Watch out for Escaping Rehab Syndrome
Leaving Rehab Early – AMA (Against Medical Advice)
It can be days, weeks, months, years or even decades from the time you notice your loved ones substance abuse to the time they actually check into a drug or alcohol treatment center for help. The pain and agony loved ones go through during that period cannot be adequately described. Now that their drug use is behind you, it is important for you to understand what to expect when your loved one is in treatment. Although it is a big relief when your loved one is in treatment I would be remiss if I didn’t explain what often happens during the treatment process.
Now keep in mind rehab is not jail and anyone can walk out of rehab at any time they wish. This article is for the loved ones of people in treatment to potentially warn loved ones of the common methods and reasons addicts give their loved ones to get “permission to leave rehab”. When I say permission it is because in many cases the loved ones of a person in treatment have some leverage over the person in treatment. Sometimes leverage is emotional, legal, financial, living situation and the list goes on in many cases.
People leave treatment Against Medical Advice “AMA” for a variety of reasons mostly all bad reasons. Day one or two is a common time for a person seeking treatment to want to leave. This is when it sinks into the person, they are being separated from the love of their life (sorry not you) drugs or alcohol forever. Not for a day, not for a week, this is when they realize they are saying goodbye to their solution to every problem “Drugs or Alcohol” forever.
For those who make it past the day one or two fear, the next most dangerous time goes to people withdrawing from opiates, benzos and other drugs who want to leave treatment between 48 and 72 hours. This is when the withdrawal period starts and the physical and mental craving becomes so severe the addicted person wants to give up. This happens even with a medicated detox process however an experienced detox facility can usually walk the client through this process successfully.
Usually, to escape rehab in the first three days, addicts will use tactics of promising this or that, begging, pleading, threatening, agreeing to follow the rules and the list goes on ad infinitum. Where it gets really dicey is when addicts want to leave treatment in days 7-14.
People may want to leave treatment between 7 to 14 days
If the person wants to leave during this time frame, It’s normally one of two reasons. It’s either because they believe they are cured or they want to use drugs or alcohol again right now.
Why would someone want to use drugs or alcohol right after detoxing? Most likely your loved one has been using a substance to avoid every negative feeling, emotion, and problem for years. When things caused your loved one negative emotions in the past, instead of facing it and dealing with it, they most likely accelerated their substance abuse to mask the feeling. Using drugs or alcohol is how your loved one has been dealing with emotions for a long time
People don’t usually make it into treatment when things are going well. Once separated from the addict’s substance of choice reality steps in and all the balls they have been juggling come crashing down. Fear that all their secrets and lies will be exposed while they are locked away in treatment creates panic. If it isn’t secrets and lies, it is just their reality sinking in. It is either problem with loved ones, finances, legal, and employer, no employer the list can go on and on.
So what does the person in treatment do when they get to this point? Some, dig into the treatment process and use all the tools available and succeed. Others try to get a “Get out of Rehab Free Card” from their loved ones. I can tell you what they don’t do — they do not call their loved ones and say “I want and need to use drugs or alcohol again”. They resort to old behavior which I call the three C’s “Con, Confuse and Conquer”.
Abusing drugs and or alcohol is a full-time job. It takes a lot of time, work and money to support a drug or alcohol addiction. From days 7-14 are where the wild stories start to fly. The facility is unsanitary (drug using is so safe and clean), there are dead bugs in the food, the staff hates me and are they mean, my roommate is an axe murderer, the place smells, everyone in here is using drugs, the night security guard made a pass at me … these are just a few of the most commonly used lies.
If you get a call from your loved one wanting to leave treatment because of some problem at the treatment center, instead of believing them without investigation, I suggest you take a deep breath then respond with this.
You have been in treatment for (7-14) days so certainly you can make it 12-24 more hours. I will find you another treatment center to go to so you can finish your treatment.
Boom there it is a solution other than falling into a trap that kills people in need of treatment.
Responding with a 12 -24-hour solution gives time for you to do some research. It also is the time needed for your loved ones overwhelming urge to use to pass. This is where you contact the placement agent, interventionist or your contact at the treatment center and find out what really is going on. Nine times out of ten the person in treatment will calm down in 12-24 hours. One time out of ten you will need to find a new center. If you’re loved one won’t wait 12-24 hours after being in treatment for 7-14 days than they are leaving treatment to use drugs or alcohol guaranteed.
Risk Of Overdose
This is when opiate and other drug addicts commonly overdose and die and alcoholics go on the bender of all benders. Prior to going to treatment, the substance abuser has built up their tolerance for their substance(s) of choice. They have years of practice and knowledge of the amount they need to get the feeling they crave. Now for the first time in a long time, their body has no drugs or alcohol in it. In some cases, substance abusers go back to the exact amount they used before and overdose and die. In other cases, they guess how much they can now use safely and miss the mark and die.
Twelve to 24 hours is all I ask
Now it’s time for you to plead, bargain, threaten and or negotiate with your loved one. 12 to 24 hours is all you are asking for. Pull out every tool in your toolbox to convince your loved one not to leave treatment for 12-24 hours while you investigate and find them a solution. This is crucial because I have yet to see a substance abuser leave treatment at this time and actually go home and then back into treatment. They should have been in treatment a long time ago so don’t be conned, confused and conquered by the disease of addiction.
Recovery Is a Lifelong Process
I am cured” I have it all figured out.
To the average person, the “I am cured” reason for leaving rehab seems like not a big deal. To me, this is just as risky as the person that swears they are being mistreated and wants to leave. The person claiming they are being mistreated that won’t wait 12-24 hours to leave treatment isn’t lying to themselves they are lying to you. They know darn well they are planning to use. Whereas the person who actually believes they have it all figured out after 7-14 days is lying to themselves which can be far more dangerous.
My observation has been a person that stays in treatment between 45-90 days has a significantly better result than one that gets spun dry in 7- 14 days.
Quite frankly I do not know how a treatment center can come up with a recovery rate success percentage. Even if they contact everyone that has been through their facility in the last 5 years there is no verification other than the person’s word what their recovery status is. Then what about the people that changed their phone number and you can’t reach them are all those stats thrown out the window? So I revert to finding facilities that have a track record that can be proven which is the average length of stay in treatment per client. Then I use 12 factors to find the best rehab for a person seeking treatment.
If someone gets kicked out of rehab they wanted it to happen. I have seen this happen before they make the “it’s horrible here call” and right after they made the call. It is imperative, when and if you get that call, you are firm that they do not leave treatment for 12-24 hours under any circumstances. If they do leave for any reason you don’t enable them in any manner. You don’t send them any money, pick them up, arrange transportation or housing, all you do is find them another treatment center. They can stay at most airports safely for 12-24 hours while you arrange to get them to another treatment center.
In closing let me repeat this for the tenth time because it is worth repeating when someone wants to leave rehab against medical advice make them wait 12-24 hours so you can investigate, solve the situation and or find them another center to go to.
About the Author
Bruce Berman personally has assisted several hundred people into treatment for alcohol, substance abuse, and dual diagnosis. He has maintained continuous recovery from various addictions since September 1989. Besides himself, he has placed his own children, employees, family members, friends and other loved ones into various treatment programs. Whether you are struggling with addiction or a loved one is most likely the author has dealt with a similar situation in the past. Bruce is a father of four children ages 9 to 31 and happily married to his wife Victoria who has also been in recovery since November 1995. Together Bruce and Victoria run 800 Recovery Hub a company that specializes in placing people in need of treatment into the best treatment center they can.
Bruce Berman is not a medical doctor, holds no degrees or licensees in addiction and has no formal education in treating addiction. He relies solely on his personal experience gained in attending and participating in over 10,000 hours in various 12 step meetings since 1989 as well as the experience he has working with addicts and their families since 1989.