Are you considering checking into a private drug rehab or detox clinic?
What is the difference between detox and rehab? Drug detox and rehab facilities typically provide distinct types of treatment for various forms of addiction.
When you are ready to ask for help in overcoming your addiction, you are going to have questions about where to start. There are many substance abuse treatment programs, and some appear to focus on one particular aspect of the addiction treatment process.
Please read this article to the end, because, while detox and rehab programs are excellent in the short term, many programs fail to successfully keep their graduates in recovery long-term. There are some important key elements that are often left out of the detox and rehab process.
While medically supervised detox is far superior to unsupervised detox, many acute detox facilities do not provide a long-term workable plan to ensure success. We will discuss this more later in this article.
You may have noticed that there are some programs that specialize in detox. Drug detox is a process that gets you from active addiction to a drug-free state. If you are a heavy drinker, you can go to an alcohol detox program.
Or, if you use heroin, fentanyl, or pain pills, such as oxycodone, you can go to an opioid detox program. Detox centers often run programs that last for a week or two, monitoring their patients closely and providing prescription medication to keep the patient safe and make them more comfortable.
While not as common anymore, there used to be rapid detox programs for opioid dependent patients. Rapid detox meant that the patient was put to sleep while the intensely uncomfortable state of precipitated opiate withdrawal was induced under medical supervision.
The idea of rapid detox was appealing, because it meant getting it all over with quickly. You could go to sleep and wake up detoxed. One problem with this process is that your central nervous system still experiences the trauma of an intense drug withdrawal, even if you are not conscious.
Is it possible to go to inpatient detox and remain drug-free?
It seems straightforward. You get the drugs out of your system, walk out the detox program drug-free. You feel refreshed and ready to face the world again.
You look in the mirror and you look and feel great. Your family, friends, and coworkers see the difference and they are pleased as well. You are done with that dark period of your life.
Unfortunately, for many people, the stresses of life catch up with them and the underlying addiction kicks in. Overcoming drug addiction takes more than cleaning the drugs out of your system.
Many people who go through a medical detox end up relapsing, going back to drug or alcohol use. They feel as if they have failed and their family may feel that way as well.
The fact is that failing to stay drug and alcohol-free after leaving outpatient detox or inpatient detox is more of a failure of the system. Detoxification is not a short-term process. It takes a long time for the brain to heal from active addiction.
Are all medical detox programs bad?
Medical detoxification is not necessarily a bad thing.
The important aspect of a quality detox center is to ensure ongoing medical treatment for addiction. Alcohol withdrawal can be dangerous. An alcohol detox program can ensure that the process goes smoothly and safely. Yet, the patient needs ongoing medical and psychosocial support.
A detox treatment program may start their patients on long-acting naltrexone, such as the Vivitrol shot, at the end of treatment. Naltrexone can be given to both patients with alcohol addiction and opiate addiction. It helps to suppress cravings for both types of substances.
A detox under medical supervision is better than an unsupervised detox. A person sitting at home, trying to quit alcohol or drugs on their own can end up in disaster.
Often, the detox process is part of a chain of treatment that keeps the patient under observation and engaged in therapy. After completing a medical detox, a patient may then attend residential rehab.
The chain of traditional addiction treatment is a process of step down and reinforcement of recovery principles.
After an extended period of inpatient rehab, the next step may be an outpatient treatment program, such as a Partial Hospitalization Program (PHP). After PHP, the next steps are an Intensive Outpatient Program (IOP), and then a regular Outpatient Program (OP).
Each step down along the way allows the patient more hours and more days away from outpatient rehab, so they can get back to living a normal life, going to work and interacting with people.
During the outpatient rehab stages and afterwards, the patient may choose, or be instructed, to live in a sober living facility. Sober homes are homes where a person lives with other people in addiction recovery. Sober homes perform regular drug tests and they support recovery activities, such as going to 12-step meetings.
Some sober homes even bring 12-step meetings to the home. I have seen a sober living home where the backyard was set up as a large meeting place with a privacy fence and a large collection of folding chairs.
Meetings were brought to the home on a regular basis, so there was no excuse for residents to not attend meetings. The meetings provided opportunities for residents to hear inspirational messages of recovery and to get involved with the 12-step process with a sponsor.
If patients are guided through the detox and rehab pathway and supported by their sober living house, why are there still so many treatment failures?
When we look at detox vs rehab, we have to consider that these are two distinct types of entities that serve different purposes. Detox is to safely get a patient drug or alcohol free in a short period of time. Rehab is to keep the patient substance free for a longer period of time, while providing group and individual therapy as well as 12-step facilitation.
There is certainly overlap between the two types of programs. An acute detox facility may provide group therapy and individual counseling. And, a rehab program may offer detox services to many of their clients.
In fact, there are large addiction treatment institutions that provide a wide array of services, including full inpatient detox and full inpatient rehab, as well as ongoing outpatient treatment. In your search for a rehab or detox program, you will likely find some of the major one-stop organizations that provide a full menu of addiction treatment programs.
Unfortunately, even with the pathway of detox to rehab to PHP, IOP, OP, and sober living, it can still be challenging for an individual to remain in recovery. Life is difficult and triggers are everywhere.
We do not always get the opportunity to step off of the hamster wheel of life to take a break from the never-ending pressure. People who have been in recovery for years and take pride in their recovery sometimes start to think about going back to using drugs or alcohol as a solution to get away from it all for just a few hours.
Is it true that repeating the same action over and over again is the definition of insanity?
Supposedly, Albert Einstein once stated that repeating an action over and over, expecting different results, is the definition of insanity. However, Dr. Einstein’s award winning work was in the field of physics and not mental health and addiction treatment.
The quote is often repeated in rehabs and recovery meetings to reinforce the idea that drug or alcohol use for someone who has been addicted never ends well. You can try it in every different way possible, trying to find a way to get high successfully, and it always ends in jails, institutions, or death.
Yet, the same could be said for the rehab industry in general. I once asked the manager of a prominent sober living home what happened to patients who had “dirty urines.”
He proudly responded that his program was strict and did not tolerate drug use. The solution was to send the resident back to detox to start from the beginning of the chain. It was back to detox, rehab, PHP, IOP, OP, and sober living again.
Are the rehab and detox industries practicing insanity?
With further questioning, he explained to me that many patients went through this process. In fact, many went through it multiple times. In some cases, the limit to how many times the clients would repeat the chain of detox and rehab was only limited by how many times their health insurance would foot the bill.
On my addiction podcast, I once interviewed a man who chose to remain anonymous and use a pseudonym. He told a story of attending over 30 rehab programs before finding one that worked for him. All of the programs were in Florida, so he referred to the pattern as “the Florida shuffle.”
Does Einstein’s quote apply to the addiction treatment industry? Why would we assume that if detox and rehab failed, that going through it again in the same exact way over and over would result in success?
Isn’t going through detox, rehab, PHP, IOP, OP, and sober living over and over again precisely repeating the same actions but expecting different results? Does this mean that the rehab industry is insane?
Rehabs blame their clients for treatment failure.
In the world of business coaching, there are fly-by-night gurus promising financial success with their books, courses, and seminars. People up late at night, endlessly scrolling through Facebook, may see ads appear for some charismatic new guru who can change their lives with top secret information that will inevitably lead to financial success and freedom.
Obviously, most people who buy into these programs will not become wealthy. If they did, everyone would take these courses and succeed. We would be surrounded by wealthy people everywhere.
How do the gurus who sell these programs convince people that their programs work when clearly most people who pay to take the courses are failing to succeed? Simple. They blame all failures on the customer.
The customer who did not succeed failed to work the program properly and to its fullest extent. If only the customer would work the program better, their success would be inevitable.
We see the exact same message from detox and rehab programs. In fact, even 12-step programs promote a similar message. If you fail, it was your fault for not working the program.
The program is never at fault for not providing a workable solution for the individual who repeatedly relapses. When a 12-step member succumbs to their addiction and overdoses, other members shake their heads and point to the victim as an example of why others must work their program harder.
Traditional detox and rehab programs do not have great success rates.
In following the posts of addiction experts on LinkedIn, I often see the request that addiction treatment programs provide outcomes data. They believe that the industry has a responsibility to report what is and what is not working.
In a perfect world where the goal is for everyone to work together to figure out what works for more people, we would see failed addiction treatment programs disappearing and successful programs flourishing. Unfortunately, in the world of business, this is not likely to happen.
For the owner of a large detox or rehab program, the most important measure of success is profit. If the company is bringing in money to pay expenses, salaries, and bonuses, the owner, or board of directors, will be satisfied.
I once spoke to a rehab owner who bragged about providing as many services as possible that might be billable to insurance companies. For example, he said that every patient gets a massage.
While not all insurances would pay for the massage, he said that when they did, it was like “found money.” His residential rehab also provided horse therapy and art therapy.
While horses and creating works of art can be legitimate forms of therapy that help patients in recovery, many programs simply go through the motions to document a billable event. Successful outcomes are measured by maximum reimbursement from top paying health insurance plans.
Rehab vs Detox: should I still go to a treatment facility for help with alcoholism or addiction?
When it comes to discussing addiction treatment, the elephant in the room that no one wants to acknowledge is the fact that long-term medication-assisted treatment (MAT) is by far the best option for success. Additionally, for MAT to be successful, it should be provided in a supportive manner.
Patients must be treated with respect. Talking down to a rehab client and reluctantly offering them medication, such as Suboxone or naltrexone, is not the best way to implement a successful program.
Opioid detox facilities do use Subutex, a similar medication to Suboxone. However, instead of providing supportive long-term treatment to allow their central nervous systems to fully recover from years of opioid addiction, they rush the process, tapering the dosage to zero within a week or two.
If you want patients to have success with medications such as Naltrexone or Suboxone, it is important to be supportive. Let the patient know that there is nothing wrong with medical treatment of a chronic condition, such as addiction.
Unfortunately, the most common point of failure for medication-assisted treatment programs is the pressure from other people to make the patient quit their treatment early.
Family members want to know when you will be finished taking that medication and seeing that doctor. Family and friends want to make sure that you know about the people who were able to recover from addiction without taking medication. It is unbelievable that such intense pressure would come from a person’s family to quit successful medical treatment for a serious mental health condition.
If your grandmother had diabetes, would you tell her to quit taking her insulin shots because your other grandmother controls her diabetes with diet and exercise? Of course not! Everyone is different and the situations are completely different.
Just because someone you know was able to “get clean” by going to meetings and not taking medication does not make them better than anyone else. I have seen people on medications such as Suboxone and naltrexone achieve incredible levels of success in life while on medical treatment.
Medication-assisted treatment works and allows people to live full lives, without having to worry about drug or alcohol cravings or withdrawal sickness. They are able to function fully without the obsessions and compulsions of active addiction.
I once spoke with a patient who told me a story of how a gas station attendant coerced him to quit Suboxone and take the herbal street drug Kratom instead. Kratom is a still-legal opioid-like substance that I have seen lead more people to dangerous relapses than to successful recovery.
I have also seen on the main world service website of a prominent 12-step program a directive that they believe addiction treatment must be abstinence-based, without the use of any medications to treat addiction. Is it right for them to spread this message?
We must follow the science.
We know that Suboxone has a very high success rate and 12-step programs do not. Rehabs and detoxes that do not provide long-term MAT also do not have very high success rates as far as keeping their graduates substance free long after they have completed the program.
In addition to understanding that study after study supports MAT as the solution to addiction treatment, we must also provide the proper support for patients. The stigma associated with MAT needs to go away.
At this time, the best way to obtain quality medication-assisted treatment for addiction is with a private concierge addiction doctor, either in person or online. Online treatment works well and helps to keep people safe from COVID-19 while working on their addiction recovery program.
For example, concierge Suboxone telemedicine therapy is an excellent way to have all the time you need to discuss your addiction recovery challenges with your doctor. This way, you will be assured the proper support and understanding when getting started with treatment.
In the future, for detox and rehab programs to remain relevant, they must learn to overcome the stigma, not only offering MAT, but providing it proudly to their patients. They must learn to encourage patients to start MAT and stick with it long-term. By providing MAT in this way, their outcomes will improve dramatically.