If you have never been to addiction treatment before, you may be wondering how exactly going to rehab is going to help someone to stay clean and sober. This is a natural thing to be curious about and I have to admit that when I was still using alcohol and drugs I was actually a bit scared of the answer.
The reason I was afraid is because at the time I did not want to stop drinking. I had no desire to stop. And so I imagined that if you went to a treatment center that they must have some way of convincing you to stop, some way of brainwashing you, some way of manipulating your will.
I am here to tell you now that if you share those same fears and anxieties that you can stop worrying. There is no such power at a treatment center. They do not have the power to make you want to stop drinking. They don’t have any methods of brainwashing people. They cannot force you to change your desires. They don’t have any magic tricks up their sleeve.
This is an important thing for everyone to realize–including the friends and families of a struggling alcoholic or drug addict. There is no magic in recovery. The results are certainly magical and downright amazing, but those results are based on hard work and serious commitment. The alcoholic hits bottom, they ask for help, and then they start rebuilding their life one day at a time. That is as much “magic” as there is in the process. Sheer consistency is what produces the amazing result of rebuilding a new life in recovery. But the actual stuff that you learn at treatment–there is no magic or secrets in that.
And I think this is an important thing to realize because so many people have this as a secret hope in the back of their mind–that there is some sort of magic cure out there for their problems. But no such magic cure exists. It is only commitment and hard work. That is the only “secret” in recovery.
So with that being said (that there are no real secrets), what exactly is the process by which a drug rehab helps someone to remain clean and sober?
Since the answer is not secret (or magic), it is actually somewhat obvious. Let’s go through it in detail though.
The foundation of recovery starts with abstinence
The foundation of addiction recovery is total abstinence from all mood and mind altering substances. No more drugs and no more alcohol, period. This is the beginning of healing.
Because of this simple and basic principle, most rehabs also include a medical detox area where people can dry out safely and under medical supervision. Most drugs are not dangerous when it comes to withdrawal but a few of them can be quite dangerous to come off of and potentially deadly (alcohol, benzos, and heavy opiates all come to mind). Therefore most people who are struggling to get clean and sober should start their journey in a medical detox facility. As mentioned, most rehabs include one of these, after which the person can go straight into residential treatment where they start attending groups, lectures, meetings, and so on.
There are people out there who try to “recover” without going the total abstinence route, and I have little or no experience with that group, other than I tried desperately myself for many years to learn how to moderate my drinking. After failing time and time again with that, I finally realized (very reluctantly) that total abstinence was the answer for me. So I finally embraced abstinence as a solution and I went to rehab for a third time. The first two times that I attended treatment I was not yet ready to embrace total abstinence as a solution for my problems. In one case my goal was to simply switch from alcohol to a different drug (marijuana). This didn’t work for me at all! Using one drug just led me back to my drug of choice eventually. So I had to come to terms with the truth, which was that I could not successfully use any addictive substances and expect to be happy. Drugs and alcohol put my life into a negative spiral and things just kept getting worse and worse. I could try to moderate or cut back but such efforts always ended up in chaos. Eventually the chemicals took control of me again and I would be out of control. Therefore I had to accept abstinence as my solution and this is how treatment centers are basically set up. You go through detox and abstain from all addictive substances. Then they attempt to teach you how to remain clean and sober after you leave rehab.
Teaching the basics of addiction and recovery
If you did not learn anything at treatment then there would be no point in going through detox. You would simply leave detox and walk right back into the same problems and life situations that you had before and you would relapse.
In order to avoid this you must learn something new and then apply it in your life. So treatment centers attempt to teach you how to avoid relapse. They try to teach you a new way to live, one that does not lead to self medicating all the time.
It is difficult for a rehab to teach a lifetime of lessons in 28 days or less. Therefore they compress the information and try to highlight the basics of what will get people started in the right direction. This is unfortunate in some ways because the typical alcoholic and drug addict is in a weakened mental condition due to detox and withdrawal. They can still learn and absorb new information but they are not exactly at peak mental power when they have 5 days sober. Nevertheless, they still have to try to learn a new way to live without their drug of choice as they really have no other options. Either they learn this new way of life or they go back to their old way of life. So they must try to learn something new anyway if they want to survive in recovery.
Treatment centers try to teach people why they may have become addicted, what some of the underlying problems might be, and what potential solutions are. They also will normally be based on either a religious approach or the 12 step program of AA. So they also introduce the struggling alcoholic and drug addict to a system of support.
Introducing people to concepts of support and community
It is generally accepted that if an individual wants to become clean and sober then they are going to need a great deal of support in early recovery. We have accepted the idea that we cannot do it alone. We need help in order to recover. We need support for many reasons.
One of the big reasons that we need support in recovery is due to the need for identification. If you just got clean and sober then you may feel like you cannot relate to anyone. This is very common in early recovery. Many, many people get to rehab and they feel like they do not belong, like they do not fit in, like they are in the wrong place. Maybe they are a closet alcoholic and they say something like “I just don’t belong here with all of these drug people!” Or they may get introduced to the program of AA and hear the suggestions for going to meetings every day and working through the steps with a sponsor and they get overwhelmed. So they make excuses and try to exclude themselves, they say that they are in the wrong place, their problem is not that bad yet, and so on. Or they argue that are not like these other people who need help, they are not that messed up, or they start to compare consequences. For example, maybe they drank every day but they have never crashed their car or lost a job because of their drinking. So they compare themselves to others in rehab who have suffered devastating consequences and so they decide that they are in the wrong place. They are unique. They love to drink but they are not like these other drunks. They love alcohol but they don’t have a real problem, not like these hard core alcoholics that they ended up with at rehab. They need to get out of here!
I worked in a treatment center, full time, for over 5 years and I have watched this happen over and over again. People get to rehab for the first time and they suffer from this “uniqueness.” They believe they are unique and that no one else understands them. Such people usually leave treatment early and go back to self medicating fairly quickly.
In fact, I was once one of those people. I could not relate to others because I had not yet experienced the misery of addiction. I was still addicted but I had not yet experienced many consequences or pain from my addiction yet. So I could not really relate much to others the first time I went to rehab. Later on I went back to rehab after much more chaos in my life, and I was able to identify much better with people. Now they were telling my story at AA meetings. Now I understood. But I had to go through a great deal of pain and misery and struggle before I got to the point where I could identify with others.
So how does rehab help people to recover in terms of support? They introduce you to a community where people that you can identify with are willing to help you. This is important. If you never identify with anyone in recovery then you have little hope of recovering. You get hope when you hear someone tell your story, and that person is living a sober life. You get hope when you can identify with other people in recovery and they have made it through the same struggles that you are facing now.
Another reason that we need support in early recovery is to help replace our old behaviors. What did you do before you went to treatment? I used drugs all day and hung out in bars. This behavior has to change in recovery, obviously. So what is going to fill that time?
If you have ever been in treatment then you will know that they recommend attending 90 AA meetings in 90 days. This sounds overwhelming to most people because it is. It is designed to be that way. And in your time outside of meetings (and work, and sleeping) you should be spending some time with the people that you meet in the AA meetings. Having coffee with them and doing other things that sober people do in life. Notice that if you actually put in this effort and do the 90 in 90 and also spend some time with the people at the meetings drinking coffee and such that you will have little time for anything else. This is sort of the point–that you are replacing your old life with new behaviors. You are surrounding yourself with positive people who don’t drink or use drugs. This is not a magical secret of recovery, it is simply common sense. You can’t keep hanging out at the bar or with your old drug using buddies and expect to stay sober. You have to replace all of that stuff with something new and positive. Going to AA meetings every single day is one way to start doing that. It is not the only way, it is just a convenient way that actually works.
You don’t have to go to AA every day in early recovery. But if you don’t, you might ask yourself this important question: “If I am not going to go to meetings every day, what exactly am I going to do that will rebuild my life in recovery and surround me with positive people who don’t drink or use drugs?” Because if you don’t have a really good answer for that question then you are probably making a mistake. In my early recovery I:
* Lived in long term treatment for 20 months.
* Attended daily meetings during this time.
* Cut all ties with former alcoholics and drug people.
* Started living a new life with the positive people that I met in recovery.
That was how I built up support in my early recovery. That was how I built a foundation of support in my journey. A few of those people that I met in early recovery 13 years ago are still in my life today (precious few though!).
Going to rehab introduces you to these support systems. Most rehabs will introduce you to AA meetings and even bring them into the rehab from the outside. People from AA will come in and put on a meeting for you (usually). There are other forms of support of course but the 12 step program and the fellowship is the main one.
If you want to achieve long term recovery then you will probably need to follow up your treatment visit with some sort of aftercare.
Luckily most treatment centers work with the individual to set up specific aftercare for them. This might be outpatient treatment, it might be counseling or therapy, and it might be long term treatment. Whatever the treatment center recommends for you, you should probably try to do. In fact, you should make a strong commitment to following through with it no matter what.
There have been numerous studies done on people who finish up a 28 day program and then either follow through with their aftercare, or fail to do so. Then they measure if such people remain clean and sober or not. There is a very strong correlation between staying sober and following through with aftercare recommendations. In fact if you look at the data the correlation is so strong that you would have to say that it is almost a perfect predictor of failure. That is, if you fail to follow through with your aftercare, you are nearly 100 percent likely to relapse. On the other hand, if you do follow through with it then you are only like 50 percent likely to be sober after a full year has gone by.
That might sound like daunting odds, but it should give you a clear indication of what is really required after treatment. You don’t just leave rehab and then prop your feet up and become lazy. That is a mistake that will just lead you back to your drug of choice. Instead you need to follow through on the suggestions that you were given and do the work.
Think about it this way: Your addiction is the default state in your life now. When you are self medicating every day that is now considered to be “normal” for your life. That is who you have become. We can put a label on it and call you an “addict” or an “alcoholic,” but the fact is that no matter what we call it, that is your normal state of being. You feel most comfortable when you are self medicating every day. That is your normal state of being.
So in order to overcome this state of being you have to do something. You have to make a decision. You have to take action. Because not taking action means that you will just revert back to normal. Relapse is actually quite natural. It is actually unnatural to push really hard in your recovery and create a new positive life for yourself in sobriety. It is not normal to do this and it takes hard work.
It is the easiest thing in the world to relapse. It is really easy to just go back to your old ways. It is comfortable. It is enticing. When you self medicate every day you know what to expect. Therefore you remove this fear of the unknown. You may be miserable in addiction but at least you know what to expect.
When you forge ahead in sobriety you are facing your fears. You are facing the unknown. And it can get pretty scary. So it is normal for people relapse, it is natural.
Obviously we want to overcome this “normal” reaction to the fear and overcome relapse.
One of the best ways that you can do that is to follow directions. The treatment center makes aftercare recommendations and tells you what to do when you leave rehab. They give you instructions. They tell you: “Go to counseling” or “Go to AA meetings” or “Go to outpatient therapy for six weeks.” Or whatever. They give you instructions and it is your job to follow through on them. Failure to do is almost always an indicator of relapse.
Living in long term recovery
The concepts and principles that you learn about in a treatment center can help to set you up for success in long term recovery.
The foundation that you build in early recovery is what will carry you through to years or even decades of sobriety. I have been sober now for over 13 years and I got my start in a 28 day program. I went through a medical detox. I went to groups and AA meetings while I was in treatment. And I was given a recommendation for aftercare that I followed through on. Thus my life has transformed for the better and the rewards of recovery continue to multiply in my life.
Have you been to treatment? Has it helped you to remain clean and sober? Let us know in the discussion forums. It only takes a second to register!