Ten Questions You Should Ask Before Choosing a Drug Rehab
Every year, millions of people enter drug rehabs in the US alone. While rehab helps many of them, the majority of them had been to rehab before and then relapsed after they went home. In fact, one in ten had been to rehab five or more times before.
For a family making their choice from a bewildering variety of different programs and different promises, an education in what to look for in a program can save both money and heartbreak. When a family knows just what to ask a rehab facility before trusting a loved one to their care, they can more accurately choose a rehab that fits their needs.
To help families make the right choices of rehabilitation service, here are ten questions that a family should ask before they make their decision.
1. What kind of result do you expect from rehabilitation?
Different programs actually expect different results. Some programs consider success to be a person who continues to attend meetings or takes the methadone or Suboxone that was prescribed. Others consider that a person completing their twenty-eight-day program is a success. Others measure success by the number of people who stay abstinent after they return home. And some include many factors of recovery, such as gainful employment, improved family relations and morality and so on.
You and the family must decide which result is acceptable or desired before making a decision. This decision will guide you through the process of selecting a facility. Ask any rehab program you are considering how they measure their success and what that success rate is.
2. Is the program short-term or long-term?
The most common type of drug rehab program is the 28-day program. This may not give people the time they need to achieve stable sobriety. Addiction is a complex problem involving both physical and mental damage. Most people need considerably longer than 28 days to become stably sober.
3. Does the program’s treatment substitute another drug for the one the person was addicted to?
Thousands of drug treatment programs offer methadone, buprenorphine or Suboxone to the person recovering from addiction to drugs like heroin, prescription painkillers or others. This type of program is often referred to as a harm reduction program. The goal of this type of program is not to create sobriety but rather to reduce the harm being created through illicit drug abuse, by giving the person a prescription substitute. Yet in essence, you are only trading one addiction for another. If your goal is complete sobriety, then a program that employs substitute drugs as treatment will fall short of your goal.
4. Does the treatment rely on the use of other drugs that may themselves be addictive or harmful?
Many rehab programs with a pharmaceutical orientation may rely on benzodiazepine-class drugs like Valium or Xanax (or even stronger medications) to alleviate symptoms of distress in those going through their programs. While benzodiazepines may be needed for a few days for a person in acute alcohol withdrawal, they are not the only solution for distress during rehabilitation. Other programs emphasize building up a person’s physical health early in the recovery process by using vitamins, minerals and exercise. An improvement in health can result in greater mental calmness and alleviation of symptoms of distress for many. Some people also find it easier to be more social and constructive when they feel healthier.
A reliance on medications as part of treatment can also result in an addiction to these medications. For example, the prescribing information for Xanax warns that dependence on the drug can occur after just twelve weeks of use at some dosage levels. Prescription opioid substitutes can result in addiction much faster.
Some other programs will give an alcoholic a drug like Antabuse to make him (or her) feel sick he if drinks again. But the possible side effects of Antabuse include severe and sometimes fatal liver problems and impotence. Some individuals may not need these drugs as part of their rehabilitation programs. Ask a potential rehab service what medications they prescribe and why.
5. Does the program have a method of alleviating physical cravings for drugs or alcohol?
This is an important point for families to understand. When a person is in addiction recovery, he (or she) may struggle each day with severe cravings. Many rehab programs do not have a direct method of alleviating these cravings. Instead, they offer prescription medications to chemically suppress cravings, frequent support meetings and counseling to help a person deal with the cravings. But if there is no method of directly addressing and reducing cravings, the urge to abuse drugs may be stronger than the support and may drive the recovering person back into drug abuse.
When a program has nutritional, detoxification or other techniques that effectively alleviate cravings, a person in recovery has a greater ability to focus on developing sober living skills and repairing the harm done to others.
6. Does the program include a nutritional component?
When an addicted person arrives at a rehabilitation program, multiple studies have shown that it is typical for him to be in a very poor state of health. For example, a report from the University of Maryland Medical Centerstated that intestinal problems resulting from opiate abuse can cause malnutrition and that alcoholism can cause anemia and brain disease resulting from nutritional deficiencies.
A thorough addiction recovery program needs to include nutritional support for the person in recovery so that the person’s deficiencies are repaired. Otherwise, symptoms of deficiency can create sleeplessness, depression, lack of appetite, lack of energy, irritation or other problems that are barriers to recovery. These problems could even lead to further prescription of medications such as sleep aids or antidepressants when nutrition might provide a healthier solution.
A review of published literature on rehab programs that included a nutritional component showed that programs without nutritional support helped 17% to 50% of those treated succeed in staying sober, but programs with nutritional support had success 60%-80% of the time.*
*Excerpt from the report of Kathleen Kerr, M.D., to the Third International Detoxification Conference in New York City in 2007.
7. Does the program teach a recovering person sufficient life skills to support a sober life?
No matter how good a person feels when he leaves a rehab program, he is going to be hit by problems, stresses and influences that might tempt him to use drugs or alcohol again. Old drug-using friends or drug dealers will come around again. There could be a setback, a job loss, divorce or other stress factor.
A person must have the skills to deal successfully with these influences and other problems so they don’t drag him down so far that drugs again look like the only solution. A thorough drug rehab program will provide life skills training to make a person capable of dealing with these stresses. If it does not, the other improvements made during the rehab period may be lost.
In addition, addicts develop destructive patterns of thinking and acting during heavy drug abuse. Their senses of morality are damaged or destroyed. They learn to hide physical and emotional pain with substance abuse. They solve financial problems by resorting to crime. In each of these areas, the person must learn how to break these addictive patterns and regain the ability to act responsibly again.
8. Does the rehab program you are considering think that addiction is a chronic disease and one should expect multiple relapses on the way to sobriety?
While there are many different forms of rehab, in general, they tend to either believe that relapses are normal aftermaths of rehab or that relapse can be prevented by a thorough, effective program. It would be wise for a family to interview a prospective rehab on this point.
Abilities and Life Skills
A rehab that does not agree that relapse is a natural result of rehab is likely to be a long-term program that thoroughly addresses the way a person approaches day-to-day problems in life. When a program has methods of relieving cravings and builds up one’s skills for dealing with stress and problems, it is possible to achieve sobriety after completion of a program.
Ask a rehab program you are considering if they feel addiction can be overcome as a result of completing their program. Their answer will enable you to choose a program that agrees with your philosophy.
9. Does the rehab seem to offer an instant cure or some other promise that doesn’t make sense?
Treatment programs may promise results that seem illogical. Some practitioners who use the hallucinogenic Brazilian jungle drug ibogaine claim that in just 24 hours, it can cure an addiction that has lasted for years. Aversion therapy programs claim success by using nauseating drugs or electric shocks over a ten-day period. Hypnosis programs make similar claims. LSD and the hallucinogen psilocybin are also being tested as fast addiction treatment drugs that bypass a recovering addict’s need to fully confront the changes that are needed in his life.
While there might be one or two “instant cures” from these unusual forms of treatment, most people only recover from addiction after the years of damage to the body, mind and spirit have been repaired. Most people only stay sober when they have experienced relief from cravings and a restoration of life skills and morality. This takes longer than a single session with a drug or a few sessions with any kind of therapist. This kind of recovery takes most people two to three months of steady work, or even longer.
The promise being made should sound right to the family trying to save the life of a loved one.
10. Are the steps of the program ones that you feel good about your loved one experiencing?
Families are trusting rehab programs with something very precious: the future of loved ones. In some cases, those loved ones go through unexpectedly severe experiences that families would not really want for them. Forced labor, confrontational methods of counseling, heavy drugging during withdrawal or rehabilitation, even electric shocks or the administration of psychedelic drugs may be used as treatment. It would be smart for a family to understand every phase of treatment and agree with its use as treatment for someone they care about. Be sure you ask the staff of the rehab facility about each phase of treatment.