Speaking in general terms, there are three identifiable factors that contribute to successful addiction rehabilitation.
First and foremost is the person’s desire to get better and to comply with treatment protocols. Second is choosing a drug recovery program that best fits with the individual and offers long-term care. The third vital component in treatment success is having a solid aftercare plan and recovery support system in place.
When selecting a drug recovery program, it is difficult if not impossible for a family member emotionally involved with the situation to select the appropriate addiction rehabilitation plan.
This is further compromised when addict or the alcoholic adds their own input. Rarely, if ever, will an addict or an alcoholic surrender to an addiction treatment plan in his or her best long-term interest without the help of a professional.
Treating addiction is not as simple as the loved one simply saying yes, with or without an intervention. Many pieces to the puzzle need to be addressed for things to improve. Letting the intervention professional put your loved one’s treatment plan together is the best option for all involved.
Thousands of rehabilitation centers in the United States claim to have the best drug recovery program. They all have impressive websites and persuasive people answering the phones, claiming to have the answers that others may not. Many of these centers are good. However, none of them are reinventing the wheel on addiction treatment, regardless of their claims.
Some facilities do more and offer more than others, but by and large, they do relatively the same thing: Clients engage in group therapy, trauma resolution, individual counseling as well as outside activities. Most are required to find a sponsor and engage in self-help activities such as 12-step meetings throughout their stay. Some facilities offer brain mapping, CBT, DBT, EMDR therapy and motivational interviewing.
Where most drug rehab centers lack is in their understanding of intervention and the necessity of repairing broken family systems. We’re not referring to a family program, but rather a drug rehab center focused on helping the family understand its role in the addiction.
Since most drug rehab centers do not offer this, having an interventionist fulfill that role is extremely important. Think about the number of times you have called a rehab center only to be told, “They have to want it; they have to hit rock bottom,” but not be told what must be changed on the family’s end.
If your loved one is in addiction rehabilitation simply because he or she agreed to go, how is a family to know how to handle next steps? Without intervention training, how will the family handle the loved one who calls, claiming to be ready to come home? Is this the truth?
Will you have the wherewithal to contact the loved one’s therapist to get the facts and the truth? What if you never signed a release allowing you to speak to the therapist? Is something being hidden?
And what if your loved one claims to have been kicked out of treatment for no reason; are you going to believe that, too?
Here is the question to ask: Is the treatment center intervention-friendly, and will it work with you to handle these situations moving forward?
Why Can't the Addict or Alcoholic Choose the Treatment Center?
Just because a person is willing to accept help doesn’t mean he or she is willing to surrender fully and follow professional guidance. Addicts and alcoholics are notorious for downplaying the severity of their addiction, frequency of use and problems associated with abusing substances.
Listening to the addict or alcoholic and trying to determine what is true makes it difficult to make an accurate assessment on the best option for a treatment center.
Part of the addiction requires seeking the path of least resistance while looking for shortcuts. Just because the person finally considers help is doesn’t mean those behaviors have disappeared and will not carry into selecting the treatment plan.
With the family selecting the treatment center under the guidance of an intervention counselor, the loved one is being offered a gift. You are saying, “We are here to help, and we can’t watch you struggle any longer.”
You are also setting your first round of boundaries and offering help on your terms, not the loved one’s.
Why Can't the Family Alone Choose the Treatment Center?
Families are emotionally involved, and most of their knowledge about what to look for has come either from their loved one or from people who shouldn’t be giving advice. The addiction rehabilitation center should not be chosen simply on the basis of what’s best for the loved one; it should equally include what is best for the family. Once the intervention is over and the transfer to the treatment center has occurred, the family is going to need an advocate with direct contact to the facility. Most interventionists have great working relationships with intervention-friendly treatment facilities and take advantage of those contacts to provide ongoing support.
If the family chooses a drug recovery program that is not intervention-friendly or that prohibits an interventionist from providing continued support, your loved one’s outcome may be compromised. Some facilities tell you they do this; the question is how often and how timely is this information provided?
In cases of families who have experienced unsuccessful or unpleasant drug recovery programs with their loved ones, most families were not notified about what happened until it is was too late, or they were not notified at all. This means the family knows only one side of the story – i.e., the loved one’s biased opinion of treatment.
At this point, the family is convinced their loved one had a horrible experience and says he or she will never go back to rehab. In our experience, we have never seen or heard of anyone leaving treatment or being asked to leave that resulted from a fault or error on the facility’s part.
Without an intervention counselor as your advocate, how is a family to know the facts and the truth?
The best rehab centers should be about more than appealing websites, equine therapy, hiking, etc. They should have drug recovery programs specifically focused on keeping the family in front of the loved one before he or she gets back in front of them.
The family is far too emotionally attached and drained to be speaking to several treatment centers, all promising the best addiction rehabilitation program. This is why you engage professionals to manage these important matters.
Factors to Consider When Choosing Drug Recovery Programs
Should Addiction Treatment Be Long Term or Short Term?
The best drug rehab centers will offer a drug recovery program that is long term.
It is quite rare for 30-day treatments to yield successful outcomes. The first 5 to 7 days of treatment take place in detox, leaving about 23 days for everything else.
In a perfect world, it takes at least 60 days to overcome an obsession, meaning 30 days to lose the obsession and the second 30 to learn to live without it. How can someone overcome the obsession of addiction in 23 days? It’s not possible.
Obsessions aside, 30 days is scarcely enough time to help someone through the traumas and the problems fueling the addiction. Too often in 30-day treatment centers the addicts’ or alcoholics’ tolerance is merely lowered, and then they are discharged before having completed, or really even started to build, a solid foundation for their lives. Needless to say, short-term treatments give rise to unreliable outcomes.
The majority of people who relapse and overdose are those who enter drug recovery programs for a short period of time or come out of jail. In both cases, they leave largely unrepaired, thinking they can use the same amount of drugs they did just a short time ago. Having acquired no new tools and not broken any ground on their recovery, they often revert back to their only known solution: drugs or alcohol.
Although some people do recover after a 30-day treatment, such cases are few and far between. This are possible, however, with consistent follow-through care. Most who undertake 30-day attempts come straight home with no aftercare plan in place.
Some families’ insurance plans will not pay for more than 30 days, and they are unable to afford self-paying for additional months of addiction rehabilitation. An effective solution to overcome this hurdle is to arrange extended treatment options, such as a halfway house or a sober living facility, outside the addict or alcoholic’s comfort zone – i.e., away from people, places and things that provide temptations and the risk of going backward.
Why Does the Treatment Center Have to Be So Far Away from Home?
The best drug rehab centers for these situations are the ones that are far away from home.
Being far removed from home makes it more difficult to leave and greatly increases the likelihood of staying and completing treatment. Families often focus on the desirability of visitation during treatment. Many reading this may disagree, but this excuse for local treatment often reveals misplaced codependency. The minimal benefits of visiting for an hour once or twice a month are overwhelmingly outweighed by the advantages of being far removed.
In fact, were a family to write out a pro and con table comparing out-of-state vs. local treatment, visitation would be the only thing on the pro side, although some would argue it isn’t really a pro at all. Nothing good can come from visitations outside of the professionally guided family week, which occurs, in most cases, several weeks or months into a person’s stay.
An addict or alcoholic in early recovery who has not yet changed his or her behaviors should not be in conversation with a family who hasn’t changed their behaviors either. Both need a break from each other.
During early recovery and about two weeks into treatment, addicts and alcoholics start to feel better physically. This does not mean they are better mentally. At about this time, their unfueled addiction starts talking to them, and phone calls ensue with excuses as to why they need to come home and end the treatment.
If they are in a treatment center with no access to their cellphone or financial resources, the likelihood of leaving the treatment center and coming home is quite negligible. Unless, of course, family members help them do it.
Oftentimes, families do not understand the power of addiction and want to believe their loved ones, especially when they sound convincing. Addiction recovery requires complete surrender to professional guidance. All involved require a separation from one another to work on their particular issues and to increase the probability of a successful outcome.
If the addict or alcoholic has the opportunity to shorten the treatment, it may well happen. After all, that is what addiction is about: taking shortcuts and looking for the quick fix.
Families would have no problem sending their loved ones far away to a university or a hospital if it were in their best interest. Why would sending them far away to treat a life-threatening addiction be any different?
Do They Need Treatment for Substance Abuse vs. Mental Illness?
It depends on the individual, and will require professional assessment.
Families frequently believe mental illness is the primary issue, and in some cases, it is. We’re often told their loved ones have been seen by various professionals and diagnosed with mental illness. Keep in mind that we are interventionists and addiction professionals, not doctors or psychiatrists. What we see far too often are misdiagnoses by these professionals due to an addiction that is either not discussed or understated.
We and many other professionals find that it is quite difficult to assess mental illness and its severity while the person is under the influence of drugs or alcohol. Frequently, after someone enters a dual diagnosis treatment center and comes off drugs or alcohol, we discover that the mental illness was misdiagnosed or didn’t exist at all. To put it another way, it is hard to hear the noise in the engine with the radio volume turned all the way up.
Addicts and alcoholics often downplay or fail to reveal their drug and alcohol abuse during mental health evaluations or psychiatric visits. Many times, drug and alcohol abuse bring out mental illness, but other times, they mask it.
Alcohol can cause depression, and sometimes individuals choose to treat depression with alcohol. As far as stimulants such as crystal methamphetamine, almost every user appears delusional, schizophrenic and hears voices. So which came first, and what is really going on?
In many cases, addicts and alcoholics self-medicate due to trauma, guilt and shame, as well as mental illness. Until the addict or alcoholic enters a dual diagnosis treatment center and is under the care of a professional who specializes in this area, you may not receive the answers you have long been seeking.
Additionally, until individuals are off drugs and alcohol and can be honest about their use and any history of mental illness, it is difficult for the treatment staff to make accurate assessments.
You may ask yourself if your loved one should be treated by a doctor, rather than an addiction specialist. In our experience, rarely do doctors and psychiatrists spend a significant amount of time assessing the situation, working through the issues leading to the addiction, and titrating the medications looking for that “magic bullet combination.”
Such treatments can end up with the doctor or psychiatrist attempting a solution of legally prescribed medication instead of street drugs or alcohol, but never finding that perfect medicinal combination. In the case of people who suffer from mental illness as the primary illness and using drugs or alcohol to medicate, this method can be effective.
That is called the Psychological Model for treating addiction, which holds that the primary problem is mental illness, and the person chooses to self-medicate without the guidance of a health care professional.
If you have tried the Psychological Model route and it hasn’t worked, it may be time to look into treating the addiction.
Evaluating the Success Rate ofDrug Recovery Programs
The success rate of a treatment center’s drug recovery program is based on the loved one and the family’s ability to:
Complete treatment, and
Follow through with aftercare recommendations.
The majority of people who are unsuccessful in addiction rehabilitation are ones who fail to take back their self-will and do what they are supposed to.
Similar to any set of directions in life, following directions achieves better results than not following them. The addict and the alcoholic spend the majority of their time working angles, taking shortcuts and doing things their way. Many find it difficult to let go of their old way of thinking and adapt to the changes required of them. But keep in mind that families play a role in determining the success of treatment as well.
A treatment center can only be effective if the addict or alcoholic is present to hear what is said. Many families fail by giving in to the loved one who make false accusations about the center’s effectiveness, accommodations, protocols and so forth. Far too often, before investigating those claims, families hang on every word the addict or alcoholic speaks as if it were iron clad truth, and then join in his or her disparagement.
It goes without saying that no treatment center is without its mistakes. The majority of addicts and alcoholics who relapse or do not complete a drug recovery program are simply not ready to surrender to an alternate solution to drugs and alcohol. Some are simply not done abusing substances.
In all of the years of conducting interventions and helping people make their way to treatment, we have never had an unhappy client ask the family to move him or her to another center. Everyone who decided to leave or called to complain only asked to come home. We have never had an addict or alcoholic’s accusations or complaints about the treatment center or drug recovery program hold any merit.
We are not calling anyone’s loved one a liar; we are saying that an addict or alcoholic will say or do just about anything to return home and resume drug or alcohol abuse.
What Happens After the DrugRecovery Program Is Completed?
The best rehab centers arrange an aftercare or discharge plan to be followed after the completion of addiction rehabilitation. These plans often include a sober living home, individual therapy, ongoing support meetings, sponsorship and the like.
What doesn’t happen enough – and almost always happens with non-intervention clients – is incorporating family boundaries into the aftercare equation.
Practically no one leaving a drug recovery program should return home right away, and some should never live at home again. They can visit, but not live there.
If a treatment center does not have the support of a family with established boundaries indicating that coming home is not an option, then that is where the loved one will go upon discharge.
Not only is it a bad idea for an addict or alcoholic to return to the old environment, it is an equally bad idea for an unprepared family to receive the loved one.
Previously, the focus was on when the addict or alcoholic would be ready to leave treatment and come home. With the guidance of an intervention counselor, the focus properly shifts to when will the family be ready, if ever, for their loved one to return home.
After an intervention, the intervention counselor should provide ongoing support, both while the loved one is in treatment and thereafter. Intervention counselors can help families stay firm in their boundaries and hold their loved one accountable. The intervention counselor is there to help the family stay strong and not give in to an addict or alcoholic wanting to stray from the aftercare plan.
Please be aware that it can take at least a year and sometimes two before an addict or alcoholic begins to make positive decisions and choices. As intervention counselors, we do everything we can to be the intermediary between a family’s codependent enabling behaviors and the loved one’s manipulative and addictive behaviors. Removing drugs and alcohol from the equation doesn’t mean the behaviors are gone; that process can take years.
It is vitally important that an addict or alcoholic follow through with sober living, drug/alcohol testing, meetings, sponsorship and individual therapy.
Anyone can stay clean and sober in treatment. It is when the loved one leaves treatment that the true test begins. He or she should learn how to stay clean and sober in a safe environment, away from previously problematic locations.
It is important to avoid old acquaintances who may represent troubling reconnections. The same applies to a family’s aftercare plan, which should include Al-Anon, sponsorship, step work, individual counseling and maybe even marriage counseling.
The more work both sides do during and after addiction rehabilitation, the better the outcomes for all concerned.
Why a Drug RecoveryProgram Can Fail
For most families, this is not the first attempt to secure help for their loved one.
Oftentimes, it is not the addict or alcoholic’s first attempt at addiction rehabilitation. When providing assessments and consultations, we look at several factors to identify the causes of unsuccessful outcomes:
The Family Did Not Change Their Behavior After the Intervention
Addiction rehabilitation can fail when the family does nothing to change their own behavior in terms of setting boundaries, holding the addict or alcoholic accountable and identifying their roles in the addiction. Finally, they continued enabling their loved one.
An intervention is not an isolated event but rather a long process. It only takes a short period of consultation and treatment preparation to have everything come together. The intervention itself may occur over two to three days. The tools, resources, and education are designed to last a lifetime.
Families will be tested several times, especially in the early stages of their loved one’s recovery. Some families make the mistake of letting their guard down because their loved one said yes to treatment. They may believe that a period of abstinence from drugs or alcohol is actual sobriety, but it is not. Abstinence and sobriety are not to be confused.
The family must never let its guard down and think the loved one is cured. At the same time, family members should take care of themselves, too.
With lifelong boundaries and accountability in place for your loved one, you’re helping him or her as well as your entire family.
The Family and Loved One Chose an Ineffective Drug Recovery Program
Another reason for past failure is that the family and their loved one chose an ineffective treatment plan that represented the path of least resistance.
In a nutshell, the rehab center was probably local and/or the treatment lasted only 30 days. In some cases, the treatment consisted of detox only, medications prescribed by a doctor or seeing a therapist once a week along with attending addiction support meetings.
As a result, the families believe addiction rehabilitation doesn’t work and that there is no hope. The reason families agree to short-term, local treatment is revealed in the comments they share with us: “They will never go that far away and never for that long.”
These families are allowing the addict or alcoholic to run the show yet again.
Choosing a local rehab center increases the chance of leaving and returning home. It is much easier to maintain boundaries during phone calls than to say no when it is face to face. It is critical that families hold their boundaries if the loved one tries to leave the treatment center, even after confirming the consequences.
In almost every case where the family has held firm, the loved one made it back to treatment. In every case where a family did not maintain their boundaries, the person did not make it back.
The Family and Loved One Didn't Give the Drug Recovery Program Their Best Shot
Not every form of treatment works for everyone in all circumstances. You can’t say something will not work if you haven’t given it your best shot.
For example, addicts and alcoholics frequently tell families that they hate 12-step programs, saying they don’t work. Many say this is because they know it is the most common method of treatment. They also look down on those who are successful in 12-step programs in order to justify their hatred.
Whenever a family tells us their loved one hates 12-step programs, we ask questions that reveal this not to be true. By expressing disdain for 12-step programs, the addict or alcoholic is really saying that it’s pointless to even try.
We have never seen an addict or alcoholic express disdain for the 12 steps who actually went through such a program. Did they have a sponsor, and if so, did they speak often and listen to the sponsor’s advice?
Did the loved one go to meetings, actually participate, and thoroughly work the steps – all 12? And if so, did he or she come back and sponsor people?
Your intervention counselor will help your family determine the best rehab centers – whether they follow the 12 steps or another philosophy – that offer a higher probability of a successful outcome.
We really appreciate all that you have done for our family, we couldn't have done any of this without you. We know that you have sacrificed time with your wife and daughters in order to be there for us and we can never thank you enough for that. What you do for families of addicts and alcoholics is truly a gift, one we will always be grateful for.