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When weighing out the various options for the treatment of addiction to alcohol, and even when deciding whether or not to try to quit, it’s common that a person will want to know a rehab’s success rate. This is perfectly understandable given the personal, professional, and financial costs that can be accrued by attending a alcohol and drug treatment program.
When discussing success rates, however, the tendency can often be to overlook the nature of alcoholism as a chronic disease, for which there is no known cure. Alcohol Use Disorder (AUD), like many other comparable diseases, has both a behavioral and a physiological component. As such, it can be managed successfully, but it is important to note that incidents of relapse are highly possible and should not necessarily be viewed as a failure on the part of treatment.
In this article, we will discuss specific characteristics of alcoholism as a disease and some of the statistics around recovery, the various options that exist for treatment, and a few recommendations for long-term care that can significantly improve the chances of maintaining lasting sobriety. While recovery from alcoholism may be extremely challenging, it’s necessary to remember that success can and does occur.
Alcoholism has been defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) as, “A chronic relapsing brain disease characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.” Research has shown that it affects up to 17 million adults in the United States alone, which represents about 7% of the population over the age of 18.
The classification of alcoholism as a disease is crucial because it is a reminder that, for the alcoholic, the choice of whether or not to drink, is not purely a decision. When discussing the treatment plan and process, it is helpful to remember that the path towards sobriety may often require multiple interventions in treatment centers across a period of months or years, and the statistics generally do not support a single attempt at a rehab program as being sufficient.
Rates of recovery among those suffering from Alcohol Use Disorder may vary widely according to the health and individual usage profile, along with the type and duration of the treatment plan he or she has undergone. A few of the factors that can affect the chances that an individual will maintain lasting sobriety include the following:
- Marriage – Married people may be more likely to stay sober than unmarried people.
- Gender – Women may be more likely to stay sober than men.
- Age – Older people may be more likely to stay sober than younger people.
- Social resources – Those with additional resources such as a higher level of education, greater income potential, and property owners may be more likely to stay sober than those with less.
- Family history – Those with a family history of alcoholism tend to have a more difficult time staying sober.
- Co-occurring mental and personality issues – Those suffering from a co-occurring psychiatric or mental health disorder may be less likely to remain sober than those who do not.
While numerous determinants exist that can contribute significantly to each individual’s experience, a generally agreed upon statistic is that around 1/3 (33%) of adults do make a full recovery. Though this number may not seem very high, a comparison with other chronic illnesses such as diabetes, asthma, and hypertension, along with a thorough understanding of the brain chemistry behind addiction can help that number be appreciated in a new light.
The National Institute on Drug Abuse has studied the relapse rates for addiction to drugs and alcohol and found them to resemble those of other chronic diseases. With Type I Diabetes having a relapse rate of between 30% and 50%, and asthma and hypertension having rates between 50% and 70%, the common perception among many that addiction is a singular case can be observed as a falsehood.
Again, it may be critical to remember that treatment does not function as a single cure lasting on into perpetuity. Instead, the recovery process from alcoholism requires continued maintenance and modification relative to an individual’s particular needs. It is important not to view relapse as a failure necessarily, but rather as another step along the path, from which valuable lessons can hopefully be learned.
Another contributing element that may help to reduce the risks of relapse to alcohol is the type and duration of treatment they undertake. Since addiction treatment centers are still a relatively new subject of study, many different philosophies and strategies inform the various program models currently in operation. Though consensus on the optimal approach may as yet be undetermined, it can be helpful to consider the range of options available.
Types Of Treatment Programs
With the number of individuals in the United States suffering from addiction to drugs or alcohol being well documented, it is little wonder that such a plentiful and wide variety of treatment programs have appeared in recent decades. As declared by the federal government, we are currently in the middle of addiction levels sufficient to be recognized as a National Health Crisis, and it has been critical to address this issue through any evidence-based means available.
The process of making a comparison between the range of programs currently in operation can be extremely confusing. One of the determining factors in a decision must surely be the success rate of rehab, but those numbers can often be difficult for a program to determine. It may also be helpful to first distinguish between the broad categories at play, in order to come to a clearer understanding of which type might best fit a client’s needs. Some of these treatment programs include:
- Long-Term Residential (Inpatient) Treatment
- Short-Term Residential (Inpatient) Treatment
- Outpatient Treatment
- Individual and Group Therapy
- Support groups such as 12-Step programs
Long-Term Residential (Inpatient) Treatment
Long-term inpatient substance abuse treatment programs that occur in a residential setting will typically provide the most intensive care option available. These programs for alcohol abuse tend to be situated in a non-hospital environment, and in terms of staffing and programmatic structure, they generally can provide round-the-clock monitoring and support for their clients.
Therapeutic Community (TC)
The most common model for long-term inpatient programming tends to be what is referred to as the “Therapeutic Community” (TC). These programs offer a holistic approach, wherein the client undergoes a process of gradual “resocialization” without the presence of drugs or alcohol. They may include a length of stay from between 6 and 12 months.
The idea behind the approach of many TCs is that clients have been using substances in order to cope with damaging psychosocial beliefs or disorders that undermine the way they interact with themselves and others. The goal or intention for each client is to become reintegrated into society by first learning how to be part of a group. Clients are required to take on responsibilities within the community and participate in activities that help present an alternative, more positive, framework for behavior.
Short-Term Residential (Inpatient) Treatment
Short-term inpatient programs tend to differ from their long-term counterparts mainly in that the treatment process is condensed into a shorter period of time. Rather than stays of up to a year, short-term programs will often last between 3 and 6 weeks. The setting may be a hospital, with the clinical model revolving more heavily around the 12 steps.
After completing a short-term residential program, it is strongly recommended that a client undergo a prolonged period of aftercare or participation in some form of therapy or support group. While short-term programs can be effective, the successful treatment of the psychosocial issues that often accompany addiction may require additional care beyond what it is possible to address within the confines of a three to six-week stay.
A distinguishing characteristic of outpatient programs is that they are usually non-residential. Beyond this, they often vary significantly regarding structure and level of care. While some programs may offer education on addiction and alcoholism, others may provide comprehensive treatment that resembles residential programming in its level of support.
Individual and Group Therapy
A critical component of many treatment plans is the process of therapy. Therapy may be undertaken in the context of a residential treatment or outpatient program, or on an individualized, independent basis. The therapeutic process can be an effective tool in dealing with the various mental and emotional traumas that can accompany Alcohol Use Disorder, and as such is strongly recommended, regardless of the course of treatment an individual has chosen to pursue for their alcohol addiction.
Likewise, the 12-Step community, in the form of Alcoholics Anonymous, can be a valuable resource at any stage of an individual’s long-term recovery. Many programs incorporate elements of 12-Step philosophy and practice into their models, and the sense of community and support the participants can provide for each other has the potential to reduce the social difficulties that may arise due to the recovery process.
A Note On Treatment Programs and Success Rates
Research and evidence-based studies have shown that longer time periods spent in treatment equates to higher chances of success in achieving long-term recovery and sobriety. While there may be cases in which a shorter period of treatment is necessary, it is generally recommended that individuals suffering from Alcohol Use Disorder plan on doing everything they can during the early stages of the treatment process to maximize the likelihood of recovery, as uncomfortable as they may be.
Another factor that has the potential to significantly affect the success rate of rehab is an individual’s commitment to aftercare once he or she has been discharged. There are a number of potential tools that can have a positive impact on a person’s recovery chances, some of which have already been touched upon. These can include:
- A healthy lifestyle
- A positive social support system
- Participation in a 12-Step or other self-help program
- Engagement with therapy
- Reaching out when difficulties arise
The implementation of a healthy lifestyle can go a long way in enabling an individual to maintain a balanced body and mind. The months following the initial treatment phase can be immensely difficult to navigate due to the onset of Post-Acute Withdrawal Syndrome (PAWS), which can include depression, anxiety, and intense cravings. It can be essential for an individual pursuing lasting recovery to combat these symptoms.
The specifics of a healthy lifestyle are often best determined on an individualized basis, perhaps in consultation with a licensed physician. However, there are a few simple and widely applicable things to remember when attempting to optimize your daily sense of wellbeing:
- Get proper sleep, preferably between 7 and 9 hours per night
- Eat a balanced diet that includes a significant amount of fruits and vegetables
- Receive treatment for any lingering or nagging health problems
- Closely monitor the way you are feeling at various points throughout the day
- This can include the HALT acronym: Hungry – Angry – Lonely – Tired
Risks Of Relapse Among Those Who Have Achieved Long-Term Sobriety
The positive news for those who have managed to stay sober for an extended period of time is that the chances of relapse diminish significantly as time continues to pass without using. Of people who make it to one year of sobriety, less than half generally relapse. Of people who reach five years sober, the relapse rate is less than 15%.
However, a few recent high-profile cases may remind us that risk of relapse does still exist, even for those with ten or more years sober. The story of Philip Seymour Hoffman is an all-too-tragic case study in the lingering dangers of addiction that reaffirms the truth that addiction is a disease for which there is currently no known cure.
While the relapse rates among those attending rehab may appear discouragingly high, it is important to remember that there is a wide range of evidence-based treatment options available. There is hope for recovery and you can learn how to stop drinking once you get the guidance you need. If you or someone you love is suffering from alcohol addiction or any other substance abuse disorder, you can get help. Make a phone call today to start the alcohol detox process.
- How Often Do Long-Term Sober Addicts and Alcoholics Relapse? Psychology Today.
- How Effective is Drug Addiction Treatment? NIH.
- 1/3 Fully Recover From Alcoholism. WebMD.