Drug addiction is a complex illness.
It’s characterized by compulsive–at times uncontrollable–drug craving, seeking, and use that persists even in the face of extremely negative consequences. For many people, drug addiction becomes chronic, with relapses possible even after long periods of abstinence. The path to drug addiction begins with the act of taking drugs. Over time, a person’s ability to choose not to take drugs can become compromised. Drug seeking becomes compulsive, in large part as a result of the effects of prolonged drug use on brain functioning and, thus, on behavior.
The compulsion to use drugs can take over the individual’s life. Addiction often involves not only compulsive drug taking but also a wide range of dysfunctional behaviors that can interfere with normal functioning in the family, the workplace, and the broader community. Addiction also can place people at increased risk for a wide variety of other illnesses. These illnesses can be brought on by behaviors, such as poor living and health habits, that often accompany life as an addict, or because of toxic effects of the drugs themselves.
Because addiction has so many dimensions and disrupts so many aspects of an individual’s life, treatment for this illness is never simple. Drug rehabs must help the individual stop using drugs and maintain a drug-free lifestyle, while achieving productive functioning in the family, at work, and in society. Effective drug abuse and drug rehab treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences.
Three decades of scientific research and clinical practice have yielded a variety of effective approaches to drug addiction treatment. Extensive data document that drug addiction treatment is as effective as are treatments for most other similarly chronic medical conditions. In spite of scientific evidence that establishes the effectiveness of drug abuse treatment, many people believe that treatment is ineffective. In part, this is because of unrealistic expectations. Many people equate addiction with simply using drugs and therefore expect that addiction should be cured quickly, and if it is not, rehab is a failure. In reality, because addiction is a chronic disorder, the ultimate goal of long-term abstinence often requires sustained and repeated treatment episodes.
Is it Abuse or Addiction?
How to Tell the Difference
Substance abuse or addiction is the chronic or habitual use of any chemical substance – alcohol, drugs, tobacco, and prescription medication – used with the intention of altering states of body or mind for other than medically warranted purposes. This maladaptive pattern can be identified by the presence of three (or more) of the following occurring at any time in the same 12-month period:
- The substance is often taken in larger amounts or over a longer period than intended;
- Persistent desire and/or unsuccessful efforts to cut down or control substance use;
- A great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain smoking), or recover from its effects;
- Important social, occupational, or recreational activities are given up or reduced because of time and/or energy and/or money involved in using substance;
- Continued substance use despite knowledge of having a persistent or recurrent psychological, or physical problem that is caused or exacerbated by use of the substance;
- Tolerance for the substance becomes defined by either:
- Need for greater amounts of the substance in order to achieve intoxication or desired effect; or
- Markedly diminished effect with continued use of the same amount.
- Withdrawal from the substance is manifested by either:
- Characteristic withdrawal syndrome for the substance; or
- The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.
Extensive data document that drug addiction treatment is as effective as treatments for most other similarly chronic medical conditions. Because of such obstacles to the right facts as personal denial and incorrect information issued by the press, thousands of people are getting misinformation instead of the help they need.
In spite of sound evidence that establishes the effectiveness of professional drug abuse treatment; many people still believe that treatment will be ineffective. Distrusting treatment can also stem from unrealistic expectations. Many people equate addiction with simply using drugs and so they expect a quick cure–and if it is not cured quickly, they think treatment is a failure.
Addiction is more than an uncontrollable desire for substances; it is an underlying behavior pattern with deeply emotional roots. Successful treatment requires digging down and revealing the long-ingrained pattern at the root level. What’s often revealed is behavior born of anger, helplessness, and shame, compounded by intense desires for immediate escape from these unsettling feelings. Because addiction is a chronic disorder, the ultimate goal of successful, long-term abstinence often requires dedication to sustained and repeated treatment.
What Should You Expect at Drug Rehab?
Taking that big first step into addiction treatment can be scary, especially when you don’t know what to expect and you fear the worst. Although you will work hard while in treatment, you are also well taken care of and free from other responsibilities, at least for a while.
Checking in to drug rehab lets you get away from temptation, responsibility and distraction, allowing you the needed luxury of recovery time for yourself.
Knowing what happens in a drug rehab can reduce some of the apprehension you may be feeling about treatment. To help you understand what to expect, here is a short list of elements common to most quality drug rehab programs.
No two drug rehabs provide identical experiences, but a majority of programs will offer the following program elements.
An Intake Interview and Assessment
Treatment works best when it is individualized. Your requirements are unique and so program staff has to get to know you and your situation well, so that they can develop a plan tailored to your personal needs. You can expect the initial assessment to include an interview period as well as a medical exam and sometimes a psychiatric exam. In some cases, program staff may wish to speak with family members about your situation to develop a more well-rounded picture of your addiction.
Although most of us would prefer a private room, especially during a difficult period in life, few drug rehabs will allow patients to sleep without a roommate. The expenses inherent in running a residential program make single rooms an expensive proposition, but more importantly, roommates keep clients from isolating behaviors and other negative patterns. In short, roommates offer safety and aid in the recovery process.
Although you may have a roommate, most drug rehabs make a real effort to protect your privacy and provide comfortable, home-like accommodations.
Detox, if Needed
During the initial assessment interview, the medical team will determine whether or not you need medical detox. Should you require a detox (medical observation for a supervised drug or alcohol withdrawal period) you will first enter into a special medical facility to ensure safety and comfort during this period.
The detox period can take as little as a couple of days or up to a week or more, depending on the drug abused and the history of abuse.
A Structured Schedule
You should not expect a lot of free time during your stay in drug rehab. Programs are scheduled carefully to maximize available time, but a regimented schedule also serves as needed structure to people emerging from the chaos of addiction. This structure is beneficial for people who, during the very early days of abstinence, may have difficulty making clearheaded decisions.
A tight schedule doesn’t imply a stay with no recreation – just that recreation and leisure activities will be scheduled!
You can expect to participate in counseling, typically on a daily basis. Different counseling modalities can include group therapy sessions (very common) and individual sessions with a therapist or certified addiction counselor. Other counseling modalities sometimes offered include cognitive behavioral therapy (CBT), animal-assisted therapy, EMDR, hypnotherapy and others.
In addition to counseling, you can expect to participate in frequent workshops on topics pertaining to addiction and recovery. Knowledge of addiction can strengthen your recovery and guard against relapse. It’s important that you understand why you feel and act as you do, and what to expect in the months to come.
Relapse Prevention Planning
Soon after your arrival in drug rehab, you’ll start planning your exit. It’s easy to stay sober while away from temptation, and although a substantial period of abstinence gives you a foundation for recovery, the real challenges begin once you get home.
You will need to determine what most threatens your continuing sobriety, make a plan to minimize your exposure to these threats and decide exactly what you will do when tempted. The time you spend planning against relapse while in drug rehab pays enormous dividends once back in the community.
No one can work all the time, and it’s important that people new to recovery realize that sobriety can be just as much fun as intoxication. You will have daily recreation time when you will have an opportunity to participate in sporting activities, community outings, cultural workshops and other leisure activities.
Although in many ways you must take the journey of recovery alone, you also live as a part of a family. Your actions affect the lives of those close to you, and you can and should rely on them for support when needed.
Family participation in drug rehab is important. Your family members need to learn what they can do to help you stay sober and what they may have done in the past that contributed to your drug abuse. Your loved ones will also need to learn to accept the limitations inherent to their assistance (i.e., they can help you, but they can’t do it for you!).
You may also have to make some amends to family members for wrongs done while using or drinking. An impartial family counselor can help guide a family through difficult reconciliations.
Drug rehab doesn’t end at the end of a residential stay. It continues on for weeks and months after, as you stay active in continuing care activities and alumni group outings.
The transition out of rehab can be difficult, and you will need the continuing support of a counseling group, even if you don’t think that you do. The statistics show clearly that people who stick with some form of addiction treatment for a year or longer have a much greater chance of long-term recovery.
Does Rehab Really Work?
Often, people who are considering drug rehab want to be convinced that treatment is going to be successful. They want proof that a treatment plan will help them stop using drugs for the rest of their lives.
Can we give you that kind of guarantee? In other words, does drug rehab always work? The most honest answer is that it can work. And for thousands of people every year, it does work. But instead of thinking about rehab as a quick fix with a magical formula, think of it like a diet. If someone is overweight and out of shape, he can hire a personal trainer and nutritionist to help get him on track. But just having the right people and the right plan isn’t enough. He has to willingly and faithfully follow the plan.
Or, better yet, think of rehab as being in the same vein as treatment for diabetes. Like diabetes, addiction is a lifelong disease. And, like diabetes, there are steps you can take to reduce your risk – but the disease will always be part of your life. This isn’t meant to be discouraging, just realistic. The worst thing a person can do is go into a rehab program expecting to come out completely free from their addiction.
What’s more likely to happen is that you’ll come out with the tools and support you need to manage your addiction, just like a diabetic has to manage his diabetes. You’ll learn about underlying causes of drug use and addiction, and will be better prepared to resist temptations to use again in the future. Through detoxification, your body will also rid itself of the drug so that it can begin to heal and function properly.
There are few guarantees in life – but if you follow your treatment plan, heed the advice of the professionals with whom you work, and commit to making the changes that are necessary to pursue a healthier future, drug rehab can work.