The Continuum Of Care For Addiction

Detoxification The first step of any recovery program is detoxifying the body and removing the substance from the system. Drug or alcohol detoxification refers to the process of avoiding a substance so that the body will naturally remove it from the system. Since an individual can experience withdrawal symptoms that are uncomfortable and even dangerous, it is recommended that individuals go into a medically supervised detox program to limit the risks. The final goal of detox is to stabilize the body so that an individual is able to focus on recovery and is not facing major health risks. Harvard University explains that detoxification is not a treatment; instead, it is a medically supervised withdrawal from the substance to limit the risks and ensure that the individual is physically stable before treatment. It is designed to address the immediate concerns related to discontinuing the substance. Withdrawal symptoms that may develop during detoxification include:

The symptoms that are associated with withdrawal are often uncomfortable, but there are severe risks associated with some substances. Any individual who is experiencing hallucinations, confusion, severe fevers or seizures should be stabilized by a medical professional. In the worst-case scenario, there is a risk of death. Due to the risk of severe symptoms, a medically supervised program is recommended. During a detox program, a medical doctor and nurses will monitor the individual and provide appropriate treatments to help reduce the discomfort or deal with any severe symptoms that develop. Severe symptoms are most common with opiate or alcohol dependency. Even though detoxification will remove the substance from the body and will ensure that the individual if physically stable, it is only the first step of recovery. It is important to continue with a treatment program after completing the detox program.

Drug and Alcohol Rehab

Detoxification is not a treatment; instead, it is a way to take the first steps without going through withdrawal symptoms alone. Additional treatment is usually necessary to recover due to the way that drugs and alcohol cause cravings and a compulsion to abuse the substance as well as the underlying emotional and psychological reasons the abuse occurred in the first place. According to Help Guide, there is no single treatment solution that works for every individual. As a result, the best treatment plan and facility can depend on the needs and goals of the person who has abused drugs or alcohol. By understanding the options, it is easier to determine the best plan for the situation and the individuals’ goals. There are two main types of treatment options: residential and out-patient. In most cases, a residential program is best for the initial treatment because it provides the initial tools and information that an individual needs to start his or her recovery. It is also a very structured environment, which can be beneficial during the first steps of recovery. A residential program can be a short-term or a long-term program. According to the National Institute on Drug Abuse, residential programs are often appropriate for severe addictions or individuals who have relapsed on a substance after completing an out-patient program. Many programs offer short-term in-patient treatment for roughly 28 to 30 days; however, there are programs that offer treatment for a longer period of time if it is determined that an individual needs additional care. The benefits of a residential treatment program include:

• A structured environment
• Supervision from professionals and medical staff
• Fewer distractions
• Focused care
• Constant focus on recovery

Although the in patient program can be beneficial, it is not always the best option for some individuals. Depending on the severity of the addiction and the current situation, some individuals may find that an out-patient program is appropriate. An out-patient program differs from a residential program because the individual is not living in the facility; instead, he or she travels to and from treatment each day. The National Institute on Drug Abuse explains that an out-patient program will often focus on counseling and cognitive treatments. It may not have the highly-structured environment, but it can be helpful when an individual has responsibilities that do not allow him or her to enter a residential program for the duration of time required. Generally, out-patient programs are best for individuals who have only used a substance for a short period of time and have never relapsed or treated for addiction in the past. It may be most helpful when an addiction has developed accidentally after taking medications for legitimate medical reasons or in similar situations. Long-term residential treatment may be helpful for individuals who have a severe addiction and have been using drugs or alcohol for an extended period of time. The long-term care can range from 3 to 12 months, depending on the needs of the individual and the specific program. Although it is not necessary for every individual, long-term treatment can help with recovery when other programs are not sufficient to treat the addiction and if the individual has relapsed several times.

Aftercare Programs

Completing a treatment program does not mean that recovery will automatically follow and be maintained for a lifetime. According to Psych Central, addiction is a problem that lasts for a lifetime and it requires a lifetime of proper maintenance and care. Since there is an addictive cycle, individuals need to learn how to avoid falling into old habits, explains Psych Central. Substance abuse can be used as a way to avoid emotions, physical pain, the symptoms of mental health disorders or a variety of other situations. Aftercare programs are an important part of maintaining recovery after completing a rehab program. Addiction Today states that aftercare is the foundation of long-term recovery because it provides support, encouragement and assistance during the first few months after leaving a treatment program. An aftercare program is a type of transitional program that helps individuals immediately after they complete a treatment program. It offers counseling services, group therapy or additional out-patient treatment options based on the needs of each individual. According to Addiction Today, the first aftercare session should take place shortly after the individual leaves a treatment facility because the highest risk of relapse occurs during the first few months. When an effective aftercare program has been developed, the individual has the support and assistance he or she needs to avoid the substance and start maintaining his or her recovery goals. Options that may be available in an aftercare program include:

• One-on-one counseling
• Family or group counseling
• 12-step programs
• Additional cognitive-behavioral treatments if they are necessary
• Continued management for dual-diagnosis

The counseling services focus on the needs of each individual, so some individuals may continue to obtain out-patient treatments as part of an aftercare program. In some cases, a treatment facility can transition an individual into an out-patient program that requires him or her to visit the treatment facility on a regular basis. The number of visits can gradually taper off as the risk of relapsing reduces. In most cases, aftercare is provided for a set amount of time. It may be available for one to three months after completing a treatment program, but some facilities offer aftercare services and group meetings for years if it is necessary for an individual to maintain his or her recovery goals.

Transitional Living Solutions

Although aftercare is an important part of treatment, it is not the only option that is available. Aftercare is important for individuals who decide to return to their normal lifestyle and living environment after treatment. In some cases, going into a transitional living program can help reduce the risks and provide the additional structure that is necessary before returning to a home environment. The National Institutes on Health explain that sober living houses or transitional living houses are drug and alcohol-free living environments that offer continued support and assistance to individuals who may need a structured environment. Since the environment has specific rules and every individual in the transitional living house is expected to follow the rules, it is possible to maintain recovery without giving up employment opportunities. Sober living houses and transitional programs are designed to meet the needs of the individual. Some programs may allow mothers to bring their young children into the home, but the options can vary based on the type of facility and the treatments that are provided. The residents are given a mentor who has completed his or her recovery program and has been in the transitional living program for a set amount of time. The mentor guides the new residents of the program through the transition into a healthier lifestyle and assists them with difficulties as they arise. The programs may offer counseling and transportation to a 12-step meeting or similar solutions to help maintain recovery goals. In most cases, there are rules regarding curfews and activities that are acceptable. The environment is more structured than most individuals have available in their home, so it can help smooth the transition from a residential treatment program into a new environment without taking the large risks that are associated with moving back into a personal home. Transitional living options are not required, but they can help when an individual has relapsed on a substance in the past and may need more structured environments for the first year or two after completing a treatment program. The support and assistance can be helpful for some individuals.

Relapse Prevention

Regardless of the aftercare or transitional options that are used to help reduce the risks, relapse prevention is a key part of maintaining a drug and alcohol-free lifestyle for a lifetime. Relapse prevention is the method of avoiding the substance, even after the individual is back in his/her home environment. It can also include a plan in case a relapse occurs so that it is possible to get into a treatment program as soon as the relapse occurs. Individuals sometimes relapse on a substance multiple times before they can completely change personal behaviors, explains Psych Central. That is why it is important to have a plan in place in case an individual takes the drug or drinks alcohol at any time after completing the initial treatment. Returning to an addictive lifestyle, which is called a relapse, can happen at any time, even years after the substance was last used or abused. Psych Central explains that the relapse process often starts with emotions and feelings. Disappointments or problems arise in life, but the individual who has abused drugs or alcohol in the past may forget that the disappointment is normal or may make the problem larger than the reality. A relapse or a lapse, which can be just  a single time that the substance is abused, can occur when the emotional state of mind becomes focused on negativity. According to Psych Central, the addictive cycle often starts with pain, or a negative emotion, that causes the need or compulsion to act out in a certain way. In the case of addiction, the compulsion will often relate to abusing the substance. After abusing the substance, the individual may feel more pain, disappointment or negative emotions due to the use of the substance. Psych Central suggests that individuals arrange a relapse prevention plan that includes a discussion with supportive loved ones, a counselor or a similar individual whenever a disappointment or negative situation occurs. Clarifying the situation and realizing that the emotions are a normal part of life can be helpful. Along with the discussion, relapse prevention should focus on finding ways to manage any cravings for the substance that may arise. Cravings will often occur during the first few months after completing a treatment program. They may reduce in intensity or the duration of time between cravings can reduce over time; however, a craving can occur at any time after an addiction develops. Even years of maintaining a drug or alcohol-free lifestyle will not prevent a cravings for a substance in some addicted individuals. Finding ways to reduce anxiety, stress or other negative emotions can also help. Since negative emotions can trigger cravings, it helps reduce the number of cravings or can help with avoiding temptation. Setting up a relapse prevention plan can ensure that there are actions to take in different situations. It should also include a plan in case a relapse has occurred so that loved ones are aware of the next steps that they can take when an individual returns to an addictive lifestyle. Addiction is not a short-term problem. It is a disease that requires proper treatment and maintenance. By understanding the options that can help prevent relapsing in the future, it is possible to set up a realistic recovery plan that will encourage a healthy lifestyle for a lifetime. Sources: What Is Detox? Treating opiate addiction, Part I: Detoxification and maintenance Signs and Symptoms of Drug Abuse DrugFacts: Treatment Approaches for Drug Addiction Overcoming Drug Addiction Aftercare: A Fundamental Tenet in Attending Long-Term Recovery What Did We Learn from Our Study on Sober Living Houses and Where Do We Go from Here? The Addictive Personality: Why Recovery is a Lifetime Thing Relapse Prevention ]]>