In 2020, 3.4 million Americans received substance use treatment, which is colloquially known as “going to rehab”. For many people, that single stint in treatment is enough to ensure that they have the tools to get clean and sober and stay in recovery. For many others, it’s not, and rehab becomes a recurring thing.
That is nowhere better highlighted than the fact that the median, or the total sum of times everyone goes to rehab divided by the total number of times people go to rehab before recovery is 2. The mean, or the middle number precisely between the highest and lowest number, is 5.4. This means that a high number of people to rehab just once and then a small number of people go to rehab a lot more than once.
So, why do some people keep failing rehab when it works for others? While sometimes treatment is just wrong for the individual, more often, failure to succeed in rehab is about situations, motivation, and lifestyle.
Moving into recovery is a commitment that requires significant personal determination and investment. Yet, many people go to rehab because they have to. Whether that’s court ordered rehab, an ultimatum from friends and family, or hitting rock bottom doesn’t matter. They’re not going because they want to recover and change their life. They’re going because they don’t see any other options. Unfortunately, that’s not very motivating to get clean or sober let alone to stay that way.
Many rehab clinics are increasingly using therapies like Motivational Therapy to improve motivation to participate in therapy. That can help a great deal and can improve both engagement with treatment and long-term outcomes.
At the same time, motivation often comes from the intrinsic belief that life can and will be good without drugs and alcohol. That means having a source of hope, having support networks, and having friends and family who believe in them and their potential. Often, the people who keep failing rehab are the people with poor relationships with friends and family. Sometimes those relationship problems stem from substance abuse and sometimes they predate the substance abuse. However, working to ensure that your loved one knows they can trust you, that you care about them not their substance abuse problems, and that you’re there for them can be extremely motivating for them staying in recovery after treatment.
Stress is one of the biggest triggers for relapse. But, for many people, they’re expected to go to rehab and then leave it, go back to their normal life, and fix their relationships with friends and family. Often, that can require a significant amount of high-stress social situations of navigating distrust, hurt feelings, and broken expectations. That, coupled with the high stress of managing coping mechanisms, increased responsibilities of self help groups and having to “prove” ongoing sobriety to friends and family can be significant. That’s even more so when that person is expected to integrate back into life and responsibilities without a gap or extra support.
People who are stressed or are using because of mental health issues also have to tackle and mitigate those issues before simply carrying on with life.
Drug and alcohol abuse are often a response to environment and stress, rather than isolated incidents. This means that if someone goes to rehab and comes back to more or the same amount of stress, they are highly likely to go back to the same coping mechanisms.
Many people use or drink as a result of being in a high stress environment. People who work in high stress environments have an even harder time, because often substance abuse starts as a form of coping. Simply returning to that environment after treatment can be disastrous for recovery.
However, your lifestyle doesn’t have to be high stress for your lifestyle and home environment to be triggering. For example, if you normally use in a certain environment, that environment can become triggering. Sometimes it’s something obvious, like driving past the liquor store you stopped at to buy liquor from on the way home from work. For triggers like this, some people can get away with simply choosing a different route home from work. However, forgetting and taking the wrong route home could still be triggering.
On the other hand, you might have created a habit or pattern where you get home from work, sit on the couch, and drink. You might get home and autopilot into that routine or suddenly experience cravings every time you sit on the couch.
For that reason, many people leaving rehab are recommended to change their lifestyle, habits, and even homes to maintain sobriety. That could involve moving. It could mean staying in a halfway house or sober home for a period after rehab. Or, it could mean assessing what’s actually triggering and working to remove it from your home and space.
Lifestyle and situation triggers can also include how you live. For example, if you take care of yourself, get enough sleep, and eat well, you’ll have energy and a good basis on which to stay in recovery. On the other hand, if sleep fluctuates, you rely on sugar and caffeine to get through the day, your diet is unhealthy, etc., you’ll often have energy dips and mood swings, which could contribute to relapse.
Recovery means taking charge of your life and making changes so that you feel better. Often, that will mean making major changes to diet, exercise, and sleeping habits. If you get home and return to your old habits, you’re likely setting yourself up for failure.
Helping someone else to fix those habits can be extremely difficult. However, if you know that they should be eating well and exercising to maintain recovery, you can join them and help motivate them to do the right thing for recovery.
Recovery is an ongoing process. Rehab can give you the tools to get and stay sober, but it can’t respond to changes in your life as they happen, to triggers as you discover new ones, or to friends and relationships as they occur. Even the process of reintegrating back into your job can be full of surprises. Finding ongoing support, ongoing accountability, and ongoing help with your disorder can be crucial for staying clean and sober.
For that reason, rehab should always include aftercare. That means access to counseling or therapy after graduating from treatment. It may also mean the option to go back into emergency treatment sessions. It may mean access to halfway houses to learn to adapt to working before having to live on your own. And, it may mean a self-help or support group that can offer social accountability and support. Here, the fewer supportive friends and family someone has, the more important it is that they have these professional networks. A good support network of friends and family also isn’t good enough to replace professional help – ideally you get both.
If you or a loved one is struggling with rehab or staying clean and sober after rehab, it’s important to look for long-term support and aftercare, to ensure that you’re investing in changing your life, and to get motivational therapy or talking before or during rehab.
Asana Recovery is located in Orange County, California. and offers detox, residential, and outpatient addiction treatment services in our modern and comfortable addiction treatment facilities. Please contact us today to speak with one of our experienced addiction treatment team if you have any questions about our programs.