Inpatient Rehab May Not Be the Answer
In the recovery community, there is an accepted industry standard for early recovery from addiction, and it almost always involves a stay in rehab. Most addiction treatment specialists recommend going to an inpatient treatment center for a period 30 days or more. But while inpatient treatment is successful for some, this one-size-fits-all approach to recovery is wrought with flaws. Many people suffering from addiction graduate from an inpatient rehab facility, only to find themselves back in detox or rehab (or both) less than a year later. This creates what is referred to as the “revolving door” of recovery, resulting in a vicious cycle of dangerous relapses, emotional trauma, and expensive stays in treatment facilities.
The only way to combat the revolving door of recovery is to rethink the way we approach addiction treatment and recovery. Treating all addicts with the same curriculum-based recovery methodology, regardless of their background or drug history, is a flawed approach. We shouldn’t automatically assume that every addict will benefit from curriculum-based inpatient treatment. Instead, we need to focus on treating the disease of addiction by assessing and addressing each person’s individual needs, only recommending inpatient treatment when it’s truly beneficial that person’s recovery.
A variety of causes, a variety of treatments
If an otherwise emotionally healthy person became dependent on opiates after a serious debilitating injury, can their addiction be treated in the same way as an someone who turned to drinking or drugs after an emotional trauma or abuse? Can a 45-year-old homeless cocaine addict be treated in the same way as a suburban teenager that’s been abusing marijuana? Can a person with a dual diagnosis like depression or bipolar disorder be treated in the same way as someone with no history of mental illness? Under the current recovery industry standards, all the people mentioned above would benefit from a stay in a 30-day inpatient treatment program. However, while some may benefit tremendously from inpatient treatment, others may find that curriculum-based 30-day rehab does not address the issues driving their addiction.
Curriculum-based inpatient treatment is a useful tool in treating addiction, but it’s not the only answer. For some people suffering from addiction, the time, expense, and resources required for inpatient rehab may be better spent elsewhere. Many recovering addicts report positive long-term results from participation in support groups, outpatient programs, wellness and mindfulness practices, healthy living, therapy, psychiatric care, or recovery fellowships like AA and NA. There is no one right way to recover, and methods of treating addiction can vary from person to person. What’s important is that no matter what the method of treatment is, it treats the disease of addiction in a healthy, productive way.
Different levels of support for different levels of addiction
Recovery starts when an addict decides that he or she has had enough, and wants a better way of life. This decision can be made at any phase of addiction, for a variety of different reasons. The decision to get sober is usually made at a low point in an addict’s life, termed their “bottom.” However, many people in addiction recovery circles use the term “low bottom” or “high bottom” to describe the point at which they decided to pursue recovery.
Someone who whose addiction brought them to a life of crime, prostitution, homelessness, or suicidal thoughts may consider themself a “low bottom” case, while someone who decided to get sober while they still have a job, family, home, car, money in the bank, etc., may refer to themself as having a “high bottom.” While it is almost certain that the low bottom case would benefit from long-term inpatient treatment, the high bottom case may be able to find meaningful and lasting recovery without checking into rehab, instead opting for help from meetings, therapy, wellness routines, and other treatment options.
Think of addiction treatment the way we think of medical care. If two people go to the hospital with a broken leg, they don’t automatically receive the same kind of cast. Both patients are examined, x-rayed, and treated according to the severity of their wounds. One patient may walk out of the hospital on a pair of crutches, while the other may be admitted and put in traction until the bone heals. Similarly, if we honestly assess the level of harm being caused by a person’s addiction, we can find the appropriate level of treatment for that addiction, and treat it more effectively.
Don’t make things worse by escaping responsibilities
High bottom cases are often referred to as functional alcoholics or addicts. While the term “functional alcoholic” may seem like an oxymoron, there are many stories of people suffering from addiction who maintain productive lives, only binge drinking or drugging to excess in the evenings, on weekends, or on what they deem “special occasions.” And although the problems caused by addiction to alcohol and drug can be harder to recognize in high bottom cases, occasional binges can still lead to tremendous harm, often resulting in legal trouble, divorce, career issues, estrangement from friends and family, and more.
While high bottom or functional addicts experience their own version of the misery and emotional trauma that addiction is known to cause, they may not need the type of immersive, full-time care offered by inpatient treatment centers. Taking a break from daily responsibilities to deal with substance abuse issues full-time in an inpatient treatment center may seem like a good idea at first glance, but going away to treatment for a month or more can have a negative impact on other areas of life that may not have been affected yet by addiction.
For people with career and family responsibilities, going away to an inpatient program for 30 days or more may needlessly create or intensify problems. For example, if a person has familial responsibilities involving child care or shared household responsibilities, a 30-day break from family life might add stress and burden to an already strained relationship. Additionally, the monetary expense of a trip to an inpatient facility may cause financial strain that affects the entire family. And though society’s view of addiction and recovery has improved over the years, there are still many industries in which substance abuse issues can put a career in jeopardy. For many, addiction is a deeply personal and private issue, and a 30-day trip to a treatment center can bring unwanted attention from employers, clients, or co-workers.
The monetary cost of treatment for addiction and substance abuse issues shouldn’t be a factor, but for many families, it is a reality. The cost of a stay at an inpatient treatment center can create a tremendous financial burden that can take years to recover from. Some families have reported selling their homes or cashing out retirement funds to enroll family members into inpatient rehabs, only to have their loved one relapse soon after completion. The monetary cost of treatment has skyrocketed in recent years, with many inpatient rehabs charging $20,000 or more for a 30-day stay. If effective, the cost of a stay at an inpatient facility is well worth it, but paying out-of-pocket for an expensive inpatient treatment facility may not be the best option.
The cost of addiction doesn’t just affect families. Businesses, insurance providers, hospitals, local police and rescue services, and state, local, and federal governments all bear financial burden of addiction. According to a recent report from NPR: “The opioid epidemic has cost the U.S. more than a trillion dollars since 2001, according to a new study, and may exceed another $500 billion over the next three years.” The cost to these agencies is often passed on to consumers and taxpayers, meaning we all bear the monetary cost of addiction in some way.
One of the ways to decrease the overall cost of addiction treatment is by rethinking the way we approach addiction and treatment. There is no doubt that inpatient treatment centers and rehabs are effective, but they may not work for everyone. If you’d like more information about alternatives to inpatient treatment programs, talk to an addiction counselor or recovery professional and ask about outpatient treatment options. By educating ourselves and others about the realities of addiction and treatment, and approaching recovery in an honest, straightforward way, we give all people suffering from addiction a better chance to experience long-term, meaningful recovery.
-- John Roesch for Life Assurance Recovery, 2018
If you or a loved one is suffering from addiction, please seek help from a medical professional, addiction specialist, recovery professional, a certified recovery coach, or someone with experience dealing with addiction and recovery. If you or a loved one is suffering from withdrawal symptoms or is having a drug-related medical emergency, please dial 911 and seek help from a qualified medical detox clinic or at-home medical detox specialist.
For more information about recovery, treatment options, interventions, at-home detox, recovery coaching, sober companions, and more, please contact Life Assurance Recovery.