Should I give rehab a try?

October 9, 2010 6:44 PM

Would rehab be appropriate for someone who binge drinks only a couple times per week, but is desperate to quit and has tried to do so many times without success?

I am starting to feel quite desperate about my drinking problem, to the point where I am considering an inpatient stay at a private rehab hospital.

But I don’t really know if I’m a good candidate for rehab. I’m a binge drinker, so am drinking not every day but rather 2 to 3 heavy sessions per week. I don’t get the shakes or anything, but my drinking is undoubtedly affecting my life and health in several problematic ways, many of them (I hope) visible only to myself and those close to me. Other than that I hold down a great full-time job, have a supportive partner who I enjoy living with, and always pay my rent and bills on time. However despite this I don’t ever seem to make progress on my drinking problem. I have seen GPs, counsellors, the best (well, most expensive) addiction psychologist in the state, tried going on health retreats, taking courses of naltrexone therapy, spent a lot of time in AA meetings and so on. I just can’t seem to stay sober for more than a few days. I also wrote this anonymous question about struggling with the motivation to quit drinking.

I think one of the environmental factors that contributes to my drinking is that a few individuals at work and a few close friends (in fact most of my friends, except my SO) are all very heavy drinkers – just like me. We all go to the same bars where we are ‘regulars’, we all support each other’s smoking and drinking and, I suppose, normalise each other’s behaviour to the point where it seems totally natural amongst most people I know to get wiped out twice a week, then still get up and put in a full day’s work. This is basically my whole social life and my normal routine. I put on a very fun, social face at these gatherings and most people probably wouldn’t know of my repeated attempts to quit, or the fact that I consider it a serious problem. But I dislike myself and the person I’m becoming more and more with each passing day. To the point where I feel, I really can’t go on like this any more, it’s seriously affecting my self-worth and my ability to be proud of the life that I’m living.

I hope that rehab might give me an opportunity to be away from the temptation of environmental factors and the constant opportunities to drink that my lifestyle presents, which I then usually fail to resist. I also hope that immersing myself in the possibility of recovery 24/7, would give me a better chance to make lasting changes. (On the other hand, I am scared – what if this seemingly extreme option still doesn’t work? I don’t really have any other cards left to play.) This cost will be mostly covered by my health insurance, and I hope to be able to get at least 1 month’s leave from work without having to disclose the full extent of the reasons why, as our work is normally pretty quiet over the Christmas/New Year period anyway. I’m in Australia and a 27yo female, by the way.

So, my questions are: would rehab help a binge drinker, or is it more for daily drinkers? What do people actually DO all day in rehab? Would I get really bored? Would I be allowed out to go for walks and things? I know it sounds trivial but in fact I’m scared that doing nothing all day in a hospital will drive me to depression and then back to drinking. At the moment, I have been diagnosed with a drinking problem but have no other mental health issues such as anxiety or anything like that (according to my psychologist).

Also, I have this (possibly ridiculous) fear that rehab is somewhat like I imagine prison to be, in that you can come out ‘worse’ than when you went in, and that mixing with other addicts constantly just makes you even more obsessed with drinking. I realise this is a judgemental and quite possibly ignorant and snobbish view. I also have stupid thoughts like, “oh no, eating bland crappy hospital food for a month will just be the pits”, that make me doubt myself and whether I am actually being a hypochondriac about this whole drinking problem – surely the food and boredom in a rehab would be the least of my worries if I was really serious about staying sober.

Anyway, in summary, is there a certain ‘type’of alcoholic that you think rehab is designed to assist? What were your own experiences in rehab as a drinker who has, perhaps, not yet ‘hit bottom’?

posted by anonymous to health & fitness (16 answers total)

Yes.

'Only' a couple times per week. If that's 2 days out of 7, then a third day for downtime/recovery (more if the drinking days aren't consecutive)...

Treatment isn't a bad thing, and can certainly help you in your situation.
posted by Rendus at 6:49 PM on October 9, 2010

One of my family members is an addictions counselor. Generally not inpatient (or rehab), but has done some work with them, and often is the counselor for people who have been in rehab.

From what I know, rehab can be worthwhile. If you've tried counselors and such, then yeah, go with rehab.
posted by Lemurrhea at 6:58 PM on October 9, 2010

Why not call some rehab clinics and ask them what their clients do with their days? I imagine different clinics have different routines, and you'd want to find one that you spark to. There's certainly no downside to asking them, and I'm sure they're very used to explaining themselves to people who aren't sure they want to come to rehab.

Just ask!
posted by musofire at 7:23 PM on October 9, 2010

Oh, and as far as whether it's appropriate: you've said yourself that environmental factors are making it hard for you to quit. So you need to change your environment.

If you talk to rehab clinics and it doesn't seem like they'd work, you could also go on a trip and stay away from bars on the trip. Heck, you could take a trip to Morocco or some other Muslim country, and you'd actually have to work to find alcohol.
posted by musofire at 7:26 PM on October 9, 2010

According to the International Classification of Disease, binge drinking several times a week is equivalent to being a continuous alcoholic (and is reported exactly the same). If you can't control your drinking and it's affecting your life, the number of days you do it is pretty irrelevant. Follow your instincts and get to rehab.
posted by Apoch at 8:08 PM on October 9, 2010

The fundamental problem, as you yourself observe, is your group of friends. Unless you break with them, you won't change the underlying dynamic that supports your addiction. Rehab followed by a reintegration into the same social network won't work. Rehab as a first step toward lasting structural change might.

Where is your partner in all this? Can (s)he help you break away from this group of friends?
posted by felix betachat at 8:13 PM on October 9, 2010 [1 favorite]

anonymous: So, my questions are: would rehab help a binge drinker, or is it more for daily drinkers?

Rehab is for people who want to quit drinking. It's residential treatment. You seem like an excellent candidate to me.

What do people actually DO all day in rehab? Would I get really bored? Would I be allowed out to go for walks and things?

You go to group. You go to individual sessions. In some places you go to in-house AA. You read. You watch TV. You hang out with the other patients. Depending on the facility, you may have options for yoga, art classes, and other activities. Generally you want to equip yourself with some time-passing activities like crosswords, books, an iPod, etc.

Every facility is different. When I was in rehab, going outside was definitely part of the programme but it was an earned privilege. You had to stay clean, stay sober, work your programme, and pass pee tests to go outside.

Which, by the way, was totally terrifying when I got out there. That's how fundamentally my view of the world and my place in it changed when I was in rehab. I walked out the door, walked outside, and walked right back in. Everything was new and bright and loud and different and it wasn't until the next day that I could take myself for a walk around the block. Which was, for the record, the best walk I'd ever taken.

I know it sounds trivial but in fact I’m scared that doing nothing all day in a hospital will drive me to depression and then back to drinking.

Well, it's pretty likely you'll get depressed; that's sort of par for the course in treatment while you confront your addictions. It's unpleasant. However in the normal course of events, you turn around, your thinking and attitudes change, and you complete rehab in much better shape than you went in.

Also, I'm not sure how this works for other people, but I completely lost my appetite whilst in residential care. I remember the food as being fine, I just wasn't interested. I was working really hard, pretty much every hour of every day, and food was a very low priority. YMMV.

Also, I have this (possibly ridiculous) fear that rehab is somewhat like I imagine prison to be, in that you can come out ‘worse’ than when you went in, and that mixing with other addicts constantly just makes you even more obsessed with drinking.

Worth noting: you're mixing with other addicts at a bar pretty constantly. How's that working out for you?

Generally, the newly sober take to sobriety like evangelists take to religion, so in my experience the opposite is true. You are actually surrounding yourself with people who are very actively not indulging in their addictions, and fairly committed to that. It's a pretty radical change, actually.
posted by DarlingBri at 9:31 PM on October 9, 2010 [4 favorites]

Your problem is that once you walk in the door of that bar with your friends you don't leave until you're obliterated drunk, right? Then what feliz said. You need to get new friends or tell the ones you have that you have quit and stop going places that serve alcohol in their company. If they don't want to hang out with Sober You then you may have to end or severely curtail the friendships. Trying to secretly quit but still hang out with them isn't going to work as you've seen.

Also consider a new job if yours is one that tolerates heavy drinking. I used to work in an industry that encouraged binge drinking and several people quit because it became a problem for them, a couple even moved far away*

Unless you make this a priority in your life it won't work. Rehab won't give you the magical powers to hang out in bars with your friends and sensibly go home after two beers or drink club sodas. It might give you the tools and resolve to completely overhaul your life but if you aren't committed to that going in it probably won't.

*Several others simply became hopeless alcoholics, at least one of whom is now homeless.
posted by fshgrl at 9:32 PM on October 9, 2010

If you're going to go into rehab, and then return to the same social pressures (YOUR COWORKERS!) when you're out, I think you might be better off cutting to the chase and changing the social pressures. Getting a new job/friends without going to rehab sounds simpler and better than going to rehab and then realizing you need to change your job and friends anyway.
posted by oreofuchi at 11:06 PM on October 9, 2010

This comment from netbros has some information on what it is like in rehab, though it sounds like he and you are/were in different places w/r/t alcoholism it might be helpful.
posted by mlis at 12:44 AM on October 10, 2010

I have seen GPs, counsellors, the best (well, most expensive) addiction psychologist in the state, tried going on health retreats, taking courses of naltrexone therapy, spent a lot of time in AA meetings and so on.

But I dislike myself and the person I’m becoming more and more with each passing day. To the point where I feel, I really can’t go on like this any more, it’s seriously affecting my self-worth and my ability to be proud of the life that I’m living.

First up, the rehab facilities I've been in here in Western Australia, both as a patient and a visitor, have had okay food and good mechanisms for dealing with conflict and other counter-productive behavior between patients. They have involved some measure of confinement but, as others have suggested, that's not necessarily a bad thing. You'll be fragile for a time, and then you'll be building a new you. Having no possibility of external distraction for a little while will help on both those fronts.

Secondly, it sounds to me like you're ready to get yourself sober, you've tried other options for getting there, and the logical next step is trying (and making a go of) a residential rehab program.

In the face of that, the worries and concerns you've got (food, confinement, contact with other alcoholics) need only be weighed against the question "how badly do you actually want/need to get sober?"

If the balance comes down on the side of "I badly want to be sober" (and your own words suggest that will be the case) then there's no question about it.

Do it.
posted by Ahab at 1:59 AM on October 10, 2010 [2 favorites]

First of all, I'm American and have been through rehab (court-ordered, out-patient).

Secondly: You are going to hate it. There is no sugar-coating the inane statements that constitute "rehabilitation" in the American language of non-judgment, "it's a disease," and "everyone is entitled to their own blah, blah, blah....."

It was the most awful, idiotic waste of time that I've ever been commanded to be a part of. Inpatient will be even worse, because you can never get away from it. Picture "inspirational" type posters with pictures of kittens on them, and they say "Hang in there!" Now picture being locked into a building whose primary decor is kitten posters. Now stab your eyes out and get it over with.

You genuinely want to stop drinking. So just stop. Your post demonstrates enough self-awareness that you don't need to lock yourself into a nightmare world of kittens and group-think. Next time there's a beer, don't drink it. It's literally as simple as that.

(although, it can be a nightmare scene. MeMail me if you would like. I once stopped drinking of my own accord, and while it was a far-from-perfect scene, I still did it. You can too.)
posted by deep thought sunstar at 2:41 AM on October 10, 2010 [3 favorites]

It seems to me you need to find something that helps take your initial efforts at sobriety to the next level, especially given the environment in which you find yourself, surrounded by other drinkers. You are not unique in that respect by the way, many heavy drinkers/alcoholics surround themselves with other drinkers. It is easier to justify the behavior, practice the behavior etc.

You said you went to AA, but did you work the program, get a sponsor, etc.? That might be your next step. Alternatively, so could rehab. After committing a month or so of your life to rehab do you really want to blow it all by having a beer or ten?

You might start with more active AA as rehab is going to send you there anyway when you get out. Rehab is not a cure, but merely the first step in an extended journey. You are going to need support to keep your commitment to sobriety and if all your current family and friends are subtly going to be working against you then AA or something like it becomes all the more important. You want someone to call when the urge to drink arises. Ideally you would remove yourself from the social situations which encourage drinking, but we don't live in ideal worlds. Enhancing that with a group of from AA that does not drink might be enough. However, I don't know how you are going to succeed without ditching the bar scene entirely, at least for some extended period.

To succeed you will need to make a commitment. The most important person to whom you must commit is yourself. Adding your spouse and perhaps an AA sponsor to that will enhance your commitment. You also have to define your commitment in a way which helps you succeed. Commitment to an entire life without alcohol sounds pretty scary. How about one month, or better three? At the end of that time you are not planning on going out to have a big party (fail) but rather to reevaluate your relationship with alcohol. You may also find that saying "I am taking some time off" is an easier conversation to have with your drinking friends than " I quit forever." They may very well find your commitment threatening to their own relationship to drink and work, consciously or unconsciously, to undermine your commitment. They may find the shorter time period less threatening. In any event the most important time period is today. Today you will not drink. That is doable and let's work on that one right now. Worry about tomorrow when tomorrow comes.
posted by caddis at 4:26 AM on October 10, 2010 [1 favorite]

Huh. Let me say that I don't know a lot about rehab and so if you think it's a good idea to go, I can't say anything different. I can tell you that there are some big things you can do at home (so to speak) to help it "stick" and make sure you get the most out of it.

I used to binge drink a lot and I should point this out:

I put on a very fun, social face at these gatherings and most people probably wouldn’t know of my repeated attempts to quit, or the fact that I consider it a serious problem.

Quit doing this and see what happens.

I don't know Australian culture, so forgive me if this is tone deaf, but I can't help but wonder why you haven't shared something so huge with your good friends. It seems like you're putting a lot of pressure on yourself to preform in a role that you don't want, and you don't even know if that's something your friends want you to do.

Social pressure is HUGE. We're social animals. It can be very, very difficult to say no to something when you feel the need to smile and go along with it.

Do your friends know that you're not happy? Are you assuming that they want you to pretend to be happy? What if they don't? What if they want to support you in quitting? What if one of them wants to cut down on the drinking, too? What if they would just rather you be up front with them and not bullshit them?

Shit got 100x easier for me when I just told everyone that I wanted to quit, that I might have trouble quitting, but that I just didn't feel good about my drinking anymore. Most people didn't care that much, a few were psyched because they were worried about me but didn't want to say anything, and one was an asshole about it and tried to pressure me to drink (ended our friendship, but turned out I didn't miss her at all).

That said, I have a lot of social worker friends, including three who are addiction counselors, so your mileage may vary.
posted by the young rope-rider at 8:32 AM on October 10, 2010

I don't doubt deep thought sunstar's experiences. I do think, however, the court that ordered her to rehab is using the wrong facility. If my treatment center experience had been the same as her's, I probably would have puked from the sweetness and gone back to drinking. And I was in the fortunate position of actually wanting to quit drinking. I didn't have to be ordered by a court. My own desperation is what ordered me.

I don't remember any kittens on the wall, but I do remember the plywood frame bed, and the austere nature of the center. But I was in a hospital, not a country club. I didn't go to rehab for gourmet food, shopping excursions, and pop-psychology. I went to get sober. I didn't want to drink anymore, and I couldn't quit of my own devices. It was as simple as that.

OP it seems to me you may be feeling a sense of that desperation. Ask yourself simply, "Is alcohol interfering with the way you want to live your life?" If so, then you may have a drinking problem, and ANYTHING you can do to alleviate that is worthwhile, including rehab, if you want to stop. But you really must want to. Nothing, including rehab, is going to work until you truly want to stop drinking. No person, no place, no psychology can make you stop until you are good and ready, and desperate.

You can't keep hanging out with your friends. I think deep down you know that. You have to make new friends. Hopefully a lot of those new friends will be other recovering alcoholics. The ability to share experiences with others who have been there is a powerful means to the end that is sobriety. When I got sober I had to change nearly everything in my life. It had to become the most important thing in my life. I had to get new people, places, and things. Clinging to the old pals, hangouts, and lifestyle is a road map to failure.

Your decision isn't really about whether to go to rehab or not. Your decision is, at age 27, whether you are totally ready to retire from a drinking lifestyle. If you simply aren't sure if you want to stop forever... if you think you might want to be able to drink socially when you are 40 or 50, then keep on as you are. You will be back sometime in the future. But, if you are desperate to stop drinking right now—if it is more important to you than your friends, and your comfort zone, then get yourself to rehab immediately with a total commitment to exercising and practicing each and everything you are taught while you are there. They will give you the tools to succeed, but only if you use them.

My best wishes to you. Please feel free to email anytime. It's in my profile.
posted by netbros at 9:44 AM on October 10, 2010

If you tried AA and it doesn't feel right for you, I recommend taking a look at Women for Sobriety. http://www.womenforsobriety.org/
posted by papalotl at 9:57 AM on October 10, 2010