Choosing To Leave Addiction Treatment
For some, entering addiction treatment can be one of the hardest decisions they will ever have to make. For others, deciding to enter treatment can feel like an easy decision. Often, the difference between these two extremes is directly related to how much harm their substance abuse has caused themselves and the loved ones they care for.
This factor is often the main motivator for those deciding to take action to prevent further harm to themselves or others; be it emotional, financial, materialistic, or physical. In fact, the most powerful forms of motivation can stem from some of the most difficult experiences. The need to make a long-lasting change for both themselves and the relationships they care so deeply for becomes an important part of the motivation to enter recovery. However, even the strongest of motivations can falter, but it’s important to remember that this fluctuation is normal, and is an expected part of the recovery journey.
Once someone decides to enter rehab, they are not held captive if they choose to leave. It is up to the individual to commit to the treatment process. The process may be difficult at times, resulting in some patients debating on whether they should leave treatment or not.
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The Red Zone
It is not uncommon for those who enter treatment to experience a change in motivation and start to question their choice to seek treatment in the first place. In fact, it is so common that many addiction professionals identify the first 1-2 weeks of treatment as the “Red Zone” or “Danger Zone.” During this time, the risk of leaving Against Medical Advice (AMA) is at its highest, which can cause many to end their recovery journey altogether.
This period is also considered an extremely high-risk time frame for relapse to occur, as urges to use substances remain substantial. It could be the “surrealness” of the trip and admission process wearing off or a realization of the difficult road ahead, which can leave them with a sobering reality that activates their fight or flight response. When this occurs, a feeling of desperation begins to set in, which often translates into finding ways and excuses to leave the treatment environment.
This fight or flight experience is quite common for those who enter a residential treatment facility, where living away from the comforts of their home, loved ones, and an environment they are comfortable in, even temporarily, can feel almost impossible in the moment. When this happens, a powerful feeling to escape can come to mind. For many, leaving feels like the right decision to make, as escaping has likely become a regular element of their life in active addiction.
Feelings regarding leaving treatment can be difficult to subside by the patient alone, and even with the support of their loved ones and trained professionals, staying in treatment can still be a challenge. Along with the fight or flight response, some of the more common reasons people cite for wanting to leave treatment include:
- “This isn’t how I expected it would look like; I don’t want to stay.”
- “This place is not nice or good enough, because (insert x).”
- “The other patients are much worse off than I am, I don’t belong here.”
- “I think I’ll be fine on my own, this was an overreaction.”
- “I have to get back to my family, they need me back home.”
The problem with many of these reasons is that they focus on external aspects of a person’s environment rather than the emotions that drive the urge to escape. Unfortunately, those who tend to leave treatment early, without a plan to continue treatment in some form, often return to their home environment resulting in a continued pattern of relapse.
This cycle of events usually leads to family members and loved ones trying their best to encourage the completion of treatment, however, in the end, they allow the patient to return knowing things have not improved.
Why Motivation Fades
Motivation is a fickle beast. It can feel extremely powerful and liberating at one moment and lackluster the next. There has been a significant amount of research into human motivation, and depending on the focus of a given study, you will usually find different strategies to effectively manage it.
For some, rewards can play a powerful role in maintaining motivation to complete a task. These rewards can be as simple as verbal encouragement or praise, or more significant such as gifts, prizes, or even cash. Rewards not only help provide recognition for achievements but also help activate the brain’s reward center to release dopamine to promote healthy behavior change.
For others, the need for a more intrinsic motivator is key to successful recovery. This is all to say that motivation can look different for everyone, and what may work for one person may fail for another. Furthermore, when a substance use disorder, addiction, or mental health condition is thrown into the mix, what motivates someone can become even more unpredictable.
What professionals in the addiction field do know is that finding the best motivator will often come internally from the person who needs help, while keeping it requires continuous effort and positive reminders from those around them of progress that has been made.
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The Bottom Line
In truth, the only person who can make a change is someone who wants to make a change. No amount of counseling, arguing, coercion, pleading, or manipulating will lead to a healthy recovery. It has always been up to the person entering recovery to find and maintain their recovery, though it is very important to know that they never have to take this path alone.
Treatment includes a strong support system of professionals, peers in early recovery, loved ones, and support systems found in both traditional and nontraditional 12 step programs. If you are currently in treatment and thinking about leaving before treatment has concluded, please remember the reason you decided to enter in the first place.
Whether it was hard or easy to make, the motivation behind your decision matters more than ever. Talk out your plan with someone you trust and care for and ask yourself, ‘will I be safe and sober after this?’ Reconsider the harm that has been done and if leaving treatment will further that harm for yourself or a loved one. For many families, trust has already faced hardships from addiction-based behaviors, and without real intervention and treatment, that trust often remains in hardship. There is a powerful phrase in treatment and 12 step programs, “Don’t leave before the miracle happens.”
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