Do You Have to Go to Rehab to Get Sober?

Substance abuse is a serious health issue in the United States, and around the world, but rehabilitation programs can seem inaccessible. Many people assume that rehab, especially inpatient treatment, is expensive, located far away, or just not right for them. Additionally, they may be in denial that they have a problem with substance use, or they may be too ashamed of their struggles to ask for help.

Fortunately, improvements in evidence-based treatment are making many options, including different levels of inpatient treatment, more accessible than ever. Without medical and social support to overcome withdrawal symptoms and change behaviors, relapse and long-term health problems are likely.

Can I Get Sober Without Help?

Substance abuse is a serious problem in the United States. According to the Centers for Disease Control and Prevention (CDC), in 2018, 11.7 percent of people 12 years old and older abused illegal drugs, and 2 percent misused a psychotherapeutic drug for non-prescription purposes. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that 14.5 million people in the US, ages 12 and older, have some level of alcohol use disorder, but only 7.2 percent of those individuals received any type of treatment in the past year.

Too many people who struggle with substance abuse do not seek treatment from a detox and rehabilitation program, and attempt to get sober on their own. Although some people can quit “cold turkey,” this is not often successful.

Most people need a combination of medical and social support that is found in both outpatient and inpatient rehab programs. Even if you do not need direct medical treatment like prescriptions to ease withdrawal symptoms, social support to maintain sobriety is a huge benefit of rehab.

Why People Choose Not to Get Help in Rehab

There are lots of different reasons someone may not want to go to rehab and may try to quit without any additional help. Here are some of the most common reasons:

• Finances: The stereotype of addiction treatment is that it is very expensive. You go to a large building somewhere near a beach or in the mountains and stay there for months, like you are in a resort with medical help.Although this type of luxury residential rehab is available to some, it is not the standard approach. There are many financing options available for many different levels of treatment.
• Family responsibilities: Too many people assume that those struggling with addiction have abandoned all their friends and family or spend time only around other addicts. This is simply not true.Many people who struggle with addiction have children, spouses, parents, siblings, or other loved ones who need their direct care. However, it is extremely important for caregivers to also get care, so they can be healthy themselves and find a good balance between supporting their loved one while still prioritizing their needs.
• High-pressure job: Often, people in high-pressure jobs love their work and devote themselves to overtime and weekend work, but this also creates a huge amount of stress that leads to substance abuse. Although they may not want to take time away from their job, this is necessary to get healthy again.
• Fewer social opportunities: Recreational substance use, particularly consuming alcohol, is common in our society. Unfortunately, recreational substance use can mask problematic substance use. Someone may not want to quit because they are worried they will lose all their friends or be unable to network for career opportunities.
• Denial: One of the first stages of getting addiction treatment is to admit there is a problem, but this can take some time. People who abuse drugs or alcohol and have few consequences to their health, relationships, and work are unlikely to believe they are at risk.Recovering from hangovers or taking pills every few hours may not seem like a big deal until the person “hits rock bottom.” It is extremely important to get treatment before an accident, job loss, or relationship problem happens because of addiction.
• Shame: People who struggle with addiction often know at some level that they have a problem, but they are too embarrassed or ashamed to talk about it. This can lead to spiraling substance abuse problems.It can be difficult to overcome shame about a personal struggle, but asking for help is the first step toward recovery. Evidence-based treatment is becoming more available, and getting into treatment as soon as possible helps you overcome these negative feelings.
• Negative treatment experiences: Sadly, many people who struggle with addiction try to get help at some point but end up in the wrong program, counseling, or support group. Addiction treatment is not one-size-fits-all, so finding the right path can take some time.

The Danger of Quitting Alone

Although quitting on your own can seem appealing, it is actually dangerous. Here are some of the risks involved in trying to quit without medical and social support through a rehabilitation program:

• Withdrawal symptoms: Some people are able to avoid intense withdrawal symptoms, but most people ending their addiction to a substance do experience withdrawal. Symptoms can include worsening mental health, nausea, fatigue and insomnia, physical aches and pains, and intense cravings for the drug.Some withdrawal symptoms are also physically dangerous. For example, quitting alcohol puts some people at risk of seizures. Medical oversight in a treatment program means you have supervision and support to ease withdrawal symptoms.
• No encouragement: When you enter a detox and rehabilitation program, you will have counselors, medical professionals, and peers to cheer you on as you manage withdrawal and begin the process of behavioral change.When you quit “cold turkey,” you may not have this support, especially if you have not told loved ones you are quitting or if several of your friends also struggle with addiction. This makes it easier to fall back into problematic drug consumption, which puts your health at risk.
• Exposure to triggers: Many people who struggle with addiction need to get out of their present surroundings. The people and places where they live, work, or visit daily might remind them of the euphoria associated with substance abuse, and this can lead to dangerous substance consumption. Getting away from these triggers helps them work on behavioral change and see that they feel better without drugs or alcohol.
• Lack of comprehensive care: Until recently, one of the biggest issues with substance abuse treatment has been the struggle to access it. Lack of health insurance and few specialists in many locations meant that people living in remote areas or with lower incomes simply could not get the help they needed. Fortunately, this landscape is changing, and you do not have to quit by yourself.

Ultimately, “cold turkey” or “going it alone” just doesn’t work for most people, even those that are more “high-functioning“. There are physical and emotional risks to trying to quit by yourself. You may suffer withdrawal symptoms that feel terrible, you may not have friends who support your desire to quit, or you may be surrounded by reminders of substance abuse. Getting help from a treatment program, whether inpatient or outpatient treatment, is the best way to overcome addiction.

The Benefits of Getting Support in Rehab

Although there are many approaches to addiction treatment, one of the most recognizable and most effective is still inpatient treatment. This includes detox and rehabilitation, especially when the person is able to move simply from detox into a rehabilitation program, without having to switch companies or residences. Residential treatment should last at least three months, although some programs allow clients to remain in the program for years as needed.

Inpatient rehab is effective for nearly every type of addiction. For example, research on people overcoming opiate addiction over 2.5 years found that those who undertook inpatient detox remained sober for longer. When the group of 150 participants entered their programs, they used opioids 23.7 out of the prior 30 days, on average. After more than two years, at the follow-up, they reported using opioids less than five days in a month, suggesting that not only were they abstinent, but they also managed relapses quickly.

Thanks to the passage of the Affordable Care Act (ACA), many drug rehabilitation programs can be paid for, in part, with health insurance. Whether you have private health coverage or are using Medicaid or Medicare, you can get treatment that works for you.

Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More