The Dark Side of Intensive Outpatient Drug Treatment

The Dark Side of Intensive Outpatient Drug Treatment


Is there really a dark side to IOP, or intensive outpatient treatment for drug and alcohol addiction?

I think that there is. This is based on two things: One is my own personal experience in attempting to, and finally becoming, clean and sober. The other thing it is based on is my observations of people in early recovery and how they fare, and this is based on the fact that I now work in the substance abuse recovery community.

So what is this dark side? In a nutshell, I believe that IOP is almost always the second or third best option for a person who is looking to get their life turned around from addiction or alcoholism. It is almost never the single best choice for treatment. Again, this is just my opinion.

Now what is this opinion based on? First of all, my personal experience: When I was initially trying to get help for my addiction, I was not yet at the level of what I would call “full surrender.” In order to me to make the leap into recovery and really turn my life around, I needed to go “all in” with recovery and that meant going “all in” when it came to addiction treatment.

But instead, I stayed stuck in denial for many years. I did not want to admit that I was miserable due to my addiction, and I did not want to dive head first into treatment in order to get the help that I needed. Instead I felt like I was “better than a real alcoholic” for some reason, even though it was very clear to my friends and family that I was most definitely alcoholic. I wanted to believe that if I really wanted to quit drinking and taking drugs, I could certainly do it without “locking myself up in rehab.”

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Therefore, the idea of going to inpatient treatment was awful to me. I was afraid of it and I felt like it was beneath me. I was better than that, or so I thought.

But my family could see that I was self destructing due to my drinking and drug use, and they wanted to help me. So they strongly encouraged me to do anything that I was willing to do, which started out with seeing a therapist on an outpatient basis.

Now once I started going to see this counselor, things did not really change very much. In fact, things did not change at all. I would go see this therapist every week, and I would talk about my problems and my using, but I actually had no intention of stopping at the time. I just kept right on drinking and taking drugs. I was not doing anything else differently in my life, and yet I was telling myself that I was making an effort.

The therapist that I was seeing on an outpatient basis was educating me. So I was learning about addiction and I was learning a tiny bit about what it meant to be in recovery from addiction. But unfortunately I was not actually applying any of this knowledge in my daily existence.

It should be noted that when it comes to real recovery from addiction, applied knowledge is everything and simply learning about the principles and mechanics of sobriety is practically useless. You can memorize the big book of Alcoholics Anonymous and still relapse and drink yourself to death. It is all about the application of that knowledge and how it changes your life in a positive way.

As such, being in IOP gave me a false sense of progress. Looking back, I realize today that I was secretly thinking and hoping that I would one day hear just the right thing from my therapist that would somehow change my life for the better. Even worse, I realize now that I was not hoping for the inspiration to quit drinking and taking drugs; instead what I was hoping for was that the therapist would say something that led me somehow magically moderate my consumption and become a “non addict” overnight! I was just continuing to self medicate while hoping for a miracle cure, all while not changing my behavior in the slightest or making any real effort other than showing up to IOP each week. Ridiculous.

And yet this is how our minds can work in addiction. We can convince oureslves of nearly anything, and if we allow ourselves to feel better because we are attending IOP then we might use that to justify our continued use of substances. We might even tell ourselves that we have “cut back” now that we go to IOP, and insidiously, we may actually cut down for a short while. The key term here is “short while,” because eventually our addiction will assert dominance again and create chaos and misery in our lives.

So what is the solution? If IOP Is so terrible (as I am making it out to be), then what is the solution?

The real solution is surrender. Total and complete surrender.

Let me be clear here: I am not actually against IOP, and I do not think that it is actually evil or anything. For certain people, in certain cases, it can certainly be effective.

What I am saying is that in most people’s cases, there is a solution that is superior to IOP. And for the majority of those people, the better solution is inpatient treatment. You know, the 28 day program.

For the other sliver of recovering addicts and alcoholics, one on one therapy combined with support from AA meetings is probably–in my humble opinion–more actionable and useful than IOP classes. This is because applied knowledge and specific therapy advice is going to do more than just learning about the stages of addiction, or whatever academic topic they are covering in IOP.

It is about taking action. If you go to a therapist one on one, they can give specific advice based on your situation and recommend a specific action for you to take. If you go to AA and get a sponsor, you can work the steps and start taking specific steps towards a better life.

But if you go to IOP then you will have to push yourself really hard in order to actually apply the knowledge and create real action from it on a day to day basis. If you can find a way to do this then IOP may be helpful to you. My experience, and my opinion is that you would do well to go to inpatient treatment, then follow that up with one on one therapy and 12 step meeting support. Again, just my opinion based on my own experiences and observations. Good luck!

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