Rehab Survival Guide

Preparing For Drug & Alcohol Treatment

This extensive guide is for individuals seeking treatment at inpatient drug and/or alcohol treatment facilities in the USA.

Do you have a problem with, or think you might have a problem with drugs or alcohol? If so, this guide is for you.

In this guide, we’ll start by talking a little about addiction. Then you’ll learn about the treatment options available, what red flags to look out for, what questions to ask, what terms get thrown around, and what a typical day looks like at a treatment facility.

There are many ways to get sober and one size does not fit all. I hope this guide will give you the tools to find the treatment option that works best for you. My goal is to make you feel comfortable and knowledgeable going into this somewhat cumbersome process. I’ll be real with you and tell you the ins and outs of selecting a rehab. 

You may also skip to the section on selecting a rehab, or view the guide’s table of contents by clicking the button in the top menu bar.

About Me: I’m speaking from decades of personal and family experience of going through countless rehabilitation and therapy programs. Keep in mind, I’m not a doctor or a therapist. I’ve just been around addiction and recovery for a long time. I try to back up my statements with science, but a lot of this is based on my own experiences. I usually do my best to write unbiased articles, but some of my biases towards certain programs definitely show through in this guide. It is ultimately up to you, with the help of a treatment team, to determine what is best for you.

I’m not endorsed by any rehab centers or making money off referrals.

A Note on Alcohol

Our society treats alcohol as somehow being different from other drugs, even though it works the same as heroin and meth as far as addiction in the brain is concerned. Its effects can, in some ways, be even stronger than cocaine or heroin¹Alcohol is a drug. Experts say it’s stronger than cocaine or heroin. (WebMD) For the rest of this guide, I’m going to use the terms “addict” and “drugs” to include alcoholics and alcohol, since alcohol is a drug.  

Alcohol is one drug that can literally kill you if you just up and quit²Alcohol withdrawal can lead to death. Complications of Alcohol Withdrawal (Trevisan, MD, et al. 1998). You need to taper off. Do not just stop drinking alcohol if you have been drinking for a prolonged period. If you haven’t had a drink and are feeling shaky or nauseous, by all means, go grab one. I’m giving you permission to drink. Hard seltzers may be a good option, as they contain a lot of water.

Do I Have a Problem? Am I an Addict?

Admitting you have some type of problem, no matter how large or small, is the first step to getting help. For this guide, I’m going to assume you recognize that you have some sort of problem with drugs. It can be anything from drinking more than you intended on the weekends or smoking too much pot to injecting a bundle of narcotics into your veins every day. Addiction is addiction. If you think you have a problem and are considering getting help, you’re doing well.

If you are involuntarily being sent to a rehab for court or being forced to go by a family member, I have a separate guide you can read on that topic before continuing on. It’s not so common, but some people that get caught using drugs or driving under the influence made a one time mistake, and do not fit the clinical definition of a substance abuser.

The term “addict” or “alcoholic” has an inherent negative connotation in our society. You’re going to hear it a lot in recovery settings. Thankfully, you don’t have to use it as a label. In fact, you shouldn’t. You can choose to call yourself whatever you want. Maybe you prefer the term “substance use disorder.” Or you’d be more comfortable saying you’re a “recovering addict.” Things like “I used to be an addict” are also acceptable. The brain is neuroplastic, meaning the neurons can change their structure over time. If you condition your brain to believe you’re an addict, you’ll always be one³Do not label yourself as an addict or an alcoholic. If you keep calling yourself an addict, you’ll always be an addict. The brain is neuroplastic and to change your thinking you should identify yourself in a more positive manner. Neuroplasticity in Addictive Disorders (Charles P. O’Brien, MD PhD, 2009), Never Call Someone an Addict (Adi Jaffe Ph.D. 2018)

Recognize that if you’re reading this guide, drugs have affected your life in some negative manner. The degree to which does not matter.

If you’re looking for a clinical definition of the problem. The DSM-5, a guide used by doctors to evaluate psychiatric conditions, defines substance use disorder (SUD) with 11 criteria⁴11 Criteria for Addiction (Elizabeth Hartney PhD), Substance Use Disorders, (Diagnostic and Statistical Manual of Mental Disorders, 5th edition, American Psychiatric Association, pp. 483,585), of which at least two must be present (I’m summarizing).

1. Using more of a substance, or taking it more often than intended
2. Wanting to quit or slow down, but being unable to
3. Spending a lot of time looking for the substance, using it, or recovering from its effects
4. Having cravings or an intense desire to use substances
5. Failure to fulfill obligations to family, work, or school because of substance use
6. Continuing to use despite negative consequences
7. Giving up time spent on family, work, or recreational activities/hobbies to use instead
8. Using the substance in risky situations where you could be physically harmed
9. Continuing to use despite physical or mental problems resulting from its use (paranoia, insomnia, infections, liver failure, worsening depression, etc.)
10. Developing a tolerance where you have to use more of a substance, or more often, to achieve the desired effects
11. Going through physical or psychological withdrawal when the drugs aren’t present (tremors or shakes, anxiety, insomnia, etc.)

So if you meet two or more of the above (many people meet most or all) criteria, congratulations. You probably have a problem that needs to be addressed. Welcome to the club.

Am I Ready to Quit?

I’ll lead by admitting that drugs aren’t all bad. They can be a lot of fun. Some of my favorite moments happened when I was absolutely wrecked and I wouldn’t trade them for the world. Drugs may help you feel less depressed, more confident, more outgoing, more (or less) energetic, and may temporarily ease or help you forget the pain in your life. They work great until you run out of supplies and money, get arrested, wake up in the ER, or your tolerance gets so high and the drugs just stop working no matter how much you take.

You may be uncertain if you’re ready to quit and may not like the idea of quitting. You may not be ready to quit for the rest of your life right now. That’s all okay. The good news is, you don’t have to be 100% ready to quit to get started⁵See Addictions & Stages of Change (W. Henry Gregory, Jr. Ph.D. 2015 (though it certainly helps). You just have to try sobriety for a little while and go from there.

I’m not recommending it, but the liquor stores, drug dealers, dark web marketplaces, and marijuana dispensaries will always be there if you decide you want to use again. If you get sober and think, “Hey, sobriety sucks. I’d rather get messed up and ride my life into the ground.” It’s probably a bad idea, but it’s always an option. If you’re not done yet, you’re not done yet.

Once you get sober, get past the withdrawal phase, make progress on addressing your core issues, and begin feeling like a regular human being again, you may find that you enjoy, or at least can tolerate, sobriety. I’m not a fan of Alcoholics Anonymous, but one of their mantras is “One Day At A Time.” This one holds true. You don’t have to commit to sobriety forever, you just have to decide to stay sober for now. You can always go back to the drugs tomorrow.

It often takes multiple tries before people finally commit to sobriety. I hope you get it the first time, but if you don’t, at least consider practicing some harm reduction strategies so you don’t get yourself killed when you go back out. Don’t get too down on yourself, either. You can always try getting sober again like you may try using again.

Determining Your Care Level

Everyone is different. What keeps me sober might not keep you sober. The good news is there are tons of different options to try out. I’ll level with you. They often require a lot of mental and physical work.

There are hospitals, detox centers, physicians, outpatient clinics, psychiatric medications, inpatient rehabs, outpatient rehabs, support groups, addiction therapists, group therapy, AA meetings, spiritual retreats, and countless other options to help you get and stay sober. Often you’ll need to try a combination of options to determine what works best for you.

I’m going to list all the programs involved in a standard course of addiction treatment, starting from the most intensive options.

1. Emergency Room or Psychiatric Hospital
   • If you are currently planning on killing or injuring yourself, please call 911, go to the nearest emergency room, or have a friend or family member stay with you until you find a nearby private psychiatric hospital that accepts your insurance. They take patients 24/7 every day of the year. A social worker will help you find a rehab to go to afterwards. Get the help you deserve. I’m proud of you.
2. Detox Only Centers
   • These are places where you go to get sober and safely taper off drugs. They rarely focus on therapy, groups, AA, or anything else. Their sole purpose is to get rid of the drugs in your system and send you on your way. This is better than nothing, but I’d highly recommend going to a facility that offers both rehab and detox, or going directly to an inpatient rehab program after completing the detox process.
   • Detox centers have 24/7 nursing staff on hand to help with the physical withdrawal phase of recovery. They use medication to help you safely come off hard drugs and alcohol, sleep, and be comfortable. If you’re addicted to alcohol or benzos, they’ll taper you down safely to prevent life-threatening withdrawal effects. They’ll also closely monitor you and be on hand in the event of an emergency, such as if you have a seizure or fall and hurt yourself. They’ll bring food and drinks to nourish you if you’re too sick to get out of bed or even function. A physician will give you an exam and make sure you don’t need to be in a hospital or something.
3. Standard Private or Non-Profit Inpatient Rehab Facilities
   • This is the type of facility this guide is mainly about.
   • Inpatient rehabs are often the first part of getting sober, but they don’t always have to be. Not everyone can go away for a month of rehab because of financial reasons, work reasons, or family obligations. There are many supportive outpatient programs and free support groups available if you can’t go to inpatient for whatever reason.
   • Inpatient rehabs are facilities which provide a drug-free environment to recuperate and mentally stabilize from your drug use. They’re “inpatient,” meaning you live and sleep there for the duration of your stay. The time you spend there largely depends on your insurance company or ability to pay, the facility you select, and, of course, how willing you are to stay there. The average stay is about one month, but it can be as short as a week or as long as several months. They’re not psych wards or jails. Unless you’re a minor, you can walk out the door whenever you choose.
   • Most inpatient rehabs offer detox services.
   • Luxury Rehabs
     • If you’re doing well financially, luxury rehabs may be an option.
     • These typically run anywhere from $60,000 to $150,000 per month and do not accept insurance.
     • They offer private rooms, internet access, first-class amenities, and the ability to work while getting treatment.
     • They offer the ability to connect with other high net worth individuals struggling with addiction.
     • The therapy is usually provided by doctors and may they accommodate your remote work schedule.
     • They may offer treatment programs and regimens not typical to standard rehabs, some of which are questionable.
     • Be extra careful when selecting a luxury rehab and be sure to focus on finding one with a good clinical team rather than a million bells and whistles.
     • You can get sober anywhere. Spending more money isn’t going to make you more sober.
4. State-Run or Free/Low-Cost Inpatient Rehab Facilities
   • These are like the private rehabs in that you live there, but aren’t typically as good. They’re often structured more similarly to boot-camps. Beds may be hard to get. They often have an old-school approach to recovery that’s primarily focused on attending AA meetings all day. They’re certainly better than nothing, and may be better than sleeping on the streets, but I’d consider them more of a last resort.
5. Partial Hospitalization Program (PHP)
   • Some rehab facilities offer residential PHP programs, which are very similar to inpatient rehabs. You’ll be in groups most of the day and they usually provide breakfast and lunch. The difference is inpatient rehabs have more supervision and are billed differently to insurance companies.
   • PHP programs may be on the same site as the living quarters, they may have apartments down the street you can live at, or they may allow you to come during the day and go back home every night. If living at facilities provided by the PHP company, you’ll likely have to pay for room and board. Usually it’s pretty affordable, like $25 a day or less.
   • PHP includes medical supervision or medication management, but it might not be 24/7 access. There probably won’t be a nurse available 24/7 like in inpatient rehab.
   • If you start off in PHP and stay sober, your insurance company will not grant you clearance to go spend a month at an inpatient facility, as that’s a step up. If you do inpatient first, you’ll have the option to pursue PHP after, thus allowing you to get more days of treatment if you believe you need the additional support. Therefore, I recommend starting with inpatient and doing PHP afterwards for the additional weeks of support.
   • Included transportation is usually offered if coming from home or a recovery house.
   • It usually runs about six to seven hours a day every weekday.
   • Program may last anywhere from 2 to 8 weeks depending on insurance and your progress.
   • They may offer remote services due to Covid, where you attend online.
6. Intensive Outpatient (IOP)
   • IOP is the next step down from PHP.
   • It’s usually 3 or 4 hours a day, 3 to 4 days a week.
   • May be offered with an optional boarding component depending on the facility, but normally you commute in each day.
   • Transportation is usually offered if coming from home or a recovery house
   • They may offer remote services due to Covid, where you attend online.
   • No medication management or medical access from the facility, you need to find your own doctors.
   • Program may last anywhere from 2 to 8 weeks depending on insurance and your progress.
7. General Outpatient (GOP)
   1. The last step in the clinical program
   2. Usually 1-2 hrs, once or twice a week.
   3. More of a maintainance program
   4. No medication management or medical access from the facility, you need to find your own doctors.
   5. Program may last anywhere from a few months to even a couple years, with some places allowing you to return indefinitely.

I’d highly recommend starting off in an inpatient facility if you are a regular drug user or experience physical withdrawal. A stable, drug free environment is ideal for early sobriety. If you stay at home, you may be highly tempted to use again. Additionally, people who stay in treatment longer tend to stay sober longer when they get out ⁶The longer you stay in treatment, the higher your chances of long term sobriety. Does retention matter? Treatment duration and improvement in drug use (Zhiwei Zhang PhD, et. al 2003, paper is behind a paywall), which is why going from inpatient to PHP to IOP and so on over the course of several months is a good idea.

If you’re an occasional user or can successfully quit for several days by yourself, and don’t have any withdrawal symptoms, you may start at the PHP or IOP level. A therapist or doctor’s consultation can help determine where you should start the process.

Work & School Considerations

If you’re afraid of losing your job because of taking a month off for rehab, don’t. Legally, companies may not fire you for claiming FMLA/disability during your stay since substance use is a recognized mental health issue⁷29 CFR § 825.119 – Leave for treatment of substance abuse. (Cornell Law School). If you’re afraid your company will make up a different reason to fire you after returning, which unfortunately happens sometimes, they’re a poor company to work for in the first place and you should cut your losses. You don’t owe them your loyalty. There’s plenty of jobs out there. You can replace them just like they can replace you.

If you’re in school you can also report this as a disability, which may allow you to get a full refund on your tuition for the semester, even if you’re past the regular drop period.

Alternatives To These Options

If none of the above options sound like a good fit, you can try a spiritual based program such as Teen Challenge (which isn’t just for teens). You can try finding 12 step meetings in your area and see if that works. I promise, the people don’t bite. You can schedule a meeting with an individual therapist to help you determine the best course of treatment. You could give Smart Recovery a shot. If there are none in your area, you can try doing them via Zoom (video calling).

You can also try stopping on your own and practice drug aversion techniques. You may find a doctor that can prescribe you appropriate medications to help with withdrawal and cravings from home. You can even try tapering yourself off the drugs or alcohol. It requires a tremendous amount of will power, but it can be done. I’d still advise you to go to inpatient rehab and seek professional treatment over these options.

Selecting a Rehab

Not all rehabs are good. There are plenty of bad ones out there. There are many good ones too that might not suit your specific needs. I’ll tell you that absolutely none of them will be perfect. There’s always going to be something or somebody that annoys you. The admissions reps may seem like pushy car salesmen. Some may even blatantly lie to you.

I don’t want to scare you off, but do your research and ask the right questions to ensure you’ve got the best chance of success. If you know a friend or family member that has gone to rehab, contact them. Even if you haven’t talked to them in a while, they’ll probably be happy to at least give you a recommendation.

If you get to the rehab and it’s nothing like what the rep said on the phone, have a backup plan before going in and leave.

Key Considerations

Here are some key things to consider when researching your rehab. Ask the admissions reps about these issues. Write down the answers. Compare several rehabs until you find the one that best suits your needs.

Reading Reviews & Websites

Even the best rehab centers don’t attract the best reviews online. Most people hate going there, some are forced to go there, and again, nothing is always perfect. Instead, I’d pay attention to the content of these reviews rather than the ratings.

Look at different posts reporting similar issues. If they’ve got a three star review and all the negative comments are about the food and the uncomfortable beds, but everyone likes the therapists, maybe that’s actually a pretty good rehab.

Pay extra attention to the reviews that go into specific details about why they didn’t like it. Ignore the generic one star reviews and people just saying “it sucks don’t go here.”

When looking at websites for rehabs, take it with a grain of salt. They’re only going to put their nicest areas on display. Sometimes, they showcase beautiful rooms on their website. Then you get there and find yourself in what looks like a cheap motel room and find out that the rooms on the website either don’t exist or are only for their VIP patients in a different unit.

Advertised success rates are a lie. Many rehabs claim high success rates, such as 90% remission or greater. Relapse rates vary by drug user and age, but anywhere between 37% and 91% of people who go to treatment end up relapsing⁸Lapse and relapse following inpatient treatment of opiate dependence (B P Smyth et. al, 2010), Abstinence and drug abuse treatment (McKeganey et. al, 2009), Relapse after inpatient substance use treatment: A prospective cohort study among users of illicit substances (Andersson et. al, 2019). They calculate these numbers based on follow-up calls to patients who answer. They’re completely subjective. They ask you how you’re doing and if you relapsed. Lots of people just lie and say they’re doing fine even if they relapsed because they just want the random phone call to end. The last thing most relapsing people want to do is talk about their relapse on a random unsolicited phone call.

Standard Admissions Process

When you first arrive you will check in. They’ll provide instructions prior to your arrival. You’ll have to take a Covid test and follow Covid protocols. They’ll want your insurance card, ID, and, if you have it, vaccination card. They’ll also want your signature on a lot of different forms and ask you a hundred different questions about your drug use. They’ll likely do a strip search in a private room and examine all your belongings. Anything you’re not allowed to have should be locked up safely for you to collect on your departure. They should inventory everything and have you sign off on what they’re holding on to.

Once you’ve been admitted, they should give you a brief tour, show you where your bed is, explain the basic rules, and offer you something to eat and drink. You’ll meet with a nurse or a physician who will check your vitals and start you on some detox medications. You might not see a physician during your first day there if you arrive later in the day, but you should definitely see one on the second day. They’ll give you a full physical to make sure you’re healthy enough to remain in the facility and refer you to a hospital if you are not.

Rehab Prep Checklist

File name: Rehab Prep Checklist.docx

Author: Kevin Olson

License: CC0-1.0

This is a link to a printable PDF containing all the rehab essentials. You may find it useful.

Download: Rehab Prep Checklist.docx

A Typical Day in Rehab

All rehabs are different, but the good ones follow a similar structure. I’m going to give my best approximation of what a normal day looks like at a decent rehab.

Here’s a sample schedule I created based on an actual patient schedule from the Caron Foundation.

Download: Caron Sample Schedule

Here’s another from the Recovery Village in Cherry Hill.

Download: Recovery Village Sample Schedule

 Personally, I prefer the second one, though it does have a bit too much free time.

They wake you up around 7:00. You have your morning coffee, cigarette, and breakfast. The dining situation is normally similar to a high school cafeteria, where you form a line, get a tray, and select your food . You go to the nurse and take your morning medications. Then they might do some type of yoga, meditation exercise, or give you gym time. You should have at least an hour of free time in the morning to take care of things like showering and personal hygiene. They may have a morning meeting where everyone gathers to discuss what’s going on that day.

After getting ready for the day, they’ll usually have some type of group session or sessions. This may be your small groups with your primary therapist, or it may be a larger psychoeducational group where they discuss a certain topic about mental health and addiction. It may also be an AA meeting, or they might take you out for an activity like recreational therapy or petting horses. The order varies between rehabs, but it’s all basically “group time.”

After your morning groups, you’ll have an hour long break or more to eat lunch, mingle, smoke, and play games or read/watch tv. You may be pulled aside to have a one-on-one discussion with your therapist.

After lunch, there’s more group time, so again you’ll be with a therapist, in an AA meeting, or doing some sort of planned group activity. They’ll give you some breaks here and there.

You’ll then eat dinner and take some time for yourself.

There’s usually one more shorter hour long group in the evening, most likely an AA meeting. Then you have the rest of the night to watch TV, snack, chat, get your meds, and go to bed.

Weekends are more laid back with less staff on, so usually no small groups or individual sessions. They’ll likely have larger groups instead of the small ones and you may have more free time.

It can become monotonous after a couple weeks, but the hope is with each passing day you’ll start feeling better physically and mentally. You’ll be able to think more clearly and make better decisions. Hopefully, you’ll setup a solid plan for when you get out of rehab and can get back to enjoying your life free of drugs.

Detox Process & Medications

I’d like to preface this section by saying that I’m not a doctor or a medical professional. Your doctor will help you make the proper medical decisions.

 Standard Detox Process

Now let’s talk about traditional detoxes as part of an inpatient program.

Detox is the first phase at inpatient rehab centers with detoxes. It’s usually a separate unit in the building where you go through withdrawal and begin waiting for the drugs to leave your system. They’ll start you on taper medications to limit the effects of withdrawal and lower risk of medical complications.

Most of your time in detox will be spent sleeping, lying around, watching TV, reading, or, unfortunately, crying and feeling horrible about yourself. They usually try to be a little nicer to you in detox, check in on you more often, give you food and drinks basically whenever you want, and won’t force you to go to group sessions. Often the nurses will come to you rather than you having to go to them.

To help with withdrawal symptoms, most detoxes offer “comfort” medications such as:

• Propranolol – lowers blood pressure, may help with anxiety and headaches
• Vistaril – an antihistamine that may help you sleep and feel less anxious
• Gabapentin – prevents seizures and may help with anxiety and cravings
• Remeron – an antidepressant that makes you sleepy and hungry (may help with underweight clients)
• Trazodone – another antidepressant that makes you sleepy
• Melatonin – standard over the counter sleep aid

Those are the ones I’ve seen offered most in rehabs. They should also have all the basic over-the-counter medications such as tylenol, ibuprofen, Claritin, and Mucinex on hand in case you need them. They’ll also give you lots of vitamins.

Next we’re going to talk about drug specific detoxes.

 Opiate Withdrawal & Meds

Opiate withdrawal may make you extremely irritable and short-tempered. Insomnia, nauseousness, and anxiety are also common. Be prepared for a few rough days with little sleep. Try not to dwell on things and just zone out for a few days if you can.

For opiate users, they’ll likely offer you Suboxone, Subutex, or methadone. You’ll often hear them referred to as “subs.” These are opioids used to help taper you off harder drugs, like fentanyl, heroin, or opioid pills. Suboxone contains both the opiate buprenorphine and the opiate antagonist naloxone (Narcan). Combined, these help to ward off withdrawal and fight cravings at the same time without making you really feel high.

Subutex is just buprenorphine without the naloxone, so it may also give you a high. You won’t really have a choice. Your doctor will probably put you on Suboxone unless there’s a reason they cannot.

You may also choose to refuse the subs and quit “cold turkey” (quitting and going through withdrawal with no help). Some people actually prefer to quit cold turkey and go through the full effects of withdrawal as an incentive to not use again.

They usually start you off at a higher dose and lower it slightly over the course of a few days or weeks until you’re no longer on any opioids and the bulk of the physical withdrawal is over. With chronic relapsers or people with chronic pain, they may start you on a maintenance program, where you can continue to receive these drugs in the future to prevent you from returning to the harder drugs. Ideally, quit using opioids altogether.

If you cannot quit and your doctor deems it necessary, maintenance programs work well for many people. Keep in mind that these drugs are still addictive and have similar side effects to other opioids. They’re just less euphoric and less likely to cause an overdose. They likely won’t make you feel high if you’ve been doing opioids for a while, but when people who don’t do opioids take them, they get a moderate high off them.

 Alcohol or Benzodiazepine Withdrawal & Meds

Alcohol and benzos (Xanax and such) both depress the central nervous system. Quitting them suddenly after prolonged use can cause severe withdrawal symptoms such as seizures, delusions, insomnia, and even death.

To make the detox process as comfortable as possible and reduce risk of seizures, they’ll likely start you on a benzo taper to prevent seizures and delirium. If you’re not familiar with them, their effects are very similar to alcohol. I’ve seen Librium used the most, though it’s not uncommon for them to use Lorazepam (Ativan) or Diazepam (Valium). The doctor will decide what’s best for you.

They’ll start you on a high dosage and monitor how you progress with withdrawal symptoms. Once they notice the symptoms (shaky hands and such) subsiding, they’ll start lowering the dose. For mild-to-moderate users, the tapering process can take as little as a few days to a week. For heavy users, it may take possibly two or even three weeks to get out of detox. I would highly recommend taking the sleep medications and trying to sleep through most of it if you can.

I won’t sugarcoat this, alcohol detox can be hellish. People respond to benzos differently. If you were already depressed to begin with, the benzodiazepine taper compounded with the fact that you’re in rehab may worsen your depression. It may feel like being miserably drunk in rehab. Self harm and suicide are associated with benzos. If you feel suicidal or like hurting yourself, tell someone on staff.

 Stimulant Withdrawal & Meds

They mainly try to treat the symptoms of anxiety, depression, agitation, and psychosis with other medications, such as the comfort meds listed above. With psychotic symptoms, which most often occur if you were doing a lot of meth, they’ll likely put you on an antipsychotic drug such as Seroquel.

They’re researching drugs to help with stimulant addiction, but unfortunately there aren’t any approved medications out at the moment specifically for it. Because of its fast acting nature, they can’t exactly give you a bump of coke every day and taper you down.

Some medications exist which are prescribed off-label to help with the cravings. Topamax (another anti seizure med) has been shown to help with cocaine cravings, so they may offer that if you find yourself constantly fiending for more stimulants.

If you’ve been taking stimulants to self medicate your ADHD, the doctor may have you try non-stimulant ADHD medication such as Strattera.

 Marijuana Withdrawal & Meds

Though weed is becoming increasingly socially acceptable, it’s still a drug like any other. You can become dependent on it and use it as a crutch the same way alcoholics guzzle alcohol or heroin users jab themselves every time something good or bad happens. Over time, with chronic use, you may start getting depressed and find that weed isn’t really making you happy anymore. If you’re here for marijuana, I’m proud of you for admitting you have a problem, even if 99% of weed smokers deny that it’s addictive.

The withdrawal symptoms for marijuana include irritability, cravings, and heightened anxiety. Thankfully, they’re less severe than the other withdrawal symptoms in this guide. Still, I don’t want to discount your feelings. You may have trouble sleeping, experience weird dreams, feel kind of depressed or flat, and get annoyed easily. There’re no drugs for marijuana withdrawal or cravings, but you can treat the symptoms if they’re bothering you. Marijuana, like alcohol, is commonly used to self medicate for depression and anxiety. So you may benefit from psychotherapy and medications that treat these underlying issues.

Other Addictions

If you regularly use other drugs not covered above, you may still experience some withdrawal effects. Hallucinogens such as LSD really only work well when your tolerance is low, so it’s difficult to really become addicted to them. If you do use them often, you could be psychologically addicted to them. This means your withdrawal symptoms will involve anxiety, cravings, and poor concentration.

If you’re addicted to a different class of drug or research chemical, your doctor will determine the best course of treatment and help with any symptoms.

Getting Through Groups & Social Interaction

It’s normal to be a little anxious during your first group meetings, even if you’ve been to rehab before. You’re coming off drugs, your anxiety’s heightened, and your thoughts may be scrambled. You may be extremely anxious, that’s okay too. Here are some tips to help you get through:

1. Take all advice given to you as a suggestion. Remember, no one can force you to do anything and everyone’s different. There’s no straight road to recovery.
2. Step out of your comfort zone. Don’t go crazy and throw yourself to the wolves, but look at yourself and try to make slight improvements. Try new things. Talk to someone you wouldn’t normally talk to. Look at the bigger picture. Watch out for others and be kind to yourself.
3. Share what’s important, but try not to go off on tangents.
4. Advocate for yourself. I’m not saying demand filet mignon and lobster, but stand up for yourself and your recovery. If something’s not working, talk about it and work on a solution with staff. Don’t let anyone walk all over you. If your therapist’s not working out, ask for a different one. If your meds aren’t working right, ask to see a doctor.
5. Don’t be afraid to talk to people or share in group. You’re all in there together, facing the problem of addiction. You might as well get to know the people you’re in there with. It’s not like you have somewhere else important to be. You will find people that can relate to your experiences and are going through similar problems. Maybe you’ll give advice to someone and realize you need to start taking your own advice. If you really are having problems in the group setting, talk about it in individual sessions with your therapist.
6. Be ready to take a breather. If you need to get up and leave the room so you don’t flip out on people, do it. If they’re trying to get you to do something that makes you feel extremely uncomfortable, tell them you’re not going to. Go for a walk. Go talk to one of the staff members somewhere away from the group. If you need some you time, take it, within reason.
7. Forgive people who are rude or ignorant. Not everyone’s functioning at 100% in rehab, and some are so far gone after years or decades of drug use, they’re literally learning basic life skills. Not everyone was raised in healthy environments. Some people have gone through a lot of trauma. It’s okay to not like everyone. Offer constructive criticism if you can, or step away and try to ignore them. If they’re directly interfering with you on a regular basis, tell staff. Don’t take things personally in rehab. You may get frustrated, but you need to let it go.
8. Don’t lie to your counselors or your peers. It’s absolutely pointless. Chances are, you’ll never see most of these people again after rehab. Everything is bound by confidentiality (unless you’re homicidal, which is another issue entirely). If you’re lying, you’re doing yourself a disservice and wasting time.
9. You will run into many chronic liars. Most people, especially other addicts, can see right through lies and will think less of people for it. It’s a nasty habit and if you catch someone in a lie, call them out on it or question them further and wait for their story to derail. Don’t intentionally belittle them, but give them a reality check. You’re really doing them a favor.
10. There’s no need to show off, exaggerate, or glamorize your life. No one cares how much money you made, how “gangster” you are, or how many people you had sex with. It’s not a competition to see who’s the biggest, baddest drug addict in rehab. Just be yourself.
11. Do not date anyone in rehab. We call them rehab romances, and they’re a horrible idea. It does not end well and leads to relapse 99% of the time. You are not the special 1%. You need to learn to stand on your own two feet without leaning hard into a new relationship. Relationships are hard enough for “normal” people. If you’re both in rehab together, you’re both not in any emotional, mental, physical, or financial state to be dating. Replacing drugs with a relationship doesn’t work. If you struggle with codependency, talk to a therapist about it.

Next Steps After Rehab

As you near the end of your time in rehab, the clinical team should assist with your aftercare plan. They’ll likely recommend therapy, an outpatient program (PHP or IOP), going to support groups or 12-step meetings, and seeing a psychiatrist or individual therapist.

They may also recommend you move to a recovery/halfway/sober-living home. It’s uncomfortable living and sharing rooms with other people, but I’d highly recommend giving it a shot if you don’t have a family to go back to, or you feel like going home will trigger a quick relapse. If you have anyone on the outside who can tour recovery homes in your area for you and call outpatient centers to get information, that would be advisable. Some treatment centers are selective about where they send their patients afterwards, but others couldn’t care less. Do your own research if you can.

Avoid going to after care in Florida. They’re improving, but the rehab industry down there is still rampant with issues due to years of lax regulation and corruption.

Final Thoughts

Regardless of which path you choose to get sober, I hope things work out well for you. Figure out why you use drugs and what you can do to work on your core issues. Be kind to yourself. Surround yourself with healthy people and build a life worth staying sober for.

I hope you found this guide helpful. Feel free to log in via social and post comments below if you have any questions. I will try to address them.

Thanks for reading and take care,

Footnotes & References

• 1
  Alcohol is a drug. Experts say it’s stronger than cocaine or heroin. (WebMD)
• 2
  Alcohol withdrawal can lead to death. Complications of Alcohol Withdrawal (Trevisan, MD, et al. 1998)
• 3
  Do not label yourself as an addict or an alcoholic. If you keep calling yourself an addict, you’ll always be an addict. The brain is neuroplastic and to change your thinking you should identify yourself in a more positive manner. Neuroplasticity in Addictive Disorders (Charles P. O’Brien, MD PhD, 2009), Never Call Someone an Addict (Adi Jaffe Ph.D. 2018)
• 4
  11 Criteria for Addiction (Elizabeth Hartney PhD), Substance Use Disorders, (Diagnostic and Statistical Manual of Mental Disorders, 5th edition, American Psychiatric Association, pp. 483,585)
• 5
  See Addictions & Stages of Change (W. Henry Gregory, Jr. Ph.D. 2015
• 6
  The longer you stay in treatment, the higher your chances of long term sobriety. Does retention matter? Treatment duration and improvement in drug use (Zhiwei Zhang PhD, et. al 2003, paper is behind a paywall)
• 7
  29 CFR § 825.119 – Leave for treatment of substance abuse. (Cornell Law School)
• 8
  Lapse and relapse following inpatient treatment of opiate dependence (B P Smyth et. al, 2010), Abstinence and drug abuse treatment (McKeganey et. al, 2009), Relapse after inpatient substance use treatment: A prospective cohort study among users of illicit substances (Andersson et. al, 2019)