Drug rehab is both an opportunity and an investment. Like all investments, it can be strategically planned and implemented, or it can be an opportunity squandered.

Even if you have all the resources you could hope for and choose the most respected program in the country, no drug rehab can do the work of recovery for you. Here are a few tips for getting the most out of your time in drug rehab:

Stay Positive. People often come into rehab feeling defeated and hopeless, especially if they have been through treatment before and relapsed. Celebrating your willingness to try again and the courage it takes to ask for help can set a positive tone for your recovery.

High-functioning alcoholics and addicts are hard to get into treatment, and pose unique treatment challenges once they arrive. What makes the high-functioning addict so difficult to reach?

Challenge #1: Denial

Denial is perhaps the greatest obstacle to getting a high-functioning addict into treatment. High-functioning addicts are often intelligent and persuasive, characteristics that are used by the disease to justify maintaining their addiction. Because they do not fit the stereotype of a drug addict, feel that their lives are manageable, and haven’t hit “rock bottom,” many HFAs insist they do not need help.

They lie, argue and manipulate their way out of addiction and rationalize their behaviors, often so effectively that loved ones and colleagues question their own observations.

Overcome it: It takes a skilled interventionist and experienced treatment team to help the HFA overcome their sophisticated system of denial and accept their powerlessness over addiction. An intervention allows the HFA to experience the full consequences of their behaviors and helps them understand the impact their addiction has had on the people closest to them.

In an ideal world, every addict that arrives in drug rehab would be cognizant of their disease and determined to get well. But when dealing with addiction, ideal situations are rare.

There is ongoing debate about whether an addict who doesn’t want help can be helped. Many believe that only the addict can help themselves. They have to want to quit. But in the midst of active addiction, few addicts want to quit. In fact, most addicts are, by their very nature, unwilling patients.

Changes in the brain, which has been hijacked by drugs, leave the addict powerless to truly see themselves and make rational decisions. Because they have come to depend on drugs to function, they will make excuses, justify the indefensible and put off treatment as long as possible.

There are many ways in which addicts are pushed into treatment: court order, divorce, loss of child custody and hospitalization, to name a few. While some flounder along the way, many go on to achieve lifelong sobriety regardless of the fact that entering treatment wasn’t entirely “voluntary.”

Most addicts develop the motivation to sustain their recovery after being helped into treatment, when they start learning about their disease and feeling better than they have since they started using. We have techniques for getting addicts into treatment that work, if not right away then over time, even in the seemingly most hopeless situations.

So how can family, friends and colleagues help the unwilling addict?

Rage. Instability. Mood swings. Impulsivity. These characteristics make people with borderline personality disorder (BPD) prone to substance abuse as well as over-spending, promiscuity, eating disorders and other compulsive behaviors. In fact, studies suggest that 50 to 70 percent of those with BPD also have a co-occurring substance use disorder.

Addicts with co-occurring borderline personality disorder are known as some of the most difficult patients to treat. Here are a few of the most common challenges, along with insights into the most effective research-based treatments:

Treatment Compliance

Addicts with BPD have been described as both treatment demanding and treatment resistant. Research shows more positive outcomes the longer an addict with BPD stays in treatment, yet keeping them in treatment is no easy task. In a study of patients in a detox program, those with BPD were significantly more likely to have an unplanned discharge than those without BPD.

While a number of treatments have proven effective for BPD, therapies for BPD patients with co-occurring substance abuse are less established. Studies suggest that the most promising treatments include dialectical behavior therapy, cognitive-behavioral therapy and psychodynamic approaches. A combination of support and management from an experienced dual diagnosis treatment center can improve retention rates, along with ongoing involvement in self-help groups such as AA and NA.

Getting an addict into drug rehab isn’t always an easy task. Getting them to stay there can be even harder. Here are five of the most common reasons people leave drug rehab against medical advice, along with suggestions to help the addict stay committed to their recovery.

1. “Detox is too painful.”

Research shows that the first week of drug rehab is the time when most addicts ask themselves, “What the heck am I doing here?” Withdrawal symptoms, drug cravings and an unfamiliar environment can fill the addict with anxiety at the same time they are deprived of their primary coping mechanism: drugs. Some addicts rationalize that they felt better when using drugs and give up on rehab before treatment really begins.

Prevention Tip: Detox can be made more comfortable with medication and alternative therapies such as neurofeedback, acupuncture and massage. Even if the addict isn’t feeling great, they should try to get involved in as many treatment activities as possible.

Rather than isolating, their peers will help them realize they are not alone and see the hope that treatment brings. The earlier the addict develops trust and rapport with a therapist, the more likely they will listen to the therapist’s recommendations and push through the uncertainty.