Treatment for addiction is hard work. Depending on the type of addiction, and in cases in which there are co-occurring disorders and multiple addictions, it is harder for some than for others. In all cases, however, there’s a critical tipping point that loved ones and supporters of the addict need to look out for. Sooner or later, every addict in treatment wants to leave. The problem, and the issue, for those who care for the addict is: what to do and say when this occurs?
How Soon After Entering Treatment
Most patients in treatment who express a desire – quiet or belligerent, unsure or demanding – to leave are in the very first phase. This is the time during which their bodies are being cleansed or detoxified of the chemical or addictive substance or behavior. Often the patient experiences side-effects during the withdrawal. These side-effects may be mildly unpleasant or all the way up to severe. Again, it depends on the type of substance the individual is addicted to, how long they’ve been addicted, whether or not there is multiple substance or co-occurring substance abuse, physical and mental health, family history, and other factors.
If your loved one falls into this category – asking or demanding to leave treatment right after entering the program and during the detoxification phase, your best response is to tell them you really want them to give it a try. Let them know you understand that it is difficult and unpleasant and something they’d really rather not go through, but emphasize that it is critical for their progression to the next phase of treatment. Call on the assistance and support from the medical professionals to give you statistics and ammunition to back up your pleas.
When addicts leave treatment prematurely, they will fall right back into their old self-destructive behavior. They haven’t yet gained the understanding of their addiction or learned the tools to help them curb the incessant urges. In short, when they leave treatment too soon, they’re falling into the trap of the revolving door syndrome – in and out of treatment for addiction. When you see headlines and news stories of celebrities who can’t stay in treatment, you realize that the reluctance and refusal to go through the hard work to overcome addiction is not unique to your loved one. It can and does happen to everyone battling addiction at some point.
The key is to help your loved one overcome this hurdle – and it is a big one, make no mistake about it. So, when you hear, “I just want to come home” or “It’s too tough in here,” or words to that effect, don’t buy it. Steel yourself against the tears, recriminations, threats, anger, and cries of betrayal and abandonment and remind your loved one that you want what they want – for them to heal, to overcome their addiction. To do so, they need to remain in treatment.
No Locked Doors
It may come as a surprise that many residential addiction treatment centers have no locked doors. That means it’s surprisingly easy for patients to just walk away from treatment at any time. In fact, unless they’re under a court-ordered drug or alcohol treatment mandate, what’s to stop them?
It is also true that you cannot force someone else to give up an addictive substance or behavior if they truly don’t want to. Patients can and do learn about addiction and go through all the phases – and still come out and relapse. They may have entered treatment because of family pressure to do so, or out of a belief that if they did, a loved one wouldn’t leave them, or because their job or a legal issue demanded they get treatment. But no matter why the patient originally enters treatment, with no locked doors and no one strong-arming them to stay, it’s so tempting and so easy to just leave.
Counter this fact by stating, right up front, that you are aware there are no locked doors in the facility (if this is true in the treatment center where your loved one is getting treatment). While nothing can prevent them from leaving, you would consider it a mark of profound respect and commitment if your loved one does the right thing and remains in treatment for the duration of the program.
Be prepared for arguments, however, and these can be pretty compelling at times.
• I’m too lonely. I miss you, my family and my friends.
• The food here stinks. It’s all greasy (or fattening or tasteless, etc.) and they never give you enough.
• There are a bunch of lowlifes here. I really don’t belong here.
• How could you stick me in a place like this?
• I can’t get a good night’s sleep. The other patients moan or talk or carry on all hours. The bed’s too lumpy (or hard). There aren’t enough blankets.
• They won’t let me watch my favorite TV programs.
• They won’t let me stay up as late as I like. And I have to get up too early.
• The work is too hard.
• I don’t like telling my private thoughts to a group of strangers.
• I don’t like my therapist.
• I feel like a prisoner.
• I promise I won’t touch alcohol (or drugs, gambling, or other addictive behavior) any more. Just let me come home. Please!
• If you love me, you’ll let me come home.
• I hate you for what you’ve done to me, telling me I have to stay here.
• I’m going to kill you if you don’t let me come home.
• When I get out of here, I’m never coming back home. Then you’ll see what you’ve done.
• Was it really so bad when I was home? I’ll try to do better. Just give me a chance. I don’t need to stay here any longer. I’ve really learned my lesson.
• I’m afraid to stay here. The other patients are too scary. Some of them are even crazy and dangerous.
The litany of complaints and excuses goes on, of course. The clever patient will start with whatever he or she thinks will work with you and gradually move on to ever more ingenious and elaborate reasons why they need to leave treatment.
Again, do your homework and have your responses in order. You never want to be caught without an appropriate comment. That will just give the addict an edge to chip away at your resolve.
Maintain Contact with Treatment Staff
You should never be in the dark about what’s going on with your loved one’s treatment program. From the outset, the treatment staff of professionals wants to keep you informed at every step of the way. Why? It’s in the best interests of the patient and the family that you are kept abreast of progress or difficulties so that modifications in the treatment plan can be implemented.
Sometimes medication is recommended to help patients reduce or eliminate withdrawal symptoms. After the detoxification phase, when the addict enters the actual treatment program (learning about his or her addiction, identifying triggers, learning coping skills, how to prevent relapse, etc.), medication may be prescribed to continue to help with urges, anxiety, depression and/or other physical and mental conditions.
There will be times when you will not be permitted to have contact with the patient. Usually, this is during the detoxification phase. Other times, there are limits on visitation. This is generally to keep order in the facility, not disturb patients during individual and group counseling, and is common to all facilities. Just like hospital visiting hours, residential addiction treatment centers will have regular times for visitation. By keeping in touch with the treatment staff, you will be kept apprised of any changes in these dates and times, as well as know if there’s something urgent that requires your presence in between regularly scheduled visitation.
When a particular treatment modality doesn’t appear to be working, or is not working as effectively as the treatment professionals hope, you will be consulted about changing or augmenting the plan to incorporate something different. There are many different types of treatment modalities, and any such change will be carefully explained to you. This way, the loved ones of the addict are kept informed of all aspects of the patient’s overall treatment program.
It’s often during a period when things seem to be at a stalemate that addicts want to leave treatment. The treatment staff can work with you to devise strategies to keep the patient motivated and overcome their desire to leave.
Read more about When Your Loved One Wants to Leave Treatment