Checking into rehab is one of the best options for people with substance abuse problems. After all, this facility can help save their lives – and give back the productive lives they lost.
While rehab is very beneficial, some may find themselves wanting to leave rehab in the middle of treatment. That being said, the question in most people’s minds is this: Can a rehab center force patients to stay?
Well, the answer is YES.
Discharge Against Medical Advice
Also known as AMA, this refers to the patient’s desire to leave the treatment facility sans the physician’s recommendation. In the rehab setting, this refers to leaving the facility within 30 days of starting.
According to a study, this occurs in 1-2% of admissions.
Those who are more likely to do AMA are males, of younger age, and those who lack insurance or are only covered by Medicaid.
The risk is also increased in individuals with a history of substance or alcohol use, a demographic with which rehab centers primarily cater. According to the study, this may be due to the person’s wish to use drugs, among many other things.
While rehab centers cannot force patients to stay, an AMA discharge brings about an untreated problem (addiction) that will most likely result in readmission. In the end, this just leads to higher healthcare costs.
When Do People Try to Leave Rehab?
1. 1-3 days
Patients usually try to skip rehab early on during treatment. This is largely because they can’t part from their abused substances.
After 1-2 days of treatment, the individual may end up suffering from withdrawal symptoms. The cravings may be too much that he/she is ready to give up treatment.
These patients often beg, plead, even threaten the rehab employees just so they could leave.
2. 7-14 days
People who leave one or two weeks after rehab do so for two reasons. One, they believe that they are already cured of their addiction. Second, they are planning to use drugs or alcohol once again. As for the latter, this is their way to mask the problems they have been experiencing for years.
Why Do Patients Try To Skip Rehab?
Substance users have a variety of reasons why they want to leave the center. As per the above-mentioned study, the most common reasons include financial problems and personal obligations. As for some patients, they try to leave the facility because they already feel ‘better’.
Other reasons specific to rehab patients include:
1. Denial
Some clients feel like they don’t belong to the rehab center. They may think of themselves as far more superior than the other patients. This thinking can prod them to leave the treatment facility without the doctor’s approval.
2. ‘No Need’ for Rehab
After undergoing rehab and a few weeks in treatment, some patients may feel that they’re already okay. While this positive mindset is good, this overconfidence can make a patient want to leave rehab way in advance.
3. Withdrawal Symptoms
Drug withdrawal comes with very uncomfortable symptoms. Apart from its crippling physical effects, it comes with intense cravings as well. This may lead some patients to walk away even if they’re just starting with detox.
4. Post-Acute Withdrawal Symptoms
After withdrawal comes another adverse event: post-acute withdrawal, also known as PAWS. This is due to the brain’s ability to produce lesser amounts of dopamine, serotonin, and oxytocin. This renders the individual unable to feel happy, making him/her want to leave treatment immediately.
Other symptoms of PAWS include mood swings, fatigue, anxiety, irritability, and violence.
Consequences Of Leaving Rehab Early
While leaving the facility against medical advice is permitted, it does come with a variety of consequences.
For one, those who leave right away may not be able to develop the skills for total sobriety. Even if the patient has already completed detox, his/her recovery will depend on other factors including counseling, therapy, nutrition, and post-rehab support. Because of these, patients who skip rehab are more prone to relapse.
Another consequence is the relationships of the patient with his/her family and friends. More often than not, addiction affects the people surrounding the individual. Should he/she opt to leave rehab immediately, there’s a chance that his/her support system will be strained even more.
In persons who enter rehab court-mandated therapy, they are legally required to finish the treatment. In the case that they don’t, they will need to pay fees and or get jailed for a brief time.
One of the worst consequences of all is the financial strain that comes with addiction. Leaving rehab early can eradicate a person’s savings, as he/she is prone to relapse and must need to start therapy all over again.
How To Talk To A Person Who Wishes To Leave Rehab
It can be hard to convince a patient who wants to quit rehab. However, you must try to do everything you can to change his/her mind. Here are some tips to help you do so:
1. Be Comforting
Let the person that you love them. Reassure them that you will support his/her decisions – but be firm that you’re not happy with this one.
2. Be Supportive
Tell the patient that you will support him/her during and after rehab. Tell the person how impressed you are with his/her courage to undergo rehab.
3. Be Positive
Let the individual know that you will be more than happy to receive his/her sober self once he/she finishes rehab.
4. Be Realistic
If your patient is hell-bent on leaving rehab, try to convince him to stay in the facility one day more. Doing this may prod him/her to stay during the entirety of the rehab.
5. Be Open
Encourage the individual to share what he/she is doing in rehab, his/her thoughts about it, etc.
6. Be Futuristic
Help the patient focus on the possibility of a sober future. This may remind the person why he/she entered rehab in the first place.
Conclusion
While it may be frustrating to talk to someone ready to leave rehab, it’s important to show a loving yet firm tone when you do so. More importantly, avoid making threats. Showing a warm and caring attitude is important, as those with a strong social support system are less likely to relapse after rehab.
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