When an individual is thinking about entering rehab for substance abuse, an early question will be how long the recovery program will last. If looked at most narrowly, a person typically enters a residential program for no fewer than 28 days. An outpatient program is less intensive than a residential program, so a minimum of three months treatment time is typically most advisable. While the National Institute on Drug Abuse now considers the gold standard for treatment duration to be at least 90 days, even this guideline does not provide nearly the amount of guidance needed to truly understand the length of recovery. Rehab is the intensive initial phase of recovery, but the entirety of recovery can last a lifetime.
The National Institute on Drug Abuse (NIDA) sets forth 13 principles of effective treatment, one of which directly relates to the length of stay in treatment. According to NIDA, individuals are best advised to remain in treatment for an adequate length of time. Although the amount of time people should stay in rehab relates specifically to their needs, research shows that individuals typically require at least three months of treatment for significant improvement to take hold.
Remaining in treatment has the twofold effect of helping a person to gain sobriety time and allow treatment to gain a strong footing in the person’s body, mind, and spirit. A longer recovery period can also strengthen a person’s commitment to aftercare services. Self-help aftercare can include attending group recovery meetings, such as Narcotics Anonymous, living in a sober living home, and/or continuing to engage in individual therapy sessions.
When individuals are in the very earliest phase of recovery treatment, counselors will assess their readiness for change. Therapists have effective and helpful strategies to help recovering people who are resistant to treatment to more fully engage the process. It is important to know that while some individuals begin therapy in conflict with the process, as they experience the benefits of treatment and become accustomed to the rehab structure and staff members, they are more likely to commit to the process. For some, it’s not that they do not want to recover; they just need time to get into the therapeutic groove of recovery.
Beyond Detox
Individuals who are approaching drug recovery with an eye toward minimizing treatment time may be drawn to pursuing detox alone. The detox timeline, depending on the individual’s biological factors and types of drugs present, can range from a few days to two weeks. Detox involves the complete elimination of drugs from a person’s body system (unless the individual is recovering from opioid abuse and opts for maintenance treatment with methadone, buprenorphine, or naltrexone). It is well established in the addiction treatment community that detox alone is never sufficient to treat substance abuse. For this reason, it is not advisable to think about recovery time solely in terms of detox time.
An individual who is new to rehab programming may question why detox is relatively short but advisable rehab times are as long as 90 days (and longer for some). After detox, a recovering person enters the abstinence maintenance phase of treatment. Therapy is the cornerstone of abstinence maintenance treatment.
In a rehab program, therapy involves one-on-one sessions as well as group sessions. Remaining in rehab for at least 90 days allows the benefits of therapy to take hold. As therapy is often complemented by other services, such as group recovery meetings, art and music therapy, exercise and wellness activities, and/or family therapy, a lengthier stay in rehab also allows the benefits of these services to take root. The availability of these supplemental services depends on the particular rehab service’s offerings.
What 90 Days Can Do
Dr. David Sack, a psychiatrist and addiction specialist, writes extensively on various topics of addiction. As Dr. Sack points out, the treatment community has shifted from the 30-day gold standard of yesteryear to a standard advisement of 90 days being a minimum treatment stay. Writing for Psych Central, Dr. Sack discusses the benefits of 90 days of rehab versus 30 days. According to Dr. Sack, at least 90 days of rehab can have the following benefits:
- Reduced risk of relapse: Reflects research that individuals who complete 90 days of rehab have significantly lower rates of relapse compared to those who do not (and hence, may have recurrent rehab stays of 30 days, which may far exceed the recommended 90-day stay over time).
- Increased brain recovery time: Research of brain scans of people in recovery show that even at the three-month mark, the brain is still recovering from the effects of drug abuse. For this reason, the more time to heal the better.
- Helps to heal relationships: A longer recovery stay can provide the recovering person and loved ones breathing room to gain perspective on the drug abuse, and to learn new and improved ways of communicating with one another. Stronger family bonds can be significant in the aftercare process.
- Facilitates diagnosis and treatment of a co-occurring mental health disorders: According to research, approximately 50 percent of individuals experiencing substance abuse have an additional mental health disorder. Being in treatment can alert medical professionals to the presence of any underlying symptoms of a separate disorder, which can then be treated. It is well established in the treatment community that co-occurring disorders can exacerbate one another, while treatment that accommodates a dual diagnosis is a relapse prevention tool for each disorder.
As there is no one-size-fits-all approach to treatment, individuals may wonder whether the 90-day treatment advisement accurately applies to them. Rehab centers typically provide free consultations with a treatment consultant who can conduct a thorough intake interview and recommend a particular length of stay. However, a general understanding of the type of individuals who may be most in need of longer treatment services can be helpful. Research reflects that following types of individuals may be among the most suited to long-term drug recovery treatment:
- Individuals who, for a host of potential reasons, are considered from a professional standpoint to be treatment resistant
- Those who have been diagnosed with diseases or other health conditions that require prolonged detox; hence, additional time is needed in order to provide them with therapy and other rehab services
- People who have a separate mental health disorder (or disorders) that co-occur with the substance abuse
- Individuals who do not have a home or family sufficiently supportive of recovery
- Those who have a history of relapsing after a prolonged period of abstinence
Dr. Sack cautions individuals that there is no quick fix for substance abuse recovery. It is a process of varying length, but treatment can be effective and lead to lifelong abstinence. The length of stay in treatment is an important piece of information to know, but it should be thought of as incidental to an effective recovery program rather than a driving factor. A preoccupation with the amount of time rehab may require can be a sign that an individual is not ready to begin the recovery process. However, as mentioned, there are many individuals who initially resisted treatment but soon became motivated to achieve and maintain sobriety after the benefits of rehab began to take effect.
To that end, therapists on staff at a rehab center may engage a new client in Motivational Interviewing or Contingency Management interventions. The aim of these therapies is to help those new to recovery to motivate themselves to fully engage the rehab services offered. Both therapies have been proven to be effective in the early stages of treatment.