Does rehab really work?

Until the early 19th century in the US, people suffering from addiction were housed in various locations or sent to jails. It wasn’t considered a mental disorder, and the mental hospitals at the time were not equipped to treat addiction. The initial approach to addiction treatment was to drink in moderation rather than abstinence and included cold baths, vomiting, and aversion therapy, which involved bleeding, blistering, and sweating the patient.

Dr Magnus Huss, a Swedish physician, coined the term Alcoholism in the mid-1800s and promoted knowledge globally. The American Association For The Cure of Inebriation (AACI) took the first step to make treatment for addiction a professional service, and the treatment plan was similar to what we see today. As professionals reported the benefits and success of addiction treatment, governments funded mental health professionals to research more in the area.

Why is Addiction Rehab Necessary?

There are various underlying factors to why an individual becomes addicted to alcohol or substances. It’s essential to work on these aspects and build healthy habits post quitting alcohol/ substances to reduce the risk of relapse, especially since addiction is a chronic disease. And detoxification through professional help is an essential first step to managing withdrawals and a successful recovery.

Quitting by yourself can be risky. Withdrawal symptoms such as panic attacks, seizures, insomnia need to be managed with professional help through detoxification, therapy and medication. In many cases, withdrawal may also be lethal.

Chances of relapse decrease with professional help. The treatment plan at the rehab centre will help you build your overall mental health instead of focusing only on abstinence.

• Counselling will help you recognise the factors causing addiction. Most people suffering from addiction also suffer from psychiatric problems, such as sleep disorders, mood disorders, anxiety, and forms of trauma.
• Psychologists use Cognitive Behavioural Therapy (CBT) to help you realise which stressors can trigger alcohol or substance abuse and methods to cope or avoid them without wanting to drink or take drugs. Many rehab centres also include families in the treatment program to heal damaged relationships.
• Medication is necessary for many people struggling with addiction, especially if there are comorbidities. It also helps combat withdrawal symptoms and cravings and stays sober after completing the program.
• You’ll meet other patients suffering from addiction and hear their stories. Peer support groups support each other during the process and it reduces the feelings of guilt and shame. These people will listen and understand your struggle with addiction and the trauma you’ve faced without judgement, which your family and friends might not be able to provide.

Addiction is a chronic illness, and individuals might need to be in therapy even after spending the required time at the rehab centre. Maintenance therapy is crucial to decrease the chances of relapse.

Does Relapse Mean Failure?

Studies report that 40% to 60% of addicts relapse at least once post-treatment. Relapse doesn’t mean you’ve failed at sobriety, and it’s part of the process.

If you compare addiction relapse with other chronic illnesses, there’s a 30% to 50% chance of relapse if you have Type 1 Diabetes, 50% to 70% for Hypertension, and 50 to 70% for Asthma, you’ll realise that relapse is common with mental or physical illnesses and one mustn’t feel guilty about it.

It’s essential to learn from the relapse experience, make changes to your current treatment plan or approach, and keep moving forward. The goal of treatment isn’t only to achieve abstinence but also to achieve your goals and build healthy strategies to live life and maintain long-term sobriety.

Reducing the risk of relapse largely depends on personal growth. After getting treated at the rehab centre, where patients are under constant care, returning home and living a sober life can get daunting. People are much likely to succeed if they’re able to:

• Hold a job or do well at school
• Build and improve relationships with friends and family
• Keep busy and indulge in healthy activities/ hobbies
• Cope with daily stresses, eat healthily, and care for themselves
• Avoid cravings during events and people indulging in alcohol or substances
• Seek help and learn from mistakes if they relapse

Studies And Factors That Affect Success

Treatment doesn’t only involve addiction but an individual as a whole, i.e. your behaviours, thoughts and emotions. It usually requires in-patient care while slowly tapering the necessary professional help over months and gradually focussing on long-term aftercare. Studies show that continuous treatment for more extended periods is most effective to treat addiction. 

Treatment plans vary depending on the severity of addiction of the individual and whether there are comorbidities. A person with mild addiction may not require to stay at the rehab centre, which the rehab staff can evaluate. But studies reported that more extended stays could reduce the risk of relapse by five times if patients spend longer at rehab centres. The National Institute of Drug Abuse noted that a 90-day treatment plan at the centre is crucial for an individual to recover successfully. 

Success rates also vary depending on the substance that you use.

• 65% of heroin and opioid addicts completed their time at the rehab centre. And 35% of individuals in outpatient treatment and medication therapy completed the program.
• 1/4th of alcoholics completed a year of sobriety, while others reduced alcohol quantity intake by 87%  and managed to stay sober for 3 out of 4 days.
• After treatment for cocaine use, only 25% reported weekly use at the 5th year and 21% after one year. It could mean that almost 75% of cocaine users were able to quit successfully.
• A study on meth users found that 33 of 100 participants who’d stayed at a rehab centre stayed sober by the 3rd month and 14 patients stayed sober for a year. Another study on patients treated under the Matrix Model revealed that 60% of meth users stayed sober for at least six months.

References:

Henninger, Sung. (2014, January). History of Substance Abuse Treatment. ResearchGate. https://www.researchgate.net/publication/258821350_History_of_Substance_Abuse_Treatment 

Hopson, D. (2019, February 11). Heroin Addiction Treatment Success Rates and Statistics. GuideDoc. https://guidedoc.com/heroin-addiction-treatment-success-rates-statistics 

McKetin, R., et al. (2012). Evaluating the impact of community-based treatment options on methamphetamine use: findings from the Methamphetamine Treatment Evaluation Study (MATES). Addiction, 107(11). https://doi.org/10.1111/j.1360-0443.2012.03933.x

McKetin, R. (2012, November). NCBI – WWW Error Blocked Diagnostic. PubMed. https://pubmed.ncbi.nlm.nih.gov/22564065/

Miller, W. R., Walters, S. T., & Bennett, M. E. (2001). How effective is alcoholism treatment in the United States? Journal of Studies on Alcohol, 62(2). https://doi.org/10.15288/jsa.2001.62.211 

Miller, Walter, Bennett. (n.d.). NCBI – WWW Error Blocked Diagnostic. PubMed. https://pubmed.ncbi.nlm.nih.gov/11327187/ 

Simpson, D. D., Joe, G. W., & Broome, K. M. (2002). A National 5-Year Follow-up of Treatment Outcomes for Cocaine Dependence. Archives of General Psychiatry, 59(6). https://doi.org/10.1001/archpsyc.59.6.538 

Simpson, D. D., PhD. (2002, June 1). A National 5-Year Follow-up of Treatment Outcomes for Cocaine Dependence. Addiction Medicine | JAMA Psychiatry | JAMA Network. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/206441 

Treatment Approaches for Drug Addiction DrugFacts. (2021, September 3). National Institute on Drug Abuse. https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction