Finding the Right Treatment for Addiction: An Alternative to RehabJul 07, 2021
When we're confronted with an addiction problem, what should we do?
Of course: find a rehab!!
That’s what conventional wisdom tells us, anyway. But, this knee-jerk reaction overlooks a few basic facts.
First, in many cases in-patient treatment is not necessary.
Next, research tends to show that rehab doesn’t work that well. In fact, that when you compare people who go to rehab with people who decide to quit on their own, there’s not much difference in the results - for better or worse.
Finally, both research and the experience of many shows that there’s another solution which has shown to be quite effective. And, it directly addresses the underlying dynamic of addiction.
In this article, I’m going to explain what I mean by all this. I want to help you move forward with a solution that’s right for you or your loved one.
But, before I dive in, spoiler alert: I’ve been a resident at lots of treatment centers - probably more than I can count on both hands! I also ultimately recovered without rehab. Since then, I've been a volunteer and as a guest speaker at various rehabs, and I’ve helped others recover and build new lives, both with and without a rehab experience.
IN-PATIENT TREATMENT: IS IT RIGHT FOR ME?
First, let’s deal with the issue at hand: do you or your loved one actually need to go to in-patient treatment? If you’re asking the question, then you probably need to do something.
If you have any doubts, here's a couple points to consider:
Am I or is my loved one physically addicted, and physically cannot stop using in the short term?
If the addiction or dependence is so great that you cannot do this without inpatient support, then the answer to this is most definitely yes. The right answer for you probably includes detox or rehab with detox - or some form of inpatient help.
Does an employer or the courts specifically require in-patient treatment?
If this is the case, then you probably need to go to rehab.
If you don’t fall into the category of these two points, I’m not saying you should not go. It's a highly personal decision, and different people have different needs. For example, if someone's addiction is so self-destructive and risky that their life is currently in danger, they may need a time-out regardless of whether they technically 'need' to be in detox or not.
But having said that, what’s critical to remember is that addiction is a long-term condition that requires a long-term solution. To succeed, you’ve got to play the long game on this. You can’t think only of short-term abstinence goals.
And rehab, whether it is a 30, 60 or 90-day program, is at best a short-term solution.
Is Rehab Successful in the Long-Term?
Every rehab claims high success rates. But, when you dig deeper, you find that their definition of success is misleading.
For example, many rehabs define success as being sober 30 days after discharge. But what about 60 days, or 90? How about a year? Those are the numbers we should be looking at. After all, a year and beyond is that we really want to achieve before we claim 'success', right??
If you're checking out treatment centers, be sure to ask about their documented success rates year or more after discharge, and where you can read more about it.
The bottom line is that for real and lasting change to occur, the solution must address the underlying dynamic behind addiction - not just the physical cravings or short-term dependence.
THE SOLUTION FOR ADDICTION
The Driving Force of Addiction
It’s hard to nail down the exact cause of addiction in any given case. For a few, genetics are a good explanation. For some, environment (family history and personal experiences) may seem likely. The best bet is that it’s a mix of both, and that it differs from person to person.
Instead of wasting time talking about the cause, it’s more helpful to address the driving force of addiction. That is, we should focus on identifying and targeting the rocket fuel of addiction because that is what makes it so powerful - and vicious. Fortunately, the latest research shows in a remarkable way what this 'rocket fuel' actually is.
Research shows is that addicted people don’t have just an addiction problem. Rather, underneath it all they have a sense of being lost, of not having purpose and meaning, and they lack real trust in themselves and others.
Disconnection is the invisible, driving force of addiction. It’s the dynamic that causes people to return to addiction even after finally managing to get sober for a period of time.
The research shows this, and so does my own experience. There was a reason I kept returning to use drugs. It wasn’t because I didn’t have the right information, or I needed to be in a drug class to learn how to deal with cravings.
The truth is that I was in pain. I felt alone, and I had no one I trusted. I had lost my way, and although the drugs sure made it worse, it wasn’t my primary issue. I used drugs to medicate and escape.
But when I began to feel connected, when I began to trust others and gain hope that I has purpose and meaning, the power of addiction began to lose its grip on me.
The True Solution: Connection
Connection and authentic relationships are the key to healing. You might ask yourself, “What does that even mean? Our family or friends love each other, and we feel very connected - so I don’t see how this can be an issue.”
I get it. I had a wonderful family, and plenty of opportunities. But the problem was not with the quality of my family or opportunities. The problem was with me and my perception of it all.
I was sick inside. I had a deep, inner loneliness and pain, and I hid it well.
What a person needs for long-term recovery is to somehow relieve the pain they're trying to escape, and they do this by getting connected.
1. Connection with Self
This means a person is in touch with who they truly are and how they are really doing. This includes awareness of emotional health, thoughts about oneself (like, I am a good person, instead of I’m such a loser), and being committed to learning to honestly assessing and addressing their own strengths and weaknesses. It means being true to oneself regardless of whether a situation feels uncomfortable.
2. Connection with a Mentor
On one level, everyone needs a mentor or a coach. Having someone with deep experience that inspires, guides and shows the way is extremely valuable. With access to such a person and their help navigating the recovery is priceless.
3. Connection with a Community
Not only is it important to have that one person we look up to, it’s also important to be involved in a community of like-minded people. This holds true for people in recovery and regular people. Having other people in recovery that are actively in the solution and making progress is inspiring, gives hope, and helps a person grow.
4. Connection with Purpose
Everyone needs to feel as though they have meaning and purpose and that they matter. This gives a person strength to face adversity and not give up. Without this, people feel hopeless and useless. Without having anything to stand for and pursue, people tend to fall into negativity - including addiction.
Having a mentor and a community that truly empathizes and provides a positive atmosphere of hope, of friendship and consistency is a tremendous help. It encourages a person to start letting down their walls and begin to trust.
This, in turn, helps them begin to discover and address their actual issues - the ones that have compelled them to make such horrible choices in the first place.
All of this is why the latest research shows that connection truly is the solution for addiction - it’s the solution because it is actually the opposite of addiction. See https://www.psychologytoday.com/us/blog/love-and-sex-in-the-digital-age/201509/the-opposite-addiction-is-connection.
How to Get Into the Solution
By the time rehab or treatment is on the table and you’re actually discussing it, something’s up. There’s been a crisis or some situation that’s made a solution urgent. Someone may have a legal problem or some family problem. Whatever it is, the they probably have suddenly become inspired to make a change.
This willingness is a rare window of opportunity. As a former addict, I can tell you from experience that that this window period is temporary. Unless a solution is implemented fast, that window period will pass.
So, if you know what the solution is, now is the time to bring it. Not in a few months. Not next year.
So, let’s talk about solutions.
Can Rehab or In-Patient Treatment Provide the Solution?
Connection and authentic relationships may be the key to healing, but unfortunately cultivating this type of experience not the primary focus in most rehabs. In fact, it can’t be - there simply isn’t enough time and resources to devote to one-on-one relationships.
Instead, the relationships people form in treatment centers are primarily either with professionals (that is, clinical and relatively impersonal) or with other residents (people who are unstable and not yet in the solution).
While outside groups and individuals may volunteer at treatment centers (where people like me come in and speak) this minimal exposure to real-world recovery is not enough.
This is precisely why for many, rehab is a revolving door. And, don’t take my opinion for it. As Scientific American and other evidence-based approaches have found, there simply is no hard evidence that rehab really works.
As I’ve mentioned, the evidence does show that connection is the solution. So if you’re considering rehab, make sure to ask important questions, like:
- In what ways do cultivating lasting relationships and connections during rehab?
- How much one-on-one time do you devote each day to residents?
- Do you believe human connection and relationships the antidote to addiction?
The reality is that most rehabs don’t have much one-on-one time available. Instead, they leave this to aftercare plans and strategies - which may include working with a recovery coach or mentor. And this is a great aftercare plan because research has shown that success rates increase when a recovery coach is involved.
But, this is also very telling. It shows that the real work of recovery isn’t accomplished in rehab in the first place - it’s done in the real world. It’s done where the stress of everyday life and relationships takes its toll - not during the couple months away from it all inside the bubble of rehab.
Which begs the question: if someone really doesn’t need in-patient treatment because they don’t have a physical addiction or a court/employer requirement, why delay the real-world work that must be done while a person is willing and motivated to do so?
You might already know that the basic role of a recovery coach is to guide and help someone make it through the recovery process successfully, regardless of whether they’ve just been discharged from rehab. In this context a coach helps a person become or remain abstinent and helps them achieve their recovery goals.
To fill this role and have long-term success, a coach must be skilled in both recovery and coaching. They must formulate a personalized strategy for the client, work with them closely, and hold them accountable to make progress and achieve recovery goals.
But, that’s not enough.
They must also have what it takes to connect with the client on a profound and personal level. A coach must inspire a person and earn their deep trust - enough that a person becomes willing to allow their coach the privilege of guiding them to the other side of addiction.
I say this not only because studies demonstrate this, but also my own experience. I know - and you may already understand yourself - that addiction is essentially an insane attempt to fill a huge, painful hole within. And I know what it’s like to wake up and not know how I got there, to feel the crushing shame of knowing I had let myself and those who loved me down - again. I know what it’s like to swear I will change, but then to feel driven by something greater than myself to repeat that vicious cycle all over again.
Because the cycle was that vicious, I needed to know in my heart of hearts that this person - my mentor - had my back and really knew how to navigate through all of these feelings and pain points. I needed to know that they had been there and that they had massive experience and would help me.
I had to have someone who inspired me and who I believed in and trusted.
Without my mentor, I would not be here today helping other people transform their lives.
The relationship with a mentor must be like this because recovery is messy work. It doesn’t feel good. It is uncomfortable for a person to face their demons, and to do the tough work it takes to make recovery stick, in their lives. And this work doesn’t happen when you’re in rehab. It happens when you’re living life in the real world.
The chances for success increase exponentially when a person has a solid relationship with someone that is available for them and who can guide them through the process.
I’m sure you can see this in your own life. It’s the quality of your relationships (and not just the information that is passed in those relationships) that impacts you - for better or worse.
So in the end, did going to rehab turn things around for me?
Nope. I just finally became wiling to ask for help. And there was a mentor there for me who stepped in and extended their hand.
And I took it and ran with it.