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Can you leave drug rehab? Helping reluctant patients make a smart choice

can you leave drug rehab

No one likes the idea of being held against his or her will, so when it comes to considering addiction and alcoholism treatment, it’s only natural to wonder: Can you leave drug rehab?

It’s a straightforward question that deserves full disclosure: If you’re at a treatment facility of your own free will, absolutely. (If you’re court-ordered to get treatment, you can still leave — very few facilities, outside of those directly associated with and connected to jails and prisons, are lockdown facilities — but treatment staff may be obligated to notify the authorities that you’ve left.)

But if you’re wondering whether you can leave drug rehab before you even get there, you may want to reassess the willingness you have to get help in the first place. Because while we’ll answer honestly if you ask, “Can you leave drug rehab?,” we’ll also tell you that just because you can doesn’t mean you should.

Why do people leave rehab?

For loved ones and family members who work hard to get an addict or an alcoholic into treatment, the idea that they can just up and walk out is often astounding. Although they’re asking, “Can you leave drug rehab?,” what they’re really wanting to know is, “You’ll keep this person here until they get better, right?” Unfortunately, that’s not the way drug and alcohol treatment — effective treatment, anyway — works.

One of the most crucial components of the recovery process, and the one thing that no amount of therapy, counseling or peer support can give to those who go to treatment for help, is the willingness to persevere. Getting clean and sober isn’t easy, although a reputable facility can make it easier with a Medical Detox unit that helps patients through the withdrawal of the first few days, as well as a robust program that’s attractive enough that they get a glimmer of hope from the very beginning.

Still, there are a number of reasons by some addicts and alcoholics will leave rehab, says Dr. David Sack, writing for the website PsychCentral:

  • Fear of detox is a big factor. Those who have gone through withdrawal at home, or in a jail cell, know full well how absolutely miserable it can be, Sack writes: “Withdrawal symptoms, drug cravings and an unfamiliar environment can fill the addict with anxiety at the same time they are deprived of their primary coping mechanism: drugs. Some addicts rationalize that they felt better when using drugs and give up on rehab before treatment really begins.” That’s why many facilities begin every patient’s journey with a detox regimen that slowly, safely and comfortably helps them wean off of alcohol and drugs.
  • A mistaken sense of uniqueness often leads addicts and alcoholics to set themselves apart from other patients, according to Sack: “It is the nature of the disease for addicts to think they are different, smarter or stronger than other addicts. This belief allows them to put up emotional walls between themselves and others and to avoid doing the soul-searching work of recovery.” Quality treatment centers have different programs to meet the individual needs of the patient population, which is why young adult men, for example, are separated from female patients, who are separated from those who have been through treatment several times in the past. By grouping like-minded individuals together, it helps to tear down the walls of “differences” that the addicted mind wants to put up.
  • False confidence is often a problem that presents in patients who stay at a treatment center for a couple of weeks and naively feel they’re ready to do it on their own: “After maintaining their sobriety for a while, they feel healthier than ever and are assured of their ability to stay clean,” Sack writes. “It is at this point that some believe they are ‘cured’ of addiction and anxiously wish to return to their families and careers.”
  • “I don’t like it here.” Change is difficult, and part of the recovery process is helping addicts and alcoholics take responsibility for their actions and decisions. Some individuals aren’t ready to do that, and so they turn their unwillingness outward, according to Sack: “Rather than accepting responsibility for their own recovery, they may place the blame elsewhere — often on the food, accommodations, rules, treatment schedule, staff or other patients.”

Can you leave drug rehab: So what can be done?

can you leave drug rehabIf willingness is the key to keeping patients invested in a process that can change their lives, how can it be nurtured? More importantly, if they’re asking, “can you leave drug rehab?,” how can it be nurtured quickly, so that they don’t decide to leave a facility that doesn’t hold them against their will? That’s where an effective staff can make all the difference.

In some of the best drug and alcohol treatment facilities in the country, staff members who interact with patients and mentor them on a daily basis are former addicts and alcoholics themselves. They’ve often gone through the same program and made the same choices, and they can communicate effectively to those who come into treatment resistant to change that while they’re feeling hopeless and powerless, one of the first steps toward taking back their lives is deciding to engage, even if they don’t want to. Even if they’re convinced it won’t work. Even if they have the freedom to pack their things and call a cab or take off down the highway on foot.

Those same staff members often do everything they can to prevent a patient from leaving against medical advice (A.M.A.). In treatment parlance, it’s known as “A.M.A. blocking,” and it’s a process that often begins as soon as staff members become aware of a patient’s restlessness. Short of physically restraining a patient, those staff members go to great lengths to encourage them to stay, by pointing out the legal and personal consequences of not completing treatment, by helping them reframe their negative thought patterns into positive ones, by encouraging them not to act impulsively and to give their decision to leave until the next day before acting on it.

In some cases, they may bring family members into the effort to keep an addict or an alcoholic in treatment. Sometimes, loved ones can have a bigger impact on a patient’s decision to stay than staff members can, and if that happens, it’s important to strike an encouraging tone, according to writers with the online mental health community

  • “Provide comfort: Let them know they are loved and provide reassurance.
  • “Offer support: Tell them you will be there during and after rehab. Compliment them on their courage and strength for sticking with rehab.
  • “Be positive: Remind them you know who they were before addiction and that you cannot wait to get that person back.
  • “Set realistic goals: If your loved one wants to leave rehab, setting a goal for one more day could be essential to their completion of treatment.
  • “Encourage sharing: Express interest in what your loved one is learning and doing in rehab.
  • “Look to the future: Help them focus on a future in which they are sober and healthy and remind them of what they want to achieve after completing rehab.”

Addiction and alcoholism are family illnesses, and treating the family is an important part of the healing process. Quality drug and alcohol treatment facilities offer family therapy for loved ones, but staff members also recognize that when it comes to determining what’s best for the patient, it’s often an “all hands on deck” situation that can require the input of those who aren’t in treatment.

Because in the end, “can you leave drug rehab?” is often code for, “I’m not ready to do this yet.” Addiction treatment counselors and therapists help them to see that they are ready, even if they don’t realize it. As Sack points out, “In many ways, drug rehab is an exercise in faith. We ask addicts to draw on coping, interpersonal and distress tolerance skills they haven’t yet developed, based on the assurance of others that recovery is possible.”

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