Monthly Archives: November 2013

How does a rehab work?

The slightly stuffy answer is at a rehab is a clinical facility, in the same way that a hospital is a clinical facility, although a rehab is not a hospital it has a number of similarities in terms of a range of clinical staff and therapeutic programmes designed to help people who have an illness.

A rehab will be residential normally, although there are daycare programs that run from rehabs, and much good outreach work that is also done by rehabs and other types of alcohol and drug rehab programs.

However for most people when they think of a rehab, they think of an institution where people go to try out and get clean and then come out again a month or so later and hopefully either don’t drink or do drugs again.

Although this is a somewhat stereotypical understanding of a rehab, it is fundamentally true.

A rehab will normally be residential because there is a belief that treatment can work better if the individual is taken out of their normal environment and put somewhere where they are safe and can be looked after for a period of time outside of their normal work/family life. This approach has two particular aspects.


One is that it creates a bit of a bubble, where the individual can feel safe enough to begin the therapeutic work they need to do to help them deal with their alcohol/drug problem. The other aspect is that this can then create a slight problem when people leave rehab treatment in terms of integrating the effect of this bubble back into their normal family or worklife.

A rehab should fully understand the nature of this dilemma in terms of the bubble effect, and should actively be helping to combine the transition of both these effects in the individual.A rehab will normally be set in a fairly luxurious set of surroundings both physical and environmentally.

There is a belief that the nature of rehab, although often strict in one sense, should be conducted in an environment that is a serene and tranquil setting, as this provides a background for someone who is an alcoholic to feel safe and secure, which can play a part in providing a context in order for them to get sober and stay sober.

In addition, a rehab will have a very structured and disciplined approach to certain areas of an individual’s life when they are in rehab, which many people find difficult to deal with. There is likely to be a very tight timetable that determines the structure of the individual’s life, although some areas of the timetable may be optional or at the discretion of the individual’s own needs.

A rehab is likely to have an incredibly specific list of what people are allowed to take in and use during their time in rehab, and this should be fully explained by the admissions officer of the rehab when processing the applicant.

What is addiction ?

The nature and range of addiction has been around pretty much for as long as humankind itself in various ways, but has probably become much more of a buzzword and a concept for a wide range of destructive behaviours and levels of self-destruction in the last maybe 20 or 30 years.

When alcoholism was beginning to be accepted as a progressive illness in the 1930s and 40s, it was the first time really that the nature of someone who had a problem with alcohol or seen as an illness rather than as some type of personal failing.

It was not thought of as an addiction in the sense that smoking is thought of as an addiction. With smoking, someone will sort off almost forcing themselves to become addicted to nicotine, and one started, the nature of striking deepens the addiction until it becomes incredibly difficult for most people to stop.

Alcoholism is different in that it is not a progressive addiction in the way that smoking is. For most alcoholics the need to drink is already present within them, although it may take a while for period for so-called normal drinking before it manifests itself as a compulsion.

When people started developing the idea of rehabs and treatment centres their primary focus was on people who were alcoholics as well as people who had a problem with various types of narcotics and prescription drugs.

The nature of rehabs and treatment centers meant that they began to talk about people who are alcoholics as having an addiction to alcohol, and essentially making the point that there was little difference between the substances in one sense.


The line of reasoning that came out from rehabs was that the problem was the individual, that they had an addictive personality and that in a sense they had a drug of choice, whether that was alcohol, gambling, food, sex or any type of mood altering substance.

There is a likelihood that rehabs developed this line of debate because it allowed them to treat pretty much anyone on the same basis as being an addictive personality and separating out the individual from their drug of choice.

This sense of understanding of addiction is widely promoted by rehabs, but needs to be looked at with much caution. Alcoholism is different from other types of addictions.

The notion of an addictive personality can be a real distraction from helping the individual. Addictive drugs are addictive by their very nature, not as a result of a personality flaw. Rehabs can be really useful in many ways, but their approach to addiction and alcoholism needs to be carefully understood and examined in order for the most appropriate help to be given.

What is alcoholism ?

The term alcoholism has been around for a long time and in many ways is less important than the behaviour and the actions and the devastation that it describes. In modern day language, people talk about a wide range of related associations such as alcohol abuse, substance abuse, alcohol addiction etc.

Alcoholism is widely accepted and understood to be a progressive illness that can affect many people, from any social background, from any age, any profession, any gender or sexuality in any country.

Given that as a general proposition, which is pretty widely accepted, beyond that there is much debate as to what constitutes the nature of alcoholism being an illness, who has it, what it means and what can be done to help people get better. The term alcoholism often puts people off because if someone has alcoholism then it follws they are effectively an alcoholic.

For loads of different reasons, the term alcoholic can seem to be a very difficult and problematic label for people to carry. This can be true for people who go to Alcoholics Anonymous and can get sober, as well as people who might be potential alcoholics and see they have a problem and need to stop.


Many years ago, a very famous rehab ran a series of ads focusing on a young smart professional wearing a suit and carrying a briefcase, with a caption underneath to the effect that this individual was much more likely to be an alcoholic than someone who was what is commonly referred to as a street drinker.

The intent of the ad was in effect to challenge people’s misconceptions and stereotypes of what an alcoholic is. Having said that it is incredibly difficult to define an alcoholic in a theoretical sense. There are a number of almost slang type expressions and sayings that have arisen in Alcoholics Anonymous, one of them being that if alcohol is costing you more than money then you have a problem.

Obviously this is somewhat of a generalisation, but there is a truth that if alcohol is having an impact that is seriously detrimental to other aspects of your life, is affecting your work or your home or family life in any area then potentially you could be an alcoholic. It is important to stress that only the individual themselves cant make this judgement as to whether or not they are an alcoholic or simply a heavy drinker who needs to stop.

The important thing is that the individual realises they have a problem, and seeks appropriate help. What works, works.

What is Alcoholics Anonymous?

The official wording of the introduction to Alcoholics Anonymous that is read out at AA meetings, which is known as the AA preamble, gives a clear if slightly awkward message, that Alcoholics Anonymous is a completely independent organisation, that has no affiliation with any outside body or enterprise, is completely free to all its membersand, raises money by donations at meetings to cover the cost of rent/tea and coffee etc.

As with many organisations, it is sometimes easier to describe what Alcoholics Anonymous is not rather than what it is. Both are important. To most people Alcoholics Anonymous is a place that people go when they have a pretty serious drink problem that they need to deal with in the hope that they will be able to stop drinking. Beyond that most people don’t necessarily know that much.

Essentially Alcoholics Anonymous is a body of experience of a number of individuals that reach into the many millions who have been able to overcome their problem with alcohol that otherwise they probably would not have been able to. This level of experience is recorded in the literature of Alcoholics Anonymous that is available for anyone to buy either through the organisation itself or online or at numerous bookstalls.

Individual members of Alcoholics Anonymous meet regularly at various venues that are normally held in church halls and community centres etc where people often share their own stories about their drinking, what happened to them and what they do in order to try and stay sober. The nature of the stories can vary widely, as do the individuals concerned.

Alcoholics Anonymous

As with many organisations there is a theory and a reality in one sense. Alcoholics Anonymous should be as described above in terms of a body of experience that people can tap into and use in their own lives as they feel appropriate. One of the aspects of Alcoholics Anonymous is that it’s body of experience and its 12th step program has been widely used in rehabs and treatment centres, often adapted very widely and with varying levels of appropriateness.

In addition, many rehabs will actively encourage clients to attend meetings of AA and other 12 step fellowships whilst in rehab, and once they have left as a way of maintaining their sobriety. This has given rise to much confusion as to whether AA and other 12 step fellowships are connected or have any type of financial association with a rehab treatment center.

They do not and most certainly should not. It is also the case that many people who either own or working a rehab or treatment center are recovering or recovered alcoholics and are members of Alcoholics Anonymous themselves. There is no other connection.

Why is alcohol a problem for some people ?

The book Alcoholics Anonymous is a body of experience that describes the nature of alcoholism in two distinct ways. Firstly by exploring its various component parts as experience of the only members of AA, and secondly by including a number of personal stories that describe people’s struggle with active alcoholism and how they have recovered.

The book does not provide a checklist of how to tell if you are an alcoholic or not. The experiences contained within the book are meant to give people an indication of how alcoholism presents itself in people, giving people an opportunity to decide for themselves whether or not they may be an alcoholic.

There is an important distinction that is made both in the book Alcoholics Anonymous and elsewhere between someone who is an alcoholic and someone who is a heavy drinker. Alcohol can be a problem for some people simply because they drink too much and has an impact on various areas of their lives. They may be an alcoholic or not.

Alcoholism is widely accepted and understood as a progressive illness that affects many people, although its origins and nature of the illness are still widely debated and researched. Many people refer to alcoholism as a disease which can in fact be a somewhat misleading and much more difficult concept to understand.


The book Alcoholics Anonymous makes the distinction between an alcoholic and a heavy drinker. In a general sense a heavy drinker may be someone who starts out moderately and drinks more and more over time due to the nature of the process. In time drinking may become a problem and affect their lives in terms of their work or their family situation.

The person may realise they have a problem with alcohol and be able to cut down and stop, albeit with some difficulty, possibly with some control and possibly some unforeseen consequences.

The nature of alcoholism does vary widely, but one generally accepted trait in most alcoholics is the sense of urgency to drink and the need to drink that comes from within rather than being a manifestation of an addiction to alcohol.

The reality of the difference between an alcoholic and a heavy drinker may not be that obvious or of such concern to people around the individual, or people who are affected by the individuals use or misuse of alcohol.

From the individual’s point of view, it is important to understand the nature of alcoholism because it is the reality that matters, in terms of treatment and in terms of rebuilding a life without alcohol.