One argument says that luxury treatment centers must certianly offer some advantages, simply due to the fact that you are dealing with more money, so that can offer a lot of solutions.  While money might not be able to fix anything and everything, here are some things that it can buy:

1) Longer stays at treatment

2) More one-on-one time with therapists or counselors

3) More specialized and individualized treatment

4) Wider treatment options, can accompany different modalities/philosophies

5) Better, and more comprehensive medical care at treatment centers

The question then, is this: do we really need a luxury treatment center in order to have these things?  Can we not incorporate these ideas into “traditional” treatment centers, without having costs spiral out of control?

What can we learn from luxury treatment centers?

1) Addiction is complicated. It is a complete mess, and turns your life into a complete mess.  We don’t become addicted overnight.  Addiction is complicated.  Therefore, recovery is necessarily complicated as well.

2) You need a replacement strategy. I was passionate about using drugs and alcohol, so I need to find passion in my life in recovery to replace that with.  Anything less will cause me to relapse.  Why be bored with life, when you could potentially return to the ups and downs of active addiction?  We need to find passion in recovery.

3) Those who find long term success in recovery actively create a new life for themselves.  This is more than just working steps and abstaining from chemicals and growing spiritually.  It is purposeful living with growth and momentum.

4) The treatment industry is broken, and needs something to supercharge it.  Everything we know about treating addiction is wrong.  There is nothing wrong with the 12 step model, but the way we implement it is clearly failing for the vast majority.  Young people in particular need something new and fresh in recovery.  We can do better.

Just my 2 cents of course.  Anyone have any thoughts on these ideas?  Let us know in the comments!

How does “The Path of Least Resistance,” by Robert Fritz, apply to recovery?

In a number of different ways. This book is pure magic for the recovering addict or alcoholic.

1) “You go through life taking the path of least resistance”

We can easily apply this principle to our drinking days or when we
were actively using drugs. Medicating ourselves with chemicals was
the quick fix; the instant gratification. For the addict mind, using
chemicals almost always represented the path of least resistance.
Fritz argues that if you try to make major life changes, chances are
good that you will eventually return to your original behavior — if
that behavior still represents the path of least resistance.

2) “The underlying structure of your life determines the path of least resistance”

This is huge. What this means is that if you quit using drugs and
alcohol, but the underlying structure of your life doesn’t change,
then you will return to your old ways.

3) “You can change the underlying structure of your life”

Recovery in action. When people refer to “doing the footwork” in
recovery, they are not talking about making superficial changes.
People who experience a genuine lasting recovery from addiction do so
through a complete change in personality; a true spiritual experience
that changes them from the inside out. Major changes, not superficial
ones. Fritz is arguing that you can indeed change the underlying
structure of your life. Recovering addicts and alcoholics who have
achieved long term sobriety have done exactly that.

When I finally got clean and sober, I did so by making truly major
changes to the underlying structure of my life. Here are some
examples of those structural changes:

1) Entered a long term treatment center and lived there for 20 months.

2) Started attending 12 step meetings every single day, sometimes 2 or
3 meetings per day.

3) Left all of my old drinking buddies, changed all of these unhealthy
associations permanently and completely

Those are major structural changes, especially living in long term
treatment–along with everything that doing so entails.

4) “You can learn to recognize these key structures”

We must increase our awareness and practice mindfulness. We can also
use our sponsor or our peers in recovery to help us see these
underlying structures.

5) “Attempting to use a psychological solution for a structural problem is not going to work”

This has huge implications for recovery. A psychologist might try to
solve your alcoholism through psychotherapy, and figuring out what
made you an alcoholic in the first place. Or, a therapist might try
some emotional therapy techniques with you, in an attempt to get you
to retrain how you react to situations. These are psychological
solutions.

But there is a mountain of evidence that points to addiction as being
a structural problem. This becomes especially true the longer someone
has been using drugs or alcohol. This is because their whole life
starts to revolve around the addiction. For example, an alcoholic
will tend to associate with other heavy drinkers, find friends and/or
a spouse who is codependent (and thus supports their drinking), and
generally set up their life so that it enables them to drink all the
time. Because addiction is a set of patterns, it really is a structural problem.
When the finally decide to quit drinking, all of these underlying structures that made
it easy to drink are still in place.

Structure and the Creative Process

Fritz says that it is easy to create with structure but difficult to
destroy or “take away.” So instead of asking “how can create a
structure in my life to get rid of my drinking problem,” the question
should really be phrased more along the lines of “how can I create an
underlying structure in my life that leads to spiritual growth?” The book
also talks about the difference between oscillating (moving towards a
goal and then sliding back) versus creating towards a resolution. The
idea is to find structures that lead to a resolution, instead of
finding ourselves trapped in oscillating structures that have us
making short progress followed by a few steps backwards (relapse).

The implications for recovery here are huge, and this is just chapter
1 out of 19 chapters!

You can also purchase this book right here if you’d like.

Keep in mind that sometimes the numbers are manipulated a bit, and a certain treatment method or a specific rehab might distort their numbers a bit. This occurs naturally as businesses want to look good and encourage more business, even if their particular method is not really all that successful at truly helping addicts and alcoholics.

How can success rates be manipulated for recovery?

One way is through the use of discounting those who relapse or fail through some line of reasoning. For example, a treatment center might do a follow up survey and ask all of the respondents if they were still clean and sober after, say, 6 months time. Many will say that they have relapsed, and the percentage of success will not look so great. So in order to improve that rate, the questionnaire might ask if they followed through explicitly with all of their aftercare recommendations (such as attending long term treatment, going to intensive outpatient groups, or attending 12 step meetings every day). If the person has not explicitly followed their aftercare treatment (a highly likely scenario), then the survey results discounts this “relapse” from their results because the person did not technically follow through with their treatment program.

Another way that relapse rates are misrepresented is with the whole drug-of-choice argument. Say a person is addicted to crack and they go to treatment and they manage to stay off the crack when they are released and might even attend an NA meeting or two. In follow up surveys, they correctly proclaim that they have in fact abstained from their drug of choice, while in the meantime, they have started drinking heavily in order to self-medicate over the lack of their “real” drug of choice. Under such a survey system, this type of person gets counted as a success story, when in fact, they are simply switching one drug for another and are likely no better off then when they started.

A third way that relapse rates are manipulated is due to the creative use of time frame. An example of this would be to show how your treatment center might have a really high success rate at getting addicts clean and sober for at least 30 days. This seems remarkable at first, until you realize that this particular treatment center is a 28 day inpatient program in a strictly controlled environment. Basing the success rate on 6 months or years clean time would be much more useful, but obviously not as compelling when it comes to marketing purposes.

Action items - what you can do:

1) Don’t pin your hopes on a number. Success in recovery is not magic, and there are not short cuts. It takes work and dedication to achieve long term sobriety.

2) Don’t limit yourself to a single treatment philosophy. There are different methods and programs for staying clean and sober, and the choice of which one you use is far less important than what any single person will tell you. Why? Because everyone thinks that the method they used to get sober is the only true way that works. Simply not true. Which program you choose is almost irrelevant. What matters is your conviction to stay sober and your level of willingness.

All 3 of these types of situations present a problem for recovering addicts.

Most treatment centers and drug rehabs take the approach that no client that is admitted to their care can use opiate painkillers while they are in treatment. This is just the approach that the majority of treatment centers have taken.

Most professionals have the attitude that it is important to try to manage chronic pain without addictive opiate medications, especially if the person is checking into a treatment center for any type of addiction (alcoholism, cocaine, whatever the case may be).

So here are some pointers about chronic pain that can help the recovering addict:

1. The pain is far less than people realize - this is because of the nature of opiate painkillers (such as Vicodin, Oxycontin, Morphine, etc.)–they do not really lessen the pain at all at the source….instead, they simply dull the brain into thinking that it doesn’t mind the pain so much–right at the level of the brain. They have found that patients given opiate medications can still accurately describe the level of their pain, even though their brain has been dulled into not caring about it so much. This is very different from how some other pain medications work, such as NSAIDS like Ibuprofen, which actually reduce the pain and inflammation right at the site of the pain itself.

2. Opiate addicts who have become dependent on painkillers are simply playing catch-up, trying to constantly medicate themselves from withdrawal symptoms. The withdrawal symptoms will eventually start to become indistinguishable from their original source of pain, so this is a long term game that they can never really win anyway. Kicking the opiates and finding an alternative is the best long term solution.

3. Alternative solutions will present themselves as people remain clean and sober, and coming to manage their pain effectively might be a learning process. If someone is taking a large dose of opiates several times a day to manage their pain, and they go to treatment and detox and get clean, it might take a month or two before they really learn how to get their pain down to a manageable level. Realize that this is very possible though! Their are alternatives to opiate medications, including both alternate medications and alternate therapies. Hypnosis, in particular, has proven to be especially helpful for some people in managing very serious chronic pain. But recovering addicts can learn what works for them and go far beyond the ideas here, using things like hot showers, massage, or even meditation to help them in alleviating their pain.

If you are addicted to opiates, understand that those types of drugs merely mask the pain, they do not lessen it, and many of the alternative therapies can actually lessen the amount of pain right at the source.

This is a common question for anyone that is thinking about going to treatment, and it’s also a big question for the family of a struggling addict or alcoholic. How can someone choose the right treatment center so that they can insure that they will stay clean and sober?

There are a few issues you will want to consider here:

What level of treatment does the addict or alcoholic need? Some people need a medically supervised detox, while others do not. This will depend a bit on what substance or substances are being used. For example, alcohol poses a serious threat when it comes to detox, so that will definitely need to be medically supervised. Opiate drugs such as heroin or Vicodin will generally need a medical detox as well. Keep in mind that not all treatment facilities have a full medical detox. Knowing what level of care you need will obviously be a key point in your research.

Is this any different from previous treatment centers? A surprising number of addicts and alcoholics go to treatment and then relapse shortly after leaving. What’s really shocking is that many of these people continue to go back to the same treatment center, clearly blaming themselves for failing to stay clean and sober. This is a tricky argument here, but I can assure you it is valid: if you keep failing with one treatment center, why not try somewhere else? Likewise, if you go to several different treatment centers for short term residential stays, why not try going to long term treatment instead? This is a concept that is thoroughly endorsed in AA as well: “insanity is trying the same thing over and over again and expecting different results.” This doesn’t mean you shouldn’t try going back to treatment again. But it does mean that you might want to try a different treatment center, or even a completely different approach (for example, short term versus long term treatment).

Will this treatment center save someone that doesn’t want help? The answer to that question is no, which means that no treatment can help this particular person in their journey (yet). Unfortunately, no one can beat an addict or alcoholic into submission, and no treatment center can convince an addict to want to stay clean. Sometimes the best you can do is offer to help someone and then get out of their way.

A corollary to this idea is this:

“When someone is truly ready to get clean and sober, it doesn’t matter what treatment center you take them to.”

In other words, the success rate of the recovering alcoholic or addict is heavily dependent on their personal convictions, not on the strength of their chosen treatment program.

This can easily be confirmed to be true by interviewing a handful of successful recovering addicts and alcoholics. Simply ask them about the treatment center or method by which they got clean, and ask them which was more important: “That they were truly done using drugs and alcohol, and desperately wanted to change,” OR “That they found the perfect treatment center that somehow worked a miracle in them.”

I can guarantee that it’s personal conviction and level of surrender.

Actually staying in a drug rehab costs a lot of money, simply because it is essentially a health care facility similar to hospital. If the rehab offers detoxification services (and most do) then these will be medically supervised by nurses and possibly even doctors which will only add to the higher cost.

But the high cost of treating addiction goes further than this. It’s expensive to treat because addiction is so complicated.

For example, many addicts and alcoholics have co-occurring disorders–a mental illness diagnosis of some sort along side of their chemical addiction. Helping this type of person to recover from addiction will usually involve treating their mental illness as well. This drives the cost of treatment up even further, as psychiatric counseling and any necessary medications are not going to come cheap.

Not only is it expensive, but the financial implications with treating addiction and alcoholism are getting worse in the following ways:

1) Treatment services are becoming more expensive - as the cost of health care in general continues to rise.

2) Insurance companies become less and less willing each year to pay the cost of treatment.

3) Insurance companies are only willing to fund shorter treatment stays, which are proving less effective, requiring more visits in the future and ultimately costing more.

4) State funding for treatment is gradually being reduced over time.

You have to give credit to AA and 12 step fellowships. While they may not have the medical facilities necessary to safely detox an alcoholic, many people have skipped going to formal treatment centers entirely and made their way to a successful sobriety through the use of AA alone. Given that it is essentially “free” (self supporting through their own contributions), a person could feasible stay clean and sober without ever spending a single dime on their recovery, simply through the use of meetings.

What makes this even more maddening is that the success rates are very close when comparing treatment centers to AA. When looking at the success and failures in recovery, it almost seems like the initial stay in rehab was inconsequential. Long term sobriety rates point to the fact that it really doesn’t matter how you got clean, it matters how you stay clean. Rehab is short term, but sobriety has to last for a lifetime.

First, if you happen to be an alcoholic, then you don’t need a list of reasons to quit.  Your whole life is dominated and basically ruined because of alcohol, and the decision no longer hinges on “why” you should quit…it only hinges on the struggle to do so.

But what about the so called “problem drinker,” someone who is not yet a full blown alcoholic, but certainly might be headed down that path?  Is there a strong chance that they will become alcoholic?  Should they quit altogether?  Will they give up too much by swearing off booze forever?  Let’s take a look.

Many of those asking this question will undoubtedly be younger people, and this represents a huge opportunity.  You have a chance to make an awesome, life-altering decision here: the decision to quit drinking.

Maybe you are predisposed to alcoholism.  Maybe you’re not.  It doesn’t matter.  What happens down the road is not important, because you can avoid all the “what ifs” by simply quitting alcohol altogether.  There are a number of benefits to doing so:

1) Health reasons - heavy drinkers suffer major health problems and live an average of 10 to 15 years less (give or take a few) than non-drinkers.

2) Avoid addiction - if you don’t put the substance into your body then you can’t fall into the trap of addiction.  Avoid this potential problem completely.

3) Social acceptance - which is more socially acceptable: the person that doesn’t drink at all, or the one who gets belligerently drunk at the family reunion?  There is very little problem with politely saying “no” to alcohol.

4) Long term costs - Alcohol has no nutritional value, yet a regular drinker might spend several hundred or even thousands of dollars each year on booze.  Don’t drink = money saved.

Realize that there are some benefits to drinking (social value, possible benefit to the heart in having a small amount of wine each day, etc.) but those benefits are fairly negligible when weighed against the potential hazards of continuing to drink.  Like I mentioned earlier, it is not that big of a deal to turn down a drink when you are offered, or to simply have water or soda instead.

If you choose to quit now, you can avoid a lifetime problems.

Relax: There’s no reason to be afraid

The thing about drug rehab facilities is that they are controlled environments, thus making them a relatively safe environment for recovering addicts. Not only do they take extra measures to keep drugs and alcohol off their grounds, they also do everything that they can to maintain a safe environment beyond the scope of substances. This means that most facilities do not tolerate violence or threatening behavior, and most have trained staff that know how to handle those types of situations.

Some people are nervous that they might be looked down upon or belittled by the staff at a treatment center…..this is extremely unlikely, as virtually all facilities employ a mix of recovering and non-recovering staff, so many of them have been in your shoes before. They know exactly what you’re going through and how scary it can be to get clean and sober, so they will only be kind and supportive–never demeaning.

Detox

Most drug rehabs have a detox area that is medically supervised. This is another big part of what makes treatment a safe place to be. Some withdrawal symptoms are potentially dangerous and can lead to seizures or even death, so being in a detox unit is really the best place you can be if you’re quitting drugs and alcohol. In most treatment centers, the only thing you have to do while you’re in detox is sleep, and the staff will do what they can to keep you as comfortable as possible. This will sometimes include certain medications, the majority of which will not be addictive or habit/forming pills. Under rare circumstances, a stronger medication might be needed if someone has become seriously unstable from withdrawal, but most patients will not experience this. Detox usually lasts about 3 to 5 days, depending on the drug or drugs that a person is coming off of.

Residential Treatment

Most drug rehabs have a residential unit that normally houses patients for short term stays. These might range anywhere from a few days to possibly 28 days. This is where the real recovery program takes place.

There are different philosophies at different rehabs, but a large percentage of all rehabs are 12-step based. This means that the foundation of their program is based on the 12 step programs of either Alcoholics Anonymous or Narcotics Anonymous. There are alternatives out there, but they are relatively scarce compared to 12 step treatment centers. Chances are good that if you are going to detox and short term treatment, it is probably 12 step based.

If you are put off or nervous about attending meetings, I would encourage you to “feel the fear and do it anyway.” Going to meetings gets easier after you go a few times and realize that the people there genuinely just want to help each other. I was terrified of meetings (and of treatment) but I eventually got desperate enough to give it a try anyway. I’m glad I did.

Residential treatment will also consist of therapy groups and maybe some informative lectures. Most rehabs will also connect you with a therapist or counselor that can work with you on a one-on-one basis. In other words, you don’t necessarily have to spill your guts or share your whole story with everyone. It is possible to connect with an individual and get a lot of relief by simple talking to them on a one-on-one basis.

Confidentiality

Some people are afraid to go to treatment because they think everyone will know and they will somehow be ostracized for their condition. This is almost never the case and drug rehabs are bound by law to protect your identity while you are there. It is unfortunate what has happened in the media when a celebrity checks into rehab and it gets plastered all over the news. Obviously, this doesn’t happen with regular people, so don’t let the negative exposure that has happened in the media deter you from getting clean and sober.

It takes guts

It takes guts to go to treatment. There are 2 major fears that you have to overcome: One is the fear of treatment and everything that it entails: is it like jail? Is it like a hospital ward? Will they strap me down? and so on. The other major fear is that of facing life without self-medicating. The fear of being clean and sober, period. The fear of facing life and actually feeling your emotions and not medicating them.

Treatment centers are set up to try to alleviate both of these fears. They do the best they can to welcome you and make you comfortable and teach you how to enjoy a sober life. There really is no reason to be afraid of checking in some where! Just gather up enough courage to give it a try, and you will be amazed at where recovery will take you, if you let it.

Good luck to everyone out there and God bless. Try recovery today…..what have you got to lose?

Before we can tackle this question, we need to first differentiate between drug abuse and drug dependency. Abuse is generally considered any time that someone is taking drugs in a manner other than what they were prescribed. For example, if someone is doubling or tripling the dose on their pain medication, that would be considered abuse.

Drug dependency can be built up from legal long term medical use, such as when someone becomes physically addicted to sleeping medication and cannot sleep without it. Dependency is characterized by a few factors, one of which is usually a noticeable and physical withdrawal when the person doesn’t get the drug. Examples of this would be shaking from alcohol withdrawal or agitation and crankiness during nicotine withdrawal.

Photo by lanuiop

Full blown drug or alcohol addiction is generally understood to include dependency along with a psychological craving for the substance. There is an element of anticipation and preoccupation with getting and using the drugs or alcohol. Therefore, addiction is more than just a physical dependency. Unfortunately, if you ask someone about possible drug use–even if you ask in a loving and caring manner–is likely to produce either anger or a defensive response.

Determining whether or not someone is addicted, and also what their level of dependency is can be a complicated question. In order to best answer it, we need to break it down by situation:

Situation #1:

Let’s say that you already know that someone is legally using drugs or alcohol (such as with legally prescribed medications). The question is really about their level of dependency, or whether they are really addicted at all. Here’s what you can do to learn more about their condition:

* Being Over-Medicated - Anyone who gets loopy or giddy off of, say, pain medication, is probably abusing the drug. This might not necessarily be drug addiction or dependency. Properly medicated pain should not have a person floating on a cloud. There should be at least some hint of underlying pain remaining.

* A Potential Missed Dose - Watch for someone’s reaction when and if they are going to run out of their medications, or if they have to go without alcohol in a certain situation. If there is a hint of panic, or if the person resents the situation, then those are warning signs that there is either dependency or addiction.

* Signs of Preoccupation - Anyone who is preoccupied with the idea of getting or using more drugs and alcohol is probably leaning towards addiction and dependence and less towards simple drug abuse.

Photo by extranoise

Situation #2:

You suspect that someone is using an illegal substance and is trying to keep their habit a secret. You question whether or not they are abusing drugs (perhaps experimenting), or if they possibly have physical dependence and/or a full blown addiction. In this case, you’ll want to look for all of the warning signs already listed above in order to determine their level of dependence, but also consider:

* Evasive Behavior and Isolation - People using illegal substances will probably want to avoid you or others who might confront them about it. This leads to isolation and distancing themselves. Sometimes an addict is torn with the burden of not wanting to hurt their loved ones, but not knowing how to break free from the addiction either. Their avoiding you could be a sign. Also, if they refuse to commit to an extended stay with you, that might be a sign as well (such as a family vacation or a camping trip or something similar).

* Abrupt change in friends or social behavior - This one is especially true for younger people.

Situation #3:

You have no hard evidence that someone is using whatsoever, but you are suspicious that something might be going on. In this case, watch for everything suggested up to this point, and also watch out for:

* Signs of physical dependence - These will vary according to different substances, of course, but symptoms might include: moodiness, forgetfulness, changes in sleep patterns, dilated pupils, and so on.

Photo by multi_everything

What to Avoid

Trying to approach someone that you think might be addicted is a delicate task. You might have a tendency to try to be as sneaky as you can in an effort to play detective and find out what is really going on. But try not to be manipulative and sneaky, as this will only drive someone further away from you and put more distance between the two of you.