Canada Drug Rehab

By Daniel Jordan

We get a lot of calls from family members looking for help for their loved ones and, occassionally, we are asked whether it is possible to lock someone up to keep them from their drug of choice. To spouses, parents, and siblings in distress, it must be hard to imagine that anything less than prison could keep their family members from drinking or getting high. We do explain to family members, however, that there are other ways to keep individuals in treatment and, almost as importantly, prepare them to live productive, fulfilling lives in recovery. 

I have observed over the years that clients, for the most part, adapt quickly to their new environment. And just because their home life is in disarray doesn’t preclude them from pointing out our faults as an alcohol and drug treatment center. Any time a client has a complaint or suggestion, we pay attention and, if the client has a valid point, we make a change *. After 4 and a half years in operation, all of these suggestions (and a “few” of our own) have created a program and facility that, we believe, is efficient, responsive, and organized.  Invariably, clients benefit from having a well-structured program. The protective “bubble” that exists in residential drug treatment is, however, a double-edged sword that has both pros and cons for the client.

Structure Benefits the Client

One of the main reasons why individuals choose residential over outpatient treatment is because of the amount of structure present in residential treatment. When clients first arrive, they frequently report not having slept for days (especially the crack cocaine users) and can’t remember the last time they have sat down for a proper meal. If basic life essentials like sleep and food can take a back seat to drugs, then it’s easy to understand why showing up for an outpatient session at a clinic across town can be a monumental, if not impossible, undertaking.

While some clients may grumble about all of the rules and restrictions of residential treatment, most seem to understand the need for structure and slowly begin to rebuild their lives due, in part, to putting structure into their own daily routine.

Structure Also Benefits the Treatment Provider

Like any business, staff and management of treatment centers also benefit from structure. Structure provides some sense of predictabilty for staff which is so important when working with clients who go through many highs and lows during the course of treatment. Management loves structure because it makes it possible to plan for the future rather than lurching day to day, from one crisis to the next.

Structure, however, has its limitations and may even be detrimental to the client if taken to the extreme.

The Disadvantages of Living in the “Bubble”

As our clients know from personal experience, too much of a good thing is usually a bad thing. So it goes with structure as it can create an artificial sense of security - a protective “bubble” of sorts- that can collapse when tested by the trials and tribulations of real life.

My colleague (and sister), Melanie Alsager, told me once how life was like as a teenager attending a private boarding school on Vancouver Island. A wake-up bell  would tell Melanie and her classmates when it was time for breakfast and another bell would tell them it was time for class. Another bell would ring to signal the end of class while another would announce lunch time. This would continue right through to “prep” at 9:30 PM. Furthermore, staff would mill about checking to make sure that homework was done and assignments handed in on time. At the time, Melanie and her classmates would grumble a bit but eventually got used to it.

The problem with this environment, however, did not appear until these boarding school graduates went on to university where there were no bells and no instructors to check up on them. In this new environment of independence, many of the boarding school’s “star” pupils were either put on academic probation or dropped out from college altogether.

The Importance of Empowering the Client

So, the life experiences and personal philosophy of ownership, suggestions from staff who have worked at other facilities, and feedback from clients have all culminated in our current approach where the extent of program structure has been tempered by the need to empower clients and help them find the resilience to face the inevitable challenges awaiting them back home.

Relaxing the Rules of Treatment to Empower Clients

Over time, many of our rules have changed as we have come to appreciate the importance of having clients experience “teachable moments” during treatment rather than after they go home. Examples of these rule changes include:

1. giving clients day or weekend passes
2. allowing clients to go down to the beach or the fitness center without a buddy or staff member
3. taking clients to convenience stores for extras (cigarettes, pop, chips, etc.) that also stock liquor
4. showing movies with scenes of drinking or drug use

Each of these rule changes were carefully considered and implemented with certain precautions. For example, clients on day or weekend passes need to be accompanied by an approved companion and are drug-tested when they return. Movies are pre-screened and a clinical staff member checks in with clients for a discussion session at the conclusion of a show.

Conclusion

The more proficient staff and management get at running an alcohol and drug rehabilitation program, the less the treatment environment resembles what awaits clients back home. Relaxing the rules is just one of the ways Sunshine Coast Health Center has tried to make for a smoother transition to life after recovery.

Admittedly, this is a contentious issue in the tradition-bound world of private addiction treatment. We understand the criticism that being too flexible with clients or exposing them to triggers can endanger clients and their early recovery. We are sensitive to these concerns and have built in provisions to minimize these risks.

In the end, however, life after treatment will always be infinitely more challenging than treatment itself. Far better, we believe, for clients to be exposed to some of these risks where they can be processed with the help of a counsellor than to give clients a false sense of security by postponing the inevitable.

About the Author

Daniel Jordan is the General Manager of Sunshine Coast Health Center. His posts in “Life in the Drug Rehab Business” are designed to lower the veil on the secretive world of addiction treatment. By being transparent, Daniel believes that Sunshine Coast can help lower the stigma attached addiction and, at the same time, raise the standard of today’s addiction treatment programs. 

(*) Note: the clinical debate over where to draw the line with complaining clients will be the subject of a future blog posting.