Treatment in Van Buren, Arkansas
The City of Van Buren, Arkansas in Crawford County, faces a serious epidemic of prescription drug abuse. The city, in the Fort Smith, Arkansas-Oklahoma Metropolitan Statistical Area has demographic profile fairly typical of many southern, small to midsize towns. The population of more than 20,000 is predominantly white with a modest median household income of about $35,000. Many residents work in low paying jobs at local food processing and manufacturing industries.
According to local prosecutors, in recent years, prescription drug prosecutions in the county have surpassed both a chronic problem with methamphetamines and also marijuana prosecutions. The trend is linked to the Arkansas’ high rate of opioid prescriptions. In a 2017 report, the Centers For Disease Control and Prevention (CDC) ranked Arkansas second only to Alabama for its rate of opioid prescriptions. The figures showed Crawford County’s prescription rate as among the worst in the state and at 158 per 100 people more than twice the national average. The problem of prescription drug abuse is especially serious among teenagers. The attorney general, Leslie Rutledge, says Arkansas ranks first in the nation for misuse of painkillers among children aged 12 to 17.
Some efforts to combat the prescription drug problem could be starting to impact the city. State legislation passed in 2017 mandates that doctors enter the information on the drugs they prescribe to patients into the state’s Prescription Drug Monitoring Program (PMP) database. Several high schools in the Fort Worth metropolitan area are taking part in a prescription drug abuse education program launched in 2017 by the attorney general. The Crawford County Sheriff’s Department, head-quartered in Van Buren, Arkansas also participates in Operation Drug Take Back and has a box for returning old prescription drugs.
An addiction assessment is used to determine if a person has an addiction, its extent and if there are other issues present. A range of professionals are able to conduct these assessments, including doctors, nurses, social workers and psychologists. The information provided is kept confidential and can consist of a questionnaire, an interview and a physical exam.
The questionnaire asks about drug or alcohol use, medical history, general health and the impact any drug use may have had on the person’s daily life. This is followed by a personal interview with a health professional that together with the questionnaire helps to form a diagnosis.
Assessment tools used by clinicians during this process include the National Institute on Drug Use Screening Tool (NIDA), the Alcohol Use Disorders Identification Test-C (AUDIT-C) and the CAGE assessment.
The person may have to provide a urine sample to test for drugs consumed. A blood sample can also be requested to help establish any health impacts from drug abuse.
The pre-intake process is the step before a person actually starts a more formal intake process to actually enroll in a drug rehabilitation program. Pre-intake procedures might involve a questionnaire or an informal interview.
The intake process determines if the rehabilitation center selected by the person seeking treatment is the right option for their addiction. The person and the center’s representative will discuss the treatments offered by the facility to decide if it’s a good fit for their stage of addiction. The rehabilitation center will ask about the seriousness of the addiction, drug use history, any relevant family history and also discuss financial options if the rehabilitation at the center goes ahead.
Recovering from drug and alcohol addictions usually involves a detoxification phase at the start of the rehabilitation process. The detox phase aims to completely remove the drugs from the body. In the case of opiate prescription drugs, maintenance medication can be administered to reduce withdrawal symptoms. Various factors impact how difficult this process is for the person experiencing the detox, including:
· The person’s metabolism and general health
· The amount and frequency the drug was being taken
· The length of time the drug was taken
· The existence of any other addictions.
Under medical supervision the process is usually safe. However, due to the severity of the process in certain situations it’s not advisable to undertake a process of drug detoxification in your own home.
During the process a person’s body experiences withdrawl symptoms which usually appear within 24 hours of taking the last dose of drugs. The person can experience a range of withdrawl symptoms, including: nausea, fatigue, depression, cramping and increased heart rate.
Some addictions, for example, to heroin, opiates, and alcohol, can require medications to ease the severity of the withdrawal process during detox. The medications can include:
This drug is often used during detox from opiate prescription medications or heroin. The dose is reduced over time and may continue beyond the actual detoxification process. Learn more about opiate replacement here.
Buprenorphine is another option for treating heroin and prescription opioid addictions. The drug’s advantage over methadone is that it doesn’t give the patient a ‘high’ making abuse and possible addiction less likely.
These medications help to relieve anxiety, general discomfort and irritability during the detox process. Barbiturates can also act as a mild sedative.
Levels of Treatment
Inpatient Treatment (IP)
A clinical professional will determine the appropriate level of care. The highest level is inpatient (IP) treatment and consists of 24-hour nursing care in a hospital setting. Individuals suffering from serious and unstable medical or psychiatric issues generally opt for an acute level of IP care. Acute care is maintained until the person is stable.
Residential Treatment Care (RTC)
Residential treatment care (RTC) is one level below IP treatment. RTC facilities are referred to as sub-acute facilities and rather than 24 hour nursing attention, provide 24-hour monitoring. Diagnostic services are also provided that aim to help people overcome any severe drug related symptoms that significantly impede day to day functioning. Residents typically receive intensive treatment through about 30 group sessions per week and seven individual sessions per week, including about three therapy sessions involving dietary consultations and individual consultations with the program’s psychiatrist and physician). Each week, a weekly family treatment allows anyone from the person’s main social network can participate. The typical length of stay ranges from 30-60 days.
Partial hospitalization (PHP)
Partial hospitalization (PHP) treatment, also referred to as day treatment, is an intensive care program that typically lasts four to eight hours per day, three to seven days per week. The care is time limited and appropriate for a person that lives in close proximity to the care program’s location and whose drug related behaviors and medical issues can be treated without a more structured treatment process. Partial day treatment programs include group, individual and family or primary support network therapy. Medications is also monitored and the duration of the treatment varies from two to twelve weeks.
Intensive outpatient treatment (IOP)
Intensive outpatient treatment (IOP) can require individuals to have a minimum of nine hours of therapy per week. A clinical professional determines if this is the appropriate level of care through screenings and other assessments. IOP is often a mixture of group and individual therapy. The nine hours of treatment are usually divided into three-hour sessions, three to five evenings a week for 12-16 weeks duration. Once the program is successfully completed, the individual steps down to what’s called a “maintenance” therapy group that may meet weekly. The average size for a group undertaking a mental health intensive outpatient treatment program is eight to 15 people.
Outpatient Care (OC)
Outpatient treatment is regarded as the lowest care level and is usually offered once a week. Outpatient settings can vary greatly but they all involve office visits with no overnight stays. Some OC facilities are located in community mental health centers and others are based in hospitals or outpatient clinics.
Aftercare for people recovering from drug addiction is continuing treatment immediately following a defined period of addiction treatment care like inpatient treatment or outpatient care.
Continuing treatment of this kind is essential for recovering addicts because substance abuse can alter normal brain function and change mental and physical health. These changes do not necessarily reverse themselves, even after detoxification and a treatment program, and may last many years after a person ends their substance abuse.
The aims of an aftercare program include:
· Stopping a relapse into drug addiction
· Maintaining a sense of purpose in life
· Ensuring a person’s mental and physical recovery from addiction continues.
A lot of aftercare includes Relapse Prevention.
Sober living homes are used by people recovering from addiction and provide a transition between their rehabilitation and move back into mainstream society. These homes are a drug and alcohol free environment and many are certified by Sober Living Coalitions or groups. Sober living facilities often have these key features:
· Residents are encouraged to take part in group therapy
· Residents are drug tested periodically to ensure abstinence.
· Residents are required to carry out chores, prepare meals and follow other house rules.
· Residents are supported in their efforts to work towards goals like finding a job or completing school.
· Residents must pay lodging fees punctually.
Most sober living homes are single sex but co-ed facilities are easy to find. Other sober living facilities are sober colleges and cater solely for young people’s recovery from drug addiction and function not unlike a college dormitory. Many establishments combine as outpatient treatment centers so they are staffed 24 hours by medical professionals and social workers. These facilities also have personnel that take care of cooking and cleaning. These sober living centers tend to cost more but can provide a cheaper alternative to often expensive inpatient treatment.
Some health professionals say sober living homes do increase the likelihood of a sustained recovery from drug addiction especially when a program based on the 12 Step model is followed. According to the Substance Abuse and Mental Health Services Administration (SAMSHA) the majority of drug addiction treatment centers use the model at least occasionally.
The 12 Step model was developed by Alcoholics Anonymous founder Bill Wilson and is based around the idea that sharing personal stories of addiction has a positive effect. Wilson believed that people can sustain abstinence from their addictions if they help one another. This help comes in the form of regular meetings where participants share their feelings about their addiction and support each other through the recovery process.
The 12 Step process can be summarized as follows:
· The addict admitting that they cannot control their addiction.
· The addict recognizing that a higher power can provide strength.
· The addict examining their past errors with the help of an experienced member of the group.
· The addict making amends for this past mistakes.
· The addict learning to live by a new code of behavior.
· The addict helping others who suffer from addiction.
Find more information on the 12 Steps here.
Our website, The Recover, is loaded with treatment information and options for the user in all stages of addiction. If you are a beginning user, and have been drawn to this page thinking you may have a problem, or if you are someone who believes he or she has a current drug abuse issue that must be immediately handled, we ask that you also review other pages on this site. We are here for you. Our search bar above will help you find further information as to your city, or your needs. Feel free to keep in touch with us, and let us know of your progress.