How to Choose The Best Rehab - Page 2

By Constance Scharff PhD 04/08/14

What you need to know when choosing an addiction treatment center.


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Be careful when considering treatment centers that are 12-step based or that use “medical” or “pharmaceutical” recovery tools. 12-step programs are no longer the gold standard in addiction treatment. They are also free and widely available outside of addiction treatment centers. 12-step programs are wonderful as part of recovery support and provide an invaluable system of friendship and accountability for those who use them. But as a primary or sole place to get sober, they are estimated to have a poor long term success rate. It is believed that at one year, only 8-13 percent of those who have tried to use 12-step programs as their primary treatment are still sober. Evidence-based treatment programs are significantly more successful. 

Pharmaceutical or medical recovery programs avail themselves of the long-term use of drugs like methadone, Suboxone, and Subutex. Essentially, these treatment programs just switch the addict from one type of addiction to another, without giving them the tools to get completely sober. Some physicians, insurers, and of course pharmaceutical companies like this type of “treatment” to “manage” addiction, but it fails to recognize and encourage the addict’s willingness to live a completely drug free life. Recovery is about living the life of your dreams, not a half-baked, half-drugged life. Certainly these medications have some value, but for anyone with a desire to truly experience life, drug dependency needs to end. 

Treatment programs that are highly individualized are preferable to those that are not. It is commonly accepted that quality treatment involves helping the addict find and heal from the underlying causes of addiction. This is generally some sort of deep-seated emotional or spiritual pain. Treatment protocols that shuffle a person between groups throughout the day are relatively inexpensive for treatment centers to run, but do not give the addict the resources to look at his/her very personal and individual problems. Daily or near-daily one-on-one psychotherapy and access to a personalized treatment plan is optimal. This does not mean that groups are bad. All treatment centers provide some group therapy and these groups are an important part of the recovery process. The best treatment is a combination of these modalities and a focus on your or your loved one’s individual needs. 

Finally, look for treatment facilities that are non-punitive. It’s easy to be angry with your loved one for being an addict. But addicts already feel incredibly low about themselves. They don’t benefit from being in facilities that confiscate their telephones, restrict their access to the internet, or force round after round of chores. Those are punitive measures that serve only to belittle the addict. These practices are demeaning and play no role in treatment. If you want to leave treatment, you will do so whether you have access to your cell phone or not. If your loved one doesn’t know to make his/her bed in the morning, s/he can learn to do that for free from a sponsor in a 12-step program. Treatment should be a time to make a commitment to focus on the underlying causes of addiction. Let the treatment center staff keep the bathrooms clean while you or your family member spend every minute in treatment getting better. 

What to Expect in Rehab

If you find a quality rehab – and there are quality residential treatment centers in every price range – you will be warmly greeted by people who genuinely care about you. They won’t know you or your loved one yet, but they do understand the suffering every addict endures and they want that to end. They know what transformed lives look like. They want that for you and the ones you love.

Addiction treatment is certainly work, but it is much, much easier than the life of active addiction; in many ways, treatment won’t feel like work at all. Though addiction treatment is emotionally draining, waking up every day in a safe, comfortable room, being provided with delicious, nutritious meals, and being helped to face and move beyond the most difficult experiences of your life will most of the time feel like a relief. Drug seeking is hard. Blowing up and regretting the damage caused in relationships is hard. Dodging all the people you’ve harmed in your addiction is hard. Seeing the disappointment in your parents’ or children’s eyes is hard. By comparison, addiction recovery is easy; it is an opportunity to set right the wrongs in your life. You will find time to begin to rebuild family relationships and the self-esteem that will allow you to re-engage in life – on personal and professional levels. If you have trouble with the law or with creditors, you will be able to make plans and have support in meeting those challenges head on. The treatment center staff will be your support through the entire process.

Day by day, your time will be filled with healthful activities. You will awaken at a particular time to engage in many different activities: meditation, exercise, psychotherapy, 12-step meetings, yoga, group therapy, and other complementary therapies. With your personal psychotherapist, you will engage in the deeply personal work of figuring out why you began using in the first place and repair those old wounds. You will also reach out, when appropriate, to your family, so that healing those relationships can begin. You will have time for personal reflection, for journaling, for stress-relief practices like art or massage (if your treatment center offers it) and recreation. And you will find camaraderie. You will get to know the people who are in treatment with you and odds are, you’ll begin to care about a few of them as they will begin to care about you. You may attend 12-step meetings where you will also develop relationships. These friendships can play an important role in helping you stay sober. Everything you do in a day at the treatment center will be designed to help you build and maintain your recovery. That’s what quality treatment is all about. 

There will be times in treatment when you will want to quit. You will have uncomfortable feelings that will make you want to return to drinking, using, or acting out in general. You may be tempted to form inappropriate sexual relationships into which you can escape instead of doing the work of putting your life in order. This happens to almost everyone. Addiction treatment is fraught with challenges. Do not be discouraged. The staff at the treatment center will be available to help you through these difficulties. The important thing is to recognize that these feelings are normal and you will get through them. Addicts don’t know how to deal with discomfort. Part of the recovery process is learning to live through normal emotional fluctuations and challenges without having to use. These feelings too shall pass. Your treatment team will help you. 

Withdrawal Need Not Be Frightening

One aspect of recovery that tragically keeps many addicts from attempting to get sober at all is detox. All addicts have had a taste of withdrawal symptoms. They are horrific and terrifying. Whether it’s the shakes, nausea, hot or cold flashes, or arguably the worst of all – experiencing emotions – no one wants to experience withdrawal. But this need not be a concern any longer. Almost every treatment center now uses medically supervised detoxification for all patients. 

Withdrawal is what occurs when the body detoxifies from a substance that has been abused. Depending on what drugs were used, how long, and in what dosages, the symptoms and severity of detox can vary. What does not vary is an addict’s fear of detox. S/he “knows” it will hurt and wants no part of it. It is these withdrawal symptoms themselves that are part of the addict’s trigger to use drugs again. Every addict knows to take another hit or drink before s/he starts to feel the first twinge of withdrawal symptoms. 

In the past, addicts just had to “sweat it out.” We’ve heard horror stories of alcoholics with the shakes or delirium tremens being locked up in psych wards. That may have happened in the 1930s, but addiction treatment has advanced considerably since then. The standard practice is for medical doctors to use a combination of pharmaceuticals to support a safe, pain-free detoxification from drugs. Some addicts can be put to sleep for the worst of the detox symptoms. Others will remain awake, but kept relatively comfortable with pharmaceutical assistance. Medical doctors will administer a variety of drugs to ease all physical and psychological withdrawal symptoms. Addicts will be monitored to avoid problems, like seizure, whenever possible. The level of discomfort to be expected should be no more than experiencing a mild flu. Diarrhea, constipation, anxiety, sleeplessness, muscle aches, nausea - all the typical symptoms to be expected can be comforted and diminished if not avoided during the detox period. 

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Constance Scharff has a PhD in Transformative Studies, specializing in addiction recovery. She is the Senior Addiction Research Fellow and Director of Addiction Research with a private treatment center and coauthor of the bestselling book, Ending Addiction for Good You can find Constance on Twitter and Linkedin.