Addiction Treatment Programs

Treatment Programs for Substance Abuse

There are many different treatment programs for substance abuse. Additionally, through further research, these programs are continuously developing and diversifying. As a result, it can be quite difficult to classify them. However, as a rule of thumb, all of the programs start with a period of detox and withdrawal, which is the first step of treatment. During detox, the body rids itself of the chemicals associated with the chosen substance, which means that afterwards the patients are no longer physically addicted. Nevertheless, the behavioral, social, and psychological issues still need to be addressed, which is done in different ways through various treatment programs.

Long Term Residential Treatment

The first option is found in long term residential treatment, whereby patients receive round the clock care outside of a hospital. The therapeutic community (TC) is the most popular treatment model, where people stay for a period of between six and 12 months. Here, individuals are “resocialized”, allowing them to become part of a full community that includes staff, other residents, and the social context. Here, addiction is seen as part of the psychological and social deficits of the individual, and patients are taught to become accountable for their own lives. Treatment in long term residential rehab is confrontational and highly structured, where patients take part in challenging activities to understand their past behaviors and learn how to be more constructive and harmonious in their lives. In a TC, you can usually have access various other support services as well, to ensure that the return to the real world will have no problems. It is known that these programs are particularly suitable for those with special needs, such as those in the criminal justice system, people with severe mental illnesses, the homeless, women, adolescents, and so on.

Short Term Residential Treatment

Through short term residential treatment, patients receive brief but very intensive treatment, which usually follows the 12 step model. Originally, short term inpatient facilities only treated alcoholism, but this was expanded when cocaine became a serious problem in the 1980s. Originally, people would stay in a hospital-based setting for three to six weeks, after which they would receive extensive aftercare and a referral to a self help group. Those who come out of residential treatment must remain engaged if they are to avoid relapse once they go back to the real world.

Outpatient Treatment Programs

There are many different types of outpatient treatment programs, with different intensity of services. This option is generally more affordable than inpatient treatment and better suited to those with strong social support and significant professional or educational responsibilities. Low intensity models essentially offer drug education, where more intensive programs require significant attendance at a center for counseling. Group counseling is usually an important element of this type of treatment. Some outpatient facilities now have the capacity to treat those who have a substance abuse problem as well as mental illness.

Individualized Drug Counseling

In individualized drug counseling, the focus is strongly on stopping the illicit use of drugs and/or excessive drinking of alcohol. Additionally, it looks at the other elements of an addict’s life as well, including social relationships, illegal activity, employment, and so on. The emphasis is on setting and reaching short term goals, which is achieved by providing patients with the tools and strategies to maintain abstinence. Patients usually also take part in 12 step programs and will also be referred to supplemental services as and when required.

Group Counseling

Group counseling is commonly used in addiction treatment because it allows people to build a social network with peers. Significant research has demonstrated the importance of this in terms of maintaining sobriety, particularly if it is used alongside individualized counseling. Positive outcomes can be achieved if therapy is delivered properly.

Treatment in the Criminal Justice System

Very often, people who abuse drugs also come into contact with the criminal justice system. In fact, they usually become known there before they become known in the social and health system. This means that there is an opportunity to reach people earlier and avoid further strain on the justice, health, and social system. There has been significant research to demonstrate that drug treatment can be imposed as a criminal sanction, and that this encourages people to stay more than those who do not have the legal pressure over them. It has also been demonstrated that if people are incarcerated while being addicted, they should start to receive treatment while in prison and this should then continue even after they are released, thereby ensuring that better outcomes are achieved.

12 Step Programs

The original 12 step program was created by Alcoholics Anonymous as a blueprint to help people overcome an alcohol addiction. After a few years, it became so successful that treatments for other forms of addiction also started following these principles. Now, there are groups such as Narcotics Anonymous, Debtors Anonymous, Cocaine Anonymous, and more, which all use the same principles.

The 12 step program relies on spirituality but it has been equally successful for people who are not religious. This is because people are asked to emphasize the presence of God in a way that interprets correctly for them as individuals. According to the 12 step program, recovery is a lifelong journey. Hence, people are encouraged to approach it the way that works best for them, which may mean revisiting certain steps sometimes, and tackling other steps in one go at other times.

The 12 steps are:

    1. We admitted that we were powerless over alcohol and that our lives had become unmanageable.
    2. We came to believe that a Power greater than ourselves could restore us to sanity.
    3. We made a decision to turn our will and our lives over to the care of God as we understood Him.
    4. We made a searching and fearless moral inventory of ourselves.
    5. We admitted to God, to ourselves and to another human being the exact nature of our wrongs.
    6. We are entirely ready to have God remove all these defects of character.
    7. We humbly asked Him to remove our shortcomings.
    8. We made a list of persons we have harmed, and are willing to make amends to them all.
    9. We made direct amends to such people wherever possible, except when to do so would injure them or others.
    10. We continue to take personal inventory and when we were wrong promptly admitted it.
    11. We sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
    12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

The program is also based on 12 traditions, which are also incorporated in some way in all other 12 step programs. These traditions are found in the Big Book, which is the literature that the AA uses. Most 12 step programs have also adapted these 12 traditions. They are:

    1. Our common welfare should come first; personal recovery depends upon AA unity.
    2. For our group purpose there is but one ultimate authority – a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.
    3. The only requirement for AA membership is a desire to stop drinking.
    4. Each group should be autonomous except in matters affecting other groups or AA as a whole.
    5. Each group has but one primary purpose – to carry its message to the alcoholic who still suffers.
    6. An AA group ought never endorse, finance, or lend the AA name to any related facility or outside enterprise, lest problems of money, property and prestige divert us from our primary purpose.
    7. Every AA group ought to be fully self-supporting, declining outside contributions.
    8. Alcoholics Anonymous should remain forever nonprofessional, but our service centers may employ special workers.
    9. AA, as such, ought never be organized; but we may create service boards or committees directly responsible to those they serve.
    10. Alcoholics Anonymous has no opinion on outside issues; hence the AA name ought never be drawn into public controversy.
    11. Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio and films.
    12. Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.

Sober Living Facilities

Last but not least, there are sober living facilities, which are homes where patients can live. These tend to be privately owned, sometimes by a nonprofit organization, and are generally in quiet areas to ensure calm and peaceful environments. These facilities are not rehab centers, as the patients have a lot more freedom and less intensive treatment there. In fact, people simply have to follow certain rules as determined by the house. Often, this includes a curfew and attending work or education during daily hours. Furthermore, they must agree to random drug testing.

Patients Simply Abide by the Rules of These Facilities

In a sober halfway house, as they are also known, people have to take responsibility for themselves. This is a vital step towards recovery, as it teaches people to no longer get enabled by others around them, or to behave irresponsibly. In the facility, people have to pay rent, buy food, and essentially live a normal life, while abiding by the rules of the facility.

Each halfway house has its own rules and regulations, but some are commonly found across the board. When moving in, residents must agree to these rules and infractions are dealt with in different ways, ranging from having to leave the home to writing a letter of apology to other residents. The number one rule across all sober living facilities is that people must remain sober. This may mean that they have to stop using certain cooking ingredients (including vanilla), that they cannot take certain types of medication, that they cannot use mouthwash, and so on.

Additionally, residents must generally agree to go to their place of employment or education during the day, and that they do chores in the home around those hours as well. They may also have to come in by a certain curfew, although this also depends on the specific home.
No Restrictions on Who Can Live There

There are usually no restrictions in terms of who can live in a halfway house. Most, however, have gone through an inpatient or outpatient rehab center first. Hence, the majority of people who enter these homes are already sober and have the tools to remain so as well. That said, people who are completely new to the recovery process can be accepted as well, so long as they feel able to remain sober during their stay.

Halfway houses come with varying costs, but the price is usually comparable to that of an apartment in the city it is located in. Rent has to be paid monthly, and utilities tend to be included in the price. However, there are limitations on how much utilities they can use. While prices are often quite high, they are usually lower than those in an inpatient treatment facility. However, inpatient (and outpatient) rehab is generally covered at least partially by medical insurance, whereas sober living facilities are not. Nevertheless, many halfway house managers understand that the goal is to keep people sober, so they are often quite flexible with their prices.

A sober living house may be the perfect solution for you, or it may be completely wrong. The same is true for all the other different treatment programs for substance abuse. It is very important that you speak to a professional drugs counselor who understands you and your personal situation, enabling them to make recommendations based on your particular needs. If you end up attending inpatient treatment, which is the most common option, you will also have to consider the type of facility you want to go to. There are state sponsored facilities, but also luxury facilities and executive facilities, each with its own rules and regulations that must be adhered to.