This article originally appeared on VICE Canada.
Rehab can be a vacation of sorts. If you’re an addict, like I was, a vacation from one’s own dangerous freewill. Have you ever gone to a friend’s party and handed over your keys, knowing it’s going to be a rough night? It’s like that but rather knowing it’s going to be a rough life.
The tricky part is deciding to fork over your keys. The foremost roadblock regarding rehab is deciding to go in the first place. Typically you don’t check-in because you’re thriving and peachy-keen. You’re scraping the bottom of the barrel and your life is a bummer. Or your mom makes you go. Or your significant other. Or the state of California, or wherever.
The 2015 National Survey of Drug Use and Health (NSDUH) revealed that approximately one in 10 individuals suffering from substance abuse disorder received treatment. This means out of the 21.7 million people living in the United States who needed substance abuse treatment in 2015, only an estimated 2.3 million received treatment at a specialty facility that year.
Often, addicts attempt to quit on their own before checking-in to a treatment facility. Sick of being a slave to heroin, I locked myself into many a Motel 6 and attempted to expel the demon on my own, thinking if I could just get through the detox, I could get back on track. I’d last a day or two before emerging into the daylight with squinted eyes and a cigarette perched between my chapped lips, already feeling better having decided to ditch my detox and get high. Perpetually telling myself I’ll quit next week.
Rehab always felt like the most extreme option, a last resort. After many trial and error runs of trying to quit sans treatment, and after several brushes with death, I finally scared myself into rehab. I’m one of the lucky ones though. Every year, tens of thousands of addicts suffer fatal overdoses before they ultimately consider the idea that treatment might be a necessity for their recovery.
There are a multitude of reasons addicts do not seek treatment. Thinking you can quit on your own is probably the most universal reasoning that people suffering from substance abuse disorder have used. It might be time for rehab if you are experiencing any combination of the following:
You have compromised your health i.e. extreme weight loss or gain, regular vomiting, sleep deprivation, experiencing sores or abscesses, depression or mood swings; the relationships in your life have deteriorated; you are lying, spending a significant amount of money, or even stealing to feed your habit; your living environment and professional circumstances have been compromised by your substance abuse; your compulsion to use overwhelms your ability to have good judgement and your days revolve around obtaining and using your drug of choice.
For me, it was time for rehab when I had been estranged from my family for a year and I spent Christmas shooting up heroin and meth cocktails, getting a black eye, and hiding in a seedy alley surrounded by garbage because of a drug-induced psychosis that had me convinced I was being chased by gang members. I was a mere 100 pounds.
How to pick a rehab
Once a person decides they need to be rehabilitated there are still common barriers to treatment. A lack of funds or medical coverage is a major concern for many struggling addicts. There are scholarships, grants, and government-run programs that may help. The fear of friends, family, or coworkers finding out this dark secret also keeps many people fearful to come clean. Although, I suspect, it’s probably not as secret as you think it is. Also, you can otherwise choose to give your loved ones or employers the opportunity to be supportive of your recovery. Ultimately, the decision to seek treatment is likely more beneficial than the decision to continue abusing your drug of choice. Checking-in can save your life.
When it comes to choosing which rehab to go to, the options are varied. There are posh luxury rehabs, there are “middle-class” rehabs that often accept insurance and are more reasonably priced, and there are rehabs that are county-run and some that are slightly scary. Also some treatment facilities are relaxed, they encourage patients to take walks on the beach and do hot yoga. Other rehabs are not-so-chill and force patients to only walk the halls in pairs, perform invasive strip-searches, and disallow patients of opposite sexes to make eye-contact.
Scouring the internet for rehab reviews can save you a bad trip to treatment and help you to make the most of your time, money, and effort.
If you’re rolling in dough and willing to drop approximately $9,000 a week, you can check into Malibu’s Promises Treatment Center where the alumni include Robert Downey Jr. and Ben Affleck. Hope Rehab in Thailand is another famed choice, especially for creatives, with alums like Pete Doherty and Cat Marnell, and claims to offer a three-month stay for a cost lower than a one-month stay in the U.S. or U.K. The Betty Ford Clinic once treated Ozzy Osbourne and is a more affordable high-profile choice, treating clients for approximately $6,000 for a 30-day program.
Glendale Adventist Alcohol and Drug Services, in California, is not a luxury rehab but it’s a quality rehab. I should know, I’ve been there twice. I stayed with GAADS for a 30-day residential program, after which I graduated to continued care where I came several times throughout the week for evening therapy groups and family-therapy sessions. GAADS accepts insurance and offers financial assistance, including loan options for clients.
When you arrive
Once you’re admitted into a treatment facility, here’s what you can expect, accompanied by some tips to help you survive and thrive.
A major apprehension for those entering rehab is suffering the detox. Ewan McGregor’s character in the film Trainspotting, Mark Renton, describes heroin detox the best: “I don’t feel the sickness yet, but it’s in the post. That’s for sure. I’m in the junkie limbo at the moment. Too ill to sleep. Too tired to stay awake, but the sickness is on its way. Sweat, chills, nausea. Pain and craving. A need like nothing else I’ve ever known will soon take hold of me. It’s on its way.”
Different rehabs tackle detox differently, some insisting patients endure the worst of it in a hospital under a doctor’s care and some having patients go through it while in treatment. I’ve been to rehabs that insist patients detox cold-turkey and to others that tapered me off of opiates with Suboxone and Valium. Regardless, you’re likely to feel out of sorts for several weeks. For the discomfort I recommend:
Hot showers or baths work wonders to relax and soothe your muscle spasms and aches. Plus regular bathing and self-care can help to wash away that grimy feeling that comes with suffering from addiction.
Sip the tea in their hood. No, really, chamomile tea has way more soothing power than seasoned heroin users are willing to consider. I dragged my feet to the health office at Glendale Adventist Alcohol and Drugs Services, shivering and sweating, suffering from a weeks long insomnia the heroin detox brought on and begged for something to help me sleep. “There’s some chamomile tea in the kitchen drawer, try that.” Heartless, I thought. Cruel. Don’t they understand death is surely upon me? Skeptical, I made myself a cup of tea and sat outside sipping hot tea in crisp 4 a.m. air, staring at the cemetery next door. Did the tea help me sleep? Absolutely not. But it did bring me comfort while I couldn’t.
Chocolate-chip cookies and other sweets can ignite the reward system in your brain, the same reward system that craves your drug of choice and is likely feeling pretty neglected. Try not to over-indulge as that could lead to excessive weight-gain or a new addiction to sugar. I used to hoard cinnamon pull-apart bread under my bed for late-night snacking and I swear by it. For me, sweets really helped and I didn’t mind the extra five pounds I left rehab with. To be honest, I needed to gain the weight.
Self-Care (and smoking)
Cornerstones of the rehab experience often include chain-smoking cigarettes and ironically, trying to take better care of yourself, mentally, physically, and spiritually.
Cat Marnell, author of New York Times bestseller How to Murder Your Life and Audible original Self-Tanner for the Soul, told VICE, “You got to be smart about self-care. It can’t all be soothing.”
For Marnell, any kind of excessive behavior caught her flak with the counselors, from eating so much sugar they had to lock away the honey jars to exercising so much they insisted she stop. Marnell said her rehab survival tip would be to eat plenty of fruits, vegetables and lean protein. “If you gain too much weight in rehab you’re going to associate weight gain with sobriety, which is just what your addiction wants. Then you’ll be tempted to get right back on drugs when you get out and your jeans at home don’t fit.”
And for patients checking-in that are smokers Marnell said, “Get really lame girl cigarettes like Vanilla Dreams or Capris, that the guys won’t want to bum.”
Another thing a person can expect when checking-in to treatment is a busy schedule filled with 12-step or similar meetings, group therapy, family therapy, specially-tailored homework assignments, and required reading... and smoke breaks. Lots of smoke breaks.
My next hot take is to take advantage of the amenities. You don’t take a trip to Italy and not indulge in the pasta or fly to Fiji and not get your feet sandy, the same goes for rehab. The treatment plan they are providing is a service; use it.
When rehab counselors dish out homework, it’s not to torture patients or assign empty busy-work, it’s with hope there is something to be gained. Some of the personalized homework I was given included writing assignments. I especially struggled with the death of my father, (I’ve written about that here) so I was asked to write a letter to my dad, explain five things I never had the chance to tell him, and five ways I planned to nurture and care for myself in recovery. Another assignment asked me to describe in detail five qualities I liked about myself and how my disease had impacted each quality. The work was heavy, but cathartic and proactive.
I recommend you participate in the Alcoholics Anonymous and Narcotics Anonymous meetings, even if the 12-step program isn’t your jam and you’re suspicious it may be a cult. The 12-step meetings were always a favorite for me because I loved getting to be around all the fresh faces, many of them successfully sober and impressively moved on from the dark days of their addiction rock-bottoms. Seeing people who were once as hopeless as you, thriving despite their disease, inspires hope.
Expect to make friends
I am still friends with fellow addicts I met in treatment. It’s like you’re all helping each other stay afloat, riding in the same lifeboat, after suffering the same ship wreck. Switching out your old using buddies for some new recovering friends can be the difference in a successful recovery versus facing another relapse.
With that being said...
Don’t have rehab sex. When you’re freshly detoxed and sobriety is a shock to your system, the chemicals in your brain go haywire. Your brain is desperate for a fix, sniffing out pheromones and thinking, as Elle Woods might put it—sex gives you endorphins and endorphins make you happy and happy people don’t shoot heroin, they just don’t. A rehab romance may give you all the feels, but distracting yourself with infatuation is not the best route.
As recovery podcast savant and “My Fair Junkie” author, Amy Dresner, said: “They’re called rehab goggles for a reason. You’re not really thinking clearly yet and will pick the best of the bunch from the limited population—like sex in prison,” says Dresner. “And with both parties so needy and vulnerable, it’s bound to be a codependent disaster. I’ve seen people hook up in rehab only to relapse together when they leave. From my own personal experience, you can end up getting kicked out of treatment, losing your phone/visitation/computer privileges for a week or, at the very least, feeling really awkward in the daily mandatory groups that you both attend when it fizzles out or one of you moves on to the next hot client.”
My last bit of weathered wisdom to impart, is that rehab is not a cure. It’s a treatment for a progressive disease that worsens with time and will likely make a comeback if it goes untreated. It’s not uncommon for a patient checking out of rehab to feel confident and cocky about their recovery—after all they’ve maintained some sobriety when that seemed so hopeless before.
One of the biggest shocks for me was relapsing after my first real trip to rehab (you can read about my rehab fails here). According to the National Institute on Drug Abuse 40 to 60 percent of patients suffering from drug addiction wind up relapsing and a relapse does not indicate failure—rather, it suggests that treatment should be reinstated, or that another form of treatment is needed. After leaving rehab, you have to work just as much as you did in rehab, out of rehab. Continue therapy or 12-step meetings, or alternative treatment methods like medication-assisted treatment, but develop a plan and adjust it when you need to. Recovering from addiction is a high-maintenance gig.
After several stints in rehab, I can now say I haven’t had to take that trip since 2013, although sometimes, oddly enough, I kind of miss it.
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