Why is relapse so high after rehab?

Unfortunately, there is no straightforward answer to this. It is a combination of multiple different factors that are different for every individual. In my experience, there are some major flaws with the drug alcohol rehabilitation model that make it difficult for people to stay sober after rehab. I have listed some below:

There aren’t many curveballs in rehab. You essentially are following the herd. Your day is laid out for you. Wake up, do a meditation, go to breakfast, do an activity, get in the van, go to a meeting; the ability to make decisions is limited. I’m not discounting the importance of isolation, especially in the first 30-60 days, but it seems silly to me to keep an individual with a drug to alcoholic tendencies completely locked down during their stay in rehab and then cut them loose at the end. Yes, there’s sober living after rehab, but the level of structure varies and the house is only as good as the clients that are in it. I’ve seen one relapsing client in a sober living take out 5 other clients before they are found out and asked to leave.

Changing dynamic. When someone gets to rehab it's usually all love and support from the people around them. “We’re so proud of you, we love you, what do you need, we want to support you,” and the individual essentially just has to stay put, do the work and follow directions. Once they graduate from rehab that dynamic changes. Now it’s time to get a job, be responsible, get themselves out of bed in the morning, get a phone, answer the phone, and join the rest of the functioning society. For some, this is too much. “What happened to me just needing to stay sober?” Life comes at them too fast and they can’t deal with it. Again, this is a failure of the rehabs to adequately prepare their clients for what comes next.

Aftercare tends to be a joke. Clients after they graduate from rehab are often times invited to attend an aftercare program at the facility. That is great if they live near the facility but oftentimes they don’t. They are back home and faced with all the temptations that were there before they left and do not have their rehab facility there as a support system.

Failure to develop an adequate support network in their hometown prior to leaving a facility. Often times rehabs will sit down with a client before they leave and map out an at-home “support network” for an individual, but it usually isn’t very thorough. It will say things like “get a sponsor once I’m home,” which is great but once an individual leaves rehab that accountability network imposed by the rehab is basically gone. The individual returns home and is only accountable to themselves, their parent, or loved one, which they probably have a history of manipulating.

Parents or loved ones oftentimes experience a loss of identity when an individual returns home from rehab. People get used to their roles; comfortable with their discomfort. Parents and loved ones who are used to being the savior in an unhealthy relationship are no different. When an individual returns home from rehab the level of structure imposed at the facility is gone. Faced with this people tend to fall back into their old patterns/roles. It’s familiar, to everyone. This might not happen overnight, but statistically speaking this is going to happen. Overbearing parents, for example, will experience a loss of identity as the relationship dynamic is challenged when their son/daughter returns home. They are used to being the savior, taking care of them, babying them; having a child come home who is self-motivated and ready to make positive changes means the parent has to figure out their new role in the relationship. “Does my child no longer need me?” I have seen this be a devastating reality for a parent and watched them unconsciously try to regain that unhealthy relationship dynamic despite it being detrimental to their child.

As I wrote this I realized we are drifting more into my area of expertise and I have more to say on the subject. I’m adding another blog post on the subject. See “Parents Aren’t Perfect” for more information.

A lack of willingness and humility. These two characteristics are crucial in my opinion to staying sober. You have to be willing to put yourself out there and be in uncomfortable situations. Unfortunately, the high-end treatment model tends to do the opposite. They cater to the client, provide a spa-like experience, and do little to build on the character of the individual. A great way to address an individual’s core issues and character defects is by taking them OUT of their comfort zone. People tend to grow through struggle and there is little struggling at spa rehabs. I went to numerous high-end rehabs, but where I finally got clean and stayed clean was at the Salvation Army in Santa Monica. It was not pleasant, but I did it and I do not want to do it again. Having a tough recovery has been a big deterrent for my choosing to pick up again. I went through hell to get clean.

These are just a few factors I have observed, there are many others. Feel free to reach out if you have questions or anything to add.