For some addicts, their home environment may have helped shape their addiction, so the thought of returning home after rehab might be difficult to even contemplate. A return home may even mean a return to addiction for some.
That’s where long-term rehabilitation programs come in; they are designed to help recovering addicts strengthen their sobriety before returning home. They learn about controlling their cravings and staying ahead of the disease, all while living with others who are going through the same process. It can be a powerful way to strengthen their resolve and allow meaningful change to take place.
According to the National Institute on Drug Abuse (NIDA), long-term rehab centers are typically not staffed by medical personnel. As opposed to an inpatient program which is usually run by a doctor and a therapist or a series of nurses, a long-term rehab facility is typically run by a small number of non-medical staff members and the residents who live there.
People living here are expected to follow a strict set of rules regarding their behavior, substance abuse, addiction services, and employment. The punishment for breaking these rules can include being forced to leave the facility. Most residents are highly motivated to follow these rules and they work hard to make sure that other residents follow them as well.
During the first month, residents are typically introduced to the facility and the other residents and the rules are carefully explained. This is when they may be asked to:
- Stay at the facility at all times, with the exception of going to work or to therapy.
- Go through periodic urine screenings.
- Perform several household chores.
- Participate in meetings.
- Check in with an in-house mentor several times a day.
The more time passes, the more freedom residents may be granted. Some facilities allow long-time residents to leave overnight and visit their families, for example, while others may allow long-time residents to perform fewer chores. This all depends on the facility, however.
As long as residents are living there, they are continually working on their addiction issues. They might meet with their counselors on a regular basis, medicate to keep cravings at bay, and attend support group meetings in the facility or in the community. The work they began in the inpatient facility continues in the long-term rehab facility.
Successes in the System
Living in these long-term rehab centers can be beneficial for recovering addicts who feel isolated because of their addiction. In these communities they are surrounded by other people who have the same issues they have, and they always have someone to talk to who will understand the feelings they’re struggling with.
Additionally, the structure provided by these facilities can be beneficial to many, as each moment of their day is accounted for and the is little time for them to indulge in temptation or give in to their cravings. Instead, they’re connecting with others and according to NIDA, these facilities can also help people learn to express their emotions appropriately.
They are living in a community of people just like them and they must learn to get along within that community and act in a manner that isn’t contrary to the needs of the group. Rewards are provided for good behavior and if their behavior is inappropriate, they are punished.
Addiction doesn’t spring from just one source, and these facilities help addicts find triggers for addiction and root them out. For example, some addicts haven’t completed their education, others can’t find meaningful work. Long-term facilities can help them overcome these challenges.
A study found that people living in long-term residential facilities tended to perform better in drug-use scores in follow-up surveys and researchers suggests that improvements in housing and job skills were partially behind those gains. Since they received complete care in their long-term facilities, they managed their disease better in the long term.
Limitations of the Model
Living in a long-term facility means leaving your family, friends, and work behind for an extended period of time, and some people have trouble managing this idea. These facilities aren’t hospital and people living there are doing so because they choose to. Some choose to leave the programs before completing them.
- Being away from families. A study found that many addicts who dropped out scored higher on scales of depression. It’s likely that their depression got worse while they were away from their families and chose to return to them instead of completing their treatment.
- Delay in getting treatment. Another study found that some people had experienced delays between when they expressed desire for treatment and when they entered a treatment program. In some states it’s difficult to find open spaces in long-term facilities for addiction and this can have serious consequences. The people in this study who endured delays didn’t benefit as much from a long-term program as those who did not experience any delays.
- Strict rules. As mentioned earlier, the rules can be quite restrictive, and some people have trouble following them. People who know they won’t be able to abide by a strict set of rules might be better off choosing another form of care.
A study found that a desire to get help and make the needed changes to get better were closely associated with success in long-term treatment. People have to really want to change in order to connect with their peers and benefit from these programs.
Some people, however, are forced to enter a long-term residential program because their addictions have led them to face criminal charges. They may not want to, but otherwise they face the prospect of jail. In order to inspire these people, therapists use a tool called motivational interviewing.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), people go through a series of predictable steps before making meaningful changes in their lives:
A therapist who is using motivational interviewing can determine where a person is on this scale and then work to push them to the next level. The idea is to get addicts to take the model seriously and benefit from it as much as possible. This may help some people see why a long-term facility is helpful.
According to SAMHSA, there are over 11,000 addiction treatment facilities in the U.S. Some provide short-term care, while others provide care for extended periods of time. No matter what your needs are, there’s a good chance help is within reach.