Does Drug and Alcohol Rehab Work?

The very definition of addiction helps explain why it is so difficult to beat without expert help. The American Society of Addiction Medication (ASAM) defines addiction as a “chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences”.

It adds that “people with addiction use substances or engage in behaviours that become compulsive and often continue despite harmful consequences”.¹ This means that it is incredibly difficult to overcome addiction using willpower alone.

Does Rehab Work?

Residential alcohol and drug rehab have many benefits and is generally recognised as the most effective way to treat serious addictions, but exact figures can be difficult to come by. Individual rehabs may keep their own records and there have been some studies in this area but there are no national databases showing success rates for private rehab. There are some figures we can look at though.

First, it is certainly the case that many people will relapse after undergoing treatment for substance misuse issues, including addiction. The US National Institute on Drug Abuse (NIDA) estimates that 40% – 60% of people with substance use disorders will relapse after treatment.² Other studies suggest the figure could be even higher, standing somewhere between 65% – 70% in the 3-month period following treatment.³

It’s important to understand that a single relapse, or even a series of relapses, does not mean the treatment has failed. Addiction is generally characterised as a relapsing disorder, meaning people in recovery will sometimes relapse and go back to using drugs or alcohol. This can be discouraging and is always best avoided, but it doesn’t have to mean the end of the recovery.

A relapse can and should be seen as a setback rather than a failure. NIDA argues that relapse rates for addiction treatment generally compared to other chronic illnesses such as diabetes, hypertension, and asthma.

While treatment for these illnesses is often considered successful without waiting to see if a relapse occurs however, addiction treatment is often considered a failure if the person relapses while in recovery.⁴

These relapse figures also apply to people in any sort of drug or alcohol treatment. Government figures show that 98% of those receiving drug and alcohol treatment in the UK across 2019-20 did so in a community-based setting, like that commonly provided by the NHS. Just 2% underwent a residential treatment programme, meaning the relapse rates cannot be easily applied to residential rehabs.⁵

Residential Rehab Vs Outpatient Treatment

There are some studies that show that residential tends to provide better outcomes. One 1999 study found that improved outcomes were strongly linked to the time spent in treatment – with those staying for at least 28 days (the typical length of many rehab programmes) being five times more likely to remain abstinent from substance use.⁶

A literature review of residential rehabs performed by the Scottish Government within a wider drug and alcohol treatment system found that residential rehabs are associated with improved substance use outcomes⁷

The report noted that residential rehab centres also showed evidence of improving mental health, social and mortality factors.