Drug rehab: definition, process, typical day, and importance

Drug rehab is a multifaceted treatment approach to help individuals with addiction issues attain a substance-free state and achieve long-lasting abstinence. Rehabs offer personalized addiction treatment programs comprising evidence-based medical and psychosocial intervention strategies.

The process of drug rehab consists of the following phases: intake and assessment, treatment planning, detoxification, psychotherapy, and aftercare. These processes are part of a holistic treatment methodology personalized to meet unique patient needs and recovery goals.

A typical day in drug rehab is rigidly structured with designated times for meals, physical activities, individual and group therapy sessions, recreational and relaxation activities, 12-Step meetings, and prayers. Depending on the services offered by the rehab, a typical day also weaves in family programs comprising modules like family therapy and educational sessions for the loved ones of the individual in treatment.

Drug rehab is important because it provides a safe, therapeutic, and substance-free environment for individuals with addiction problems to heal, attain lasting sobriety, and optimize multiple domains of their lives, such as careers, relationships, and finances. Drug rehab has also been shown to reduce drug-related criminal activities and provide multiple economic benefits across diverse domains like healthcare, social services, individual quality of life, and workplace productivity.

What is drug rehab?

Drug rehab is a multidimensional psychotherapeutic approach to help individuals with substance use disorder overcome their addictive behaviors and achieve lasting sobriety. According to a publication by Healthdirect Australia, titled “Drug and alcohol rehabilitation” last reviewed in August 2022, drug rehab aims to help patients stop or reduce drug and alcohol use and learn and develop the coping skills necessary to maintain a drug-free lifestyle. 

Drug rehabs offer various evidence-based medical and psychosocial therapies to treat addiction in a safe and structured environment using a meticulously crafted and individualized treatment protocol. They provide varied levels of care in different physical settings aligned with the requirements of the various stages of a patient’s recovery journey.

How does drug rehab work (process)?

Drug rehab works by helping an individual with substance use disorder achieve a substance-free state, overcome their addiction, and learn and develop the coping skills necessary to attain and sustain sobriety in the presence of triggers and drug cues. Addiction is a multi-faceted disease with complex biological, psychological, social, and environmental etiologies. The process of drug rehab aims to address these diverse factors and includes the following phases: intake and assessment, treatment planning, detoxification, counseling, and aftercare and support. These interventions are personalized to accommodate the unique neurobiological characteristics, psychological landscapes, and socio-environmental contexts of individuals, according to a 2020 article by Nora D. Volkow published in The American Journal of Psychiatry, titled “Personalizing the Treatment of Substance Use Disorders.”

The intake and assessment stage involves gathering information about the patient’s addiction problem, their physical and mental health status, and their socio-environmental milieu. This information is crucial for formulating a personalized treatment plan, which typically involves multiple therapies that address the diverse needs and recovery goals of the patient. Detoxification is critical for individuals who have become physically dependent on a substance of abuse. The process helps them attain a substance-free state after navigating the withdrawal phase safely and prepares them for the next phase of treatment.

Addiction counseling aims to address the psychological, social, and emotional causes of substance abuse. Individual and/or group therapies are offered to help patients identify these causes, develop resilience, and learn coping skills to attain and sustain sobriety. Aftercare interventions are aimed at helping patients transition from a supervised, structured, and substance-free environment to independent living. The above-mentioned processes aim to promote a holistic and personalized treatment protocol, which is the overarching objective that directs how a drug rehab works. 

What does a typical day in drug rehab look like?

A typical day in drug rehab looks different depending on the treatment being offered, the physical setting, the strategies utilized, the philosophy guiding the treatment protocol, and the itineraries involved. However, adherence to a structured daily routine as part of the treatment plan is a common feature of drug rehabs that provide residential and inpatient treatment. The typical day in drug rehab starts early. The daily routine consists of having nutritious meals and engaging in physical exercises, such as doing yoga, working out in the gym, walking, or jogging, at designated times. There are rehabs where morning activities include meditation and journaling exercises. Other rehabs incorporate prayers in their morning routines.

Typically, rehabs offer 12-Step programs in the evenings. The meetings are held at their premises or else, the residents are encouraged to go out and participate in the programs conducted by the local community. Drug rehabs that offer adventure therapy as part of their addiction treatment program include activities like hiking and navigating obstacle courses during a typical day of stay while those that offer art or music therapy incorporate arts and crafts-making sessions and activities that involve listening to or creating music.

Attending psychotherapy sessions in individual and group settings often twice during the day is a major component of the daily activities carried out in a drug rehab. These counseling sessions focus on different facets of addiction recovery like the emotional, physical, social, and environmental stressors that contributed to the addiction issues of the individual and their maladaptive coping strategies and compulsive drug-seeking behavioral patterns. These sessions aim to teach the participants healthy thought patterns, coping strategies that do not involve the use of drugs, and how to recognize relapse triggers and manage these.

Specialized sessions focusing on specific issues like anger management, grief counseling, trauma processing, and stress management are included in the day’s itinerary depending on the treatment modules offered by a particular rehab and the needs of the patient.

Rehab centers that offer family programs design interventions that allow the patient’s loved ones to be a part of the recovery process. These interventions include family therapy sessions where the person seeking recovery and their loved ones participate and address dysfunctional relationship issues, process powerful feelings of anger and resentment, and identify co-dependent and/or enabling behaviors. At other times, only family members take part in educational programs to learn about addiction as a disease and how to support their loved ones during recovery.

Why is drug rehab important?

Drug rehab is important because it provides a safe and therapeutic environment where patients seeking recovery from addiction are able to heal and receive the physical, psychiatric, and emotional support they need to overcome their substance use disorder and attain lasting abstinence. Drug rehabs offer multiple evidence-based therapies and treatments that address the physiological, psychological, social, and environmental dimensions of addiction. Round-the-clock medical supervision and medications enable safe and effective detoxification and treat co-occurring medical and psychiatric ailments that hinder recovery.

Entering a drug rehab brings structure to the life of the individual seeking recovery. Routines help individuals replace self-destructive and compulsive behaviors with positive ones that promote healing and abstinence. Additionally, the coping skills learned and practiced during a stint at the rehab empower individuals in recovery to resist the urges and cravings that they are likely to experience after they return to their former lives and/or environments containing drug cues.

Drug rehab is important because it helps an individual achieve and sustain a substance-free state and empowers them with the knowledge and skills needed to optimize multiple aspects of their life like relationships, careers or vocations, and finances, as mentioned in the chapter “Specialized Substance Abuse Treatment Programs” from the 1997 publication by the Substance Abuse and Mental Health Services Administration (SAMHSA), titled “A Guide to Substance Abuse Services for Primary Care Clinicians.”

The importance of drug rehab is also evident on a larger societal level. According to a 2009 article by Chandler et al., published in the journal JAMA, titled “Treating Drug Abuse and Addiction in the Criminal Justice System: Improving Public Health and Safety,” substance abuse treatment comprising multiple therapeutic modalities has been shown to reduce drug use and drug-associated criminal acts. Drug treatment delivered in prison settings and community-based recovery programs post-incarceration have been shown to prolong abstinence and reduce re-arrest rates.

Reduction in criminal activities produces the largest economic benefit of addiction treatment interventions. Treating substance use disorder produces other significant economic benefits across domains like utilization of health care services, social services, productivity, instances of infectious diseases, infant health outcomes, and individual quality of life, according to a 2023 article by Fardone et al., published in the Journal of Substance Use and Addiction Treatment, titled “Economic benefits of substance use disorder treatment: A systematic literature review of economic evaluation studies from 2003 to 2021.”

Who should go to drug rehab?

Individuals with an addiction to substances, those who believe they have problematic substance use behaviors, and those whose loved ones have raised concerns about their addictive behaviors or suggested or considered treatment for them should go to rehab. The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), published by the American Psychiatric Association, mentions 11 criteria to diagnose problematic substance use. Individuals who fulfill three or more of these criteria should go to drug rehab.

Individuals who tend to self-medicate their mental health issues with substances should go to drug rehab because they risk fatally overdosing themselves or developing a full-blown addiction problem. Individuals who experience withdrawal symptoms upon reducing or stopping usage and those who exhibit increasing tolerance to a substance need to seek treatment for their problematic drug use. Tolerance and withdrawal indicate a drug abuse pattern that is likely to progress to addiction. Losing control over one’s use of substances is a sign to seek addiction treatment. Impaired control over substance use manifests as an individual continuing to consume drugs even when they are aware of its negative consequences.

So, individuals experiencing chronic physical and mental health issues caused by substance use and those battling financial and/or legal troubles due to their addictive behaviors should go to drug rehab. It is a tell-tale sign of compulsive drug use if an individual is always short of money and is unable to make their paychecks last a week or a month. Individuals who endanger their lives or that of others because of using substances should go to drug rehab. For instance, individuals are known to jeopardize their well-being by engaging in illegal or risky behaviors like selling drugs, committing robberies, and exchanging sexual favors to facilitate their drug use.

How do you convince a loved one to enter a drug rehab?

To convince a loved one to enter a drug rehab, formulate a strategy and execute it with compassion. Educate yourself on the subject of substance abuse in general and the specific addiction of your loved one. Learn about the tell-tale signs of substance abuse and identify if your loved one is manifesting these. This knowledge will help you build a stronger case for drug rehab. Learn about the disease of addiction and how it affects your loved one’s mental health and cognitive abilities.

When you recognize that addiction is not a moral flaw, you will be able to enter into and participate in a conversation about drug rehab with greater understanding, empathy, and compassion. Learn about the different addiction treatment options so that you are able to offer solutions. Plan what to say during the conversation and rehearse the speech. Use non-stigmatizing language and refrain from accusing your loved one.

For instance, do not use words like “junkie,” “alcoholic,” or “addict.” Be calm, objective, and non-judgemental during the conversation, and use words that convey support and love. Choose a time to talk when your loved one is not on a high and is able to focus on the conversation.

Consider planning an intervention where you and other friends and family members gather to speak to your loved one about entering drug rehab. Let your loved one know how their addictive behavior has negatively impacted their lives, relationships, and careers. Often, people with substance abuse are unaware of the consequences of their actions. An intervention serves as a powerful wake-up call. Take the help of an addiction expert or a professional interventionist to arrange an intervention. Ensure that you have arranged a place at a rehab that is convenient for your loved one before you proceed with the intervention. So, if the intervention is successful, your loved one will be able to begin treatment immediately.

An intervention presents an opportunity to engage in an honest conversation. Utilize this opportunity to outline the consequences if your loved one chooses to continue with their addictive behaviors. These consequences include stopping monetary allowances or support or not allowing them to visit their nephews and nieces. Ensure that you and other loved ones follow through with the consequences.

Do not wait for your loved one with a substance abuse problem to hit rock bottom before you attempt to convince them to enter a drug rehab. Overdosing on a substance and their lives imploding to a state that cannot be resurrected are possible outcomes of “rock bottom.” Be proactive in helping your loved one as soon as you suspect that they have a substance use problem.

What are the types of drug rehab?

The types of drug rehab are listed below.

• Inpatient treatment program: This intensive treatment program involves hospitalization of the individual seeking recovery. The patient is under 24-hour medical supervision. As such, this mode of treatment is suitable for individuals experiencing severe substance withdrawal or overdosing and those with a history of failed attempts at abstinence. An inpatient treatment program is advised for individuals with co-occurring psychiatric disorders and underlying medical conditions.
• Residential treatment program: Residential treatment programs require individuals seeking recovery to stay in an inpatient facility where they are monitored around the clock. However, the degree of medical supervision is less than that of inpatient hospitalization. These programs are ideal for individuals with substance use disorders who have to be stabilized and their psychosocial needs addressed before they are able to transition to an outpatient facility where there is less supervision and finally, to an unsupervised environment with drug cues.
• Detoxification programs: Detoxification programs provide medical interventions to manage acute intoxication and/or severe withdrawal in substance-dependent individuals. However, detoxification is not a treatment for addiction. Rather, one of the aims of detoxification is to prepare the patient to transition to a more formal treatment regimen according to their particular needs and recovery goals.
• Partial hospitalization: Partial hospitalization is a variation of the outpatient treatment modality. Although an overnight stay is not required, the patient must attend 20 hours of treatment every week.
• Intensive outpatient program (IOP): Patients enrolled in intensive outpatient programs are required to attend treatment at the facility for at least 9 hours for 5-7 days a week. They do not have to stay overnight at the facility and are able to return home or to any other safe and therapeutic environment for the night.
• Outpatient treatment programs: Outpatient treatment programs are the least intensive and restrictive of all types of addiction treatment programs. The patient is required to attend treatment for less than 9 hours a week at the facility. They are allowed to return home or a sober living house for the night.
• Medication-assisted treatment (MAT): Medication-assisted treatment (MAT) is based on a “whole-patient” approach to treating addiction involving the administration of medicines along with counseling and behavioral therapies. The medicines used in MAT are approved by the Food and Drug Administration and used to manage withdrawal, discourage drug use, and treat co-occurring psychiatric disorders. MAT is also used for opioid maintenance treatment.
• Therapy-based programs: Therapy-based programs offer psychosocial interventions to address and/or modify the psychological, social, and environmental factors that have contributed to the development of addiction in an individual. The strategies include cognitive behavioral therapy, dialectical behavior therapy, family therapy, contingency management, and motivational interviewing.
• 12-Step programs: A 12-Step program is a theoretical model consisting of 12 consecutive steps of activities aimed at managing addictive, compulsive, and behavioral issues to aid recovery and promote abstinence. These programs are typically led by peers. Addiction treatment centers offer 12-step programs as an adjunct to formal treatment and as part of an aftercare program to facilitate continuing care after the initial treatment phase.
• Support groups: Support groups comprise individuals with lived experience of addiction and being in recovery. The group members, called peers, are not mental health professionals. These groups promote long-term recovery and abstinence by working on the principles of cooperation, accountability, guidance, and inspiration through shared experiences. These groups complement formal addiction treatment modalities, so drug rehab centers provide access to recovery support groups as part of a rehab aftercare program.

How long does drug rehab last?

The duration of drug rehab is typically 30, 60, or 90 days. There are also rehab programs that span six months, a year or two years, and extended-stay rehab programs like sober living houses where an individual has the option to stay for longer periods. A longer duration of stay in residential drug rehab is linked to more favorable outcomes, according to a 2016 article by Brie Turner and Frank P. Deane published in Therapeutic Communities: The International Journal of Therapeutic Communities, titled “Length of stay as a predictor of reliable change in psychological recovery and well being following residential substance abuse treatment.”

The mean duration of stay that marks the difference between reliable change and no improvement has been found to be 37.37 days. The length of treatment depends on multiple factors like the level of care needed, the cost of the program, and the individual personal circumstances of the patient. For instance, a medical detox program lasts till the patient has safely navigated withdrawal syndrome, which is, on average, 7+ days.

However, detoxification does not treat the psychological, social, and environmental factors that contribute to addiction. So, patients who require and choose to go through a comprehensive treatment program that addresses the varied aspects of the etiology of their specific addiction problem participate in lengthier drug rehab programs that offer interventions like psychotherapy and family therapy. Insurance coverage for drug rehab varies across providers and the particular insurance plan chosen by the individual seeking recovery. Individuals choose short-duration rehab programs or opt for less expensive outpatient treatment if their insurance coverage is limited. Childcare and employment circumstances too, determine the duration of drug rehab.

Who works in drug rehabs?

The professionals who work in drug rehabs include admissions staff, physicians, nurses, therapists, psychiatrists, dieticians, holistic and complementary health practitioners, case managers, and technicians or aides. The administrative team working in drug rehabs comprises the medical director who is likely to be a medical doctor who provides services at the rehab, the nursing director, and the clinical director. The non-clinical personnel at drug rehabs include cooking staff or chefs; members of the maintenance team, such as plumbers, electricians, and HVAC technicians; members of the business office who deal with the financial aspects of the treatment and stay; and the drivers from the transportation department.

The members of the admissions team are the first point of contact between the individual seeking recovery and the rehab. Drug rehabs employ healthcare professionals like medical doctors who are certified to prescribe medicines, licensed practical nurses, licensed vocational nurses, registered nurses, and advanced practice registered nurses (APRNs) to monitor and treat patients for their withdrawal symptoms. APRNs hold master’s degrees or higher and prescribe medicines in those jurisdictions where they are allowed to. Doctors who hold advanced degrees in addiction medicine are called Addiction Medicine Physicians. The professionals who provide therapy in drug rehabs include counselors, licensed clinical social workers, licensed marriage and family therapists, psychiatrists who are medical doctors specializing in mental health, psychologists, and certified addiction specialists.

Usually, psychiatrists and psychologists work together on complex cases, such as those involving mental disorders co-occurring with substance abuse. Holistic and complementary health practitioners include yoga instructors, massage therapists, mindfulness teachers, acupuncturists, somatic therapists, naturopathic doctors and herbalists, and experts who are qualified to provide interventions like adventure therapy and experiential therapy.

Case managers help patients coordinate the changes in their lives that stem from them seeking treatment at a rehab. The tasks of case managers include managing employment documents needed to obtain leave from work, handling paperwork related to short-term disability and/or Family and Medical Leave Act, and addressing the legal requirements of court systems or probation officers. Technicians or aides coordinate with patients to ensure appointments and treatment schedules are being adhered to and handle tasks associated with the orientation of new patients and administration of drug screening tests.

How much does drug rehab cost?

The cost of drug rehab varies based on factors like the type and duration of treatment provided, the severity of the addiction problem, whether there are co-occurring medical or psychiatric disorders, the type of drug(s) used, the insurance coverage of the individual seeking recovery, the location of the facility, the amenities provided by the rehab, and whether the facility is an in-network rehab.

The most expensive type of drug rehab is an inpatient rehabilitation program that ranges in price between $5,000 to $80,000. The cost of inpatient programs that span 28-30 days ranges from $5,000 to $20,000. The cost of 60-90 day programs starts from $12,000 and goes up to $60,000 or more. The cost of an outpatient detox program ranges from $1,000 to $1,500.

However, the costs increase in proportion to the severity of the withdrawal symptoms experienced by the patient and the level of medical monitoring and management required. Outpatient rehab costs less than medical detox and inpatient rehab programs. The cost of a 30-day general outpatient rehab program ranges between $1,400 and $10,000. An intensive outpatient program costs, on average, $500 to $600 per day while the average cost of a partial hospitalization program is $350 to $450 per day. Additionally, patients have to pay admission fees of $3,000 to $4,000 for inpatient and residential treatment programs.

What happens after drug rehab?

After drug rehab, the recovery process continues with the focus shifting to avoiding relapse and achieving long-lasting sobriety while living in an environment that is filled with drug cues and navigating the stressors of life. Patients who complete rehabilitation choose one or more options for continuing care that encourage a healthy and drug-free lifestyle. Rehab facilities often connect their outgoing patients with step-down levels of care and other follow-up recovery resources like addiction support groups, individual counseling services, sober living homes, transitional homes, and sober networks.

Sober living homes and transitional homes, the latter also known as halfway houses, are residential facilities where individuals stay after completing rehab. These are ideal for individuals in the early stages of recovery who do not possess a strong social support network or a home environment that is conducive to a sober lifestyle.

Addiction support groups include substance abuse self-help communities like Alcoholics Anonymous, Narcotics Anonymous, and Cocaine Anonymous that follow the 12-Step methodology. There are alternative addiction support groups, such as Self-Management and Recovery Training (SMART), that do not follow the 12-Step plan. Individual counseling services offer personalized therapy to address the underlying emotional and/or psychological factors that contributed to the addiction problem and teach healthy coping skills that help prevent relapses.

What is the success rate of drug rehab?

The success rate of drug rehab is 68% for outpatient and inpatient programs combined, according to data presented in a 2004 article by Hser et al., published in the journal Psychiatric Services, titled “Relationship Between Drug Treatment Services, Retention, and Outcomes.” The success rate for inpatient programs is 60% and that for outpatient programs is 73%.

According to the authors, completing treatment or longer treatment retention, increased intensity of the therapeutic services offered, and patient satisfaction with the treatment program are positively associated with improved treatment success rates. The National Institute on Drug Abuse notes that a 90-day rehab program is associated with the most favorable treatment success rate.