The idea of going to an inpatient rehabilitation facility for the first time can be scary. Aside from the fact you are probably at the worst place mentally and physically you’ve ever personally been at upon check-in, not knowing what your life is about to look like can be daunting.
Consider yourself lucky for two reasons. First, you’re still alive. According to the United States Centers for Disease Control, more than 17,000 deaths were attributed to illegal drug use in 2009, which works out to around 114 per day. Second, you’re receiving treatment. The Substance Abuse and Mental Health Services Administration conducted a survey in 2013 and found the amount of people going without help was staggering. That year, more than 24 million people were suffering from substance abuse issues, but just slightly more than 2.5 million checking in a rehab facility.
It’s important to recognize addiction for what it is, a disease. Despite some people believing it just a choice and willpower is all that is needed, the science now shows that addiction, regardless of the type, is a disease of the mind. It’s also important to recognize that drugs and alcohol are not the only things people head to rehab for. There are people in facilities across the country struggling with eating disorders, sexual compulsion, gambling addiction and more.
If you’ve ever seen the television show Intervention, you know what a horrible monster addiction can be and just how hard it is to beat it, even if you have professional help. If you’re coming to terms with your issues and you think a stay at an inpatient facility may help, terrific. To help get you through the butterflies, here are 15 things you should know before you enter rehab.
15. You Have a Problem
You’re going to rehab, dude. You may know you have a problem, or you may be in denial, but the fact is, people who don’t have problems don’t go to rehab. Maybe your family or friends forced you into it or a judge ruled you have to be there…consider it a wake-up call. There are plenty of people in this world who drink too much, do a lot of drugs and have unhealthy eating, sexual or gambling habits. These people would benefit from inpatient treatment. Consider yourself lucky that you’re actually getting it. The quicker you accept that your behavior is out-of-hand, the easier the first few days or weeks at rehab is going to be.
14. It’s Going to Cost a Lot
You spent a lot of money digging this hole, you’re going to spend a lot of money getting out of it. If you’re made of money, it won’t be an issue and you can go to one of the holistic facilities where everybody gets a masseuse and a personal chef. They usually only take cash. If you’re like the rest of us, insurance is going to need to cover some of it. On the low-end, you can expect to spend $300-$350 per day. The higher end facilities can run between $2,000 and $3,000 per day. Make sure to find out from your insurance what is covered and for what length of time. Far too many people have had to leave treatment before they were finished because they money ran out.
13. Get The Picture Out of Your Head
Do you have a picture of rehab in your head? Is it the one from the Passages Malibu ads? Is it the one Sandra Bullock stayed at in 28 Days? Is it what you imagined from the book A Million Little Pieces? Will Dr. Drew be there like on Celebrity Rehab? Are the patients going to be twitching from withdrawals and throwing furniture? Will the patients be sitting on a mountainside chanting mantras? The answer to all of those questions is: Yes, but likely not in your case. Inpatient rehab facilities are as different as restaurants or clothing stores; they all do the same thing but they are all very different in how they do them. Head into rehab with an open mind and as few preconceived notions as possible.
12. You’re Walking Into an Established Social Order
Everybody in rehab falls into one of three categories: New person, Been there a while, Almost Ready to Leave. The people in the last group were once the new guy, they got to know the people and the system and now have a comfortable sense of entitlement. Consider them the seniors in high school who seemed to be treated differently. As a freshman, you should hang back and understand that within these three categories, you’ll find all of the personalities you remember from high school: The funny one, the alpha male, the slut, the brain, and so on. It would be nice to think that a place where people are trying to defeat addiction might be a little more mature, but it isn’t. Just remember, much like the freshman who becomes a senior, you will be one of the people who is Almost Ready to Leave eventually.
11. It Will Be Like House Arrest
Whatever your addiction, you’re not able to keep it under control in your real life. In order for treatment to begin, you need to be removed from real life. Some rehabs are very strict and some are more lax, but all will have a set of rules you need to follow and at the top of list is that you can’t leave. Or, like house arrest, you can leave but there will be consequences. You’re going to be told when to wake up in the morning, when you’ll get to eat and when you need to be in your room for the night. Your days are mapped out for you and there will be few surprises and little spontaneity. Disobeying the rules will result in punishment. Addicts are not good with structure and schedules, and adhering to them is a vital part of the recovery process, even if it feels like prison in some ways.
10. You May Be There a While
There seems to be a belief among most people that rehab is 28 days and then you’re done. While there are certainly facilities with 28-day programs, and some with even shorter durations, you should probably clear your calendar for a while, especially if you are required to get a certificate of completion. This is sometimes needed by a judge, a licensing board (medical, educational, governmental) or some other entity to have proof you successfully finished treatment. That proof doesn’t come until the professionals there decide you’re ready, whether it’s 30 days, 90 days or 150 days. People who are less sick than you will leave sooner, while others will stay longer. Instead of circling a date on the calendar to leave, wait until you’re told by those in the know that you’re ready.
9. The Rules Will Frustrate You. Get Over It.
Walking into an inpatient rehab facility is not like walking into a hospital. They don’t have to serve you and they are there to make money. There is a very fine line between quality healthcare and commerce and you’ll see that line crossed again and again. Patients who have been there longer than you already know to let it go because there is nothing you’re going to say to change things. Go ahead, threaten to leave or to tell everybody on Facebook how greedy the facility is being. Why would they care? They’re in a business that will never run out of customers and never have to utter the phrase “The customer is always right” because their customers are addicts. Practicing radical acceptance will help in recovery, and you’ll get a lot of practice at rehab.
8. Former Addicts Will Be Treating You
While most brain surgeons probably haven’t had their heads operated on and the bulk of oncologists have never had cancer, you’ll find a lot of the staff at rehab facilities are made up of former addicts, many of whom were likely at that same facility not too long ago. Like any corporate hierarchy, there are people at the bottom, plenty of middle management and the executives on high you never see. Those at the bottom, people who work in the kitchen or are techs, are making minimum wage. Who wants to work at a rehab for minimum wage? People who are either trying to stay clean or people who can’t get a job anywhere else. Many of the social workers and case managers will also be former addicts, looking to give something back and be a model that the disease can be overcome. Who better to help than someone who has been there?
7. There is Very Little Communication With the Outside World
Much like prisoners, patients in rehab develop an “in here/out there” mentality since most facilities limit exposure to family and friends during your stay. The people who you surrounded yourself with may not have been bad influences, but they didn’t help anything and you need time away from them to get better. Most facilities have prescribed telephone time, with many allowing patients only 5-to-15 minutes per day. Usually a couple of hours on the weekend is reserved for visitation, but in most cases, visitors have to be cleared well in advance before they show up. It’s hard to leave people behind and you’ll get homesick, but you’re there for a reason.
6. You’re Not in a Place Free of Temptation
Despite best efforts from the facility to keep an environment free of the substances or triggers for behavior that lead you to be an addict, there are people who will try to indulge in their addiction and who may try to take you with them. While not conducive to your recovery, it is also something you’re going to face every day when you leave. It is not hard to find drugs, alcohol, someone wanting sex or other negative behaviors that led people to being there in the first place. If uncovered, facilities can handle it anyway they want, from contacting the police, to kicking someone out, to doing nothing at all. Don’t let this throw you off. It’s just the first test of many to come.
5. You’ll Build Strong Connections to Fellow Patients
Most rehab facilities treat patients for drug and alcohol problems. Some expand it to include sexual addiction, eating disorders and other issues. The minimum age is usually 18 for admittance and there is no cap for the elderly. You’ll find poor people and well-to-do and patients from all over the country, if not the world. It’s a lot of very different people bonded by one major negative flaw and the experience of rehab has been likened to that of being in a foxhole in a war. Despite the differences, huge bonds will form as individuals face their underlying issues and seek support from others. Often, the deep connections are recognized until you’ve left the facility. Make sure to get phone numbers and email addresses because you’ll need some of that support on the outside.
4. Learn the Policies on Nicotine and Caffeine
Whatever the reason, most addicts love to smoke and always have a coffee or energy drink in their hand. Some facilities believe that letting their patients smoke cigarettes and have coffee are ways to help take the edge off a difficult experience. Others, recognizing both nicotine and caffeine and technically drugs, ban both on their campuses. This can be nice if you’re a non-smoker or unencumbered by the chains of caffeine, but the withdrawal and cravings can be just as bad as any other drug if you’re addicted. Before you check into rehab, ask yourself what you really can live with or without. Maybe now isn’t the best time to try and quit smoking. On the other hand, if you’re trying to eliminate negative behaviors, you might as well ditch them all at once. It’s for you to decide, but you really should know in advance.
3. Get Used to the 12 Steps
Most, but not all, treatment programs (both inpatient and outpatient) push a 12-step program. All 12-step programs are based on the principles of Alcoholics Anonymous, which was created 80 years ago. The cornerstone of all 12-step programs is the belief in a “higher power” defined as a “God of our understanding.” It’s a challenging piece for atheists, agnostics or those who are just unsure or don’t care, but the statistics don’t lie. Twelve-step programs are statistically proven over any other method to yield the best results. You’ll attend daily 12-step programs in rehab and be encouraged to find a sponsor and go to 90 meetings in 90 days upon your discharge.
2. Leaving Will Be Strange
In The Shawshank Redemption, Morgan Freeman’s character of Red describes life in prison, saying, “These walls are funny. First you hate ’em, then you get used to ’em. Enough time passes, you get so you depend on them. That’s institutionalized.” A lot of people have trouble leaving rehab because they held onto the idea they hated it throughout, but came to depend on the people, the support and the schedule they loathed. Returning to a world that hasn’t changed while you were on the inside is surreal and can be difficult, which is why so many facilities offer a transitional living option to help ease patients back into real life.
1. Success is Rare, But Happens
If it’s your first time in rehab, you’ll probably be surprised that you’re in the minority, with most of the people around you on their second, third or 14th try. Thankfully, they keep coming back but it does show how few people succeed upon leaving a facility on their first try. Depending on the statistics you look at, successfully maintaining sobriety after leaving a rehab center on the first try is between 5 and 20 percent. Beating the demon of addiction is the hardest thing you’ll ever have to do, but it can be done and if it doesn’t work the first time, continue to fight it. Your life depends on it.