What can you expect when you check into a drug or alcohol rehab center in order to get clean and sober? What type of treatments do they provide exactly, and how can those treatments help you to overcome a drug or alcohol addiction?
I was quite honestly curious about this when I was still struggling with my alcoholism, because I had no idea exactly what a rehab center might be able to do that would assist me in quitting drinking. Quite frankly, I could not imagine what might help. And I think a part of me was trying to imagine what the rehab might do in order to try to convince me to WANT to stop drinking.
But that is just it–the treatment centers do not try to convince you to stop drinking or using drugs. They already know that this is a fool’s errand. Therefore they do not even attempt to change people’s minds or try to get them to do something that they don’t want to do. Rehab is not brainwashing. It doesn’t work that way. They assume that you already want to stop drinking on your own. They do this because there are plenty of people who will come to them for help who already want to stop. And even then, it is still very difficult to help such people. Just imagine how much the odds are stacked against you if you have no real desire to stop drinking yet! Some of those people who really want to change still end up relapsing. It is a tough job to rehabilitate people.
So what exactly happens at alcoholism rehab?
Let’s take a look.
The basic conception of disruption and why it is so vital to your recovery
First of all, there is a basic concept that I explore quite heavily on this website known as “disruption.”
Alcoholism is a pattern of drinking. Addiction is a pattern of abusing drugs. You are trapped in a cycle and your actual environment becomes part of the problem, part of the daily triggers. For example, the alcoholic who walks or drives down the same street every day that has liquor stores on it. Or the drug addict who buys drugs from people that they naturally run into every single day.
Your environment is not the entire excuse for an addiction, but it certainly makes a big impact. So a big part of treatment is simply removing yourself from your addiction. Going to rehab is a way to protect you from yourself. There are no drugs or alcohol at rehab to tempt you. There are no liquor stores or drug dealers there either. So you are “safe” in that if you just stay in rehab for the duration then you will not relapse while you are there.
I have heard some alcoholics and drug addicts who believed that it was impossible for certain people to ever get clean and sober. This is silly. Of course it is possible, they just have to find the right disruption. If you take an alcoholic and put them in jail for 30 days then they don’t have much of a choice. Going to rehab is very similar, not because it is similar to jail (it is nothing like jail, actually), but because it is very easy to disrupt your pattern of addiction while you are staying there. In fact it is super easy to be at rehab and not drink or use drugs. People who have never done it before probably have this image in their minds that it is very difficult to be in rehab and that the temptation to bolt out the doors would be overwhelming. This is not the case at all. I worked in a rehab for 5 plus years. It was extremely rare for someone to bolt out the door and go use their drug of choice. It was, in fact, quite easy to be in rehab.
Now this is not to say that it was easy for every person to stay clean and sober forever, because after you leave treatment it is an entirely different story. But while you are in detox and residential treatment it is very easy to be clean and sober. There is nothing to it. They make you comfortable as far as the withdrawal symptoms go (or at least they try to do so using medications). You have a group of peers there with you who are all going through the same process. It may be difficult to stay sober in the long run, but getting through short term treatment is very easy. Once you are there, it is a piece of cake. Treatment is easy. Getting there might be difficult (asking for help, picking up the phone, surrender) and staying sober after leaving may be a challenge, but actually staying in rehab is not difficult at all.
They have a saying in recovery: “If nothing changes, nothing changes.” You need a massive disruption in order to overcome your addiction. Going to rehab is one such disruption.
Counseling and therapy
What happens in most treatment centers is that there are a group of therapists and counselors who are working with all of the alcoholics and addicts. There may be one counselor for every 5 or 6 people or so. So what is most likely is that when you have been in treatment for a few days they will assign a therapist to work with you.
Now you might think that this means you will sit and talk with this therapists for hours on end each day. You will talk to them, but probably not quite as much as you would like. Instead, you will talk with them a little bit so that they can do some sort of initial assessment with you to find out what your problems and issues are.
One of their ultimate goals for you in most cases is going to be to figure out a plan for you. Rehab is nothing if you don’t come out of it with some sort of plan. If you leave treatment and simply “hope” to stay sober then you really have nothing at all. On the other hand, if you have a specific plan to help keep you sober then you have a real shot at staying clean. You need a plan. The therapist’s job is to make one for you.
So while you are in rehab the therapist will write up a treatment plan that has specific goals for you and objectives.
Teaching about addiction and recovery
While you are in residential treatment they will expect for you to attend groups and lectures and meetings.
Now there are two kinds of rehabs: The rehabs that force you to attend all of these groups while you are in treatment, and the ones that make it optional and allow you to skip out on most of the stuff if you want to sit around and be lazy.
I can tell you right now that any rehab that allows you to skip any of the groups and lectures is not going to have as good of a success rate as the one that makes it mandatory. Really you have to ask yourself: What is the point of being in rehab if you are not going to learn anything new about how to live sober? Disruption is useful but it only goes so far. Eventually you have to leave treatment and when you do you had better be prepared. If you don’t have a plan in place then you will relapse.
So what are these groups and lectures like at rehab? What is it like to go through a typical day of rehab?
I can tell you that it feels a little bit like being in school when you were a kid, because I have heard a lot of people make that remark when I was working in a treatment center. But it is not quite so bad as school because there is typically more variety in a treatment center. So you are not just studying subjects all day long or listening to straight lectures. Instead, they mix it up. They will do different things with you. So you might watch a movie. You might do some group therapy where everyone gets a chance to talk and interact. Then you might hear a lecture, which will probably feel a lot like being in school. Then you might do an activity where you get active, partner up with someone, or even doing something physical. You eat lunch. Then you do more groups, exercises, activities, movies, and lectures. Typically at some point you will do a 12 step meeting, which actually feels a lot different than all of the other stuff. Many times people from the outside will come into a rehab and put on the AA or NA meeting, so this can be a point of variety as well.
So it is not just all one big boring lecture. They try to mix it up. It will probably be interesting for most people. You will learn a lot of things about addiction, alcoholism, and what it is like to live in recovery. This of course is the whole point, to learn. If you don’t learn anything new in rehab then you have little chance of remaining sober.
At the end of each day you will probably be amazed at how much stuff you did. It is a long day because you sort of keep going the whole time. Most rehab centers do not have a lot of down time because it is a waste of time and money for the person who is struggling to get clean and sober. If you sit around or nap all day then you are not learning how to live a sober life. Therefore they keep you fairly busy. Expect to go all day long, pretty much every day while you are in rehab.
Introduction to 12 step programs (or alternatives)
Most rehab centers have what is known as a “treatment philosophy.” So they may base their treatment on the 12 step program, or in some cases they may base their treatment on religious principles. Whatever the case may be, you will likely be introduced to this treatment philosophy as part of the rehab process.
At a typical 12 step based rehab you can expect to go to one AA or NA meeting every single day. In many of them they will have people from the outside come into the rehab and bring a “real” AA meeting right into the treatment center. This can be really helpful for the people who are in treatment because then they get a glimpse of what “real recovery” looks like on the outside. It gives them more perspective.
If you go to rehab and they are presenting you with their solution, their philosophy, then you might want to grab a hold of that philosophy and make it your own. Many people who go to rehab and are introduced to AA do not pick up on the fact that this is their lifeline when they leave treatment. Think carefully about what you are going to do when you walk out of rehab: How are you going to prevent yourself from taking a drink? How are you going to avoid relapse when the temptation becomes very great?
Being in rehab can give you a false sense of security. It seems easy to stay sober while you are in rehab because there is absolutely no temptation in sight. And it is easy to fall into the trap of thinking that it will remain easy after you get out of rehab and you are back in the real world. Therefore many people brush aside the suggestions regarding AA and they do not think that they need to go to meetings every day.
For example, many rehabs will recommend that you follow up your visit to rehab with going to 90 AA meetings in the next 90 days. Some people think that this is far too demanding, to go to an AA meeting every single day. But you have to realize just how powerful your addiction is, and what it really takes in order to overcome it. The people who work at rehab have a really good idea of the success rates. They know this because they see it every day in action. When I was working in a treatment center I was frankly amazed at how many people would leave rehab and then come back for more treatment at a later time. In fact, I would say that over half of everyone that I checked into rehab had already been there at least once before. This was shocking to me. Why so much repeat business? Why were these people not “getting it?” I found that most people who left rehab did not follow through. They were given a treatment plan but they did not follow through with it. They were told to go to “90 in 90” but they often would stop going to AA meetings or never start at all. They failed to follow through.
The best way to leave rehab is to immediately dive into a recovery program, right when you get out. This is why they suggest that you go to an AA meeting the first day that you walk out of rehab. Don’t wait even one more day to go. Get to your first meeting and tell them what your situation is and ask them if someone can at least be your temporary sponsor. Does this sound like overkill? It’s not. At least half of people who leave rehab have relapsed within the first 30 days. About 90 percent will have relapsed within the first year of leaving.
So you have to ask yourself: How are you going to be part of the 10 percent who are still sober after a year? Line up 10 people who you went to rehab with. All but one of them will relapse within a year. How can you avoid being one of those 9 who relapse? What can you do to prevent that from happening?
It’s all about follow through.
You must take action.
Follow up care and long term sobriety
In order to be part of the slim percentage who stay clean and sober for the long run, you have to take massive action.
Recovery doesn’t really start until you walk out of rehab. That is when the real test begins. Like I said earlier, being in rehab is easy. The real challenge is after you leave treatment.
Think about what the average person does when they leave treatment. The average person will go to an average number of AA meetings, right? The average person will follow up with their aftercare a little bit, but they might miss an appointment or two. The average person will try, but they will not try super hard.
Now look at the success rates again. Roughly 90 percent will relapse after a full year goes by. So even if you are “above average,” you still have a very high chance of relapsing.
Are you starting to get the idea here? You cannot just make a modest effort and expect to stay clean and sober.
This is deceptive because most people have experienced various challenges in their life before, and they treat recovery in the same way that they treated previous challenges. Don’t do this! If you treat recovery like most other things in life then you will relapse for sure. This is because most things in life will reward you for making an average effort. Recovery does not work this way.
If you make a modest effort in recovery then you will relapse and become miserable again.
If you make a slightly harder effort in recovery then you will still relapse.
If you try really pretty hard then chances are good that you will still relapse.
In order to insure sobriety, you must try harder than you have ever done so before in your life. “This is it, fight like hell.” Hold nothing back, because you have never faced a greater challenge than this.
This is the sort of attitude that you must adopt when it comes to follow up care and long term sobriety. Don’t just think that you can take a few suggestions and have everything turn out well. “OK, I will hit a few of these AA meetings, and maybe go see that therapist once or twice, and maybe I will actually get a sponsor in AA but I probably won’t talk to him much,” etc.
That won’t work! If you take that casual attitude then you are headed for relapse.
When you go to a rehab center, they are trying to teach you the intensity that you need in order to recover. They are trying to teach you that you need to dedicate your life to recovery for a really long time in order to overcome your addiction.
Alcoholism treatment starts with disruption, but it ends with personal growth. You are not really living sober until you are challenging yourself to learn and to grow every single day. This is the lesson that rehab centers struggle to teach you. It is a difficult lesson because it never really ends, and the importance of personal growth can never be overstated enough.