Every year, millions of people wrestle with an addiction to drugs and/or alcohol. In fact, within the past decade, more people than ever have been battling opioid addiction. What is now known as the “Opioid Epidemic,” this recent and rapid increase in opioid-related overdose deaths has reached new heights in the United States.
According to the U.S. Centers for Disease Control and Prevention (CDC), an estimated 130 people die as a result of opioid overdose per day, and these numbers show no sign of slowing.
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With such a severe problem on our hands, many people are left wondering what to do. Addiction — a substance use disorder (SUD) or alcohol use disorder (AUD) — is a chronic and progressive disorder.
The American Psychiatric Association (APA) defines addiction as a complex condition marked by compulsive substance use despite the harmful consequences that result. Someone with an addiction will exhibit an intense focus on using alcohol or drugs to the point it takes over their life.
Addiction is a condition that is ongoing and worsens with time. While there is currently no cure for it, there are viable treatment options whether you have an issue with alcohol or drugs.
The relapse rates of substance use disorders are between 40 and 60 percent, according to the National Institute on Drug Abuse (NIDA). That rate is comparable to chronic medical illnesses such as asthma and hypertension.
One effective treatment option is drug rehab. Most people have heard the term drug rehab or simply “rehab” before, but they may not know what it is or what it entails.
Learn more about drug rehabilitation programs and how they work so that you or your loved one can get the help needed to overcome drug or alcohol addiction.
How Addiction Is Diagnosed
Drug rehab can be used interchangeably with addiction treatment. This refers to the process where addicted persons undergo various clinical and medical techniques designed to help them overcome their use disorders and live a healthier life. Drug rehab will employ various addiction therapy techniques and, in some cases, utilize medications and other means to rehabilitate or heal those afflicted with addiction.
Addiction is recognized as a disease in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition(DSM-5). The condition manifests through physical, psychological, and behavioral effects.
The physical aspects of addiction comprise the use of drugs or alcohol in an obsessive and compulsive way. The psychological aspect of addiction refers to the negative feelings or underlying forces that drive addicted persons to engage in self-destructive behaviors.
There are specific criteria the DSM-5 has set forth to successfully diagnose a substance use disorder. The criteria cover physical and emotional symptoms that people battling addiction often encounter. According to the DSM-5, for a person to be diagnosed with a disorder due to a substance, they must display two of the 11 symptoms over 12 months.
PsychCentral lists the following criteria used by the DSM-5 to make an SUD diagnosis:
- Consuming more alcohol or other substance than initially intended
- Exhibiting worry about stopping or consistently failing in your effort to control your use
- Spending a large amount of time using drugs/alcohol, or doing whatever is required to obtain them
- Substance use results in the failure to “fulfill major role obligations” at home, work, or school
- “Craving” the substance whether it is drugs or alcohol
- Continuing substance use despite the health problems it causes or exacerbates. This can manifest in the domain of mental health (psychological problems may include sleep disturbance, depressed mood, anxiety, or “blackouts”) or physical health.
- Continuing substance use despite its negative effects on relationships with others (for example, using even though it leads to fights or despite people’s objections).
- Repeated use of the substance in a dangerous situation (for example, when operating heavy machinery or when driving a car)
- Giving up or reducing activities in your life because of drug/alcohol use
- Building up a tolerance for drugs or alcohol. The DSM-5 defines tolerance as “either needing to use noticeably larger amounts over time to get the desired effect or noticing less of an effect over time after repeated use of the same amount.”
- Experiencing withdrawal symptoms or bodily disturbances after stopping use. Withdrawal symptoms typically include, according to the DSM-5: “anxiety, irritability, fatigue, nausea/vomiting, hand tremor or seizure in the case of alcohol.”
The Goal of a Drug Rehab Program
A drug rehabilitation program aims to help address both aspects of the disease to help an addicted person find relief from their symptoms. Without addressing both areas, the individual will likely be unsuccessful and resort to old behaviors and subsequently relapse.
Drug rehab centers have their own methods and approaches toward treating their patients. Reputable centers have the same underlying goal: ultimate and sustained recovery for their clients. However, how medical and clinical professionals address the disorder can be different.
Choosing the correct drug rehabilitation program is crucial to your success in recovery. There are many options to consider, so learning more about drug rehab is important before heading off to treatment.
Some clients may be battling co-occurring/comorbid disorders. This is defined as a dual diagnosis. Dual diagnosis patients have both a substance use disorder and another mental health disorder, such as bipolar disorder or depression, at the same time. These clients require special therapy approaches to be successful in treatment, so locating a drug rehab center that specializes in dual diagnosis treatment is important.
Depending on how severe your substance use disorder diagnosis is, you may opt to participate in an inpatient/residential treatment program. This involves living at the facility throughout treatment. If your substance use disorder is less severe, than perhaps an outpatient program may be right for you. This involves finding alternative housing and commuting to therapy sessions.
With so many different options for treatment available, it can be challenging when attempting to isolate the perfect one for yourself or your loved one. Do not be discouraged! Finding the right treatment facility involves a lot of research and understanding of the drug rehab process in general.
Read on to learn just how drug rehabilitation programs work and how they can make a difference in your or your loved one’s life.
Drug Rehabilitation Process
Despite the various differences between drug rehab centers, the overall drug rehab process is generally uniform across all different facilities. The method in which drug rehabilitation programs are conducted is in a “stepped” format known as providing the full continuum of care, which is set forth by the American Society of Addiction Medicine (ASAM).
The full continuum of care is the best method of approach to drug rehab due to the way it provides substantial medical and clinical intervention and support in the beginning stages of treatment and gradually lessens over time as clients require less hands-on techniques by the medical and clinical staff.
This allows the client to naturally progress through the program and slowly take on more freedom and responsibilities when they’re stable enough in their recovery to handle it. Without this approach, clients may be subject to relapse due to having inadequate clinical and medical support when they need it most.
The beginning stages of drug rehab feature 24-7 surveillance and care. During the first few days and weeks of recovery, clients will need to be medically stabilized. After prolonged drug use and abuse, people may experience a wide variety of health complications after attempting to stop taking their drug of choice.
This is known as withdrawals and can present various uncomfortable and even dangerous symptoms. As clients become medically and emotionally stabilized, they will begin to amass more freedom and require less medical supervision. This will promote clients learning responsibility for their recovery and how to navigate challenges without resorting to relapse.
The following is a breakdown of each level of care you or your loved one can expect to encounter throughout drug rehab:
The first level of the full continuum of care is known as medical detox. Detox is the process by which, under 24-7 medical and clinical surveillance, clients are guided through the withdrawal process and medically stabilized. Since using drugs and alcohol over a long period can cause one to develop a physical dependence on the substance, getting off of drugs and alcohol is not always easy.
The manifestation of withdrawal symptoms can lead individuals to continue using even when they don’t want to or return to using to alleviate symptoms. Certain drugs, such as benzodiazepines, can cause withdrawal symptoms that can even be life-threatening. This is what makes medical detox so important in the drug rehab process.
Upon arriving at detox, you’ll be given a full medical assessment by a team made up of doctors, nurses, and medical support staff. They will take a look at the severity of your addiction as well as your overall physical health.
After your assessment is completed, they will create and implement a personalized detox plan designed to detox you as quickly, comfortably, and safely as possible by meeting all of your individual needs. This detox plan will likely include certain detox medications designed to combat any detox side effects you may encounter.
Since another large aspect of addiction is the emotional/psychological aspect, this is particularly applicable in detox. Detoxing can cause emotional turmoil for patients, as certain withdrawal symptoms are emotionally based. The clinical team of therapists, case managers, and support staff are there to help guide you through this difficult time as well.
While the primary focus of detox is usually the physical aspect, since medical stabilization is needed before the rest of drug rehab can commence, there will be some therapy sessions and groups held while you’re in detox as well.
The next stage in drug rehab is known as inpatient or residential treatment. This is the part of treatment most people envision when picturing drug rehab. At this level, you’ll live onsite at the facility but require less medical care. You will be completely medically stabilized, meaning that the primary focus of treatment can be placed on the therapeutic aspect of drug rehab.
Each rehab center is different, so the curriculum of addiction therapy and amenities offered may be different. However, the underlying goal is to do the majority of the therapeutic work while living in a safe, sequestered environment away from outside distractions and stressors that could take the focus off of treatment
At inpatient or residential, you’ll learn different life skills, coping mechanisms, and relapse prevention techniques designed to help you live your life successfully in recovery following drug rehab.
Inpatient/residential provides around-the-clock clinical care and still provides access to medical care as well. However, clients will be undergoing full-time therapy and cannot leave the premises without permission and a chaperone from the facility. This helps protect clients from potentially relapsing and keeps everyone on track in treatment.
After inpatient comes outpatient programs. These programs can be broken down into two distinct levels: intensive outpatient (IOP) and routine outpatient (OP). While having many similarities, there are key differences that make each level of care distinct in their own way and important to the full continuum of care associated with drug rehab.
IOP offers far less clinical and medical intervention than the proceeding levels. Clients will no longer live at the facility, but instead must find alternative housing and commute to therapy sessions. Many clients choose to live at a halfway house due to the structured, recovery-oriented environment offers at these sober living homes. But, some clients also choose to return home following inpatient. It’s important to remember that at this point in treatment, much of the responsibility for maintaining recovery will be on you. You will have free time, which can result in relapse if not used properly.
IOP will usually occur several times a week for multiple hours at a time. Clients will no longer participate in full-time therapy, but rather part-time. While in sessions, however, there will still be a high level of clinical intervention with intensive therapy methods employed by therapists to help clients continue in their drug rehabilitation program. Clients are also subjected to random drug testing to help ensure they stay on track.
Following IOP, OP will begin. Much like IOP, clients must find other living arrangements, and medical and clinical intervention is more hands-off. However, the number of hours spent in sessions is decreased further to only one hour per week. This is the lowest level of clinical and medical care.
At this point, clients should be fairly stable medically and in their recovery. This is to ease the final transition from drug rehab back into society at large as a recovering person. By having minimal clinical support, it offers clients lasting assistance as they make this important and sometimes challenging transition.
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Aftercare is still an important part of treatment. Despite drug rehab seemingly finished, it’s always important to remember that recovery is a lifelong process. It does not end when treatment does. Recovery requires constant attention and work to maintain your sobriety long term. This is why participating in aftercare programs is both suggested and helpful.
Apart from outpatient programs, there are different ways one can participate in aftercare. By attending 12-step programs or joining an alumni group associated with your drug rehab center, you can help solidify your place in recovery and the surrounding recovery community. By having access to such a large network of support, you can continue growing in your recovery for years to come.
Commonly Abused Substances and Treatment Approaches
Professional treatment is not a “cookie cutter” process. A reputable program will help a client tailor a specific drug rehab program that considers the substance of abuse and, above all, a client’s particular needs.
Different substances require different treatment approaches. Commonly abused substances include:
- Alcohol: This legal, commonly abused drug is also one of the most dangerous substances you can put into your body. Alcohol is capable of producing life-threatening withdrawal symptoms, especially for heavy, long-term drinkers. Thus, people with severe cases of alcoholism or alcohol use disorders are often recommended for intensive inpatient rehab services due to the substance’s manifold effects. They will also very likely need aftercare support in the form of a recovery community to help them realize sustained sobriety.
- Marijuana: This commonly abused substance is often underestimated as a “safe” drug to abuse. However, the marijuana available in these times have unprecedented potency and can produce deleterious effects like circulatory issues and mental illness. While there are no medications available to treat marijuana dependency and addiction, behavioral support has proven to be effective, according to NIDA.
- Opioids: The class of drugs that encompasses prescription (OxyContin and Vicodin) and illicit substances (heroin and fentanyl) have an unparalleled ability to ensnare the brain with addiction. While they do not produce life-threatening withdrawal symptoms, they require a comprehensive answer. For many, this means intensive intervention in the form of inpatient and outpatient treatment, along with long-term aftercare through a recovery community.
- Stimulants: Illicit drugs like cocaine and meth and prescription stimulants like Ritalin and Adderall are abused for the euphoric rush they induce. However, stimulant substances like these boost heart rate, blood pressure, and breathing, leading to ruinous health effects such as irregular heartbeat, heart failure, and seizures. Abuse of these substances can also result in psychosis. While there is no commonly agreed upon medical treatment for stimulant addiction, psychosocial therapies like contingency management and cognitive behavioral therapy (CBT) have been effective in treating stimulant abuse.
- Depressants: These medications which are often prescribed for anxiety, sleep, and panic can be highly dangerous, especially in withdrawal. These sedative medications, which encompass benzodiazepines and barbiturates, are capable of inducing an alcohol-like intoxication. Abuse of these medications can lead to slow or stopped breathing, which can result in death. Popular brand name drugs in this category include Ambien, Xanax, and Valium and phenobarbital. NIDA states that people with prescription depressant addictions should undergo a medically supervised detox so that they can be tapered off the drug gradually. Counseling in an inpatient or outpatient setting can help clients achieve sobriety. CBT has been proven to help patients stop using benzodiazepines, says NIDA.
American Psychiatric Association. (n.d.). What Is Addiction? Retrieved from from https://www.psychiatry.org/patients-families/addiction/what-is-addiction
American Society of Addiction Medicine (ASAM). (2018, July 20). What are the ASAM Levels of Care? Retrieved from from https://www.asamcontinuum.org/knowledgebase/what-are-the-asam-levels-of-care/
Centers for Disease Control and Prevention. (2018, December 19). Opioid Overdose. Retrieved from from https://www.cdc.gov/drugoverdose/epidemic/index.html
Medina, J. (2016, May 17). Revised Alcohol/Substance Use Disorders. Retrieved from from https://psychcentral.com/addictions/substance-use-disorder-symptoms/
National Institute on Drug Abuse. (n.d.). Treatment and Recovery. Retrieved from from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
National Institute on Drug Abuse. (n.d.). Most Commonly Used Addictive Drugs. Retrieved from from https://www.drugabuse.gov/publications/media-guide/most-commonly-used-addictive-drugs
National Institute on Drug Abuse. (n.d.). Marijuana. Retrieved from from https://www.drugabuse.gov/publications/drugfacts/marijuana
National Institute on Drug Abuse. (2018, June 06). Prescription Stimulants. Retrieved from from https://www.drugabuse.gov/publications/drugfacts/prescription-stimulants