Alternatives To Inpatient Rehab
In this guide, we'll examine several alternative options for people who cannot or will not go to rehab to treat their drug or alcohol disorders. These may also be good options to try after completing a successful rehab or detox stay. I'm essentially throwing everything at the wall and hoping something sticks.
Note that my first suggestion is to seek professional help and probably go inpatient, but I understand if that's not an option. If you're scared or unsure about inpatient rehabs, I have written an entire guide on the subject. I also have one for people who don't want to go to rehab or are being forced to go to rehab.
If you're currently experiencing deeply troubling thoughts, please tell a trusted friend or family member, go to the doctor, or call the national help line (USA) at 1-800-273-8255. You may also call or text the new help line at 988.
If you can't go to inpatient rehab due to school, work, or family obligations, outpatient services may be your best option. There are many programs around and I'm sure you can find one that's flexible enough to accommodate your schedule. They have programs that are during weekdays, weeknights, and weekends. There are also many treatment options you can do online. Starting your recovery journey with outpatient services is only appropriate in certain cases. If you're a heavy daily user, they may not take you, and will refer you to an inpatient center or detox center instead.
My first recommendation is to go to an outpatient Partial Hospitalization Program (PHP) for substance use disorder. These programs usually run four or five days a week and are most frequently offered during the daytime. So this might not be the most flexible option. This will largely be group therapy, with some individual sessions mixed in. If you have the time or can take off work, but family obligations are holding you back, this may be a good option, as you commute in each morning and return home each night, much like a job. This will provide a stable environment for you to recover in without having to be influenced by drugs most of the day. They'll test for drug use regularly to hold you accountable. Many also offer medical services and can start you on psychiatric medications, if needed. Remote options may be available.
The next step down from PHP is Intensive Outpatient (IOP). This is the best place to start if you have a chaotic work schedule or cannot do PHP during the daytime. This will also largely be group therapy. They usually offer separate weekday, weekend, and weeknight programs, so you can find one that fits into your schedule. You'll go 3-4 days a week for 3-4 hours at a time. Remote options may be available.
Transportation services to and from the outpatient facilities is usually offered at no additional cost, and it shouldn't be hard to find one that takes your insurance. Insurance companies are required to cover mental health and addiction services.
If you're heavily addicted to a substance, a detox facility may be the only way for you to get clean for a few days without relapsing.
Detox is where you go to get all the drugs out of your system safely and relatively comfortably. They don't always offer therapy or recovery programs, they're just there to get you off the drugs and out the door. You can also go to a rehab that offers detox, and just leave when you're done detox. I highly recommend doing this, especially if you're addicted to alcohol or benzodiazepines, where going through withdrawal can literally kill you.
The detox center will monitor you in a safe, medical environment with nurses and doctors present to help in the event of an emergency. They will provide detox medications to help taper you off your drugs without feeling like death. They usually offer medications to help with anxiety and sleep, too. They may refer you to additional support centers.
The nice thing about detox is that, when you leave, you can pick up your life shortly after you left off, without having to go away for weeks or months. Detox stays are usually relatively short, typically between five and ten days, though it may be shorter or longer depending on your situation. If you're concerned about work, use your vacation time, take unpaid leave for a "family emergency," or try to time it during an extended holiday weekend.
Rapid Detox for Alcohol and Opiates
If you're addicted to alcohol or opiates, rapid detox may be an option. With rapid detox, they put you under anesthesia and flush your body with naloxone (Narcan), This puts you into withdrawal and blocks the opioid receptors in your brain. Four to six hours later you wake up and you've been "detoxed."
While this might seem like an appealing method or a quick fix, it should really only be used as a last resort if all other methods have failed. Anesthesia comes with its own complications and you're putting undue stress on your body by using this method. In most cases, rapid detoxes are a medically unnecessary and unadvisable process. But the option is out there if you really want to try it.
At Home Detox with Medication
Consult with your primary physician or an addiction doctor. You may be able to detox yourself at home. They can provide detox medications to assist you with withdrawal, cravings, anxiety, etc. You may have to consult with multiple doctors before you find one that will help you.
Quitting Cold Turkey
Quitting "cold turkey" means to simply stop using your substance of choice and going through the withdrawal process in full on your own. If you're addicted to opiates, stimulants, or hallucinogens, you may be able to safely quit this way. You'll feel horrible and it won't be fun, but it is possible. It's not without potential risks, but it probably won't kill you.
Alcohol & Benzo Abusers
Consult with a medical professional to determine if quitting cold turkey is an option for you. If you're addicted to heavy amounts of alcohol or benzodiazepines, you may need to either taper down, find a doctor to prescribe you medications to take at home, or go to an inpatient detox facility so you don't literally die going through withdrawal.
If you've been drinking very heavily, like ten or more drinks a day, almost every day for the past week or longer, you're going to need to taper. If you've been drinking moderate amounts of alcohol, like 5 drinks a day, but almost every day for several weeks or months straight, you're going to need to taper. If you've been drinking a fifth or a handle of liquor a day, you're absolutely going to need to taper.
If you find yourself getting uncontrollable tremors (the shakes), experiencing delirium (hearing voices, sounds, or seeing things that might not be there, questioning your own reality), experience tunnel vision, or your head feels like it's going to explode, have a few drinks or seek immediate medical attention. Your withdrawals might kill you.
Risks of Quitting Cold Turkey
Aside from the risks associated with benzos and alcohol stated above, the biggest risk to quitting cold turkey is relapse. You're extremely likely to relapse if you try to quit on your own. You're still probably in the same environment you used to get high or drink in, the same people are around, and you still have access to the same drug dealer or liquor stores. Picking up the phone and calling your buddy to drop off some stuff is going to be extremely tempting as you go through withdrawal.
Overcoming the urge to use is possible through sheer willpower, but it's extremely difficult. If you have developed a tolerance, that means your brain has adapted to the drug, and expects it to be present. The drug likely ranks higher on your subconscious primal priority list than even food, water, and shelter. Your body and brain are screaming "I need this drug to survive," because you've been conditioning it to think and behave that way.
Other risks of quitting cold turkey include some standard side effects. Side effects may include cravings, insomnia, hypersomnia, anxiety, depression, nausea, vomiting, and more. Cravings, depression, and anxiety occur in almost every case.
Tips for Quitting Cold Turkey
If you've committed to the cold turkey method (against the advice of myself and most medical professionals out there), here are some tips that may help you.
- Get rid of all your drugs and alcohol.
- Don't hide it or give it to a friend to use.
- If there's a lot, don't use it all in a "last hurrah" and overdose.
- Flush it or throw it out if you have to (this is bad for the environment for several reasons), or better yet, find a safe drop off location at a police station or hospital. There are places you can go to get rid of your drugs with no questions asked and no risk of charges.
- Get rid of everything that reminds you of the drug.
- Throw out any drug paraphernalia. Dispose of any needles, cottons, spoons, lighters, bongs, bowls, pipes, vaporizers, empty bottles, etc.
- Get rid of anything and everything that's associated with using. Get rid of any clothing, posters, or other objects with drug references on them.
- If it's valuable, like an expensive wine collection, collector's items, or pieces of artwork (some bongs and glass pieces), sell it or have a sober friend hold on to it for you to sell later.
- Stay hydrated. Drinking water helps nourish the body and may help with headaches.
- Eat food. Things rich in complex carbs, protein, and healthy fats. Good "comfort food."
- If you've been drinking a lot, you've been consuming a lot of sugar. Your body will want to replace that lost sugar from the drinks with other sugars. Treat yourself to some candy or ice cream, but try not to go too overboard. Don't be discouraged if you put on a few pounds, you can worry about your weight after you get clean.
- Take some tylenol, again for headaches.
- Use melatonin or over-the-counter sleep aids to help you sleep - but don't use them more than suggested on the label. Using more that directed can lead to long-term sleep issues and health problems.
- Use natural substances such as chamomile tea to help reduce your anxiety or help you sleep.
- Stretch, do yoga, or go for a walk or jog. This helps release natural endorphins and dopamine and may be a good way to distract yourself from cravings. Don't do this is you feel too sick or nauseous.
- If you have supportive friends or family, spend some time with them and tell them what you're going through. They might not be able to help directly, but at least they can listen. Be careful not to take this too far, you shouldn't lean on one single person for all your sobriety, as it puts too much pressure on them which isn't fair and won't be sustainable.
- Get to an AA, NA, or other recovery-focused meeting. Raise your hand and ask for help. You'd be surprised at how willing some complete strangers may be to help you.
- Distract yourself. Watch a movie, play a game, listen to music, or read a book.
- Make sure whatever you're doing doesn't have lots of drug references in it, or you'll just end up torturing yourself. Games like Grand Theft Auto and movies like the Hangover aren't a good idea right now.
- Watch something calm, light hearted, and uplifting.
- Stay away from anything really dark, depressing, or serious.
- Pay attention to what music you're listening to. Don't listen to anything too sad or down and don't listen to songs that glamorize drug use or partying.
- Don't worry about the big serious stuff. Easier said than done, but now's not the time to be figuring out all your problems and dwelling on them. Work on getting you better first. It's okay to just zone out for a bit.
For some, filling a spiritual void in their life helps keep them sober. This could involve religion, or it could be something else entirely.
Being part of a healthy community is essential to growth and sobriety. Connect or reconnect with God. Go to Church and become an active member of a congregation. Some people get addicted to Jesus, and hey, if that's what keeps you sober, do it.
If you're a Christian, or want to be one, you may consider Celebrate Recovery, which is a 12-step program for Christians. Their meetings feel kind of like going to a church group. You'll sing songs and fellowship with other Christians in recovery and get connected with God. It's not my cup of tea, but it clearly works for many people.
A hallmark of 12-step programs is getting connected with a God of your understanding. Programs such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), Cocaine Anonymous (CA), Marijuana Anonymous (MA), or whatever other AA-like program you choose to attend, believe you need to get in touch with God to help stop using. They believe addiction is a spiritual malady, and that it can be cured by filling that hole.
Note that 12-step programs do not consider themselves to be religious programs. When they say "God" they're not always talking about the biblical God. You can choose whatever you want to be your God. It could be your family and friends. It could be believing in a "Group of Drunks (GOD)." It could be the entire world, nature, or the universe. It could be God from the bible. The point is to find something to believe in bigger than yourself, whatever that may be.
12-Step programs will encourage you to get a sponsor. Usually they're relatively easy to find, but it may be hard to find a good one. These are recovering alcoholics or addicts who have more clean time than you and have gone through the 12-Steps with a sponsor of their own. Their job is to put your hand in God's hand, by walking you through the 12 steps. They're also there to talk if you're having a bad day or are thinking about relapsing. They should be able to call you out when you're slacking off and give you a healthy kick in the butt from time to time.
Even if you don't like the idea of God or spirituality, 12-step meetings are still a good option to consider, as they're a great way to meet other recovering addicts and develop a support network.
12-step meetings can be regularly found online and across the globe. They're incredibly accessible, they're free to go to, and you get crappy free coffee (and sometimes snacks) at most of them. There's a million different 12-step meetings. Some meetings you just sit and listen to a speaker, some meetings you discuss a topic, and some meetings talk about the "Big Book," which is essentially an AA Bible. There are Gay meetings, women's only meetings, mens only meetings, military meetings, trauma meetings, first-responder's meetings, young people's meetings, old people's meetings, and basically everything else you can imagine.
Personally, I'm not a fan of 12-step meetings, but you won't know unless you go. AA and the 12-steps have saved millions of people's lives. It works if you work it, as they say in the rooms.
Technically, you don't even have to be sober to go to these meetings. Some may frown on this, but it just means you need help. Just be respectful and no one should give you any problems, even if you are stumbling in drunk the first time. Maybe start with an online meeting if you're intoxicated, so you can just sit back and listen, then ask for help after.
Here's a 12 Step Meeting Finder if you'd like to give this a shot.
Buddhist Recovery Options
Some find practicing Buddhist techniques helps keep them sober. Get in touch with and learn to be at peace with yourself. These groups are becoming increasingly prevalent in recent years, so there may be one or more in your city, though they're nowhere near as many as AA meetings. You can find an online meeting if there's no in-person meetings in your area. Their focus is on mindfulness, which essentially allows you to be more comfortable in your own skin. You'll learn to sit with your feelings and act on them calmly and rationally.
You may find a "mentor" at these programs who acts similarly to a sponsor in AA. They'll teach you Buddhist principles and their approach to recovery.
These meetings usually involve a guided or silent meditation, followed by some sort of discussion or reading.
The meetings are free to attend. If you're looking for meetings in your area, check out Recovery Dharma, formerly known as Refuge Recovery, or look at BuddhistRecovery.org, which has a mix of different Buddhist meetings in its meeting locator. The guy who founded Refuge Recovery is a piece of work, but the program itself is solid.
Smart Recovery is a CBT (Cognitive Behavioral Therapy) based approach to recovery. Unlike AA or other 12-Step programs, Smart is based on psychology rather than spirituality. The two don't have to be mutually exclusive. You can try both, one, or neither.
Their groups center on practicing coping skills to get through tough situations and cravings. They encourage rational thought processes, and their methods are effective for many people. For example, if you're making a major decision, they may have you write a pros and cons list. If you're thinking about using, they may recommend you do a cost-benefit analysis. If you hate yourself, they may have you examine why you hate yourself and try to help determine if the thoughts your having are rational, productive thoughts, or irrational, negative thoughts.
One of the biggest differences in how groups are structured is that Smart Recovery encourages cross-talk in meetings. That means you can give direct feedback to others when they're struggling. They encourage you to relate to others' experiences with your own without giving direct advice. For example, if you're having marital problems, someone else who has similar issues might tell you about their own problems, and then tell you what worked for them. They try not to give direct advice (eg. "You should do this...") but they will kindly nudge you in the right direction. You don't have to wait until "after the meeting" to get feedback from others like you do in AA.
While it's not a 12-step program, they do still offer a book which explains the program. You'll be encouraged to get a mentor to help you frame your negative thoughts better with various Smart recovery tools. Remember, most of these people are not trained counselors or psychologists, though some are. So don't use this as an alternative to meeting with an actual therapist or group therapy.
Unfortunately, Smart Recovery meetings are harder to find in person than many other meetings. They're not as prevalent as the spiritual approaches. There's still a good chance that one may be in your area if you live in or near a large city. You can try their Meeting Finder to see if there's a meeting near you. Alternatively, you can find Smart meetings online. You will have to register an account and go through some steps in order to see the Zoom meeting links.
Addiction Psychiatrists & Psychologists
Addiction is a mental health disorder and doctors have been studying it for decades. While we're not quite at the point where addiction can be cured, we do have a pretty solid understanding of how it works and how to treat it with science. These treatment approaches can be used in combination with the spiritual programs above, if desired, or you can take a purely scientific, non-spiritual approach.
Sometimes, you may skip rehab and work directly with one of these professionals to treat your underlying mental health issues. Note that if you are severely addicted or still using at the moment, they might not take you. They'll recommend you go inpatient instead, as you're a liability and may be beyond the scope of help they're prepared to offer in an outpatient setting. If you want to try these options out, you need to be sober first, or they won't work. That means if you really don't want to go to rehab or detox, you'll have to quit cold turkey. Personally, I'd wait about 2-4 weeks after my last date of use before going to them if you're seeking ongoing treatment with them. If you show up high or hungover, they'll likely just refer you elsewhere and show you the door.
As far as talk therapy goes, group therapy is the standard treatment you'll receive for any type of addiction. You're in an office with a small group of other people trying to get clean and your therapist. You come regularly, talk about your struggles, relate to each other, give each other feedback, and hopefully learn some healthy coping mechanisms.
You'll learn about your character defects and how to work on them, how to regulate your emotions, how to deal with stress and triggers, how to maintain healthy relationships, and how to get on with your life without drugs.
Individual therapy may be useful in combination with group therapy, and on an ongoing basis, once you "graduate" from the group therapy program. In individual therapy, you and a professional will work on dealing with some of your deeper issues. These can be family problems, work problems, underlying mental health issues, anger issues, or basically whatever areas of life you're struggling with.
Most people suffering from addiction also have one or more co-occurring mental health diagnoses. So getting to the root of why you self medicate with drugs and addressing these problems may help you stay clean and sober. If you treat your depression and anxiety, you may find you no longer need or want to use drugs anymore.
Along with individual therapy to address your mental health issues, psychiatrists can help provide medications. There are medications to help treat many mental health issues, including depression, anxiety, drug cravings, anger, sleep issues, personality disorders, and more. Naltrexone is especially effective for opiate and alcohol cravings.
Against Psych Meds?
Many people are averse to taking psychiatric medications for several reasons. There's a lot of fear and social stigma that may play into it, or you may have been raised in an environment where seeking mental help is frowned upon. My advice to you is to at least give it a shot. Go talk to a doctor to see what they say. They may address your concerns. The doctor will not force you to take anything, they're only there to help.
If you get a severe headache, you probably take medicine for it. If you get a seriously sick, you probably take medicine for it. Why should your mental health be any different from your physical health? If you have a psychiatric condition, consider taking medicine for it the same way you would for any other medical condition.
Think about this logically. You may have been self-medicating your underlying mental health illness for years with illicit substances. If you're willing to put these harmful, life-wrecking substances into your body, why aren't you willing to do the same with healthy medications that have been clinically proven to help you? Check your motives. Are you subconsciously denying the help because you actually want to be miserable and have another excuse to use? Do you really want to get better? If you do, you need to use everything in your toolkit, and psychiatric medications may be one of them.
You may notice the benefits of some medications right away. Others might take a while. They might not all be right for you, and you may experience some negative side effects. But the benefits often outweigh the costs. Your doctor is there for you. There's no shortage of options and there are countless combinations that could work for you. Work with the psychiatrist and make changes until you find an effective combination of medications that addresses your needs. It will take time, likely several months to a year, before you find the right "cocktail" of psych meds for you, but I promise it's an option worth exploring.
Finding Psychiatric Resources
It can be hard finding good help. You may call around and find that there aren't any psychiatrists in your area taking new clients. You may not be sure that the therapist you booked is the right fit for you. They might not be. Unfortunately, the only way to find the right person to help you is to do the leg work and try things out. If you don't like a particular therapist or doctor for whatever reason, find a new one. There are plenty of amazing ones out there, I promise. Don't give up just because it's hard and you'd rather lie in bed feeling bad about yourself. You're stronger than that.
Here are some options for you to look into:
- Look at your insurance company's website. There should be an option to find providers in your area.
- Talk to your primary care physician. They may start you on some medications themselves, or refer you to a psychiatrist they trust and work with.
- Ask for references. If you have friends or family who have struggled with mental health, see if they can refer you to someone. You can also visit the rooms of AA. Ask people after the meeting if they can point you in the right direction.
- Look into online options. Some insurance companies offer free or low-cost telehealth options where you can talk to psychiatrists from the comfort of your home. Note that your options may be more limited when visiting an online psychiatrist. They can prescribe most antidepressants and some other medications, but the overall amount of options is severely reduced. If you are in crisis or extremely unstable, an in-person visit is better.
- Look into self-pay online options.
- If you're a recovering alcoholic, I have had good luck with Monument. The doctor I met with was kind, supportive, and understanding. If you just want Naltrexone (a drug which lowers alcohol cravings), they offer a relatively affordable "Physician Care" plan that's $45 for the first online doctor visit and $10/mo to continue getting your medication refilled after. I cannot speak to their therapy options, as I have no experience with them. Note that they don't do other psych meds like antidepressants. WebDoctors and the c3 Foundation also provide similar Naltrexone-based services. I would still recommend finding a regular psychiatrist that can help with all your issues, but this might be a good starting point to hold you over in the meantime.
Opiate Maintenance Programs
If you're addicted to prescription opiates, heroin, fentanyl, or other opiates, a maintenance program may work well for you. These programs are usually recommended to chronic relapsers or people who have tried other methods but repeatedly failed to stay clean, people who have been using for a long time, and people who cannot completely give up opiates because of other lifelong physical health problems, such as chronic pain.
There are several maintenance drugs, such as methadone, Subutex, and Suboxone. These drugs are still opiates, but they're less likely to cause an overdose and produce less euphoria when taken at prescribed levels. Many times you can do a taper, where you take a higher dosage and gradually lower it over several weeks or months, until you are no longer using them anymore.
Sometimes, if a doctor deems it necessary, such as with chronic pain or chronic relapsers, you may stay on these maintenance programs indefinitely for years.
By using these drugs in a controlled manner under the supervision of a physician, your brain is still getting the opiates it's been trained to need to survive, and you can hopefully go on living a normal, functional, productive life.
My first pick for a maintenance drug would be Suboxone or, even better, Sublocade (Suboxone as a once monthly shot). These are likely the drugs your doctor will recommend as well, unless there's a particular reason Suboxone won't work for you (pregnant women and people allergic to naloxone are some examples). Suboxone contains the opiate burepnorphine and the opiate blocker naloxone (Narcan). The idea is basically that together; you get the opiates you need to stop withdrawal symptoms while not feeling the euphoric, addictive effects.
If Suboxone isn't an option, Methadone or Subutex (burepnorphine without naloxone) may be another option for you. You may have heard of methadone clinics before. You can still get high off these drugs more so than Suboxone, but they're not nearly as strong as the illicit substances you may have been using. If you misuse them, you're less likely to die from an overdose.
Using maintenance drugs instead of harder drugs is a great option if you've had bad luck quitting in the past. Some consider this to be a harm reduction strategy or don't count it as "true sobriety" when you're on a maintenance program. I would argue that if you're taking it as prescribed and you're not using it to get high, you can consider yourself sober and in recovery. It works for many people. Since they're opiates, you'll still get the pain-relieving effects needed if you suffer from chronic pain, with less risk than the more powerful opiates.
Maintenance programs don't come without their own risks. They're still opiates after all. You can still die from them, sell them for heroin, or mess up your body. They have the same side effects as other opiates (nausea, constipation, etc.) as well.
Only you and your doctor can decide if a maintenance program is right for you. It may be difficult and will require some legwork to get into one of these programs. They may be selective of who they choose to treat. There are regulations saying they can only treat so many patients at a time. For a while, this sector of the addiction industry was overrun with corruption. Some less than noble doctors were dispensing these medications like candy and getting kickbacks, hence the newer regulations on patient limits and required trainings.
A good place to get into one of these programs is to look at the services offered by your outpatient treatment team (if you're getting outpatient services). If your treatment team has valid reasons suggesting you might not be a suitable candidate for a maintenance program, you can decide to listen to them or find another treatment team. Some treatment centers are fundamentally against all forms of maintenance programs. If you believe this to be one of them, find a different treatment center or call around for recommendations. You can also search the web for programs accepting new clients in your area.
Note that to start on a maintenance program, you will have to be clean of the illicit substance for somewhere between one and three days, as there are adverse effects which can occur if you use them in combination with street drugs or more potent prescription opioids.
Far Out Alternatives
Everything mentioned up to this point has been a pretty traditional, standard way to help you get and stay sober. If none of the above options sounds like a good fit for you, here are some final alternatives to rehab.
The Sinclair Method (Alcoholics)
The Sinclair Method is a novel approach to alcohol addiction in which you continue to drink alcohol while taking naltrexone. That's right, you keep drinking. This is an option they probably will not discuss in rehab. In fact, I tried talking to some doctors about it in rehab before, and they looked at me like I had three heads. If you absolutely refuse to quit drinking, but can recognize that it's interfering with your life, this may be an option. Note that objective research on this method is limited, but there are doctors willing to help, and plenty of individuals who report success using this method.
Essentially, this program works by taking the anti-craving medication Naltrexone an hour before you plan on drinking, every time you're planning on drinking. You wait an hour, then you drink. This method was originally developed by Doctor John Sinclair.
The medication won't stop you from getting drunk, but it may help you to cut back on your usage. Over time, usually several months or even years, if you do this without fail each time before you have a drink, you'll condition your brain into drinking more like a normal person. It's supposed to remove some of your primal desire to drink. Over time, you may notice your desire to drink lessens and you can drink like a "normal" person. You may even reach a point of extinction where you simply don't feel like drinking anymore, which is the goal.
This is not a silver bullet to cure alcoholism. It can be a helpful tool, but you still have make a conscious effort to cut back on your use and remember to take the medication as directed.
I've tried this method out and can see how it could work. I certainly noticed myself drinking less than I used to, but I was still a depressed mess and ultimately gave up on the process because at the time I decided I'd rather be a miserable, drunken drug addict. I guess my main takeaway here is that if you're severely depressed, the naltrexone won't make your depression go away, it'll just make you drink less. You still need to seek outside help to address those other issues.
If you're a moderate daily drinker or a binge drinker, and you don't have any other major mental health issues going on, this might be a great option for you and I'd recommend checking it out.
You can learn more about how it works at several websites. The C3 Foundation is one of them. They also offer paid telemedicine services so you can get your naltrexone prescription online. There's also a TedX video explaining the subject and an entire subreddit dedicated to it.
In some states, you can get a prescription for marijuana if you're an opiate addict. You can also buy it legally in many states now. Where it's illegal, I'm sure you can find it easy enough. I'd like to start by saying that I don't recommend this method at all, and I don't think it's a proper solution to the problem, but if it works for you then it works for you.
Marijuana Maintenance essentially means smoking weed instead of doing other drugs. You're replacing one addictive substance with another. It's impossible to overdose on, you're probably not going to be getting into fights over it, and it's plentiful. I'd consider this more of a harm reduction strategy.
The difference between marijuana maintenance and Suboxone maintenance is that with Suboxone, you're not really getting high even though you're still replacing one drug with another. With weed, you're objectively using it to get high. Habitual long term use of marijuana has been linked to lower dopamine levels, which lowers your ambition to do things. If you're anything like me, it'll make you lazy and content with sitting around doing nothing with your life all day. Additionally, marijuana is known to make people depressed and anxious, especially for chronic or daily users. So if you're already depressed and anxious to begin with, smoking weed all day every day will ultimately just lead to more depression and anxiety, even if it helps at first.
It affects everyone differently, but in most daily users I see little benefit. Don't get me wrong, I love marijuana. I used to smoke it, dab it, vape it, and eat it four times an hour every day. I also was working a dead-end job and achieving nothing with my life because the marijuana made me feel content and happy sitting around playing video games all day. I don't believe this is a sustainable approach, and you could do better things with your life, but if it keeps you away from harder drugs or drinking than by all means, give it a go. You're better off being a stoner than being dead, and less likely to hurt yourself and others. You must might not be living up to your full potential.
This isn't medically advisable at all for several obvious reasons. If you proceed with this, you do so at your own risk.
If you have the willpower, you may taper yourself off your drug of choice by starting with your regular dose, and gradually reducing it over several days or weeks. It can be done. I've seen it done, and I've even done it myself. You can do it with alcohol, benzos, and opiates. Probably won't work well for stimulants. Probably won't work at all, but you can give it a shot if you've exhausted all your other options.
Keep in mind that this can be dangerous. If you're tapering yourself off alcohol to avoid killing yourself with the withdrawal, you likely already understand the risks involved. If you taper too quickly off alcohol, you could have seizures, experience delirium, or die. If you taper yourself off street drugs like heroin, you likely don't have a way of knowing how strong each bag or bundle is going to be, so you could start tapering, only to find you accidentally get a stronger batch and now you have to start all over.
Ideally, it helps to have someone who lives with you that doesn't use themself to assist you with this. Come up with a tapering schedule, give all your substances to your trusted helper to hold on to, and have them give it to you according to the schedule. Be as consistent as possible with your dosing, and slowly lower your dose by a set amount each day.
The goal isn't to get super high or drunk while doing this. You'll want to spread your doses out in smaller amounts over longer periods of time. For drug users, this could mean doing smaller calculated amounts more frequently over several hours instead of doing a bag or more at once. For alcoholics, this means drinking a beer or a hard seltzer (maybe pick something you don't like the taste of) over the course of an hour or several hours instead of drinking a single shot of vodka.
You may want to invest in things like a blood pressure monitor and make sure your blood pressure doesn't get too high.
If you're doing this with alcohol, again, be extremely careful. If you notice yourself experiencing severe withdrawal symptoms, such as very shaky hands or tremors, tunnel vision, severe headaches, or hallucinations, you need to slow your taper and drink more or seek medical help. Here's a subreddit with some more tips on tapering yourself off alcohol. I also have written an entire guide to Self Tapering Off Alcohol with alcohol, if you refuse to go to Detox or see a doctor.
Keep a paper log or a phone log of your use and see if you can reduce it. There are apps that might help.
Follow all the tips back in the quitting cold turkey section, with the exception of the part where you throw out all of the substance. Stay hydrated, try to eat, and try to get some sleep. Keep your supply out of sight and out of mind between doses. Do whatever you can to distract yourself. Good luck.
Hallucinogenic/Psychedelic & Related Therapies
Some people find a sort of spiritual awakening in drugs such as LSD or Mushrooms (Psilocybin). Some even report that they no longer have the desire to drink or do hard drugs after experiencing them. You're unlikely to become addicted to them, as using them for several days in a row has severely diminishing returns (tolerance builds up fast, you need to wait several weeks between uses for them to really work again). I've heard of ketamine helping some people with their underlying depression, PTSD, and anxiety issues. There are clinics you can look into that offer these sorts of experiences in a safe environment. Personally, I've done all these drugs, and I was still a depressed, anxious mess until I found the right combination of psychiatric, not psychedelic, drugs.
You can also try microdosing magic mushrooms (psilocybin) or LSD. Microdosing is the practice of taking a little, not enough to trip but enough to feel slight effects, and going about your day. Some people claim this helps with their cravings. Clinically, microdosing hasn't proven to be any more effective than a placebo (doing nothing).
If you're not in the right frame of mind, which if you're here you probably aren't, going on a trip to rehab might serve you better than a trip to space. In my experience, mushrooms may have helped slightly with my cravings, and made me not want to use other substances, at least for a day or two. I was right back to my usual drug addicted self within a couple days. Personally, I think this could be a placebo effect and it'll only work if you think it'll work. Still, it might work for you. Who knows? Look into it and give it a shot if you think it sounds worthwhile.
If you've made it this far and still don't see something that's worth giving a shot, I've completely run out of ideas. I've offered you over a dozen different alternatives to going to rehab at this point. I hope you found at least one of them useful and will give it a shot. My first recommendation is rehab and/or psych meds, my second is outpatient therapy, and my third is equally tied between getting spiritually connected or Smart recovery. Try a combination of the options if you can.
In my personal experience, I have found that the right combination of psychiatric medications and therapy helps most. I've treated my underlying mental health issues, and continue to stay on top of them. Most of my anxiety is gone, and I'm no longer depressed. I live with other people in recovery and stay away from my old drug addicted friends. I'm living in a much healthier environment. I'm happy to say I have little reason to want to use, and most days the thought doesn't even cross my mind. I don't like 12-step meetings and I never felt a need to find God. Group therapy sessions and smart recovery meetings are more productive than AA meetings, for me. What works for you might be entirely different.
I can't endorse anything I mentioned in the "Far Out" section. I've tried and failed at all of them repeatedly.
Keep in mind, this writing was based on personal experience, with some medical references. I'm not a doctor.
Thanks for reading and best of luck to you,
- Suboxone Tabs Image - Jr de Barbosa (CCA SA 3.0)