Treatment may be either residential or outpatient. In outpatient treatment, the patient may continue to live at home and attend sessions and programs at a facility during the day or in the evenings. Residential treatment is more comprehensive, providing a complete care plan that can help each person hit the reset button on life and maintain a successful and healthy recovery long-term. Treatment duration differs depending on each person’s specific needs, and a team of medical professionals will work together to determine the optimal course of action for each specialized circumstances after a detailed assessment.
The goal of drug treatment is for the individuals to control compulsive drug use, successfully divert cravings, and remain abstinent or drug-free long-term. Relapse, or returning to substance use, is a common part of the recovery process and should not be viewed as a failure, but rather as another stepping-stone toward recovery. The National Institute on Drug Abuse (NIDA) compares relapse rates for those treated for substance abuse disorders with other chronic diseases (like diabetes, for example) and found similar relapse rates in around 40 to 60 percent of cases.
Sustained recovery is attainable, however, with the right treatment plan. A study published in Psychology Today found that after five years of sobriety, less than 15 percent of people will relapse, meaning that 85 percent will not relapse. Therefore, those who are actively involved in treatment programs and who take an affirmative stand to make positive changes in their lives are capable of achieving long-term success.
DRUG ABUSE, DEPENDENCY, AND ADDICTION
In 2013, the National Survey on Drug Use and Health (NSDUH) found that as many as 24.6 million Americans over the age of 12 were considered to be current illicit drug users, meaning that they had used illicit drugs in the past month. Illicit drugs come in many forms and typically fall into three main categories: stimulants, depressants, and hallucinogens. Each of these classes of drugs affect the brain and body in different ways.
Using prescription medications for non-medical purposes is considered drug abuse, making medications illicit drugs at times as well. Stimulant drugs include cocaine, attention-deficit hyperactivity disorder (ADHD) medications, and methamphetamine, which raise heart rate, blood pressure and body temperature, increasing metabolism, attention, energy, and wakefulness. Depressants like heroin, marijuana, tranquilizers, pain relievers, and sedatives, on the other hand, tend to suppress bodily functions including respiration, heart rate, and pain sensations, creating a numbing and relaxing affect. Hallucinogens include LSD, mushrooms, and PCP. These drugs alter mood and personality and also induce hallucinations.
All drugs interfere with the brain’s natural reward pathways. Many of them interfere with the production of neurotransmitters, the brain’s messengers, including dopamine, which is responsible for pleasure. Therefore, taking these drugs often makes users feel good, which is a feeling many are eager to recreate. Over time, the brain develops a tolerance to the drug. This occurs when the brain becomes accustomed to the chemical stimulation or depression of brain functions the drug provides.
Tolerance means that it will take more and more of the drug each time in order to produce similar effects. Tolerance often leads to dependence, wherein the brain relies on the drug in order to feel normal or balanced. Cravings develop, and in-between doses or when the drug is removed from the system, withdrawal can occur.
Withdrawal symptoms may be both physical and emotional, and they can include flu-like symptoms as well as depression, irritability, agitation, and even psychosis. Dependence in turn can lead to addiction. Addiction is defined by the American Society of Addiction Medicine (ASAM) as a chronic and relapsing disease involving the brain’s reward system, identified by compulsive substance abuse without regard to negative consequences.
Signs of Addiction
In order to determine when to seek treatment, it is important to recognize the symptoms of addiction. Some of the signs to watch for include:
SIGNS TO LOOK FOR
Some of the signs you should look for include:
- Financial difficulties as money is spent to maintain drug habit
- A drop in work or school performance
- Social isolation or withdrawal from family and friends
- Lack of interest in activities or events previously enjoyed
- Obsession with the drug; large amount of time spent obtaining, using, and recovering from drug use
- Tolerance to the drug
- Withdrawal symptoms when the drug is removed
- Intense drug cravings
- Risk-taking behavior
- Physical changes, including weight fluctuation
- Personality shifts and mood swings
- Inability to stop taking drug despite efforts to quit
It is important to remember that addiction is not a choice, but rather a chronic and reoccurring disease that requires proper treatment to manage successfully. The NSDUH estimated that as many as 6.1 million Americans, or 2.3 percent of the total population, needed treatment for an illicit drug use problem in 2013, yet did not receive the proper care they required at a specialized facility. Fortunately, treatment is readily available and accessible.
Often, one of the first steps in drug treatment is detox, which is the purging of toxins from the body. This process is often medically supervised, and many times, it is managed with medications. Withdrawal symptoms may be dangerous and even life-threatening for some drugs, so stopping suddenly, or “cold turkey” may not be advised. Instead, a weaning, or tapering, schedule may be set up wherein the drugs are slowly removed from the body over time to ease the withdrawal process.
Withdrawal symptoms may start as early as 24 hours after the last dose and may continue for a week or even more, depending on the type and method of drug abused, duration of abuse, and other environmental and genetic factors. Brain chemistry is altered by substance abuse, and regaining a healthy balance may require a little patience.
Medications such as buprenorphine, methadone, or naltrexone may be used to make the withdrawal process smoother and reduce cravings. This is called medical detox, and it can be performed in a residential and specialized facility with 24-hour supervision from consulting physicians. The medications used in detox may vary depending on the drug or drugs abused. Buprenorphine is often used in opioid addiction treatment, for example, as it works as a partial opioid agonist. This means it binds to opioid receptor sites in the brain, reducing cravings and staving off withdrawal symptoms but without producing the euphoric effect or high full agonists like heroin do. Antidepressant medications or mood stabilizers may also be used to help with the emotional side effects of withdrawal.
The primary goal of drug detox is physical and emotional stabilization. In addition to the physical cleansing process, emotional support during and after detox is vital as well. A therapeutic environment, including support groups and counseling, is key to a successful detox protocol.
Dual Diagnosis Treatment
As many as 53 percent of those suffering from drug addiction also suffer from another mental health disorder, according to a study done by the Journal of the American Medical Association (JAMA). When two disorders occur in the same person at the same time, it is called co-occurring disorders and considered a dual diagnosis. Specialized treatment is necessary for the successful management of all aspects of both primary disorders.
The most successful dual diagnosis treatment is thought to be an integrated method that includes a team of medical professionals all working together to achieve the same results. Many mental health disorders need to be managed with medications as well as therapy, and prescribing physicians need to be aware of any substance abuse disorders. All treating team members then work with psychologists or therapists to ensure that both disorders are being successfully managed and treated simultaneously.
There are many theories about what causes the high co-occurrence of mental illness and substance abuse. In some cases, the mental health disorder may come first and substance abuse may be a form of self-medication – a way to numb the pain of mental illness symptoms. Other times, the substance abuse may lead to the onset of mental illness symptoms, or exacerbate these symptoms. Substance abuse greatly exacerbates mental health disorders and vice versa, increasing the potential side effects and health risks of both.
Integrated dual diagnosis treatment often utilizes evidence-based practice models to ensure success. The Agency for Healthcare Research and Quality (AHRQ) defines evidence-based practice as the “integration of a health care provider’s knowledge and expertise with scientific supporting evidence and individual preferences and needs.” Evidence-based methods therefore include different types of medical professionals all working together to share their collective clinical expertise as well as the most current research available while taking into account specialized circumstances and cultural preferences to promote recovery.
EXTENDED AND AFTERCARE
Drug treatment does not end with rehab, and the recovery process is ongoing. Addiction can be successfully managed long-term with the proper tools in place. Approximately 10 percent of Americans over the age of 18 are thought to be in recovery from substance abuse problems, according to the New York State Office of Alcoholism and Substance Abuse Services (OASAS).
The period after issues with substance abuse are successfully controlled is considered recovery. During this time, there are several options and levels for continuing treatment, depending on where you are in the process.
After completing a stay in a residential treatment program, extended care via sober living facilities may be beneficial to ease the transitional period from living in the facility to reintegrating with normal life. These homes are for groups of people in recovery who have completed a residential treatment program and may require additional assistance, bridging the gap between a treatment facility and home. After returning home, support groups and alumni programs help facilitate long-term recovery.
Here at The Canyon, we work with each individual to create a lasting specialized plan, from detox to reintegration and aftercare, to ensure the greatest chance of a continuing healthy life. Call today to speak with one of our compassionate admissions coordinators and begin the recovery process.