Long Term Rehab for Drug and Alcohol Addiction

Addiction is a chronic, long term and complex condition affecting you both physically and mentally, so it is rare to overcome it by simply stopping your use of drugs and alcohol, sometimes known as going ‘cold turkey’.

In fact, the NHS National Treatment Agency for Substance Misuse shows that in some of the best performing long term rehab facilities, the percentage of people achieving five-year sobriety following treatment can be up to 80% ^[1].

Centres like this can enable you to get the focused, professional and evidence-based treatment you are likely to require.

Long term alcohol and drug addiction rehab programmes typically last around 120 to 180 days although it varies very much from individual to individual with some requiring many months, years even of treatment.

Be assured that you are not alone if you are considering treatment for addiction. According to charity Action on Addiction, 1 in 3 adults aged between 18 and 65 have an addiction to something in the UK and as many as 118,500 are in rehab ^[3].

Beginning your journey to recovery can be daunting, so this article will explore what you can typically expect in long term rehab, hopefully reassuring you.

An Overview of Long Term Drug and Alcohol Rehab Facilities

As previously mentioned, the way in which treatment is delivered varies from centre to centre, especially depending on whether the centre you attend is outpatient or inpatient.

In general, outpatient centres offer fairly short term treatment whilst inpatient facilities are more suited to longer-term and more severe addictions with multiple relapses ^[4].

Additionally, inpatient facilities with a longer and more structured treatment process are well suited to those who have a dual diagnosis or addiction and another mental health condition. Again, if this is you, you are not alone as up to 75% of people with a substance abuse disorder have a dual diagnosis ^[5].

A range of long term rehab facilities exists to meet the specific needs of certain demographics. For example, there are rehab facilities serving different genders, the young including adolescents, the old, those who are pregnant and even different religions.

Regardless of the facility, treatment tends to be split into stages; an initial assessment, medically assisted detox, psychological rehabilitation therapy and aftercare help and support.

The Treatment Process in Long Term Inpatient Rehab

Almost always, the process begins with an initial assessment to understand what your physical and mental needs are and how these might be best addressed. This means a bespoke programme of treatment, highly individualised to your needs can be made.

Next comes the detox stage. Detox is a process beginning soon after your last drink or hit where your body rids itself of any harmful products that may have built up as a result of substance abuse, especially if it has been happening over a long period of time.

The detox process is often accompanied by the so called ‘withdrawal’ symptoms. These unpleasant symptoms are the result of your body has gotten used to having a certain level of substance on board. This interferes with the chemical signals (neurotransmitters) in your brain, especially dopamine which is prominent in the brain’s reward system and GABA.

When the substance is suddenly withdrawn, the brain initially struggles to adjust. This can cause symptoms including; fever, shakiness, sweating, nausea and headaches. For some, this may progress to a dangerous condition called ‘delirium tremens’ which can involve sudden confusion and seizures.

Because of this, trained professionals will be on hand at the rehab facility with a range of medications that can make detox safer and more comfortable. This is called ‘medication-assisted

detox’ and further details about the drugs used in this process can be found on the NHS’ website ^[6].

The detox process typically lasts around one week although factors such as pre-existing physical and mental health problems can affect its duration.

Detox alone to overcome the physical aspects of addiction is rarely enough and is only one of the first steps towards lasting recovery. Next, work begins on addressing the psychological component of addiction. This can take the form of individual sessions or group sessions but typically involves taking part in a range of talking therapies, led by an experienced professional.

These help you understand why and how your addictive behaviour was formed as well as helping you to manage situations that might otherwise lead you to substance use. Such treatments include:

Cognitive Behavioural Therapy (CBT)
Multidimensional Family Therapy
Contingency Management
Motivational Interviewing

What is Cognitive Behavioural Therapy?

This is an example of a talking therapy that teaches you about your addiction, why and how it developed and what triggers your use of substances. It then teaches you effective coping strategies to deal with life’s stressors instead of reaching for drugs and alcohol, preventing relapse.

CBT can also be used alongside medication-assisted treatment (MAT) which combines talking therapy with medications that can normalise the brain’s chemistry.

As mentioned previously, drugs and alcohol can disrupt and interfere with the brain’s normal function over time.

Which medication is used depends on the type of addiction you have but studies have demonstrated that compared to more traditional therapies using talking therapy alone, MAT is associated with significantly lower rates of relapse ^[7]. For more information about CBT, please see the NHS’ website ^[8].

What is Multidimensional Family Therapy?

The target of multidimensional family therapy (MDFT) is adolescents and teenagers with alcohol and drug addiction. This home-based treatment aims to prevent the need for residential treatment by addressing four key areas of influence in a young person’s life; themselves, family members, friends and the wider community.

MDFT therapy sessions involve both the young person and their family and help them to understand why their behaviour is problematic and then change it for more positive ways of behaving.

Sessions can take place once or many times a week for up to six months. This approach has a very strong evidence base and you can more about it on the MDFT organisation’s website ^[9].

What is Contingency Management?

This approach helps change people’s behaviour by reinforcing positive behaviours such as maintaining sobriety. The positive reinforcement usually comes in the form of tangible prizes such as vouchers, privileges, food items and coupons as a reward for demonstrating a positive behaviour change.

This could be evidenced by, for example, a negative urine drug screen. As contingency management doesn’t address the underlying root or cause of addiction, it is often used alongside other treatments such as CBT.

Despite this, contingency is backed by the National Institute of Clinical Excellence (NICE) as being highly effective in the treatment of addiction ^[10].

What is Motivational Interviewing?

This is another technique used to increase your motivation to dramatically change your behaviour and encourage you to continue to engage with treatment. Working closely with a highly trained professional, motivational interviewing recognises that beating an addiction is difficult so helps the individual recognise for themselves, what might be causing any ambivalence to real change.

This is done in a non-judgmental, non-confrontation manner, helping the individual to help themselves. Again, this is a highly effective method with some studies showing that almost 70% of people receiving this therapy had significant improvements in their ability to manage their addiction ^[11].

What is Community Like at Long Term Drug and Alcohol Rehab Centres?

A key part of the success of long term treatment facilities is their ability to foster a real community, Following closely supervised detox and rehab sessions, residents in recovery have their own free time to spend. In centres for adolescents and young people, this time outside formal therapy might be spent in education at schools and colleges provided by the centre.

Residents who are older may occupy their time by securing jobs in the facilities. In addition to passing the time, work is therapeutic in and of itself, preparing the client for their transition back to normal life beyond treatment. Recovering patients are also able to access skills training and workshops that can help in the long term.

Long term rehab programmes frequently provide the opportunity for outings, perhaps in nature or daily excursions to promote recovery.

Psychological therapies such as CBT and contingency management are the mainstay of treatment but there is plenty of evidence highlighting the efficacy of more alternative and complementary therapies ^[12].

These can include meditation, art therapy, music therapy, hypnotherapy and even animal-assisted therapy.

Finding a Long Term Rehab Facility That’s Right for You

Choosing which rehab facility is for you is difficult given how many different options are available to you. As mentioned previously, rehabs can cater for all with different facilities catering to different genders, ages, cultures and traditions. When it comes to choosing a rehab facility, it’s important to take the time to gather as much information as possible.

Your local GP or another healthcare provider should be able to signpost you to services and organisations like Mind has a wealth of resources online.

What do I Need to Prepare Before Reaching Out to a Rehab Centre?

When you first get in contact with a treatment centre, it is likely that they will need to take a full history of your drinking or drug-taking habits. This could include which type of drugs/drink abused, dose/amount, route of administration like injecting or snorting and previous treatment journeys, including any periods of withdrawal.

They will also most likely need to know if you have any physical health problems as that could impact how treatment is delivered, particularly given the withdrawal period.