Recovery from drug abuse and addiction is very individual.
Different programs and methods may work better for one person than they do for another. The same can be said about the length of time someone stays in a drug recovery program. There are many things that can influence the recovery timeline, from the abuse of multiple substances, to underlying mental health or medical conditions, to environmental aspects, to the level of dependency to the substance being abused.
Inpatient drug abuse treatment programs, or residential programs, are often considered the most comprehensive form of care for addiction in that the individual stays on site in a particular facility for a period of time. The National Institute on Drug Abuse (NIDA) publishes that a person should remain in a residential drug abuse treatment program for at least 90 days. In the past, 30 days was the standard length of time for addiction treatment programs; however, research has shown that those who remain in a program for at least 90 days have lower relapse rates than those who leave sooner.
There is a lot of evidence that indicates that the longer a person remains in an inpatient drug recovery program, the more likely they are to remain abstinent and have a more favorable long-term outcome. Relapse rates for drug addiction are high – NIDA estimates them to be between 40 and 60 percent – and prolonged abstinence can help to reduce episodes of relapse. For instance, Psychology Today reports on studies that show individuals who remain sober for five years have a much lower rate of relapse than those who are abstinent for less than year; about 85 percent who are abstinent for five years remain so, while only 30 percent of those who stay abstinent for less than a year avoid relapse.
- When a person abuses drugs, the chemical pathways in the brain that are related to how a person feels pleasure, and that help to regulate moods, are altered. Many of the chemical messengers’ production and reabsorption rates are disrupted. When this interference is perpetuated regularly through continued drug abuse, brain chemistry and even the wiring itself may be changed. Fortunately, studies published in Drug and Alcohol Dependence and Scientific American show that, over time, the brain may be able to at least partially heal itself from the damage done by certain mind-altering substances, like methamphetamine and alcohol. Long-term inpatient drug recovery programs give individuals the time necessary to recover and help them to learn new and effective ways for managing life without the influence of drugs.
- Admissions and Using Insurance for Substance Abuse Services
In 2014, more than 21 million Americans who were at least 12 years old, battled a substance use disorder, according to the National Survey on Drug Use and Health (NSDUH). Only about 10 percent of those needing treatment in 2013 actually received it at a specialized drug recovery facility, NSDUH reports. Not understanding, or seeing the need, for treatment and cost were some of the barriers to obtaining it.
Drug addiction costs American society over $190 billion annually in healthcare costs, legal and criminal justice expenses, and costs related to loss of production in the workplace, NIDA estimates. A drug recovery program can save money, both on the individual level and on a societal scale. The benefits of care are clear, but for many people, accessing necessary care comes down to price. Often, determining how to pay for a drug recovery program is the first step in working toward receiving treatment.
Many insurance policies cover substance abuse treatment, as the Affordable Care Act included it as one of the 10 “essential health benefits,” requiring it be covered in a manner equal to surgical or other medical issues. Different insurance policies will have variable rules or regulations in place on how to use the insurance to cover an inpatient drug recovery program, and it is best to check with the insurance company directly to better understand how the specific plan works. In many cases, the first step is to obtain a referral from a primary care physician for specialty services like addiction treatment. In other cases, individuals may be able to go directly to the facility and request admission if there is an opening.
Insurance policies may first require that an individual try an outpatient drug abuse program first, and find it lacking, before covering a residential program. They may set limits on the length of time a person can spend in a treatment program each year as well. For this reason, many families may decide to pay for treatment services themselves, called private pay. Substance abuse treatment facilities have trained professionals on hand to help individuals and families work out the best way to get the individual in need the care needed in a financially feasible manner.
- What to Expect during Treatment
An inpatient drug recovery program generally follows this timeline:
- Behavioral modification training through therapy, counseling, education, and life skills workshops
- Relapse prevention
- Aftercare services
After being admitted, an assessment of the client, both physically and emotionally, is conducted to determine if there are any potential co-occurring disorders that also need to be addressed during treatment. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that in 2014, close to 8 million American adults (18 and older) battled both a mental health disorder and a substance abuse disorder at the same time. When co-occurring disorders are present, a dual diagnosis is given, and an integrated treatment plan is considered the “gold standard” in care.
A drug screening test is also done during the evaluation in order to determine exactly what substances might be in the person’s system, so they can be successfully, and safely, removed through detox. The removal of drugs and toxins from the body is called detoxification, or detox for short. Detox is usually short, lasting around 5-7 days on average, and may use medications to manage drug cravings and withdrawal symptoms. Detox is the physical stabilization part of a drug recovery program. After the person reaches a safe physical level, the emotional and psychological sides of addiction can be better understood and managed.
The bulk of an inpatient drug recovery program is spent learning new and effective ways for handling stress, working through and controlling difficult emotions, and applying new life skills and healthy habits. A daily schedule is usually structured with set sleeping, waking, and eating times. Individuals attend group and individuals therapy and counseling sessions as well as educational programs and life skills training workshops throughout the day. Holistic approaches, such as a balanced diet, exercise regime, and complementary therapies like yoga, meditation, or massage therapy, may also be part of an individual’s recovery program.
Behavioral therapies teach individuals how to understand their emotions and the relationship that these feelings have with their actions. Coping mechanisms, relapse prevention, and the ability to recognize and circumvent potential triggers are all strategies taught in a drug recovery program. Longer treatment stays are correlated with better recovery outcomes.
Discharge and Moving Forward
Individuals are encouraged to join support groups or 12-Step programs while in treatment. These programs connect people with peers who can empathize and therefore support each other, thus working to prevent relapse and sustain abstinence. After completing an inpatient drug recovery program, individuals may move on to a transitional program before returning home. Sober living homes, or halfway houses, may serve as a kind of in-between step after a residential treatment program and before returning to regular life. Individuals in recovery may all live in a sober living home together, and they are required to maintain the household by performing chores and abiding by a few house rules. Individuals in sober living homes are required to remain drug-free and often to attend 12-Step meetings, counseling, and therapy sessions each day or a few times per week. A sober living home can provide a stable and substance-free environment for individuals after structured treatment. While there isn’t a set timeline for how long people stay in a sober living home, the norm is generally a few months to a year or two.
Aftercare services are important after discharge. Individuals may continue to attend therapy and counseling services weekly, or more often, for a period of time as needed.
Time is necessary to heal from an addiction. There is no set amount of time that works for every person, as recovery is a personal process. Trained professionals at a substance abuse treatment facility provide assessments and evaluations throughout treatment to ensure that individuals are moving between levels of care as needed and continue to receive what they need to recover. While there isn’t a way to tell someone the exact period of time that inpatient drug recovery will take, treatment professionals can give individuals an estimate at intake, and that timeline can be reassessed throughout the treatment process.