Do You Really Need Rehab?
If you want to recover from a drug, alcohol, or behavioral addictions, you may be wondering if you can do it alone, or if you need to go to rehab.
While rehab might seem like too extreme of a step, attending rehab greatly increases your chances of making lasting change and successfully overcoming addiction. This article will help walk you through some of the ways to determine if you need rehab, and if so, how to choose one that’s right for you.
While most people struggling with an addiction can benefit from formal treatment, people with very mild addictions or who have a step-by-step plan to stop may be able to do so without treatment.
Some of the people who may have more success stopping on their own might be:
- People who can go long periods without using
- People who have been using for only a short amount of time
- People who have been able to cut back or stop on their own in the past easily
- People who use sporadically, recreationally or socially
- People with naturally higher willpower and strong impulse control
- People who are highly motivated to stop and who do not experience cravings
- People with a strong support system involved in their recovery
When a person’s use is more regular, heavy or severe, treatment is usually the best option.
Also, people who have tried in the past to stop on their own but were unsuccessful also should consider seeking addiction treatment. There are different levels of addiction treatment, ranging from basic outpatient rehab to more intensive outpatient or inpatient rehab programs. Finding the one that is right for you is important for your recovery.
The most important factor in choosing between inpatient and outpatient rehab is the severity of your addiction (2). Addiction specialists measure the severity of a person’s addiction by evaluating their physical, psychological, social, and environmental risks (1).
Some of the following are risk factors which often indicate more severe addiction, and a need for either intensive outpatient or inpatient rehab:
- Heavy use of a substance that endangers a person’s health or increases their risk of an overdose.
- Use of substances that naturally have higher risks for overdose including opioids (ie: pain meds like Vicodin or Oxycontin, heroin, and especially fentanyl), Benzodiazepines, or use of either of these drugs combined with alcohol or other substances.
- Experiencing symptoms of physical withdrawal, especially for Benzodiazepines or alcohol.
- Using a substance to self-medicate a serious underlying physical or mental health condition, or needing to remain on certain controlled medications because of these issues.
- Multiple previous hospitalizations or inpatient stays related to substance use or related effects of substance use.
- Past experiences of overdose, severe health or mental health symptoms, or other serious consequences resulting from the use of a substance or addictive behavior.
- Previous unsuccessful treatment attempts in outpatient rehabs for addiction treatment.
- A high risk for relapse due to an inability to avoid drugs or alcohol, exposure to triggers, or a lack of social and environmental support for recovery.
- Serious or unacceptable consequences if treatment is unsuccessful and drug use is continued (ie: a partner who threatens to leave, drug testing required for a job, probation, or child protective services, or needing to stop because of a pregnancy, etc.).
A person without any of the above symptoms but who identifies with one or more of the following could consider beginning in an outpatient treatment setting:
- Being able to stop for a day or a few days before reverting back to using.
- Patterns of binge drinking or drug use only in specific settings (like social settings).
- Previous successful recovery attempts either on your own or in outpatient settings which resulted in sobriety lasting 1 year or longer.
- Feeling motivated and ready to stop, and feeling confident in your ability to be successful.
- Wanting to use treatment as a way to stay accountable for stopping, cutting back, or maintaining changes you have already started on your own.
- Having experienced some consequences as a result of the addiction, but none which were fatal or catastrophic in nature.
People who are unsure if outpatient or inpatient rehab is the right option for them should make an appointment with a licensed medical, mental health or addiction specialist who is able to conduct a substance use evaluation. This evaluation process can provide key information that can help you make a determination about the level of treatment you should consider.
At the end of the evaluation, you will also be given the professional recommendation of the professional, who also can usually review local options for treatment centers and facilities.
Often, getting more than one recommendation is helpful, and equips you to do your own investigation to find the option that is best for you. The first step is to get a list of treatment options (either from a provider or from your own research). Once you have a list, the next step would be to call each of the facilities to get more information that can help you determine which is right for you.
Some of the important information that may be needed to help you determine which treatment is right for you includes:
- The cost of treatment: this includes whether or not the treatment will be covered by your insurance, understanding your insurance plan and out of pocket costs, and determining self-pay rates if not using insurance. If finances are a barrier to treatment, you should also inquire about whether there are discounts, sliding scale options, or payment plans available (even if these are not openly advertised by the facility).
- The time commitment: this includes understanding how often you will need to attend treatment (if outpatient), what days and times treatment is offered, and the estimated length of treatment. Some programs have flexible lengths while others will have structured treatments that last a certain amount of time like 30 days, 90 days, or even longer in some cases.
- The type of treatment offered: this includes whether the facility offers group therapy, individual therapy, family therapy, or a combination of these. This also includes whether other services are provided as a part of treatment, like case management, or medication. This also involves asking about the type of therapy used by the rehab facility and any therapeutic activities that are offered.
- The requirements of treatment: each facility will have different rules, expectations and requirements, and it is helpful to know what these are up front. Requirements can include things like mandatory drug testing and requiring clean screens as a condition of treatment, or requiring participating in groups. Programs that offer medication assisted treatment like suboxone often require clients to participate in therapy, and methadone clinics often require daily trips to the clinic. Inpatient programs often have many rules like restricted visitation or not allowing clients to bring certain items, smoke, or take any controlled medication (even if it is prescribed).
- What to expect in treatment: it is important to have an understanding of what treatment will be like, and sometimes the best way to get a feel for this is to visit the facility, meet the treatment provider, or even sit in on a group session. Many inpatient and outpatient rehabs will be able to accommodate requests for a free consultation or tour, and this can provide invaluable information about whether the program is a good fit for you.
Usually, people who are curious enough to search online about whether they need rehab understand that they are struggling with a drug, alcohol, or behavioral addiction.
While some people with addictions are able to stop on their own, many need treatment to help them begin or maintain their recovery. If you are still unsure about if you need rehab or what type of rehab is right for you, consider reaching out to a professional for help.
- Mee-Lee, D., Shulman, G. D., Fishman, M. J., Gastfried, D. R., & Miller, M. M. The ASAM criteria: Treatment Criteria for Addictive, Substance-Related, and Co-occurring Conditions. #rd ed. Carson City, NV: The Change Companies; 2013.
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