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What is Drug Rehab? Myths and Misconceptions

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT
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Drug Rehab: First Encounter



I roll over in the dark and bury my head in the pillow. The noise sounds like it’s coming from my bedroom door. Probably my mom, trying to wake me up for school. At sixteen years old, I have the set-up all my friends want: a basement bedroom with its own entrance, separate from the rest of the house, down at the bottom of the porch stairs.

Basically, it’s heaven for a teenage boy.

“Mom,” I moan. “Leave me alone. I need sleep.”


Again. Slowly I realize it’s not coming from the door.

“Dude. Duuuuuuuude. Dude c’mon.” The muted whisper is coming from my window. Not from the door at all.


Dude, let me in!”

I recognize the voice. Definitely not my mom. It’s my friend, John. I roll over and peer through the window. He’s standing there in the bushes by the side of my house, barefoot, wearing just a white t-shirt and blue jeans.

“John, what are you doing?” I whisper. “I thought you were –”

“Just shut up and let me in,” he says. “I need help.”

I swing my legs off the bed, tiptoe to my door, and open it slowly. John appears from around the side of the house and slips inside. His feet are black and bruised.

He looks tired and hungry.

“Thanks. I really need this.”

“No problem. But what’s going on?” I look over at the clock. 3:12 am. “Aren’t you supposed to be in…”

“Rehab. Yeah. It was a total nightmare, dude. Night. Mare. I couldn’t take it. I broke out. That place is like prison. I’m not going back. They wouldn’t even let me go to the bathroom alone. Big stupid burly football player holding the back of my pants every time I had to pee. Like I was gonna swim off down the toilet or something. I just need a place to crash for a few hours. And some shoes. Can you hook me up? I’ll be gone before your mom wakes up.”

Problems with the Popular Image of Drug Rehab

I’ll let you in on a secret: everything you read up to this point happened almost thirty years ago. To me. Nowadays, I’m a full-grown adult, and I actually work in rehab. More specifically, I work in alcohol and substance use disorder treatment for teens. Or, as it’s widely known, teen drug rehab.

And that was my first real encounter with a person who’d been in rehab.

My friend John, showing up at my house at three o’clock in the morning, on the run from a local drug treatment center called Hillview. I let him in. He talked. He slept, then took a shower. I gave him some clothes and a pair of my shoes. He was gone, as promised, by the time my mom came down to wake me up for school. He got caught later that afternoon, breaking into his own house, and they sent him back to rehab.

This time to a place up far away, up in the mountains, where, even if he managed to slip away, he’d have nowhere to go.

For years after that, I considered rehab to be a bad place. A place to avoid at all costs. And no matter how much I grow, learn, and mature, I just can’t seem to shake that first impression: the idea that a rehab center is a place where they go into the bathroom with you and hold your belt while you relieve yourself.

A place from which one needs to escape.

I deal with that baggage every day.

And like I said, I know better, because I work in rehab.

So why can’t I shake the baggage?

Media Coverage of Rehab Does Not Help

Sadly, the negative baggage I have around rehab centers is bolstered by the national media and the way it covers the rehab experiences of popular celebrities, who often appear to use rehab like retreats or vacations.

They go for a while. They check in and out at will. Then they come back into public view, film a movie, make an album or two, then head back to rehab for a spell. Regardless of the person, the place, or the addiction, they all seem to treat rehab as a necessary evil, not as a place to go to become whole and address their issues. They treat it like something to be suffered through, and what’s worse, they publicize their stints in rehab – or maybe their publicists do that.

Sure, it’s a different concept of rehab than the one I got from John. But it’s relevant in that it’s as inaccurate as that first impression.

I really don’t know how celebrities do rehab. Sometimes it looks like they use their time in rehab to advance their personal fame and media exposure. But like I said: maybe it’s their publicists doing all that. I like to think so, because I want everyone who tries to recover to be successful in their recovery.

For the record, if they want to recover, the way they recover is their choice, not mine. I support them on their journey, no matter what path they choose.

The Truth About Rehab: It’s Called Treatment (And it Works)

The fact is that most people who enter rehab are neither rich nor famous, nor have they been compelled into rehab by run-ins with the law or embarrassing public meltdowns. Furthermore, most people who enter rehab do not end up in spa-like settings, nor do they end up in prison-like environments with burly orderlies (like my friend John described) following them into the bathroom stall.

In fact, statistics released by the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2018 show the following:

  • 52% of treatment centers are private, non-profit institutions
  • 11% are run by local, state, federal, or tribal governments
  • 66% accept Medicaid
  • 48% accept State-financed insurance
  • 36% accept Medicare

In addition, it’s important to understand the type of treatment people receive:

This data directly contradicts both my first impression of rehab and the image of rehab popularized by national media. These numbers paint a very different picture of what happens in rehab than the picture painted by the media.

And totally different than the picture painted by my buddy John.

It’s difficult to admit that my first impression of rehab plagues me to this day, even though I know now – because I see it every day – that those impressions were dead wrong. The truth about rehab centers is that most are good places doing good work, staffed by hardworking, honest, caring professionals who truly want to help and heal the people who come to them for treatment.

And let’s get one detail straight: it’s called treatment – and if you’re motivated to heal, grow, change, and recover, I’ll say it again:

Treatment works.

ps. Straight facts here: John is alive and well. He lives with an alcohol use disorder. He’s had slips over the years, but works his program and goes to meetings. He has a wife, kids, and owns a small business.

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