Going Out of Town for Addiction Treatment: Is It More Effective?
Recovery from addiction is not easy. The addict has, at least to some degree, organized their life around their addiction. Using has become more important than their job or career, their social life, their hobbies, and more important than even their family and friends. Their money and time has been consumed to increasing degrees by acquiring the drug they crave. Many addicts end up “couch surfing”, meaning that they have no place to live and so will sleep on the couch for a couple of nights at the home of a fellow user. Their possessions have been sold or pawned to get money for drugs. When deciding to finally make a change and get addiction treatment, being anywhere near this environment can be disastrous, which is why it’s sometimes best for the addict to consider going out of town for addiction treatment.
A Letter From Addiction
Many people are familiar with a letter written from the point of view of addiction. Part of this letter reads:
“The countless good jobs you have sacrificed for me. All the fine friends that you deeply cared for-you gave them up for me. And what’s more, for the ones you turned against yourself because of your inexcusable actions-I am more than grateful.”
Later, the letter says:
“And especially your loved ones, your family, and the most important people in the world to you. You even threw them away for me.”
The letter concludes with by promising:
“You can depend on me to keep you in living hell, to keep your mind, body and soul. FOR I WILL NOT BE SATISFIED UNTIL YOU ARE DEAD, MY FRIEND.”
This letter is powerful because it so accurately describes what addiction does and that it will never go away on its own.
Keeping in mind that addiction has resulted in such wholesale destruction of the addict’s life, it is surprising that the recovering addict often wants to stay near the people and places that were touched by their addictive behavior.
Principles of Addiction Treatment
Research completed in the 1970’s has revealed that there are several principles which are important for sustained recovery from addiction:
- Addiction is a complex but treatable disease that affects brain function and behavior.
- No single treatment is right for everyone.
- Those suffering from addiction should be able to enter a treatment program quickly.
- Treatment should address all an addict’s issues, not just the addiction itself.
- Staying in treatment long enough is critical.
- Counseling and other behavioral therapies (like Cognitive Behavioral Therapy and Mindfulness-Based Cognitive Therapy) are the most common treatments for addiction.
- Medicines can be a vital element of treatment and can be effectively used along with behavioral therapy.
- Regularly scheduled reviews of treatment plans should be completed and treatment plans should be modified as the patient’s needs change.
- If co-occurring disorders are present, they should be treated along with addiction treatment.
- Detox should begin treatment, but is only the first stage of treatment.
- Involuntary treatment can still be effective.
- Regular drug screens should be scheduled during treatment to verify that relapse has not occurred.
- Treatment programs should test patients for HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as teach them about steps they can take to reduce their risk of these illnesses.
These principles should and will be a part of any addiction treatment which hopes to result in long-term recovery.
Treatment for Addiction
SAMHSA’s yearly survey regarding addiction treatment in 2014 found that 22.5 million US citizens needed treatment for drug abuse or addiction. Of these, only 4.2 million, about 1/5th of those who needed it, actually received treatment.
There are several elements of successful drug addiction treatment:
- Stop using drugs
- Behavioral counseling
- Medication (for opioid, tobacco, or alcohol addiction)
- Evaluation and treatment for co-occurring mental health issues such as depression and anxiety
- Long-term follow-up to prevent relapse
- Stay drug-free
- Contribute to the community by being productive at work and caring for their family.
Over the years, different kinds of treatments have been developed. There are differences in where treatment is given. For severe addiction, partial hospitalization is preferred, while less severe treatment may be accomplished with intensive outpatient treatment (IOP) or outpatient treatment. A major benefit of IOP and partial hospitalization treatments is the presence of a team of trained professionals who can monitor your progress through detox, withdrawal, and counseling. This same treatment team can also prepare an individualized treatment plan for you, based on your needs. This treatment plan will include both individual and group counseling, treatment of any co-occurring mental health issues, and training to develop skills for coping with life and avoiding relapse.
The amount of time spent in treatment may last a few days or even several months, depending upon the severity of the addiction. Other people may choose to live in a sober living community where they will be with other recovering addicts who will mutually support and encourage one another. Other options for treatment include long-term outpatient treatment, in which the person lives at home but visits the treatment center up to several times a week for individual and group therapy.
The tools and techniques used in treatment vary as well. Behavioral counseling is frequently used. In the case of addiction to an opiate, some medications have been approved that are useful for managing withdrawal symptoms. Training to develop skills in relapse prevention and long-term follow-up are also important elements of treatment. The addict should also be evaluated for co-occurring mental health disorders. Any such disorders found should be treated as part of the addiction treatment program.
The Pros and Cons of Local Treatment
The primary benefits of local addiction treatment are that it’s potentially less expensive and the recovering addict may have more contact with supportive family and friends. A local treatment center is also more convenient for easy transportation. Family or friends can drop you off when it’s time to start and pick you up when treatment is completed. There are a couple of risks involved in local treatment. For one thing, it can be easy to leave treatment when things get difficult since home and family are close by. The addict can also connect more easily with friends who are still using drugs. When they decide to get addiction treatment locally, they’re also choosing ironically, and likely self-destructively, to receive treatment in a location probably right near the locations connected to where they were using their drug.
Why Go Out of Town for Addiction Treatment?
It’s been said that the recovering addict must find a new sandbox and new friends to play with. While it may sound juvenile, this image is an easy way of saying that the addict who wants to achieve sobriety must stay away from the places where they had previously used drugs and break their connection with the people they previously used with and who may still be using. A complete change of scenery is needed.
There are many good reasons for going out of town for addiction treatment:
- Triggers: Getting out of town for treatment allows the addict to get away from triggers. The reality is that being in a familiar place may result in seeing places where drugs were purchased or used can be a powerful trigger. Similarly, people who are still using may choose to visit, another powerful trigger.
- Difficult to Quit: The recovering addict who receives treatment out of town is more or less stuck there. If you attend a treatment center close to home it is too easy to leave when you hit a challenge or painful situation. Some counselors talk about “revolving door treatment”, referring to people who frequently leave treatment early and then return to treatment again. Receiving treatment out of town means the addict is in an unfamiliar place where they have no contacts who can either give them a ride home or bring them drugs. The person has little choice but to stay in treatment until it’s completed. In addition, the money you spent on travel is something you can’t get back. If you leave without completing treatment, that money will simply be wasted.
- Privacy and Confidentiality: An out of town treatment center also increases privacy and confidentiality. People in your home town will not know you are in treatment, unless you decide to tell them. This can be very important for a person who has a good job or who is involved in some way in the community, such as being a leader at their church or other social organization. Despite the changing attitudes about drug addiction, many people still believe that an addict’s problem is their own fault and may judge them accordingly. In addition, the addict may not want to be recognized by either staff or other patients. For example, a pastor would probably not want one of his parishioners to see him in a treatment center. Treatment is hard enough as it is, without the additional risk of be recognized and judged by staff, other patients, or even being judged by your own family. Going out of town for addiction treatment reduces the risk of being recognized almost completely. All anybody at home needs to know is that you are going away for a while. The why and where are nobody else’s business.
- Focus on Recovery: The addict who goes out of town for treatment can focus completely on their recovery. Without the distraction of family and friends living nearby, the recovering addict can focus on themselves for a while. This “me time” is an important part of the recovery process, primarily because the person has their own issues that need to be resolved or at least addressed.
- Starting Over: Going out of town for addiction treatment creates a kind of “fresh start”. Once the addict is away from home, they can start over and adopt a new way of living their life. Thinking of the time spent out of town as a kind of vacation, which is much more positive than just going for treatment, is a part of this. You will also be able to get away from the pressures and other things which may have led to your drug use in the first place.
- Confidence Boost: Leaving town for treatment can also boost your confidence. As you travel to a whole new city on your own, you can become more confident that you’re able to accomplish your goal of recovery from addiction.
- More and Better Choices: Going out of town for addiction treatment also gives the addict more choices. Rather than having to settle for whatever is available nearby, you’ll be able to evaluate various options and choose the one you think will work for you. At some of the more expensive “luxury” treatment centers, you’re likely to find excellent food, beautiful scenery and nice individual rooms, giving the whole situation a kind of vacation-like feeling. Rather than being “in a hospital for treatment”, you can think of yourself as being on a personal vacation for your own benefit. As with many other aspects of life, you’ll have to travel if you want the best.
- Easier Transition to Sobriety: Traveling out of town for treatment provides an opportunity to make the important mental transition from daily life to recovery. Simply getting dropped off at a treatment center near your home can seem or feel very abrupt. Making the physical journey from home to an out of town treatment center allows you to make the mental and emotional journey from your past using to a life of sobriety and continued recovery. Even the change of scenery and weather will help you make this important adjustment in your thinking and feeling.
- Better Treatment: Studies show that out of town treatment is more successful. 12% more people complete treatment at out of town treatment centers, and detox is 20% more effective.
- Recovery Community: At an out of town treatment center, you’ll probably encounter other people who have left behind their homes and families for a while to focus on treatment. You’ll be able to form a community of recovering addicts whom you can support and who will also support you.
It’s no wonder that going out of town for addiction treatment produces better results than going to a local treatment center. By getting away from the pressures and triggers of being close to home, the addict seeking recovery creates a space in which they can accomplish the important tasks of recovery. These tasks include detox, counseling for mental health issues, and the development of skills for resisting triggers and avoiding relapse.
Deciding If Going Out of Town For Addiction Treatment Is Right For You
Treatment for addiction is difficult and demanding. Any small benefits of attending a treatment center close to home, such as it being slightly less expensive and the availability of nearby support from friends and family members, are overwhelmingly outweighed by the benefits of going out of town for addiction treatment. Going out of town for treatment may be more expensive, but it’s worth it for many different reasons. Don’t cheat yourself or sell yourself short. Get the best treatment you can, even if it means going out of town for addiction treatment.
Additional References: SoberRecovery, DrugAbuse.gov, Rehabs.com, Addiction.com