Treatment for Drug Abuse
Treatment for Drug Abuse
There are so many questions about treatment for alcoholism and drug addiction, and there so many forms of treatment that can be effective, but exactly which form of treatment is right for you is the most important question to be asked. It is not our intent to sidestep this question. Rather, we want to help you ask the right questions.
To understand why treatment is or is not effective, factor in three major areas of concern—body, mind and spirit.
Body: Medical issues
Mind: Cognitive/Emotional/Psychological Issues
Soul: Spiritual Issues
Regardless of religion, or lack of religion, regardless of belief in God or a higher power, or no belief at all, we are spiritual beings. Not accepting that simple fact makes a huge different in our ability to go through treatment and recovery, and live a healthy, fulfilling life. Whether one is an atheist or a Bible-believing Christian, or a Muslim, or a Hindu, we all share the human experience, and there are an infinite number of ways that the billions of people on this planet can relate to spiritual matters.
In treatment, one size does not fit all and so it is important to understand that any treatment program must be individually designed to meet the specific needs of the person, body, mind and soul.
Given those three major areas of concern, getting back on track for a person involves three major steps: Detoxification, Treatment and Recovery, so the area of treatment must include all three.
The fear of withdrawal is often more difficult for an addict/alcoholic to deal with than the disease itself. If you have ever experienced a hangover, for example, you understand the discomfort of mild alcohol withdrawal. You had “one too many” last night and you have a headache, so you may reach for the aspirin bottle for relief.
Your body wants to get back to “normal,” which means getting rid of the poison or toxins in your system. Your body is trying to regain balance and the substance is an intruder. Detox is the withdrawal process and just the anticipation of feeling bad is enough for some to avoid going to treatment.
People often think they can bypass this step in the process to detox at home, without medical assistance. This is a bad idea. Detoxification procedures are personally designed to meet the individual needs of the person. Without medical intervention, withdrawal can be agonizing and in some cases fatal. We recommend medical detox because it is safer and can offer comfort measures to avoid the extreme physical agony.
We should also point out that the detoxification process does not mean the person is no longer an addict/alcoholic; far from it. It just means that the medical risk is no longer the concern and the person is ready to move into the rehabilitation stage of his/her program. Moreover, rehabilitation programs are more than just keeping the person from using, which we will go into later.
The advantage to medical detox is it lessens the dreadful withdrawal symptoms that accompany “cold turkey” attempts at getting off a substance. Most of the time people do not succeed trying to do this on their own. Going back to using is easier and more comfortable.
Another factor that needs to be considered is people who use opiates, such as heroin or prescription medications, will not have life-threatening withdrawal symptoms. They will be uncomfortable, but not necessarily at risk of dying. The withdrawal is miserable, agonizing, so the lesser of two “evils” for them is to use. Alcoholics are in a different category, as their withdrawal can be deadly.
Medical detox will follow a carefully designed plan for the patient. The user’s drug of choice presents individual challenges, so the procedures are geared towards meeting those needs. Each drug has its own symptoms of withdrawal and complications, so it’s necessary to individualize the process to keep the patient safe and as comfortable as possible.
Patients can detox in-patient or out-patient. The out-patient programs are still under medical supervision, but the patient is at home. The doctor with prescribe the requisite medications to ease the patient off the drug and monitor the situation over the phone.
The out-patient takes longer, as there is no close medical supervision, and the biggest risk is that the withdrawal symptoms will be too much to tolerate and the patient goes back to using again. Another problem can arise when the person trades one drug for another, such as patients to abuse Suboxone, which was prescribed for opiate withdrawal.
In-patient detoxification is under much more controlled situations. The person has round-the clock medical care in a hospital or residential facility. Be careful when selecting a facility, because you need to be sure that there is proper medical staff at hand, not just a room to sleep in. When a patient hits a “bad patch” they can make the proper adjustments, a medical intervention that will ease discomfort and anxiety. A medical facility will also tend to dietary needs and facilitate social interaction. Going to an in-patient facility is also faster, because there are so many controls.
Once a person has gone through detoxification and is in a position to receive information and encouragement to begin rebuilding their lives, the treatment or rehabilitation phase begins. This is particularly difficult because people will naturally resist anything that prevents them from doing what they want, where they want to and when they want to do it. Amy Winehouse’s famous song illustrates this. “They say I should go to rehab and I said no, no, no.” It’s a chilling reminder that rehab is serious business and people who minimize or try to short-circuit a program are only fooling themselves.
In selecting a treatment program there are several important factors to keep in mind, not the least of which is we are all different. No two people are alike so it is necessary to design treatment programs to meet individual needs. No treatment center is going to guarantee that the program will be completely successful for every patient. That just doesn’t happen, but given the individuality of each program, keep trying if you fail. People as how many times does it take to get better, but that depends on the person. Each person has different needs, so any treatment program may require a different approach if one is not successful.
Here are a few tips to consider when beginning your search. We talked about detoxification and the need for proper medical treatment, so that is an important first consideration when making your selection. Do they have 24/7 medical care? Remember that we are all body, mind and spirit, so is there should be an interdisciplinary team on hand to meet individual needs.
Hospitals, for example, have doctors and nurses of course, but there are also respiratory therapists, physical therapists, occupational therapists, behavioral health professionals, chaplains, etc. to meet the body, mind and spirit needs. Each discipline has its own certification process, which is easily verified, so do not be afraid to ask questions about the qualifications of the staff.
For example, ask if the medical team is certified in addiction medicine, or do they have an addiction psychiatrist?. That sounds fundamental enough, but it’s an important question.
We are all so different, so the approach to rehab is very personal. The relationship a person has with a drug may not be the only issue to deal with during rehab, so you need to make sure that the facility has the capability to diagnosing more than one problem. There is great controversy surrounding rehab, because much of what is passed on as fact is really opinion. Just because a person has gone through detox and might even be feeling a little better, that is only the first step. The successful rehab program teaches us how to manage our disease and learn to live within healthy boundaries, through both individual and group sessions, not just relating to substance abuse but to lifestyle choices, nutrition and physical fitness.
Here’s another important factor to consider in treatment, the family. Treatment centers also understand that addiction is a family disease and each member of the family has a role to play in the recovery of an addict. Is there a family therapy program? The program must include sensitivity to gender issues, sexual orientation, race and ethnicity. The pathway to becoming clean and sober is not just limited to the physiological issues, it must include the entire scope of human experience.
Counselors and therapists will employ a variety of theories and techniques to help the individual through the rehab process. This is another important area to consider when choosing the right rehabilitation program. Here are a few examples of approaches that behavioral health professionals will use in helping patients.
This is the disease model of addiction. This theory suggests that addiction is purely a physiological problem. For example, one of the aspects is temperament and this model would suggest that human temperament is a physiological phenomenon, nothing more, and some temperaments are more predisposed to addiction than others. The points they examine for diagnosis are heredity, anatomy, physiology and biochemistry. They exclude the impact of personal history or any spiritual component.
Most people have heard of Sigmund Freud, who was the father of psychoanalysis. You are familiar with the scene of a patient lying on a couch talking about their childhood. This theory would argue that drug addiction is caused by unresolved conflicts and repressed anxieties. The therapist would use free association, memories, dreams and tests like the ink blots to make a diagnosis. The therapist will probe the unconscious and try to identify defense mechanisms. They assume some childhood anxiety is at the root of your defensiveness, and somehow using drugs is a coping tool.
The therapist using this model is looking for incongruence. Say for example, that you are asked how you feel. You render a deep sigh and replay with a droopy face, “Oh, I’m OK.” That’s incongruence. They would view drug addiction as being a problem, because it limits or denies self-actualization. It is all based on the patient’s reporting of their attitudes and feelings.
The operative word is learned. Drug addiction would be considered a maladaptive behavior, caused by deficiency in learning—that is, you’re not learning the right things. Drugs are a conditioned response. You take drugs, you feel good and you want more. Therefore, you have to unlearn that maladaptive response.
This perspective integrates all of aforementioned approaches. Borrowing from all four, a spiritual component is added. This is “soul care” and is an integrated, holistic approach to the problem. A prime example is the 12 Step process, although it is not, by definition, a faith-based method, as practiced by Alcoholics Anonymous. It encompasses all of the theories, but also addresses the helplessness of addiction by introducing the idea of a “Higher Power” and “God, as we understood him” to help the individual deal with the changes. Many religious groups have embraced this approach, adding their own belief system to the process.
Treatment is designed to restore the individual to his/her family and life. Treatment, however, is really just the beginning. A person is well advised to become a part of the recovery community to maintain healthy choices and have access to emotional support when dealing with difficult moments.
What does it mean when a person says, “I’m in recovery?” They have gone through treatment and they’re back on their own, trying to stay clean and sober. They are not using. If a person is using, they are not in recovery.
Availability Critical for Drug abuse programs
Everything needs to be in place in order for drug abuse programs to be effective. If a person is in need of treatment, treatment needs to be available.
If a person is put on a waiting-list, or if there is not treatment available in their community, or perhaps a short distance away, the degree of difficulty increases.
By the time people are entering drug abuse programs, in so many cases, they have lost their driving privileges, or they’ve recently lost their job, or worse yet, they have nowhere to live. In many cases the drug abuse programs have been ordered by a judge. Regardless of the circumstances, people need services, individual services to meet the needs of their condition.
Some people who enter drug abuse programs must first go through medical detoxification, which in effect gets the drug out of their system, but that isn’t the answer to the problem. While they may not have the drugs in their system, patients completing detoxification needs to begin work on managing their drug addiction.
In-Patient can be either short-term or long-term, depending on the needs of the patient, and all too sadly, the patient’s ability to pay. People have a busy schedule of therapy sessions, which are not limited to drug addiction but can include job counseling, socialization skills, etc. The day is filled from early morning to bedtime.
Out-Patient can be very similar only sometimes people just come in for their therapy sessions, but are well enough to go home at the end of the day. These programs are well-designed for people with jobs, people who have family support and access to resources.
Drug abuse programs Take Time
Drug rehabilitation programs can be long and arduous and because of that people need encouragement to stick with it and finish. According to research statistics, drug recovery patients will reach a milestone in their recovery after three months, but that doesn’t necessarily mean that the treatment program is finished, or that additional treatment will not be helpful.
When people leave their treatment programs early, and do not hit that all important stage in their recovery, their chances for full recovery drop. Even with full completion of the program, patients can fail and need to return to treatment. It’s important to stay with it.
While in drug abuse programs patients need to stay off drugs. This is a minimum expectation, but centers will inspect wheat they expect, and drug testing is routine. If a patient relapses and uses during treatment, the program will require modification to meet the needs of the patient.
Even if a patient makes it through the program, there is a change they may fail sometime in the future, and therefore, some people need to go back into treatment to completely manage the addiction problem. People fail. But it’s important to remember that the person’s health is most important, so if it takes two or three attempts, or more, so be it.
Whether in-patient or out-patient, drug abuse programs can vary in intensity and length, and so careful examination of each program is necessary to make the best choice of treatment.
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HOW TO USE THIS SITE:
Read these five pages and learn what you need to know to spot Addiction to Drugs in:
Yourself… Your Family… Your Friends… Your Community…
The rest of the pages are there for your reference to explain important topics in more detail.
Finally don’t miss the Spiritual and 12-step sections to fully explore how understanding THE SPIRIT can lead to recovery!