“Rehab should be the last tool you turn to for getting off substances.”
We provide ten (10) options individuals should consider before committing to a drug and alcohol residential treatment program. This goes directly against the popular understanding of the standard course of care promoted by the media and governmental agencies. While residential treatment is helpful to some, we argue that it should be employed when all other options have not helped meet the desired changes in problematic substance use the individual has committed to.
Is Rehab The Answer?
Well, Yes and No!
Attending residential rehabilitation for the treatment of drug and alcohol addiction is considered the singularly most powerful solution for addressing problematic substance use. This notion is supported by popular media and TV shows such as Celebrity Rehab, and Intervention. Governments also funnel substantial public resources towards residential treatment programs, further promoting the idea that all one needs is this one level of intervention for getting off drugs and alcohol as part of a recovery pathway.
For some, attending residential treatment is a life changing experience, one that helped launch an amazing journey of personal transformation. Nevertheless, it should be noted that these same individuals tend to demonstrate a persistent commitment to change, have higher than average motivation at intake, and a healthy support network (family and friends).
Finally, Research by Hubbard & Anderson (2003), indicates that those who show the most progress attend long term residential treatment (90 days or more) and are highly engaged in outpatient care following completion of treatment. Depending on the severity of use, this may or may not be something individuals are ready for.
While residential treatment is effective for some, we argue that it should be the last resource individuals getting off drugs and alcohol should access, not the first. Engaging too early may result in repeated admissions and therefore a general sense of failure. Residential treatment also requires a disruption in commitment to other areas in your life such as work and family. This level of care should be saved after several other approaches have been attempted.
Assess Your Readiness
Before we cover the various outpatient options designed to help you establish a substance free life, we should first discuss ‘readiness‘, a concept popularized by William R. Miller and Stephen Rollnick in, “Motivational Interviewing – Helping People Change.”
Readiness is the sense that you want to commit to making changes in your life. It requires a belief that the past has not gone as planned – You feel motived to create a new future. A lack of feeling ready also means that you understand how your choices impact you in a negative way. However, in this stage, you are unable at this time to commit to change. A lack of readiness is not a state of denial – You simply need more time to build evidence and commitment.
Take time to assess your own readiness for change. If you feel stuck, do a cost-benefit analysis of your current state, and another imagining what your life would be like free of substance dependence. The more you can acknowledge both the good and bad of staying the same, and the good and bad of changing, the greater the probably that you will spark readiness.
Establishing Options – The First Step
We believe that you should evaluate and attempt multiple approaches for treating problematic substance use prior to residential treatment. Following is a list ten (10) options you should consider. It is advised that you employ any or all approaches. In other words, use the gunshot approach!
**Please note that it is assumed you have approached your primary care provider about the changes you want to make. Any change in use of substances should be discussed and monitored by your family physician or Nurse Practitioner.
- Controlled Use: Map your current use pattern, and make a commitment to the amount of change you are willing to make this week. After you have completed your controlled use commitment, evaluate how it felt. Then, move on to a new goal for the next week.
- Build a Support Network: Engage with individuals who support your readiness for change and are willing to hang in there through the ups and downs.
- AA/NA: The abstinence recovery community does one thing right, and it does it remarkably well – The ability to engaged with others with lived experience of getting off drugs and alcohol, and accountability. We strongly suggest you attend an AA or NA meeting near you.
- Weekend Retreat: Look for a weekend getaway focused on recovery. This is an amazing way to build on your support network and firm up your commitment to change. It can also build motivation.
- Hit the Library: Knowledge is power. Head on over to your public library and look for resources on addiction and recovery. We challenge you to consider all the approaches to care you read about in an effort to build a database of options you find interesting.
- See a Substance Use Counsellor: Get a referral from your family physician to see a counsellor that specializes in substance misuse. This provides the option to engage in both individual and group therapies specific to your individualized needs.
- Call an Addiction Helpline: There will be times when you question your motivation but know you need to stay committed to your transformation focused path. This is a good time to reach out to a helpline focused on substance dependence.
- Attend an Anxiety or Depression Support Group: For many, the root of their problematic substance use is anxiety and/or depression. Using substances is an effective (but dangerous) way of decreasing anxiety and elevating mood. Attending a support group will help build insight into this ubiquitous connection.
- Commit to a Physical Fitness Program: You need a way to burn off intrusive thoughts and ruminations. The best approach is to engage in some form of physical activity at a sustainable level. This could be walking, running, etc.
- Engage Your Zen: Spend time disengaging your thoughts and engaging your senses. Committing to a medication and mindfulness practice has been shown to effectively manage anxiety and enrich your recovery journey.
Assessing The Outcome
Evaluating the outcome is the most important step in your approach to treating substance misuse. We recommend that you keep a journal and/or log of the important benchmarks in your recovery process. If a particular approach did not work, don’t be harsh on yourself. Simply ask what did or did not work. Rate the effectiveness of the approach. Then, either try the approach again with adjustments, or move on to another.
Commitment and Sustainability
Taking the first step towards a substance free life requires monumental commitment. We know that you have all it takes to get you there. We also acknowledge that commitment is much easier when you make incremental changes that feel sustainable. In other words, you may initially choose to decrease your use rather than eliminate it altogether. This reduces the harms associated with substance misuse, an approach that we fully support as part of your transformational journey.
