Does Drug Rehab Work?

Yes. The question of whether or not drug rehab “works” is a complex one, but the fact is that it has changed and saved the lives of millions of people.

Statistics are hard to come by, because recovery is a multidimensional process and therefore difficult to pin down with a rating scale. For this reason, success rates are not yet measured uniformly across facilities and the inquiry “does drug rehab work?” is answered with subjectivity at best.

Part of the difficulty in creating a rating scale is that the goals of recovery vary widely from person to person and from facility to facility. On a basic level, the aims are usually to get the individual to acknowledge their addiction, to have them commit to recovery, and to reduce or eliminate their inducements to use. Contrary to popular belief, the goal is not to “cure” people of their addictions; chemical dependence is a chronic, long-term disease that requires lifelong treatment and management.

How Does Two Dreams Measure Success?

We believe in individualized, holistic drug addiction care here at Two Dreams, so we determine our success rates primarily using client self-reports and private satisfaction surveys. We also, of course, consider feedback given to us throughout the treatment process and adjust our processes accordingly. Our comprehensive approach increases the likelihood that clients commit to recovery long-term, as they leave with the skills and understanding needed to avoid future use and live a healthy lifestyle.

Clients are considered “successful,” AKA ready for discharge, when they complete our “Three Phases of Treatment.” The Three Phases come about naturally through the progression of recovery; they are constructs meant to frame the treatment process. Clients transition through the phases at their own pace and are not bound by any time-restrictions.

1. During the Coming In phase, we help clients to establish trusting relationships with peers and staff members. We emphasize to clients that they are supported in their recovery journey and we work with them to establish healthy rituals. There is a focus on building up self-confidence as a foundation for the upcoming therapeutic work. Clients are encouraged to share their addiction stories and embrace honesty as a key component of the recovery process.
2. During the Looking In phase, we help clients to expose negative core beliefs in order to form a healthier sense of self. Transparency and introspection are essential during this phase, and we encourage clients to honor and express their thoughts, feelings, and aspirations. We hope to reduce shame and guilt while working on the deeper issues fueling their addictions. Clients practice analyzing the motivations behind their actions and ultimately learn to acknowledge their addiction and commit to recovery.
3. During the Looking Out phase, we help clients to make a plan going forward. They are fully empowered and possess the tools needed to succeed in lifelong recovery. We review with them methods of controlling cravings, managing relationships, etc. They prepare for reintegration into their next living environment and practice their newly gained skills in our supportive environment.

We discharge clients with the expectation that, after participating in our program, they will have the tools necessary to achieve long-term recovery from substance abuse and co-occurring disorders. Treatment modalities and therapy received are designed to promote three particular long-term goals, or as well call them, “the Three P’s” or “the Three Outcomes”: mental peace, physical wellbeing, and personal productivity. In our eyes, clients are set up for success when they have attained the three outcomes.

1. We aspire to help our clients attain mental peace that will last even in the face of personal challenges. Addiction has a tendency to govern the feelings, thoughts, and behaviors of those it touches, but our program helps clients take back control. We teach mindfulness; we teach acceptance; we teach self-confidence and self-worth. Clients leave feeling positive about the future, but also knowing how to live for the present.
2. Physical wellbeing is critical to recovery from the disease of addiction as well. Clients are required to abstain from substance-use during treatment, which allows the body to start healing the harms caused by drugs and alcohol. Clients are thoroughly educated on nutrition, exercise, etc. in order to promote overall bodily health and functionality. Our hope is that clients leave the program with established, healthy routines that can be continued outside of the treatment facility. We are also focused on achieving individual physical goals set by our clients, such as weight gain, weight loss, muscle build-up, etc.
3. Our final tenet is personal productivity, or continued growth and achievement outside the facility. Every client has a different set of goals and skills, so we specialize our support to fit their needs. We recognize strengths, work through insecurities, and provide recommendations to encourage each client to realize his or her full potential. The aim is for each individual to leave treatment with goals and the self-esteem to see them through.

We virtually guarantee at least some form of improvement by working on so many potential problem areas with each client.

We strongly recommend that clients participate in our treatment program for at least 30 days in order to gain insight into their addiction and engage in adequate self-exploration. Clients who are unwilling to acknowledge their addiction and/or commit to recovery have less of a chance of success, since they either leave the program early or participate in it half-heartedly. Patients who stay in treatment for the clinician-recommended amount of time (which varies by individual) and patients who commit to recovery have a great chance at long-term success. We strive for progress, but don’t expect perfection; addiction cannot be cured but it can be curbed, and that is success.

How Do Other Facilities/Individuals Measure Success?

The following are different ways that one might measure success. Each section includes questions that could be used collect data needed to make the assessment. These questions can mostly be answered via the individual’s self-report or direct observation.

Individual Admits to Having an Addiction and Wants to Stop or Cut Down Use

Admitting to compulsive drug use is a huge part of recovery, since addiction is a disease of denial. Oftentimes individuals with substance use disorders are unable or unwilling to see that they are stuck in a problematic cycle of addiction; they continue to hurt themselves and others, rejecting the notion that the benefits of stopping outweigh the risks of continued use. The act of admittance can be a significant indicator of success for loved ones especially, since oftentimes family and friends find themselves hurt and rejected while trying to convince the individual that they have a disorder.

• Has the individual verbally admitted to a maladaptive pattern of substance abuse manifested by an increase in tolerance?
• Has the individual described an inability to stop or cut down use of mood-altering chemicals, despite a verbalized desire to do so and acknowledgement of the negative consequences of continued use?
• Upon discharge, did the individual have insight into their addiction, or did they leave thinking that they never needed to be admitted?

Individual is Able to Maintain Abstinence and Stay Free of All Drugs

Abstinence means eliminating dysfunction-causing substances and mentalities. It means no drugs or alcohol, of course, but it also means no negative thoughts, codependent behaviors, self-defeating communication techniques, etc. Abstinence is usually measured in lengths of time stayed sober, and people celebrate milestone goals as they achieve them. Lifelong sobriety is the big, overarching objective that people tend to associate with completing addiction treatment. While abstinence is a key point of success, we stress that relapse does not equate with failure. Relapse is a commonly occurring feature of the addiction cycle. Everyone make mistakes, and no method of treatment can take away that aspect of the human condition.

• How many weeks/months/years post-treatment have you totally abstained from substance use?
• How many weeks/months/years post-treatment have you defined yourself as a non-regular substance user?
• Have you experimented with any new drugs since leaving the facility?
• Has the individual acknowledged specific triggers and taken steps to avoid them when possible?
• Has the individual been involved in criminal activity since leaving treatment?
• Has the individual resolved any outstanding legal issues and refrained from accruing additional ones since leaving treatment?
• Is the individual regularly attending counseling to maintain sobriety and work through triggers and dangers responsibly as they arise?

Individual Has Established Supportive Social Networks and Solid Intimate Relationships

Peers, family, and other forms of social support can be invaluable in sustaining recovery. Oftentimes before treatment, individuals fall in with a “bad crowd” or lack supportive peers. Others have support system resources, but chose not to utilize them due to emotionality or feeling forced into accepting help. During treatment, the community milieu promotes healthy bonding and accountability between individuals of similar experiences. Those who take advantage of this novel environment often leave treatment with new tools needed to effectively develop and/or utilize support systems.

• Is the individual associating with a sober peer group post-treatment?
• Is the individual regularly attending 12-step meetings or other support groups to maintain accountability? Do they have a sponsor?
• Does the individual manage their feelings around concerned peers, or does feedback tend to lead to negative social interaction?
• Does the individual report having a support system and positive social connections?
• Is the individual involved in sober social clubs or activities?
• Does the individual report an improved family life?

Individual is Engaged in Career Development, Meaningful Recreation, Volunteer-work, etc.

In active addiction, substances take precedence over passions. Even necessities like food and sleep can fall by the wayside, so certainly personal interests are at risk of withering away. The treatment environment is a safe place for individuals to refocus their efforts and learn to enjoy life again. Successful individuals can continue to grow and achieve personal goals outside of the facility using the skills they cultivated while there.

• Does the individual recognize personal strengths? Are they utilizing them?
• Has the individual worked through their weaknesses and insecurities, or are they seeking regular counseling for continued self-esteem training?
• Does the individual report living a satisfying, personally productive life?
• Has the individual maintained employment since leaving treatment?

Individual is Maintaining Physical Health by Focusing on Improved Nutrition, Exercise, Sleep, etc.

Addiction is a physical disease as much as it is a mental and spiritual one. In order to address the physical impacts of addiction in the treatment environment, clients are expected to adhere to meal, exercise, and sleep schedules. A balanced diet provides the fuel needed for maximal recovery, health, and satiety, and exercise is a proven method of mood elevation and health optimization. Maintaining good sleep hygiene is also essential during recovery because sleepiness and fatigue lead to irritability, irrationality, and other negative states of mind that are not conducive to healing. Sleepiness can worsen cravings and increase susceptibility to use. Oftentimes individuals find that this holistic organization dramatically improves their wellbeing, and maintenance of their sobriety in the post-treatment environment is heavily influenced by their health routines. The hope is that, with education and practice, clients will continue to incorporate appropriate nutritional, fitness, and sleep hygiene values into their lives outside of the treatment facility. Follow-up reports with clients can determine whether or not they are continuing to maintain their physical health.

• Is the individual eating nutritious meals on a regular basis?
• Is the individual over- or underweight? Have they undergone major weight fluctuations since treatment?
• Is the individual exercising on a regular basis?
• Does the individual report maintaining a regular sleep schedule?
• Does the individual report feeling healthy?

Individual has Established Emotional Stability and an Appropriate Level of Self-Esteem

Substance use is often a reflexive response to an emotional stimulus. By learning to manage emotional triggers via coping skills, one can hopefully avoid cravings and/or relapse. Of course, it is difficult to achieve self-actualization and reverse years of poor emotional skills, so it is unjust to base drug rehab success on perfection in this area. Taking steps towards emotional stability and committing to working on the issues in the future is largely significant. Any attempt at improvement is better than not even trying, and it is important to remember, again, that nobody is perfect. Everyone will have emotionally trying days and act irrationally; that doesn’t mean they’ve “failed,” it just means they handled a particular situation less than appropriately.

• Does the individual practice self-soothing techniques?
• Do peers and loved ones report that the individual is emotionally stable, or do they report problematic behaviors?
• Can the individual express their emotions in words instead of through actions?
• Does the individual think before they act?
• Are symptoms of a mood disorder present? Are preexisting symptoms of mood disorders improving or holding steady since leaving treatment?

Individual has Established A Habit of Mindfulness and Other Healthy Rituals that Promote Sobriety

Rituals and structured activities keep clients accountable and goal-driven. Successful completion of planned rituals promotes confidence that individuals can use when forming their new, healthy identity. Addiction often goes hand-in-hand with an atmosphere of chaos, so many individuals struggling with substance abuse live in a mental fog without discipline or routine. Their focus is on the past or future instead of on the present. Their thoughts run on autopilot and their actions follow suit. The mind must be trained to move from its distracted state to one of peace and clarity in order for recovery to be optimally effective. It is best to practice mindfulness on a regular basis to ensure long-term outcomes and overall wellness.

• Does the individual put a pause between thoughts and actions, or do they act out irrationally?
• Does the individual often experience racing thoughts and/or a lack of focus?
• Does the individual take time to reflect on intentions?
• Does the individual relax on a regular basis? Do they have any routine practices, such as yoga or meditation?
• Can the individual identify and appropriately attend to their levels of hunger, anger, loneliness, and tiredness?
• Does the individual have insight into their addiction and recovery?
• Can the individual appropriately manage emotions and implement self-soothing strategies as needed?
• Is the individual accepting of the past and living for the present moment?