Going to Rehab
Joseph Goldberg, MD
If you can’t stop using alcohol or drugs, even when your use harms your health, job, or family, you may need to go to rehab.
That’s the common name for a drug rehabilitation center. It can be part of a hospital, or it can be a single facility, that offers intense care for addiction. Doctors, nurses, and therapists will try to help you stop using, recover, and get you on track to stay sober. You may stay in the center for a week, or longer than a month.
Steps to Recovery
While each program is unique, you can expect some things in common:
- Assessment. Doctors and therapists learn the details of your addiction and any related problems, like depression.
- Detox. Once you stop using drugs or drinking, you may go into withdrawal. During this time, you might feel distress, pain, or nausea as your body craves the chemical high it’s no longer getting. You may need prescription drugs to help your body manage the physical effects of withdrawal, plus food and fluids to avoid dehydration and to feel stronger.
- Stabilization. After detox, your doctors will make sure you have a long-term plan for your recovery, including medicines and mental-health therapy.
- Individual, group, or family therapy. Talking about your problem may help you better manage cravings for drugs or alcohol.
“Rehab shouldn’t be one-size-fits-all. Treatment should be tailored to the person and take into account his or her physical, emotional, and spiritual needs,” says David Sack, MD. He's the CEO of Elements Behavioral Health, a network of facilities that includes Promises Treatment Centers in Malibu and Los Angeles.
“The recovering addict needs help learning how to manage day-to-day life and its stresses, and to avoid triggers that may lead to relapse.”
Who Needs Rehab?
There are many warning signs that someone needs rehab, Sack says. They include:
- Higher tolerance -- needing more drugs or drinks to feel the effects
- Withdrawal symptoms when you try to quit
- You try to stop using but can't
- You keep drinking or using drugs although you may lose your job or marriage, or go to jail
People who have these symptoms often say they have “reached rock bottom,” says Michael Fiori, MD. He's the inpatient treatment unit chief at Butler Hospital, a mental health facility in Providence, RI. Many people try to avoid coming into the hospital and only come to rehab when “they are at a point where things have either completely fallen apart or they are about to."
Most will fight their problem for years, even for a lifetime, says Fiori. As many as 60% of people who kick their habit at some point use drugs or drink again, and some will return to rehab many times, he says. “One of the very common feelings patients have is shame. They lost control and had to come back.”
One goal of rehab is to find the triggers that make a person want to drink or take drugs, then teach them ways to fight urges, Fiori says.
Addiction is a physical disease, not a weakness, he says. “The biggest myth is that someone is choosing to behave badly. Nobody chooses to be an addict.”