How long am I required to stay in rehab?

Q. How long am I required to stay in rehab?

Assuming that you have not been court-mandated into treatment, you are usually free to leave rehab at any time — against professional advice.  Assuming that you use good sense and stay, the answer varies depending on a variety of factors.

Getting the alcohol and/or other drugs out of our system is only the first of many things that need to happen in order for us to have a decent shot at long-term sobriety. Getting clean and sober (and staying that way) requires time.

I’ve written here often about the physical changes in our brains that cause us to be unable to function without drugs. Until our brains have had time to heal themselves, we are at great danger of relapse, because cravings can return at any time. Along with that danger goes the issue of how we feel physically and emotionally while the repairs are taking place. Post-acute withdrawal can be a bear, and it can last for quite a while. Without a plan and good support, that alone can make us uncomfortable enough to want to use again.

Psychological and emotional damage from our period of active addiction — and perhaps even before we first used, need to be addressed. Getting clean does nothing to deal with those issues, and ignoring them puts us at great risk of using simply to make the bad feelings go away again.

There are social and legal issues to be considered. Getting clean does not prepare us to go back to work immediately, repair damaged relationships with family, friends and perhaps employers, clear up financial and legal problems, and deal with the other situations surrounding our addictions. Only time, along with some support and work on our part, can prepare us to deal adequately with those things.  One of the prime targets of rehab is to help clients develop a plan, a support system, and learn how to use them.

Some help and support for family members and significant others is needed. Therapy, or at least a support group, is highly desirable for them because living with an addict is traumatizing. This is easier to arrange if we are under the guidance of people who know how to help our families and friends begin to heal too, because us telling our family that we think they need help is pretty much a non-starter.

Finally, we get to the addict behavior that we need to change. When we used, we developed behavior that protected our addictions.  Over time it became ingrained. (I like to use the example of putting Kobe Bryant in a basketball game, but telling him he can do anything he would normally do except try to score. How long would it take Kobe to blow that assignment, after spending most of his life working to do nothing but score? His instinct to shoot when the opportunity arises would trip him up, sure as taxes.) The point is, until we develop habits of thinking and responding to the world like a sober person, we are likely to respond to stressful situations just as we did in the past. More than one addict has come back saying, “I don’t know what happened — one day it seemed like a good idea and I just picked up!”

So there’s no way, really, to give a simple answer to this question. A safe one would be “Stay in rehab as long as possible.” Of course we all know that other factors can stymie a plan like that. Best answer: consult with the experts who are handling your rehab, and take their advice if possible. More rehab can’t hurt.  There are very few problems that can be solved if we don't have the skills to tackle them, and if we relapse — well, let’s just say that’s not the best way to remain out of rehab.

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