By Beau Black
Patients are taught how to recognize cues, how to handle cravings, how to develop contingency plans for handling stressful situations, and what to do if there is a slip.
How long does rehab take? And is inpatient or outpatient treatment going to be more effective in helping me achieve and maintain sobriety? These are two of the biggest factors considered when deciding to enter drug or alcohol addiction treatment. Many people want to expedite their path to recovery, but effective treatment can’t be rushed. And in the long run, the time invested in an alcohol or drug rehab program yields life-long benefits.
There are several understandable reasons to want to speed up the treatment process: a longer program means more time away from work, which may have financial consequences for many. We’re also away from family and friends. And longer stays are also more conspicuous to co-workers or friends if privacy is a concern.
That said, the real work of recovery involves relearning ways of healthy living on several fronts, and simply put, it takes time. According to A Guide to Substance Abuse Services for Primary Care Clinicians, “Patients who remain in treatment for longer periods of time are also likely to achieve maximum benefits.”
What Happens After Detox?
Getting sober is only part of the battle. The authors of the Guide to Substance Abuse Services explain that many patients in addiction rehab have “multiple and complex problems in many aspects of living,” which include:
- medical or mental illness
- broken relationship
- lack of sufficient social or job-related skills
- difficulty performing as needed at work or in school
- legal problems and/or money problems
Some of these problems have led to their struggle with addiction, while others may have resulted from — or been made worse by — it. Effective treatment must address these issues comprehensively in order for individuals to assume appropriate and responsible roles in society. This means addressing physical well-being, any psychiatric disorders, marriage or family problems, and financial or legal problems. Patients will also work on general coping skills and develop tools to make sure they can succeed in recovery once treatment is over.
An effective treatment program helps patients plan for the possibility of relapsing. It also teaches them how to identify and sidestep triggers that might drive them back into drug or alcohol misuse. “Patients are taught how to recognize cues, how to handle cravings, how to develop contingency plans for handling stressful situations, and what to do if there is a ‘slip,’” the guide explains. “Relapse prevention is particularly important as a treatment goal in an era of shortened formal, intensive intervention and more emphasis on aftercare following discharge.”
Inpatient Vs. Outpatient Treatment
The difference between outpatient and inpatient substance abuse treatment is about more than just location (residential treatment vs. living at home). They also differ in the amount of time devoted to treatment (full-day programming vs. partial-day sessions) as well as the amount of holistic and wellness offerings included. Both can be effective, but the right choice will really depend on the patient, the severity of their addiction and co-occurring issues, and also their living environment and family responsibilities. A shorter program may run for 3-6 weeks (30 days is a standard length for many treatment programs), followed by outpatient treatment, while longer-term treatment can last for 6-12 months.
Aftercare programs like sober living and case management can also help reinforce the skills learned in treatment.
If the patient has a severe substance misuse disorder or lives in an unstable environment, they may be better off at a residential treatment center. Although either may be the better choice for an individual, inpatient therapy lends itself to more engagement, fewer outside distractions, and a better chance of completing the program.
In the study Bridging the Gap between Practice and Research: Forging Partnerships with Community-Based Drug and Alcohol Treatment, authors Thomas McLellan and James McKay observe that “in [numerous] studies, patients who were assigned to one of several outpatient treatment programs, were less likely to complete treatment than those assigned to the inpatient programs; but those who did complete treatment showed equal levels of improvement and outcome in the inpatient and outpatient settings. It is important to note that virtually all studies of this type have shown greater engagement and retention of patients in inpatient settings.”
Relapse prevention is particularly important as a treatment goal in an era of shortened formal, intensive intervention and more emphasis on aftercare following discharge.
Why Giving Treatment Time Matters
Patients in substance abuse treatment need time to cement new behaviors and new ways of encountering and addressing potential triggers as they come up in a safe environment that’s free of external obstacles to their recovery. A shorter or less time-consuming option can be tempting, but if someone doesn’t take the time they need to really heal not just their addiction but also the underlying issues that contributed to it, they are more likely to relapse. That’s why it’s important not to get hung up on length of stay, but instead to let the experts do a thorough assessment and help determine the right course of treatment to make last recovery attainable.