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How Hard Is It to Stop an Addiction Without Rehab?

Addiction is a chronic relapsing disorder that is best addressed in formal treatment and with support from friends and family.
The formal definition of drug rehabilitation (rehab) is the use of medical or behavioral therapy to help an individual who has a substance abuse issue (a substance use disorder).
Many people think that going to rehab implies entering a residential treatment unit, but this is not the case. Residential treatment is one type of rehab.

Many Factors Affect Recovery

Because addiction is a very complex and pervasive condition, treatment involves many components that have different areas of focus. These areas include:

  • Drug use
  • Support system and attempts to strengthen it
  • Level of education
  • Physical health
  • Effects of substance use on various areas of life, such as relationships, career, and social functioning
  • Psychological or emotional health

Treatment vs. No Treatment

It is generally assumed that getting treatment for a substance use disorder is a far more effective approach than not getting treatment. Although there are no actual population figures or parameters to support this notion, there are numerous small-sample research studies that compare different types of treatment for substance use disorders to other types of treatment and to control conditions where no treatment is administered.

The studies consistently find that treatment for substance abuse is significantly more effective in reducing addictive behaviors and the problems associated with them than no treatment at all. However, this does not mean that people in treatment for any form of addiction have an easy time or do not experience setbacks.

Treatment for Addiction Is Not a Cure

One of the mistaken notions about going to rehab for addictive behavior is the notion that rehab will automatically fix the problem, sort of like getting a vaccination for the measles or some other type of disease. The misconception is that once you get treatment, everything is fine. Unfortunately, this notion is wildly unrealistic.Data provided by the National Institute on Drug Abuse (NIDA) indicates that relapse rates for people who are in treatment for substance use disorders are between 40 and 60 percent.
Relapse refers to an individual returning to a former behavior that was once diagnosed as a disorder.

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When the person returns to that behavior, they again meet the diagnostic criteria for the disorder.
This data indicates that a substantial portion of people who are in active treatment for substance abuse will have a relapse despite being in treatment.

Relapse Rates With Other Conditions

The relapse rates associated with treatment for substance use disorders are comparable to the relapse rates for other types of physical disorders that have a strong element of choice and volitional behavior associated with them. According to NIDA:

  • About 30 to 50 percent of people in treatment for type I diabetes relapse.
  • About 40 to 60 percent of people being treated for hypertension relapse
  • About 40 to 60 percent of people being treated for asthma relapse.

Recovery Is Tough

The realization that a substantial proportion, if not the majority, of individuals in treatment for substance use disorders, will experience at least one lapse or a full-blown relapse has led to the notion that relapses are part of recovery and when a person experiences a relapse, it should not be viewed as a treatment failure. Instead, it should be viewed as a chance to readjust the treatment program to help the person move forward.Because individuals who do not get formal treatment are not closely monitored in supervised and controlled conditions to determine their level of success, there are no similar figures for the percentage of people who attempt to recover on their own and then relapse. Most professional sources assume that the figure is significantly higher than those in treatment and near 100 percent.
Even when an individual is in treatment, recovery is a tough process. But recovery is even harder when someone is not in a formal treatment program.

What the Data Shows

The data demonstrate that the continued practice of abstinence is strongest for people who remain in treatment. The severity of their substance abuse is lowest while they are active in treatment.

The data indicates that people who are in treatment for longer periods have better long-term success than those in treatment for shorter periods. For instance,  going through a medical detox program and not continuing in ongoing treatment (a substance use disorder treatment program that occurs after the medical detox program is completed) is associated with nearly a 100 percent relapse rate.
Moreover, individuals who go into residential programs for less than 90 days demonstrate significantly lower rates of success in recovery than those who remain in these programs for 90 days or longer.

Do I Need to Stay in Treatment Forever?

Many people who belong to 12-step groups firmly believe that their continued participation in these groups is the driving factor of their success in recovery. They often believe that if they stop attending 12-step meetings, they will inevitably relapse. Their belief is based on observations of people who stop attending these groups and eventually do relapse.
Many people are able to taper off treatment gradually. It comes down to what works best for you.

Some people may wean off outpatient therapy. They may initially see their therapist on a weekly basis and then scale that back to monthly. Once they have a firm foothold in sobriety, they may scale that back even more.

Some people continue attending 12-step meetings for life, and that works well for them. Others don’t need that level of attendance.

It’s about creating an aftercare plan that works for you long term. If you feel you need more support during a particular time, you can increase participation in recovery-related activities.

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What’s the Minimum?

The frequently quoted timeframe to ensure that you have a significantly reduced risk of relapse is between five and seven years in treatment, but this is not written in stone. Many individuals achieve success with less lengthy involvement in the course of treatment, and others require even longer participation.
Those with moderate to severe substance use disorders should remain involved in treatment-related activities for at least one year before tapering their involvement.

People who maintain abstinence and participation in treatment-related activities (therapy and support groups) for a continuous five-year period have about the same risk of being diagnosed with a substance use disorder as someone who was never struggled with addiction before.

What Type of Treatment Is Best?

There is no single “best” treatment for a substance use disorder. Organizations like NIDA have listed the components associated with an effective treatment program.

  • Medicines (MAT) when appropriate.
  • Behavioral interventions like therapy
  • Treatment for co-occurring disorders
  • Involvement of family members and friends
  • Ensuring personal accountability
  • Tailored treatment
  • Treatment that lasts for a sufficient timeframe

Treatment Effectiveness

The goal of substance use disorder treatment is to help the person return to a productive level of functioning without the use of drugs or alcohol.
Numerous research studies track individuals in treatment over extended periods, and most people who remain in treatment stop using drugs or alcohol, improve their functioning in numerous areas and decrease involvement in illicit or criminal activities.
Actual individual success in treatment depends on numerous factors, including the nature and extent of the problem, the appropriateness of the treatment intervention to address that problem, and the quality of the interaction between the person in treatment and care providers.

Conclusion

The chances of successful recovery from any substance use disorder are significantly enhanced by involvement in formal treatment.
This does not mean that being in treatment makes the recovery process easy or that it guarantees recovery without relapse. However, choosing rehab to treat addiction is a far better choice than attempting to go it alone.