Which form of addiction treatment is right for you? Part One
by Ned Wicker
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.