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What it Means to Leave Rehab Against Medical Advice (AMA)?

by Demarco Moore

July 6, 2022
Friends and family convincing their loved one not to leave rehab early

Leaving Rehab Early

When someone wants to leave an alcohol or drug rehab center early, it’s typically because the treatment program is working the way it should. Imagine drinking or doing drugs for an extended period of time, developing an addiction and then being told to stay at a place for 30 days or more without that particular substance. Depending on the substance you’re addicted to and how long you’ve been misusing it, there’s a good chance you’re not ready for the challenge of tapering your body off the substance. 

Within a few days of detoxing from a substance, many people begin to feel better. Some people who’ve been in a recovery program for even a few days may think they don’t need to complete therapy and counseling. Others might believe all they needed to do was stop using a substance for a few days and can go through recovery on their own, which goes against the advice of medical professionals.

There could be many reasons why a person might decide to leave rehab against medical advice. None of them should take priority over reversing the effects of addiction and substance dependency. Inpatient rehab programs are equipped to handle the harmful effects of addiction, 24 hours a day, seven days a week. If you leave early, you could be prolonging the process of learning how to live a healthier life, where you gain control over your addiction. 

Landmark Recovery programs are based on evidence and clinical data. We have a proven success rate at helping people sustain long-term recovery from substance abuse. Stopping a program early just doesn’t work.

A woman packing her suitcase to leave rehab early AMA

There are no benefits to stopping addiction treatment and leaving a rehab program early.

 

What Does it Mean to Leave Rehab Against Medical Advice?

Every competent, adult patient at a rehab facility has the right to refuse treatment and leave against medical advice (AMA). Despite recommendations from the present physician and clinical staff against it, patients may sometimes want to leave the facility. However, AMA discharges don’t happen very often. 

In fact, one study published in the Journal of Addiction Medicine found that AMA discharges happened once out of every seven admissions to a dedicated unit for treatment of substance withdrawal of alcohol. That’s still one AMA discharge too many when we talk about helping people overcome their battle with substance abuse. Even if the staff follows facility procedures to convince the patient to remain in treatment, the choice to stay or go falls on the patient.  

The Dangers of Leaving a Recovery Program Early

There are no benefits to stopping addiction treatment and leaving a rehab program early. Substance use of any kind increases the risk of addiction and other negative health effects, like cancer and mental health conditions. Not to mention, leaving rehab without the resources and discipline needed to deal with temptations and triggers leaves people vulnerable to more than just health consequences. Landmark’s recovery programs are designed to teach coping skills and help patients understand where their triggers and cravings come from. The classes, counseling and therapy sessions take time. 

“What I have seen happen is patients leave our program, and it gets worse for them,” said Katherine Connell, the executive director at Landmark Recovery of Las Vegas. “They lose that job. They get kicked out of the house – sometimes because they left treatment early. I’ve never seen anything good happen from someone leaving treatment early.”

3 Reasons Why People Leave Rehab Early

Leaving rehab early or against medical advice is an impulsive decision. Reversing the effects of addiction is a long and sometimes uncomfortable process. Depending on the severity and length of a person’s addiction, they could be struggling to adjust to a daily routine that doesn’t include drinking alcohol or injecting themselves with drugs. Therefore, it’s not uncommon for treatment center staff to hear a laundry list of reasons why patients want to leave the facility.

“I find a lot of times that they sometimes aren’t even employed at the moment, but they still are worried about a job,” said Connell. “I’ve seen every reason in the book and they’re all about the same. Just whatever excuse gets put in their head, like, ‘I gotta get out of here.’ They’ll use it and run with it.”

Here are three common reasons why patients leave rehab AMA:

1. They never wanted to come to rehab

Not all people come to rehab voluntarily. Some people receive court-ordered rehab to avoid jail, as a condition of probation, or to avoid losing their job. They were forced to come and don’t enter the program with the willingness to change their lifestyle and behavior. Therefore, it’s easier for them to have a lower tolerance for staying in treatment long-term.  

2. Detox is physically and mentally hard

Detox is an important role in the early stages of addiction recovery. Depending on usage history and the severity of the addiction, the process often lasts for the first 10 days of treatment. During that time, patients may experience uncomfortable withdrawal symptoms as a result of abstaining from drugs or alcohol.

If the addiction involves alcohol, patients may experience heavy sweating, vomiting and even hand tremors. Even though the symptoms usually go away after a few days, that’s enough to make some patients beg, plead or even bargain with loved ones to leave rehab early. That’s why going through detox at a rehab facility is so crucial.

At Landmark Recovery, our team of physicians and clinical staff monitor patients 24/7 for mild-to-severe withdrawal symptoms. If the addiction involves alcohol and a patient begins to show signs of a severe withdrawal symptom like Delirium tremens (DTs), our trained staff can provide the appropriate medication to prevent any complications. That’s not something people have access to if they leave early to go detox at home.

3. The negative stigma of addiction

Addiction doesn’t discriminate. Although rehab brings together people from different walks of life,  society often paints addiction with a broad brush of bad character rather than treating it like a disease. This might influence someone in rehab not to want to be seen as like people around them. The end result is them leaving rehab early.

Preventing Patient Discharges AMA

Preventing patient discharges against medical advice is among the highest priorities of every staff member at Landmark Recovery. To accomplish this, we have protocols in place to encourage patients to stay and finish treatment.

24-hour rule

If a patient tells the facility staff they want to leave rehab, they will be asked to stay for at least 24 hours to encourage an additional conversation between them and every available department within the facility. 

Reaching out to loved ones

Another effective retention protocol is reaching out to the patient’s loved ones. This method gives the patient’s support system an opportunity to explain the importance of finishing treatment.

“That usually helps a lot, hearing their loved ones say, ‘Hey, you can’t leave. I need you there. I need you to complete this and see this through,’” said Connell. “Sometimes that’s kind of that little push they needed to say, ‘I do need to be here.’”

If every option is used up and the patient still wants to leave the facility, then the staff has to let them go.

Friends and family convincing their loved one not to leave rehab early

Can You Go Back to Rehab If You Left Early?

“It depends on how they left – if they left in a violent manner or became aggressive and hostile towards staff,” said Connell, referring to patients who check themselves out of treatment early.

If patients are violent or aggressive on their way out of rehab, they could face a 60-to-90-day evaluation when and if they decide to come back. Each discharge AMA is evaluated on a case-by-case basis.

“I’ll sometimes put a do not admit for a certain amount of time,” said Connell. 

There are also cases where patients must go through a waiting period before returning to rehab. That’s because some patients form a habit of leaving treatment early and coming back more than once.

The Benefits of Finishing Rehab

Recovery doesn’t stop once a patient completes rehab, but finishing rehab sets the foundation for them to sustain a healthier, more productive life. There is no daily schedule of activities and therapy sessions once a person returns home. Completing a residential treatment program equips patients with the following:

  • A greater understanding of how addiction works
  • A better understanding of triggers and temptations
  • The knowledge of how to set boundaries for themselves and their loved ones

Being connected to an alumni network

At Landmark Recovery, we continue to monitor patients once they complete rehab. We connect them to an alumni network that provides resources and information on recovery meetings, support groups and community events.

Being an example for someone else to follow

Whether it’s a sibling, a cousin, or even a child, finishing rehab and sharing your recovery story could empower someone else struggling with addiction. You finishing rehab can be the evidence and push they needed to get help.

Find Local, Affordable Rehab

If you or someone you know is struggling to control their drinking or drug use, call 888-448-0302 to speak to one of our recovery specialists. You can also find a list of Landmark Recovery locations to find the closest treatment center to you.

About the Author

Demarco Moore

Demarco Moore

Demarco is a Middle Tennessee State University graduate. He focuses on addiction recovery-focused content writing and search engine optimization (SEO) at Landmark Recovery.

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