_____________________________________________________

THE DECISION Rarely does anyone wake up one morning and say to themselves, "Hey, I think I'll go to rehab today! I am feeling confident, pleased, and encouraged at the thought of spending anywhere from 21 days to 36 months in a rehabilitation program, have to come-to-terms with issues that I have knowingly buried for years ... and learn to recognize and admit others about which I am at this time totally unaware ... change the ways that I think, feel, and act about almost everything ...and do this all while being apart from whatever it is that I still might have a shred of value for in this world."

The real truth of the matter is that most people seek treatment based upon a set of difficult circumstances. For whatever reason, they had reached an emotional crossroad, and there was a small opening in what we call "the window of opportunity."This window ... whether it be emotionally or circumstance-based ... usually presents itself infrequently, though commonly more than once, across the life of all those who have experienced a serious substance-involved history. Interestingly, if an individual fails to take advantage, the window usually closes ... and the cycle of substance--involvement continues.

Maybe it's an increased level of pressure or appeal put upon by family members or significant others that will ultimately lead some toward treatment. The 12-Step programs refer to "hitting your bottom," a reference to an individuals lowest point along their own addiction continuum, though it seems to be 50%-50% as to whether this "bottoming out" is in fact the tipping point leading individuals into treatment ... or simply a future reference point for a true story during a 12-Step topic meeting concerning, "What was your bottom and when did you hit it?" So while we know that every substance-involved person has experienced their own "bottom," it cannot be said with any certainty that everyone's bottom marked the last straw. For too many, it does not.

An arrest, and the subsequent arraignment process usually contribute to an immediate (involuntary) cessation of alcohol and other drug-seeking behaviors ... though they have little to do with a conscious decision to seek treatment ... though such circumstances can be a catalyst to opening the window of opportunity that we are discussing here.

When review the residential adult treatment population at any given moment ... the overwhelming majority of admissions were driven by either the court's mandate, or was chosen as a quasi-choice alternative to facing incarceration in a locked, restricted-access facility such as a municipal jail or a state prison. THE LESSER OF TWO EVILS is an apt way to describe this circumstance-driven decision to seek treatment.

And every once-in-a-while, someone decides that they are sick and tired of being sick and tired ... and seek treatment based upon their own subjective motivations ... without pressing circumstances other than the promise of their own chemically-dependent future, and their thoughts of an increasingly difficult future.

AND THEN CAME TREATMENT Almost as rare as waking up in the morning and out-of-the-blue deciding it's "treatment time," an individual MIGHT seek treatment during the early stages of substance-involvement ... before the full-blown effect of addiction have came-to-bare. Regrettably, most individuals who make it into treatment have a somewhat more broad and extensive substance-involved history. Might we be reasonable in assuming that they were probably "using" longer than the 30-day residential program where they were admitted? Or even using longer than a 6-month program ... and more likely using alcohol or other drugs for at least a few years ... if not more ... "How long might it take to get better? What about individuals who attend outpatient therapy, or those individuals who have chosen to work a 12-Step program? Can we say how long it takes them to overcome or transcend their substance-involvement?" AND THAT, AS WE SAY HERE, IS THE $64,000 QUESTION.

So what can we say about how much ground an individual can gain by the time they either graduate or complete a primary treatment program?

Without question, ALL PROGRAMS stress that initial treatment efforts are focus and work toward attaining an immediate cessation of drug & alcohol seeking behaviors. Urges and cravings are usually the second priority on the treatment "hit list" ... consistently reinforcing the tenants of whatever their own program's fundamental framework sets forth in order to "head the above-mentioned red-flags off at the pass" BEFORE one picks up again.

AND AS MANY OF YOU ALREADY KNOW ... once an individual has either drank or drugged (even one, single time) ... such a "relapse" can place them right back where they started ... and the all too familiar cycle of addiction begins once again.

So, based upon the ultimate destination of this conversation (thanks for listening ... keep on reading ... it gets even better), it would appear that once initial treatment has been completed ... any individual could further benefit from a continuing access to a treatment-based support system in an effort to take their new-found sobriety to a higher level ... if, in fact ... quality, long-term sobriety is truly the goal.

It's an unfortunate fact that for too many ... completion of a primary treatment program simply satisfies the judicial system, unwitting family members, friends, employers, etc ... and the individual in question breathes a sigh of relief in the (mis)belief that their substance-involved troubles are now over. THOUGH FOR THE MOST PART ... THEY COULDN'T BE MORE WRONG.

THE STRAIGHT CASE FOR AFTERCARE

Getting clean and sober is a great the only beginning. Once alcohol and other drug-seeking behaviors have been put in check .. this point in the recovery process merely signals that one now has a license to "get a life." For the more privileged ... a common rationalization might be, "I already have all the trappings in life ... I just had this substance-use disorder." WOW. This statement couldn't be more misguided. if such a person's life was so good, they were so happy, and their emotional needs were being consistently met ... then why would they choose to live in a bottle ... or high most all of the time?

For others ... the one's that might have had it "rough" their entire lives ... the graduation or completion of a primary treatment program might mark the first time in their adult lives that they have been substance-free. Individuals who might have short-changed themselves by dropping out of high school, or early in their college experience. While many are as intelligent as anyone else ... they lack both basic skills and confidence ... and may not have received the consistency that a good support system can provide throughout their formative years (almost sounds like a Wonder Bread commercial, eh?). For these individuals ... the need to transition into an adequate Aftercare program is not only important, but essential. There may very well exist the need to come-up-to-speed in many, many ways ... and the failure to DEVELOPMENTALLY MOVE AHEAD will almost surely doom them to return to past alcohol and other drug-seeking behaviors. In the movie The Shawshank Redemption, the character portrayed by the great actor Morgan Freeman insists that one must, "Get busy living ... or get busy dying." We suggest here that as far as recovering substance-abusers are concerned ... there is no truer statement !

_____________________________________________________

_____________________________________________________