Addiction & Substance Abuse Treatment

Addiction is a complex disease that happens when people start to compulsively use a substance, or engage in activities that initially feel pleasurable but later on interfere with their daily life and responsibilities. Often, people don’t realize that there is a problem with their behavior and, if they do, they are incapable of stopping it.

What Addiction Means

“Addiction” as a term can be used in a number of different ways. One way focuses on physical addiction, which means that the body has developed a tolerance for the drug and will develop withdrawal symptoms if the substance is no longer used. Another way to describe it is more psychological in nature and describes the inability of the addicted person to resist the substance when confronted with triggers. Most of the time, addictive behavior goes above and beyond these two scenarios, however. Generally speaking, people also have a deeper psychological addiction. This is one of the reasons why so many people switch between different drugs, because the compulsion for them is not necessarily the substance, but a method of taking action when confronted with a certain emotional state.

It is important to understand that addiction is not a response to someone simply looking for pleasure. It also does not describe the strength of character or morality of an individual. It is now agreed that addiction is a disease. The debate, however, is whether it is a physical disease, a psychological disease, or both. Nevertheless, regardless of the outcome of that debate, treatment is available for people who need it.

Those who are addicted must understand that they have a problem. They then have to be offered the necessary support to overcome this. That said, treatment doesn’t have to be voluntary in order for it to be effective. It has to be tailored to the need of the individual, however, which is why there are so many different options for them to choose from.

Addiction Treatment Programs

Typically, the focus of an addiction treatment program is on achieving sobriety and avoiding relapse. This is usually done through individual, family, and group counseling. Treatment can be offered in residential settings, or on an outpatient basis.

Psychotherapy
Usually, recovering patients will be offered psychotherapy. This will enable them to handle their cravings, learn to avoid their substance, and deal with a relapse if and when it happens. It is generally preferred to include the family of the patient, as this increases the chance of success.

Self Help Groups
Self help groups are equally important. Here, patients can meet their true peers, who have gone through the same process and are on a different point in their recovery. This is educational, informational, supportive, and motivational. Narcotics Anonymous (NA) and Alcoholics Anonymous (AA) are perhaps two of the best known ones, but there are many others as well.

Detox and Withdrawal
When someone is addicted to a substance, the initial phase of treatment is to rid the body of the remaining chemicals. This is achieved through a period of detox, which is usually paired with significant withdrawal symptoms. Detox can be achieved in different ways, including tapering (gradual reduction), or going cold turkey. They may also be provided with medication to help them cope with the withdrawal symptoms.

The way withdrawal is treated depends mainly on the substance that someone has used. As such:

      1. People with an addiction to depressants, such as benzodiazepines and barbiturates, usually experience insomnia, anxiety, restlessness, and sweating. Sometimes, they also experience seizures, whole body tremors, hypertension, hallucinations, fever, and a rapid heart rate. Delirium can happen in very severe cases and this can be life-threatening.
      2. People with an addiction to stimulants such as amphetamines and cocaine generally experience depression, tiredness, moodiness, anxiety, sleep disturbances, low enthusiasm, and low concentration. During treatment, they are supported through bedside care. Medication may be prescribed if the depression becomes severe.
    3. People with an addiction to opioids, such as methadone, oxycodone, codeine, morphine, or heroin, usually experience anxiety, sweating, and a stuffy nose, with reasonably mild symptoms. In rare cases, people can experience tachycardia, serious sleeping problems, diarrhea, and hypertension. It is common for alternative substances, such as buprenorphine or methadone, to be prescribed to help fight cravings.

Substance addiction can lead to serious complications, affecting a person’s life in a variety of different ways:

      1. The person’s general health. When someone is addicted to any kind of substance, from nicotine to heroin, it has consequences on health. Drugs and alcohol can lead to both physical and psychological problems as well. Nicotine is one of the few drugs where the health consequences are generally physical only.
      2. Death, unconsciousness, or coma. This is of particular concern in people who take a high dosage of a certain drug, or who mix it with other substances.
      3. Various diseases. This is most common in people who use intravenous drugs, as they may share needles. This can lead to hepatitis, HIV/AIDS, and other diseases. There are also certain drugs, including alcohol, that can increase the chance of someone engaging in risky sexual behavior, thereby also increasing the chances of catching a disease.
      4. Death and accidental injuries. This is not just due to overdose, but also because people who use drugs have an increased chance of engaging in dangerous driving, or of falling over.
      5. Suicide. Significant research has demonstrated that people who are addicted to drugs and alcohol are also more likely to become suicidal. The exception is with nicotine addiction.
      6. Relationship problems. As the life of an addicted person is centered solely around getting more drugs, it can have a serious strain on relationships, often leading to divorce or breakup.
      7. Child abuse and neglect. Through statistics, it is known that a huge percentage of children who have been abused or neglected come from homes where at least one parent has an addiction problem.
      8. Homelessness, poverty, and unemployment. Many people who are addicted to drugs and/or alcohol find it difficult to hold down a job and to pay the rent.
    9. Legal problems. Many substances are illegal and, even if they are not, they are very expensive. As a result, in their pursuit of another hit, it is common for people to break the law. This can lead to imprisonment as well.

Questions and Answers on Addiction & Treatment

Q. When should I get help?

A. The sooner someone gets help, the better it is. However, it is always never too late to get help. Some people believe that addiction can only be cured when people hit rock bottom, but evidence suggests that people can get help whenever they are ready for it, often after an intervention by their family or even the courts.

It is also for this reason that it is recommended for people who have substance abusing relatives or loved ones to organize an intervention. This is something that has to be properly prepared in order for it to work properly. There are addiction counselors that can help with setting this up, as well as interventionists. It is very important to make sure that an intervention is done in a supportive way, not in an accusing way, but that real consequences are set as well. If you care about someone with a substance abuse problem, your influence on that person is incredibly strong, which is why family therapy is often so important.

Q. Who should I see first?

A. It is possible to visit your primary care physician or family doctor to get referred to a rehab center. This can be done at any point, even if you don’t feel ready to stop. Doctors can also provide you with information on resources that are out there for you. Additionally, they can point you in the direction of the nearest AA or NA meetings, helping you to find the help you so desperately need.

Many times, you can also refer yourself to a rehab center. If you know you want help, you can start researching the options that are out there, choosing the one most suitable to your needs. Do make sure that you speak to your insurance company about coverage.

Q. What kind of treatment will I receive?

A. One of the main principles of effective treatment is that every person with a substance abuse problem is unique, and that treatment has to be developed for individual needs as well. As such, there is no clear answer as to how you will be treated, as many factors will be of influence. However, you can expect to go through a period of detox, followed by extensive talking therapies.

Generally speaking, you will be encouraged to think about the things that you would like to change in your life. This is done in a non-judgmental way, and you will be encouraged to believe that you can make a real change. You will also talk about your outlook on life, what obstacles are in your way, and how you can overcome them. Furthermore, you will learn about triggers and stressors and how to identify and avoid them, instead of using drugs.

When people have a dependency, their entire life is focused on getting hold of the next hit and using it, while at the same time dealing with the after effects. It takes a lot of strength to actually change that lifestyle. The hardest part, in fact, is not to stop using, but rather to stay clean and sober.

Q. How do residential rehabs and self help groups work?

A. There are a number of self help groups that have been shown to be very beneficial, particularly if the addicted persons do not have a supportive network around them. Through these groups, people can start to build a community that they feel they belong to. Residential rehab, meanwhile, is mainly for those have completed their period of withdrawal and are ready to change their life, but require a little bit of extra support to actually actually achieve this.

Q. Does outpatient treatment benefit anybody?

A. Absolutely. While outpatient treatment is generally for those who only have a mild dependency, that doesn’t mean the treatment is useless either. One of the greatest benefits of outpatient treatment is that the patients remain in their own home. This means that the same stressors that they came across as users will remain around them, enabling them to make the right decisions whenever necessary. However, self-help groups and outpatient treatment require a great deal of commitment and willpower and, for some, the temptation is just too great. This is, therefore, about being honest with yourself. If in doubt, an addiction counselor will make recommendations that the patient has to follow.

Q. Can I recover without being abstinent for life?

A. A very small group of people who only have a moderate drinking problem are able to lower their alcohol intake. However, this is very rare, and the chance of them slipping not just back into their destructive behavior, but further into addiction is high. The aim of all drug and alcohol treatment is complete abstinence and a sober life.

Q. How do I protect myself from relapse?

There are lots of help out there for you to stop you from going into a relapse. A relapse is not a single event, but one that most people build up to. You will be taught to recognize the stages of relapse, so that you can get help before you return to using the substance. Also, if you do relapse, it is not that you have failed, but rather evidence that you still need a little support.

Addiction and Relapse

Unfortunately, the vast majority of people with a substance abuse problem will relapse after they have received treatment. Because it is so common, it is no longer seen as a major disaster, but rather as an opportunity for further targeted support. Patients who relapse will have been able to identify more situations, triggers, and stressors that they have to work on. Addiction takes a long time to recover from, and you have to give yourself enough time.

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