Addictions are far from contagious, so people who have an addiction don’t run the risk of giving their condition to the people they love through their tears, saliva or breath. Addictions do tend to thrive in the presence of other addictions, however, as people who have addictions to a variety of substances can use the same thought patterns and behaviors to justify their substance use and abuse. Families might know this all too well, and consequently, families might fight tooth and nail to keep the people they love far, far away from others who have addiction issues. It might be surprising to learn then that addictions are sometimes best treated in residential programs in which the addicted person lives, eats and shares with other people who have addiction issues. In a residential program like this, far away from those who don’t have addictions, true understanding can form and people can heal.
The National Institute on Drug Abuse reports that only 11.2 percent of people who needed care for an addiction in 2009 got that care at a specialized facility. This statistic might seem to suggest that treatment programs for drug addiction are relatively rare and that the programs that do exist tend to be quite similar to one another. In reality, there are a variety of different ways to treat an addiction, and each facility that provides care might use a slightly different approach in order to help the clients who need help. Residential programs, in particular, can vary widely, offering people a great deal of options when it comes to handling their addictions.
Some residential programs are similar to outpatient programs, in that people who enroll are provided with:
Residential programs can provide an advanced degree of monitoring, as the person lives on the grounds and doesn’t go home at any point, but the care provided is very similar between these two programs. These residential programs might also provide additional therapies that outpatient programs do not offer, including alternative medicine or art therapy, and the grounds themselves might be considered part of the care package. Where outpatient programs might provide care in standard medical offices, residential programs might give clients access to beautiful landscaping and breathtaking vistas, and that might help them gain the strength to heal. Residential programs might allow people to develop new hobbies, including golf, gardening or cooking. While these activities might help people to heal from the damage an addiction can cause, they can also help people to fill up their time and avoid drug use when the program is over.Not all residential programs are like this, however. Some residential programs are more like apartments in which all of the residents are committed to remaining sober, even though there is no medical staff available to help people to maintain that sobriety. These types of programs are sometimes called “therapeutic living communities” or “sober living communities,” and they shouldn’t be confused with residential rehab programs. Where a rehab program offers people therapy, sober living communities do not. As a result, a sober living community isn’t usually considered a good option for people who are very new to sobriety. They need a little more work before they can succeed in a residential program like this. People can transition from residential drug rehab programs to sober living communities, but they really can’t skip the rehab step and expect recovery to follow.
While all drug rehab programs should tailor the care provided to meet the needs of clients, residential drug rehab programs can provide an intense level of specialization that might not be available via other types of rehab care. For example, some residential programs provide care just for women, and all the people who both use and work in programs like this are female. A study of these kinds of programs in the Journal of Health Care for the Poor and Underserved found that women who enrolled in these kinds of programs tended to have more severe addiction- and life-related problems than women who enrolled in mixed-gender rehab programs, but the women in the women-only program tended to fare better than the women in the mixed program. Studies like this seem to suggest that specialized programs made for just one segment of the population can be helpful, and those who choose to obtain care in a program like this might be able to achieve a recovery that might elude them in another forum.
Residential programs also allow people to speak the language of recovery 24/7 in a supportive and understanding environment. They are consistently surrounded by therapists, counselors and peers who are also thinking about recovery, and they can practice the skills they’re learning in therapy with everyone they meet.
Where people in outpatient programs might be plunged into these sorts of communities on a hit-or-miss basis, depending on whether or not they have therapy scheduled for that day, people in inpatient residential drug rehab programs are living and breathing their lessons day in and day out, and this kind of immersion could help them to reset the way they think and the way they behave in a way they might not be able to replicate in an outpatient program.
In general, people who have severe cases of addiction that haven’t responded to other modes of care are often considered ideal for residential drug rehab programs. People who are new to substance abuse might just need a few counseling sessions to help straighten them out, but those with entrenched patterns might need more intensive help that can only come in a residential program.
For example, in a study of inpatient versus outpatient utilization, the Center for Behavioral Health Statistics and Quality found that 85 percent of people who were sober in the 30 days prior to an addiction admissions appointment were placed in outpatient programs. These people had maintained at least a small amount of sobriety, so it’s likely they can improve with mild amounts of care. People who can’t even get through detox, on the other hand, need more intensive help in order to avoid a relapse, and they might not be able to get this kind of care in an outpatient program.
Succeeding in an outpatient program also means relying on friends and family members to help stay sober and ensure that the person has a safe and clean place in which to recover. As the process moves forward, the person in treatment might not feel sociable or friendly, and it’s not uncommon for old emotions to break free and cause crying jags, temper tantrums or worse. People with strong family ties can handle these sorts of issues, and the understanding and gentle care the person might receive could help him/her to weather these storms. Those with loose family ties, or even worse, family ties that have been frayed by anger, disappointment or pain could find it difficult to heal at home. They might need to step away from the family for at least a short time, and a residential drug rehab program might let them do just that.The type of addiction the person faces might also dictate where that person should receive care. People who are addicted to marijuana, for example, might feel sad and low while they go through rehab, but they might not have physical signs of pain and discomfort that are common to those who attempt to stop abusing heroin, prescription painkillers or benzodiazepines. These people might need substitution medications in order to recover from addiction, and their dosing schedules might necessitate at least a short stay in a residential program. Those who have serious medical complications due to their addictions might also need residential care, as they might need medical monitoring in order to heal.
Residential drug rehab programs are more expensive than outpatient programs, mainly because the cost of care includes room and board. The therapies provided might also be more extensive, and this can add to the cost. Smart shoppers well versed in checking Consumer Reports before making any purchase might demand to see studies that pit residential programs against outpatient programs, just so they can ensure that the added cost will translate into real benefits the person can experience. It’s a noble idea, but unfortunately, it’s a difficult request to honor. As an article in the Journal of Psychoactive Drugs puts it, the treatment influences the person, but the person also influences the treatment. The only way to really test how well one form of therapy works versus another form would be to build a time machine, provide the person with one type of care, and then go back in time and use another measure instead. Comparing these two treatments would provide real results, but all other experiments aren’t really comparing the care between the same two people, and the results are bound to be suspect.
There are some measures that can be used, however, to measure how well a treatment works in the field of addiction, and these measures include:
How long the person stays enrolled in the program
How much the substance abuse abates while the program is in progress
How much time passes until the person uses again, when the program is complete
How much the person claims to learn during the program
Some of these measures are under the sway of outside influences. For example, a study in the journal Substance Use and Misusesuggests that 63 percent of the variance in completion rates in an inpatient program can be attributed to employment and outside social support. But, using these markers can help families to find programs that have a history of success.
It’s vital not to place too much importance on long-term abstinence as proof of the efficacy of an inpatient program. Addictions are chronic conditions, much like diabetes and heart disease, and as a result, people who have addictions sometimes slip back into behaviors they thought they had overcome for good. As they reintegrate back into their old lives, they begin to take risks, testing the boundaries of their sobriety and the limits of their skills, and a relapse to drug use is common in this environment. As long as that experimentation is spotted and treated early, however, it might not result in a full-blown return to drug use. A few touchup sessions on an outpatient basis might be all that’s needed to get the person back on track. Those who do relapse to full-blown addiction might need to reenter their inpatient programs, however, so they can learn how to avoid such a relapse in the future.
Finding the Right Program
Interventionists and family mediators can help family members find treatment programs that might be appropriate for the person who needs care. Some interventionists, in fact, tour addiction facilities on a regular basis and they have an in-depth understanding of what each program offers and whom the programs are designed to serve. Leaning on the expertise of an interventionist can help families to make decisions that are both reasonable and knowledgeable. However, it’s also important to allow the person who needs care to voice an opinion about the treatment facility chosen. This person will need to live in the facility, after all, and this person will need to be committed to the care provided in order to really absorb all the lessons provided during therapy. Sometimes, it’s best to allow the person to choose between several treatment programs at the end of the intervention. This allows the person to feel some semblance of control, and it might allow the person to begin to take ownership over the journey to sobriety.
If you’d like help in holding an intervention, or you need help with finding the right kind of residential drug rehab program to help the person you love, please contact us. Our family mediators have experience in helping families just like yours, and we’re happy to match you with the professional who might be able to meet your needs. Please call us to get started.