Why Your Loved One Keeps Leaving Rehab Early: Understanding AMA Discharges

Authored by Chris Schumacher | Medically Reviewed by Dr. Elizabeth Drew,
Last Updated: June 30, 2025

Co-occurring mental health conditions significantly increase the likelihood of AMA discharges. When someone has untreated depression, anxiety, trauma, or other psychological issues alongside their substance use disorder, treatment becomes more complex and potentially more uncomfortable.

Depression can make the recovery process feel pointless or overwhelming. Someone experiencing depressive symptoms might convince themselves that treatment isn’t helping and that nothing will change regardless of whether they stay or leave.

Anxiety disorders can make the group therapy sessions, structured schedules, and social aspects of treatment feel unbearable. Rather than working through these challenges with professional support, some people choose to escape the anxiety-provoking environment altogether.

The Impact of Trauma and Attachment Issues

Trauma responses can be particularly disruptive to treatment engagement. As therapy begins to address underlying issues, traumatic memories or feelings may surface. Without proper preparation and coping skills, this can feel too threatening to continue facing.

People with personality disorders or significant attachment issues may struggle with the relationships formed in treatment, both with peers and staff. When conflicts arise or when they feel misunderstood, leaving can seem like the only solution.

Family dynamics play a crucial role in whether someone completes treatment or leaves early. Often without realizing it, families can inadvertently make it easier for their loved one to give up on treatment.

The most common way this happens is through what’s called “rescue behavior.” When your loved one calls with complaints about the facility, the food, their roommate, or their treatment team, the natural instinct is to want to fix these problems or validate their concerns. While this comes from a place of love, it can reinforce their desire to leave rather than work through challenges.

Some families make the mistake of negotiating with their loved one about treatment length or intensity. Comments like “Well, you’ve been there for 30 days, maybe that’s enough” or “You could probably do outpatient from home” send the message that incomplete treatment is acceptable.

Financial concerns can also inadvertently pressure someone to leave early. When families express worry about the cost of continued treatment, it gives the person in treatment permission to prioritize finances over their recovery needs.

Another way families contribute to early departures is by maintaining the same enabling patterns that existed before treatment. If your loved one knows they can return home to the same level of support and comfort they had before, there’s less motivation to do the difficult work of recovery.

There are usually signs that someone is considering leaving treatment before they actually make the decision. While AMA discharges occur in around two percent of all hospital stays nationally, the rates can be much higher in substance abuse treatment settings, making early recognition of warning signs crucial.

Complaints about the facility often escalate before someone leaves. While some concerns may be legitimate, a sudden increase in criticisms about everything from the food to the staff to other clients can signal that they’re building a case for leaving.

Changes in communication patterns are another red flag. Someone who was previously engaged in phone calls or family sessions may become distant, argumentative, or start missing scheduled communications altogether.

They might begin talking about external pressures or responsibilities that supposedly require their immediate attention. Work problems, family emergencies, or financial issues suddenly become urgent reasons why they need to leave treatment right away.

Another warning sign is when they start minimizing their need for treatment. Comments like “I’m not as bad as the other people here” or “I think I’ve learned what I need to know” often precede AMA discharges.

How you respond when your loved one expresses wanting to leave treatment can significantly influence their decision. The goal is to remain supportive of their recovery while not enabling their avoidance of necessary treatment.

First, avoid immediately trying to solve whatever problem they’re presenting. Instead of jumping in with solutions or validation, ask questions that help them think through their decision. Questions like “What do you think will be different if you leave now?” or “How do you plan to handle the situations that led to your need for treatment?” can be more effective than arguments or pleas.

Setting Boundaries and Consequences

It’s important to distinguish between legitimate concerns and manipulation. If your loved one is genuinely having problems with their treatment team or feels unsafe, these issues should be addressed. However, if the complaints seem designed to elicit sympathy or create reasons to leave, responding differently is important.

Setting clear boundaries about what will happen if they leave AMA is crucial. Many treatment centers and intervention professionals recommend that families create accountability letters that outline the consequences of leaving treatment early. These aren’t meant to be punitive, but rather to help your loved one understand the real-world implications of their decision.

Navigating AMA situations effectively usually requires professional support. Treatment centers, intervention specialists, and family recovery coaches can provide guidance specific to your situation and help you avoid common mistakes that families make.

Many families benefit from working with professionals who can communicate with both the treatment team and the family. This helps ensure that everyone has accurate information about what’s happening and can respond in ways that support continued treatment rather than enabling early departure.

Professional support also helps families understand the difference between supporting their loved one and supporting their addiction. This distinction becomes particularly important when someone is threatening to leave treatment.

Understanding why people leave treatment early is only part of the picture. The other crucial element is creating conditions that support long-term recovery success, whether someone completes their initial treatment program or needs multiple attempts.

Statistics show that 40 to 60 percent of individuals in treatment for substance use disorders will relapse, but this doesn’t mean treatment failed. The relapse rate for addiction is actually lower than relapse rates for other chronic diseases like hypertension and asthma at 50 to 70 percent.

Structure and accountability remain important even after treatment ends. Many people who leave AMA do so because they believe they can maintain sobriety without the intensity of residential or intensive outpatient treatment. However, without replacing that structure with something else, relapse becomes more likely.

Trust must be rebuilt gradually and based on consistent actions rather than promises. Families who immediately return to previous patterns of support after someone leaves AMA often find themselves dealing with the same problems that led to the need for treatment initially.

Multiple Attempts and Long-Term Hope

Re-engagement with treatment becomes necessary for most people who leave AMA. Rather than viewing this as failure, it’s helpful to understand that recovery often requires multiple attempts and different approaches. The key is learning from each experience and making adjustments that increase the likelihood of success.

Research shows that roughly 75 percent of individuals who experience addiction ultimately recover over time, highlighting that persistent efforts and multiple treatment episodes can pay off in the long run.

Dealing with repeated AMA discharges is exhausting and discouraging, but it doesn’t mean recovery is impossible. Many people who initially leave treatment early eventually find their way to lasting sobriety, often after experiencing the consequences of incomplete treatment.

The most important thing families can do is maintain their own recovery and well-being regardless of their loved one’s treatment decisions. This means continuing to set healthy boundaries, seeking support for yourselves, and not allowing your loved one’s choices to derail your own healing process.

Recovery is ultimately a personal decision that each individual must make for themselves. While families can create conditions that support recovery or make continued addiction more difficult, they cannot force someone to want sobriety. Understanding this can be both challenging and liberating for families who have been trying desperately to control outcomes they cannot control.

If your loved one continues to struggle with completing treatment, remember that professional help is available for both them and your family. Recovery is possible, but it often requires patience, persistence, and the willingness to try different approaches until you find what works.

Watching someone you love repeatedly leave treatment early can feel overwhelming and hopeless. At Peace Valley Recovery, we understand the unique challenges families face when dealing with AMA discharges and incomplete treatment attempts.

Our experienced team specializes in helping both individuals and families navigate these complex situations with compassion and expertise. We’re here around the clock to provide guidance, support, and evidence-based treatment options tailored to your specific needs.

Don’t let another failed attempt discourage you from seeking help. Call us at (267) 489-2681 or contact us online – together, we can find a path forward that works for your family.