Why Do I Need Rehab?

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Calendar icon Last Updated: 11/3/2021

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If you are wondering if you or a loved one needs rehab for a substance use disorder (SUD), it is important to know the signs that rehab is needed, the benefits of rehab, what it entails, and how to find the program that will best meet your needs.

Why Is Rehab Necessary?

Substance addictions are chronic conditions characterized by uncontrollable drug or alcohol use, regardless of negative consequences on a person’s life. Substance use may affect aspects of work, school, relationships, finances, mental health, physical health, and beyond.

Because individuals struggling with an addiction engage in compulsive substance use, it’s often difficult for them to quit on their own. Addiction treatment is typically necessary to help end the cycle of drug use and achieve and maintain sobriety. While it may be possible to temporarily stop substance use without rehab, relapse is, unfortunately, very common—however, rehab can help create lasting changes that can improve motivation to recover, coping skills, stress management, impulse control, emotional regulation, and other vital recovery skills.1

Effects of Long-Term Substance Use

The long-term effects of substance use vary considerably from substance to substance and between methods of administration, such as injecting, snorting, and smoking. However, some general effects of long-term substance use may include:2

  • Occupational issues
  • Financial or legal problems
  • Dysfunctional relationships
  • Neglecting hobbies or previously enjoyed activities
  • Development or exacerbation of physical or psychological conditions

Chronic substance use can lead to the development of a drug or alcohol addiction. Addiction results in functional and structural brain changes that interfere with normal rewards, such as sex and food, which means that these natural rewards will cause little to no pleasure anymore—rather, only the substance will. These neuronal changes make it challenging for people with addiction to quit using substances on their own, even if they have the desire to stop.
Other consequences of long-term substance use may include:3

  • Lung disease
  • Heart disease
  • Cancer
  • Hepatitis
  • Increased risk of injury, violence, and trauma
  • Impaired decision-making
  • Increased impulsivity
  • Poor nutrition and sleep
  • Mental illness

Addiction and mental health conditions commonly co-occur. The relationship is complex and not fully understood, but substance use can cause mental health symptoms while mental health conditions can lead to substance use and addiction. And sometimes the two develop simultaneously, perhaps because of shared genes or environmental influences. Co-occurring conditions can complicate and fuel one another, which is why having co-occurring disorders further increases your need for comprehensive rehab treatment.4

Dependence and Withdrawal

Long-term drug or alcohol use can cause adaptations in the brain responsible for physiological dependence. Physiological dependence means that your body has adapted to the presence of a substance and now requires it in order to function optimally and avoid withdrawal symptoms. If you abruptly stop using drugs or alcohol or try to quit cold turkey, withdrawal symptoms will emerge. These typically range from unpleasant or uncomfortable to potentially life-threatening without medical treatment.

Withdrawal symptoms vary from substance to substance, but some examples include:2

  • Nausea and vomiting
  • Chills and fever
  • Sweating
  • Insomnia or sleep disturbances
  • Anxiety or depression
  • Tremors
  • Rapid heart rate
  • High blood pressure
  • Seizures
  • Hallucinations

Due to the distressing nature of withdrawal symptoms, individuals may return to substance use to alleviate these symptoms and find relief. This cycle of quitting and using substances can contribute to the development of an addiction, as well as the progression from a mild to a severe addiction. Once you are dependent on a substance, you may require a medical detox program to help you quit safely and comfortably. Withdrawal syndromes associated with alcohol, benzodiazepines, barbiturates, and opioids can be particularly complicated and dangerous and should only be treated in a medical detox program.

Benefits of Rehab

The benefits of addiction treatment and rehab programs are comprehensive and involve treating the physical as well as psychological aspects of a substance use disorder. These benefits include comprehensive care from medical as well as mental health care professionals to treat various concerns.

The two main treatment settings include inpatient treatment, which involves residing at the facility, and outpatient rehab, which involves living at home and visiting a treatment center for therapy.

The benefits of inpatient rehab include:

  • Highly-structured environment
  • Serene, peaceful atmosphere
  • Separated from triggers and stressors
  • 24/7 treatment and support
  • Access to medical care
  • A variety of therapies and interventions
  • Support group meetings
  • Around-the-clock detox services
  • Higher success rate

The benefits of outpatient rehab include:

  • Flexible treatment option
  • Can continue working or attending school
  • More affordable than inpatient rehab
  • Family support

The right treatment setting for you depends on your needs, priorities, and preferences, as well as your previous treatment experiences. If you’ve tried outpatient rehab before, you may want to opt for the structure of an inpatient drug rehab this time.

Medical Treatments

If it is indicated upon admission to a program, rehab first involves detox, or a set of interventions with the goal of managing withdrawal syndrome and achieving medical stabilization. Medical detox includes:

  • Withdrawal medications to relieve symptoms and cravings
  • Supportive care, such as IVs
  • Symptomatic medications

These programs also have psychiatrists who can prescribe medications for mental health conditions, such as generalized anxiety disorder, panic disorder, bipolar disorder, or major depressive disorder, and doctors who can provide treatment for any comorbid medical conditions.

Psychological Treatments

Psychological treatments provided by rehab programs include those such as individual and group therapy, family therapy, or eye-movement desensitization and reprocessing therapy (EMDR) that is used to treat the effects of trauma. These therapies help you to address and heal from psychological conditions that contribute to your substance use.

Rehab programs also provide training on the use of healthy coping skills that you can continue to use after rehab to sustain improvements made. In one study, patients in a treatment program sustained fewer days of drug use 15 weeks after receiving a mindfulness-based relapse prevention treatment.5 This type of treatment involves learning to increase your awareness of your thoughts, feelings, and actions associated with drug use, which can then lead to consciously addressing those thoughts and feelings in healthier ways.

Case Management Services

After completing rehab treatment, a program will often provide bridge services, which includes helping you transition to the next level of care needed. The next level of care will depend on your unique situation. It may include step-down care programs like substance-free residential settings to help you sustain the improvements made in rehab before returning to independent living.6

Follow-up care may also include outpatient treatment to sustain the recovery achieved in rehab. Outpatient treatment might include therapy to continue building upon the coping strategies you learned in rehab as well as develop new and useful relapse prevention skills.

What Are the Signs That I Need Rehab?

Generally, if you are struggling with controlling or quitting substance use, you may need rehab to help jumpstart your road to recovery. Other signs you may need rehab include:2

  • You are concerned about your level of drug or alcohol use.
  • Loved ones have expressed concerns about your substance use.
  • You have continued to use the substance despite it harming areas of your life, such as your physical health, relationships, school, or work.
  • You spend more money on the substance than you can afford.
  • You spend an inordinate amount of time using and obtaining substances, as well as recovering from the effects.
  • You neglect your responsibilities at home, school, or work due to substance use.
  • You have used substances in physically hazardous situations, such as while driving or operating heavy machinery.
  • You neglect hobbies or recreational activities in favor of substance use.
  • You need higher amounts of drugs or alcohol to feel the desired effects.
  • You have experienced withdrawal symptoms after stopping the use of a drug.

Note that if you are not certain if you need rehab, you can seek a consultation with your doctor, who can assess your substance use and refer you to an appropriate level of care.

What Happens if I Do Not Go to Rehab?

While some people are able to quit using substances on their own, without professional treatment, others may experience negative consequences for avoiding rehab. These can include:

  • Worsening of your substance addiction
  • Increased severity of drug dependence
  • Increased risk of distressing withdrawal symptoms
  • Poorer life functioning and impairments in more areas of life
  • Increased risk of overdose and fatality
  • A myriad of potential medical or psychological complications

Substance use affects everyone differently, and if you don’t attend rehab, it doesn’t mean that you’ll definitely experience these consequences—however, continued drug or alcohol use increases your risk for experiencing various complications.

How Do I Find the Right Rehab Program for Me?

Choosing the right treatment program is important for the best chances of recovery. Finding a rehab program can be overwhelming as there might be various factors to consider, such as cost, location, your individual needs, and services provided by various programs. You can follow these steps to help guide you to the right rehab program:

  1. Contact your insurance company to find out what types of programs and services your health plan covers, such as detox, inpatient, outpatient, or residential treatment.
  2. Ask about any co-pays or out-of-pocket costs.
  3. Work with your primary care doctor; given that your doctor knows your medical history, they can help determine the best program for you and also be a part of your treatment team for more comprehensive treatment.
  4. Obtain a list of referrals of different rehab programs from your health insurance company.
  5. Share with a friend or family member you trust that you are seeking treatment. Those who have emotional support in their recovery process are more likely to be successful.

If you don’t have insurance, feel free to call our helpline at (800) 662-HELP (4357) to find a treatment program. We can help you find a rehab that will fit with your financial needs.

Once you have a list of potential rehab programs based on location and cost, you’ll want to call them and ask questions, such as:

  • What types of services does your rehab center offer?
  • Do you have experience treating my particular addiction or co-occurring condition?
  • What credentials do your staff members have?
  • What accreditation does your program have?
  • How long is your rehab program?
  • Do you offer holistic therapies, such as yoga or mindfulness?
  • Do you offer case management services?
  • Do you offer individualized treatment plans?
  • What are your program rules?
  • What is a typical day like?
  • Do you offer nutritional counseling?
  • Do you allow family visits?

This is by no means an exhaustive list, so make sure you ask whatever questions will help guide your rehab decision. At the end of the day, it’s essential that you feel comfortable with the drug or alcohol rehab that you’ve chosen.


  1. Brandon, T.H., Vidrine, J.I., & Litvin, E.B. (2007). Relapse and relapse prevention. Annual Review of Clinical Psychology, 3, 257-284.
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders(5th ed.).
  3. National Institute on Drug Abuse. (2020). Health Consequences of Drug Misuse: Introduction.
  4. Brunette, M.F., Mueser, K.T., & Drake, R.E. (2009). A review of research on residential programs for people with severe mental illness and co-occurring substance use disorders. Drug and Alcohol Review, 23(4), 471-481.
  5. Witkiewitz, K., Warner, K., Sully, B., Barricks, A., Stauffer, C., Thompson, B.L., & Luoma, J.B. (2014). Randomized trial comparing mindfulness-based relapse prevention with relapse prevention for women offenders at a residential addiction treatment center. Substance Use and Misuse, 49(5), 536-546.
  6. Ngo, H., Ennals, P., Turut, S., Geelhoed, E., Celenza, A., & Wolstencroft, K. (2020). Step-up, step-down mental health care service: evidence from Western Australia’s first – a mixed-method cohort study. BMC Psychiatry, 20(1).

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