The process of rehabilitation is neither short nor easy. However, the rewards and outcomes of successful and lasting recovery are irreplaceable: you get your life back.
Those who go through rehab and come out the other side often emerge as more self-actualized adults, able to handle challenges in their lives without drug and alcohol addiction. They are also happier and healthier, able to pursue their dreams and form solid relationships.
If you or someone you love struggles with drug or alcohol addiction, know that rehabilitation and recovery is possible. You can get the help you need to live a nourishing and fulfilling life.
How does rehab work?
Those going through drug and alcohol rehab take advantage of one of the following:
Inpatient rehab programs
Inpatient drug and alcohol rehab facilities offer 24/7, residential care. Because all needs are taken care of (food, housing, medication, therapy, treatment), you are free to focus solely on recovery. Inpatient rehab is particularly recommended for those who have either struggled with drug or alcohol addiction for an extended period of time, or those with a dual diagnosis (people who have a mental health condition or other condition in addition to addiction).
Inpatient drug and alcohol rehab programs take place either within an actual hospital or at a residential facility of their own. In addition to standard inpatient rehab programs, luxury drug and alcohol rehab centers offer upscale facilities in retreat-like settings, and executive rehab centers cater to professionals who wish to continue working while they go through substance abuse treatment.
Outpatient rehab programs
Outpatient drug and alcohol programs offer many of the same services as inpatient rehab programs, but patients live off-site, at home. If you aren't able to leave home for substance abuse treatment for some reason (for example, you have children), attending outpatient rehab may be the better option for you.
Outpatient drug and alcohol rehab is also an option for those whose addictions are less established. If you have a dual diagnosis or a very severe addiction, inpatient rehab will likely be the better choice. If you already know you have a dual diagnosis (i.e. alcoholism and bipolar disorder), you should also consider looking into a dual diagnosis treatment center.
What happens in rehab?
Just as one's individual life experience is intensely personal, so is rehab and recovery. That said, most drug and alcohol rehab centers follow a standard format, and the shape of recovery is similar for many recovering drug and alcohol addicts.
The steps of rehabilitation are generally:
- Detox (detoxification)
- Addiction therapy (rehabilitation)
- Recovery (ongoing self-care and support)
The first part of the rehabilitation process involves selecting the right drug and alcohol rehab facility.
This will depend in part on the nature of your addiction (what kind of drugs and/or alcohol you've been using), as well as the kind of substance abuse treatment offered at the center. During intake, rehabilitation centers themselves will also have questions for you, to better understand your situation and see whether they feel they're a good fit. Some rehab centers will request that you be screened (interviewed by a rehab expert) or take certain diagnostic exams.
Information gained will be along the lines of:
- Family history (including history of alcoholism or drug addiction and other medical or mental illness backgrounds)
- Your personal history with drug and alcohol abuse (what you've been addicted to, and for how long)
- Your financial situation (insurance information and other information regarding paying for the rehab center itself)
2. Detox (detoxification)
When someone engages in substance abuse, such as alcohol addiction or heroin addiction, the body adjusts to levels of the addictive substance. Addiction thus becomes, in part, a physiological reality – the body starts to need the substance to function normally. If denied the drug or alcohol, the body can go into a form of shock called withdrawal.
In almost all cases of drug and alcohol addiction (particularly long-term substance abuse), the first thing that must happen in rehab is detox. During detox, the body is removed of all drugs and alcohol. In order for this to be done safely, it must happen in stages – going "cold turkey" can be harmful or even fatal.
The detox process will vary in intensity depending on:
- Your body's metabolism
- Which drug was being taken and at what dose
- How long the drug use went on for (duration of substance abuse)
- Co-addictions (whether other addictions or substance abuse was taking place)
Detox is closely related to withdrawal, which is what happens when the body is denied access to a substance upon which it has become dependent. Withdrawal can happen in as few as a few hours after not getting the drug or alcohol that has been abused, but is more often experienced within the first 24 hours of the last intake.
Withdrawal symptoms differ based on which drug was used, and can include:
- Trembling, shaking, increased heart rate, difficulty breathing
- Muscle pain, muscle tension, cramping, agitation
- Sweating, runny nose, nausea, diarrhea
- Sleep issues (not being able to fall asleep)
- Seizures, stroke, and heart attack
Without the proper medical supervision, detox and withdrawal can be a very painful process, and can even result in death. It's extremely important to seek help when ending alcohol or drug addiction, especially if it has been severe and ongoing.
In some cases, medication is used to ease the discomfort associated with detox and withdrawal. This is especially true of alcohol addiction, heroin addiction, and addiction to opiate prescription drugs. Many drug and alcohol treatment centers use pharmaceutical medications to help ease the process and make the body as comfortable as possible while going through detox and withdrawal.
Medications that can help with this phase of rehabilitation include:
For those who struggled with heroin addiction or prescription drug addiction (specifically opioids like Vicodin, OxyContin, and Percocet), methadone can be helpful in weaning the body off of opiate dependence. The dosage of methadone is usually decreased over time, eventually leaving the person totally substance-free.
Some recovering drug addicts will continue to take methadone for months or even years after rehab. This population can be at risk of forming an addiction to methadone itself. The risk of this new addiction is part of why substance abuse treatment should be tailored to the individual, and monitored on an ongoing basis.
Similar to methadone, buprenorphine is used for those recovering from heroin addiction and/or addiction to prescription opioids. Medical practitioners and rehab experts have started to favor buprenorphine over methadone since it has fewer addictive properties. While the goal is always to lessen doses until the patient is no longer taking anything at all, depending on the severity of the drug addiction, substance abuse treatment may include a patient continuing to take buprenorphine for months, years, or indefinitely.
Benzodiazepines are anti-anxiety medications frequently used to reduce the severity of those detoxing and going through withdrawal from alcohol addiction. They can reduce the occurrence of seizures and help with the intense anxiety and depression that accompanies alcohol detox and withdrawal.
Similar to benzodiazepines, barbiturates help lessen detox and withdrawal symptoms like seizures, anxiety, and depression. They function as mild sedatives that help calm the body as it releases toxins sometimes accumulated over years.
3. Addiction Recovery
After the detox process is complete and the person's body is clean, they move onto the next phase of substance abuse treatment: therapy.
It's important to keep in mind that many times, drug and alcohol addiction began in part to cover up something valid and painful in someone's life. Addiction is often an attempt to self-medicate, to numb very real mental and emotional suffering. Addiction recovery and therapy is about exploring the cause of that suffering, and moving forward and through it with the right support.
Drug and alcohol rehab often offers three kinds of therapy: one-on-one counseling, group therapy, and family therapy.
Lasting drug and alcohol recovery involves addressing and processing the underlying causes of addiction. Individual therapy uses modalities like Cognitive Behavioral Therapy (CBT) to help patients explore root causes of, as well as present-day triggers for, drug and alcohol abuse.
Patients can expect to get the following out of one-on-one therapy:
- Guidance on how to work and process initial reasons for drug and alcohol abuse, including history of trauma
- Strategies on how to identify and interrupt alcoholism and drug abuse triggers (i.e. reaching out for support or engaging in self-care instead of drinking or taking a hit)
- More structured ways of dealing with challenging thoughts and emotions, to help build up resourceful thinking patterns and behaviors
- The establishment of plans for tempting situations (such as seeing certain people or going to certain places). The more you have a system for handling triggering situations, the more likely you are to stay strong and avoid relapse
- Support in creating a new, healthy, and fulfilling life – the best way to stay sober is to thrive
Group therapy is an integral part of substance abuse treatment, as it allows recovering alcohol and drug addicts to share with others and hear the stories of those in similar situations. Group therapy is illuminating because it shows people they're not isolated, and that they don't have to go through recovery alone.
Perhaps most importantly, group therapy connects those who've been through similar struggles, which builds a sense of community. Many of those who've been through rehab say that group therapy was one of the most important parts of the process, since it allowed for healing and growth in a truly compassionate setting. The friendships and connections formed in rehab are often lasting and important in the overall recovery process.
Family systems can be the origin of both issues as well as solutions when it comes to addiction. Many drug and alcohol rehab centers encourage family therapy, since it is a powerful way of addressing concerns as well as setting a recovering addict up for success upon completion of the program.
A number of drug and alcohol rehab programs have recovering addicts to invite family members to therapy at the rehab facility. Family therapy is important not only for the recovering addict, but for the loved ones ones themselves. Many times, they're deeply impacted by the addiction and don't have the resources to address it in a healthy way.
Family therapy can help everyone involved move forward with love and grace. It's also one of the best ways to ensure that the family home is a safe and supportive place for the recovering addict once they graduate from the rehabilitation program.
Leaving a drug and alcohol rehab center is not the "end" of recovery. Like many things in life, sobriety is an ongoing process that takes energy and commitment.
Before graduating from a drug and alcohol rehab center, patients normally meet with rehab experts to make a plan for aftercare. This can involve living in a sober living environment such as a halfway house. Sometimes, it includes the ability to return to the rehab facility on certain weekends when the person feels extra support is in order.
Ongoing care also often involves attendance at 12-step groups like Alcoholics Anonymous (AA) or Narcotics Anonymous. Recovering drug and alcohol addicts often report that 12-step programs are a valuable tool for continued sobriety. There are a branches of 12-step programs for any number of addictions, including:
- Cocaine Anonymous (CA)
- Crystal Meth Anonymous (CMA)
- Overeaters Anonymous (OA)
- Pills Anonymous (PA)
- Gamblers Anonymous (GA)
- Sex Addicts Anonymous (SAA)
What happens after rehab?
Choosing to go to rehab is brave. It's a declaration that you want to live.
It's also the beginning of a new phase of life – one based on self-awareness, a greater understanding of both your strengths and limitations, and an expanded sense of support.
Addiction is not a life sentence. Circumstances change and growth is always possible. Rehabilitation and recovery is a series of learning opportunities taken, and healthy choices made, over and over. You can make it through and emerge with dignity and strength, ready to live a life of joy and purpose.