It can take a lot of time and effort to convince a friend or family member to enter treatment for addiction. Many people find it difficult to accept they need help. While entering treatment is a big achievement, it’s only the beginning of recovery. There’s a lot of work left to do and studies have found that around 17 percent of people in treatment will try to leave early. What makes people want to leave?
Withdrawal is hard.
The biggest challenge for most people is detox. This may last a week or two depending on the person’s addiction history. Withdrawal symptoms can be intense. They are different for every drug, but they often include agitation, anxiety, irritability, headaches, nausea, and insomnia. People who have detoxed from opioids describe it as the worst flu they’ve ever had. People with severe alcohol withdrawal, or DTs, may experience shaking, sweating, hallucinations, and seizures. It’s easy to understand why people want to give up halfway through. If someone wants to leave treatment because withdrawal is too hard, it’s important to make them understand a few things. The first is to remind them why they agreed to treatment in the first place, including any possible legal consequences of quitting treatment. The next is to remind them that detox is unavoidable. If they don’t finish it this time, they will have to go through it all over again next time. Finally, detoxing in treatment center is the least bad detox will ever be. Staff can monitor your symptoms, make sure you’re getting enough fluids, and sometimes administer medications to relieve some of the symptoms.
Many people get into treatment, look around and think, “I’m not like the other people here.” This is what AA people call “terminal uniqueness.” It’s the trap of thinking you’re somehow different, that everyone around you is an addict, but your own addiction is the result of special circumstances. In reality, everyone’s addiction is the result of special circumstances. The whole point of treatment is to address those specific circumstances. Everyone has a story and everyone feels like she might not belong there. Often it’s hard to accept that the way other people in treatment look to you is how you look to everyone else. When someone feels like treatment isn’t for her, or that she’s somehow different, it’s hard to convince her otherwise. And, in a sense, she’s right. Everyone is different. A better approach might be to convince her to play along for a while. Most of the time, treatment doesn’t require enthusiasm, only participation. Treatment staff are used to working with reluctant patients. If you can convince someone just to stay a little longer and play along, eventually she will likely become invested in the process.
PAWS stands for post-acute-withdrawal syndrome. This is the feeling many people get after they have finished detox but their body’s haven’t quite adjusted to the absence of the substance. Levels of dopamine, serotonin, GABA, and other neurotransmitters may remain out of balance for months after detox. This leaves many people feeling depressed, emotionally numb, and unable to feel pleasure. It’s easy to associate this feeling with your immediate surroundings and feel like you have to leave–and possibly resume using–if you’re ever going to feel right again. It’s important for someone experiencing PAWS to tell their therapist about it. Sometimes antidepressants or other medications can help. It’s also important for family to participate in treatment. Patients who feel less cut off from family support may feel better and be more willing to stay. Family involvement may also help discover whether the patient has a legitimate complaint and is not just irritable because of PAWS.
Some specific conditions may make it more challenging for people to persevere in treatment. Addiction usually comes with at least one co-occurring condition, such as anxiety, depression, OCD, bipolar disorder, ADHD, schizophrenia, PTSD, or borderline personality disorder. Some of these may make it harder to stay put. If someone with bipolar disorder, for example, has a manic episode during treatment, she may suddenly feel she doesn’t need treatment, that she’s perfectly fine, or that she has an important purpose to fulfil and treatment is just a way to undermine her mission. When someone gets into a state like this, it’s very hard to convince her to stay. The best thing to do is just support the efforts of the staff to keep her in the program. Other conditions may be a little more manageable. Someone with anxiety or ADHD might start feeling restless and want to leave, but they may be more easily persuaded to stay. Someone with borderline personality disorder may have a lot of interpersonal conflicts with staff or other patients. Convincing her that learning to resolve these conflicts is part of the treatment process and is also necessary for your own relationship may help convince her to stay.
Some people just find treatment boring. To be fair, the purpose of addiction treatment is not really to have fun. It’s possible to tell someone all she needs to know about recovery in the first day or two, but knowing it intellectually is much different from being able to practice it. A patient may feel like she already knows what people are telling her, or that she’s heard the same thing a thousand times in the first week and she feels like she’s wasting her time. It may be tedious at times, but it takes practice and repetition to make new concepts stick. If someone tells you she wants to leave because she’s bored and she already knows this stuff, the best you can do is empathize. Point out that knowing is different from doing and it takes time to internalize new ways of behaving. Keep in mind that boredom may be an excuse for something else, possibly fear of failure or vulnerability. Be a good listener and see if you can figure out if something else is going on.
If you or someone you love is struggling with addiction or mental illness, we can help. Recovery Ways is a premier drug and alcohol addiction treatment facility located in Salt Lake City, Utah. We have the resources to effectively treat a dual diagnosis. Our mission is to provide the most cost-effective, accessible substance abuse treatment to as many people as possible. Request information online or call us today at 1-888-986-7848.