Why Didn’t Drug Rehab Work? 5 Wrongs That Don’t Make a Right
Once, twice, three times in rehab – the story isn’t uncommon. For many recovering addicts, it takes multiple treatment attempts to get well. Disappointed, angry and ready to give up, addicts and their loved ones are left asking, “What went wrong?” Here are a few possibilities:
#1 Wrong Understanding of Addiction
Prolonged drug use alters the chemistry in the brain, doing damage that can take weeks, months, even years to reverse. As a chronic, relapsing disease, there is no quick fix for addiction. Expecting to go to treatment for 30, 60 or 90 days and be “cured” is a set-up for relapse.
#2 Wrong Drug Rehab Center or Type of Treatment
Not all drug rehab centers offer the type of evidence-based treatment that we know works. In fact, the National Center on Addiction and Substance Abuse at Columbia University recently reported that only one in 10 people in need of addiction treatment get it, and of those who do, most “do not receive anything that approximates evidence-based care.”
Some treatment centers use outdated, overly confrontational approaches that have been shown to do more harm than good. Others provide only short-term treatment delivered by minimally qualified staff. Since roughly half of addicts also suffer from depression, anxiety and other mental health disorders, the relapse risk is particularly high if they don’t receive specialized dual diagnosis treatment addressing all conditions at once.
Instead, look for a program that employs board certified health professionals, master’s level therapists and other highly qualified professionals. Being in a comfortable, home-like environment and having a medical team that can provide medically monitored detox to minimize the discomfort of withdrawal can improve the odds of program completion.
Sometimes treatment works the first time; other times the process is cumulative. Even if you choose the right rehab, it may take more than one attempt to get it right, but each effort is an essential part of the journey that eventually leads to recovery. Even if someone is not yet ready to change their lives, they are exposed to recovery concepts and tools that can help them later on. They can see that there is a path to recovery that others have successfully taken.
#3 Wrong Attitude
Recovery is a challenge even for a motivated participant. The process can be more complex for a patient who is unwilling to change, who fakes their way through or who gives up on treatment early. Treatment can certainly work for people who don’t want to be there but holding onto anger, resentment or other negative emotions can make for a bumpier road.
Addicts are not to blame for their disease but they do need to accept responsibility for managing it. Post-treatment, watch out for complacency, overconfidence or an unwillingness to work an ongoing program of recovery as these can sabotage long-term success.
#4 Wrong Timeframe
Many addicts, families, insurance companies and even treatment centers treat addiction like an acute illness. The norm continues to be detox and/or a 30-day treatment program. But addiction is not an acute illness; it is a chronic disease similar to heart disease and diabetes which requires long-term care.
Research shows that 90 days is a more realistic timeframe for treatment, followed by outpatient treatment, counseling and support groups. For most people, avoiding drugs and alcohol isn’t enough to prevent relapse. Recovery requires lifestyle change; for example, healthy diet, exercise and sleep habits, sober recreational activities that provide fun and fulfillment, supportive relationships with other sober people, and volunteer work or other activities that instill purpose.
#5 Wrong Support System
One of the biggest mistakes people make fresh out of rehab is spending time with old drug-abusing friends or returning to an environment full of triggers. Understandably, the early days of recovery can be lonely. Leaning on family and support groups and working to make new sober friends requires a leap outside your comfort zone.
Rather than offering support, some people may make the process more difficult. Loved ones may disregard your needs and drink or use drugs in your presence; they may continue to enable or engage in other destructive patterns. Some relationships must come to an end but healthier ones will take their place.
If your recovery took a wrong turn, there’s only one way back: trying again. Relapse is disheartening but it doesn’t have to be tragic. What is tragic is that millions of people never seek help at all and endure a lifetime of suffering. Equally tragic are those who go to treatment, relapse and decide a life of sobriety must not be possible for them. Recovery is not a way of life reserved for the select few; it is possible for anyone who refuses to give up on themselves.
David Sack, M.D., is board certified in psychiatry, addiction psychiatry and addiction medicine. Dr. Sack currently serves as CEO of Elements Behavioral Health, a network of drug and alcohol addiction treatment centers that includes Promises Treatment Centers, The Ranch, Sexual Recovery Institute, The Recovery Place, Right Step, Promises Austin, Lucida, Journey, Sundance, and Clarity Way.
Sack, D. (2015). Why Didn’t Drug Rehab Work? 5 Wrongs That Don’t Make a Right. Psych Central. Retrieved on February 23, 2017, from https://blogs.psychcentral.com/addiction-recovery/2014/04/why-didnt-drug-rehab-work-5-wrongs-that-dont-make-a-right/