If you’re struggling with a drug or alcohol use disorder, rehab is your best option to recover. Rehabilitation includes medical support during detox, clinical support, and psychological treatment over the course of your stay. But, with dozens of options available – ranging from simple medical detox over the course of a few days to long and intensive in-patient stays, deciding how long you should stay can be complex. For most of us, we want to be in and out as quickly as possible. Medical treatment is not something you want to invest more time into than you absolutely have to.
The problem is that, for most of us, more care means a better chance at recovery, more time to heal, and more tools to use to stay in recovery once you leave rehab. Deciding how long to stay in rehab should depend on factors like your history of substance use, your history of treatment, and the extent of your substance use disorder.
Rehab normally includes detox, clinical counseling, behavioral therapy (Cognitive behavioral therapy, motivational therapy, family therapy, etc.), and group therapy and support. In most cases, you’ll also get complimentary therapy, such as nutritional therapy and treatment, art therapy, exercise, and learning skills like time management, stress and anger management, and cravings management. Each of these is intended to help you navigate life and to better cope with stress once you leave rehab. They’re also intended to give you a solid baseline of support and social support once you leave, so you can be happy without leaning on drugs or alcohol.
Most importantly, rehab is normally conducted in stages with goals. Often, these stages are updated throughout the program, based on your progression.
Detox – Physically withdrawing from drugs or alcohol to remove chemical dependence. This means the substance is fully out of your system, no longer causes ill effects, and any withdrawal symptoms have abated. This stage lasts 2-14 days for most people but can be as long as 30+ days for individuals with withdrawal complications.
Motivation – Therapy focuses on building motivation to recover and to removing obstacles to treatment. This might include treating co-occurring disorders, it might include building motivation for treatment and recovery, it might include building motivation to get back into your life, and it might include helping you to understand that change is possible and reachable. Motivational therapy can take many forms, but the goal of early rehab is most often to ensure you are invested in the rest of treatment and can focus on it.
Treatment – Treatment assesses behavioral problems, trauma, stress, and other factors that could be contributing to, underlying, or enabling continued substance use. It also helps you to assess what changes you need to make to fully recover. This might include dealing with self-esteem issues, getting treatment for mental health disorders, making changes to behavioral responses, learning to cope with cravings, building new and better habits, and creating behavioral responses that rely on good coping mechanisms.
The duration of a successful rehab program fully depends on your substance use disorder, your mental health, and your openness to treatment. Someone who has developed a chemical addiction to a substance but who isn’t showing seeking behavior can easily go to detox and then go home. Someone with a very light addiction can go to detox and then attend outpatient programs. But, the worse your problems are, the more you’ll benefit from long-term and ongoing support.
Detox – Most people need full detox. That’s especially important with opioids, alcohol, methamphetamine, and most prescription medication. Withdrawing on your own can be difficult and dangerous. It also puts you at higher risk of overdose if you do relapse, and relapse for home-withdrawals are incredibly high. If you only go to one form of treatment, detox should likely be it.
A 30-Day Stay – A 30-day stay in a rehab center is a good baseline for most people to seek out treatment. Thirty days allows you to fully detox, to learn new habits, to benefit from significant therapy and treatment, and to spend a significant amount of time rebuilding yourself. Most people start out here, whether or not they go on to stay in a 60- or 90-day program instead, because it provides a good baseline of initial care. 30-day programs are also low-cost, most insurance companies cover the maximum amount of the program, and you can always choose to continue in a longer program if your rehab clinic has the space.
A 60-Day Stay – A 60-day rehab program follows up on initial treatment during the first 30 days and works to continue to build habits and strengthen therapy. This gives you more time to adjust to recovery, to build better habits, and to get the social and psychological support you need to recover.
A 90-Day Stay – A 90-day stay may seem like a long time to most people, but it’s also the most backed in science. For example, while most people think that a habit takes 28 days to change, the real truth is closer to 2-3 months. That means that if you stay in rehab for 90 days, you’re building habits that may be automatic when you leave. That’s also true when it comes to physical recovery. Most people need at least 3 months to recover lost grey matter and white matter in the brain to pre-substance abuse levels. Within 90 days, your dopamine and serotonin levels are likely to be as close to full health as they will be for the next several years. This means that a longer stay provides you support during the full “recovery” period of your initial treatment – so you have psychological support, counseling, and someone to reach out to during your most at-risk period.
Most people benefit from a longer stay in rehab. However, it’s understandable that barriers like costs, responsibilities, and time may get in the way. For that reason, it’s recommended that you seek out a minimum of detox and a 30-day rehab program. Afterwards, you’re strongly advised to move into an aftercare program such as sober living, seeking out self-help support via 12-step or similar, or continuing therapy. If you can go to a longer program, it’s almost always advisable. However, you can specifically ask your counselor to determine what’s the best treatment option for you based on insurance, budget, and time constraints.
Eventually, the longer you stay in treatment, the more likely treatment is to stick. That’s why many recovery programs include extensive aftercare, sober living options, and ongoing support.