Whether you choose inpatient or outpatient drug rehab, recovery requires an investment of time and money. Naturally, you want results. Does drug rehab work? How effective is rehab?
In trying to get answers to these questions, many people look to success rates. But the definition of success in recovery varies from person to person. Drug rehab success rates don’t take this into consideration. Furthermore, the way success rates are calculated is complicated and sometimes misleading. Here are a few reasons why:
- There is no standard measure of success for drug rehabs. Comparing success rates among treatment centers is like comparing apples and oranges. Whereas one facility may count how many people complete the program, another may measure how many clients stay sober months after treatment.
“I don’t believe the numbers that are touted by some of these centers because the success rates are not measured systematically over time,” says David Sack, MD, a board certified psychiatrist and chief medical officer at Elements Behavioral Health. “What we see is the first six months are the hardest. Many people do well the first month or second month. Then all of a sudden, they’re put under stress, and they start to use again. Family problems, financial problems, work problems. So if we’re going to measure success we need to do what we can not just in the first 30 days but to give that person the tools and support so they can stay clean and sober for the rest of their lives.”
- There is no standard definition of personal success. Another important question is how is success defined? Is success completely abstaining from any mood-altering drugs? Is it drinking or using fewer days per month? For example, a person may complete rehab, relapse six months later for one day, get back into recovery and spend the next year sober. Some facilities would consider this a success; others would lump the person into the “failure” statistics.Aside from complete abstinence, which isn’t always the best gauge of a person’s progress, some success factors or signs that rehab is effective include:
– Drinking/using less frequently and/or in smaller doses
– Having longer stretches of time between relapses
– Improvements at work, school or in relationships
– Better quality of life
– Fewer health issues, doctor visits or hospitalizations
- Success rates are often established at the end of a rehab program. Most people can stay sober in a supervised, highly structured residential drug rehab. But what happens next? “For many addicts quitting is not the problem, it’s staying quit,” Dr. Sack explains. “It’s collecting an amount of time where their brains can heal because drugs are injuring the brain; they rewire it. Unless you stay off drugs long enough, the brain doesn’t have a chance to heal from this cumulative injury.” Also problematic is that many facilities only measure success rates based on the clients who completed treatment, not those that dropped out early.
- Most drug rehabs do not follow up after treatment. Most facilities do not follow up with clients after treatment to gather data on the effectiveness of rehab or allow outside researchers to assess their client outcomes. Of those that do follow up with clients after treatment, some only ask the client for a self-report on how they’re doing while others also consult with family members and therapists or other treatment providers.“Many rehabs will tout very high success rates,” says Dr. Sack. “They’ll say, ‘95% of our people are cured when they leave’ or ‘87% are in remission’ but what they don’t really talk about is how long. It’s not hard if someone is with you for 30 days to get someone to be abstinent for 30 days. They’re under supervision; they can’t leave without staff being with them, so the issue really isn’t how good they are on the day they discharge but what happens to them afterward?”
- Addiction is a chronic disease with high relapse rates. As much as addicts and their families would like to hear high success rates or be promised a “cure,” science tells us these are empty promises for a chronic, relapsing disease like addiction. According to the National Institute on Drug Abuse, there is no cure for addiction and relapse rates range from 40 to 60%. Because relapse is a real risk, it’s important to find a treatment center that offers aftercare and referrals for ongoing therapy and support.
Success also depends on the individual’s personal willingness to attend treatment and commit to recovery long term. One client of Promises Malibu, Marcia (name changed to protect privacy), agreed to go to rehab after being pressured by her therapist and immediate family. She spent 31 days in treatment but knew she was just going through the motions to appease others. She broke rules and left despite advice from her treatment team that she needed more time in rehab. Before long, she relapsed and became severely depressed. She got back into treatment and the second time around, she had a “whatever it takes” attitude and was fully committed to doing the work of recovery. Today, she’s been sober for two years and still makes her recovery a priority.
Other Ways to Measure Success
Rather than rely on ill-defined, often artificially inflated success rates, research shows it can be more helpful to ask the following questions:
- What percentage of clients complete your drug rehab program?
- What quality of care can I expect? Do you use evidence-based therapies/medications, offer personalized treatment plans, and have highly credentialed staff?
- Do you treat co-occurring mental health disorders such as depression, anxiety and trauma? Do you have medical staff and provide psychiatric care?
- Are you accredited by CARF or The Joint Commission (third-party organizations that have rigorous requirements for quality of care)?
- How are your clients doing 3/6/12 months after completing the program?
- How can I expect my quality of life to change after completing treatment?
- Do you offer aftercare, an alumni program and/or resources for ongoing therapy and support? How will you help me develop a sober support system I can rely on after treatment ends?
- Do you offer family therapy and resources for loved ones?
- Can I talk with alumni about their experience?
It may also be helpful to inquire about whether the treatment center tracks its success through studies or client interviews or questionnaires. Elements Behavioral Health, for example, participated in a study that followed dozens of patients at several of its treatment centers from arrival in treatment and then again at one, three and six months following discharge. The researchers found significant and sustained improvement in the number of days abstinent from drug and alcohol use, in strength and frequency of cravings, in mood, and in quality of life.
Elements Behavioral Health treatment programs also collect client satisfaction surveys to assess whether clients completed their goals, would recommend the treatment center to friends and family, and other measures. Its facilities consistently report satisfaction rates over 85% and as high as 98%.
The best rehab for one person may not be the best rehab for another person. Figuring out which one is right for you requires asking the right questions, and the facility’s success rate may not be the most helpful way to find out does rehab work. If you do inquire about success rates, be sure to ask how it is calculated and defined and consider a variety of other factors in your decision as well.