What Happens During Drug Rehab? A Day-by-Day Guide to the Treatment Process

"What actually happens in rehab?" This is one of the most common questions families ask when considering treatment for a loved one. The uncertainty creates anxiety—both for the person entering treatment and for the family sending them.

Will they be comfortable? What will they do all day? How does treatment actually work? Will they be safe? What if they want to leave?

This comprehensive guide walks you through every phase of drug rehabilitation, from the moment of arrival to graduation day. Understanding the process helps families make informed decisions and supports the person in treatment by knowing what to expect.

While specific details vary by program, this guide focuses on comprehensive, residential treatment programs like Narconon Africa, which provide 3-6 months of intensive, drug-free treatment.

Before Arrival: The Admission Process

Initial Contact and Assessment

Treatment begins before the person ever arrives at the facility. The admission process typically includes:

Phone consultation: Family or the individual calls the helpline to discuss the situation, substance use history, and treatment needs.

Assessment: A trained counselor conducts a detailed assessment covering:

• Substances used (type, frequency, amount, duration)
• Previous treatment attempts
• Medical history and current health status
• Mental health history
• Legal issues
• Family situation and support system
• Motivation and readiness for treatment

Medical clearance: For safety, most programs require recent medical evaluation to identify health issues that need attention during treatment.

Financial arrangements: Discussion of program costs, payment options, and insurance (if applicable).

Travel planning: For international clients or those traveling from other provinces, assistance with flights, visas, and transportation from the airport.

What to Bring

Most programs provide a packing list, typically including:

Clothing: Comfortable, casual clothing for 1-2 weeks (laundry facilities available), including exercise clothes, swimwear, warm layers for evenings

Toiletries: Personal hygiene items (most facilities provide basics if needed)

Medications: Current prescriptions in original bottles (will be managed by medical staff)

Personal items: Photos, journal, books (non-drug-related), comfort items

What NOT to bring: Alcohol, drugs, drug paraphernalia, weapons, excessive valuables, revealing clothing, items with drug references

The Day Before

The night before entering treatment is often filled with mixed emotions: hope, fear, relief, anxiety. This is normal. Many people experience:

• Last-minute doubts ("Maybe I don't really need this")
• Fear of the unknown
• Grief about leaving family
• Worry about work, responsibilities, pets
• Relief that help is finally coming
• Determination to succeed

Families should:

• Reassure their loved one that this is the right decision
• Avoid emotional confrontations or bringing up past hurts
• Help with practical preparations (packing, arrangements)
• Express love and confidence in their ability to recover
• Avoid "one last" anything (meal, conversation, etc.) that creates drama

Day 1: Arrival and Orientation

Arrival

Most people arrive at the facility in the morning or early afternoon. The arrival process is designed to be welcoming and reduce anxiety:

Greeting: Staff members welcome the new arrival warmly, understanding that this is a vulnerable moment.

Tour: A staff member provides a tour of the facility, showing:

• Living quarters (bedroom, bathroom, common areas)
• Dining area
• Program spaces (classrooms, counseling rooms, exercise areas)
• Outdoor areas and amenities
• Emergency exits and safety features

Belongings check: Staff review belongings to ensure no prohibited items were brought. This isn't punitive—it's for everyone's safety.

Medical intake: A medical professional conducts a health assessment, takes vital signs, reviews medical history, and discusses any immediate health concerns.

Orientation: Introduction to program rules, daily schedule, expectations, and what to expect in the first few days.

The First Few Hours

The first day is intentionally low-key. The person is likely exhausted—physically from drug use and travel, emotionally from the decision to enter treatment. The focus is on:

Rest: Time to settle into their room, unpack, and rest.

Nutrition: A healthy meal (many people entering treatment are malnourished).

Hydration: Plenty of water and electrolyte drinks.

Initial connection: Meeting their primary counselor or case manager who will guide them through treatment.

Meeting other residents: Informal introduction to others in the program (this often provides immediate relief—"I'm not alone").

What Families Can Expect

Most programs have specific communication policies for the first few days:

Limited contact: Many programs restrict phone calls and visits for the first 3-7 days. This isn't punishment—it's to help the person focus on treatment without outside distractions during the critical early period.

Update calls: Staff typically call family within 24-48 hours to confirm safe arrival and how the person is settling in.

Patience: The first few days are an adjustment. The person may be emotional, uncertain, or even regretful. This is normal and usually passes within a week.

Days 2-7: Withdrawal and Stabilization

The Withdrawal Phase

For most people, the first week involves managing withdrawal symptoms. The intensity depends on:

• The substance(s) used
• Duration and severity of addiction
• Individual physiology
• Whether medical detox is needed

Medical detoxification (for alcohol, benzodiazepines, severe opioid dependence):

• 24/7 medical supervision
• Medication to manage dangerous symptoms (seizures, severe agitation)
• Vital signs monitoring
• Gradual tapering of substances when medically necessary
• Transition to drug-free status as soon as safely possible

Drug-free withdrawal support (for most other substances):

• 24/7 staff supervision
• Nutritional support (vitamins, minerals, healthy meals)
• Hydration
• Rest and sleep support
• Gentle physical activity when able
• Emotional support and reassurance
• No substitute drugs (no methadone, Suboxone, or psychiatric medications)

Common Withdrawal Symptoms by Substance

Opioids (heroin, prescription painkillers):

• Flu-like symptoms (aches, chills, sweating)
• Nausea, vomiting, diarrhea
• Anxiety and restlessness
• Insomnia
• Intense cravings
• Duration: 5-10 days for acute symptoms

Alcohol and benzodiazepines:

• Anxiety and panic
• Tremors
• Sweating
• Nausea
• Seizures (potentially life-threatening—requires medical management)
• Hallucinations (in severe cases)
• Duration: 3-7 days for acute symptoms, weeks for psychological symptoms

Stimulants (cocaine, methamphetamine):

• Extreme fatigue and need for sleep
• Increased appetite
• Depression and anhedonia (inability to feel pleasure)
• Anxiety
• Intense cravings
• Duration: 1-2 weeks for acute symptoms, months for brain healing

Marijuana:

• Irritability and mood swings
• Insomnia
• Decreased appetite
• Anxiety
• Mild physical discomfort
• Duration: 1-2 weeks

Daily Routine During Withdrawal

The schedule during withdrawal is flexible and focused on comfort and safety:

Morning:

• Wake naturally (sleep is prioritized)
• Light breakfast (as tolerated)
• Vital signs check
• Brief check-in with medical staff

Midday:

• Nutritious lunch
• Rest or gentle activity (short walks if feeling able)
• Hydration focus

Afternoon:

• Light activities (reading, journaling, art)
• Beginning to attend some group activities (as able)
• Snacks and continued hydration

Evening:

• Dinner
• Relaxation activities
• Sleep support (comfortable environment, sleep aids if needed)

Throughout the day:

• Staff check-ins every few hours
• Medical monitoring as needed
• Emotional support
• Reassurance that symptoms are temporary

What Families Experience

The first week is often the hardest for families:

Worry: "Are they okay? Are they in pain? Do they hate me for sending them?"

Guilt: "Should I have done this sooner? Is this the right place?"

Relief: "Thank God they're safe and getting help."

Impatience: "When will they be better? When can I talk to them?"

What helps:

• Trust the process—withdrawal is temporary
• Understand that limited contact is therapeutic, not punitive
• Focus on your own self-care and support (family support groups, therapy)
• Avoid calling constantly for updates (staff will contact you if there's a problem)
• Prepare for the first phone call (the person may be emotional, uncertain, or even angry—this doesn't mean treatment isn't working)

Days 8-30: Early Treatment Phase

Physical Stabilization

By the second week, most people are through acute withdrawal and beginning to feel physically better. The focus shifts to:

Nutrition: Regular, healthy meals to repair malnutrition. Many people gain healthy weight during this phase.

Exercise: Gradual return to physical activity (walking, swimming, yoga, gym). Exercise helps with mood, sleep, and brain healing.

Sleep normalization: Establishing healthy sleep patterns (often disrupted by drug use).

Medical care: Addressing health issues that emerged during addiction (dental problems, infections, chronic conditions).

Beginning the Therapeutic Work

With physical stabilization underway, the real therapeutic work begins:

Individual counseling: One-on-one sessions with a primary counselor to:

• Explore the history of addiction
• Identify triggers and patterns
• Address underlying issues (trauma, mental health, family dynamics)
• Set recovery goals
• Begin developing coping strategies

Group therapy: Daily group sessions where residents:

• Share experiences and challenges
• Learn from others' insights
• Practice communication skills
• Build supportive relationships
• Reduce shame and isolation

Educational sessions: Classes on:

• The science of addiction
• How drugs affect the brain and body
• Recognizing triggers and cravings
• Understanding relapse patterns
• Introduction to recovery principles

Life skills training: Beginning to learn practical skills:

• Stress management
• Emotional regulation
• Communication skills
• Problem-solving
• Time management

Daily Schedule (Typical Day)

7:00 AM - Wake up, personal time, breakfast

8:30 AM - Morning meeting (community gathering, announcements, motivational start)

9:00 AM - Individual counseling or therapy session

10:30 AM - Educational session (addiction science, recovery principles)

12:00 PM - Lunch

1:00 PM - Group therapy session

2:30 PM - Life skills workshop (communication, stress management)

4:00 PM - Physical activity (exercise, sports, yoga, swimming)

5:30 PM - Personal time (rest, reading, journaling, socializing)

6:30 PM - Dinner

7:30 PM - Evening group (reflection, peer support, planning for next day)

9:00 PM - Personal time, prepare for bed

10:30 PM - Lights out (quiet time, sleep)

Emotional Ups and Downs

The early treatment phase is emotionally volatile:

The "pink cloud": Days 7-14, many people experience a honeymoon period—relief, optimism, energy, gratitude. This is wonderful but temporary.

The crash: Days 14-21, reality sets in. The person realizes recovery is hard work. They miss home, doubt their ability to succeed, feel overwhelmed. This is normal and expected.

Stabilization: Days 21-30, emotions begin to stabilize. The person settles into the routine, forms connections with others, and begins to engage more deeply with treatment.

Family Contact

Most programs allow increased contact after the first week:

Phone calls: Usually 1-2 scheduled calls per week (15-30 minutes)

Letters and emails: Encouraged (but monitored for safety)

Visits: Some programs allow family visits after 2-4 weeks (with guidelines)

Family therapy: Many programs begin involving family in therapy sessions

What to expect in calls:

• The person may be emotional (crying, angry, homesick)
• They may ask to come home (don't agree—this is normal ambivalence)
• They may share insights and progress
• They may complain about rules or other residents
• They may express gratitude and love

How to respond:

• Listen without judgment
• Offer encouragement and love
• Avoid solving problems for them
• Don't agree to early discharge
• Share positive news from home (but avoid drama)
• Express confidence in their ability to succeed

Days 31-90: Core Treatment Phase

Deep Therapeutic Work

Months 2-3 are where the most significant therapeutic progress happens. The person is physically stable, emotionally more regulated, and ready for deeper work:

Trauma processing: Many people with addiction have unresolved trauma. This phase involves:

• Identifying traumatic experiences
• Processing emotions related to trauma
• Developing healthy coping strategies
• Reducing trauma's power over current behavior

Addressing root causes: Why did addiction develop? Common issues include:

• Childhood adversity (abuse, neglect, household dysfunction)
• Untreated mental health conditions (depression, anxiety, ADHD, PTSD)
• Relationship problems
• Loss and grief
• Identity and purpose issues
• Chronic pain or illness

Cognitive restructuring: Changing thought patterns that support addiction:

• Identifying distorted thinking (all-or-nothing, catastrophizing, victim mentality)
• Challenging negative beliefs about self and recovery
• Developing healthier perspectives
• Building self-efficacy and confidence

Relationship repair: Beginning to address damaged relationships:

• Understanding how addiction hurt others
• Taking responsibility without drowning in guilt
• Learning to communicate honestly
• Setting healthy boundaries
• Rebuilding trust gradually

Advanced Life Skills Training

This phase includes intensive skill development:

Communication skills:

• Assertiveness (expressing needs without aggression or passivity)
• Active listening
• Conflict resolution
• Giving and receiving feedback

Emotional regulation:

• Identifying and naming emotions
• Tolerating uncomfortable feelings without using drugs
• Healthy expression of emotions
• Self-soothing techniques

Problem-solving:

• Identifying problems clearly
• Generating multiple solutions
• Evaluating consequences
• Making decisions and following through

Stress management:

• Recognizing stress triggers
• Relaxation techniques (breathing, meditation, progressive muscle relaxation)
• Time management and prioritization
• Saying no and setting limits

Social skills:

• Making new friends
• Navigating social situations without drugs
• Identifying healthy vs. unhealthy relationships
• Building a sober support network

Specialized Components (Narconon Program)

Narconon's program includes unique components during this phase:

New Life Detoxification Program:

• Sauna-based detoxification to remove drug residues from fatty tissues
• Exercise and nutritional supplementation
• Reduces physical cravings by eliminating stored toxins
• Typically 2-4 weeks, done after initial withdrawal

Objectives (Communication Training):

• Drills that improve communication ability and present-time awareness
• Helps people become more comfortable in their environment
• Reduces anxiety and improves interpersonal skills
• Builds confidence and self-control

Life Skills Courses:

• The Ups and Downs in Life Course (how to identify and handle suppressive people)
• The Personal Values and Integrity Course (rebuilding personal ethics and self-respect)
• The Changing Conditions in Life Course (how to improve any area of life)

Physical and Mental Health Improvement

By month 2-3, significant improvements are visible:

Physical health:

• Healthy weight gain or loss (normalizing)
• Clear skin and bright eyes
• Improved sleep quality
• Increased energy and stamina
• Better overall health markers

Mental health:

• Reduced anxiety and depression (as brain chemistry normalizes)
• Improved mood stability
• Better concentration and memory
• Clearer thinking
• Reduced cravings

Social functioning:

• Improved relationships with other residents
• Better communication with family
• Increased empathy and emotional awareness
• Reduced self-centeredness
• Growing sense of responsibility

Family Involvement

Family participation increases during this phase:

Family therapy sessions: Regular sessions (in-person or video) to:

• Educate family about addiction and recovery
• Address family dynamics that may have contributed to addiction
• Heal relationships
• Prepare for the person's return home
• Establish healthy boundaries and expectations

Family education: Workshops or materials covering:

• Understanding addiction as a family disease
• Recognizing enabling behaviors
• Setting healthy boundaries
• Supporting recovery without controlling
• Taking care of yourself

Family visits: If geography allows, visits help:

• Reconnect in a healthy environment
• See the person's progress firsthand
• Participate in family therapy
• Learn about the program
• Build confidence in recovery

Days 91-180: Advanced Treatment and Transition Planning

Consolidation and Integration

The final months of treatment focus on consolidating gains and preparing for life after rehab:

Mastery of skills: Practicing life skills until they become automatic, not just intellectual knowledge.

Real-world application: Applying skills to increasingly complex situations and challenges.

Identity development: Building a new identity as a person in recovery, not just "an addict."

Purpose and meaning: Discovering or rediscovering purpose, values, and goals beyond just staying sober.

Relapse prevention: Developing a detailed, personalized plan for maintaining sobriety.

Relapse Prevention Planning

A comprehensive relapse prevention plan includes:

Trigger identification: Detailed list of personal triggers:

• People (specific individuals who trigger cravings)
• Places (locations associated with drug use)
• Things (objects, paraphernalia, money)
• Emotions (stress, anger, loneliness, boredom, even happiness)
• Situations (parties, conflicts, success, failure)

Coping strategies: Specific actions for each trigger:

• Avoidance (when possible)
• Escape plan (when avoidance isn't possible)
• Alternative behaviors (what to do instead of using)
• Support contacts (who to call)
• Self-soothing techniques

Warning signs: Early indicators of relapse risk:

• Behavioral (isolating, lying, skipping meetings)
• Emotional (irritability, depression, overconfidence)
• Cognitive (romanticizing past use, thinking "just once won't hurt")
• Physical (poor sleep, neglecting health)

Support system: Building a network:

• Sober friends and mentors
• Support groups (if desired)
• Therapist or counselor
• Family members who understand recovery
• Activities and hobbies that provide meaning

Emergency plan: What to do if cravings become overwhelming:

• Crisis contacts (24/7 helpline, sponsor, therapist)
• Safe places to go
• Immediate actions to take
• When to seek additional help

Transition Planning

Preparing for life after treatment:

Living situation: Where will the person live?

• Returning home (with family support and clear boundaries)
• Sober living facility (transitional housing with structure and accountability)
• Independent living (if appropriate and supported)

Work or school: What will the person do?

• Returning to previous job (if healthy environment)
• Finding new employment
• Vocational training
• Returning to school

Support structure: How will ongoing support be maintained?

• Outpatient therapy or counseling
• Support groups (if desired)
• Regular check-ins with treatment program
• Sober activities and social connections

Practical matters:

• Legal issues (court dates, probation, fines)
• Financial recovery (debt, budgeting, employment)
• Relationship repair (ongoing family therapy)
• Health care (ongoing medical or dental treatment)

Graduation Preparation

The final weeks include:

Graduation ceremony: Most programs hold a ceremony where:

• The person shares their journey and insights
• Family attends and celebrates
• Other residents offer support and encouragement
• Staff recognize achievements
• The person receives a certificate or completion recognition

Final assessments: Evaluating progress and identifying ongoing needs

Aftercare planning: Detailed plan for the first 90 days after discharge

Alumni connection: Introduction to program alumni network for ongoing support

What Happens After Rehab?

The First 90 Days

The first three months after treatment are the most vulnerable:

Continued support: Most successful programs include:

• Regular check-in calls or video sessions
• Outpatient therapy
• Alumni groups
• 24/7 crisis support

Gradual reintegration: Slowly returning to normal life:

• Starting with low-stress situations
• Gradually increasing responsibilities
• Building new routines and habits
• Avoiding high-risk situations

Ongoing skill practice: Recovery skills must be practiced daily, not just when crisis hits.

Long-Term Recovery

Recovery is a lifelong journey, not a destination. Long-term success requires:

Continued growth: Always working on personal development, relationships, and life skills

Vigilance: Remaining aware of triggers and warning signs

Support: Maintaining connections with others in recovery

Purpose: Building a meaningful life that doesn't include drugs

Self-care: Prioritizing physical, mental, and emotional health

Choosing the Right Program

What to Look For

Not all rehab programs are created equal. Essential elements include:

Sufficient length: Minimum 90 days, ideally 3-6 months for severe addiction

Comprehensive approach: Addressing physical, psychological, and life skills deficits

Drug-free philosophy: No substitute medications that create new dependencies

Individualized treatment: Personalized to each person's needs, not one-size-fits-all

Family involvement: Including family in treatment and recovery planning

Aftercare: Ongoing support after discharge, not just "good luck"

Qualified staff: Trained, experienced counselors and medical professionals

Safe, comfortable environment: Clean, secure, comfortable facilities

Evidence of success: High completion rates, low relapse rates, satisfied alumni

Red Flags

Avoid programs that:

• Promise quick fixes or guaranteed success
• Use substitute drugs (methadone, Suboxone) as primary treatment
• Have very short duration (less than 30 days)
• Lack medical supervision
• Have poor living conditions
• Don't involve family
• Have no aftercare plan
• Can't provide references or success data
• Use shame or punishment as treatment methods

Get Help Today

Understanding what happens in rehab reduces fear and increases confidence in the treatment decision. Comprehensive, drug-free treatment works—but only if the person enters treatment and stays long enough for real healing to occur.

Contact Narconon Africa for confidential help:

• 24/7 Helpline: +27 (0)800 014 559
• Website: www.narcononafrica.org.za
• Location: Magaliesberg Mountains, North-West Province, South Africa

Your loved one's recovery journey can begin today. The first step is reaching out for help.