What Is Addiction Treatment?

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Most addiction treatments are designed to do more than simply reduce or remove alcohol or drug use - they focus on getting addicted people to change their lifestyle and even their core life values as a way of preventing return of the problems. Like treatments for other conditions, addiction treatments can also include medications and forms of talk therapy, but addiction treatments may be provided by a much wider range of personnel (clergy, counselors, social workers, physicians) than most other forms of healthcare.

No available therapy, program, medication or surgical procedure can remove recurrent desire or craving for alcohol and/or other drugs. Eliminating the desire to use drugs or alcohol is not an outcome of rehabilitation. A more reasonable expectation is that medication may reduce this urge and effective rehabilitation will teach a person what they must do to manage and contain their recurrent desires to use, much in the same way as a person with diabetes or hypertension must learn to manage their lives to control their illness.

It is best to think of three stages of addiction treatment, each with a different function in the larger picture of care:

  • detoxification/stabilization
  • rehabilitation
  • continuing care

Detoxification/Stabilization

Following a period of heavy and sustained alcohol or drug use, most individuals develop significant physical and emotional symptoms. While some of these physical problems can resolve with just rest, the use of drugs like alcohol, opiates (heroin, OxyContin, Vicodin, etc.) and tranquilizers (Valium, Xanax) usually need medically supervised detoxification or stabilization.

Detoxification/stabilization is not treatment - only preparation for treatment. Detoxification must be followed by continued rehabilitative treatment for lasting improvement.

Settings of Care:

Almost always in hospitals or other residential facilities where medical care is available.

Methods of Care:

The treatments involve various medications to reduce withdrawal and physical discomfort.

Duration of Care:

Usually 3-5 days. More severe cases require a few more days.

Desired Results:

1. Reduced physical and emotional instability caused by substance use.
2. The patient is motivated to recognize and accept that there is a problem that she or he can address.
3. The patient is engaged in some form of continued rehabilitative care.

Rehabilitation

Rehabilitation is appropriate for patients who are no longer suffering from the acute physical or emotional effects of recent substance use. Rehabilitation care typically offers an array of treatment components to help to address the many health and social problems associated with substance use.

Settings of Care:

Most rehabilitative care for addiction occurs in specialty "programs" that include the components described above. If a person has very serious substance use and/or a life situation that has gotten so out of control that they cannot become sober even with treatment in their living situation - they should seek residential rehabilitation. Most other, less severe forms of substance use can be rehabilitated in outpatient settings that provide essentially the same components of care.

Methods of Care:

Medications can help reduce craving for drugs and/or help with co-occurring medical or emotional illness. Individual, group and family therapy helps assist with understanding the specific issues that may have led to the addiction and that will have to be faced again following treatment. Assistance and guidance in developing a new drug-free lifestyle are also important parts of rehabilitation.

Duration of Care:

Most residential rehabilitation programs last 21-30 days, 8-12 hours per day. Outpatient rehabilitation programs are typically 60-90 days, where patients spend 2-8 hours per day, 2-5 days per week.

Desired Results:

1. Sustained elimination of alcohol and other drug use.
2. Improved health and social function.
3. Engagement in continuing care, personal therapy, mutual help groups and/or other healthy lifestyle changes to sustain the improved health and function.

Continuing Care

The first 3-6 months following addiction treatment is the period of greatest vulnerability to relapse. Consequently, continuing care services are designed to monitor the emotional health of recovering people, remind them of their commitment to lifestyle change and support their needs as they attempt the difficult job of living their former lives with a new perspective and resolve.

Settings of Care:

All continuing care occurs in the community setting to assist people in adjusting to their day-to-day lives.

Components of Care:

The components of continuing care are very similar to those in rehabilitative care but they typically occur less frequently. Individual, group and family therapy sessions may be scheduled monthly. Some rehabilitation programs offer telephone counseling and support services for people to talk with their former counselors.

Duration of Care:

Most continuing care programs continue for 6-12 months following completion of rehabilitation. Telephone calls occur semi-weekly during the first month, gradually decreasing to once per month over time and last 10-30 minutes depending upon the recovering person's needs.

Desired Results:

The goals of continuing care are exactly those of rehabilitation. Effective continuing care will help a recovering person to self-manage the recurrent occasions of temptation and craving and as importantly, develop an enjoyable, fulfilling life.

Special Role of AA

For the past 60 years, Alcoholics Anonymous (AA) and the various other mutual help groups (Smart Recovery, Narcotics Anonymous, etc.) have been the most common and often the only form of continuing care. Most cities have many types of AA and mutual help groups. Many have a strong spiritual component but others do not. Some permit smoking during the meetings and others do not. Some are reserved for particular groups of recovering people (e.g. physicians, nurses, lawyers, athletes) while the majority are open to all. A person should consider trying several different meetings prior to deciding upon the value of mutual support group participation in his or her recovery.









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