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In Patient Vs. Out for rehab

Old 08-04-2011, 07:53 AM
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In Patient Vs. Out for rehab

AH has decided he needs rehab (details on this on my other thread). What we really need is good information on the difference between in and out patient rehab and how to decide what is best for him. An addiction specialist we have both seen for counseling believes in patient is the way to go and that out is not good at all. She indicated out lacks the one on one and in general really lacks quality. My AH's PA at the GP's office thinks out patient is the way to go. I have some mixed emotions on it because in I know there will be little to no contact for a month and him being away from the family will be really hard on everyone. BUT I would like to see him go where he has the best chance because really that is all that matters. Being gone a months is nothing to his illness progressing and dying early. In patient could be over kill given where he is at, but honestly I don't think either of us has the knowledge/education to make that kind of determination. I have encouraged him to see a specialist to get another opinion and he seems open to that.

I would love to hear from those of you who have had someone go through rehab or have gone though rehab yourself and your thoughts on this.
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Old 08-04-2011, 08:04 AM
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I will share my own experience as a long-term recovering alcoholic, and that was I completed in-patient rehab, and thank God.

It was exactly what I needed. I was taken out of the environment where I was doing my drinking/drugging, and started very intensive work on healing. There was a lot of one-on-one time with my counselor, which was another Godsend for me. We were required to work through the first 7 steps, and I am also grateful for that. Left to my own devices, I know that outpatient would not have worked for me.

Sending you hugs of support!
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Old 08-04-2011, 09:17 AM
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I would take the suggestion of the expert .... the addiction specialist.

Like Freedom - inpatient was exactaly what I needed. I did attend an out-patient program prior to that and stayed sober for 8 months. I got so much more from the inpatient treatment.
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Old 08-04-2011, 09:50 AM
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I forgot until Anvil mentioned it that we had an aftercare session once a month for a year after being discharged from rehab. It was a great opportunity to discuss anything we might be struggling with and how our recovery was going in general.
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Old 08-04-2011, 10:33 AM
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The option he is looking into the most is out patient however he would be there from 8- 4:30 everyday. Basically comes home at night and would do the same things as in patient while there. The other times he has quit drinking he never seemed to have withdrawals, and has gone as long as 6 months. He is still high functioning and has never had any major health issues due to drinking. When I read up on in vs. out it seems that out maybe an okay option, but really only he knows how much he drinks and how much it is interfering with his life. If he sticks with an in network facility I don't think the financial cost would be much different for us for either. The quality of these places is a whole different story and trying to find something that is good could be difficult. I say that because the places I know are good, like the Betty Ford Center, are not on this list. I looked up the cost for Betty Ford and it is almost $30k.... WOW!

Thanks for the help you guys are giving me.
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Old 08-04-2011, 02:39 PM
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Hey Alone22 ---

Have y'all checked out the home page here on SR. On the home page, on the right-hand side, there's a "Start here" with a downward arrow. Under 'Key Links' the swecond link is 'Featured Centers.' You migjht want to check them out. They're all over the US. Some list costs (or mebbe just approx's), but what the hey, it's worth a shot..................
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Old 08-04-2011, 02:41 PM
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I'm curious why he's shying away from the inpatient treatment.
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Old 08-04-2011, 03:57 PM
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If you've got the money/insurance to pay for it, I think in-patient is the way to go. Maybe I shouldn't offer an opinion, because I just did AA, but I think the total focus of in-patient would have been awesome to have.

My guess is that it's sorta like the difference, in trying to learn a language in a classroom versus immersing yourself in the country for a spell.
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Old 08-04-2011, 04:04 PM
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The only downfall to inpatient (that I saw with my A) is that it took him away from everything. He did 2 months. During that time they did everything for him (except his laundry). He didn't have a care in the world. Which I suppose is the point...to ONLY focus on their addiction. However, when he got out he wasn't able to cope or apply the tools he learned in rehab. He started drinking 6mo later. However, if your A really wants to quit, and contiunues with a good aftercare program I think it would be best. Mine has to get sober and then learn how to cope with life with the support. (I think a sober living place for 6mo or a year would benefit him most).

Anyways, my only question about wanting to do the outpatient for your A....is it so he can say he's in rehab and then drink in the evenings?? Don't know your situation but mine is a secret drinker (until he gets too drunk that is). Just saying...
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Old 08-04-2011, 05:31 PM
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A PA? Really? Out-patient can be excellent for people who have already been in treatment, or for people who simply cannot do in-patient because of finances or other issues. But for a first-timer, in my opinion, it's just a way to avoid "real" rehab.

In other words, if in-patient is possible it's the way to go. They'll not be able to cheat and drink, they'll be accountable 24/7, and they'll get the seeds of recovery thoroughly planted for when they relapse later.

My two cents.

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Old 08-04-2011, 05:38 PM
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My XABF went to inpatient rehab for two and a half weeks. (That's all insurance would pay for; part of that was detox). He was calling me non-stop the entire time, and was so centered on me and telling me what to do and trying to force me to answer his calls that I would be surprised if he got anything out of the experience at all.
The rehab had very strict rules about how often patients were allowed to use the phone (10 minutes a day maximum) and when they could call (the pay phones were turned off the rest of the day). That was nice, except they didn't enforce it - he spent $20 in quarters on the first day there, and kept borrowing the phone at the nurses' station when the pay phones were turned off.
They had all the patients write their New Year's resolutions (he went to rehab on Christmas). The exercise was to write down a list of ten things to stop doing, and ten things to start doing. His were all centered around things that he thought I wanted to hear, and it was obvious that he hadn't really thought about what he wanted to do. They were also the same list. Stop drinking alcohol, stop mistreating StarCat, stop avoiding exercise. Start being sober, start treating StarCat nicely, start exercising. There wasn't anything behind it. To top it off, he showed it to me with his daughter there, and when I pointed out that there was nothing on there about his family and that it was all about me, his response? "I don't understand your question." (His daughter went ballistic - "It wasn't a question! Don't you care about me?!?")
I had split with him by the time he started the outpatient program, and he actually wasn't working at all during the first two weeks, so I can't vouch for it, except to say that at least his family got to experience a mostly-sober XABF because he had to either stop drinking or control his drinking enough to fool the outpatient people, and he had to go about every other day. So I'm guessing they may have appreciated that.


tl;dr
Some inpatient rehabs are better than others, and some alcoholics are better at fooling the system than others. When I visited the rehab people couldn't tell me enough about how well XABF was doing, while I was having a really hard time trying not to strangle him because I had already seen that movie, and I hadn't liked it the first time.
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Old 08-05-2011, 04:24 AM
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My xah did intensive outpatient program and also an inpatient program. The out patient one was 30 days after detox. The inpatient was a 4-6 week program but he stayed longer to deal with anxiety (I guess - my info is sketchy at this point as we were already divorced). He said the inpatient program was really great - way better. He has had more success with but he has a hard time coping away from their programs - probably because he doesn't do follow up meetings. Also, our marriage was falling apart when he did the inpatient so he had more stress etc. We were already divorced when he did the inpatient. He is no longer in a rehab but still affiliated with them and so continues to get follow up there etc. He went through the VA. I hope he can carry those tools with him and remain in recovery once he moves away from their systems etc.
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Old 08-05-2011, 04:52 AM
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Originally Posted by Alone22 View Post
AH has decided he needs rehab (details on this on my other thread). What we really need is good information on the difference between in and out patient rehab and how to decide what is best for him. An addiction specialist we have both seen for counseling believes in patient is the way to go and that out is not good at all. She indicated out lacks the one on one and in general really lacks quality. My AH's PA at the GP's office thinks out patient is the way to go. I have some mixed emotions on it because in I know there will be little to no contact for a month and him being away from the family will be really hard on everyone. BUT I would like to see him go where he has the best chance because really that is all that matters. Being gone a months is nothing to his illness progressing and dying early. In patient could be over kill given where he is at, but honestly I don't think either of us has the knowledge/education to make that kind of determination. I have encouraged him to see a specialist to get another opinion and he seems open to that.

I would love to hear from those of you who have had someone go through rehab or have gone though rehab yourself and your thoughts on this.
If a specialist recommends something don't you think he's making the right choice?
It's easier for an outsider to make a call like this because he's not emotionally involved.
30 days is nothing, when I went into rehab it was 90 days. And you do know rehab isn't a cure?
Hopefully in 30 days they are able convince him that alcoholism isn't to be taken lightly
and he'll need to go to meetings. The only people I have known to have long term sobriety are the one who still go to meetings.
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Old 08-05-2011, 05:48 AM
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Inpatient is the way to go if you can afford it. It's true that it will take him away from the family, that is part of the point. Nothing changes if nothing changes, and for those with a serious addiction issue outpatient is like trying to apply a part time solution to a full time problem... with predictable results.

That said, the success or failure of whatever path he chooses depends on his ability to bring and apply three things without reservation: honesty, openess, and willingness. If he brings those and holds nothing back, either option is sufficent - inpatient is just easier to keep at it and get the desired result.
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Old 08-05-2011, 06:13 AM
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Originally Posted by Eddiebuckle View Post
Inpatient is the way to go if you can afford it. It's true that it will take him away from the family, that is part of the point. Nothing changes if nothing changes, and for those with a serious addiction issue outpatient is like trying to apply a part time solution to a full time problem... with predictable results.

That said, the success or failure of whatever path he chooses depends on his ability to bring and apply three things without reservation: honesty, openess, and willingness. If he brings those and holds nothing back, either option is sufficent - inpatient is just easier to keep at it and get the desired result.
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Old 08-05-2011, 07:57 AM
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Again thank you to all who have posted and offered their wisdom.

When I brought up in patient his response was I don't want to be away from the family and cost. It appears cost (if he stays in network) would not be an issue. I really do see his point in being away, and if it were me I would have a really hard time doing it. Reading and talking with a few people my one concern with in is the transition after. While I see that being in 24/7 is fantastic for removing them from temptation and giving them 100% focus on recovery, I also see the flip side of it which is life if full of temptations and having those during rehab does make it more real time dealing with it.

"That said, the success or failure of whatever path he chooses depends on his ability to bring and apply three things without reservation: honesty, openess, and willingness. If he brings those and holds nothing back, either option is sufficent - inpatient is just easier to keep at it and get the desired result. " This is so true and honestly where I am at with this is if he really wants to quit and wants to live his life sober he will be given the help he needs, in or out. If he is being honest and out patient is giving him time to drink/ too much temptation, then HE needs to step up and change it. Bottom line is if he wants to drink he is going to , during rehab or after. Doesn't it really come down to how bad he wants to be in recovery? If it is a half hearted attempt it really doesn't matter if it is in or out, it isn't going to change his behavior.

I should clarify the addiction specialist... she is a counselor not an MD and while I trust her opinion more than a PA, I don't think she has enough education to make "the" determination. I spoke with her again yesterday and told her about the out patient program at the facility the PA recommended and she actually liked it. Since the facility does do both she pointed out he could switch to in if needed. I think this is where the honestly on his part comes in. I was also thinking they may have him drug test too, which would keep him honest.

Ultimately it is not my choice it is his. I am here to support his choice to seek recovery, but will continue to focus on my own recovery too. Going to Al-anon and reading here on SR I think I fully understand that while rehab could be the answer to his problem, it very well might not be. While I am optimistic, it is with great caution that I am.
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Old 08-05-2011, 09:17 AM
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Originally Posted by Alone22 View Post
Again thank you to all who have posted and offered their wisdom.

When I brought up in patient his response was I don't want to be away from the family and cost. It appears cost (if he stays in network) would not be an issue. I really do see his point in being away, and if it were me I would have a really hard time doing it. Reading and talking with a few people my one concern with in is the transition after. While I see that being in 24/7 is fantastic for removing them from temptation and giving them 100% focus on recovery, I also see the flip side of it which is life if full of temptations and having those during rehab does make it more real time dealing with it.

"That said, the success or failure of whatever path he chooses depends on his ability to bring and apply three things without reservation: honesty, openess, and willingness. If he brings those and holds nothing back, either option is sufficent - inpatient is just easier to keep at it and get the desired result. " This is so true and honestly where I am at with this is if he really wants to quit and wants to live his life sober he will be given the help he needs, in or out. If he is being honest and out patient is giving him time to drink/ too much temptation, then HE needs to step up and change it. Bottom line is if he wants to drink he is going to , during rehab or after. Doesn't it really come down to how bad he wants to be in recovery? If it is a half hearted attempt it really doesn't matter if it is in or out, it isn't going to change his behavior.

I should clarify the addiction specialist... she is a counselor not an MD and while I trust her opinion more than a PA, I don't think she has enough education to make "the" determination. I spoke with her again yesterday and told her about the out patient program at the facility the PA recommended and she actually liked it. Since the facility does do both she pointed out he could switch to in if needed. I think this is where the honestly on his part comes in. I was also thinking they may have him drug test too, which would keep him honest.

Ultimately it is not my choice it is his. I am here to support his choice to seek recovery, but will continue to focus on my own recovery too. Going to Al-anon and reading here on SR I think I fully understand that while rehab could be the answer to his problem, it very well might not be. While I am optimistic, it is with great caution that I am.
MD's are not qualified or educated in the field of addictions.
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Old 08-05-2011, 09:25 AM
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I would listen to the addiction counselor.
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