Once you’ve chosen a treatment philosophy that best fits the person you’re trying to help, it’s time to pick an actual program. But there are still some questions that you’ll need answer before you’ll know which one is best.
Inpatient or Outpatient?
As much as your loved one may promise to do better and even be sincere in his desires to change, most outpatient programs become a revolving door. The gradient is just too low to solve the problem. If an addict has been using drugs or drinking for months or years on end and has habits like breaking the law, being dishonest, an inability to follow through, and developed the viewpoint that he is a victim of life as opposed to being in control of it, then spending a few hours a day in a group setting isn’t going to cut it. For one thing the person is going to return to his same environment after each session. The therapist at the program may tell you that they’re going to do their best and it may take some time. The addict will tell you that he’s going to clean up an outpatient program is the best choice. But I can tell you from personal experience that at the end of the day, these programs have abysmally low success rates. It’s not for lack of trying. Even addicts in residential programs face enormous challenges in achieving sobriety and staying clean, so to think that someone who is going to stay in a re-stimulative environment day after day is going to fully recover is a fools journey, not to put too fine a point on it.
It’s important to match the program to the problem.
For an addict or alcoholic residential treatment is typically the best choice. I don’t represent a residential treatment program, but I can tell you as a professional that if you want to chance a true success, residential treatment is probably the way to go.
There are rehab programs ranging from two weeks to two years and everything in-between. Two weeks is usually a detox program, nothing more. It’s enough time for a person to clean up physically, without addressing the emotional or operating problems that led the person to use in the first place, and which continue to be the cause of his addiction. Probably the most important point to keep in mind when looking at detox programs is it the addict or alcoholic may tell you that that’s all he needs, that all he needs to do is clean up, get a job and life will be better. Believe me, if the solution to addiction was simply detox then everyone getting out of jail would stay clean. If it all boils down to cleaning up and getting a job I would’ve been permanently clean before the age of 17. But I wasn’t and it isn’t and it won’t be. Detox is just the first step. It needs to be followed by a comprehensive program of repair otherwise the cycle of addiction will invariably continue.
On the other hand the process doesn’t need to take two years. Two year programs do exist, but they tend to be for hard-core cases and for people who end up living at the facility and working in some aspect of it.
People are going to have different opinions, but I think a lot can be said for programs that are between two and six months.
Without meaning to insult any of the dedicated and well-meaning employees of these kinds of facilities, 30 day programs tend to be a revolving door. I attended three of them myself. I can’t tell you how many people I’ve met in treatment centers who have been in and out of 30-day programs over and over again. I think the reason the 30 day programs fall short is that 30 days is simply not enough time to address the myriad of problems most addicts and alcoholics face when they go into treatment. If the first week is spent coming in for a landing, getting to know the program and the people, the person really only spends about three weeks addressing his or her problems, and any benefit is proportional to the degree he is being honest. This is one of two fundamental flaws with the 30 day program. The second is that since everyone wants a quick fix, 30 day programs can seem like the easiest solution. But like they say, there’s the easy road and then there’s the right road. My advice is to look at programs longer than 30 days. If you feel cornered into looking at 30 day programs, make sure the one you choose is followed up by a comprehensive aftercare program, the more intense the better.
Most of the success stories I’ve heard come from people who gone through programs that are at least two months in length. These aren’t necessarily twice as much in terms of cost as a thirty-day program. The program I work for now for example, takes about 90 days to complete and is in the $25-$35,000 range. For private pay programs this is about what you’d expect to pay for a good 30 day program. So keep hope alive, don’t take the easy road and do your homework. This starts by taking the time to do your research. If you do, your hard work will pay off in the end.
The most common argument used to support choosing a program that is close to where the addict lives, is convenience for visitation. The other side of that coin however is that when the addict has a bad day, doesn’t want to participate in the program or otherwise feels the need to leave, a program that is close to home is the easiest to blow from. Making sure somebody stays in the program and completes it can sometimes boil down to the simplest thing like the fact that it’s too far away from home to easily leave.
I’m not suggesting that the program has to be in Timbuctu or thousands of miles away from where the person lives, but there is something to be said for making it inconvenient for him or her to leave when the challenges seem too difficult, for when the person has a bad day and by habit wants to revert to using or drinking in order to solve the problem.
Professionally I make the same argument when it comes to choosing a location, as I do when it comes to picking a place the does or doesn’t have horseback riding for yoga Or satellite TV. You have to pick your battles, and if you love one has lost his way in life the the most important thing is is too find an effective program no matter where it is. The better chance the program has to help your loved one repair his life, the higher up on your list it should be. In 10 or 15 years it won’t matter whether the facility was down the street or in another state. What will matter is that it worked. That’s the only thing that will matter.
(to be continued)