You get what you pay for. That applies to almost everything in life. So, it’s no surprise that a dry, $1 burger is akin to a hockey puck in taste and texture. It is also no surprise that sumptuous, $25 Wagyu burger with blue cheese can yield a mellifluous symphony of flavor.
When it comes to professional drug treatment, you get what you or your insurance can afford. Residential recovery programs can range from the sparest and most basic, offering rudimentary services, to luxurious and extravagant, providing resort-style amenities. The level of expense, however, is no indicator of effectiveness as relapse and dropout rates occur at every financial level.
The one constant with all residential recovery spaces is this: clients can leave any time they want. However, there are consequences to that decision.
If it’s a court-ordered stay, that could mean stiff penalties such as imprisonment. Without the threat of imprisonment, people who enter treatment on their own and decide to drop out will have to deal with the lingering effects of that decision, such as relapse and the utter waste of time, money, and resources.
Still, there are instances where clients get to leave a facility. Read on to find out.
The Need to Leave
Dropping out of treatment hampers a user’s rehabilitation and eventual recovery. However, drug treatment attrition is commonplace with treatment programs. In an outpatient setting, for example, the rates for the first month of attrition are at about 30 percent, and dropouts before three months can be 50 percent or more.
The road to recovery is fraught with physiological, psychological, and spiritual challenges at every step. There is the physical toll of addiction, where a user must confront the withdrawal symptoms and chemical imbalances levied by the disorder. There are the cold, hard realities of addiction, that it is a disease that profoundly rewires your brain, impacting the chemicals that govern pleasure, reward, stress, and self-control.
Finally, there is the spiritual aspect of addiction, where patients are not only forced to contend with their demons, but they must also confront the ravages their addiction has wrought, on themselves and their relationships. Inflicted by drug or alcohol cravings, poor self-image and esteem, and the consequences of their abuse, many people relapse, and some even drop out of their programs.
Writing for psychcentral.com, Dr. David Sack provides five reasons people leave treatment early:
- Detox is too painful or hard: The unfamiliar treatment environment, withdrawal symptoms, and drug cravings can be enough to drive them back to using.
- I’m not like these other people in rehab: After their first 12-step or group therapy session, a patient may feel like they are better — i.e., smarter or stronger — than their peers. This is a mechanism that allows a user to put up walls and avoid the necessary work required for recovery.
- I do not like it here: The lure to relapse and reuse is such that someone in recovery will blame the accommodations, food, rules, or schedule for their unpleasant experience rather than pursue his or her own recovery.
- I already know this stuff: Recovery is often a process of learning by repetition. So it isn’t unusual for certain themes and messages to be repeated throughout the process to foster learning and reinforcement. Someone in recovery may use this as an excuse to want to leave rather than engage in the painful memories and feelings conjured up by therapy.
- I can do this by myself: A person in recovery may come to a point where they feel “cured” of their addiction and want to return home to family and friends. They feel healthy and confident in their ability to stay clean.
Anyone enrolled in a treatment program can leave of their own volition, however detrimental that decision is to their life and health. Such an action almost certainly leads a person back to the drugs they were attempting to get clean from as relapse rates hover between 40 to 60 percent.
What’s more, the therapists, counselors and social workers who are charged with overseeing that individual’s recovery will do all they can to keep that person in treatment.
When Can Clients Leave Treatment?
A comprehensive treatment program will not only treat the addiction, but it will also allow patients to engage in a variety of therapeutic and fun activities. This includes recreational time, games, and group outings. Whether these are scheduled trips to the grocery store or social outings, clients will enjoy scheduled outings that allow them to leave the facility.
What Makes for an Effective Residential Treatment Program
Residential treatment offers a structured environment where care and supervision are provided around the clock. These programs can last anywhere from 28 days to a full year or even more depending on the case.
The traits of a quality treatment program are that it is comprehensive, specialized, and multifaceted. A recovery program must also adhere to these principles as set forth by the National Institute on Drug Abuse (NIDA) to meet the standard of effective treatment:
- Addiction is a complex but treatable disease that affects brain function and behavior.
- No single treatment is appropriate for everyone.
- Treatment needs to be readily available.
- Effective treatment attends to multiple needs of the individual, not just his or her drug abuse.
- Remaining in treatment for an adequate period is critical.
- Behavioral therapies—including individual, family, or group counseling—are the most commonly used forms of drug abuse treatment.
- Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.
- An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.
- Many drug-addicted individuals also have other mental disorders.
- Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse.
- Treatment does not need to be voluntary to be effective.
- Drug use during treatment must be monitored continuously, as lapses during treatment do occur.
- Treatment programs should test patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk-reduction counseling, linking patients to treatment if necessary.
The Hallmarks of a Safe Drug Treatment Facility
If you are considering professional treatment for yourself or a loved one, here are five questions you should consider in reviewing your options:
- Does the program use treatments backed by scientific evidence?
- Does the program tailor substance treatment to the needs of each patient?
- Does the program adapt treatment as the patient’s needs change?
- Is the duration of substance treatment sufficient?
- How do 12-step or similar recovery programs fit into drug addiction treatment?
To ensure that the treatment program you’re considering is reputable, safe, and secure, you will want to determine whether the facility is properly accredited by the Joint Commission and is certified in good standing with the state.
Other questions to consider:
- Does the treatment program offer U.S. Food and Drug Administration (FDA)-approved medications (for alcohol or opioid addictions, especially)?
- Does the program also offer treatments that have been proven effective in treating substance abuse disorders?
- Does the program support the inclusion of family members in the treatment process?
- Does the facility provide ongoing support beyond the substance addiction?
An effective residential treatment program is safe and secure, and it offers treatment that is comprehensive and specialized, providing you with opportunities for recreational and therapeutic activities.