Rethinking In-Patient Addiction Rehab Programs: Why they are not always the best choice


A staggering statistic: about 120,000 people die of addiction every year—in just the United States. That means that 350 people lose the battle against addiction and their lives EACH DAY.

An addiction can strike people when they least expect it: as they’re trying to handle an increase in their workload, childcare or child-rearing, mental health issues, family issues, or for no reason whatsoever. It often begins innocently—trying to relieve the stress of everyday life, or just to try something new. Before the person knows it, they’re turning to the drug or alcohol as a way of coping with any negative feelings or stress in their lives. They may find they need more and more of the drug or drink to gain the same benefits from it. Efforts to scale back or to stop altogether are difficult or next-to-impossible.

Drug addiction and alcohol addiction is usually not easily overcome on one’s own. Most people who face an addiction to a substance or alcohol need additional help—which makes treatment so important.

Unfortunately, treatment methods are not foolproof, and the ones that show the most effectiveness are cost- or situationally-prohibitive for many people suffering from addiction. And the success rates of treatment are difficult to know exactly; for one reason, centers often only quote the number of patients who complete the program (which seems to be around 30%). However, it’s also believed that only 30% of patients stay clean for a year. Some treatment centers consider themselves effective if their patients don’t die.

Many people seek treatment from in-patient addiction rehab centers, which shows the desire to break the addiction. However, there is no standard for treatment among these facilities. Some specialize in past-life therapy, while others are programs that claim “tough-love” by making patients scrub floors with toothbrushes or do other painstaking but menial tasks. Sometimes, these centers are run by “specialists”—not doctors or psychologists or other licensed practitioners, but former addicts who have gotten “clean.”

So what can a person struggling with addiction, or a loved one of that person, do? First, it is important to note that not all treatments work for all people. There is no single right way to treat a drug or alcohol addiction. And while popular groups like Alcoholics Anonymous preach that abstinence is the only way you can kick an addiction, drugs and alcohol become addictive when the brain loses its volition and becomes rewired to need the substance. What may have started as a choice is no longer a choice, and stopping an addiction goes well beyond “choosing” to stop or “wanting” to stop—and doing so “cold turkey” can cause additional physical and psychological harm, and often results in relapse.

Therefore, it is also important to understand that morality-based types of therapy, which have been the traditional modes of addiction therapy, often fail because patients are not simply morally weak or bad. Many in-patient facilities require participation in a 12-step program, and for some patients, this entails piling on guilt and depression that might have led to the “self-medication” through substance abuse in the first place.

There is no one-stop approach to successful addiction recovery, and no one-size-fits-all program. And twelve steps, while popular and sometimes effective, have not solved the addiction problem in our country—not with 350 people dying of addiction each day.

Beating addiction requires a nuanced and multi-layered approach. The National Institute for Drug Abuse outlines key principles for an effective treatment program:

• Addiction is complex, but it is a treatable disease. It is important to treat addiction as a disease because it affects brain function and behavior.

• Quick access to treatment is essential. People need to recognize the signs of addiction, but also, effective treatment needs to be understood on a broad scale and needs to be made widely available, not available to the few and privileged.

• To be truly effective, treatment needs to address all of the needs of patients, beyond the drug abuse. Many patients begin drug use because of psychological trauma or depression, bi-polar disorder, or other disorders.

• It is critical that patients remain in treatment long enough to overcome their addiction.

• Counseling and other behavioral therapies are essential to the recovery process.

• Medications are often an important part of addiction treatment. Many people shy away from the idea of treating chemical dependence with another chemical, but for many patients, this could be the only way to truly break through the hardwiring for dependence in the brain caused by the first substance.

• Detox (medically-assisted) is only the first part of treatment.

• Any drug use during treatment must be monitored continuously.

• Patients should be tested by the program for HIV/AIDS, hepatitis B and C, TB, as well as other infectious diseases. The programs should also provide support for patients diagnosed with these diseases and teach them about the methods they can use to reduce the risk of contracting these diseases.

• The patients’ needs will change throughout treatment; therefore, the treatment plans should be regularly reviewed and modified to meet these changing needs.

• Beyond detox, behavioral counseling, medication, and treatment for co-occurring mental health issues, programs should include long-term follow-up with their patients to prevent relapse.

There are alternatives to in-patient programs that may not follow the standards outlined by the National Institute for Drug Abuse or even successful ones that may not offer the same access to all patients. Intensive outpatient treatment can provide a more accessible type of help required for beating addiction. Outpatient programs can allow for continuity of life while still undergoing treatment, learning to cope with every day stresses in real-world scenarios. This is perhaps the greatest advantage to such programs.

It is important that addiction be treated like the disease that it is, and the first inroad to make toward successful treatment is to understand how this disease works. Addiction affects people not only in densely-populated urban areas; it hits homes in La Jolla, our neighbors, our family. Addicts are sons and daughters; they can be siblings, spouses, co-workers. Addiction does not happen because people are “bad,” nor can it be treated with a flip of a switch or with “punishment.”

If you or someone you know is abusing, please, don’t wait. Get help immediately. The next pill you take could be the last thing you ever do. If you are in La Jolla or the surrounding areas and want more information on addiction or treatment, visit us at, or contact our office at 858-454-4357 (HELP).