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Addiction Rehab: What to Expect from Inpatient Treatment

by Demarco Moore

September 5, 2022
A patient comforts a woman during inpatient rehab

Day-by-Day in Addiction Recovery

Many people considering a residential treatment program for a drug or alcohol addiction want to know what a typical day at a rehab center is like. Inpatient treatment at Landmark Recovery provides patients with a safe and caring environment, where they can focus on understanding their addiction and learn skills to avoid a relapse. 

In order to understand what addiction rehab is really like, it’s best to hear from someone who has gone through a residential program. While no two recovery journeys are the same, Eric Jordan’s experience with inpatient treatment exemplifies how a residential program is designed to work.

Jordan was in the emergency room when he received a warning about his drinking. His stomach was damaged to the point where he couldn’t keep food down. It was time to make a life-saving change.

“It was a matter of life and death,” Jordan said. “I basically had a medical doctor tell me that if I did not seek help and quit drinking, my family would be burying me in six months to a year.”

A resident of Bowling Green, KY, Jordan got into a residential treatment program at Praxis of Louisville by Landmark Recovery

Day 1-3: Getting a Feel for Treatment and Aftercare

Jordan said he felt “humbled” during his first day at Praxis of Louisville. He’d gone through another treatment program and experienced a relapse, followed by the grim ultimatum from the ER doctor. Jordan was motivated to recover from his drinking and drug problems. He could’ve stayed close to home for treatment, but decided to travel almost two hours to Lousiville without a car to show how committed he was to his recovery.

“My mom had a hard time understanding why I chose to come to Louisville for treatment,” Jordan said. “I had to explain to her that I had to go away from Bowling Green. If I’m in Bowling Green, I can walk out of treatment and get to my vehicle. If I’m in Louisville, where am I going?”

Addiction treatment professionals like Keith Farah, executive director at Praxis of Louisville, believe the first few days of treatment represent some of, if not the most, important days for patients in recovery. Most rehab facilities follow retention protocols when patients want to leave rehab early. Many of these occur during the first five days of treatment. 

Therefore, from the beginning, expectations should be understood from both the facility’s and patient’s perspective that residential treatment is often viewed as the first phase of recovery. This introduction to the program and level of understanding gives the staff an opportunity to develop rapport and trust during one leg of their lifelong recovery marathon.

“The retention process starts as soon as the patient gets in the building,” Farah said. “We tell patients our job here is to get them as mentally, emotionally and physically stable as we can to prepare them for further treatment when they leave. The intake process is the opportunity for us to begin to make this a place that they want to be and that they trust to take care of them.”

Incoming patients are assessed for the severity and symptoms of their substance use, which are used to determine both their residential treatment and aftercare plans.

Jordan said his treatment plan was laid out by day three. He knew he’d be on his way to intensive outpatient rehab after graduation. But first, he needed help safely removing the drugs and alcohol from his system.

Eric Jordan at an alumni event for former patients at Landmark Recovery

Eric Jordan graduated from inpatient rehab at Praxis of Louisville by Landmark Recovery. He attends alumni events and is often invited to come to speak to current patients. (Photo provided by Eric Jordan)

Day 4-7: Managing Withdrawal Symptoms

Jordan was one of the exceptions to the typical withdrawal timeline. He arrived at Praxis of Louisville with detox medication in his system after a brief withdrawal at the emergency room.

Medical detox is often the most challenging time for many patients. They become physically sick as they experience uncomfortable withdrawal symptoms. Therefore, their withdrawal timeline depends on the substance they’ve used and the rate of use before they arrive at the facility.

“You can count on anyone who has been using alcohol, opioids or benzodiazepines, their first three or four days is just gonna be rough,” Farah said. “We do the best we can to mitigate that medically.”

During residential treatment, the facility staff might allow patients with painful withdrawal symptoms to skip certain activities if they feel too sick during their first few days.

“Their withdrawal symptoms are going to be much more acute and more difficult to mitigate for the first week,” Farah said. “The expectations of them and treatment initially are going to be different.”

Jordan’s withdrawal timeline started at the hospital after he relapsed. He started residential treatment at Praxis of Louisville ahead of schedule, so to speak, and was able to engage in daily activities and group therapy quicker than someone who didn’t start detox until after they arrived at the facility.

“I know that if you want to kick this you cannot just lay in the bed,” Jordan said. “You have to be active in your treatment.” 

In the event that he wasn’t feeling well during group or individual therapy sessions, Jordan said he was given the opportunity to rest in his room until he felt better. That expectation was a part of the intuitive nature of the staff at Praxis of Louisville. Knowing and understanding that patients sometimes needed time to acclimate themselves into the program also helped establish a relationship between the patients and facility staff, many of whom are in active recovery.

“They would tell me to go lay down and if I felt better later, come back to class,” said Jordan, who suffers from migraines and drank alcohol to cover them up in the past. “I would communicate with them if I wasn’t feeling well and they could tell if I wasn’t feeling well because I wasn’t myself.”

Farah said he and his staff get creative with how they handle the different detox and withdrawal timelines patients deal with. If a patient is feeling too sick to go to meetings, a patient engagement specialist goes into their room, sits with them for about 30 minutes and talks to them. Patients are monitored around the clock for any harmful withdrawal symptoms that can be soothed with the proper medication.

“They understand what their withdrawal looks like, what the person’s feeling, and they kind of just intuitively know how hard to push them,” Farah said.

The approach helps the staff learn the individual needs of each patient so they know how hard to push them to get engaged and have a successful rehab stint.

“We’ll err on the side of caution of getting them moving and attending things and being a part of the groups here,” Farah said. “Even if it means irritating them a little bit, we expect that and we don’t take it personally. We know how hard to push, and we also know when they just need to rest.”

Life After Detox

Many facilities stagger patients throughout residential treatment, meaning there are just as many incoming patients as outgoing patients. It might seem challenging to someone on the outside looking in. However, Jordan saw the process as a positive for his progression through rehab. It allowed him to see what impact the program had on patients at different stages during his 23-day stint.

“That actually helps the new person coming in because that helps them get settled more quickly,” he said. “If they have questions, I can answer. That way the staff members aren’t the only ones having to answer questions.”

Patients are expected to start engaging in daily activities and counseling sessions once they’re past the worst of their detox, which Farah said usually happens after four-to-seven days.  Jordan explained that seeing patients that are farther along creates an example for incoming patients to follow and can help them feel more comfortable opening up to other patients as well as in counseling sessions. No matter how long a person has been in treatment, there’s a benefit to being surrounded by other patients who can prepare a new patient for what’s to come.

“It’s good to have people at different levels because they can talk about their experiences,” Jordan said.

Day 10: Halftime Reflection

Jordan said he turned the corner in his treatment journey around the 10th day. It’s considered to be the halfway point for many patients during a typical 21-day residential treatment program at Praxis of Louisville. Some withdrawal symptoms are known to linger,  but most patients are expected to start feeling and sleeping better, eating and engaging more in treatment. Jordan said his mind cleared as he remembered the words of people like his uncle and a temporary sponsor, who encouraged him to do things like go to sober living and get a sponsor after rehab.

“I was like okay, maybe I should listen to my uncle,” said Jordan, whose uncle has more than 16 years of sobriety under his belt. “I started thinking about what they were telling me before my relapse and thinking maybe I need to listen and take the advice of some people that have told me, ‘Take the cotton out of your ear, put it in your mouth, shut up, sit down and listen for once.”

Jordan also saw possibilities of what was to come if he didn’t follow the advice of the people with years of sustained addiction recovery. He said it was eye-opening to witness patients who had graduated as he got to Praxis of Louisville leave the facility and come back by the time he was halfway through the program.

“It’s like okay, maybe I need to listen, because I don’t want to be like them and be returning not even a week later,” Jordan said.

Family Visitation in Rehab

Landmark Recovery places a high value on family dynamics. Evidence shows that without a strong support network at home, patients are less likely to sustain their recovery after completing residential treatment. Family members are invited to participate in group counseling sessions.

Jordan got to see his mother, who came for visitation around the 10-day mark. It turned out to be another moment of reflection and clarity he needed to finish treatment.

“When my mom told me that I looked a lot healthier than I have been in a long time, it just made me push harder,” said Jordan, who remembers losing more than 70 pounds during rehab.

Jordan’s mom came bearing “tough love” as well. Her words resembled the kind of boundary many families of people struggling with substance misuse establish to stop enabling their loved one. Jordan’s mom wouldn’t block him from facing the consequences of his addiction.

“She basically told me that if this didn’t work, if I didn’t stop doing the drugs, the alcohol, and everything, there was gonna be a point that she was gonna say f–k it,” Jordan said. “She was gonna be like, ‘I’m done with you. I ain’t gonna help you anymore,’ because of all the sleepless nights she’s had.”

Post-Rehab Prep 

About one week prior to graduation, Jordan said he felt uncertain about leaving rehab, even though his aftercare plan was solid. He would stay in Lousiville to participate in the intensive outpatient program at Praxis of Louisville. As part of a local partnership with the Healing Place, he would have free transitional housing while he traveled to and from Praxis of Lousiville four times a week for counseling sessions. 

Jordan knew he would have to submit to drug tests and avoid alcohol to maintain his housing, which was the accountability he wanted and needed coming out of rehab. 

“I had that accountability to where I knew that if I showed up drunk or anything I would lose my housing,” he said.

However, because this was as far as he’d gotten in his recovery journey, he was reminded of his relapse before coming to Praxis of Louisville. He wanted to avoid that by any means necessary.

“I was terrified that I was gonna mess up again,” Jordan said.

The transition turned out to be smooth for Jordan. He graduated from Praxis of Louisville on a Friday, entered IOP the following Monday and finished up in June.

The Takeaway

Rehab is not easy, but it’s an effective tool for conquering addiction day by day. We’re not asking you to enter a residential treatment program today. Instead, reflect on your substance misuse. Then, consider and trust that there are people out there willing to help you overcome it. 

Since completing residential treatment, Jordan has been invited as a guest speaker at both Praxis of Louisville, and Landmark Recovery of Louisville

After speaking appearances, Jordan said he’s been approached by former patients who he “helped be able to adjust to rehab.” Others have handed him notes with kind words of appreciation. However, none of it was possible without “tough love” from the ER doctor and his family, as well as inpatient addiction treatment.

Ready to Learn What Your Options Are?

If you or someone you know struggles to manage your drinking or drug use, call 888-448-0302 to connect with a recovery specialist. The confidential phone line is open 24/7. Learn more about addiction recovery services, the cost of treatment or the admissions process. 

Click here to see a full list of addiction treatment centers near you.

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About the Author

Demarco Moore

Demarco Moore

A graduate of Middle Tennessee State University, Demarco Moore currently writes blogs about drug addiction treatment and recovery to help save lives at treatment provider Landmark Recovery. Before that, he cut his teeth as a sports writer at the Manchester Times, where his coverage and stories won Tennessee Press Association awards in 2016 and 2017.

He’s always had a knack for storytelling. Moore’s written content for junior golf tournaments and helped to amplify the “People Not Profits” message of credit unions. When he’s not writing, Moore loves to travel, laugh and put his mental health into the hands of the Tennessee Titans during football season.