The Rehab - Relapse Cycle

By Allison Holland 03/05/15

I was always the client that was “going to make it,” because I could use “prefrontal cortex” correctly in a sentence.


My mother asked me this morning, based on my extensive personal experience, what I believed to be the best approach to addiction treatment. After her question, we sat in dead silence on the phone for a period of time before I piped up with a completely unintentional voice-fried response, “I don’t know.” I have been known to speak up, and out, against the absurdly lucrative treatment-center industry that has completely saturated the state of Florida that I reside in. I truly feel as though the addiction-treatment industry is doing more harm than good in certain aspects, but I also don’t feel it should be completely done away with.  

The mystery of how to effectively treat drug and alcohol addiction is something I occasionally ponder. My first instinct is to always answer this rhetorical question with the boilerplate solution of inpatient addiction treatment, because oftentimes I have no idea what else to say. I sometimes forget the literal hellacious cycle of treatment centers that I endured, and how they were of very little benefit. I do understand and personally know some people who were able to maintain sobriety after their stays in an inpatient treatment facility, but to be honest, it’s very few. When you are in rehab, the clinical staff will readily tell you that there is a very low chance that everyone who is in your entire “graduating addiction class” will stay sober, but some of them do. For those individuals who did stay sober after treatment, I applaud you. For the rest of us who continued to use, drink, and return back to those twin beds, enduring 10 hours of mindless groups a day—I truly wonder if inpatient treatment was of any benefit, or usefulness, in the quest to achieve sobriety.

I’m one of the upper-middle-class lucky adult children who rode the coattails of my father’s PPO insurance in-and-out of addiction treatment centers for years. I will readily admit that I am not from the hard streets of Detroit, I didn’t run with a gang, and I didn’t deal drugs. I got wrapped up in abusing addictive substances and refused to even attempt to stop, because I hated myself on multiple levels. I continued to refuse to listen to the voices of reason that gave me advice on how to subdue this addiction disease nonsense. I was a brat who waltzed in-and-out of cushy rehabs, and who knew how to work the system to my full advantage. I was pressured into rehab on numerous occasions by my father, mother, and other members of my family who were making themselves sick while watching me slowly kill myself.  

Because I’m an excellent codependent who wanted to continue to get high—but didn’t want Mommy and Daddy to cry at night—I would go back to rehab, only to try and cut every corner in an attempt to go right back to what I was doing. I made false promises, and I put on a really good act—claiming that this time I was going to give sobriety my all. Inevitably, I knew that I could spend 30 days in an institution for the payoff of a few weeks of getting high before I would be dragged back into a rehab to do it all over again. Selfishly, I didn’t care because I knew that my father wouldn’t let my insurance lapse and I would be taken care of. I lived at treatment centers, and was OK with that. And they were OK with that too, because when your father is an attorney—you have some pretty decent insurance that can be charged up until the cows come home and will still pay.

Living in-and-out of hotel rooms when using, and treatment centers when times were “good,” wasn’t all bad. I used to love inpatient care, because it is mindless. This should be prefaced with the truth that I have met some incredible therapists and social workers who are truly passionate about helping people in rehabs. However, for the most part, the facilitators of groups and therapeutic activities always droned on-and-on about the “why’s” of addiction. WHY can addicts and alcoholics not stop using? WHY can you never drink again? WHY is alcohol considered a drug?  I very rarely ever heard addiction therapists answer these questions with “how” to stop using and drinking. I learned a lot about the disease of addiction, how it affects the brain, and essentially why I was the way that I was, but was never pressured to give answers about why I was unable to apply any of this information.  

This fundamental entry-level knowledge about addiction that I picked up from multiple rehabilitation groups and therapists was enough for me to regurgitate in group-therapy sessions and earn myself a gold star. I was always the client that was “going to make it,” because I could use “prefrontal cortex” correctly in a sentence. This natural intellect was enough to allow me to skate under the radar at treatment centers. I would lie about the amount of sobriety I had in the past, blaming silly things like a death in the family, or fictional abuse, as the reasons why I had picked up again. I created my own fictional lives from facility-to-facility, changing the story as I went. It was never important for me to be honest about anything in my life, because inevitably I knew that I was simply going to return to drinking and using after I was discharged—I just had to patiently wait until that time. I became accustomed to this cycle of treatment, active addiction, and returning to treatment. I became so used to it that I began knowing all of the staff at certain treatment centers and started to view them as some sort of sick second family. Essentially, that was my downfall—my lack of understanding that although some treatment centers did really care along the way, most of them saw me as a cash cow.

The cold hard fact about addiction treatment is that you rarely get quality care if you don’t have medical insurance. And even then, the care isn’t always necessarily “quality” in the sense that the facility is 100% invested in the clients recovering as much as they are invested in the business aspect of treatment. I would occasionally have brief intervals of sobriety in between my rehab stints, during which time I typically lived in another form of addiction treatment: a halfway house. I would watch residents move-in, and then days later end up at a motel doing crack cocaine with people they met from rehab. When they decided they were done and had used up their last resources, I often received calls about helping them get into rehab because of the extensive list of “connections” I had in my phone.  

I felt important, like I could be that girl who always “knows a guy.” However, when I would call these “friends,” the same “friends” who had helped me get out of crack-dens and into rehab, and tell them that I knew people who needed help—the first thing they would ask is if they had insurance. If they didn’t, my phone calls would be ignored for the rest of the evening. There was no kick-back for them, so they had no interest in helping these people. These same people who had helped me over and over again, were willing to allow people who really needed help to rot in a hotel room due to lack of insurance coverage. Rehab is for the wealthy and fortunate, and it caters to such. If what is known as the “treatment industry” welcomes individuals with ample insurance policies and turns their backs upon those without, what is it that they are really treating?

When you have absurdly low self-esteem, any amount of attention that makes you feel important is enough—whether this attention is healthy or not. Being greeted and recognized by the CEOs of huge treatment-center corporations made me feel special every time I made it back through the doors of a rehab in which I had previously been. When I would run out of money, or was so down on my luck that I needed a break from using, I would call one of the multiple treatment center contacts I had in my phone and ask them for help. Inevitably, they would rush to my rescue within the hour and bring me back to their facility.  

The warmth and love that I thought I felt walking into those establishments was mostly synthetic as was my perception of affection. In some instances, there were members of staffs that were genuinely pleased to see that I had survived another round of the Russian Roulette that I was playing with my life, but none of them were on the clinical level of treatment. The owners, the interventionists, the admission directors, essentially anyone who had their hands in the money pot was happy because I was a guaranteed payout. Sure, they had compassion for my life, but they wouldn’t have treated me with such care and concern if I hadn’t had a fantastic insurance policy.

When my inpatient insurance coverage ran out, I started getting asked to leave inpatient facilities earlier than 30 days—being told that I knew all there was to know, and I simply needed to practice it. While there was some truth to that, my insurance was still being pumped for outpatient services through the same companies who could get no money from me by providing in-house treatment for me, so I would be transitioned to secondary housing where groups were less often but the payout was just as fruitful.  I had absorbed all the knowledge I could have about addiction treatment, but I still had no interest in putting it to good use.

However, I was still welcome at treatment centers for short stays. They would claim I was a “scholarship” and then charge my insurance for months at a time for outpatient services after I would leave. I still continued to relapse, and then take short breathers at treatment centers before continuing the abuse. That was until I realized exactly what I was doing.

I cannot recount the exact day, time, or what was even being discussed the last time I was in treatment and realized that I was never going to return to an establishment like that again. My life was literally in shambles and all of my possessions were strewn across South Florida, left in various halfway houses and treatment centers. I had nothing to my name except clothes that didn’t fit. More importantly, I hated myself and I didn’t want to hate myself. I wanted to live differently; I wanted to learn to love myself.  

That was the moment that I decided for myself that I was done using and drinking. Nothing that was said in any of the treatment-center groups leading up to that moment had any impact on that decision I had made; no consequence had been great enough to help make that decision any quicker. I simply had to make the decision for myself that I no longer wanted to continue to use drugs or alcohol addictively anymore. It was at that point that the shift in my head went from one extreme to another. For so long I had viewed treatment centers as a safe haven that were available to help me survive during the interim between when I wanted to use and didn’t have money and when I was actively using drugs and alcohol. I now curse them and all the people in them for having coddled me, and for aiding me in my extended drug-use period.

The last time I was in rehab, I remember looking into the eyes of an 18-year-old boy who had been sent to treatment by his parents who were extremely wealthy. When he was asked whether he wanted to stop using, he stared at the floor and replied, “Yeah, definitely.” He relapsed in treatment a few days later. I do believe that treatment centers play an integral part in some individual’s lives and can be the key, for some, to find sobriety. It was not mine.  

When I came into the rooms of my 12-step fellowship of choice, I became friends with women and men who had gotten sober on their own accord, without the aid of treatment facilities. They had reached what is referred to in the “Big Book” of Alcoholics Anonymous as a “bottom” and then decided to try something different, turning to people who had gotten sober before them for help, not a corporation.

I do not envy those who got and stayed sober after attending a single rehabilitation center, nor do I wish that my story was more along the same lines of my friends who simply detoxed themselves in the rooms of AA. I have respect for treatment centers, especially because in a certain way they kept me alive for a period of time. I do not, however, cite a rehab as the reason why I got, or how I stay sober on a daily basis.  

If anything I believe that the game of playing with fire, relying on an insurance policy, and an open bed at a treatment center to save the day, is a life-threatening and scary game to play. I both lived this and I watch it happen all-too-often. My experience is my experience, and nobody else’s. I’m grateful for the path that I have walked, and for families of chronic relapsers who keep looking towards inpatient rehabs as the key to saving their loved ones. Sometimes, you have to fall all the way down in order to get all the way back up.

Allison Holland is a native Virginian who currently resides in Florida. She blogs and helps share her story with other recovering addicts and alcoholics.

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