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5 Reasons to Refuse an Addiction Treatment (and 5 Reasons Not to)

During drug rehab, dozens of different therapies may be incorporated into a treatment plan. If you’ve done your research and chosen a reputable rehab center, it’s best to keep an open mind and trust the advice of your treatment team. But there are a few instances when you may want to do your own research, get a second opinion or even decline a certain treatment:

#1 The Treatment Isn’t Backed by Research
Thanks to a growing body of research, we have a good idea of what works and what doesn’t in the treatment of addiction. Even with this knowledge, a surprising number of treatment centers use interventions that are not backed by research. In fact, a five-year study by the National Center on Addiction and Substance Abuse (CASA) at Columbia University found that most people receiving treatment for addiction “do not receive anything that approximates evidence-based care.”

Psychosocial therapies, medication, nutrition and exercise, and self-help support groups are a few examples of effective components of a comprehensive treatment plan. Newer therapies that haven’t been around long enough to be thoroughly studied also may be worth trying, especially if they have very little potential to do harm.

#2 The Program Makes Promises it Can’t Keep
Be wary of drug rehab programs that claim unusually high success rates or promise to “cure” addiction in 30 days or less. According to the National Institute on Drug Abuse, the percentage of drug addicts who relapse is between 40 to 60 percent and, depending on the type and severity of the problem, treatment typically must last 90 days or more. If you’ve chosen a drug rehab that makes lofty promises that it can’t fulfill, you may have reason to question the recommended course of treatment.

#3 The Program Isn’t Taking into Account Your Individual Needs
Addiction treatment can only be effective if it is tailored to the unique needs of each individual patient. Because no one treatment is effective for everyone, you should question a treatment plan that is the same for you as it is for everyone else or that addresses only your drug use and not you as a whole person with physical, social, emotional and spiritual needs.

#4 The Treatment Provider Lacks the Appropriate Qualifications
Treatment is only as effective as the people delivering it. Before agreeing to a treatment plan, and ideally before entering a drug rehab, make sure the treatment providers have the appropriate licenses and credentials. According to CASA, the treatment team should be made up not only of addiction counselors but also physicians, nurses and graduate-level mental health professionals.

#5 The Treatment Approach Is Overly Confrontational
In the past, humiliation and blame were commonly used to break through denial in addiction treatment. We now know, and have known for some time, that this shame-based approach is unethical and counterproductive; it actually increases the risk of relapse. Instead of punishment, addicts deserve to be treated with honesty, acceptance and compassion. If a treatment provider approaches you in a way that you feel is inappropriate or abusive, share your concerns and talk to a manager or administrator if they aren’t addressed.

Reasons Not to Refuse an Addiction Treatment

While there are some valid reasons for declining a particular treatment (the above list is not all-inclusive), there are equally important reasons not to. Take an honest look at whether your dissatisfaction stems from the following:

#1 Denial
Sometimes it’s easier to direct your anger and fear toward the treatment center, staff or situation than it is to face your addiction. In these cases, refusing a treatment becomes a way to justify continued drug use and ultimately, distracts you from the work of recovery.

#2 Fear
Fear can assume different forms in drug rehab. You may be afraid that a particular treatment could work, which would change your relationship with your primary coping mechanism (drugs). You may also be afraid that it won’t work and you’ll have extended your time and energy only to be disappointed. But if you don’t take the risk and open yourself up to trying new approaches, you take the much bigger risk of never finding the therapies that work for you.

#3 Anger or Resentment
If you’re refusing a particular treatment to get back at a friend or family member who pressured you into going to drug rehab, anger and resentment will likely prevent you from getting the most out of treatment. Fortunately for those who stay the course beyond the first week or two of rehab, anger and resentment can grow into humility and gratitude, two qualities that are highly supportive of long-term recovery.

#4 Never Heard of it Before
Some of the treatments that may be recommended to you, such as acupuncture, equine therapy and Eye Movement Desensitization and Reprocessing (EMDR), may not be familiar to you. By itself, this isn’t reason to decline the treatment. Many alternative therapies are effective in the treatment of addiction, even if they seem unusual at first. In the field of addiction, no one has all the answers and there are always new advances. Keeping an open mind can ensure you get a balance of traditional and cutting-edge therapies.

#5 It Didn’t Work Last Time
If you’ve been in rehab before, you may have tried certain therapies only to later relapse. This doesn’t necessarily mean the therapy was flawed, but rather that addiction is a chronic, relapsing disease that requires ongoing care. Give each therapy a few tries before ruling it out entirely.

Addiction recovery is an individualized process. Some therapies will support your process, others will not. By trusting in the drug rehab program you’ve chosen and communicating your preferences and experiences, you can get the right blend of treatments for your needs.

5 Reasons to Refuse an Addiction Treatment (and 5 Reasons Not to)

David Sack, M.D.

Dr. David Sack is board certified in psychiatry, addiction psychiatry, and addiction medicine. As CMO of Elements Behavioral Health, he oversees a nationwide network of treatment centers including drug and alcohol rehab programs at The Ranch in Tennessee and The Right Step in Texas.

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APA Reference
Sack, D. (2015). 5 Reasons to Refuse an Addiction Treatment (and 5 Reasons Not to). Psych Central. Retrieved on July 13, 2020, from


Last updated: 9 Jun 2015
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