What the Research Says

Research by the National Institute on Drug Abuse (NIDA), published in the Archives of General Psychiatry, showed that treatment lasting less than 90 days tends to increase the chances of relapse. NIDA reports that the relapse rate after primary care drug rehab is between 40 to 60 percent.

Another study, which followed 549 patients who entered a long-term residential program, found that those who dropped out of treatment before 90 days had relapse rates similar to those who stayed in treatment only a day or two. However, after 90 days, relapse rates dropped steadily the longer a person stayed in treatment.

Studies suggest that the connection between longer care and a greater chance of recovery holds true for adolescents as well as adults. A 2001 UCLA study of 1,167 teens receiving substance abuse treatment found that those in treatment for at least 90 days had significantly lower relapse rates than teens in programs lasting 21 days.

90 Becomes the New 30

These recent findings about the need for longer term addiction treatment came as no surprise to the renowned Sober Living By The Sea family of addiction treatment centers in Newport Beach, California. Sober Living was one of the first drug rehab programs to focus on long-term care.

“Until recently, 30 days was considered the overall standard in addiction treatment. But we have always known the importance of longer term care, offering our signature 90-day extended care program since 1986,” says Bill Swiney, Executive Director of Sober Living By The Sea.

In their 23-year history, the addiction experts at Sober Living By The Sea noticed that most clients had been to a multitude of 30-day programs without continuing on to extended care. They completed the programs successfully, but fell short in the transition to mainstream living and suffered repeated relapses.

Lisa Onken, chief of NIDA’s behavioral and integrative treatment branch, told L.A. Times writer Shari Roan for a Nov. 10, 2008 titled “The 30-Day Myth” that longer treatment reflects the fact that addiction is a chronic, relapsing disorder.

“The more you have a treatment that can help you become continuously abstinent, the better you do,” Onken told the Times. “You have to figure out how to be abstinent. You still have cravings. You still have friends offering you drugs. You still have to figure out ways not to use. The longer you are able to do that, the more you are developing skills to help you stay abstinent.”

During the first 30 days of treatment, clients detoxify their minds and bodies, develop relationships with their therapist, staff, and fellow residents, and learn to cope with withdrawal symptoms and the feelings that arise as their underlying issues begin to surface.

“Issues come up during treatment that require processing and closure,” says Swiney. “In most cases, 30 days simply isn’t long enough to be prepared for the onslaught of emotions and temptations clients face outside the protective walls of a primary care drug rehab facility.”

Sometimes the most significant problems are just becoming evident after 30 days of treatment, notes Swiney. Many clients have to address not only their addiction to drugs or alcohol, but also co-occurring issues such as physical or mental health problems, eating disorders, or past trauma.

“If those issues aren’t discussed and processed, when clients return to the same home environment, drug-using friends, and lifestyle after only 30 days in treatment, they are at high risk for relapse,” states Swiney.

A Long-Term Addiction Treatment Plan

Thirty-day addiction treatment programs are still common, and are still an appropriate starting point for many individuals, depending on their particular needs. However, according to Swiney, staying clean and sober often requires a series of “step-down” levels of care, preferably over the course of a year.

“We believe keeping clients in some level of care in that first year of sobriety is critically important,” says Swiney. “At Sober Living, we’re trying to teach men and women in recovery how to walk by the liquor store, drug dealer, or pharmacy, and give them the opportunity to face real-life situations while moving forward in recovery with the support of staff and peers.”

According to Swiney, an ideal long-term addiction treatment plan may include 30 days in a primary care facility, 90 days of extended care, one semester in a college program or five months in a transitional work program, followed by 90 days in an outpatient program.

“Primary care helps people get clean and sober,” he says. “Extended long-term care teaches them how to live again – this time without drugs or alcohol.”

The “Three S’s” of Sustained Recovery

With long-term treatment, individuals learn how to handle real life stressors, cope with triggers for drug or alcohol use, and build the social support network that is essential for lasting sobriety. After primary care, clients should be looking for what Swiney calls “the three S’s” of sustained recovery: an environment that is safe, structured, and supportive. “Sober Living is just that – a safe, structured, and supportive place to come home to,” says Swiney.

It is never easy for people to leave their job, school, or family for three months or more to focus exclusively on treatment. That’s why Sober Living By The Sea offers a variety of extended care programs that allow clients to continue treatment while working, going to school, and reintegrating into normal life. In order to make extended care accessible to more individuals and families in need, Sober Living offers discounted fees for clients committed to staying in treatment for a longer period of time.

For people interested in returning to school, Sober Living offers T.E.A.C.H., a program that allows patients to attend college and earn transferable academic credits while in recovery. Sober Living also offers a transitional work program that allows clients to continue working while living in a therapeutic community.

While enjoying sober activities in a vibrant recovery community right on the beach, Sober Living’s transitional programs require clients to check in regularly, consent to drug and alcohol testing, participate in a recovery program designed by clinical staff, work with a sponsor, and attend 12 step meetings.

“It’s so much easier to live in a facility where you get up with five other people and go to a meeting than it is to motivate yourself to get off your own couch and walk into a meeting alone,” notes Swiney.

Make the Commitment

It is now well-accepted in the medical and mental health communities that addiction is not a problem that can be addressed in 30 days and swept away forever. Chronic drug use damages the brain, with brain scans of recovering addicts showing that changes are still taking place three months or more after treatment.

The disease of addiction, like any chronic condition such as heart disease or diabetes, requires time, attention, and commitment to remain healthy and drug-free. Although recovery requires hard work and patience, the time and cost save lives. If you are battling addiction, make the commitment and start enjoying the best days of your life.

Learn more about Sober Living by the Sea in Southern California.