They tried to make me go to rehab
I said, no, no, no…
- Amy Winehouse, Rehab

From just one page of today’s paper I learn that two young Queenslanders were busted carrying 18 MDMA tablets to the ‘Rabbits Eat Lettuce’ bush-doof near Casino, while police were investigating the discovery of a 20kg package of cocaine found floating off the coast near South West Rocks.
And that’s just locally.

To say we are living in a drug riddled society is a massive understatement, despite the many medical and law enforcement efforts to reduce the usage of legal and illegal substances, not least alcohol produced by companies that continue to be major sponsors of sporting clubs and events.
One initiative has been the development of ‘therapeutic communities’, or TCs, residential rehabilitation facilities known in Australia and overseas to have considerable success with those addicted to drugs and alcohol. But not to everyone, according to a newly published study* on why some clients withdraw early and how the programs do help those who go the distance.
The study  was conducted by researchers** associated with the University of Sydney, the University Centre for Rural Health North Coast, the University of Wollongong and the drug and alcohol facility The Buttery, near Bangalow. It was prompted by the knowledge that “low program completion rates, ranging from 9% to 56%, continue to represent a major obstacle in effective and sustainable DA treatment”.
The aims were to explore reasons for early withdrawal from TC programs and clients’ perceptions of successful recovery. The study also aimed to explore how employment and volunteering related to early exit and perceptions of positive outcomes.
‘If I hadn’t had gone through the <rehab organisation> I’d probably be dead to be honest.’
The team noted that, “Length of stay in treatment is associated with higher levels of abstinence, reduced crime and unemployment, and improved quality of life,” explaining that, “Predictors of early withdrawal have therefore been explored to identify clients who may be at increased risk of dropout and enable more appropriate referral to TC services for clients who are most likely to benefit from the program.”
Attempts, not all successful, were made to contact 35 residents who had left the TC program early. In the end, 13 interviews were conducted (7 male and 6 female). The age range was 31–61 years, mean age 44 years. Reasons given for leaving treatment early were multi-faceted and revolved around positive and negative relationships, planning future employment, and program characteristics.
Nearly one-half had entered the program because of alcohol dependence, 31% had stayed 5-8 weeks, and the same number longer than 16 weeks.
Self-worth and feeling able to contribute to society through employment, studying and volunteering were perceived to be essential elements of successful recovery: “For many, it was only after leaving the TC program that they began to understand and appreciate the skills they had learnt and recognised the importance of ongoing DA treatment,” the researchers found.
The team noted that low program completion rates of TCs continue to represent a major obstacle in effective and sustainable drug and alcohol treatment, advising that clinicians, policy makers and program developers should use the extended definition of successful recovery from the ex-clients’ perspective when determining the clinical and economic effectiveness of TC programs.
‘… anything you’d put in front of me that would change the way I felt and make me feel a bit better I’d take it.’
“Perceived success extends far beyond achieving and maintaining abstinence to encompass improved relationships, psychological and physical wellbeing, understanding of addiction and employment, studying and volunteering,” they concluded.

* BMC Psychiatry 18 Sept 2018 -
Factors influencing early withdrawal from a drug and alcohol treatment program and client perceptions of successful recovery and employment: a qualitative study -
Tarran Prangley, Sabrina Winona Pit, Trent Rees and Jessica Nealon.