Should Addiction Treatment Become Longer than 28 Days?

Should Addiction Treatment Become Longer than 28 Days?


Should alcohol and drug rehab be longer than the standard 28 days? Some people think so. Delaware Online suggests that “Understanding that at a minimum those suffering from this disease must receive at least 90 days in treatment followed by months of extended follow-up, allowing a transition from a safe clinical setting to a partial outpatient setting that includes the outside recovery community and family support.”

So some treatment centers have done their own homework, so to speak, and they are finding that 90 day programs are vastly superior to the more standard 28 day programs.

Why is this? One reason could be physiological. The Daily Mining Gazette says that “The Surgeon General’s Report on Alcohol, Drugs and Health recognizes addicts’ brains change as a result of continued abuse, making long-term treatment an increasing necessity in the multi-faceted war on drugs.”

In other words, the human body has changed as a result of the addiction, and the human brain becomes rewired. This takes a certain amount of time to repair, and 28 days is apparently not cutting it.

On the other hand, I am quite sure you can find some data out there that suggests that opposite: That 28 day programs show similar results to longer term programs. People arguing that shorter treatment stays work just as well will often argue that it all comes down to the individual’s level of surrender.

It is important to keep in mind that there is no such thing as a magic bullet in the world of addiction treatment. You cannot send a person to the supposed “best rehab in the world” and get vastly different results than if you sent them to cheap or free rehab alternative. In fact, you could make a strong argument that it would make no difference at all which rehab you sent an addict to, that it is entirely up to their level of surrender as to whether or not they remain clean and sober.

There is an old paradigm that includes sending certain people to very long aftercare programs, such as to a halfway house for up to 2 years following inpatient rehab. You would think that having people stay in treatment for up to 2 years would produce vastly improved rates of success over the shorter 28 day programs, but they found this to not be the case.

The sweet spot is probably somewhere between 28 and 90 days. But it is also important to keep in mind that many struggling addicts and alcoholics have done just fine with shorter rehab programs, and some have managed to sober up with no official rehab at all–they simply started attending AA meetings in some cases.

That said, any treatment is certainly better than nothing at all. Any willingness is better than none at all. Agreeing to go to a 28 day program is probably a bit easier for most addicts to handle versus going to somewhere for 90 days. It might be interesting to see how the data stacks up in terms of willingness when it comes to longer treatment stays, as most people likely hesitate when someone suggests a longer time frame than a single month. Committing to rehab for 28 days takes a leap of faith, and committing to treatment for 90 days or more takes an even greater amount of guts. So it might be interesting to see how this affects people’s level of willingness and what they are really willing to commit to in terms of longer treatment stays.

My suggestion is that the struggling addict should just go to rehab. Period. Don’t worry about the details right now, don’t concern yourself over the length of stay or the color of the bedrooms or anything at all, other than the fact that you need to get yourself into inpatient rehab. Just go.

Pick up the phone and just get yourself into rehab. That’s the most important thing by far. Everything else will work itself out. Everything good that happens in your life will be a domino that falls after you check yourself into an inpatient rehab.

There are a lot of potential false starts when it comes to addiction recovery. As an addict or an alcoholic, you can talk yourself into just about anything, and this is always very easy to do. We fool ourselves so easily. This is one way that denial can hold us back from taking real action.

An example of this is when the alcoholic promises to switch from hard liquor to beer. “From now on, I will only drink beer, never any more of the hard stuff.” This is their master plan and it fails every time for the true alcoholic.

Or they swear off booze during the week. Or they swear to only drink after 5PM. Or some other half measure.

In the end it doesn’t matter, because the only thing that matters is total and complete surrender. All of these other solutions are merely rearranging the deck chairs on the Titanic. If the alcoholic continues to put addictive substances into their body, in any quantity greater than zero, then the madness is just going to keep spiraling further and further out of control.

No, the only real solution is total and complete surrender, followed up by willingness and positive action. In this regard, the more willing you are to go to long term treatment, perhaps the better. In other words, it is not necessarily critical that you go to a longer term facility, but if you are not willing to do so, then that is a red flag. A 28 day program may be enough for most people, but the level of willingness and surrender is what will really make or break their recovery.

Perhaps more data is needed as well, with addicts and alcoholics who are seriously motivated for change in their life, to see what lengths of treatment are truly more effective than others. Or perhaps the length of residential treatment is not significant when comparing 28 days to much longer stays. The data and research that we have in regards to this is fairly limited, though we do have some. Again, the key usually comes down to level of surrender and willingness, not specific program details.

In that regard it may be more important to qualify the people coming to treatment. In other words, if you want to boast a nearly perfect success rate for your treatment, then you just need to screen out all of the people who were not going to make it in recovery anyway. That is a very cynical view of recovery that we have to move past, because sometimes the best that we can do with treatment is to plant a seed. I went to treatment 3 times before I “got it.” Were the first two rehab visits a total waste? I don’t think so. Those visits were all about planting seeds for me. Later on, when I became more open to real recovery, I knew that there was a solution available for me in the form of inpatient rehab.