28–30 Days of Inpatient Treatment: Just Right or Too Little?
For many years now the standard length of stay for substance abuse Inpatient treatment has been 30 days. With the rise of the heroin epidemic many are wondering, Is 30 Days of Inpatient Treatment Enough? The answer to this question is not simple, but I’m not going to tell you something convoluted like, “Well the answer is yes and no!” Answers like that don’t help anyone. The answer is…
No, 30 days is usually not enough, but the truth is 30 Days of inpatient treatment was rarely enough and few who went through 30 days in rehab ever stayed sober with only 30 days of treatment under their belts. The real question on your mind is most likely what amount of time does it take to help me or my family member recover from their addiction. That question we will answer here today once and for all, but first we need to understand where the 28 to 30-day model originated.
Who Decided 30 Days of Inpatient Treatment was Enough?
Many people believe the 30-day model for treatment was invented by our friends at the insurance companies, but this is not true. In 1970, the first addiction treatment center for the United States Air Force was established. Back then men and women who were removed from duty for a period of 30 days or less did NOT have to be reassigned. This allowed the fighting and flying men and women of the armed forces to receive inpatient treatment for chemical dependency and then return to their units. After seeing success under this model, other treatment centers started to follow suit and soon the insurance companies made the 28 to 30-day model the industry standard. No one ever checked to make sure that this number was sufficient to spawn adequate recovery, the number just seemed to fit so the model was duplicated until it was used so much that everyone just assumed somebody checked the number. Well, it turns out that almost 30 years later someone did check the data and it’s not good.
Substance Abuse Data Proves 30 Days Is NOT Enough
The National Institute on Drug Abuse published a report in 1999 that stated that anyone attending inpatient substance abuse therapy for a period of under 90 days has a far greater chance of relapse. The study also reports that 90 days is not the gold standard and staying in rehab for 90 does not guarantee recovery by any means. *One study of narcotic users showed that 35% of patients who attended 90 days of inpatient treatment stayed off drugs for a period of one year or more. Addicts who received 30 days of inpatient treatment only reached 1 year of sobriety at a rate of 17%. Another study of children under that age of 18 showed a significant increase in relapse rates for patients who attended less than 90 days of treatment.
90 Days Equals 90% Success Rate for Airline Pilots and Doctors
One of the more ^convincing arguments for an increase from the 30-day model comes from the substance abuse care administered to medical professionals and Airline pilots. For many years now Doctors and Airline Pilots have been required to complete a 90-day drug rehabilitation program before they could be considered for reinstatement to their profession. When we look at how this 90-day rehab requirement imposed by airlines on their chemically dependent pilots affects the success rate of recovery lasting for a period of 1 year or more the results are staggering. 90% of airline pilots who are required by their employer to go to treatment stay sober for a year or more. This success rate far exceeds that of the general population by more than 80%. This drastic increase in success is partly based on the consequences that could potentially end their career as well as the fact they are doing 90-days of treatment. Once this data began to shine a dim light upon 30 days of inpatient treatment, the substance abuse industry took notice and began to offer longer stays.
Treatment Centers Now Offer a Variety of Program Lengths
Today, more than 46 years after 30 days of inpatient treatment became the unproven duration for recovery, many substance abuse providers have begun to offer much longer programs for inpatient therapy. Yes, 90 days has become the go to number for many of the big, long established drug rehabs across the United States, but many have even enacted longer terms of treatment. One Minnesota based provider of treatment services devoted an entire unit of their facility for treatment lasting a period of one year. This facility has seen success for many of its patients partly because of the increased duration of treatment but also because the center allows for its clients staying for one year to gradually assimilate back into society and then process their cravings and temptations at the rehab when they return.
Another successful substance abuse brand in Florida employs a highly-individualized approach to treatment length with substance abuse counseling ranging from 90 days to 2 years. Here again the success rate is also based on the length of stay and the fact that the addicts and alcoholics are weaned back into society over an extended period, limiting the shock of being thrust back into the world too soon (the main drawback of 30 day inpatient programs). The reintegration under supervision policy used by these treatment facilities is a major factor in helping their clients find long term recovery for their drug and alcohol problems, but it is nothing new, it is what has been suggested for many years. Here we find the answer to your question.
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It’s the Number of Days of Aftercare That Really Matters
30 days of inpatient treatment was never enough. 90 days of inpatient treatment is better but what really matters is the number of days the addict or alcoholic is involved in an aftercare program. No one who has found 5, 10 or even 50 years of recovery from addiction has done so without participating in a program of recovery for a long period of time. Inpatient treatment regardless of the length of stay can only be successful if followed by a rigorous and enthusiastic aftercare program. This is nothing new, this is the way it has always been.
All treatment providers suggest that their clients struggling with substance abuse take part in a long series of step down programs that culminate with attendance in 12-step programs lasting for the duration of one’s recovery. So, no, 30 days is not enough, the number of days required is not the question you should be asking. The real question is, if my loved one follows all recommended aftercare recommendations will they stay sober? That answer is Yes! Yes! Yes! The first step is going from inpatient to intensive outpatient.
Attend and IOP After Inpatient Treatment
Intensive outpatient programs for men and & IOP for women provide the opportunity to receive treatment for chemical dependency without having to leave work, school, or other responsibilities, thus affording then the ability to slowly enter back into their lives under the care of treatment professionals. This step-down form of treatment is the second phase in the journey to long-term recovery – a very, very important phase that has always been suggested by reputable facilities.
Men and women involved in this form of treatment still receive one-on-one therapy with a treatment professional as well as attend group therapy 4-5 times a week. They live and work in their community and may be exposed to the triggers and temptations that life offers but then return to their IOP group to process, learn and grow from these experiences. After an extended period and after the treatment team feels another step down is appropriate for the patient, they enter the Outpatient (OP) phase of recovery.
After Intensive Outpatient Comes, Outpatient
Traditionally, outpatient programs consist of one private session with a chemical dependency therapist and one group session every week. This step in the recovery process is ideal for women and men who no longer need inpatient treatment and have successfully completed IOP. With Outpatient services clients still receive private and group therapy but are also introduced to life skills training and long-term relapse prevention. Most importantly, the addicts and alcoholics at this phase are prepared to and get more involved with the aftercare that they will be encouraged to participate in for their lifetime, a 12-step program.
90 Meetings in 90 Days Bridges the Treatment Gap
Most successful recovering drug addicts and alcoholics attend 90 12 step meetings in 90 days upon completing the final stage of their treatment centers aftercare program. This is referred to as a 90-in-90. Here they take all of the information they have been learning throughout the treatment process and apply it to their life and their meetings. The 12-step model has proven to be successful since the 1940’s and is supported and recommended as the primary source of permanent recovery by all successful and trusted chemical dependency treatment providers. In programs such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) recovering alcoholics and addicts find a sense of community, support and embark on a path of recovery that they can retain for a lifetime.
So, no, once again 30 days of inpatient treatment is hardly enough. It rarely has been. There has never been a magic number. If one wants to stay sober they need to stay involved in some program of recovery for a lifetime. At 45 years sober that may be one AA meeting a week or month. At 7 months sober, that may look like 4 meeting a week and OP treatment. At 6 years of recovery, maybe you’re looking at 4 AA meetings a week. However, every person is different, and there is a saying that “when we don’t feel like going to a meeting, is usually when we need one most.”
There is not set number because there always needs to be some form of recovery prevalent in the life of the recovering alcoholic or drug addict. Addiction is not curable in 30, 60,90 or 365 days. It must be treated in some way each, and every day.
But, if you’re still looking for a number I guess the number is one…
One Day at A Time.