Thursday, April 18, 2019

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Addiction and Treatment in Baltimore, Maryland

Given that a quarter of the population lives below the poverty line in Baltimore, Maryland, it comes as little surprise that the crime rate is far above the United States’  national average. With a population of only around 600 thousand, as compared to New York City’s population of over 9 million, Baltimore nevertheless had more homicides than New York City in 2015. Baltimore had 344 homicides in 2015. In the same year, New York City had less. In 2017, Baltimore had the highest number of homicides in the city’s history.

Among cities of similar size, Baltimore has the highest opiate drug death rate in the entire United States. According to the DEA, over 10% of Baltimore’s population is addicted to heroin, alone. Baltimore is a city that suffers from major problems with poverty, major problems with violence, and a massive number of avoidable deaths.

According to the U.S. Drug Enforcement Agency, city has the highest heroin addiction rate in the country. And because so many people are so poor in Baltimore, it only makes sense that no matter how many people are arrested for dealing, the illegal sale of heroin and other opioids will continue, because there is so much money to be made.

Drugs other than opioids are prevalent in Baltimore as well.  Alcohol contributed to 582 deaths in 2016, in Baltimore, Maryland. Cocaine contributed to over 464 deaths in Baltimore, in 2016, as well.

If you live in Baltimore, and have fallen victim to substance abuse don’t hesitate to seek treatment. There are enormous resources in at your disposal.

Even though heroin is so relatively inexpensive, so potent, and in such wide supply, just like in the rest of the county, many addicts regularly use prescription opioids and fatally overdose from them. And just like the rest of the U.S., too, fentanyl has resulted in a massive number of overdoses, and deaths. By dose, fentanyl is much cheaper than heroin, and for this reason dealers mix it in with heroin to save money. But because fentanyl is so much more potent than heroin, it’s easy for the dealers to sell a much more potent drug than they need to, and people who are used to injecting heroin inject the same amount of the fentanyl-laced bag, and overdose, and often die.

There are countless ways in which drug addiction harms oneself and one’s community. In Baltimore, Maryland you can count so many of them with a first look. There’s sickness and poverty. There’s criminality and imprisonment. There’s the associated violence, and frequent homicides, that accompany the drug trade in Baltimore. And on top of all this there is the looming and very likely threat of overdose.

Treatment

Thankfully, if you live in or around Baltimore, Maryland there are many people that can provide you with treatment. There are treatment centers scattered throughout the area, of varying quality and varying suitability to your unique situation. No matter your needs expectations, in Baltimore you can find a treatment center that’s the right fit for you. In the following, I will explain the treatment process, from beginning to end. With information, you can make a better decision about what treatment center is best for you. With so many treatment programs present in the city of Baltimore, there is no reason that you shouldn’t find a treatment program perfectly fitted to your situation. It’s only a matter of making an informed decision, and you’re on your way on the path to recovery.

Intake

The first part of the treatment process is intake. This is the part of the process during which you learn more about the treatment center and its treatment programs, so that you can decide whether the treatment center is right for you. This is also the part of the process where the treatment center asks you a series of questions, to help them decide whether the treatment center and the programs there are suitable for your situation.

Once you have selected a treatment center that you are interested in and would like to apply to, you will be asked a series of questions to assess whether you are a good fit for the treatment center. These questions will be diverse in the areas that they concern. You will likely be asked about your medical history, your family, and about the current status of your addiction.

The treatment center may interview you in-person, over the phone, or over the internet. Different treatment centers perform this first interview in different ways. But what almost all treatment centers have in common is the kind of questions that they will ask. Some examples of the specific questions that they may ask are: How long have you been using the drug that you are dependent on right now? When was the last time that you used the drug that you are addicted to? How much of the drug do you take on a daily basis? What’s your family’s history of drug use?

It is very important to answer the questions honestly, because your answers to these questions are what they are going to use to decide if the programs that they offer can be of benefit to you. Different treatment centers offer different treatment programs, and because every program is the best fit for some set of needs and expectations on the part of the patient, not every treatment center may be the best fit for you. Some treatment centers will suit your needs much better than others.

It’s important to be honest in answering these questions also, because the treatment center will design your individualized treatment program in part based on your answers to these questions.

It is during this interview stage that it is your time to ask questions of the treatment center as well. Everyone has different needs and expectations, so if there is something that it is important to you that the treatment center has, then it is important that you ask the treatment center questions about it. You need to find out if he treatment center meets your needs well because you need to find a treatment center that you can feel comfortable at. It is extremely important that you find a treatment center that you can feel comfortable staying at for a long time.

The reason that it is so important to find a treatment center that you feel comfortable staying at for a long time, is because a major predictor of the success of treatment,  according to many medical professionals, is how long the patient stays in the treatment program. It is usually recommended that the patient stay in the treatment program for at least three months, for the best results.

After the treatment center has interviewed you and you have interviewed the treatment center, if you have decided to attend the treatment center, once you have arrived you will be interviewed for a second time. Now this interview, unlike the first interview, will definitely be in-person. This interview will be more in-depth than the first interview. They will likely ask you many of the same questions, additional questions that they did not ask you in the first interview. They will use this interview to help them design your treatment program going forward, so it is very important to be honest in your answers to their questions.

It is also during this stage of intake, once you have arrived to the treatment center, that the items that you have brought with you will be looked through. When you arrive to the treatment center, a treatment worker will take you to the room that you will be staying in for the duration of your stay at the treatment center. Together, you and the treatment worker will go through the bags that you have brought, and go through the items that you have brought, one by one.

This informs another important series of questions that you may want to ask before you arrive at the treatment center. Treatment centers prohibit patients from having certain items during their stay. Treatment centers do not allow patients to bring alcohol or illegal drugs into the treatment center. Most treatment centers do not allow patients access to their cellphones during their stay. Additionally, many treatment centers prohibit patients from bringing other items as well. Many treatment centers do not allow patients to bring certain electronic items other than cell phones, and many treatment centers do not allow patients to bring musical instruments with them to treatment.

For these reasons, if having an item with you during your treatment, such as a musical instrument, is important to, then you need to ask the treatment centers that you are considering receiving treatment from if the item that you would like to bring is prohibited.

If you bring medications that you have been prescribed by your doctor, when you arrive at the treatment center, they will be taken away from you. The medications will be put in the treatment center’s pharmacy, and you will be given doses of the medication as it has been prescribed by your doctor. You are not allowed to use prescription medication that you have not been prescribed, in the treatment facility.

Aside from the second interview and the review of the items that you have brought with you, on your first day in the treatment center you will also be administered a drug test. This drug test will usually be a urine test, and it will be used to decide whether or not you need detox. The test will also help to inform the decision as to what kind of detox you need.

Detox

There are different kinds of detox, all suited to different patients’ needs and situations. This is another reason that it is very important to let the staff know of whatever medical problems you have, aside from drug dependence, because your medical condition may determine how your detox is carried out.

It is especially important to let the medical workers know if you suffer from any infectious diseases, because if you do not let them know, you may be endangering yourself and others. The more information they have about your medical condition, the better they can prepare the detox for you. And the more aware they are of any contagious medical conditions that their patients have, the better the medical workers can protect themselves from being infected, and therefore protect their future patients from infection as well.

No matter what kind of detox a patient undergoes, it will always be difficult, to some extent. It won’t be too difficult; it won’t be impossible; it won’t be unsafe, when you’re assisted by medical workers. But detox will always be uncomfortable to some extent.

Nevertheless, detox is worth it. You will feel so much better after you are no longer physically dependent, or regularly using, the addictive drug. And, it is only after you have successfully completed your detox that you can really begin with rehabilitation. In competing detox, you will be that much closer to the end goal of recovery.

In addition to the drug test you take that will determine whether or not you need to undergo detox, you may also be given other medical tests before undergoing detox, especially if you have other medical problems. Also, in addition to medical service related to detox, the medical workers that are assisting you with your detox may also help you with other medical problems that you have, if they arise during your detox procedure.

There are a few different ways to detox. The main two detox programs available through treatment centers are called inpatient detox and outpatient detox. In inpatient detox, the patient undergoes detox at the treatment center, under constant medical supervision. In inpatient detox, medical care is always immediately accessible to the patient. The patient sleeps at the treatment center, and stays in the area for the entire duration of the procedure.

This is unlike outpatient detox, in that during outpatient detox, the patient does not sleep at the treatment center. The patient sleeps elsewhere, and the patient is not under constant medical supervision. In fact, the patient does not even necessarily undergo detox at the treatment center. A patient can undergo detox at a variety of locations in outpatient detox programs. Sometimes the location that a patient undergoes detox will be another mental healthcare center, and sometimes it may be a doctor’s office. In some outpatient detox programs, the patient still undergoes detox at the treatment center, but goes somewhere other than the treatment center at night, to sleep.

Medical care is still accessible to the patient in an outpatient detox program at all times. But in an outpatient detox program, the patient may have to go to the medical care provider, because the patient is not under constant medical supervision at all times in the outpatient detox program. Whereas, the patients in the inpatient detox program will be under medical supervision at all times.

Different detox programs are suited to different people’s needs, expectations, and situations. A significant consideration when determining what detox program is best for a certain patient, is what drug the patient is addicted to. Withdrawal from drugs such as alcohol and Xanax can result in seizures, and therefore the withdrawal from these drugs can be fatal. For this reason, it is recommended that patients withdrawing from these drugs stay under constant medical supervision.

If a patient suffers from a medical condition that might complicate their withdrawal, then they may also be recommended to undergo inpatient rather than outpatient detox for this reason. Constant medical supervision is better for patients who are at higher risks for other medical problems.

Ultimately, though, which detox program is best will be decided on an individual level, based on your needs and situation.

Some people try to detox at home. Doctors recommend against this in many cases, because some drugs can exhibit fatal withdrawal symptoms. There are also other medical problems that can come up due to withdrawal, that medical workers need to be present to deal with. There are a lot of risks from withdrawing at home, and that is one of the reasons why treatment centers usually recommend that you participate in one of their outpatient or inpatient detox programs.

Another benefit of doing inpatient detox is that the drug that the patient is addicted to will not be accessible, at the treatment center. So whereas during an at-home or outpatient detox, the patient may be strongly tempted to use the drug that they are addicted to so that they can be ride of the symptoms of withdrawal, in an inpatient detox program this is impossible.

What is withdrawal? How long does it last?

Rehabilitation

The next step on the road to recovery, after detox, is rehabilitation.

During rehabilitation, the patient participates in many programs and activities to enable them to solve the root problems that led to their addiction. Treatment center workers will try to reveal and solve the deeper problems that the patient may have, which led to the patient’s addiction.

In addition, during rehabilitation some treatment centers try to teach patients skills which will enable them to live lives without addiction, once they leave the treatment center. Some treatment centers teach basic skills.

There are many kinds of rehabilitation programs, each one suited to different needs, expectations, and situations. The three main kinds of rehabilitation programs are: Intensive Outpatient Programs (IOP), Partial Hospitalization Programs (PHP), and Residential Treatment Center programs (RTC). During intake, by using your interviews, a treatment center worker may help you decide which program is most suitable for you.

Intensive Outpatient Programs are the least time-consuming of the three kinds of rehabilitation programs. In Intensive Outpatient Programs, the patient is only involved in the program a few hours a week, usually in the afternoons and evening. In this kind of program, the patient lives outside of the treatment center, only to interact with treatment staff for those few hours a week that the patient is required to attend treatment activities.

The other kind of outpatient rehabilitation program is called the Partial Hospitalization Program. This program is much like the Intensive Outpatient Program, except that in this program the patient’s time commitment is longer. In this program, rather than attending treatment for a few hours a week, the patient will meet treatment professionals every day of the workweek, and sometimes during weekends.

Both of these programs are outpatient programs, which means that the patient resides outside of the treatment center for the duration of the rehabilitation program, and only visits the treatment center to receive treatment during the day.

Whereas, in inpatient rehabilitation programs, such as Residential Treatment Center programs, the patient stays at the treatment center overnight, and during the entirety of rehabilitation.

Residential Treatment Center programs are much more structured than the other two kinds of rehabilitation programs previously mentioned, because in Residential Treatment Center programs the patient is under constant supervision. They don’t leave the treatment center at night, and they are subject to rules concerning, for example, what items they can and cannot have with them. For these reasons and more, many treatment professionals consider Residential Treatment Center programs to be the most effective kind of treatment program, because in Residential Treatment Center programs, the patient is subject to an environment created to rehabilitate them, at all times.

No matter what rehabilitation program a patient undergoes, once the patient has successfully completed the rehabilitation program, the patient can move on to recovery.

Recovery

Recovery is the stage in which the patient learns to maintain the sobriety that they achieved in the treatment program. It can be a continuation of the treatment program, in cooperation with the treatment program, or it can be a transition to another treatment program, that specializes in recovery. Sometimes patients who have successfully completed rehabilitation don’t participate in any treatment program at all, once they’re out of rehabilitation. But it is best to continue treatment in recovery, to find a program that meets your needs, based on where you are in your recovery.

Just like there is a variety of detox and rehabilitation programs, there are also many recovery programs for different needs and situations.

One thing that some patients do, is begin an outpatient rehabilitation program as a recovery program. For patients who have undergone an inpatient recovery program, an outpatient recovery program can offer a smoother transition into another recovery program, after being in such a structured program for so long. It is usually just patients who previously underwent inpatient rehabilitation, that choose to undergo an outpatient rehabilitation program as their recovery program.

An option for patients who are motivated and in a favorable position for recovery, is attending support groups. Support groups are groups of former addicts, people in recovery, who regularly gather together to their addictions, to share stories, and to provide support for one another. Support groups are usually part of recovery programs in some form, but it is also possible to use support groups as one’s only recovery program. Support groups are a great option no matter where the patient is in their recovery.

Another kind of recovery program is called Sober Living Houses. Sober Living Houses are similar to support groups, in that they involve addicts in recovery coming together to help each other, to share support. In Sober Living Houses, multiple addicts in recovery will live together, in one house, usually without a treatment worker. The people in recovery will usually hold jobs, to financially support themselves. Which is to say that the people living in Sober Living Houses usually pay their own rent, their own bills.

Some people are allowed to live in Sober Living Houses without working. These people are usually required to regularly attend extensive treatment, if they’re not working.

Although Sober Living Houses offer a lot more freedom to people in recovery than Residential Treatment Centers do, there are still some rules. Different Sober Living Houses have different rules that their respective residents have to follow.

Many Sober Living Houses do not allow patients in recovery to have guests overnight, and it is usual that people living in Sober Living Houses are randomly drug tested. To live in these houses, too, it is usually required that the patient in recovery regularly attend treatment meetings, with other people in recovery.

It is also required that everyone staying in the Sober Living House pay their fees for residing there on time. In addition, it is important to be get along with one’s housemates. Many Sober Living Houses require that residents get along with their fellow residents.

These are the rules with many Sober Living Houses have in common, but different Sober Living Houses have different rules. Just like choosing a treatment center, whether you make a good decision about what Sober Living House to live in may depend on whether or not you ask the right questions of the people in charge of the Sober Living House. Just like with treatment centers, it is important to find somewhere you are comfortable, so that you can stay for a long time if you need to.

And there are many other recovery programs available, other than support groups and Sober Living Houses. Many different kinds of recovery programs exist in the Baltimore area.

There is a lot of violence and there is a lot of addiction in Baltimore. A lot of people go to prison because of using drugs and because of selling drugs. Countless more suffer, overdose, and sometimes die, because of their addictions, and the addictions of those around them.

If you or a loved one has a drug problems, in or around Baltimore, then it is important to find treatment as soon as possible. It is too important to wait.

There are many good treatment centers in and around Baltimore. Some of our recommendations are below.

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