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Why Didn’t Rehab Work the First Time?

Why didn't rehab work the first time

The National Institute on Drug Abuse  (NIDA) defines addiction as a chronic, often relapsing brain disease. Although addiction relapse is unwelcome, it is not uncommon, and does not mean that recovery is unattainable. It can be helpful for people who have relapsed to examine the possible reasons in order to determine how best to proceed.

Treatment-Related Relapse Factors

Relapse may be due to multiple factors including those related to treatment and to the individual. Possible treatment-based factors include the following:

  • More time was needed – In a publication titled “Principles of Drug Addiction Treatment,” NIDA notes the importance of patients remaining in treatment for an adequate period of time. They report that the appropriate time frame varies according to individual circumstances but that most people need at least three months with the best outcomes correlating with longer treatment times.
  • Therapies were not the best match – There are many possible therapies, and it is important for clinicians to match them to individual needs and characteristics. It is also important for therapies to be evidence-based. The Substance Abuse and Mental Health Services Administration maintains a National Registry of Evidence-based Programs and Practices, which contains information on more than 300 therapies. If treatment for drugs like clonazepam with one intervention does not prove to be fully successful, there are many others to be tried.
  • Co-occurring disorders were not identified or adequately addressed – Substance abuse disorders commonly co-exist with other mental health conditions. If a condition such as anxiety, depression, bipolar illness or post-traumatic stress disorder (PTSD) is not addressed, addiction treatment is likely to be less successful than it would otherwise be. The best outcomes arise from integrated treatment in which the conditions are addressed in a coordinated manner preferably within the same treatment facility.

Personal Relapse Factors

There are also individual factors that may play a role in relapse. These include the following:

  • Ambivalence was unresolved – It is common for people to enter treatment with a degree of ambivalence about their desire to abstain from drugs like clonazepam or alcohol. One goal of the addiction treatment process is to help individuals move through the stages of change until they have fully committed themselves to abstinence.
  • There was an incomplete understanding of addiction and recovery – Drug and alcohol abuse affect memory, judgment and cognitive functioning. During rehab and early recovery, the brain is still healing, and cognition may still be impaired. Patients may not fully grasp important concepts until their brains have had more time to repair themselves.
  • Relapse triggers were not fully identified – Any number of physical and emotional states can contribute to relapse. A goal in treatment and early recovery is to identify as many potential triggers as possible so that they can be avoided.
  • The support system needed to be strengthened – A 2002 article in The American Journal on Addictions reported on a study of 748 individuals who completed inpatient rehab. Of the variables studied a patient’s post-treatment support network was the most likely to correlate with successful recovery.
  • Substance abuse was not replaced with new, healthier activities – It is important for people in recovery to develop new interests and habits. Those who leave a vacuum are more likely to return to substance use.
  • Physical health was neglected – Physical and emotional health are intertwined. Lack of sleep, an unhealthy diet, insufficient exercise and exposure to toxins can all weaken both the body and mind and make relapse more likely.
  • Stress was not adequately managed – Stress is an extremely common relapse trigger and can take many forms. A 2013 article in the journal Addictive Disorders and Their Treatment  reports that substance-dependent people who live in critical interpersonal environments and have high sensitivity to rejection are especially vulnerable to relapse.

Relapse Means Setback, Not Failure

NIDA makes the point that relapse rates for addiction are similar to those for other chronic diseases such as asthma, hypertension and diabetes. They note that addiction should be treated as other illnesses are with relapse signaling a need for renewed intervention.

Because relapse is a signal that treatment needs to be adjusted or reinstated, it is not uncommon for individuals suffering from addiction to return to rehab for drugs like clonazepam. Sometimes people attend a different sort of program than they did the first time choosing a residential rather than outpatient facility for example. At other times they return to a similar treatment program but with a renewed understanding of the tasks that need to be completed and a stronger sense of purpose and motivation.

If you have suffered a relapse, we can help you get back on the recovery path and find a treatment program that meets your needs. Our toll-free helpline is answered 24 hours a day by compassionate and knowledgeable individuals who understand relapse and addiction to drugs like clonazepam. They can explain your options and can even check your insurance coverage if you wish, at no cost or obligation. There is no need to stay down after a fall. Give us a call, and let the healing resume.