How to Decide if You Need Rehab
Addiction is a serious and growing problem in the United States. According to the 2018 National Survey on Drug Use and Health, around 14.8 million people aged 12 or older had an alcohol use disorder, while an estimated 8.1 million people aged 12 or older had at least one illicit drug use disorder.1 Addiction can wreak havoc on your life and the lives of those around you. Your life can quickly spiral out of control if you don’t seek help. If you suspect that you have a problem, it’s time to say, “I need help with my addiction.” At the same time, if your loved one struggles with substance abuse, you should understand that a person cannot typically just stop using on their own; they need professional help to get better.
When life become unmanageable because of substance abuse, you may start asking yourself hard questions. “Do I have a problem with substance?” “Can I handle this problem on my own?” “Do I need rehab?” You should not wait to seek treatment just because you haven’t hit rock bottom. In fact, treatment can help you regain control of your life, your well-being, your relationships, and your health before things go from bad to worse.
Addiction vs Dependence & Tolerance
The American Psychiatric Association’s Diagnostic and Statistical Manual has developed the criteria for a diagnosis of addiction, which is referred to as a substance use disorder. To receive this diagnosis, a person needs to meet at least two of the following symptoms:3
- Taking more of the substance or using it for longer than originally intended.
- Expressing a desire to cut down on substance use yet being unable to do so.
- Spending a lot of time obtaining, using, and recovering from the effects of the substance.
- Experiencing cravings or an intense desire to use the substance.
- Being unable to fulfill your work, school, or home obligations due to substance use.
- Continuing to use the substance despite social or interpersonal problems that are probably caused by substance use.
- Giving up activities or hobbies you once enjoyed so you can use.
- Using the substance in situations where it is dangerous to do so (such as while driving or operating machinery).
- Continuing to use the substance despite knowing that you have a physical or mental health issue that is probably due to substance use.
- Experiencing tolerance.
- Developing withdrawal symptoms when you try to stop using.
While many people struggle with addiction, it’s important to realizes that addiction isn’t the same thing as dependence or tolerance. Not everyone who uses a substance will develop an addiction. Dependence means that a person who uses drugs or alcohol needs the substance to feel normal; if they stop using, they develop withdrawal symptoms. Tolerance means that a person’s body has adapted to the presence of the substance and they need more of it to achieve previous effects. Addiction is a chronic, relapsing disease characterized by compulsive drug- or alcohol-seeking behaviors despite the negative consequences of substance use.2
Tolerance can occur in people who chronically use any substance, which is why some medications (such as benzodiazepines and sleep medications) are intended only for short-term use.4 Similarly, people who regularly and repeatedly use a substance may develop dependence and need to gradually taper their use to avoid withdrawal when they stop using. While tolerance and dependence can lead to addiction, they do not mean a person is addicted. Tolerance, dependence, and addiction can all occur with repeated use of a substance. The difference is that tolerance and dependence are physical issues, while addiction is both a physical and psychological problem.2
How do your family and friends feel?
Your social environment plays an important role in addiction and recovery. Social pressure is a risk factor for substance abuse. Conversely, having positive relationships is a protective factor, meaning that it reduces your risk for substance abuse.5 Do your family and friends use drugs or alcohol? Being surrounded by people who use can be a significant trigger and will likely impede your efforts in rehab. Do your family or friends acknowledge your addiction, and do they encourage you to seek help? If you have a supportive social circle, then you are more likely to succeed in recovery.
One thing to realize is that addiction often has a serious impact on your social well-being and can negatively impact your relationships with family and friends. Ask yourself if you are hiding your substance use, engaging in secretive behavior, lying to family or friends, or stealing money to buy drugs or alcohol. While these are all signs that you may have a serious problem, being willing to ask yourself these questions is a positive indication that you are ready to get sober.
Addiction and Your Career
Addiction can have wide-ranging effects on your career. People who have substance use problems often show up late, call in sick due to hangovers, miss deadlines, experience diminished job performance, and have problems with their peers.
Addiction affects people’s careers regardless of whether they hold white-collar or blue-collar jobs. A 2019 survey published by the National Safety Council showed that 75% of employers said they were affected by the opioid epidemic, 38% reported absenteeism or impaired worker performance due to opioid use, and “31% have had an overdose, arrest, a near-miss, or an injury [in the workplace] because of employee opioid use.”7 Studies have also shown that addiction has a significant impact on a person’s ability to obtain and maintain employment. One study that examined people from low-income, high-crime areas showed that “chronic drug use significantly reduced the probability of being employed.”6 You don’t need to come from a low-income or high-crime area for addiction to have a detrimental effect on your career.
People with successful careers may be able to function in the workplace while simultaneously suffering from serious addictions. This is known as high-functioning addiction, but don’t be fooled into thinking it’s not a problem. High-functioning addicts can hold jobs and perform at work, at least for a time, until the addiction eventually starts to impede their ability to function. Supervisors and managers are often aware of the problem but they may turn their backs until people stop fulfilling their job obligations. Workplaces should be aware of the signs of addiction so they can provide early intervention and support.8
If your addiction starts to affect your livelihood and your ability to earn an income, you should seriously consider rehab. Studies have shown that admitting yourself to rehab can help you retain employment. One study reports that people who completed treatment “were 22% to 49% more likely than non-completers to be employed and to earn higher wages in the year following treatment.” It also showed that people who stayed in treatment for longer than 90 days were “22% to 43% more likely to be employed in the year following treatment than those who stayed a shorter time.”9
Are You Actually in Control?
You may think that you don’t have a problem and that you can control your substance use. But ask yourself, are you actually in control, or are you just telling yourself you are in control? It’s important to evaluate your situation today and ask yourself if it’s sustainable. Do you want to be in the same situation 5 years, 1 year, or even 1 month from now? Left untreated, addiction will become worse. Your life will continue to become increasingly unmanageable and spiral out of control.
The Truth About Rehab
It’s usually not possible or advisable to stop using drugs or alcohol on your own. Rehab offers you the best chance for taking back control of your life. Comprehensive treatment often starts with detox. How do they detox you in rehab? Detox is a set of interventions that focus on stopping you from using and helping you safely and comfortably manage withdrawal as the substance is cleared from your body. It is often safest to detox in a medically supervised environment.10
Once you have completed detox, you will need to enter inpatient or outpatient treatment and learn to develop the skills you’ll need to stay sober and to avoid relapse. This will allow you to build a happier, healthier, and more manageable life.
Although addiction recovery is a lifelong process, you should know that it’s the best (and often the only) way to begin your life again. Life won’t go back to what you were used to before treatment, and that’s a positive thing because you, not drugs or alcohol, will be in charge. It will take time, patience, and commitment, but you will no longer be dependent on drugs or alcohol. You will also have the necessary tools to make better choices, build healthier and more functional relationships, and have a more productive and purposeful life.
Still Have Questions About Rehab?
Still have questions about rehab? American Addiction Centers may have the answers you need. The mission of American Addiction Centers (AAC) is to help people access treatment. If you have any questions, call the free and confidential AAC helpline. You’ll speak with a passionate and understanding admissions navigator who will either help you start treatment at one of AAC’s centers or give you the resources you need to find treatment elsewhere. When you are ready to say, “I want to go to rehab,” ACC is standing by to help. They are available 24/7, 356 days a year at 1-888-935-1318.
- Center for Behavioral Health Statistics and Quality. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19-5068, NSDUH Series H-54). Rockville, MD: Substance Abuse and Mental Health Services Administration.
- National Institute on Drug Abuse. (2017). Tolerance, dependence, addiction: What’s the difference?
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Findlay, S. (2017). Insomnia? Skip the meds for other therapies without side effects.
- National Institute on Drug Abuse. (2020). Drugs, brains, and behavior: The science of addiction drug misuse and addiction.
- Alexandre, P. & French, M. (2008). Further evidence on the labor market effects of addiction: Chronic drug use and employment in metropolitan Miami. Contemporary Economic Policy, 22(3), 382-393.
- National Safety Council. (2019). Poll: 75% of employers say their workplace impacted by opioid use.
- Glauser W. (2014). “High-functioning addicts”: Intervening before trouble hits. CMAJ: Canadian Medical Association Journal; Journal de L’association Medicale Canadienne, 186(1), 19.
- Arria, A., & TOPPS-II Interstate Cooperative Study Group (2003). Drug treatment completion and post-discharge employment in the TOPPS-II Interstate Cooperative Study. Journal of substance Abuse Treatment, 25(1), 9–18.
- Center for Substance Abuse Treatment. (2006). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series, No. 45.) 1. Overview, essential concepts, and definitions in detoxification. Rockville, MD: Substance Abuse and Mental Health Services Administration.