Rehabilitation for Alcohol and Other Substance Abuse
If you had hurt your knee in a car accident, you would need some level of rehabilitation. Whether it be physical, social, or occupational, a team of trained professionals would assess your situation and provide a competent level of treatment to restore your abilities to the state before your injury. Rehabilitation takes people from a low stage in their life and points them towards a direction of happiness and fulfillment.
Rehabilitation does not only come after a physical injury, though. A variety of treatments are available for those struggling with numerous injuries to their mental health as well.
One of the primary forms of rehabilitation is used for substance abuse. People who engage in substance abuse, addiction or dependence are damaged by their use and will require rehabilitation to recapture their lives.
What Are Drugs of Abuse?
For someone to need rehab for their addiction, they need to have a problematic relationship with drugs, but what qualifies as a drug of abuse? The answer is actually quite long and complicated.
Let’s begin with illicit drugs. This category is the easiest to define because the use of these substances is almost always associated with problems. Additionally, these drugs are almost always illegal, and possession will lead to problems with the law.
Illicit drugs include:
- Heroin.
- Cocaine/crack cocaine.
- Methamphetamine/crystal meth.
Prescription drugs are much more confusion because many of these regulated drugs are safe and effective when used under the direction of a medical professional. There is another group of prescription drugs that can result in abuse and addiction. Some drugs can create physical dependence, even when used as prescribed.
Problematic prescription drugs include:
- Opioids pain medications. Vicodin, Percocet and OxyContin are helpful in reducing someone’s perception of pain. They also create a strong feeling of euphoria when abused.
- Stimulant medications. Adderall, Concerta and Ritalin are prescribed to help people with attention-deficit/hyperactivity disorder (ADHD) focus and concentrate. They can be abused to boost energy, improve attention, reduce the need for sleep and diminish appetite.
- Sedative medications. Xanax, Klonopin and Ativan are recommended to treat anxiety disorders and improve sleep. People abuse them to induce a calm, relaxed state.
There are illicit drugs and prescription drugs, and then there is everything else. Many other substances are problematic including marijuana, hallucinogens, like LSD and mushrooms, ecstasy (MDMA), over-the-counter medicines and numerous household products that can be inhaled, like cleaners and gasoline.
At least some of these substances are in your house right now. Most of the time they are used as intended, but those interested in the high will find ways to abuse these substances as well.
Who Needs Addiction Rehabilitation?
Before you can appreciate what rehabilitation can do, it is helpful to understand who rehabilitation is appropriate for. Simply put, everyone is impacted by addiction.
Addiction does not care about your address, race, ethnicity, or religion. Addiction does not care about how much money you make or what kind of car you drive – it only cares about wrecking every aspect of your life until there is nothing left to destroy.
One group of people who need rehabilitation are those with substance use disorders (SUD). A SUD is a diagnosable mental health condition marked by a series of unwanted symptoms that present after some time of using substances, like alcohol and other drugs.
Someone with a SUD will:
- Use alcohol and other drugs in higher amounts than intended for periods longer than intended.
- Spend large amounts of time trying to get, use and recover from the drugs of abuse.
- Make frequent attempts to cut back or end their use with poor results.
- Feel strong cravings for the substance when none is available.
- Shift their social relationships to those involved with substance use or experience more conflict with their established peer group.
- Struggle to meet the demands of their work, school, or home life.
- Continue to use substances even when it would result in problems with their physical or mental health.
- Need higher doses, more frequent doses, or higher potency substances to achieve the same high as previous use.
- Feel odd, uncomfortable and ill when no drugs are available.
People who are actively having issues with alcohol and other drugs may also:
- Change their dress or hairstyle in drastic ways.
- Decrease their self-care as shown by showering less often, wearing dirty clothes and having scratches and bruises all over their body.
- Display wildly changing mood and energy levels. The person may seem to have unlimited energy and then sleep for two days straight.
- Leave signs of drug abuse around the house like pill bottles, baggies and scales, pipes, bongs and bowls and needles and lighters.
Finding an Addiction Rehabilitation Center
If looking over this list makes you realize something in your life needs to change, you should consider rehabilitation. But where do you start?
It might seem like finding rehab is a confusing and overwhelming process, but this is rarely the case. The good thing about entering a rehabilitation center is that once you are connected, the treatment professionals will guide you through the rest of the process.
Begin the search for rehab through various options like:
- Your family doctor/primary care physician (PCP).
- A community mental health/addiction center.
- A national hotline.
- An internet search.
- Recommendations from a trusted friend.
If you have insurance coverage, your provider might be the best way to access services. Call the hotline on the back of your card, explain your situation and listen to their advice for the best path to treatment.
Sometimes rehab will be close by, which allows you to visit and tour the facilities before committing your time to the program. Other options will be located out of town or out of state, which requires some faith in your decision or the reputation of the program.
The Rehab Intake
Every rehab will complete an intake evaluation to fully assess your current situation and status. By doing this, the program can ensure you are placed in an appropriate level of services to best meet your needs.
During your intake, you will be interviewed by a professional regarding your current drug use including:
- Your drug or drugs of choice.
- The frequency, dose and duration of use.
- The primary reasons or goals of your use.
- The presence of co-occurring mental health conditions.
- The presence of co-occurring physical health conditions.
- Current stressors and struggles in your life.
- Current supports and coping skills available.
Your assessment may also involve a drug test to identify all of the substances you have consumed, and an interview of your friends or family members to gather more information about the level of your abuse and addiction.
The Risk of Withdrawal
When someone habitually uses or abuses alcohol and other drugs, the body and brain begin adjusting to the presence of these substances. With time, the body requires more and more of the drug to achieve the wanted results due to a condition called tolerance, and tolerance often leads to dependence.
Dependence is the product of the brain adapting to the drugs in the system. Rather than being overwhelmed by the substances, the body and the brain now require the presence of alcohol and drugs just to feel well and function normally, so when the drugs are not available at the desired level, the brain is out of balance, which triggers withdrawal symptoms.
Some withdrawal symptoms are quite dangerous and include:
- Seizures.
- Cardiac complications.
- Dehydration from excessive sweating, vomiting and diarrhea.
- Risk of choking on own vomit.
- Severe depression with suicidal attempts or completed suicides.
- Violence and aggression towards others, especially close loved ones.
A challenging aspect of withdrawal is that it is impossible to predict with certainty exactly who will encounter withdrawal symptoms, which symptoms they will experience and how severe the symptoms will be. Because of this, safety and prevention should always be a primary goal of anyone ending their substance use.
Option 1: Detox
Depending on the results of your intake, your evaluator may recommend detoxification as your first treatment. Detoxification (detox) refers to the body’s ability to process and remove toxins from the system.
Professional detox is different, though. Professional detox is a set of strategies and interventions used to safely and effectively transition someone to a drug-free state.
Detox is an option for people with severe addiction and people who are using opioids, sedatives, or alcohol. These three types of substances are significant because they tend to produce the most dangerous withdrawal symptoms when use ends.
Detox occurs in a number of different levels and locations with most detox treatment separated by inpatient or outpatient detox. Generally, people with the most severe addictions or physical dependences will require inpatient detox while people with fewer, less severe symptoms will do well in outpatient detox.
Many detoxes are medically assisted or medically supervised, which means a team of medical professionals is tasked with observing and treating the symptoms of withdrawal as they present. This level of care, which can occur in numerous inpatient and outpatient settings like hospitals, standalone detox centers and doctors’ offices, often involve the medical professional prescribing and dispensing medications to ease the detox process.
Another type of detox, called social detox, does not offer medications, and instead, focuses on offering support, encouragement and reassurance for appropriate steps towards sobriety. Though this method of detox is helpful for many, it is a dangerous level of care for someone detoxing from multiple substances or opioids, alcohol and sedatives.
The time it takes to complete detox varies greatly from program to program. One of the major factors is the treatment plan the professionals choose to employ. In some treatments, the substance use is abruptly discontinued, which will produce a shorter, more intense period of withdrawal.
In other situations, the professionals will switch the individual to a prescription substance to establish a level of stability on the new drug before gradually reducing the dose over time. This tapering or weaning process will minimize the unwanted effects of withdrawal, but it will extend the overall time of the detox process.
Depending on the abused drug and the new medication used to relieve symptoms, the detox process can last for months or years. With this being the case, treatment may begin as an inpatient before switching to outpatient detox when enough safety and stability is established.
Since detox specifically deals with the physical health risks associated with ending substance use, it is the best tool to target and end physical dependence. The problem, though, is that detox, by itself, is not enough to completely end the psychological addiction triggered by the substance.
Option 2: Inpatient Rehab
If detox is for dependence, rehab is for addiction. Rehab is not a specific term with a strict definition, but it usually refers to any form of substance abuse treatment that is not detox.
Like detox, rehab takes place in a number of settings, offers a number of services and lasts for a number of durations. The most intense form of rehab is inpatient rehabilitation.
Inpatient rehab is any type of rehab that involves that individual living entirely at the treatment center during their stay in treatment. Unlike detox, inpatient rehab settings will appear more like home, rather than the stark, hospital-like environments of most detoxes.
During inpatient rehab, the residents – as they are often called – spend their day engaging in a variety of activities and exercises focused on establishing and maintaining a drug-free life. These activities may include:
- Individual therapy.
- Group therapy.
- Family therapy.
- Medication assessments.
- Spirituality exercises.
Physical health activities may also be done, like:
- Hiking.
- Yoga.
- Swimming.
- Horseback riding.
- Healthy eating.
Some inpatient rehabs will provide simple treatments in a simple setting, but other rehabs will be quite luxurious with picturesque scenery, gourmet meals, treatments conducted by world-class professionals and even workspaces for executives to manage their business affairs. These elaborate treatments frequently come with a cost that exceeds tens of thousands of dollars for the entire stay.
Option 3: Outpatient Rehab
Inpatient rehab means living at the facility for the duration of your stay, and outpatient rehab lets you live, work and tend to your other responsibilities while attending some level of rehab daily or weekly. Since outpatient rehab offers less intensive services, it is a better option for people with less severe addictions and a fantastic support system at home.
Even though outpatient rehab is less concentrated than inpatient, the service can be quite intense. Outpatient rehab comes in three levels:
- Partial hospitalization programs (PHPs). PHPs, sometimes called day programs, involve about 30 hours of treatment each week with the patients attending services at least five days per week.
- Intensive outpatient programs (IOPs). IOPs are the middle level of outpatient rehab and consist of about nine hours of treatment each week divided between two or three days.
- Standard outpatient. Standard outpatient rehab involves just one hour of therapy each week, biweekly, or monthly depending on the needs of the individual.
Along with these therapy programs, many outpatient rehab programs will provide medication management for addiction and mental health concerns. In these situations, the prescriptions will be recommended by psychiatrists or nurse practitioners.
Since outpatient rehab does not have the time or resources of inpatient/residential rehab, the individual will be tasked with completing more recovery-related activities outside of formal treatment to maintain sobriety.
Option 4: Support Groups
To this point, the rehab options have all referred to professional services conducted by trained, experienced and paid recovery experts, but there is another option – support groups. Support groups are informal group meetings that are usually led and maintained by other people in recovery.
Well-known groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are good examples of support groups. People may be wary about entering into a room full of people in recovery, but these group meetings are great ways to complement and extend the benefits of professional treatment.
Chances are, there is an available meeting close to your home just waiting to offer you the fellowship, community and support you need.
How to Choose the Right Rehab
You’ve got detox, inpatient rehab, outpatient rehab and support groups. How can anyone possibly choose the right rehab? Don’t worry. There is good news.
You do not have to choose just one form of treatment. Many of these treatment options can be mixed and matched to help you find the best fit for your needs at the moment.
For example, someone in outpatient detox can also engage in outpatient rehab and support groups. Even some inpatient rehab programs offer access to support groups to ease people into the community.
In other situations, people will progress through each form of treatment sequentially. These people may start with inpatient detox before moving to inpatient rehab, outpatient rehab and finally, support groups.
Even outpatient rehab can be moved through with people beginning at PHP before moving to IOP and finally standard outpatient. With so many available forms of treatment, there is something out there to help you.
The important thing is that you seek the treatment you really need to make your life full of happiness, good health and stability. Drugs only stand in your way.