It is no secret that recovery takes time. In fact, many people will tell you that the journey is actually a lifelong process. And while there is no singular method that has trumped all others in the exclusive treatment of drug and alcohol addiction, there are certain facets that seem to have a great impact on the long-term success rate of those trying to break free from the grip of substances. While some people do manage to create and maintain a life of sobriety without the aid of professional help, the overwhelming majority seek medical or psychological support as they begin their journey.
Research has shown that the chance for long term success is exponentially higher in those who have managed to maintain a year of consistent sobriety versus that of individuals in their first days or months. This should come as no surprise when factoring in the physical aftermath of substance use as well as the behavioral and circumstantial change that can occur in a year; but the question still remains—how does one even begin to navigate the vital decisions made in the first year to create the best chance for successful long-term recovery?
And beyond that, if the first year of recovery is so important, then why is the standard length of drug and alcohol rehabilitation only 28 days?
Unfortunately, the average success rate of rehabilitation programs across the country is dismal, with less than 20% of individuals who complete these programs maintaining any long term sobriety. While the insurance companies do cover some lengths of treatment, which vary from person to person, it is rare that insurance plans will cover lengths of treatment longer than 60 to 90 days in any meaningful capacity. So as more addicts and their families find themselves perplexed trying to figure out where to go after leaving rehab, sober livings and other extended care programs have sprung up in droves trying to fill this gap. However, given the lack of regulatory structure around these programs, many will take up questionable practices under the guise of treatment.
Often times, supposed sober livings will even completely overlook an abstinence policy in order to continually exploit desperate individuals for a rent check. But do not let this deter you from extended care programs as a whole, there is a wide range of facilities across the country offering legitimate and successful treatment catered to an array of different needs and life circumstances. So before choosing an aftercare program for you or your loved one, it is extremely important to be informed so you can find the best fit for you. Here are some of the factors to look for when making your decision.
Length of Time
One of the first questions you may want to inquire about, is how long the average stay is for residents at the facility. As stated earlier, maintaining a stable and supportive environment through the first year of recovery is incredibly important for the afflicted individual. If the majority of residents are only staying anywhere from a few weeks to a few months, this should probably raise a red flag.
First of all, if residents are only staying for short periods of time, they are likely returning to the generally unhealthy environments from which they came. Beyond that, the communal aspect of sober livings and recovery in general is incredibly important. As such, an aftercare program will be much more conducive to recovery if its residents are further along in their recovery process. Newly sober individuals are far more likely to commiserate in negative behaviors and co-sign one another’s unhealthy thought patterns.
The integrity of the community that is fostered by the recovery program can make or break an individual’s success. Interpersonal relations are widely regarded as a cornerstone of recovery. Those who surround themselves with a healthy, positive, and motivated peer group, generally fare much better in the long term; while those who remain involved with the same or similar negative influences of their prior peer groups often fall back into patterns of relapse. That said, it is extremely important to get a gage on the individuals that make up the community. This is also why a zero-tolerance policy in terms of substance use should be expected as an absolute.
Beyond the immediate residents involved in the program, the involvement of the recovery program in the outside community should be taken into consideration. For instance, do they partake in local volunteer work? Does the program work closely with any business establishments to help get residents back into the workforce? And most importantly, is the sober living immersed in the local recovery community? Facilities that work to enlarge the support groups and resources of the individual beyond the walls of the program often provide a much more solid foundation for long term recovery.
Age or Gender Specific
As I stated earlier, the interpersonal aspects of an individual’s recovery play a huge role in the chances for success. Unfortunately, a large portion of facilities are more concerned with collecting the rent or insurance check from the client than properly placing the individual in a place that is most conducive to their well-being. This means that more often than not, recovery programs will take anyone assuming they have the financial means to pay. So if the goal is to strengthen and build the social areas of someone’s recovery, it stands to reason that they should embark on that journey with a peer group of similar circumstance. This is not to say that and 18 year old high school male and a 60 year old business woman cannot learn to confide in one another, but it certainly isn’t ideal for recovery.
If the individual is further along into adulthood, the age gap seems to be a little less pertinent, but particularly for young adults, becoming involved in a community of other recovering young adults can be crucial. As they learn to utilize one another for support, they often develop a sense of trust and connection with others that can greatly influence the recalibration of the person‘s values and lifestyle.
Gender specificity is also wildly important, again, primarily for young adults looking to achieve sobriety. Co-ed programs can facilitate a whole slew of detrimental behaviors and unhealthy relationships that could otherwise be avoided by gender-specific modes of treatment. When an individual ceases the substance abuse pattern, they are often plagued with the same negative internal feelings that precipitated the using in the first place.
Many will turn to alternative means of gratification, which can often be found in romantic relations or other risky behavior. And while there is nothing wrong with romantic relationships in a life of sobriety, those in the initial stages of sobriety will often gravitate towards other unstable counterparts, particularly when they are residing in the same facility during such vulnerable times. Aftercares geared towards specific genders simply take away a lot of that risk, while also allowing individuals to become comfortable being vulnerable with others of the same gender, without the added stress of a romantic relationship.
Most addicts and alcoholics have strayed from any semblance of a value system, generally as a means to sustain a secretive or dangerous lifestyle that accompanies addiction. As such, the structural policy of the program and communal integrity that it encourages can play a huge part in the displacement of maladaptive behaviors. There are a number of levels of accountability that can play large roles in the overall effectiveness of an aftercare program.
The first of which is implemented in the structure of the program itself. For instance, are residents expected to maintain a regular line of communication with the program? Is there staff available that handles the logistics of residents, and how often are they present? Does the sober living keep tabs on the work lives of its residents (i.e. schedule and work stability)? What is expected in terms of a program of recovery? Meetings? Sponsor? Volunteer work? What does day to day life look like?
A major part of recovering from addiction lies in the ability to replace old behavioral patterns with newer, healthier behaviors. While this may seem obvious to some, many programs will focus solely on things like talk therapy whilst allowing historically destructive behaviors—sleeping all day, playing video games for hours on end, engaging in unhealthy relationships, or gambling. In order to counter some of these deeply rooted tendencies, some extended care programs will implement structural guidelines such as mandatory wake-up times, exercise regimens, group meetings or community outreach opportunities. These can serve as a fantastic aid in the habituation of new and productive behavioral patterns.
However, in my personal experience, a culture of peer accountability has proven to be one of the most powerful tools in developing and reinforcing a whole new means of life. What I am talking about is a heavy emphasis on accountability between the residents from one another, usually influenced or encouraged by the structural rigidity of the program. This level of interpersonal involvement helps to really solidify a positively motivated environment where the majority of the support comes from fellow residents rather than staff members, often fostering a long-term recovery community born of the camaraderie of having recovered together. Those bonds and the continued accountability, even outside of the structure can provide tremendous stability for an individual.
Early recovery can be extremely difficult and any number of things can trigger the individual to use again. With time, these triggers become gradually less influential, but in the primary stages, even the simplest of things can rekindle the phenomenon of craving—anything from social media to contact with old friend groups, explicit movies and music that glorify drinking and using, or even certain jobs.
While a program that insulates individuals from these external stimulus may seem extreme, in the context of lifelong sobriety, the necessary precaution is a worthwhile sacrifice. In fact, it can really allow for the individual to focus solely on their own program of recovery facilitate a level of natural insight that may not be easily accessed with so much outside influence. Many extended care programs put little to no effort into this, but finding one that sets parameters in these areas can be paramount.
The family dynamic can play a huge role in the life of a recovering addict or alcoholic, no matter the age. Deep-rooted family influence is often a major catalyst in relapse, sometimes even if the family has the best of intentions. How involved your extended care program is willing to be with the residents family is usually a pretty good indicator of effectiveness. Maintaining a consistent line of communication with the immediate family can help to mend broken relationships, instill effective communications, and serve to repair broken family dynamics that have developed over the course of many years. A strong and productive family support can do wonders in restoring a level of self esteem that is many times long in the grip of substance use.
It is extremely hard for addicts and alcoholics to re-engage in life without substances after years of abuse. Depending on the lifestyle to which they had become accustomed, many aspects of day to day sober life may be completely foreign. Things like career building, relationships or financial responsibility can be incredibly hard to navigate. Most short-term, intensive rehabs to not deal with any of those issues as their primary purpose is to separate the individual with their drugs of choice. However, for a sober living or extended care program, these things are absolutely imperative and should not all be tackled at once.
Instead, they should be approached as building blocks to a full and healthy life, which is why sober livings that utilize a “step-down” or “phase” ideology prove to be so successful. This means that responsibilities and privileges are granted gradually, as the individual is deemed ready to take on the next levels of their lives. A program that initially focuses solely on the inner workings and coping mechanisms of an alcoholic can, with time, return the individual to a wholesome and independ life, by slowly incorporating facets of responsible adulthood. The goal being, of course, that the resident transfers out of the sober living and into real life seamlessly.
So, How Do I Know Which Is Right For Me?
Unfortunately, the only way to know is to ask questions. If at all possible, do a site visit. Talk to others who have succeeded in their transition—a program with an active and prominent alumni community can be an amazing gage of the effectiveness and integrity of the program you are considering. There are so many different factors that can be taken into account, so make sure you know what works for you. If it seems fishy, it probably is.
All of this to say, no matter what it is that you are looking for, choosing an extended care program for yourself or your loved on is incredibly important. While there are those who succeed after short-term 28 day programs or even with no programs at all, the numbers are slim. For myself, it is not a risk I was willing to take. Recovery involves a complete overhaul of an individuals lifestyle and belief system and this cannot be done in a month.
If you, or someone that you know is looking to begin a life free from drugs and alcohol, please reach out and ask questions to find a program that is right for you.