What Does It Mean to Leave Rehab Against Medical Advice (AMA)?

Last Updated on January 21, 2022

No matter what type of medical care you’re receiving, it’s wise to follow the doctor’s orders. The same is true for substance use disorder treatment. However, in some instances, individuals receiving substance abuse treatment may leave rehab against medical advice or AMA.

Leaving rehab AMA is one of the factors that’s most likely to harm a person’s likelihood of recovering from addiction, so it’s important to understand why it’s dangerous, what can be done to prevent someone leaving rehab AMA, and how you should respond if a loved one decides to leave rehab against medical advice.

Related post: How to Deal With Homesickness In Rehab

Can I choose when I leave rehab?

The short answer is, yes, you can leave rehab whenever you want. Although treatment staff won’t hold you at the rehab center against your will, they will likely intervene if they find out you’re planning to leave before you complete your program, and they may do everything they can to convince you to stay. Why? Because sticking it out and completing your rehab program will give you the best chance at achieving lasting recovery and freedom from addiction.

Although most rehab centers offer 30 or 90+ day treatment programs, each individual progresses through treatment at a different rate. Generally though, research shows good outcomes are contingent on adequate treatment length. According to the National Institute on Drug Abuse (NIDA), people in residential or outpatient treatment should aim to stay in treatment for at least 90 days. However, treatment experts recommend participating in treatment for much longer to maintain sobriety.¹

What does it mean to leave a rehab center AMA?

Leaving a rehab center against medical advice is when a patient chooses to leave the treatment program and facility before the treating physician and/or treatment team recommends discharge. According to an article published in the journal Mayo Clinic Proceedings, about one to two percent of all medical admissions result in an AMA discharge.²

Based on the results of previous studies, common predictors of leaving treatment AMA include:

• Young age
• Having Medicaid or no insurance coverage
• Being male
• Current or history of substance abuse

Of course, leaving rehab AMA has many consequences that a person should carefully consider before deciding to go home. Additionally, similar to those who leave the hospital before their medical treatment is complete, people who leave rehab AMA also have a high likelihood of returning to treatment within 30 days.³

Why do people leave rehab against medical advice?

There are many reasons why a person might leave rehab against medical advice. However, some of the most common reasons include:

Not wanting to go to rehab in the first place

Someone that initially refuses help but feels pressured by family and friends to go to rehab may be more likely to leave AMA. Once they’re at the rehab facility, they might realize how much they don’t want to be there and choose to go before they finish their program. 

Withdrawal symptoms

The cravings and other physical and psychological withdrawal symptoms people experience when they first get sober are not easy to deal with. If someone is suffering from post-acute withdrawal syndrome (PAWS), which is an intense and lengthy form of withdrawal, they might feel like it’s too much to take and leave rehab against medical advice because using drugs or alcohol is just easier.

Denial 

It’s not uncommon for people to believe that they’re smarter or better than other people who use drugs. Some people in rehab might not feel like they should be there because they’re not like “everyone else” in treatment. 

Homesickness

Being away at rehab and away from family is challenging. Some people may feel like it’s just too much and decide to leave before completing their treatment program.

Work

Many people worry that they may lose their job or that they need to get back to work or take care of financial duties at home, so they leave rehab earlier than recommended.

Overconfidence

Some people might feel like they’re ready to take on the world sober after completing detox and a few weeks of rehab. In reality, they likely still have a lot to learn! It takes a good amount of time to establish the life tools and strategies you need to stay sober and recovery is an ongoing, lifelong process.

Powerful, negative emotions

Often, people use drugs and alcohol to mask the pain and hurt they’re feeling due to past trauma or other life difficulties. In rehab, these things tend to come up and out into the open, where they can be incredibly difficult and painful to deal with. Sometimes, a person might feel like it’s just too much and they might choose to leave rehab AMA.

What are the dangers of leaving rehab against medical advice?

When a person leaves rehab AMA, it means they have not met the goals and objectives of their treatment plan. In turn, this means they’re more vulnerable to many negative consequences, such as: 

• High rates of relapse and overdose
• High rates of readmission
• Lack of access to aftercare and recovery support programs
• Lack of skills that will help them remain sober
• Legal and employment problems (if employment or court order was dependent on the completion of a rehab program)
• Strained relationships with family and friends who are supportive of the person’s sobriety
• Death (relapse and overdose can sometimes be fatal after a period of sobriety)

What can loved ones do to prevent individuals from leaving rehab AMA?

If your loved one communicates their intention to leave rehab against medical advice, you may feel frustrated, angry, upset, or a variety of other complex emotions. However, it’s important to stay calm and collected when you speak with them. Some of the most beneficial ways you can help them stay in treatment are to:

• Stay calm and remind them of why they’re in treatment and who they used to be prior to addiction.
• Let them know that they are loved and supported and encourage them to stick it out, even if it’s just for one more day.
• Help them focus on their sobriety and what their future can look like if they stick with treatment.
• Encourage them to share their thoughts and experiences about rehab. Find out what they’re learning and doing in rehab. (This might prompt your loved one to think twice about leaving rehab AMA).
• Talk to their treatment team and find out if they can discuss the issue with your loved one and help them to think through the decision more thoroughly before leaving.

Treatment centers can also play a role to prevent people from leaving rehab AMA. For example, offering individualized treatment programs is likely to encourage people to stay in rehab longer because it’s catered to their unique needs and circumstances. Additionally, many rehab centers offer alternative and complementary treatment methods, such as yoga, art therapy, music therapy, or animal-assisted therapy, which may also help incentivize people to stay in treatment.

Related post: How to Tell People You’re Going to Rehab

What to do when a loved one leaves rehab AMA

Ultimately, you may not be able to force someone to stay in substance abuse treatment against their will. If they still choose to leave rehab against medical advice, you’ll need to accept their decision. You can still remain supportive of their initial choice to get help and voice your opinions, but they may not want to hear it.

After leaving rehab AMA, an individual may face consequences like the termination of employment or legal problems. They may also relapse or be readmitted to another treatment center shortly after leaving rehab. Regardless, watching a loved one make such choices is very difficult and will affect your mental health. You should consider seeking counseling or therapy for yourself. 

If your loved one has a history of leaving rehab AMA and chronic relapse, they may have a false perception of rehab and its efficacy and benefits. At Nova Recovery Center, we offer individualized treatment plans and comprehensive evidence-based 90-day programs to help people establish a firm foundation in recovery and firmly grasp the tools and life skills they need to stay sober. If you’d like to learn more about our drug rehab Austin, TX, please contact us online or call (888) 427-4932 to speak with an admissions representative today.

References:

1. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment-usually-last
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664598/
3. https://pubmed.ncbi.nlm.nih.gov/28125826/

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