I surrendered fully. I threw up my hands and became willing to do anything to avoid further misery. I no longer cared what the solution was, at all. I was willing to do anything, it did not matter. I had finally chosen to “face fear” rather than to continue on in misery.

How many levels of denial are there really?

There are at least 2 levels of denial. One level is the one that we all think about right away. Imagine a person who is so drunk at a party that they become obnoxious and belligerent. We all know that they have a problem but the person themselves may be oblivious to it. They outright deny that they drink too much. They honestly do not believe it themselves that they could possibly have any sort of real problem with drugs or alcohol. They are in complete and total denial of any problem.

That is the first and most obvious level of denial. We are all familiar with how that works. It is “outright” denial.

But there is a more subtle level of denial that has to do with that choice between fear and misery. This is something that most people are not as clear about.

For example, when I had gone to my first rehab and then went back to drinking and drugs, I obviously was still in denial to some extent. But I readily admitted at this point that I was screwed up, that I had a major problem, and that my problem was drugs and alcohol. I admitted all of this readily. And yet at that time I was still in denial. Why? Because I was in denial of the fact that I could be happier if I were clean and sober. I denied the solution. I cried out to the world saying “I am unique, I am different, and even though AA works for other alcoholics, I am different so it could not possibly work for me!”

Now here is the truth so listen very closely:

That was fear. Plain and simple, that was me being very, very afraid. I was afraid of AA meetings and I was afraid to face life sober. I was choosing misery rather than facing my fear. And this was denial. I was still in denial because I refused to admit that I was miserable, that my life was terrible, that I might be happier if I would just face my fears and give sobriety a chance. I was still in denial even though I could admit to having a problem.

And this is a big part of why people can go to rehab who are not truly ready to change yet. They go for the wrong reasons. They go to rehab to avoid misery rather than to face their fear. This is a key distinction that most people will not even acknowledge. They don’t want to talk about their fears and how they keep them stuck. It is too damaging to the ego. Yet this is why people end up going to rehab and then relapsing. They have not fully faced their fear, they have not surrendered fully to the disease, they are not ready to fully embrace recovery and do everything that they need to do.

I finally got to the point where I was so incredibly miserable that I no longer cared about my fear. I became willing to face my fear because I was utterly defeated and miserable. This is the point of surrender. This is where you become “cured” and have a shot at long term sobriety.

The problem is that nearly all addicts and alcoholics will give treatment a try before they reach that point. Thus they do not stay clean and sober. They relapse after treatment because they were not truly ready to attend in the first place. They were not ready to face their fears completely. At best they were “partially ready” to recover. Which gets you nowhere in this game, unfortunately. Recovery and sobriety is pass/fail. If you relapse a little then you relapse a lot. Therefore full surrender is the only way to be successful.

When enough is enough and someone is truly ready to change

My experience is that surrender is measured in misery. No one will change if they are happy and things are going good for them. Why would they?

This is why it is important to stick to the principles and concepts that are taught in Al-Anon. Detachment is one of these concepts. Setting healthy boundaries is another.

If we are enabling an alcoholic or an addict then it generally means that we are denying them of their pain.

What does this mean?

If an alcoholic or addict in your life needs help, the question for you is: “Should you help them?”

The answer depends on their level of surrender. If they are fully surrendered to their disease then you should definitely help them. Take them to rehab. Help them find treatment.

On the other hand if the struggling addict or alcoholic is NOT in a state of full surrender (very likely in most cases) then you will want to avoid helping them. Because at this point you are not really helping them at all, in fact you are only enabling them and alleviating their pain.

For example: The addict is in jail due to addiction and needs bailed out. You bail them out and you thus alleviate their pain. Then they continue to use drugs. You enabled them rather than help them. Leaving them in jail adds to their misery. When they finally get enough misery they will seek out recovery. Do not deny an addict their pain.

Another example: The addict is out of money and cannot afford food or groceries. They spent their money on drugs or booze. Instead of giving them money you buy them food directly. This is still enabling though because now you are training them to do the same thing in the future: waste money on drugs and then beg for food. Not only that but you have once again denied them of their pain. Going without food would have brought them closer to surrender. Do not remove consequences for the addict or alcoholic. Allow them to experience all of the pain and misery that they bring on to themselves. Do not deny them their pain.

The alcoholic or addict will change their life when they have finally had enough pain.

Therefore the friends and family of that addict can accelerate the process of surrender by taking consistent action. They must agree to stop enabling. They must agree to never deny the addict of their pain. This is hard to do because we feel like we are hurting them, or turning a cold shoulder to them when they are in need. But if we “help” them then we only prolong the agony of addiction. Turning the cold shoulder (“tough love”) is what brings them closer to surrender, quicker. When they are miserable and run out of options they will be closer to real surrender.

Is going to rehab ever a mistake?

I do not believe that it is ever a mistake to go to rehab.

I went to two treatment centers when I was “not ready” to recover. I was still choosing misery over fear.

But this still may have been a critical part of my journey. Failed trips to rehab are not a total loss. They were part of what I had to learn and go through.

I don’t think that rehab is ever a mistake. Obviously if someone relapses post-treatment then they were not ready yet, they had not fully surrendered. But this may have been part of their path, to see what they are really up against when it comes to addiction, so that in the future they will not make a half hearted attempt again.

Ultimately you never know when the miracle is going to happen. It is not a mistake to hold out hope. Some treatment is always better than none at all. And any trip to rehab may be an important step in the process, even if it does not result in an instant “cure.”

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