Can I Choose When I Leave Rehab?
Yes, you can. People choosing to leave rehab against medical advice (AMA) is a common issue that treatment facilities face. However, leaving rehab before your treatment team recommends it can adversely affect your long-term fight against addiction.
Reasons People Leave Rehab Early
A variety of factors can contribute to a person's decision to leave rehab early. Thought and feelings someone might have about leaving rehab include:
- Overwhelming withdrawal symptoms: The physical, mental, and emotional effects of withdrawal are not easy to cope with. The intense cravings and anxiety people experience during detox may lead them to rationalize that it is better to keep taking the drug than quit.
- Post-acute withdrawal syndrome (PAWS): A lengthy withdrawal period may lead to the development of post-acute withdrawal syndrome. PAWS, characterized by irritability, anxiety, fatigue, mood swings, loss of focus, and violence, can develop when a person stops using an addictive substance after prolonged use. This causes the brain to release less oxytocin, dopamine, and serotonin. As a result, individuals in treatment may feel unable to experience happiness on their own and try to justify leaving rehab to resume drug or alcohol use.
- “I am not like the other people here”: Individuals affected by addiction may experience denial. They may view themselves as smarter or stronger than other people who abuse alcohol or drugs. This mindset can hinder them from addressing their issues and getting the help they need.
- “I do not need rehab”: Some skills need to be learned over longer periods of time to make sure an individual is well equiped to leave. However, after completing detox and a couple weeks of rehab, some might think they have learned all they need to overcome addiction. While confidence is an important part of the healing process, overconfidence is often detrimental to long-term recovery. People who leave rehab with a less developed skill set may not be able to avoid relapse.
How Many People Leave Rehab Early?
Leaving against medical advice typically results in increased mortality and health care costs. The percentage of people in mental health facilities who leave against medical advice ranges from 3% to 51%, with an average of 17%.
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Factors that predict AMA discharge include:
- Lower socioeconomic status
- Medicaid or no insurance coverage
- Young age
- Substance abuse
- Being male
What Can Happen if Someone Tries to Leave Early?
People who leave rehab early may not have acquired the skills necessary to maintain sobriety. Even if detox is completed, long-term recovery depends on additional factors including individual counseling, group therapy, nutrition, and building a post-rehab support system. Relapse is much more likely among individuals who discharge against medical advice.
A second concern is maintaining healthy relationships with friends and family members. Addiction often has a negative effect on important relationships in a person’s life. Choosing to quit rehab early can put strain on relationships with those supporting a person's recovery.
Some individuals are in rehab due to a court order, and part of their sentence may involve completing a rehab program. In this case, leaving rehab before the scheduled date may result in legal penalites.
Finally, drug and alcohol rehab can be expensive. Quitting rehab could take a toll on a person’s finances, especially if they relapse and must restart the process.
How to Talk to a Loved One Who Wants to Leave Rehab
Speaking with a friend or family member who wants to leave rehab early can be difficult, but it is important to do so. If your loved one is thinking about leaving rehab, you can:
- Provide comfort: Let them know they are loved and provide reassurance.
- Offer support: Tell them you will be there during and after rehab. Compliment them on their courage and strength for sticking with rehab.
- Be positive: Remind them you know who they were before addiction and that you cannot wait to get that person back.
- Set realistic goals: If your loved one wants to leave rehab, setting a goal for one more day could be essential to their completion of treatment.
- Encourage sharing: Express interest in what your loved one is learning and doing in rehab.
- Look to the future: Help them focus on a future in which they are sober and healthy and remind them of what they want to achieve after completing rehab.
In your conversations, it is important to be loving and firm, but it's best to avoid threats. A person in treatment who has strong, sincere social support is much less likely to leave rehab early and experience relapse.
- Alfandre, D. J. (2009). “I’m going home”: Discharges against medical advice. Mayo Clinic Proceedings, 84(3), 255-260. doi:10.4065/84.3.255.
- Meadows, B. (2017, January 23). 4 reasons a loved one will try to leave rehab early. Retrieved from http://www.addictioncampuses.com/resources/addiction-campuses-blog/4-reasons-a-loved-one-will-try-to-leave-rehab-early/
- 10 things to do when someone wants to leave rehab. (2013, August 2). Retrieved from http://www.narcononarrowhead.org/blog/10-things-to-do-when-someone-wants-to-leave-rehab.html
Last Update: 12-08-2017