What is Rehab? Rehab is short for residential rehabilitation; it is used to describe a drug and/or alcohol treatment program that is usually provided at a residential centre. Ie: you stay there, like a hotel but without the bar. Most programmes are abstinence based and you are expected not to use drugs or alcohol while there. Most programmes make exceptions for doctor prescribed medication, even ones that are potentially addictive. Some notable exceptions however are like the Narconon programme that do not believe in using any drugs. We would never recommend a centre that would suggest going against your physicians orders without an expert opinion from a specialist of at least the same or higher qualifications.
For example, if your doctor prescribed a course of anti-depressants and an addiction psychiatrist suggested they should be changed or discontinued, that might be an exception. Better though would be that your primary physician was included in the decision-making.
Rehab is generally for people that have a difficult time changing their drug or alcohol using habits in their normal setting and community and it is best to get away from your regular triggers and into a controlled environment for at least your primary treatment.
Many rehabs encourage a person to have a total break from their regular environment and circumstances where they can concentrate on getting clean of the drugs or alcohol with as few distractions as possible.
There are also out-patient rehabs where you go to the program during the day and return to your home for the evening.
The Stages of Rehab are as follows, remember each programme is different and will have their own definition of what constitutes the stages.
Stage 1 (Primary Treatment): The first stage of rehab is generally a short to mid-length program in a residential facility where you are expected to stay under supervision and be completely abstinent of illegal drugs and alcohol. This can be as short as two week or up to 12 weeks. This could include your initial detox, or following detox, depending on the facilities of the centre. Some rehabs will insist you have been abstinent of drugs or alcohol for a specific period of time prior to accepting you into the program.
Stage2(Secondary Treatment): Stage two rehab is generally a longer stay program where they will work on life skills, reintegration with society and possibly education for entering back into the work force. They may even teach trades or other useful skill towards employment into the future. Most will also still work on learning and enforcing the skills that are going to be required to maintain a drug or alcohol free lifestyle once returning to mainstream society.
Stage 3 Tertiary): As offered by some centres and treatment programs usually involves independent living, sometimes in supported housing with some form of support, monitoring and mentoring. You can also consider this aftercare or sober living.
What is Rehab – Different Approaches to Treatment
There are a number of different approaches to treating addiction, which generally fall into two categories.
1: Disease model of addiction. The disease model of addiction basically states that addiction is a disease, no different then diabetes or herpes and once you have it you have it for life. There is no cure, only lifelong treatment and recovery, the only way to treat addiction is life long abstinence and you have no control over your addiction.
2: Lifestyle model of addiction. The lifestyle model of addiction believes that you choose to drink or not to drink, or use drugs. Since choosing to use in the first place you can choose to stop with help and long term work. Most all programs are abstinence based, however some of the lifestyle rehab centres do not believe that addiction is a life long disease and that some people can go back to controlled drinking after a long period of abstinence.
Treatment Models fro Addiction
12-step The 12 steps of Alcoholic Anonymous or Narcotics Anonymous is probably the most used model in the world. It is also called the Minnesota Model. The 12 step approach is based on the disease model of addiction and the belief that you have no control over your addiction. Residents will work their way through the steps as they progress in their recovery. The model is continuously being modified and adapted by rehab centres around the world. Your time in a 12 step rehab will generally be 12 weeks or less and you will spend time in the step groups. People attending are also expected to continue in the NA/AA group meetings in their communities once returning home.
Cognitive Behavioural Therapy, CBT These programs use psychological treatments and counselling in which people learn to recognise and control their thoughts since it is believed that thoughts and actions can influence future behaviour. Generally CBT programs do not believe in addiction as a disease and more of a socially learned behaviour. Being that your drug or alcohol use is a behaviour and not a disease then the behaviour can be changed and your beliefs can change.
Christian / Faith Based Rehab Faith based rehabs are as the name states, they look at treatment through a moral and faith lens. Most of these programmes will involve a considerable amount of time studying religious texts and time in prayer.
Therapeutic Community, TC TC programs tend to be longer then others and can easily go 6 – 12 months and I have even seen some recommending 3 years or more. In TCs people live as a community, generally working in a commune style system. Some have hierarchical structure that residents work through gaining more and more responsibility and freedom as they achieve higher levels. The support is by the community itself. Some may use 12 steps, some may not, some may be faith based and others will not be. If you are looking at the possibility of a TC it is best you visit and understand their philosophy prior to committing, as no two are alike, just like no two communities of any kind are alike.
Eclectic These programs do not follow any one approach or philosophy and will use a range of different methods and approaches to try and fit the individual’s needs.
What is Rehab – The Very First Step
The very first step you will need to take is to do some research and get in contact with rehabilitation centres, the next is going to be your detox, so lets look at that!
So what is detox? Well in really simple terms, it is getting the drugs or alcohol out of your system, the best way to facilitate this is to stop using drugs. It is also generally used to mean getting you over the withdrawal symptoms once you have stopped. Basically once you have stopped putting more drugs or alcohol into your system, if your liver still works, your body will get the drugs or alcohol out all on it's own. Your liver sees it as poison and wants it out of you. Remember though some drug and even alcohol can be dangerous to quite abruptly and should always be done under the supervision and following the advice of a qualified medical doctor.
As stated above some rehabs have detox facilities or will assist in your detox on site, others will insist you have a certain period of abstinence prior to entering the program. If you can't do your own detox prior to going to a centre that says you have to be sober when you show up, then find a centre that doesn’t insist on that and will assist you with your detox. Depending on the severity of your symptoms many rehabs will do it onsite if it is just a matter of regulating your medication. If you are prone to severe withdrawal symptoms then you may need to do this in the hospital. It will totally depend on you, your history and symptoms.