Treatment:

Aspects of Recovery

What is Treatment?

Making the decision to address alcohol and drug use is both the best decision you can make-it is also one of the most difficult paths to navigate and find the right fit for you to meet your individual needs.  Its confusing at best and at worst, many, many people just give up.  Please don’t give up on you!  I have tried to describe and break down the process in the following.  As always, please shoot me an email if you have questions and just need some answers.  

Drug & Alcohol treatment is a professional  implementation of a variety of  medical and/or behavioral ‘tools’ to help addicted individuals stop compulsive alcohol and/or drug seeking and use. Treatment occurs in a variety of settings, take many different forms, and last for different lengths of time.  Treatment is addressing the psychological, social, and behavioral problems associated with addiction and promises the hope of producing lasting behavioral changes necessary for recovery.

Because drug addiction is typically a chronic disorder characterized by occasional relapses, a short-term, one-time treatment is usually not sufficient. For many, treatment is a long-term process that involves multiple interventions and regular monitoring.

Aspects of treatment for alcohol and drug abuse include assessments, treatment planning, pharmacotherapy, behavioral therapy, substance use monitoring, case management, support groups, and continuing care as well as child Care, vocational, mental health, medical, educational, HIV/AIDS, legal, financial, housing/transportation, and family services.

Why Choose Treatment?

Alcohol and substance use disorders play no favorites as to why and how alcohol or drug use began.  Regardless of the initial reason, and often for numerous reasons, dependency on drugs or alcohol happens.  But how alcohol and drug use developed  is an important piece in choosing treatment.

If alcohol or drug use is negatively impacting your life, whether that is your health, your relationships, your job, or legally; when deciding to stop using alcohol or drugs is no longer possible for you on your own; when alcohol or drug use has become a physical or emotional need, then it may be time to seek professional treatment.

Alcohol  and/or drug addiction treatment typically have classified programs into several general types or modalities. Treatment approaches and individual programs continue to evolve and diversify, and many programs today do not fit neatly into traditional drug addiction treatment classifications.

Most treatment programs, however, start with detoxification and/or medically managed withdrawal, often considered the first stage of treatment. Detoxification, the process by which the body is cleared of drugs, is designed to manage the acute and potentially dangerous physiological effects of stopping drug use.

Detoxification alone does not address treatment however-treatment is addressing the psychological, social, and behavioral problems associated with addiction and promises the hope of producing lasting behavioral changes necessary for recovery.

Detoxification should be followed by a formal assessment and referral to drug addiction treatment.

Note:  Because it is often accompanied by unpleasant and potentially fatal side effects stemming from withdrawal, detoxification is often managed with medications administered by a physician in an inpatient or outpatient setting; therefore, it is referred to as “medically managed withdrawal.” Medications are available to assist in the withdrawal from opioids, benzodiazepines, alcohol, nicotine, barbiturates, and other sedatives.

 

Assessments

Regardless of which type of treatment or detox you are looking for, you will undergo a Screening and an Assessment.

Detox

Detox is not treatment, but a necessary and initial part of your recovery.  This process allows for (usually) a medically managed and safe, time limited, physical withdrawal from substances.  

Group Therapy

We humans are naturally social beings, and many of us are drawn to each other which makes  group therapy a powerful therapeutic tool for treating substance abuse.  Groups can be as helpful as individual therapy, and sometimes more successful, if they are facilitated by qualified and competent counselors skilled with substance use disorders and co-occurring disorders.   

Groups have many rewarding benefits—such as reducing isolation and enabling members to witness the recovery of others—and these qualities draw clients into a culture of recovery. Another reason groups work so well is that they are suitable especially for treating problems that commonly accompany substance abuse, such as depression, isolation, and shame.

Individual Counseling

Addiction is more than a physical dependence on drugs or alcohol. Even after detox, when your body is no longer hooked, you’re at high risk for relapse. Certain psychological and social factors can be powerful triggers that lead to relapse:

  • Stress, especially sudden life stresses
  • Cues in the environment, like visiting a neighborhood
  • Social networks, like spending time with friends who continue to use 

These things can create a strong ongoing urge to use again. Counseling helps you escape cravings and learn to manage what life throws at you without drugs or alcohol.

Long-Term Residential Treatment

Long-term residential treatment provides care 24 hours a day, generally in non-hospital settings. The best-known residential treatment model is the therapeutic community (TC), with planned lengths of stay of between 6 and 12 months. TCs focus on the “resocialization” of the individual and use the program’s entire community—including other residents, staff, and the social context—as active components of treatment. Addiction is viewed in the context of an individual’s social and psychological deficits, and treatment focuses on developing personal accountability and responsibility as well as socially productive lives. Treatment is highly structured and can be confrontational at times, with activities designed to help residents examine damaging beliefs, self-concepts, and destructive patterns of behavior and adopt new, more harmonious and constructive ways to interact with others. Many TCs offer comprehensive services, which can include employment training and other support services, onsite. Research shows that TCs can be modified to treat individuals with special needs, including adolescents, women, homeless individuals, people with severe mental disorders, and individuals in the criminal justice system

Short-Term Residential Treatment

Short-term residential programs provide intensive but relatively brief treatment based on a modified 12-step approach. These programs were originally designed to treat alcohol problems, but during the cocaine epidemic of the mid-1980s, many began to treat other types of substance use disorders. The original residential treatment model consisted of a 3- to 6-week hospital-based inpatient treatment phase followed by extended outpatient therapy and participation in a self-help group, such as AA. Following stays in residential treatment programs, it is important for individuals to remain engaged in outpatient treatment programs and/or aftercare programs. These programs help to reduce the risk of relapse once a patient leaves the residential setting.  Currently,  average stay s in Short -Term residential treatments are 21 days; with some as brief as 7 days and up to 28-30. 

Please note:  This does not include Detox-Detox is not treatment.  When a person enters into a medically monitored detoxification program, the focus should be primarily upon managing the symptoms of withdrawal.  There may be exposure to counselors and therapy, but for the majority of people, medications to control physical withdrawals impact the ability to engage in treatment.  Read more about residential treatment below.

Outpatient Treatment Programs

Outpatient treatment varies in the types and intensity of services offered. Such treatment costs less than residential or inpatient treatment and often is more suitable for people with jobs or extensive social supports. It should be noted, however, that low-intensity programs may offer little more than drug education. Other outpatient models, such as intensive day treatment, can be comparable to residential programs in services and effectiveness, depending on the individual patient’s characteristics and needs. In many outpatient programs, group counseling can be a major component. Some outpatient programs are also designed to treat patients with medical or other mental health problems in addition to their drug disorders.

Individualized Drug Counseling

Individualized drug counseling not only focuses on reducing or stopping illicit drug or alcohol use; it also addresses related areas of impaired functioning—such as employment status, illegal activity, and family/social relations—as well as the content and structure of the patient’s recovery program. Through its emphasis on short-term behavioral goals, individualized counseling helps the patient develop coping strategies and tools to abstain from drug use and maintain abstinence. The addiction counselor encourages 12-step participation (at least one or two times per week) and makes referrals for needed supplemental medical, psychiatric, employment, and other services.

Group Counseling

Many therapeutic settings use group therapy to capitalize on the social reinforcement offered by peer discussion and to help promote drug-free lifestyles. Research has shown that when group therapy either is offered in conjunction with individualized drug counseling or is formatted to reflect the principles of cognitive-behavioral therapy or contingency management, positive outcomes are achieved. Currently, researchers are testing conditions in which group therapy can be standardized and made more community-friendly.

https://www.drugabuse.gov/

Methadone Treatment for Opioid Use Disorder

A methadone clinic is a treatment facility for a person addicted to opioid drugs, like heroin or prescription painkillers. Methadone clinics are also known as Opioid Treatment Programs (OTP). Patients receive treatment medication, such as methadone, to stabilize the body from unbearable withdrawal symptoms in order for the patient to receive meaningful and lasting recovery therapy. Methadone is an opioid analgesic that offers patients a tolerable method for withdrawing from illegal opioids and promotes the continued resistance to returning to illicit drugs.

Methadone must be administered and monitored by medical professionals. Medication-assisted treatment is paired with counseling services in order to provide the patient a comprehensive approach to long-term recovery.

Individuals who have prescribed methadone for opioid addiction experience neither the cravings for the illicit opioid nor the euphoric rush typically associated with the use of the illegal drug. Methadone suppresses drug withdrawal symptoms for 24- to 36-hours

The National Institute on Drug Abuse reports methadone is the preferred method of treatment for opioid dependency when combined with other protocols:

  1. Medication-Assisted Treatment (MAT): Treatment medications, when used as prescribed by a licensed physician, block how illicit opioids affect the brain to cease drug cravings and dependencies. Methadone is the most widely-used treatment medication due to its effectiveness & affordability.
  2. Buprenorphine and Suboxone relieve drug cravings with fewer side effects than methadone and are recommended for patients with a lower dependence on illegal opioids for a shorter period of time. should be used only in patients who have already been detoxified.​

www.drugabuse.gov/category/drugs-abuse/methadone

Resources:  https://www.ncbi.nlm.nih.gov/, , https://americanaddictioncenters.org/

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