Outpatient Alcohol & Drug Treatment

Substance abuse, dependency, and addiction are very complicated issues. They have an impact not just on the life of the person who has the addiction, but also every other element of society. They affect work, health, and relationships. However, it is hoped that those who are in the grips of an addiction will reach out for help at some point. This can occur after an intervention from their loved ones or the criminal justice system, or out of their own volition. Either way, there are many different settings across the country where people can go to get treatment and be assisted on getting on the road to recovery. This starts with a medical assessment by a physician, or by a qualified addiction professional. Depending on the level of abuse or dependency, they may be referred to outpatient alcohol & drug treatment facilities.

Addiction Is a Progressive Disease

Addiction is a chronic, progressive disease It is characterized by uncontrollable and compulsive drug use, despite the user being aware of its harmful consequences. The brains of people who are addicted have undergone some changes, and these can last for a long time. These changes lead to the harmful and dangerous behaviors that characterize people who use or abuse substances. Furthermore, most people who have an addiction will, at some point, relapse back into their behavior. This means that they have tried to stop for a period of time, but later return to drug use.

Addiction doesn’t happen overnight. It always starts with somebody choosing to use drugs, or even being prescribed drugs by a physician. However, over time, people are no longer able to make that choice. They become compulsive in their efforts to find and take their substance of choice. This is because brain function is significantly altered when a person takes drugs. When someone has an addiction, the part of the brain that gives motivation and reward is altered, as are the elements that control behavior, influence learning, and enable memory. As such, addiction is a disease that can best be described as affecting both behavior and the brain.

Is Treatment for Addiction Possible?

Yes, but it is very difficult. Addiction is chronic, which means that people cannot simply stop taking a substance for a few days and be classed as cured. In fact, some say that there is no cure for addiction at all. People need to be provided with long term care, often repeated, in order to regularly stop them from using the drug again during those times when the urge becomes so strong.

Because of this, addiction treatment has to be designed to:

  • Help the patients stop using drugs
  • Help the patients to remain free from drugs
  • Help the patients to become productive in their family, in their job, and in society as a whole

The Principles of Effective Treatment

The National Institute on Drug Abuse has released a number of key principles of effective treatment. These are based on significant research that have been conducted since the mid-1970s and all effective treatment programs now follow them. They are:

    1. That addiction is a complex disease but one that can be treated, and that it affects both the way the brain works and how a person behaves
    2. That there isn’t a single treatment that suits everybody
    3. That treatment can only be effective if it addresses all of the needs of the patients, and not just their drug use
    4. That it is critical that someone stays in treatment for the right period of time
    5. That treatment should include behavioral therapies and counseling
    6. That medication may be used as part of treatment when combined with behavior therapies
    7. That a treatment plan must regularly be reviewed and changed to ensure the changing needs of the patient continue to be met
    8. That any co-occurring mental disorders should also be addressed
    9. That medically assisted detox is just the first part of treatment
    10. That treatment can be effective even if it is not voluntary
    11. That patients should be monitored for drug use continuously during treatment
    12. That patients should be tested for infectious disease and should be educated about how to lower the risk of contracting them

How Drug Addiction Is Treated

There are a number of steps involved in successful treatment:

    1. A period of detox, to clean the body of the unwanted chemicals
    2. Behavioral counseling
    3. Possible medication
    4. Evaluation for co-occurring disorders and treatment
    5. Aftercare to avoid relapse

In order for patients to be successful on their road to recovery, they must be offered a program that is tailored to their particular needs, with excellent aftercare. The program should include medical treatment and mental health treatment. Aftercare can include recovery support systems within the family and/or the community.

What Is Outpatient Treatment?

Those who have a substance abuse problem can use a number of different treatment options. One of those is outpatient treatment. At outpatient centers, people who know that they need help but are unable to stop going to school or work in order to get help, can receive the treatment they need. Each outpatient center will offer treatment in different ways, but they all generally enable patients to attend several times a week for a few hours. They are, as such, very flexible. Unfortunately, they are also often much less effective, particularly if someone requires psychological recovery as well as medical recovery.

The Benefits of Outpatient Alcohol & Drug Treatment

Depending on the needs of the individual, outpatient services can offer excellent help for someone to attain sobriety. It is suitable for those who have a stable condition with mild symptoms, and only for those who are willing participants. If someone meets those criteria, then outpatient treatment offers a number of clear benefits, such as:

  • The fact that it can be offered in many different settings, including community clinics, psychologist’s and doctor’s offices, over the telephone, or in an addiction clinic
  • The fact that it is very flexible, enabling people to get treatment while taking care of their personal, professional, and educational responsibilities

It is very important, however, that someone is first properly evaluated and that their drug abuse issue is fully examined by a qualified professional. They should then recommend whether or not outpatient treatment is suitable.

Types of Outpatient Treatment

1. Intensive Outpatient Treatment

Intensive outpatient treatment may be a good option for people who have mild to moderate substance abuse problems. Here, the problem of addiction is addressed, but it can also address mild to moderate co-occurring disorders such as mental health issues. Usually, this is achieved by increasing how often patients visit the center, and for how long.

2. Partial Hospitalization or Day Treatment

Partial hospitalization is also an option for some people. Although this means staying inside a hospital, it is still classed as a form of outpatient treatment. This is known as a “very intensive” therapy option, or as a “day treatment”. It is suitable for people who have a more serious form of addiction, or a lengthier addiction history, or psychological or medical conditions, and who therefore require more intensive therapy in order to recover.

For people to be classed as suitable candidates for partial hospitalization, they can usually demonstrate that they are committed to continue to meet their treatment goals when they are at home, at work, or at school, but that they also need more concentrated and frequent time periods where they receive care and interaction from addiction treatment professionals. In so doing, they are able to maintain their momentum towards recovery.

Sometimes, day treatment is offered to those who have already gone through a residential inpatient treatment program, but who are struggling not to relapse after their treatment. It can also be suitable for people who require laboratory services or medical services for issues relating to their treatment. As expected, this type of outpatient treatment does require a bigger time commitment than other forms of outpatient treatment. While this will vary depending on the individual, it is usually between two and eight hours per day, everyday. However, it continues to be classed as outpatient treatment because patients go home after they have received their daily treatment.

Inpatient or Outpatient Treatment?

By far the most important thing in terms of deciding whether to choose inpatient or outpatient treatment is how serious the addiction is. Various scientific studies have demonstrated that outpatient treatment can be highly successful and help people get on the road to recovery, with the main advantage of outpatient treatment being that patients do not need to change their living arrangements.

Advantages of Outpatient Treatment

Some experts have said that enabling patients to remain in their own homes and to continue to maintain their professional and/or educational responsibilities has a number of distinct advantages. In inpatient treatment, patients are completely removed from the environment in which their abuse was facilitated, but this often also means that returning to the real world can be very difficult, as the patients are suddenly exposed to all those familiar triggers again. Some suggest, therefore, that outpatient treatment is able to truly assess what the coping mechanisms of the recovering patients are, while also ensuring that they have the support they need if they feel things are getting too difficult.

Difficulties in Outpatient Treatment

Outpatient treatment is also more challenging. Patients have to commit to finding and using support that is around them. This includes finding recovery mentors or self help groups within their community, helping them achieve sobriety. Transitioning from inpatient to outpatient treatment can be very difficult, not in the least because those support networks are not in place yet. By remaining in the community, patients are immediately supported by those around them to remain sober for the rest of their lives.

That said, there is a counterargument to be made as well. People who are in the grips of addiction will find it far more difficult to remain abstinent if they are in outpatient centers, particularly during the first stages of their recovery. This is because their environment doesn’t change, and they are therefore able to continue to obtain their chosen substance. Being faced with temptation so often can be too much to cope with.

Additionally, outpatient treatment does not include aftercare treatment or followup once the agreed therapy actually ends. This means that people have to take responsibility themselves for finding continued support. Again, this can be quite difficult and may mean that relapse is more likely.

How serious your condition is will be the main determining factor in terms of seeking inpatient or outpatient care. If your abuse means that you can no longer take part in normal everyday life, or if you have a dual diagnosis, then inpatient care is generally recommended. Additionally, if you have to go through medical detox, then inpatient options are preferred.

Statistics on Drug Addiction Treatment

According to the Substance Abuse and Mental Health Services Administration (SAMSHA), which completed the National Survey on Drug Use and Health in 2014, some 22.5 million people in this country over the age of 12 (8.5% of the entire population), required treatment for alcohol or drug abuse. Unfortunately, just 4.2 million, which is 18.5% of those who required treatment, actually received it. 2.6 million of them went to a specialty treatment program for help.

Important Points to Remember

Drug addiction is a treatable condition but treatment is difficult. It is vital that treatment is designed to ensure that the patient:

  • Stops to use drugs
  • Remains free from drugs
  • Becomes productive in society, at work, and within the family unit

To achieve this, successful treatment has to follow a number of steps, whether offered on an inpatient or outpatient basis:

    1. Detox
    2. Behavioral counseling
    3. Possible medication for alcohol, tobacco, and opioid addictions
    4. Evaluation for co-occurring mental health problems and treatment for this, including anxiety and depression
    5. Long term aftercare as part of relapse prevention efforts

Medication can be an important form of treatment to help people cope with the symptoms of withdrawals, to treat co-occurring mental health conditions, and to prevent relapse.

Finally, behavioral therapies should be offered in order to help patients:

  • Change their behavior and attitude towards drug use
  • Enhance their healthy life skills
  • Persist with treatment, including medication

Last but not least, people who are within the criminal justice system often need further treatment in order to be effective. Unfortunately, those who are incarcerated often do not have access to these types of services.

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