Long-term substance abuse treatment, once thought a luxury, is quickly becoming overwhelmingly obvious to be a necessity if one hopes to develop an alcohol and drug-free lifestyle that is not only sustainable, but joyful and fulfilling. Many experts today prescribe to the disease concept of addiction. Alcohol and drug addiction is a disease that affects the mind, body, and social abilities of the individual, all of which require individualized attention and care if the period of sobriety in treatment is to transform into a lifestyle. The individual who refuses or does not receive appropriate treatment and develop recovery often face the same consequences: jails, institutions, and death. The fact that long-term treatment increases one’s ability to achieve sustainable sobriety has become so evident that many therapeutic courts across the nation have mandated their programs to be 12-18 months at minimum. The outcomes focused on by the court systems are mainly decreased recidivism, or a decrease in repeat offenses that brought individuals to the drug, alcohol, and family court systems in the first place.

Long-term treatment has proven effective in application by data collected not only by the courts, but psychiatrists, psychologists, and substance abuse counselors as well. What seems to be most effective in this approach is that it allows for therapeutic change from the biological, psychological, and social perspectives, and facilitates a transitional phase back into societal roles and norms. In the past, the one-stop 28-day treatment was nothing more than a “spin-dry,” merely to remove the individual from the stimuli, but accomplishing very little with regards to re-entry to life, it’s many pressures, and the coping skills required to face those pressures. The challenge does not stem from getting a person sober, but keeping them sober. Short-term programs were helpful in having a person “dry up,” and maybe allow for a brief evaluation of any underlying mental health or medical issues, but fell drastically short in continuum when compared to long-term treatment programs. Once these individuals leave a short-term treatment, they return to the many challenges that most of us face in a day: work, school, bills, familial obligations, deadlines, and commitments, with the same limited coping skills they entered the treatment center with in the first place. In addition, they frequently return to the same social circles which often promote drug or alcohol use, or an inevitable path to relapse. On top of all of these challenges, the majority of addicts will experience up to two-years of post-acute withdrawal, a time of emotional and mental instability that exacerbates relapse motivation and challenges dedication to continue with recovery. This is a period when prescription medication management, psychotherapeutic support, and sober living support, are crucial. It is within this time frame that many addicts will self-medicate via relapse if not properly treated.

Long term treatment not only allows for the stabilization of biological consequences of use, but also allows for time to develop volition; the ability to make healthy choices, and autonomy; the ability to establish and maintain independence. In long-term treatment, the person learns not only to begin to reestablish healthy habits with regards to self-care, but also begins to learn cognitive skills that help identify emotions – emotions that at one time paralyzed them, but now may be used as strengths in creating positive lifestyle changes through positive behaviors, which create positive outcomes. Individuals learn how to develop healthy communication, healthy assertive skills, the assigning and maintenance of healthy boundaries for self and others, the many dynamics of interpersonal relationships, and how to make positive changes within those relationships.

There are many families out there who will continue to ask the question, “Why did this have to happen to our loved one,” in reference to having paid the final price for addiction: death. These families may have experienced many bouts with lapse and relapse, treatment center after treatment center, and spent a considerable amount of money. I have spoken to families after such a tragedy, and they all say the same, that they would gladly go through it all again and spend until they had nothing left to spend if it would bring their husband, wife, father, mother, son, daughter, brother, or sister back. I have yet to hear a family complain after a loved one has completed nine months, or even 18-months in treatment, seeming to be relieved of their alcohol and drug addiction, and say, “I wish they wouldn’t have spent that much time in treatment.” In closing, this message not only serves the alcoholic and drug addict that may still be suffering, but their families as well. Always remember, “They didn’t get addicted overnight, nor will they recover overnight.”