“Recovery didn’t open the gates of heaven and let me in. Recovery opened the gates of hell and let me out!” Anon
To a degree, I was truly blessed. My life had been chaotic and full of trauma. I perfected all the wrong coping mechanisms which allowed me to be highly effective in escaping my reality. First, I became a workaholic, then an alcoholic, with a sprinkle of emotional overeating thrown in for good measure. Truly blessed, are you mad, Stephan?
Well, at the time of my personal rock bottom, I was exposed to an amazing rehab facility which regrettably is no longer in existence. However, the teaching of my mentors will forever guide me. The 12 steps of the AA program made sense to me. Not in the original sense as a religious frame-work, but as a method of rescuing a failing business. And the business concerned was me.
Had I been living in other parts of the world I might have sought help from a different provider with a team that works along the lines of a different mental model. But how do you know who to trust? Who can really judge such a question and by which measures?
First and foremost, I would like to frame addiction not as a problem of moral choice but as a safety/risk management challenge. By focusing on the medical diagnosis of addiction, rather than primarily a law enforcement problem, we can make a huge difference. In a nutshell, recovery is neither rare nor random — with the right kind of support, it can even be expected.
But what is the right kind of support? How can you find the answer to this question?
Welcome to Pandora’s box!
Looking through web sites and publications, even my head is confused.
Firstly, there is no agreed definition of what rehab actually is.
1. Programs can last 28/30 days, 2 moths or 3 months. The reason that many programs were 28 days is simple — the American insurance companies paid up to a maximum of 28 days. Cynical, but true.
2. Rehab can be done as an inpatient and as an outpatient
3. Some utilize mainly psychological and psychiatric approaches, for whom medications are considered counterproductive (or shall I say evil?).
4. Other programs are run by doctors for whom rehab without medications (such as naltrexone) is unthinkable.
5. One program might not have all the bells and whistles, but is run by such an enigmatic character, that it is virtually impossible not to get sober. Other programs have everything and then some, yet, the first stop for discharged patients is the bar at the airport.
6. Proponents of different avenues (or schools of thought) will highlight their successes, and are not very keen to talk openly about the not so nice cases.
7. Inevitably — are we not comparing apples with oranges? In some cases it is like fitting a round peg through a square hole.
8. So, if you were hoping for a sound answer, supported by extensive scientific evidence — I am sorry, I can’t be of help. But I can guide you to the principles outlined by the National Institute on Drug Abuse (NIDA) in the US. In other words, that’s how rehab should look like.
Features of a good rehab
1. There must be recognition that addiction is a treatable disease that alters the functioning of the brain.
2. There is not one approach to treatment that will work for everybody.
3. Treatment interventions need to be available when the individual needs them.
4. Effective treatment for substance abuse addresses the multiple needs of the person and not just their use of drugs or alcohol.
5. A crucial component to a successful treatment outcome is to remain in treatment for a sufficient length of time.
6. Behavioral interventions, such as individual therapy, group therapy, or family therapy, are the most common forms of treatment for substance use disorders.
7. Medications can be an important aspect of substance use recovery, particularly when combined with behavioral therapy.
8. Treatment should begin with an assessment of the person’s needs, a formal treatment plan, and then the assessment and readjusting of the plan as needed to suit the situation.
9. In many cases, individuals with substance use disorders will have co-occurring mental health disorders that also need to be treated along with the individual’s substance abuse.
10. Medically assisted detoxification (medical detox) is only the first step in recovery. If individuals only receive medical detox services, there is little change in their substance abuse behavior. Individuals require long-term treatment programs after medical detox.
11. Substance use disorder treatment does not have to be voluntary in order for it to be effective. Individuals who are coerced into treatment have similar outcomes to individuals who volunteered to enter treatment.
12. Those in substance use disorder treatment programs should be continuously monitored for drug and alcohol use. Lapses and relapses are common.
13. Individuals in substance use disorder treatment programs should also be tested for infectious diseases like HIV, hepatitis, or tuberculosis. If they are positive for any of these conditions, they should be treated accordingly.
My own rehab ticked all the boxes and then some. But there are other programs out there that could equally benefit you. We are all different. Find what works for you, and then work it!
Recently research has attempted to answer if other programs can be as effective as the 12 steps. And it seems that this is indeed the fact. The Peer ALlternatives for Addiction (PAL) Study showed similar outcomes for Women for Sobriety, LifeRing and SMART Recovery when compared to a 12-step program.
One way or the other — don’t listen to the lies that addiction tells you.
There IS hope.
And there IS help out there.
Don’t give up.
One Day At A Time.
I have the honour of interviewing amazing guests on my show Neff Inspiration! If you want to learn more about different treatment approaches – check out the following interviews.
“You don’t recover from an addiction by stopping using. You recover by creating a new life where it is easier to not use.” Anon
