Residential treatment is a level of care in the continuum of care in addiction treatment. It involves 24-hour access to medical or clinical care. It also means living at a treatment facility or in a sober living environment that’s run by your treatment center. Residential treatment comes with a variety of important rules, but what happens if you want to leave?
Addiction treatment can be stressful, what if you don’t want to be there anymore? It’s true that treatment and recovery is a challenge that takes work. It’s also true that sticking with it is usually the best option in addressing your substance use disorder. But what happens if you leave residential treatment?
Learn more about what you should do if you’re thinking about leaving residential treatment and the rules that you should know.
Addiction treatment, even residential treatment, is a form of healthcare, and like other forms of healthcare, you can refuse treatment and leave as long as you’re an adult. Also, like other forms of healthcare, abandoning your treatment plan before it’s complete can have consequences. Still, treatment is your choice. You can choose not to participate and to leave a residential program as long as you’re a legal adult that’s physically and mentally capable of being on your own.
There are a few exceptions to this. One example is court-ordered rehab. In some states, it may be possible to attend a relapse program as part of a probation program or instead of serving jail time. In these cases, the laws may vary from state to state, but leaving may be a violation of your probation and may come with legal consequences. In such cases, even refusing to participate in therapy may be considered a violation. Even in that case, remaining in treatment and participating is your choice, though the alternative may be worse.
Treatment is a process designed to help you learn how to cope with cravings, negative emotions, and other triggers without using drugs. The goal is to achieve long-term sobriety. If you go through a detox program, it may not be enough to facilitate long-term freedom from active addiction.
If you’ve been placed in a residential level of care, it means that there is sufficient need for you to have 24-hour access to medical or clinical care. Cutting treatment short at that level may mean leaving before you’ve developed the coping skills to avoid relapse or other issues.
Remaining in treatment for long enough is an essential part of addiction treatment. According to the National Institute on Drug Abuse (NIDA), the ideal minimum effective time in treatment is three months.
The three months can span multiple levels of care, but spending that much time addressing addiction and underlying causes each week can help significantly reduce or stop drug use. NIDA also reports that addiction has treatment shown to be effective when you enter and remain in treatment. Addiction treatment can effectively facilitate stopped drug use, decreased criminal activity, and improved occupational, social, and psychological functioning.
A person may have many reasons for wanting to leave treatment, many of them are perfectly understandable. But leaving treatment before completing your treatment plan can be potentially dangerous. People may want to leave for a variety of reasons. Addiction treatment is a tough process that takes a lot of hard work, and the recovery process can sometimes leave you feeling frustrated, ashamed, embarrassed, and sad.
For many, working through that process leads to lasting healing. But when you experience those negative emotions along with powerful drug cravings, the urge to leave and use again can be powerful. Even if you don’t leave in order to use again, relapse is common when people leave treatment early.
Relapse after a period of sobriety can be more likely than when you were using drugs before. Many people get caught in a pattern of active addiction that lasts for several months or years before they seek treatment. During that time, you’re likely to build a tolerance to the drug, but many of the most popular recreational drugs can cause tolerance and dependence over the period of several weeks to months.
Tolerance can cause you to feel like your normal dose isn’t having the same effects that it once did. To compensate, many people increase their dose over time. When you go through detox, and a period of sobriety, your tolerance will go down. Depending on the drug, tolerance can significantly diminish within a week or two after your last dose.
If you go through a few days or weeks in addiction treatment, you’ll lose some of your tolerance, and smaller doses will become more effective. Many people who leave treatment early relapse by taking their usual dose, which can lead to an overdose. This is often seen with opioids like heroin.
Treatment also disconnects you from a life of active addiction. This is one of the biggest benefits of treatment, but it can also make cutting treatment short and relapsing more dangerous. Disconnecting from your old life can mean cutting ties with people that enabled or facilitated your addiction in the past.
If you go to treatment in your hometown, the landscape of your neighborhood can change, and the people you knew during addiction treatment may not be around anymore. If you go to treatment away from home, you’ll find yourself in an unfamiliar town when you leave. You may no longer have access to your old sources of addictive substances.
Illicit drugs are unpredictable. Heroin, pills, cocaine, and other drugs are routinely cut with inert substances or mixed with more powerful drugs like fentanyl. Many people get used to adulterated versions of drugs, thinking they’re taking a full dose.
If you were taking an adulterated version of the drug before and now you’re getting your drugs from a new, purer source, you may mistakenly take a very high dose. You may also find a source that mixes in powerful drugs like fentanyl, greatly increasing the potency of your dose without knowing it. This can also lead to a dangerous overdose.
Contemplating leaving is very common in addiction treatment, and even people who never decide to leave may think about it. Since the process is a challenge, you’re not alone if you feel like you want to give up. However, addiction treatment may also be what leads you to a life free from active addiction. If you want that, but right now, you’re feeling the urge to leave, there are a few things to do before leaving to make sure you’re making the right decision.
First, never leave in haste. If your emotions have reached a boiling point and you just want to cut and run, take a step back and try to cool off before you leave. When you’ve taken time to weigh your options and assess your priorities, you may find that leaving isn’t a good decision. It’s often recommended that you wait 24 hours between thinking about leaving and actually making the decision. This can allow your mood and perspective to shift. What was very important yesterday may seem trivial today.
Speak to your therapist as soon as you can. It’s likely that an experienced therapist has had clients that wanted to leave treatment before. Every person’s journey through treatment is unique, but your therapist may know some of the emotions you’re dealing with and the challenges you’re facing. Speaking to your therapist may help you work through some of the problems that are making you want to leave.
Think about why you started treatment in the first place or why you decided you wanted treatment. When people are faced with difficult challenges on the road to recovery, it’s easy to lose sight of the things that motivate you to seek help initially. Addiction treatment plans have both objectives and goals. Goals are big generalized desires that you have to work toward over time. A goal may be to gain sobriety. An objective is a smaller, more concrete task that can help you toward your goal.
An objective might be to share your experiences in group therapy in two sessions next week. For many people, objectives may be difficult, and they may cause some discomfort and negative emotions in the short term. No matter how badly you want to achieve your goal, your objective may still be a challenge. Remembering your goal and putting your objective into the perspective that it will help you achieve your goal may help get you through it.
ASAM. (n.d.). What is the ASAM Criteria? from https://www.asam.org/resources/the-asam-criteria/about
National Institute on Drug Abuse. (2018, July). Treatment and Recovery. from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
National Institute on Drug Abuse. (2019, November). Heroin. from https://www.drugabuse.gov/publications/drugfacts/heroin
National Institute on Drug Abuse. (2019, November). 8: Definition of dependence. from https://www.drugabuse.gov/publications/teaching-packets/neurobiology-drug-addiction/section-iii-action-heroin-morphine/8-definition-dependence
National Institute on Drug Abuse. (2019, November). 6: Definition of tolerance. from https://www.drugabuse.gov/publications/teaching-packets/neurobiology-drug-addiction/section-iii-action-heroin-morphine/6-definition-tolerance